PURPOSE: The present study aimed to examine the age and gender distributions among chronic cough patients referred to a tertiary cough clinic in Korea, and to investigate clinical factors related to the demographic findings. METHODS: Study participants were unselectively recruited from adult chronic cough patients who attended the cough clinic for the first time during one year. To validate their representativeness, their age and gender distributions were compared to the entire chronic cough population, or with those presenting with other chronic disease. Data from the baseline investigations were analyzed to identify clinical factors related to the demographic findings. RESULTS: A total of 272 chronic cough patients were included. They had a middle-aged female predominant feature (mean age: 52.8+/-15.7 years and female 69.1%). Their age and gender distributions were almost identical to the entire chronic cough population, but were distinct from patients with hypertension. Among clinical factors, the older female predominance was associated with enhanced capsaicin cough sensitivity, and also with the presence of 'cough by cold air' symptom. Allotussia and laryngeal paresthesia were highly common in chronic cough patients, affecting 94.8% and 86.8% of them, respectively. CONCLUSIONS: The present study demonstrated older female predominance among adult chronic cough patients attending a referral cough clinic in Korea. The demographic features were significantly associated with the capsaicin cough responses and also potentially with allotussia (particularly cold air as the trigger). These findings suggest a role of cough reflex sensitization in the pathophysiology of chronic cough in adults.
Adult ; Capsaicin* ; Chronic Disease ; Cough* ; Female ; Humans ; Hypertension ; Korea ; Paresthesia ; Referral and Consultation ; Reflex ; Respiratory Hypersensitivity

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.
Antitussive Agents ; Asthma ; Bronchitis, Chronic ; Bronchodilator Agents ; Child ; Cough* ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Interview, Psychological ; Male

Massive pancreatic pleural effusion is a rare complication of chronic pancreatitis. It results from leakage of pancreatic secretion into the pleural space through the aortic or esophageal hiatus, either by a pancreatic duct disruption or communicating pseudocyst. The presentation of the pancreatic pleural effusion is often misleading as respiratory rather than abdominal symptoms because of predominance of pulmonary complaints. Markedly elevated amylase level of the pleural fluid is highly suggestive of the diagnosis. We experienced a case of chronic pancreatitis with massive pleural effusion in a 9-year-old female, who presented with a 6-months history of intermittent abdominal pain, and cough and chest pain for 3 days.
Abdominal Pain ; Amylases ; Chest Pain ; Child ; Cough ; Diagnosis ; Female ; Humans ; Pancreatic Ducts ; Pancreatitis, Chronic* ; Pleural Effusion*

BACKGROUND/AIMS: The Cough Symptom Score (CSS) is a simple, useful tool for measuring cough severity. However, there is no standard Korean version of the CSS. We developed a Korean version of the CSS and evaluated its clinical utility and validity for assessing chronic cough severity. METHODS: The CSS was adapted for Korean use following a forward-backward translation procedure. Patients with chronic cough enrolled from five university hospitals were graded using the CSS and a 100-mm linear visual analog scale (VAS) of cough severity at each visit. Patients completed the Leicester Cough Questionnaire (LCQ) upon presentation and completed the LCQ and Global Rating of Change at follow-up visits after 2 to 4 weeks. The concurrent validity, repeatability, and responsiveness of the Korean version of the CSS were determined. RESULTS: Correlation coefficients between the CSS and LCQ, and between the CSS and VAS, were –0.66 and 0.52, respectively. There was a weak correlation between the scores for night and day symptoms (r = 0.24, p = 0.0006). The repeatability of the CSS in patients with no change in cough (n = 23) was high (intra-class correlation coefficient, 0.75; 95% confidence interval [CI], 0.51 to 0.88). Patients who reported an improvement in cough (n = 30) at follow-up visits had a significant improvement in the CSS (median, −2; 95% CI, −3 to −1; p = 0.0003). CONCLUSIONS: The Korean version of the CSS correlated well with other tools for accessing cough severity in chronic cough patients. Therefore, it could be a reliable method for measuring chronic cough severity.
Chronic Disease ; Cough* ; Follow-Up Studies ; Hospitals, University ; Humans ; Methods ; Surveys and Questionnaires ; Visual Analog Scale

PURPOSE: There are no specific tools for measurement of the severity of chronic cough in Korea. We developed a Korean version of the Leicester Cough Questionnaire (LCQ) and tested its scaling and clinical properties. METHODS: The LCQ was adapted for Korean conditions following a forward-backward translation procedure. All patients referred to chronic cough clinics at 5 university hospitals between May 2011 and October 2013 completed 2 questionnaires, the LCQ and the Short-Form 36 (SF-36), upon presentation and completed the LCQ and the Global Rating of Change (GRC) upon follow-up visits after 2 or 4 weeks. Concurrent validation, internal consistency, repeatability, and responsiveness were determined. RESULTS: For the concurrent validation, the correlation coefficients (n=202 patients) between the LCQ and SF-36 varied between 0.42 and 0.58. The internal consistency of the LCQ (n=207) was high for each of the domains with a Cronbach's alpha coefficient of 0.82-0.94. The repeatability of the LCQ in patients with no change in cough (n=23) was high, with intra-class correlation coefficients of 0.66-0.81. Patients who reported an improvement in cough (n=30) on follow-up visits demonstrated significant improvement in each of the domains of the LCQ. CONCLUSIONS: The Korean version of the LCQ is a valid and reliable questionnaire for measurement of the severity of cough in patients with chronic cough.
Chronic Disease ; Cough* ; Follow-Up Studies ; Hospitals, University ; Humans ; Korea ; Quality of Life ; Reproducibility of Results* ; Surveys and Questionnaires

