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만성기침 환자에서 유도객담내 호산구와 기관지과민성 및 천식 치료 반등도와의 관계
이병재(Byung Jae Lee),정재원(Jae Won Chung),장윤석(Yoon Suk Jang),장윤혜(Yoon Hae Chang),김상훈(Sang Hoon Kim),정희(Hee Chung),김윤근(Yoon Keun Kim),조상헌(Sang Heon Cho),민경업(Kyung Up Min),김유영(You Young Kim) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.6
N/A Background: The value of the induced sputum examination in chronic cough has not been determined. We performed this study to investigate the relationship between eosinophil percentage on induced sputum and bronchial responsiveness to methacholine or capsaicin, and responses to anti-asthmatic treatment in chronic cough patients. Subjects and Methods Forty-seven patients with chronic cough persisting for more than 1 month without current wheezing or dyspnea were studied. According to the eosinophil percentage on induced sputum, the subjects were divided into two groups group A (sputum eosinophil ≥ 3%) and group B (sputum eosinophil < 3%). Methacholine bronchial provocation test (MBPT) and capsaicin challenge, and responses to anti-asthmatic treatment were compared between the two groups. Results : Group A consisted of 26 subjects and group B consisted of 21 subjects. There were no differences in sex, clinical characteristics of cough, atopy prevalence, and peripheral eosinophil counts except serum IgE level between the two groups. MBPT positivity was much higher in group A than group B (46.2% vs 0%, p<0.001), but there was no difference in capsaicin test positivity(44.0% vs 50.0%). Group A showed much higher response rates to anti-asthmatic treatments than in group B (73.1/o vs 19.09o, p(0,001). Conclusion : Eosinophilic airway inflammation in chronic cough was related to methacholine bronchial hyperresponsiveness, but not to capsaicin cough threshold. Induced sputum eosinophil percentage was a good indicator in predicting the response to anti-asthmatic treatment in most chronic cough patients. (J Asthma Allergy Clin Immunol 20: 895-905, 2000)
이병재,김윤근,조상헌,민경업,김유영 ( Byung Jae Lee,Yoon Keun Kim,Kyung Up Min,You Young Kim ) 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.3
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.
집먼지진드기에 감작된 비염환자에서 메타콜린에 대한 기관지과민성의 증가
김우경,반준우,이병재,김윤근,조상헌,민경업,김유영 (Woo Kyung Kim,Jun Woo Bahn,Byung Jae Lee,Yoon Keun Kim,Sang Heon Cho,Kyung Up Min,You Young Kim) 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.2
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.
운동유발성 천식환자에서 운동후 요중 메틸히스타민 및 설피도펩티드 류코트리엔의 농도 변화
박재경,반준우,이병재,손지웅,이상록,김윤근,조상헌,민경업,김유영 (Jae Kyung Park,Jun Woo Bahn,Byung Jae Lee,Jee Woong Son,Sang Rok Lee,Yoon Keun Kim,Sang Heon Cho,Kyung Up Min,You Young Kim) 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.1
Background: Exercise can aggravate asthmatic symptoms in many patients with bronchial asthma. It is caused by that inhaled air bypasses nasal cavity and goes directly to the lower airways through open mouth dring exercise. Although the pathogenetic mechanisms of exercise -induced asthma(EIA) have not been clarified yet, there is evidence that chemical mediators, released from the inflammatory cells triggered by airway cooling or drying, might be responsible for induction of bronchoconstriction. However, it has been controversial which chemical mediators or cells are involved in such process. Objectiye . The aim of this study was to evaluate t.he role of activated mast cells in the pathogenesis of EIA and find out whether or not sulfidopeptide leukotrienes (LTC4/d4/E4) are involved in the exercise-induced bronchoconstriction. Material and Method: Eleven asthmatics with documented exercise-induced bronchoconstriction and 10 control subjects were studied. Before and 6 hours after free running for 6 minutes, forced expiratory volume in 1 second (FEV,) and the concentrations of N- methylhistamine, LTE4, and creatinine in unine collected for 6 hours after exercise were determined. Result: Urinary concentrations of N-methylhistamine(mean+SE, ng/mg creatinine) of EIA patients before and after exercise were 159+40 and 450+75, respectively. Those of control subjects were 208+ 54 and 275+ 62, respectively. Uninary N-methylhistamine levels of EIA group increased significantly after exercise, while those of control group did not change. Urinary concentrations of LTE,(mean+SE, pg/mg creatinine) of EIA patients before and after exercise were 15.6 k2.6 and 22.2+5.8, respectively. Those of control subjects were 10.4+ 4.0, 18.2 +7.0, respectively. The concentrations of LTE4 in the urine samples collected before exerise revealed no difference between EIA and control subjects (p=0.07). There was no change after exercise in both groups. Percent fall of FEV, was 29.1+8.0% (mean+SD) in EIA group and 3.4 + 4.0% in control group, respectively. There was no correlation between reduction of FEV, and change in urinary concentrations of N-methyl-histmine after exercise. Conclusion'. Chemical mediators of activated mast cells may be involved in exercise-induced bronchoconstriction, but there is little evidence for enhanced sulfidopeptide leukotriene generation as assessed by urinary LTE4.
