건강한 성인에서 폐기능과 혈청 Carcinoembryonic Antigen (CEA) 수치와의 연관성

정재우 ( Jae-Woo Jung ),최승호 ( Seung Ho Choi ),김세훈 ( Sae Hoon Kim ),강혜련 ( Hye Ryun Kang ),박흥우 ( Heung Woo Park ),장윤석 ( Yoon Seok Chang ),김선신 ( Sun Sin Kim ),조상헌 ( Sang Heon Cho ),민경업 ( Kyung Up Min ),김유영 대한천식알레르기학회 2010 천식 및 알레르기 Vol.30 No.1

Background: Carcinoembryonic antigen (CEA), a serological marker of malignant tumors, may show a modest increase under some nonmalignant conditions, such as aging and cigarette smoking. Objective: We analyzed clinical characteristics according to smoking status and determined whether serum CEA levels are associated with pulmonary function. Method: The cross-sectional data from 2,691 subjects who participated in health screening programs were analyzed. The subjects were divided into 3 categories according to smoking status: never-smokers, former smokers and current smokers. A systematic method to derive an optimal cutoff point of CEA which indicates the difference in FEV1% was used. Result: Smoking status was associated with increased serum CEA levels, WBC counts and neutrophil counts and decreased FEV1% in never-smokers, former smokers and current smokers with increasing correlation. Logistic regression analysis adjusted for age and sex showed no differences in FEV1%, WBC counts and neutrophil counts between never-smokers and former smokers. Logistic regression analysis adjusted for age, sex, BMI and smoking amount in former and current smokers showed significant differences in FEV1, WBC counts and neutrophil counts between those with a CEA level of <2.0 and those with a CEA level of ≥2.0. Conclusion: Our results suggest that smoking cessation may affect recovery of systemic inflammation and decreased lung function. A slight elevation in serum CEA in former or current smokers may be associated with systemic inflammation and decreased pulmonary function. (Korean J Asthma Allergy Clin Immunol 2010;30:30-35)

Easy Diagnosis of Asthma: Computer-Assisted, Symptom-BasedDiagnosis

최병휘,유광하,Jae-Won Jeong,Ho Joo Yoon,김상헌,Yong-Mean Park,Wo-Kyung Kim,Jae-Won Oh,Yeong-Ho Rha,Bok-Yang Pyun,Suk-Il Chang,문희범,김유영,Sang-Heon Cho 대한의학회 2007 Journal of Korean medical science Vol.22 No.5

Diagnosis of asthma is often challenging in primary-care physicians due to lack of tools measuring airway obstruction and variability. Symptom-based diagnosis of asthma utilizing objective diagnostic parameters and appropriate software would be useful in clinical practice. A total of 302 adult patients with respiratory symptoms responded to a questionnaire regarding asthma symptoms and provoking factors. Questions were asked and recorded by physicians into a computer program. A definite diagnosis of asthma was made based on a positive response to methacholine bronchial provocation or bronchodilator response (BDR) testing. Multivariate logistic regression analysis was used to evaluate the significance of questionnaire responses in terms of discriminating asthmatics. Asthmatic patients showed higher total symptom scores than non-asthmatics (mean 5.93 vs. 4.93; p<0.01). Multivariate logistic regression analysis identified that response to questions concerning the following significantly discriminated asthmatics; wheezing with dyspnea, which is aggravated at night, and by exercise, cold air, and upper respiratory infection. Moreover, the presence of these symptoms was found to agree significantly with definite diagnosis of asthma (by kappa statistics). Receiver-operating characteristic curve analysis revealed that the diagnostic accuracy of symptom-based diagnosis was high with an area under the curve of 0.647±0.033. Using a computer- assisted symptom-based diagnosis program, it is possible to increase the accuracy of diagnosing asthma in general practice, when the facilities required to evaluate airway hyperresponsiveness or BDR are unavailable.

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 주민의 벌독 알레르기 유병율

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.

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.