BACKGROUND: Chronic cough is a common clinical problem to which various etiologies are attributable; postnasal drip, asthma, gastroesophageal reflux (GER) and chronic bronchitis, However, in some cases, no particular etiology can be confirmed. OBJECTIVE: This study was aimed to evaluate cough sensitivity and the clinical manifestations of patients with idiopathic chronic cough. MATERIALS AND METHODS: We recruited 70 non-smoking patients who had been coughing for more than 3 weeks without any history, symptoms or signs of rhinitis, sinusitis, typical asthma, GER or recent upper respiratory infection episodes. Nineteen healthy controls were also enrolled. Bronchial provocation tests with methacholine, capsaicin and distilled water (DW) were performed. RESULTS: Thirteen patients were positive to rnethacholine test (PC20 < 25mg/ml) and defined as cough variant asthma. The others are classified into idiopathic chronic cough. By capsaicin and DW challenge tests, idiopathic cough patients could be divided into two groups, i.e., increased cough sensitivity (ICS) and normal cough sensitivity (NCS) groups. DW- induced cough counts were negatively correlated with C7 (lowest capsaicin concentration inducing continuous 7 or more coughs) (r=-0.739, p<0.001). No difference was found in clinical features such as age, sex, atopy, or peripheral eosinophil counts between these two groups but cough counts per cough burst were significantly higher in the ICS group. CONCLUSION: The heterogeneity in cough sensitivity of idiopathic chronic cough patients may refiect different pathophysiologic mechanisms. It is unclear whether patients with NCS merely have habitual or psychogenic cough or not. These suggest that different therapentic strategies should be established on idiopathic chronic cough patients according to cough sensitivity.
Asthma ; Bronchial Provocation Tests ; Bronchitis, Chronic ; Capsaicin ; Cough* ; Eosinophils ; Gastroesophageal Reflux ; Humans ; Methacholine Chloride ; Population Characteristics ; Rhinitis ; Sinusitis ; Water

Recurrent respiratory papillomatosis(RRP) is a chronic disease that is caused by the human papillomavirus(HPV) type 6 and 11. The most common site of the lesions is the larynx, but papillomas can occur throughout the respiratory and upper gastrointestinal tracts. Frequent recurrence of disease, can result in airway compromise and even death when papillomas either obstruct the airway or spread to the lung parenchyma. We encountered a case of a recurrent respiratory papillomatosis in a 23-year-old patient, who improved after treatment with interferon-alpha. The patiented with hoarseness, exertional dyspnea, and a productive cough. We report this case with a brief review of the relevant literature.
Chronic Disease ; Cough ; Dyspnea ; Hoarseness ; Humans ; Interferon-alpha* ; Larynx ; Lung ; Papilloma* ; Recurrence ; Upper Gastrointestinal Tract ; Young Adult

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.
Abdominal Muscles ; Abdominal Pain ; Abdominal Wall ; Aged ; Cough ; Epigastric Arteries ; Hematoma* ; Humans ; Pregnancy ; Renal Insufficiency, Chronic* ; Risk Factors ; Rupture

Vaccination in adults is recommended according to the age group and underlying diseases or risks of exposure. Patients with chronic diseases including chronic obstructive pulmonary diseases are susceptible to infectious diseases and related serious complications. They need risk-related vaccination along with age-related vaccination. Both influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary diseases. They are additive if administered simultaneously. Pertussis vaccination is also needed in adolescents and adults. Although there is strong need for these vaccinations, the actual vaccination rate is low. Measures to effectively enhance the vaccination rate are needed.
Adolescent ; Adult ; Chronic Disease ; Communicable Diseases ; Humans ; Influenza, Human ; Lung Diseases, Obstructive ; Respiratory Tract Infections ; Streptococcus pneumoniae ; Vaccination ; Whooping Cough

We evaluated the role of antimicrobials in the treatment of chronic maxillary sinusitis in children with chronic cough. At the first visit 216 of 276 cases with chronic cough had radiologically abnormal maxillary sinuses (78.3%). By the Waters x-rays around 50 cases each were assigned randomly to four groups; among them, 48 cases were given an amoxicillin, 51 cases were given trimethoprim-sulfamethoxazole (TMS), 53 cases were given amoxcillin plus TMS and 50 cases were given expectorant plus decongestant (control) group. Thus, 202 children were included for data analysis. Treatment was given for two weeks in each group. The group treated with antimicrobials had a significantly higher cure rate than that of expectorant plus decongestant group (P < 0.001). Most of the patients who had roentgenographic improvement have successfully recovered from the chronic cough and the other cardinal signs of chronic sinusitis.
Adolescent ; Anti-Infective Agents/therapeutic use* ; Child ; Child, Preschool ; Chronic Disease ; Cough/drug therapy* ; Female ; Human ; Male ; Sinusitis/drug therapy*