김윤근,장윤석,정재원,이병재,김희연,손지웅,이상록,조상헌,박해심,이명현,민경업,김유영 ( Yoon Keon Kim,Yoon Suk Jang,Jae Won Jung,Byung Jae Lee,Hee Yeon Kim,Jee Wong Son,Sang Rok Lee,Sang Heon Cho,Hae Sim Park,Myung Hyun Lee,Kyung Up Min,Y 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.3
Backpwnd: Prevalence of bee venom allergy in Korea is unknown, Objective'. We performed a cross-sectional study to evaluate the prevalence of bee venom allergy and importance of risk factors, such as age, sex, and atopy, in the development of the allergic reaction in children and adults living in rural area of Cheju Island. Swbject and method: The prevalence was investigated in subjects with 1,054 children and 370 adults (701 male, 723 female), aged 7-87 years, living in rural area of Cheju Island. A history particularly focused on the systemic reactions after the bee stings was taken in all subjects. Skin prick test,s to common inhalant allergens, including house dust mites, fungi, tree, grass, mugwort and ragweed pollen, cockroach, animal epithelium, Japanese cedar pollen, and citrus red mite were performed. Result: The prevalence of bee venom allergy was 5.8% (mild systemic reactions 5.0%, severe systemic reactions 0.8% ). The prevalence was higher in adults than in children (10.2% vs. 5.0%, g = 12.0, p<0.01). Among t,he child!'en, the prevalerlce wB.S Signifcant,ly higher ill male than in female (8.6% vs. 1.3%, x=28.7, p<0.01), but no significant diffecence was noted between male and female in adults (10.0% vs. 10.3%, p>0.05). The prevalence of bee venom allergy was not significantly different between subjects with positive skin reaction and those with negative skin reaction to inhalant allergens (6.4% vs. 5.4% ), Conclasion'. The prevlence of bee venom allergy in inhabitants of rural area of Cheju Island is 5.8% (mild systemic,' 5.0%, severe systemic reaction. 0.8%), and bee venom allergy was more common in adults than in children, and in male children than in female children.
3차 의료기관을 방문한 천식 환자에서 아토피 유병률의 변화
박흥우(Heung Woo Park),김상헌(Sang Heon Kim),김상훈(Sang Hoon Kim),장윤혜(Yoon Hae Chang),정희(Hee Chung),이병재(Byung Jae Lee),김윤근(Yoon Keun Kim),조상헌(Sang Heon Cho),민경업(Kyung Up Min),김유영(You Young Kim) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.1
N/A Background: The prevalence of atopy and atopy-related disease has been known to increase during the past decade. Objective : This study was desinged to evaluate the changes of atopy prevalence among asthmatic patients and the causative allergens. Method : A total of 698 asthmatic patients visiting Seoul National University Hospital in 1983, 1990 and 1997 was recruited. Skin prick test with common inhalant allergens was carried out and interpreted as positive when the mean wheal size formed by allergen was larger than 3 mm. Atopy was defined when skin reaction to one or more allegens was positive. Result. The prevalence of atopy among asthmatic patients was 54% in 1983, 48.8% in 1990 and 58% in 1997, respectively. The prevalence of atopy decreased as the age of patients in- creased. Recently, old asthmatic patients ( >55 years) showed a higher tendency to visit the tertiary referral hospital. When the data were analyzed according to age, the prevalence of atopy significantly increased among asthmatic patients aged 15-35 years, in whom the prevalence was 60.4% in 1988 and 81.3% in 1997 (p< 0.05). The positive rate of skin test to Dermatophagoides pteronyssinus, cat fur, mugwort, ragweed, and grass pollen were significantly higher in 1997 than in 1983 (p < 0.05). Conclusion : The prevalence of atopy among asthmatic patients aged 15-85 years showed significant increase in 1997 compared to 1983. The changes of skin response to Dermatophagoides pteronyssinus, cat fur, mugwort, ragweed, and grass pollen contributed to the increase of atopy.
