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손성욱 ( Seong Wook Sohn ),양민석 ( Min Seok Yang ),이소희 ( So Hee Lee ),송우정 ( Woo Jung Song ),이상민 ( Sang Min Lee ),권혁수 ( Hyouk Soo Kwon ),김덕인 ( Deok In Kim ),박창한 ( Chang Han Park ),박흥우 ( Heung Woo Park ),장윤석 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.2
Background: Eosinophilic bronchitis (EB) is recently regarded as an important cause of chronic cough. However, sputum eosinophilia is commonly encountered in the other causes of chronic cough such as upper airway cough syndrome (UACS) and asthma. Objective: To evaluate the cause of chronic cough with sputum eosinophilia. Method: We investigated patients with chronic cough. Induced sputum, methacholine bronchial provocation test, skin prick test, throat examination, chest X-ray, paranasal sinus (PNS) x-ray and rhinoscopy were performed. Result: Sputum was induced in 287 patients. Sputum eosinophilia greater than 3% was present in 117 (40.8%) patients. Among 117 patients with sputum eosinophilia, eosinophilic asthma was diagnosed in 36 (30.8%) patients, chest X-ray abnormality or ACEI use was detected in 18 (15.4%) patients, and the remaining 63 (53.8%) patients could be considered to have EB. Among 63 patients with EB, UACS and GERD were found to be combined in 48 (76.2%) and 2 (3.2%) patients, respectively. EB alone without the other causes was diagnosed in 13 (11.1%) patients. Among total 287 patients, EB was detected in 22.0%, and EB alone without the other causes in 4.5%. Conclusion: Sputum eosinophilia can be frequently detected in chronic cough. EB is the common cause in chronic cough with sputum eosinophilia. However, EB is likely to be associated with UACS, which should be considered in cases of EB. (Korean J Asthma Allergy Clin Immunol 2007;27:125-130)
Leukotriene C4 Synthase 유전자 Promoter 부위 유전적 다형과 아스피린 과민성 천식의 연관성
김상헌 ( Sang Heon Kim ),박흥우 ( Heung Woo Park ),손성욱 ( Seong Wook Sohn ),이상민 ( Sang Min Lee ),오선영 ( Sun Young Oh ),김선신 ( Sun Sin Kim ),박준우 ( Joon Woo Bahn ),장윤석 ( Yoon Seok Chang ),신은순 ( Eun Soon Shin ),이 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.2
Background: The 5-lipoxygenase, 5-lipoxygenase associated protein and leukotriene C4 (LTC4) synthase are enzymes involved in the synthesis of cysteinyl leukotrienes which are known to be important lipid mediators for the development of aspirin-intolerant asthma (AIA). Several studies have evaluated genetic association between polymorphisms of these enzymes and AIA, reporting inconsistent results. Objective: To evaluate the genetic effect of polymorphisms of promoter areas of ALOX5, ALOX5AP and LTC4S genes in the development of AIA. Method: Polymorphisms in promoter areas of ALOX5 (-1761G>A, -1708G>A), ALOX5AP (21A/18A repeat) and LTC4S (-444A>C) were genotyped in patients with AIA (n=44), aspirin-tolerant asthma (ATA, n=104), and healthy-normal controls (NC, n=107). Result: The frequency of LTC4S -444 AC or CC alleles was significantly lower in AIA patients than in ATA patients (19.0% vs. 36.5%, P=0.005, OR=0.23, 95%CI 0.08∼0.64). However, the frequency of these genotypes was not different between AIA and NC (19.0% vs. 24.8%, P=0.458). As to LOX5 -1761G>A, -1708G>A, and ALOX5AP 21A/18A repeat, the frequency of these genotypes was not different between AIA and ATA patients and between AIA and NC. Conclusion: A significant association was found between LTC4S -444A>C and the frequency of AIA. This finding suggests that LTC4 synthase may be involved in the development of AIA in the Korean population. (Korean J Asthma Allergy Clin Immunol 2006;26:115-121)
강민규 ( Min Gyu Kang ),김주영 ( Ju Young Kim ),방보람 ( Bo Ram Bang ),정재우 ( Jae Woo Jung ),손성욱 ( Seong Wook Sohn ),강혜련 ( Hye Ryun Kang ) 대한천식알레르기학회 2012 천식 및 알레르기 Vol.32 No.3