급성 천식발작 환자에서 치료 전후의 혈청 Eosinophil Cationic Protein 농도

김윤근(Yun Keun Kim),이상록(Sang Rok Lee),손지웅(Jee Wong Son),김우경(Woo Kyung Kim),박재경(Jae Kyung Park),지영구(Young Ku Jee),송숙희(Sook Hee Song),조상헌(Sang Heon Cho),민경업(Kyung Up Min),김유영(You Young Kim) 대한내과학회 1997 대한내과학회지 Vol.52 No.3

N/A Objectives: To prevent progression to fatal asthma it is essential to assess the severity of asthma and treat adequetely. But there was no objective index to evaluate the severity of airway inflammation in asthmatic patients, So we evaluated that serum ECP concentration is a objective parameter of airway inflammation in patients with acute severe asthmatic attack. Methods: We measured the parameters of asthamtic severtity(clinical parameter, FEV1, arterial blood gas, peripheral blood eosinophil counts, and serum ECP levels) before and after antiasthmatic treatment in 9patients with acute severe asthmatic attack, And we compared serum ECP concentrations of severe asthmatic patients with those of control patients with mild to moderate severity. Results: 1) The serum ECP levels in patients with acute asthmatic attacks compared to patients with mild to moderate, asthmatic severity were significantly increased. 2) The serum ECP levels and pheriperal blood eosinophil counts 2hours after antiasthmatic treatment were significantly lower than the value before treatment, but the total scores of clinical parameter, FEV1, and scores of arterial blood gases were not significantly different from the basal values, Conclusion: It is suggested that the serum ECP level is a objective parameter as a response to antiasthmatic treatment as well as a severity of airway inflammation in patients with acute asthmatic attack.

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.

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.

감초(licorice)에 의한 직업성 천식 1 예

김유영,박재경,민경업,김윤근,조상헌,윤호주,최동철 대한내과학회 1994 대한내과학회지 Vol.47 No.6

More than 200 kinds of occupational allergens are known to cause occupational asthma. But there has been no case report of occupational asthma caused by herb materials except one case reported by Moon et al in 1986 in Korea. Licorice is one of the oldest traditional chinese medicines and is used as a tonic, antiphlogistic, mucolytic, expectorant, and an analgesic for the treatment of gastrointestinal and respiratory disorders and also to alleviate the toxicity of some other drugs. We report a case of occupational asthma caused by licorice. A 34 year-old male patient came to the clinic because of cough, dyspnea and wheezing which had developed one month ago. He had worked at a herb drug store for 3 years. His symptoms used to be worsened during and shortly after his work and subsided several hours after rest. When he visited the clinic, he had no such symptoms and revealed no abnormality on physical examinations. At that time peripheral blood eosinophil count was 590/㎣, total IgE (PRIST) was 770 IU/ml. Radiologic findings of chest and paranasal sinus were normal. Skin prick test with common inhalant allergens revealed positivities to various allergens and licorice extract. He showed a bronchial hyperresponsiveness on methacholine bronchoprovocation test, which increased 24 hours after allergen bronchial provocation with licorice powder and extract. he showed early asthmatic responses to allergen bronchial provocations with licorice powder and extract. Licorice is constituted by triterpenoid, flavonoid and isoflavonoid derivatives. The structures of these constituents are almost low molecular chemicals. In this case the patient showed a positive bronchial provocation test to licorice powder and licorice extract and a positive skin prick test to licorice extract. Thus it is suggested that pathogenic mechanism of licorice induced asthma may be an IgE-mediated allergic reaction. But further studies will be necessory to evaluate exact pathogenesis of licorice induced asthma.

집먼지진드기 항원 - 특이 T - 세포 클론에서 추가 자극에 따른 IL - 4 , IL - 5 , IFN - r mRNA 발현양상의 변화

박재경,홍수종,김유영,김윤근,문희범,조상헌,심정연,민경업 대한알레르기학회 1998 천식 및 알레르기 Vol.18 No.4

Background: It is known that immunotherapy promotes the development of allergen-specific Thl-like lymphocytes whose products are effective in inhibiting clinical response of sensitized atopic patients to allergen exposure. At the single cell level in short term culture, however, IL-4 and IL-5 are co-expressed, while IL-4 and IFN-γare exclusively expressed. Objective. IL-4, IL-5, and IFN-γmRNA were measured in Der pI-specific T-cell clones (TCCs) to evaluate whether expression of cytokine in allergen-specific TCC is fixed regardless of stimuli. Methods: Seven Der pI-specific TCCs were made from two asthmatics sensitive to D. pteronyssinus. IL-4, IL-5, and IFN-γmRNA were measured by RT-PCR in these TCCs after antigen-specific (Der pI) and nonspecific (PHA + TPA) stimuli. Results: IL-4 and IL-5 mRNA were expressed in four and six of seven TCCs, but IFN-γmRNA was not expressed in any TCCs after Der pI-specific stimuli. Meanwhile, after the stimulus of TPA plus PHA, IFN-γmRNA as well as IL-4 and IL-5 mRNA were expressed in four of seven TCCs, and in one TCC, only IFN-γmRNA was expressed without expression of IL-4 mRNA. Conclusion: The expression of cytokine may be variable in allergen-specific TCC according to the type and amount of stimuli.