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- 저자 : 이재천 ( Jaechun Lee ) (검색결과 12 건)
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이재천,Lee, Jaechun 제주대학교 의과학연구소 2018 The Journal of Medicine and Life Science Vol.15 No.1
Allergy is conditions when a hypersensitivity reaction happens with a certain element, called as an allergen, which is commonly not reactive to ordinary individuals. Allergic diseases involve various organs or systems in the body. The purpose of allergy tests is to make a diagnosis of allergic diseases and to identify the affecting allergens. In vivo tests, more relevant in clinical situation, include skin test, patch test and provocation test. In in vitro tests, there are specific IgE test, histamine releasing assay, and lymphocyte activation test, safer and more objective than in vivo tests. In the view point of clinical practice, skin test, provocation test, total IgE test and specific IgE test were reviewed in depth.
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일개 대학병원에서 수집한 스티븐스-존슨 증후군 및 독성표피괴사용해 70사례 분석
이재천 ( Jaechun Lee ),김재왕 ( Jae Wang Kim ) 대한내과학회 2017 대한내과학회지 Vol.92 No.2
목적: 스티븐스-존슨 증후군(SJS) 및 독성표피괴사용해(TEN)는 중증 피부약물이상반응이며, 치명적 결과를 유발할수 있다. 한 지역 기반의 대학병원에서 경험한 사례를 분석하였다. 대상 및 방법: 2008년부터 2014년까지 전문가에 의해 진단된 SJS/TEN 사례의 임상 양상, SCORTEN 등을 후향적으로 수집하였다. 결과: 7년간 SJS 56사례, TEN 14사례 등 총 70사례가 발생하였다. 40대에서 60대(남성 평균 55세, 여성 평균 54세)에 흔하게 발생하였으며, 흔한 원인 약제는 항전간제(42.8%), 탄산탈수효소저해제(20.0%), 항균제(15.7%), 알로푸리놀(7.1%), 진통소염제(7.1%) 등이었다. 독성표피괴사용해 7사례(50%)가 사망하였다. 사망 사례의 평균 연령은 67세였고, 남성(20%)보다 여성(67%)에서 흔하였다. 치명률은 SCORTEN으로 예측되었다. 생존 사례와 치료 방법에는 차이가 없었다. 결론: SJS/TEN의 원인약물 및 치명성에 대한 숙지가 필요하다. 고령 여성의 TEN에서 치명률이 높다. SCORTEN을 활용하여 치명률을 예측할 수 있다. 조기 발견 및 적절한 치료가 필수적이다. Background/Aims: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions that frequently result in fatal outcomes. We investigated cases of SJS and TEN in a regional hospital. Methods: From 2008 to 2014, SJS and TEN cases were enrolled retrospectively by allergy and dermatology specialists, and their clinical features and severity-of-illness score for TEN (SCORTEN) were assessed. Results: During the 7-year study period, 56 SJS and 14 TEN cases were recruited. The majority (71%) were 40-70 years of age (mean age of male and female patients, 55 and 54 years, respectively). Regarding drugs, anticonvulsants (42.8%) were the most frequently causative, followed by carbonic anhydrase inhibitors (20.0%), antimicrobials (15.7%), allopurinol (7.1%), and non-steroidal anti-inflammatory drugs (7.1%). No fatal case of SJS was seen. However, 7 of the 14 patients with TEN died (50%; mean age, 67 years; 1 of 5 [20%] males and 6 of 9 females [66.7%]). The mortality rate was reflected in the SCORTEN values. Vancomycin, allopurinol, methazolamide (two cases each) and megestrol (one case) were the causative drugs in the seven fatal TEN cases. Treatment modality did not affect the likelihood of death due to TEN. Conclusions: The causative drugs of, and frequency of mortality due to, SJS and TEN should be recognized by physicians. Elderly females with TEN are at high risk of mortality. SCORTEN values reflect the mortality rate of TEN patients. Early recognition and proper management of SJS and TEN may reduce the mortality rate. (Korean J Med 2017;92:171-176)
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이재천 ( Jaechun Lee ) 대한천식알레르기학회(구 대한알레르기학회) 2021 Allergy Asthma & Respiratory Disease Vol.9 No.3
