• Title/Summary/Keyword: wheezing

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A Clinical Study on 61 Cases of Tuberculous Tracheobronchitis (기관 및 기관지 결핵 61예의 임상적 고찰)

  • Ahn, Chul-Min;Kim, Hyung-Jung;Hwang, Eai-Suk;Kim, Sung-Kyu;Lee, Won-Young;Kim, Sang-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.4
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    • pp.340-346
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    • 1991
  • Tuberculous tracheobronchitis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus and recognized as one of the most common and serious complication of pulmonary tuberculosis. It had been a diagnostic challenge in prebronchoscopic era and since 1968, fiberoptic bronchoscopy has been accepted as a safe and valuable diagnostic procedure of tuberculous tracheobronchitis. Now, it remains a troublesome therapeutic problem due to its sequelae such as bronchostenosis, bronchiectasis and bronchial deformity. The authors analyzed the clinical features, radiological findings and bronchoscopic findings with pathologic and bacteriologic study on 61 cases of tuberculous tracheobronchitis and following results were obtained. 1) The peak incidence was in the fourth decade and male to female ratio was 1:3.4. 2) The most common symptom was cough (86.9%) and followed by sputum (49.2%), dyspnea (27.9%), fever (19.8%), weight loss (11.5%), hemoptysis (6.6%), hoarseness (6.6%) and chest discomfort (3.3%) and localized wheezing was heard in 18%. 3) In chest X-ray, consolidation with collapse was observed in 70.5%, and followed by consolidation only (18.0%), mediastinal node enlargement (8.2%), cavitary lesion (6.6%), suspicious hilar mass (3.3%) and miliary lesion (1.6%) and there was no abnormal findings in 4.9%. 4) Bronchoscopy showed hyperplastic lesion in 67.2%, mucosal lesion (18.0%), ulcerative lesion (9.8%) and stenotic lesion (4.9%). The most common site of bronchial lesion was right upper bronchus (36.1%) and followed by right main bronchus (34.4%), left main bronchus (29.5%), left upper bronchus (16.4%), right middle bronchus (8.2%), right lower bronchus (6.6%) and left lower bronchus (3.3%). 5) Chronic granulomatous inflammation with or without caseation necrosis on microscopic examination was confirmed in 69.7%, bronchial washing AFB stain was positive in 34.1%, prebronchoscopic sputum AFB stain was positive in 88.1% and postbronchoscopic sputum AFB stain was positive in 30.1%.

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Reliability and Validity of the Korean Version of ISAAC Questionnaire (한국판 국제 소아천식 및 알레르기 질환 연구 설문지의 신뢰도 및 타당도 연구)

  • Choi, Seong-Woo;Ju, Yeong-Su;Kim, Dae-Sung;Kim, Jae-Yong;Kwon, Ho-Jang;Kang, Dae-Hee;Lee, Sang-Il;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.361-371
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    • 1998
  • Recent increases of asthma and allergies in childhood made the need for a standardized approach to international and regional comparisons of their prevalence and severity. To address these issues, 'International Study of Asthma and Allergies in Childhood (ISAAC)' is currently underway. In Korea, 'Nationwide Study of Asthma and Allergies in Korean Children' began in 1995 according to ISAAC protocol. ISAAC written and video questionnaires were used in this survey, but their reliability and validity were not evaluated properly yet. In this study, our aim was to evaluate the reliability and validity of two kinds of questionnaires and their usefulness in international and regional comparisons. The test and retest of two questionniares were completed by male(n=110) and female(n=111) middle school students with two and three weeks interval each. Kappa(or weighted kappa) were calculated from each questions and validity coefficients were estimated from those statistics. In Korean version of written questionnaire, the questions for allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and food allergy proved to have high kappa values (or weighted kappa values) and validity coefficients and they can be used in further studies without any correction. But some questions about asthma(especially nocturnal cough, wheezing in exercise, and severe asthma) and drug allergy need to be revised for better under-standing to study subjects. Video questionnaire has the same degree of reliability and validity when compared to written questionnaire and this is the unexpected result. Accordingly, it also need to be revised to overcome the racial and cultural differences of the study subjects. In conclusion, the Korean version of written and video questionnaires may be considered to be useful methods in international and regional comparisons of asthma and allergic diseases in childhood after correction of some questions.