제주도 농촌지역 주민에서 알레르기성 비염의 유병현황과 원인 항원
김유영,김윤근,민경업,이명현,장윤석,정재원,반준우,이병재,김희연,이상록,손지웅,조상헌,박해심 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.1
Objective: Cross-sectional survey was performed to evaluate prevalence of allergic rhinitis and its causative allergens in people in rural area of Cheju Isl~and. Subject and method: A total of 1,236 people with 1,055 children and 181 adults in rural area of Cheju Island were enrolled in this study. In children, 544 were males and 511 were females, and their mean age was 12.3(ranging from 7 to 16) years. In adults, 78 were males and 103 were females, and their mean age was 50.1 (ratging from 18 to 87) years. Evaluations included a questionnaire survey, and skin prick test with extracts of Japanese cedar (Cryptomera japonica, J cedar) pollen and citrus red mite (Panonychus citri, CRM) as well as eleven common inhalant allergens. Results: Prevalence of chronic nasal symptoms was 40.6% (429/1,055) in children, and 45.8 % (83/181) in adults. Prevalence of allergic rhinitis based on positive nasal symptoms on the questionnaire and positive skin response to one or more of the 13 inhalant allergens were 15.4 % (159/1.035) in children, and 19.3% (35/181) in adults. Of 1,035 children, skin-test response was positive in 37.6%, and common sensitizing allergens in order of decreasing frequency were Dermatophagoides pteronpssinus (DP) (26.6%), D. farinae (DF)(22.6%), CRM(14.2%), cock- roach(11.3%) and J cedar(9.7%). Of 181 adults, skin-test response was positive in 25.9%, and t,he most common sensitizing allergen was CRM(16.5% ), followed by cockroach(11.0% ), DP(9. 9%), DF(9.4%), and J cedar(6.6%). Of 159 children with allergic rhinitis, the common sensitizing allergens in order of deereasing frequency were DP(79.2%), DF(67.3%), CRM(35.8%), J cedar(32.7%), and cockroach(27.0%). Of 35 adults with allergic rhinitis, the most common sensitizing allergen was CRM(68.6%), followed by DP(40%), DF(34.3%), cockroach(34.3%), and J cedar(28.9% ). Conclusion: Allergic rhinitis is a very common disease with a prevalence of 15.4% in children and 19.3% in adults in rural area of Cheju island, and common sensitizing allergens include house dust mite, citrus red mite, cockroach, and Japanese cedar pollen.
IL - 5에 의해 활성화된 호산구가 폐섬유모세포에 의한 교원질 젤 수축에 미치는 영향
김유영,김윤근,이병재,민경업,조상헌,김상훈,박흥우,김상헌,이수연,전순영,정재원,장윤석 대한알레르기학회 2001 천식 및 알레르기 Vol.21 No.2
Background:Subepithelial fibrosis plays a major role in the development of irreversible airway obstruction in asthma. Eosinophils are major effector cells in allergic inflammation, and it has been suggested that eosinophil-derived mediators such as transforming growth factor-β (TGF-β) play a role in the pathogenesis of airway remodeling. Objective : The aim of this study was to evaluate whether eosinophils activated by IL-5 plays a major role in the collagen gel contraction by lung fibroblasts. Method : Various cell numbers of lung fibroblasts were cultured in collagen gels to determine the appropriate numbers of fibroblasts. Purified human peripheral blood eosinophils were activated by IL-5 for 3 days, and TGF-β Mrna expression was evaluated using semiquantitative RT- PCR. The cultured supernatants with or without TGF-β were added to the collagen gel media with lung fibroblasts, and collagen gel diameter was serially measured to evaluate collagen gel contraction. Results : The amount of collagen gel conion was significantly associated with the number of fibroblasts (p$lt; 0.05), and TGF-β significantly contracted the collagen gel to contract in a dose-dependent manner (p$lt; 0.05). However, supernatants derived from IL-5-activated eosinophils did not contract the collagen gel compared to controls (p$gt; 0.05). Moreover, expression of TGF-β Mrna in eosinophils was the same before and after stimulus of IL-5. Conclusion: Activated eosinophils by IL-5 may play a minor role in the collagen gel contraction by lung fibroblasts.