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천식 의심 환자에서 천식 치료에 의한 유도 객담 내 염증지표의 변화
심명기 ( Myoung Ki Sim ),최인선 ( Inseon S. Choi ),김우진 ( Woo Jin Kim ) 대한천식알레르기학회 2012 천식 및 알레르기 Vol.32 No.3
Background: Eosinophilic airway inflammation is characteristic for typical asthma, but neutrophilic inflammation has been found in severe asthmatics resistant to steroid therapy. This study aimed to evaluate responses to asthma treatment according to inflammatory cell types in sputum. Methods: For a cross-sectional study, 240 consecutive patients with suspected asthma who underwent a 4.5% saline-induced sputum test and a test for airway hyperresponsiveness to methacholine or for airway reversibility were enrolled. Of these patients, 23 who inhaled corticosteroids were entered to a follow-up sputum study. Results: The number of sputum eosinophils was significantly related to the forced expiratory volume in one second/ forced vital capacity (r=-0.180, P<0.05) and airway hyperresponsiveness (r=-0.222, P<0.01), and the number of neutrophils was significantly related to age (r=0.165, P<0.05) and forced expiratory volume in one second (r=-0.157, P< 0.05). Subjects with sputum eosinophilia (n=88, 20.5%) had received asthma treatment before the tests more often than those with neutrophilia (n=23, 4.3%) or mixed granulocytic nature (n=11, 0%) (P<0.05 for each). In the follow-up study, the number of eosinophils was significantly decreased in the eosinophilic subjects (P<0.05), and the Δinterferon- γ/interleukin-5 ratio was significantly related to Δeosinophils (r=0.933, P<0.001). There was an inverse relationship between the number of neutrophils and the increase in forced expiratory volume in one second (r=-0.459, P<0.05) or Δinterferon-γ (r=-0.842, P<0.01). Conclusion: The severity of asthma may depend on inflammatory cell types in sputum. Although inflammatory markers of sputum improve by asthma treatment, treatment responses differ according to cell types. Therefore, sputum examination may be useful for predicting therapeutic responses in asthmatics.
과립구집락자극인자 투여로 치료한 범혈구감소증과 피부 박리를 보인 붉은사슴뿔버섯 중독 1례
김중석 ( Jung Seok Kim ),김규원 ( Gyu Won Kim ),정재일 ( Jae Il Chung ),심명기 ( Myoung Ki Sim ),윤기철 ( Ki Chul Yoon ),최용훈 ( Yong Hoon Choi ),이하람 ( Ha Ram Yi ),최인주 ( In Zoo Choi ),심찬섭 ( Chan Sup Shim ),한정호 ( Joung 대한임상독성학회 2015 대한임상독성학회지 Vol.13 No.1
Podostroma cornu-damae is a rare species of fungus belonging to the Hyocreaceae family. Its fruit body is highly toxic, as it contains trichothecene mycotoxins. The morphology is similar to that of immature Ganoderma lucidum, making identification difficult for non-experts. We experienced such a case of a 56- year-old male who picked and consumed podostroma cornu-damae, and consumed. Later that day, he developed digestive system symptoms, including nausea, vomiting, and abdominal pain. He presented to the emergency room (ER), there were no abnormal physical findings, symptoms improved after gastric lavage, and the patient voluntarily discharged himself on the same day. The following day, as the symptoms gradually deteriorated, he was admitted via the ER. He was presented with severe pancytopenia, alopecia, desquamation of skin, and acute renal failure. He recovered without any complications after conservative care, antibiotics therapy, and granulocyte colony stimulating factor administration. The most commonly reported complications of podostroma cornu-damae intoxication were reported pancytopenia, infection, disseminated intravascular coagulation, acute renal failure, etc. since Prevention is especially important because its toxicity can be lethal and there is no particular treatment to date, prevention is especially important. Promotion and education for the public are needed.
응급실 내원 천식발작 환자수와 발작 중증도의 최근 변화 추세 -단일기관연구-
문장식 ( Jang Sik Mun ),최인선 ( Inson S. Choi ),심명기 ( Myoung Ki Sim ) 대한천식알레르기학회 2005 천식 및 알레르기 Vol.25 No.4
Background: There have been few studies concerning the change in asthma severity in Korea. Objective: To investigate the recent trend in the prevalence and severity of acute asthma at a hospital in Gwangju. Method: The charts of 332 adult asthma patients, who were selected randomly from 1,240 patients who visited the emergency department from 1996 to 2003 except 2000, were reviewed retrospectively. Result: The proportion of asthma to total visits increased progressively from 0.20% to 0.28%, 0.44%, 0.45%, 1.04%, 0.99%, and 0.98% (P<0.001). The proportion of patients with severe asthma attack (FEV 1< 50%) and the age also increased progressively (P<0.001, respectively), and there was increasing tendency in male sex. When compared between before and after 2000, the mean annual number of asthma patients increased 3.43 times from 87 to 298, and the mean proportion of asthma 2.90 times from 0.34% to 1.00%. The proportion of patients with severe asthma attack increased significantly (52.1 % vs. 69.5%, P < 0.01), and post-treatment FEV1 decreased significantly (69.l±2.6% vs. 63.3 ± 1.6%, P < 0.05). Conclusion: The prevalence and severity of acute asthma at a hospital in Gwangju was progressively increased from 1996 to 2003, with increases in age and the male sex, and irreversible airflow obstruction. (Korean J Asthma Allergy Clin Immunol 2005;25:284-290)