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Congenital cystic adenomatoid malformation (선천성 낭포성 선종양기형 -1례 보고-)

  • Sun, Kyung;Baek, Kwang-Je;Lee, Chol-Sei;Chae, Sung-Soo;Kim, Hark-Jei;Kim, Hyung-Mook
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.118-124
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    • 1984
  • Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

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Pulmonary Function and Its Influence Factors of Residents in Yeosu Industrial Complex

  • Hong, Eun-Ju;Ahn, Gi-Sub;Chung, Eun-Kyung;Guo, Xinbiao;Son, Bu-Soon
    • Journal of Environmental Science International
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    • v.20 no.7
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    • pp.799-809
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    • 2011
  • Objectives: This study is aimed at identifying the influential factors on the pulmonary function of ordinary residents in the surrounding areas of Yeosu Industrial Complex. Methods: The PFT (Pulmonary Function Test) was conducted on the target residents numbering 989 people (male 361, female 628). The exposed group (813 people) resided within the radius of 5km from Yeosu Industrial Complex and the control group (176 people) resided in the radius of more than 15 km from May 2007 to November 2007. The survey also took into account other factors including personal characteristics, life habits, respiratory diseases and allergic symptoms, medical histories, and the living environments of the residents in order to further identify influential factors on pulmonary function. Result: When comparing the PFT values of the exposure groups to the control group of the same city, values of the exposure groups were meaningfully lower with an %$FEV_1$ of 107.05% and %FVC of 100.28%. Conversely, the control group reported an %$FEV_1$ and %FVC of 107.26% and 102.85% respectively, indicating that ambient air pollutants reduce lung function. The odds ratio of asthma diagnosis history increased when a subjects residence was close to a heavily trafficked road, traffic amount was huge, a bed was used, and the family had less than four members. However the results were not statistically meaningful. The odds ratios of abnormal pulmonary function were statistically higher among those with asthma(OR=4.29, CI=1.75-10.56), wheezing (OR=2.59, CI=1.24-5.41), and nasal congestion (OR=2.87, CI=1.36-6.08) (p<0.01). The factors affecting $FEV_1$ were symptoms including asthma, passive smoking and allergic eye disease ($R^2$=0.049, p<0.001). For the FVC symptoms including asthma ($R^2$=0.014, p<0.001) were measured. The analysis showed that FVC decreased with increases in $O_3$ and CO(p<0.01). Furthermore, $FEV_1$ decreased with increases in $O_3$(p<0.01). Conclusions: These results will provide preliminary data for establishing responsive measures to protect the health of residents in industrial complexes from air pollution, and to develop lasting environmental health policies.

Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea (좌측 주기관지 및 기관에 발생한 선양낭포성암 2례)

  • Cho, Young-Bog;Lee, Hak-Jun;Kim, Ki-Beom;Jung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Kim, Mi-Jin
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.347-359
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    • 1996
  • Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usually arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential for extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolonged course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She has been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed as bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenoid cystic carcinoma by bronchoscopic biopsy. The patient underwent radiation to relieve a bronchial stenosis caused by her tumor. The patient has remained well and is asymptomatic without evidence of clinical recurrence. The other case was 25 year old female. She complained shortness of breath and inspiratory difficulty during sleep. The tumor was located in upper trachea, which protruded from the posterior wall of the trachea and obstructed the lumen nearly complete, by CT demonstration. Tissue diagnosis was confirmed as adenocystic carcinoma by rigid bronchoscopic biopsy. The patient was underwent operation for removal of the mass and received radiotherapy. The patient has remained well are following up now.

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Comparisons of Clinical Characteristics and Outcomes in COPD Patients Hospitalized with Community-acquired Pneumonia and Acute Exacerbation (만성폐쇄성폐질환에 폐렴과 급성악화로 입원한 환자의 임상적 특성 및 예후 비교)

  • Jeong, Seung-Wook;Lee, Jae-Hee;Choi, Keum-Ju;HwangBo, Yup;Kim, Yi-Young;Lee, Yun-Ji;Yoon, Won-Kyung;Kim, Min;Cha, Sung-Ick;Park, Jae-Yong;Jung, Tae-Hoon;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.1
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    • pp.31-38
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    • 2010
  • Background: Data comparing the clinical characteristics and outcomes in chronic obstructive pulmonary disease (COPD) patients hospitalized with community-acquired pneumonia (CAP-COPD) and acute exacerbation (AECOPD) are very limited. Methods: Eighty episodes of hospitalization in 65 CAP-COPD patients, and 111 episodes of hospitalization in 82 AE-COPD patients were included in this study. The baseline characteristics, clinical presentations, potential bacterial pathogens and clinical outcomes in these patients were retrospectively reviewed and compared. Results: No significant differences were found between the two groups in parameters related to COPD and co-morbidities, except a higher rate of male among CAP-COPD patients. Clinical presentations by symptoms and laboratory findings on admission were significantly more severe in CAP-COPD patients, who showed higher rates of fever and crepitation, but less wheezing than AE-COPD patients. S. pneumoniae and P. aeruginosae were the most common bacterial pathogens in both groups. With no difference in the overall hospital mortality between both groups, the mean length of hospital stay was significantly longer in the CAP-COPD patients than in AE-COPD patients (15.3 vs. 9.8 days, respectively, p<0.01). Additional analysis on CAP-COPD patients showed that systemic steroid use did not influence the length of hospital stay. Conclusion: Although there was no significant difference in bacterial pathogens and overall hospital mortality between the two groups, CAP-COPD patients had more severe clinical symptoms and laboratory findings at presentation, and longer hospital stay than AE-COPD patients.

