Airway Responses to Bronchoprovocation Using High-Resolution Computed Tomography in Patients with Bronchial Asthma / 결핵

BACKGROUND: Bronchial hyperresponsiveness and abnormal response such as a loss of distensi- bility are pathophysiologic characteristics if bronchial asthma. The only means of direct in vivo measurement of airway size had been a tantalium bronchography, until high-resolution computed tomography(HRCT) enabled to measure noninvasively two dimensional airway area more accurately and reliably. METHOD: To investigate airway area responses to bronchial provocation with methacholine and evaluate the major sites of bronchial constriction in patients with bronchial asthma. We examined HRCT scans in five patients with bronchial asthma who had significant bronchoconstriction(20% or more decrease in FEV1) using CT scanner(5,000T CT, Shimadzu Co, Japan) before and in 3~5 min. after methacholine inhalation. Airways which were matched by parenchymal anatomic landmarks in each patient before and after methacholine inhalation were measured using film scanner(TZ-3X scanner; Truvel Co. Chatsworth CA, USA) and a semiautomated region growing method. RESULTS: 1) We identified 9 to 12 airways in each patient which were matched by parenchymal anatomic landmarks before and after methacholine inhalation. 2) Airway responses to methacholine are quite different even in a patient. 3) The constriction of small airways(average diameter 2 mm; area >3.14 mm2), 53.8% (4.4;SEM, n=10), but not significantly different(p>0.05). 4) There was no significant difference in the degree of constriction between upper(44.3% +5.8; mean + SEM, n=30) and lower lung regions(56.7% +4.5, n=23). CONCLUSIONS: Thus airway responses to methacholine bronchoprovocation is quite variable in a patient with bronchial asthma and has no typical pattern in patients with bronchial asthma.

The Statistical Observation for Pediatric Inpatients

Statistical analysis according to W.H.O. classification for the patients admitted to 11 hospitals during the years of Jan. 1974 to Dec. 1975 was made. The result obtaind were as follows: 1) Total No. of patients were 15,885 2) Infections and parasitic disease were the most frequent, 4655 cases (29.3%) and respiratory tract disease the next, 3,516 cases(22.13%) 3) Major leading causes of hospitalization were pneumonia, 12.5% of all patients, ingectious diarrhea, hyperbilirubinemia and postmaturity, prematurity, upper respiratory tract infection nephritis and bronchiolitis in order of incidence.