• Journal of Oral Medicine and Pain
• /
• v.48 no.3
• /
• pp.118-122
• /
• 2023

In this study, we investigate the emergence of bullous pemphigoid (BP) after the administration of the Severe Acute Respiratory Syndrome-Coronavirus Disease 2019 (SARSCOVID-19) vaccine. The study presents two cases of women, aged 47 and 53, diagnosed with BP following SARS-COVID-19 vaccination. BP is a common autoimmune blistering disorder prevalent among older populations, with an incidence rate ranging from 2 to 40 cases per million individuals. This condition arises when autoantibodies target adhesive proteins in the skin, resulting in blister formation and mucosal erosion. Drug-induced bullous pemphigoid (DIBP) shares similarities with the classic form of BP but may be influenced by medication usage. Notably, DIBP exhibits distinct characteristics, such as affecting a younger demographic and involving mucosal regions more prominently than classic BP. The growing incidence of BP is linked to factors such as an aging population and the rise of drug-induced cases. This case report provides valuable insights into comprehending DIBP, elucidating post-vaccination discomforts, particularly those related to oral lesions and the exacerbation of existing lesions. By elucidating these aspects, we aim to advance the understanding of DIBP within the medical community.

• IMMUNE NETWORK
• /
• v.21 no.3
• /
• pp.19.1-19.18
• /
• 2021

Clinical and molecular phenotypes of asthma are complex. The main phenotypes of adult asthma are characterized by eosinophil and/or neutrophil cell dominant airway inflammation that represent distinct clinical features. Upper and lower airways constitute a unique system and their interaction shows functional complementarity. Although human upper airway contains various indigenous commensals and opportunistic pathogenic microbiome, imbalance of this interactions lead to pathogen overgrowth and increased inflammation and airway remodeling. Competition for epithelial cell attachment, different susceptibilities to host defense molecules and antimicrobial peptides, and the production of proinflammatory cytokine and pattern recognition receptors possibly determine the pattern of this inflammation. Exposure to environmental factors, including infection, air pollution, smoking is commonly associated with asthma comorbidity, severity, exacerbation and resistance to anti-microbial and steroid treatment, and these effects may also be modulated by host and microbial genetics. Administration of probiotic, antibiotic and corticosteroid treatment for asthma may modify the composition of resident microbiota and clinical features. This review summarizes the effect of some environmental factors on the upper respiratory microbiome, the interaction between host-microbiome, and potential impact of asthma treatment on the composition of the upper airway microbiome.

• 대한상한금궤의학회지
• /
• v.15 no.1
• /
• pp.183-196
• /
• 2023

Objective : This study reports a case of chronic Bartholin's cyst treated with Sosiho-tang and suggests a modifying method. Methods : We reviewed a 41-year-old female patient with fatigue accompanied by chronic Bartholin's cyst. Symptomatic changes were checked on every visit using SF-12 (Short-form-12 health survey) and VAS (Visual analogue scale). The 104^th provision in Shanghanlun was compared with diagnosis and process analysis. Results : The modified Sosiho-tang removed Scutellariae Radix and used Phlomidis Radix of the same weight. The exacerbation factors were characterized with excessive activity (大), Edema and swelling of the foot (滿), Feeling tired in morning (朝) in 104th provision. After 45 days modified Sosiho-tang and 15 days Sosiho-tang, SF-12 and VAS ameliorated. No adverse effects was observed to the last follow-up visit. Conclusions : Modified sisiho-tang and Sosiho-tang were effective to the patient. Clinical application of 104^th provision of Shanghanlun can consider excessive activity, edema, and morning fatigue.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.2
• /
• pp.190-200
• /
• 1996

Background : Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. Method : We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure $6-8cmH_2O$ and an expiratory positive airway pressure $3-4cmH_2O$. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. Results : Pretreatment and after 3 days of treatment, mean $PaO_2$ was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and $PaCO_2$ was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in cr group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean $PaO_2$, $PaCO_2$ and pH respectively. Conclusion: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPD, is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.