Relation between Subjective Symptoms and Rhinolaryngoscopic Findings or Sputum Eosinophilia in Chronic Cough Patients (만성기침 환자의 주관적 증상과 비후두경 소견 및 객담 호산구 증가증과의 관련성)

  • Kim, Hyun-Kuk;Choi, Eun-Young;Lee, Jae-Seung;Bae, Yun-Jeong;Song, Jin-Woo;Kim, Tae-Bum;Cho, You-Sook;Moon, Hee-Bom;Lee, Sang-Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.5
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    • pp.368-374
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    • 2010
  • Background: Rhinolaryngoscopy and sputum examination are popular tests for the evaluation of chronic cough. Little is known about the relationship between symptoms and rhinolaryngoscopic findings or sputum eosinophilia in chronic cough patients. Methods: One hundred patients, who had chronic cough with normal chest radiography and who also had undergone both rhinolaryngoscopy and induced sputum analysis, were reviewed retrospectively. Eleven associated symptoms of chronic cough were asked; postnasal drip (PND) and laryngopharyngeal reflux (LPR) were examined by rhinolaryngoscopy. Induced sputum analysis was performed for evaluation of sputum eosinophilia. Cross tabulation analyses with chi-square tests were used to evaluate the relationship between symptoms and objective findings. Results: The most frequent symptom was sputum (70%). The prevalence of PND and LPR on rhinolaryngoscopy were 56% (56/100) and 25.6% (22/86), respectively. Sputum eosinophilia was observed in 23 (23.7%) of 97 patients. The dyspnea (p=0.001), sputum (p=0.003), nasal obstruction (p=0.023), and postnasal drip sense (p=0.025) were related with PND on rhinolaryngoscopy. LPR on rhinolaryngoscopy was not related with any symptoms. Dyspnea (p=0.003), wheezing (p=0.005), nasal obstruction (p=0.013), and belching (p=0.018) were related with sputum eosinophilia. Conclusion: Any symptoms might not be related with LPR on laryngoscopy. Some symptoms might be related with PND on rhinoscopy or with sputum eosinophilia.

A Clinical study on Pediatric Bronchial Asthma (소아천식에 대한 임상적 고찰)

  • Kim, Yun-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.1
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    • pp.133-148
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    • 2002
  • Objective : This study was to investigate more effective oriental medical treatment for Pediatric Bronchial Asthma Method : Aroma therapy and Herbal medicine was given to 28 pediatric bronchial asthma patients(19 males and 9 females) for about 5months from the First, August 1999 The Fifth, January 2002. Results: 1. Demographic factor : The sample consisted of 28 persons among whom 19 were male, 9 were female. The age ranges from 1 year old to 6 year old. Less than 2 year old were 4 and 2-6 year old were 20. 2.Residence : Apartment and villar dwellers were 19(67.9%), Residential street divellers were 9(32.1%). 3.Age distribution at on set : 6(21.4%) fell ill befor 1 year old and 22(78.6%) fell ill after 1 year old 4. The period of illness : 9(32.2%) suffered during 1-3 year and 6(21.4%) suffered during 6 mouth-1year and 6(21.4%) suffered during more than 3 year. 5. Frequency of the symptoms : The symptoms appeared 2-3 times a year in the case of 16(57.2%), one time a year in the case of 1, 4 times a year in the case of 6(21.4%). 6. Concomitance symptoms : All experienced coughing sign, wheezing, 23(82.1%) experienced epistaxis, nose dripping, 13(46.4%) got fever, anorexia. 7. Past history of illness : 16(57.1%) got brochiolitis, brochitis, 12(42.9%) suffered pneumonia, 9(32.1%) had allergic rhinitis. 2 had allergic rhinitis, sinusitis, atopic dermatitis, bronchial asthma, 3 got atopic dermatitis, bronchial asthma and 7 had allergic rhinitis, sinusitis, bronchial asthma, 8. Family disease : In the case of family disease, 21(75%) had allergic dermatitis, 9(42.9%) had bronchial asthma, 8(38.1%) had allergic dermatitis. 9. The symptoms became very severe in the change of season in the case of 13(46.4%) and in the case of 11(39.3%), the change of season made no difference 10. Associated caused of induction symtoms : 28(100%) got sick by common cold, infectional disease, 8(28.6%) got sick by cold food, cold air 11.The kind of therapy : 15(53.6%) got oriental therapy after occidental therapy, 11(39.3%) took only oriental therapy. 12. Improvement degree of each symptoms : In the case of cough and wheeze that are the main symptoms of bronchial asthma, 78.6% and 64.3% of the patients replied < improvement > and in the case of dyspnea, tachypnea 41.7% of the patients replied . In other symptoms, all replied 13. Degree of satisfaction : 19(67.9%) replied , 2(7.1%) replied . Conclusion : Herbal medicine and aroma therapy proved to be a very effective oriental medical treatment for pediatric bronchial asthma.