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a major culprit of drug-induced hypersensitivity. No reliable diagnostic tests other than a direct challenge are available. Cross-reactivity among NSAIDs that inhibit cyclooxygenase-1 is common. However, in rare cases, the mechanism underlying hypersensitivity is immunologically understood, without involving cross-reactivity of NSAIDs or even with a positive skin test for an NSAID. A 55-year-old woman was referred to the Emergency Department for anaphylaxis. She suffered from generalized hives, chest tightness, and hypotension a few minutes after intramuscular diclofenac injection. One year before, she had experienced a similar reaction after intramuscular injection of aceclofenac. Thereafter, she had been taking naproxen as needed to relieve her osteoarthritis pain, without having an adverse reaction. To confirm drug hypersensitivity and to find alternative drugs, provocation tests were performed with acetaminophen, celecoxib, and lysine-aspirin. All tests were negative, and a skin prick test with diclofenac was also negative. However, intradermal injection of 0.05 mL (37.5 mg/mL) diclofenac provoked an anaphylactic shock and resulted in her admission. Here, we report a rare case of single NSAID-induced anaphylaxis, which was only triggered by acetic acid derivatives of NSAIDs, presumably by an immunoglobulin E-mediated reaction. (Allergy Asthma Respir Dis 2021;9:184-186)
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Ti<sub>0.3</sub>Zr<sub>0.2</sub>V<sub>0.5</sub> 합금게터의 활성화 및 수소흡수특성
김원백,이동진,박제신,서창열,이재천,Kim Wonbaek,Lee Dongjin,Park Jeshin,Suh Changyul,Lee Jaechun 한국재료학회 2005 한국재료학회지 Vol.15 No.2
The lowest activation temperature of a commercial vacuum getter reported so far in literature was about $400^{\circ}C$. Recently, $Ti_{0.3}Zr_{0.2}V_{0.5}$ alloy has been reported to exhibit the activation temperature lower than $200^{\circ}C$ when they are prepared as thin film. In this study, the alloy was prepared as bulk form and its activation temperature and hydrogen sorption properties were investigated in compliance with a standard method. The alloy powder was prepared by arc melting and subsequent HDH(Hydride-DeHydride) process. The activation temperature of the alloy was estimated from the ultimate pressure-temperature curve and located between $150^{\circ}C\;and\;200^{\circ}C$. The hydrogen sorption speed measured by an orifice method was 0.895 liter/sec which is comparable to thin film of same composition.
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베타-락탐 항생제 알레르기: 일개 지역병원의 실제 임상
김혜림 ( Hyerim Kim ),이재천 ( Jaechun Lee ),김세진 ( Sejin Kim ) 대한내과학회 2021 대한내과학회지 Vol.96 No.1
목적: 베타-락탐 항생제는 약물이상반응의 흔한 원인 약물이다. 베타-락탐 알레르기는 처방 패턴에 따라 크게 다른 양상을 보이지만, 이에 대한 최근 국내 연구는 없다. 방법: 베타-락탐 항생제를 포함한 약물에 의한 약물이상반응 사례에서 베타-락탐 알레르기의 임상 양상을 후향적으로 조사하였다. 결과: 175명 중 약물이상반응의 원인약물로 베타-락탐 항생제가 가장 흔했다. 베타-락탐 알레르기가 확진된 79명(45.1%, 여자 53.2%, 나이 49 ± 14세) 중 두 명(2.5%)은 처방 약물조사로, 33명(41.8%)은 항생제 특이 IgE 항체 검사로, 29명(36.7%)은 피부시험으로, 15명(19.0%)은 약물유발 검사로 확진되었다. 소양감이 가장 흔하였고, 두드러기, 호흡곤란, 혈관부종, 저혈압 등의 증상 및 징후를 보였고, 대부분(61명, 77.3%) 투약 후 1시간 이내 발생하였다. 아나필락시스가 67%에서 발생하였고, 이 중 절반은 응급실을 방문하였다. 흔한 원인약물은 세파클러와 아목시실린 순이었다. 베타-락탐 항생제 이외에는 진통소염제(nonsteroidal anti-inflammatory drugs) 및 퀴놀론계 항생제가 흔한 원인약물로 확인되었다. 결론: 베타-락탐 항생제를 포함한 약물에 의해 발생하는 약물이상반응의 흔한 원인은 베타-락탐 항생제다. 