• Journal of Environmental Health Sciences
• /
• v.46 no.4
• /
• pp.359-367
• /
• 2020

Objectives: Exposure to mold is strongly associated with adverse health effects (development or exacerbation of allergic diseases). We reviewed the health effects of mold exposure and explored to determine the annual distribution of indoor mold in facilities with susceptible populations. Methods: The health effects of mold exposure were mainly summarized by reviewing related papers and WHO research reports. We selected 10 facilities, including daycare centers, postpartum care centers, medical institutions, and elderly care facilities within the Seoul Metropolitan. Mold sampling was performed once every week or once every quarter from February 2016 to 2017. In addition, fungal species analyses was performed, and distribution status by month and facility was analyzed in the same manner as concentration. Results: Adverse health effects attributed to fungal exposure are largely divided into allergic symptoms, toxic effects, and infectious effects. Monthly mean concentrations of mold indoors and outdoors was 368.8 CFU/㎥ (geometric mean 213.4 CFU/㎥) and 496.0 CFU/㎥ (327.9 CFU/㎥), respectively. The indoor concentration has begun to increase in February, peaked in July, declined in August, increased again until October, and then decreased in November. About 36 genera of indoor fungal species were found in each facility. Cladosporium sp., Penicillium sp., Fusarium sp., Aspergillus sp., Alternaria sp., and Arthrinium sp. were observed as the dominant species. Conclusions: Our findings showed that the overall level of indoor mold was below the 500 CFU/㎥ level recommended by the Ministry of Environment. The development of DNA-based assessment and expanding facilities to be monitored for mold would be necessary for preventive aspects.

• Journal of Korean Academy of Nursing
• /
• v.48 no.4
• /
• pp.389-406
• /
• 2018

Purpose: This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma. Methods: We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies. Results: Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence. Conclusion: The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

• Health Policy and Management
• /
• v.7 no.1
• /
• pp.155-182
• /
• 1997

Objectives : This study was designed to compare North Korea and South Korea in measures of the quality of life (physical quality of life index and human development index) and to investigate the impact of selected medical and socioeconomic factors on PQL variables. Data and Methods : The World Bank, the United Nations Development Programme, and Population Reference Bureau were the principal sources of statistical data of 121 countries. Variables included infant mortality, life expectancy at birth, literacy rate, secondary school enrollment (male and female), GNP per capita, population per doctor, daily calorie supply per capita, and a composite PQL index. The Ordinary Least Square model was employed for cross-countries analysis. Findings : Both countries under quite different political and economic systems saw big improvememts in the quality of life, reducing mortality and prolonging life expectancy during the past three decades. In recent decad, however, North Korea has experienced abrupt exacerbation in the quality of life. Significant improvements in infant mortality of the population wer attributable mainly to GNP per capita and the secondary school enrollemt of female. The principal predictors of life expectancy at birth were population per doctor, infant mortality, and literacy rate. The secondary school enrollment of female and population per doctor were significantly associated with improvements in the physical quality of life index (PQLI). Conclusion : The results of this study confirmed a point illustrated by other studies : The association between quality of life as a measure of health status and socioeconomic factors was strong and positive. The important contribution of educational attainment in general, female education level in particular to improvements in the quality of life deserves good news for building an integrated health care system in the reunified Korea, taking into account the high level of education two koreas are enjoying. Meanwhile, when a sharp drop in the quality of life has been observed in North Korea under serious economic difficulties and food shortage in recent decade, the significant contribution of economic development to improvements in the quality of life poses bad nows for reunifying Korean health care in economic terms.

