A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria

No abstract available.
Classification ; Elasticity Imaging Techniques ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Liver Cirrhosis

Optimal treatment strategies for patients with advanced hepatocellular carcinoma (HCC) is yet to be determined. Herein, we present a case of advanced HCC with tumor invasion into the right anterior portal vein and right hepatic vein where complete response (CR) was achieved via a multidisciplinary approach. This patient had a 10.5 cm-sized HCC invading segment VI, without extrahepatic spread. Liver function was classified as Child-Pugh class A, and the performance status was good. Transarterial radio-embolization (TARE) was performed 6 weeks after the completion of liver-directed concurrent chemoradiotherapy, and CR was confirmed 3 months post-TARE. Adoptive cell therapies were performed as adjuvant therapy and CR was maintained for over 15 months, until the local recurrence of a 2 cm-sized HCC was found. Therefore, in selected cases with preserved liver function, combination therapies, including LRTs and systemic therapy, can be a useful therapeutic option for advanced HCC.

Optimal treatment strategies for patients with advanced hepatocellular carcinoma (HCC) is yet to be determined. Herein, we present a case of advanced HCC with tumor invasion into the right anterior portal vein and right hepatic vein where complete response (CR) was achieved via a multidisciplinary approach. This patient had a 10.5 cm-sized HCC invading segment VI, without extrahepatic spread. Liver function was classified as Child-Pugh class A, and the performance status was good. Transarterial radio-embolization (TARE) was performed 6 weeks after the completion of liver-directed concurrent chemoradiotherapy, and CR was confirmed 3 months post-TARE. Adoptive cell therapies were performed as adjuvant therapy and CR was maintained for over 15 months, until the local recurrence of a 2 cm-sized HCC was found. Therefore, in selected cases with preserved liver function, combination therapies, including LRTs and systemic therapy, can be a useful therapeutic option for advanced HCC.

PURPOSE: Pneumatic reduction has rapidly replaced traditional barium reduction owing to its potential advantages, such as higher reduction rate and greater safety; however, the effects on surgery after reduction failure have not been studied. In this study, we evaluated the influences of attempted barium and pneumatic reductions on subsequent surgical procedures. METHODS: One hundred and sixty-one barium reductions were performed on 158 patients while 153 pneumatic reductions were performed on 145 patients. Statistical comparisons of these two reduction methods were made regarding the following variables: the reduction rates, frequencies of bowel perforations and recurrences, mean operation times, fasting periods, and durations of admission. RESULTS: The reduction rates were similar for both groups with barium reduction being successful in 67.1% of the cases (108/161) and pneumatic reduction in 69.3% (106/153). Two cases of bowel perforation occurred during the pneumatic reductions, none were noted during the barium reductions. Recurrence of intussusception was noted in three cases initially reduced with barium and in nine cases reduced pneumatically. The mean operation time (130.7 minutes vs. 81.7 minutes), postoperative fasting time (61.6 hours vs. 37.6 hours), and duration of admission (6.7 days vs. 5.4 days) were significantly prolonged in the pneumatic reduction group. CONCLUSION: A part from a comparable reduction rate pneumatic reduction demonstrated no favorable outcome relative to barium reduction. Furthermore, it resulted in some obstacles to surgery and recovery, such as prolonged operation time, fasting period, and duration of admission.
Barium* ; Child* ; Fasting ; Humans ; Intussusception* ; Recurrence

Despite the substantial amount of asthma-related information available on the internet, little is known about the quality of such information. We assessed asthma-related information on the Korean internet intended as an educational material for asthma patients. By entering the key word, 'asthma', into 4 popular search engines, 32 web sites were identified and categorized with respect to authorship. The core asthma educational concepts and Health On the Net Code of Conduct principles were used to evaluate informational value and justifiability of unreliable information. Eight of 32 web sites were categorized as western physician, seventeen as oriental physician, four as commercial, and three as others. The mean number of core asthma educational concepts on the whole web sites was 2.7 out of 8. By type of authorship, 1.7 on the commercial sites, 2.1 on the oriental physician sites, 3.5 on the western physician sites, and 5.0 on the others sites in decreasing order. One of the western physician sites, two of the commercial sites, and all of the oriental physician and others sites contained unreliable information. However all of them except one site failed to satisfy our criteria of justifiability. Asthma-related information currently available on the Korean internet is highly variable in quality and lacks core asthma educational concepts and justifiability.
Asthma/*diagnosis/*therapy ; Health Education ; Human ; Internet ; Korea ; Medical Informatics ; Patient Education/*methods ; Quality Control