Background: Ciprofloxacin can induce immediate hypersensitivity reactions such as urticaria, angioedema, and anaphylaxis. These reactions are usually immunoglobulin E -mediated but non-immunoglobulin E mediated reactions were also reported. Case History: A 47-year-old man visited our emergency department with generalized erythematous rasheses. Skin rash, febrile sensations and conjunctival injection had developed 1 hour after he took ciprofloxacin and tamsulosin 5 hours ago. Initially, his blood pressure was normal but abruptly dropped to 75/36 mmHg 5 hours after arrival. His blood pressure was normalized with repeated epinephrine injection followed by hydration and norepinephrine continuous infusion. Results: Oral provocation tests were performed by using tamsulosin and ciprofloxacin. While tamsulosin did not evoke any symptoms, the patients had itching, erythematous rashes on the whole body 10 minutes after taking ciprofloxacin 62.5 mg and delayed hypotension (87/49 mmHg) occurred 5 hours later. He was diagnosed with delayed hypersensitivity to ciprofloxacin. Peripheral blood mononuclear cells isolated from the patient and normal controls were incubated with ciprofloxacin. The patient showed an increase in interleukin-5 and interleukin-13, while normal controls did not. Conclusion: This is the first case of ciprofloxacin-induced delayed anaphylaxis which was confirmed with oral provocation tests and in vitro cytokine analysis.
윤영순 ( Young Soon Yoon ),김경선 ( Kyung Sun Kim ),정선영 ( Sun Young Jeong ),박근민 ( Gun Min Park ),손성욱 ( Seong Wook Sohn ) 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.1
Background: Antibiotics skin test (AST) is routinely performed to examine hypersensitivity in clinical practice. However, it is difficult to select antibiotics in case of positive AST because of poor validation of AST, crossreactions among β-lactams, etc. Objective: To evaluate the change of antibiotics and following results in case of positive AST. Method: Eighty-six hospitalized patients with positive AST between June 2008 and May 2009 were enrolled. The changing patterns of antibiotics, skin test-reactivity of changed antibiotics, history of antibiotics allergy and adverse events after administration of antibiotics were examined in review of medical records. Result: The patients with positive AST were 95 cases. The skin test positive-antibiotics were 11 penicillins and 84 cephalosporins, respectively. The finally administered antibiotics were changed in 84 patients except 2 patients, which were non β-lactams in 13 patients, cephalosporins in 59 patients, and penicillins in 14 patients. Total 3 (3.5%) adverse reactions (ADRs) were reported. Among them, one was reported in 2 patients whose antibiotics were not changed and 2 (2.4%) in remaining 84 patients. Conclusion: Most antibiotics were changed and the changing patterns of antibiotics were varied in case of positive AST. The guidelines for changing antibiotics are needed. (Korean J Asthma Allergy Clin Immunol 2011;31:48-54)
박창한 ( Chang Han Park ),권용은 ( Yong Eun Kwon ),김덕인 ( Deok In Kim ),권혁수 ( Hyouk Soo Kwon ),손성욱 ( Seong Wook Sohn ),박흥우 ( Heung Woo Park ),장윤석 ( Yoon Seok Chang ),김선신 ( Sun Sin Kim ),성기민 ( Ki Min Seong ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.1
Background and Objective: A novel multiple antigen simultaneous test using ELISA assay (GENEDIA-ELISA) has been developed. It includes two spotted spider mite (TSM) and Japanese Hop pollen (Hop J), which are currently common allergens in Korea but were not readily available for test in the past. The aim of this study was to validate GENEDIA-ELISA assay and to compare it with MAST-Immunoblot assay which was one of the commonly used in vitro tests in Korea. Method: One hundred eight patients were evaluated with skin prick tests, MAST-Immunoblot and GENEDIA-ELISA assay. Using skin prick test results (A/H ratio>1) as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of GENEDIA-ELISA (cut-off=class 2) and MAST-Immunoblot (cut-off=class 2) were examined. The results