• Korean Journal of Biological Psychiatry
• /
• v.8 no.1
• /
• pp.147-152
• /
• 2001

Objective : It has been thought that estrogen has neuroleptic like effect in women schizophrenic patients. This study aimed to investigate neuroleptic side-effects severity in women with schizophrenia and to investigate their putative association with variations in sex steroids over menstrual cycle. Based on the estrogen theory, The author hypothesized that parkinsonian side-effects would be exacerbated when estrogen levels were high. Method : 26 schizophrenic women were assessed using the ESRS(Extrapyramidal Symptom Rating Scale) and estrogen analysis. Tests were conducted twice, in the mid luteal and mid follicular phase. Result : It was hypothesized that high level of estrogen would lead to an exacerbation of parkinsonian side-effects but the results indicated that parkinsonian side effects decreased overall when estrogen levels were high. This effects were more marked for the group taking typical neuroleptics than those taking atypical neuroleptics. Conclusion : The results of this study suggest that estrogen and progesteron may reduce the severity of neuroleptic induced extrapyramidal side effects over menstrual cycle in women with schizophrenia. It was concluded that estrogen has different effects on dopamine dynamics in the mesolimbic and mesostriatal pathways according to estrogen, progesteron, catecol estrogen, prolactine.

• Korean Journal of Biological Psychiatry
• /
• v.12 no.2
• /
• pp.151-158
• /
• 2005

Background:Clozapine is a unique atypical antipsychotic medication. It is considered to be superior, even amongst the newer agents, in treatment-resistant schizophrenia. However, de novo emergence or exacerbation of obsessive-compulsive(OC) symptoms during treatment with clozapine has been reported. We prospectively evaluated 19 cases which newly developed OC symptoms during clozapine treatment and discussed the treatment of OC symptoms induced by it. Methods:We recruited 19 patients(8 males, 11 females) with a DSM-IV diagnosis of schizophrenia and schizoaffective disorder who had developed OC symptoms during clozapine treatment. OC symptoms were assessed using the Padua-ICMA and YBOCS on a monthly basis over three months. Results:Eleven female and eight male patients were enrolled and the average age of patients was 32.8 years. At baseline, no patients showed OC symptoms. Moderate to severe OC symptoms appeared with mean daily dose of 298.68 mg of clozapine. There were no significant differences in improving OC symptoms between the clozapine dose reduction group and the OC treatment group. Conclusion:We noticed the possibility that the appearance of OC symptoms is connected with the effect of clozapine. The clozapine-induced OC symptoms were improved both by reducing clozapine daily doses, and by adding OC treatment drugs. With other atypical antipsychotics now available, to know and treat the side effects of clozapine would be of considerable value, offering clinical guidance in making a decision on treatment-resistant schizophrenia.

• Journal of Preventive Medicine and Public Health
• /
• v.44 no.3
• /
• pp.118-124
• /
• 2011

Objectives: Although cigarette smoking is known to be related to the exacerbation of asthma symptoms, several studies have indicated that the prevalence of cigarette smoking among asthmatic adolescents is similar to or even higher than that among non-asthmatic adolescents. The aim of this study was to evaluate the relationship between asthma and cigarette use behaviors and whether or not the presence of suicidal ideation modifies this relationship among Korean adolescents. Methods: We analyzed data from the 2008 Korea Youth Risk Behavior Web-based Survey, which included a nationally representative sample of middle and high school students. Multiple logistic regression models were used to calculate odd ratios and 95% confidence intervals of cigarette use behaviors among current asthmatics, former asthmatics, and nonasthmatics, after adjusting for gender, grade, school records, socioeconomic status, current alcohol use, and suicidal ideation. Results: Of 75 238 study participants, 3.5% were current asthmatics and 4.5% were former asthmatics. Compared with non-asthmatics, asthmatics were more likely to report current cigarette use, frequent and heavy cigarette use, and cigarette use before 13 years of age. There were statistically significant interactions between asthma and suicidal ideation in cigarette use behaviors. Conclusions: This study demonstrated that asthmatic adolescents are more likely than non-asthmatic adolescents to engage in cigarette use behaviors and the presence of suicidal ideation is an effect modifier of the relationship between asthma and cigarette use behaviors. Particular attention should be paid to the awareness of health risks of cigarette smoking and mental health problems among asthmatic adolescents.