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천식 환자에서 메타콜린 기도 과민성에 미치는 임상적 인자 평가
김희규 ( Hee Kyoo Kim ),이현승 ( Hyun Seung Lee ),이상민 ( Sang Min Lee ),송우정 ( Woo Jung Song ),손성욱 ( Seung Wook Sohn ),박창한 ( Chang Han Park ),김경묵 ( Kyung Mook Kim ),박흥우 ( Heung Woo Park ),김상헌 ( Sang Heon Kim 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.1
Background: Airway hyperresponsiveness (AHR) is a key phenotype of asthma. The expression of AHR is known to be variable in asthma patients, but the underlying mechanisms are poorly understood. Objective: The aim of this study was to evaluate the relationship of clinical characteristics such as smoking history, duration, atopy, total IgE levels, basal lung function, disease severity, and airway inflammation with methacholine AHR in patients with asthma. Method: A total of 109 asthma patients underwent spirometry and methacholine bronchial provocation test (MBPT). According to PC20, asthma patients were classified by mild AHR group (PC20 between 4 to 25 mg/mL) and by severe AHR group (PC20 of less than 4 mg/mL). They gave induced sputum for airway inflammation and serum for total IgE, and atopy were evaluated by the skin prick test to common aeroallergens. Result: Atopy and serum total IgE levels were not significantly different between the two groups. Basal FEV1 was significantly higher in mild AHR group (87.5±14.7%) than in severe AHR group (80.5±17.4%)(P=0.023). In addition, frequencies of severe severity were higher in severe AHR group than in mild AHR group (5.8% vs. 19.3%; P=0.002). The number of neutrophils and eosinophils in induced sputum was enhanced in the former group than in the latter group, although the statistical significances were not found (18.9±88.0 vs. 8.2±8.8×105/g; 7.1±16.6 vs. 2.8±5.9×105/g, respectively). Conclusion: Basal airway obstruction and asthma severity were positively associated with severity of methacholine airway responsiveness in asthma patients. (Korean J Asthma Allergy Clin Immunol 2006;26:59-63)
이상민 ( Sang Min Lee ),송우정 ( Woo Jong Song ),양민석 ( Min Seok Yang ),이소희 ( So Hee Lee ),권재우 ( Jae Woo Kwon ),김태완 ( Tae Wan Kim ),김경묵 ( Kyung Mook Kim ),김희규 ( Hee Kyu Kim ),박창한 ( Chang Han Park ),박흥우 ( Heu 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.3
A patient with a history of anaphylaxis after local administration of lidocaine was referred to screen a safe local anesthetic agent for dental procedures. We performed skin prick test with procaine, lidocaine, bupivacaine, mepivacaine, ropivacaine, and levobupivacaine. In accordance with the history of patient, lidocaine showed a positive result in skin prick test (wheal and flare reactions larger than those of histamine, a positive control) while other local anesthetics failed to produce positive reactions. Then, we performed the intradermal test with the above-mentioned anesthetics except lidocaine. As a result, procaine, mepivacaine, and bupiva caine showed positive results. Meanwhile, levobupivacaine and ropivacaine showed negative results in both the skin prick and the intradermal test and no systemic reactions after subcutaneous injection of testing dose (0.5%, 1:1 dilution, 3 mL) of levobupivacaine. Based on these results, we recommended levobupivacaine as a safe agent, and dental procedures were successfully done with it. This case clearly demonstrates that the cross reactivity between local anesthetics is unpredictable and should be confirmed before administration of a different anesthetic. (Korean J Asthma Allergy Clin Immunol 2006;26:249-253)
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박창한 ( Chang Han Park ),김경묵 ( Kyung Mook Kim ),김희규 ( Hee Gyu Kim ),손성욱 ( Seoung Wook Son ),김상헌 ( Sang Heon Kim ),박흥우 ( Heung Woo Park ),장윤석 ( Yoon Seok Chang ),김선신 ( Sun Sin Kim ),김윤근 ( Yoon Keun Kim ) 대한천식알레르기학회 2005 천식 및 알레르기 Vol.25 No.4
Mastocytosis is a rare disease characterized by pathologically increased mast cells in various tissues. Cutaneous mastocytosis, the most common manifestation of the mastocytosis, is confined to the skin without involvement of the other organs. Cutaneous mastocytosis is mostly found in children. It usually presents as symmetrically distributed red-brown macules or papules. Wheals and erythema may often develop with pruritus if mechanical irritations such as stroking (Darier`s sign), heat or sudden change of temperature are given to the skin lesions. Clinical symptoms include flushing, urticaria, angioedema, anaphylaxis, peptic ulcer disease, abdominal pain, diarrhea and bone pain caused by the release of mast cell mediators. We report a case of adult-onset cutaneous mastocytosis that presented as generalized urticaria developed after hot bath. (Korean J Asthma Allergy Clin Immunol 2005;25:328-332)
이지현,장태원,김희규,김낭희,양성우,김선정,옥철호,정만홍 고신대학교 의학부 2005 高神大學校 醫學部 論文集 Vol.20 No.1
Background: This study aimed to reduce the delayed diagnosis of the coexisting active pulmonary tuberculosis in patients with lung cancer. Methods: We analyzed clinical data of 30 cases (0.6%) among 4991 patients with coexisting lung cancer and active pulmonary tuberculosis encountered at Kosin University Gospel Hospital from January 1995 to July 2003. Results: There were 23 men and 7 women, and eighty percent of patients were smokers. The histologic types of lung cancer were squamous cell carcinoma in 14, adenocarcinoma in 12, small cell carcinoma in 3, and large cell carcinoma in 1. The disease stages of lung cancer were stages Ⅱb in 1, Ⅲa in 4, Ⅲb in 11, Ⅳ in 11 in non-small cell lung cancer, limited stage in 1, and extensive stage in 2 in small cell lung cancer patients. The most common site of lesion was upper central part of the lung (50%). We classified the 30 cases into 2 groups as follows; The first group was active tuberculosis patients concurrently detected with lung cancer (Concurrent group, 17 cases), and the second group was tuberculosis sequential to lung cancer (Sequential group, 13 cases). Radiologic features in the concurrent group were nodular mass in 11, cavitary lesion in 3, consolidation in 2, and pleural effusion in 1. In contrast to this findings, in sequential group it showed consolidation in 8, cavitary lesion in 3, other findings in 1, and pleural effusion in 1. There was 27 days delayed at the diagnosis of pulmonary tuberculosis in the sequential group. The median survival time was 12 months in the concurrent group and 42 months in the sequential group. Treatment of pulmonary tuberculosis was 100% successful n the concurrent group and 62.5% successful in the sequential group. Conclusion: This study indicated that physicians should consider the possibility of pulmonary tuberculosis in the cases with atypical chest x-ray presentation at the diagnosis of lung cancer, and during treatment of lung cancer also should suspect the coexistent active tuberculosis in such cases of pneumonia that does not respond to treatment.