were analyzed using receiver operating characteristic (ROC) analysis. Result: The overall sensitivity of GENEDIA-ELISA was higher than that of MAST-Immunoblot (61.4% vs. 38.4%; P<0.05) while the overall specificity of each test was similar (88.5% vs. 93.9%). There was a higher correlation between GENEDIA-ELISA and skin prick tests than that obtained between MAST-Immunoblot and skin prick tests (0.47 vs. 0.39). In ROC analysis, the overall result of GENEDIA-ELISA yielded an area under the ROC curve (AUC) of 0.75, which indicated that this assay is more accurate test than MAST-Immunoblot (AUC=0.66). The sensitivities for TSM and Hop J on GENEDIA-ELISA were 83.3% and 83.3%, respectively, and AUC were 0.73 and 0.89, respectively. Conclusion: GENEDIA-ELISA assay may be a sensitive and acceptable tool of specific IgE against common inhalant allergens in Korea. (Korean J Asthma Allergy Clin Immunol 2007;27:26-32)
이연경 ( Yeon Kyung Lee ),김미경 ( Mi Kyeong Kim ),강혜련 ( Hye Ryun Kang ),김태범 ( Tae Bum Kim ),손성욱 ( Seong Wook Sohn ),박혜경 ( Hye Kyung Park ),고영일 ( Young Il Koh ),장광천 ( Gwang Cheon Jang ),김철우 ( Cheol Woo Kim 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.3
Purpose: To investigate whether causes of anaphylaxis vary according to regions and seasons in Korean adults. Methods: Based on previous retrospective studies of anaphylaxis between 2007 and 2011 at the 15 university hospitals. Regions were classified into 4 groups: region I, Seoul; region II, Gyeonggi; region III, Chungcheong; and region IV, Chonnam and Busan. The cases induced by 5 major allergens including drugs, food, bee sting, radiocontrast media, and exercise, were analyzed in the present study. Results: Among a total of 1,661 cases reported (53% male, 45.9±16.0 years), 367 (22.2%), 706 (42.5%), 319 (19.2%), and 269 cases (16.2%) were enrolled in regions I, II, III, and IV, respectively. Of the 5 major allergens, drugs (37.3%) were the most frequently reported, followed by food (25.7%), bee sting (17.9%), radiocontrast media (12.9%), and exercise (6.2%). There was no significant difference in the total occurrence of anaphylaxis in 4 seasons (374 in spring, 460 in summer, 460 in autumn, and 367 in winter). Multiple logistic regression analysis revealed that drug-induced anaphylaxis was significantly associated with the winter season (odds ratio [OR] 1.0 vs. OR 0.597, P<0.05 for spring; OR 1.0 vs. OR 0.481, P<0.01 for summer; OR 1.0 vs. OR 0.653, P<0.05 for autumn). Food-associated anaphylaxis was mainly reported in region I, whereas the frequency of insect sting was relatively higher in regions II, III, and IV than in region I. Older age and female gender were significantly associated with drug-induced anaphylaxis. Conclusion: Specific causative allergens of anaphylaxis in adults may vary according to age, gender, region, and season in Korea.(Allergy Asthma Respir Dis 2015;3:187-193)
이서영 ( Suh Young Lee ),양민석 ( Min Suk Yang ),정재우 ( Jae Woo Jung ),오미정 ( Mi Jung Oh ),박창한 ( Chang Han Park ),손성욱 ( Seong Wook Sohn ),강혜련 ( Hye Ryun Kang ),조영주 ( Young Joo Cho ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.4
As the use of chemotherapeutic agents increased rapidly in recent years, more patients are under the potential risk of chemotherapy related adverse reactions. Multiple regular exposures to the same drug by chemotherapy protocol may increase the risk of sensitization to a chemotherapeutic agent, which can result in hypersensitivity reactions. Once severe hypersensitivity reactions occur, causative drugs should be avoided. However, a substitute with equal efficacy is not always available. When there is no effective alternative, desensitization is a safe tool for maintenance of chemotherapeutic agents causing hypersensitivity reaction. In this review, we introduce the latest knowledge about desensitization protocol for chemotherapeutic agents which are frequently used recently.