응급실 방문을 요하는 아나필락시스가 흔히 발생하며, 다성분 처방으로 원인약물 확정에 어려움이 있다. Background/Aims: Beta-lactam (BL) antibiotics are widely prescribed for controlling bacterial infections and relevant culprits of adverse drug reactions (ADRs). BL allergy may vary according to prescription patterns within a given period of time. However, BL allergy in contemporary clinical practice has rarely been a focus of research. Methods: To investigate the clinical characteristics of BL allergy, subjects with ADRs to medicines, including BL antibiotics, were retrospectively reviewed. Results: Among the 175 enrolled subjects, BL antibiotics as culprits were confirmed in 79 (45.1%, female 53.2%, age 49 ± 14 years). Among the patients with confirmed BL allergy, only two (2.5%) were diagnosed via a prescription survey completed as part of multi-drug administration. The others were confirmed by serologic tests in 33 patients (41.8%), skin tests in 29 (36.7%), and drug provocation tests in 15 (19.0%). Regarding the symptoms and signs, onset within an hour of taking medicines was common (61 patients, 77.3%). Itchy skin was most common, followed by hives, rash, breathing difficulty, angioedema, and hypotension. Anaphylaxis occurred in 67%, and one-half (50.6%) of patients visited the emergency room. Cefaclor and amoxicillin were common BL culprits. Among others who did not have BL allergy, nonsteroidal anti-inflammatory drugs were found to be common culprits, followed by quinolones. Conclusions: BL allergy is common among patients who experienced ADRs to medicines including BL antibiotics. For multi-drug administration, a prescription survey hardly helped in confirming BL allergy. Anaphylaxis is common in patients with BL allergy, frequently leading to emergency room visits. Cefaclor and amoxicillin are common culprits. (Korean J Med 2021;96:42-47)
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김지영 ( Ji Young Kim ),이재천 ( Jaechun Lee ),이종후 ( Jong Hoo Lee ),성길명 ( Gil Myeong Seong ),정선영 ( Sun Young Jeong ),현창림 ( Chang Lim Hyun ) 대한천식알레르기학회 2012 천식 및 알레르기 Vol.32 No.1
Background: Asthma is characterized by the symptoms of breathlessness, wheezing, chest tightness and cough, and variable airflow limitations that are reversible spontaneously or with treatment. The symptoms may be exacerbated by aggravating factors, such as exercise. Case History: A 45 year old female patient presented at our clinic with breathlessness, chest tightness, wheezing and cough, especially during and after exercise. She visited regional hospitals, had undergone diagnostic bronchial provocation tests with methacholine and exercise, and had received medical treatments for asthma. Results: At presentation, spirometry exhibited an abnormal flow-volume curve, which was confirmed as large airway narrowing by chest computed tomography and bronchoscopic examination. Pathologic examination revealed focal calcification under the normal airway surface without inflammation. Conclusion: We report the case of idiopathic tracheobronchial stricture in a patient with asthma-mimicking symptoms. (Korean J Asthma Allergy Clin Immunol 2012;32:61-65)
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Ti<sub>0.3</sub>Zr<sub>0.2</sub>V<sub>0.5</sub> 합금의 수소흡수 특성에 미치는 수소화물의 영향
이동진,박제신,서창열,이재천,김원백,Lee Dongjin,Park Jeshin,Suh Changyoul,Lee Jaechun,Kim Wonbaek 한국재료학회 2005 한국재료학회지 Vol.15 No.5
The hydrogen sorption properties of $Ti_{0.3}Zr_{0.2}V_{0.5}$ NEC(non-evaporable getter) alloy and its hydrides were evaluated at room temperature. The alloy and hydride powders were prepared by the Hydride-DeHydride(HDH) method. The hydrogen sorption speed of $Ti_{0.3}Zr_{0.2}V_{0.5}$ alloy was measured to increase with the amounts of hydride phase in the getter. The hydrogen sorption speeds of $Ti_{0.3}Zr_{0.2}V_{0.5},\;(Ti_{0.3}Zr_{0.2}V_{0.5})H_{1.52},\;and\;(Ti_{0.3}Zr_{0.2}V_{0.5})H_{1.94}$ were 2.22, 3.14 and 5.08 liter/sec, respectively. The unexpected enhancement of hydrogen sorption speed with the presence of the hydride phase is considered to be due to the pre-saturation of hydrogen trap sites which can retard the diffusion of hydrogen in the alloy.
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