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A Retrospective Study of Chronic Pulmonary Disease Patients Treated with Chungsangboha-tang : IgE, eosinophil, PFT (청상보하탕(淸上補下湯)을 복용한 천식, COPD 등 만성호흡기환자에 대한 후향적 연구)

  • Baek, Hyun-jung;Bhang, Yeon-hee;Kim, Jae-hyo;Kim, Sang-jin;Kim, Kwan-il;Lee, Beom-joon;Jung, Hee-jae;Jung, Sung-ki
    • The Journal of Internal Korean Medicine
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    • v.37 no.3
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    • pp.484-494
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    • 2016
  • Objective: This study was designed to analyze the treatment effects of Chungsangboha-tang through retrospective chart reviews.Methods: Fifty-one outpatients who had visited the Allergy, Immune & Respiratory System Division at the Kyung Hee Korean Medicine Hospital and who had taken Chungsangboha-tang from February 1, 2006, to February 1, 2016, had their basic medical records and examinationsretrospectively reviewed with respect to IgE, eosinophil, AST, and ALT. The PFT results of 11 patients were also investigated with respect to FEV1, FVC, and FEV1/FVC.Results: The percentage of males and females was 49.02% and 50.98%, respectively. The past histories of patients included asthma (66.67%), unspecified cough (21.57%), COPD (9.80%), allergic rhinitis (7.84%), and others. The subjective symptoms included cough (82.35%), sputum (39.22%), dyspnea (37.25%), and others. The most numerous pattern identification was wheezing dyspnea. IgE was significantly reduced, and eosinophil had a reduced tendency after 116.76±160.40 days of taking Chungsangboha-tang. PFT results also significantly increased after 213.09±266.62 days, while AST and ALT results showed a reduced tendency. In the asthmatic group, IgE also showed a reduced tendency. In particular, IgE was significantly reduced in patient groups taking medicine for more than 12 weeks.Conclusions: The conditions of patients with chronic pulmonary disease such as asthma and COPD significantly improved with Chungsangboha-tang after more than 12 weeks.

Epidemiological Characterization of Adenovirus and Human Bocavirus Detected Acute Respiratory Patients in Busan (부산지역 호흡기감염증 환자로부터 분리한 아데노바이러스와 보카바이러스의 유행양상 분석)

  • Hwang, Su-Jeong;Kim, Nam-Ho;Park, Dong-Ju;Ku, Pyung-Tae;Lee, Mi-Ok;Jin, Sung-Hyun
    • Journal of Life Science
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    • v.27 no.3
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    • pp.275-282
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    • 2017
  • Adenovirus (ADV) and human bocavirus (hBoV) cause acute respiratory tract infections, and are often associated with increased rates of hospitalization and death, particularly in infants and young children. The aim of this study was to analyze the clinical features and molecular phylogeny of ADV and hBoV isolated in Busan, from January 2011 to November 2013. In total, 3,230 specimens (throat swabs) were collected from patients with influenza-like illnesses and acute respiratory tract infections. Multiplex real-time RT-PCR was performed to detect eight respiratory viru [rhinovirus, adenovirus, respiratory syncytial virus, human coronavirus, human metapneumovirus, human bocavirus, parainfluenza virus and influenza virus] and detected 1,485(46.0%) cases. Among 1,485 positive specimens, 257(8.0%) cases were ADV and 68(2.1%) cases of hBoV. A significant clinical feature of ADV is fever and headache whereas hBoV is wheezing. Serotypic distributions of isolated ADV and hBoV were analyzed by sequencing of hexon and VP1/VP2 gene, respectively. ADV was identified seven different serotypes(1~6, 8), revealing a high similarity among the isolates (>97%). The predominant types of ADV were type 1 in 2011, type 3 and 4 in 2012, type 3 in 2013, respectively. ADV type 3 was major causative type during outbreaks in 2013. All of the hBoV was identified as hBoV type 1.