BACKGROUND: Molecular methods have rapidly replaced the classic diagnostic procedures of tuberculosis. Especially, the nested polymerase chain reaction (nPCR) is widely used for the diagnosis of tuberculosis in various specimens. In our previous publication, we suggested the availability of nPCR in specimens of solid tissues and in fine needle aspirates for the diagnosis of tuberculous cervical lymphadenitis (TCL), but nPCR has the possibility of false positive due to its repetitive amplification and contamination. Also, nPCR shows variable sensitivity and specificity, depending on the kind of target sequence and the probe used. We intended to improve the diagnostic efficacy of nPCR by the means of combination with the result of fine needle aspiration cytology (FNAC). And we applied restriction fragment length polymorphism (RFLP) to the amplicon of nPCR to rule out false positives. METHODS: Thirty five specimens of aspirates from enlarged cervical lymph nodes of suspected TCL cases were examined by cytological examination and nPCR. Fifteen amplicons from nPCR were analyzed by RFLP. The sensitivity and the specificity were calculated in each nPCR and FNAC. The sensitivity and the specificity based on the result from combining nPCR and FNAC were also calculated. The results of RFLP were compared with the results of the corresponding nPCR. RESULTS: Twenty patients were definitely diagnosed as having tuberculosis based on the result of FNAC, nPCR, and tissue pathology. The sensitivity of FNAC was calculated to be 0.8, and the specificity was 0.92. The sensitivity of nPCR was calculated to be 0.76 and the specificity was 1.0. When we analyzed the patients infected with tuberculosis who had had positive results in FNAC or nPCR, the results showed a sensitivity of 0.95 and a specificity of 0.92. There were no different RFLP fragmentation patterns between the individual amplicons of the same nPCR results. CONCLUSIONS: The result of combining FNAC and nPCR offered good sensitivity and specificity in the diagnosis of TCL. It is suggested that anti-tuberculosis medication be immediately started when the result of FNAC or nPCR reveals a positive reaction. RFLP did not show any diagnostic value in our series, but it could be a great help in differential diagnosis of another strain of M. tuberculosis or atypical mycobacterium in treatment-resistant cases of TCL.
Biopsy, Fine-Needle* ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphadenitis* ; Needles ; Nontuberculous Mycobacteria ; Pathology ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length ; Publications ; Sensitivity and Specificity ; Tuberculosis

BACKGROUND: Allergic rhinitis is often associated with bronchial asthma, and intranasal treatment with topical corticosteroids reduces bronchial responsiveness. OBJECTIVE: In this study, it was evaluated that the bronchial responsiveness to methacholine increased in non-asthmatic adults with house dust mites (HDM)-sensitive allergic rhinitis compared to those without, chronic nasal symptoms. SUBJECTS AND METHODS: A questionnaire, skin prick t,est to common inhalant allergens, and methacholine bronchial provocation test (MBPT) were performed in a total of 216 subjects, who were composed of 40 non-asthmatic subjects with HDM-sensitive allergic rhinitis (HAR), 63 HDM-sensitive subjects without nasal symptoms (HS), and 113 non-atopic subjects without nasal symptoms (NHS). The bronchial responsiveness was evaluated by positive rate of MBPT (PC,-methacholine200mg/ml), provocative concentration of methacholine at which FEV, decline to 15% compared to baseline value (PC,-methacholine), and slope of dose-response curve (%fall of FEV, / log[last concentrat,ion of methacholine, mg/ml]). RESULTS: Positive rate of MBPT was significantly increased in HAR than in HS and NHS, and there was no difference between HS and NHS (77.9% vs. 50.7% vs. 38.0%). Log PC[5- methacholine was lower in HAR than in HS and NHS, and lower in HS than in NHS (mean+ SE, 1.568+0.126 vs. 2.05+0.085 vs. 2.277+0.047). Slope of dose-response curve was higher in HAR than in HS and NHS, and there was no difference bet,ween HS and NHS (mean+SE, 22.7 + 11.3 vs. 7.3+ 1.2 vs. 4.9+ 0.5%/mg/ml); CONCLUSION: In non-asthmatic adults with HDM-sensitive allergic rhinitis, the bronchial responsiveness to methacholine increased compared to those without chronic rhinitis.
Adrenal Cortex Hormones ; Adult ; Allergens ; Asthma ; Bronchial Provocation Tests ; Dust* ; Humans ; Methacholine Chloride* ; Pyroglyphidae* ; Rhinitis ; Skin ; Surveys and Questionnaires

BACKGROUND: Although occupational asthma is defined as a reversible airway obstruction causally related to exposure in the working environment, many occupational asthmatics complain of asthmatic symptoms despite avoidance of the causative agent. Subjects and methods. Twenty-nine patients with occupational asthma who had been confirmed by specific bronchial challenge with reactive dye or isocyanates and had avoided the causative agent for at least 6 months were included in this study. A questionnaire about asthmatic symptoms and medication requirements, a lung functiontest, and a methacholine bronchial provocation test were performed. RESULTS: Asthmatic symptoms at follow-up were remitted in seven (41.2%) isocyanate-induced asthmatics, but none with reactive dye-induced asthma were remitted. At follow-up, the symptom-medication score and FEV1 were significantly improved in isocyanate-induced asthmatics than in those with reactive dye-induced asthma, but the geometric mean of PC20-methacholine was not different between the two groups. Among 17 isocyanate-induced asthmatics, a duration from symptom onset to avoidance was significantly shorter in the remission group than in the nonremission group, although the symptom-medication scores, FEV1 (% predictive value) and logPC20-methacholine at an initial diagnosis, and follow-up period defined as duration from avoidance to follow-up, showed no difference between the two groups. CONCLUSION: The outcome of occupational asthma may be determined by the causative agents and the duration from onset of asthmatic symptoms to avoidance.
Airway Obstruction ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Diagnosis ; Follow-Up Studies ; Humans ; Isocyanates ; Lung ; Methacholine Chloride ; Prognosis ; Surveys and Questionnaires