수족냉증 환자의 실태 및 HRV(Heart Rate Variability)를 이용한 자율신경계 기능 평가 연구

김은숙,황재호,이진무,이창훈,조정훈,장준복,이경섭,최재호,Kim, Eun-Sook,Hwang, Jae-Ho,Lee, Jin-Moo,Lee, Chang-Hoon,Cho, Jung-Hoon,Jang, Jun-Bock,Lee, Kyung-Sub,Choi, Jae-Ho 대한한방체열의학회 2006 대한한방체열의학회지 Vol.5 No.1

Objectives : This study was designed to analyze basic data for cold hypersensitivity patients with a questionnaire and investigate correlation between cold hypersensitivity and Heart Rate Variability(HRV). Methods : 49 patients who complain of cold hypersensitivity on hands and feet in ambulatory care were investigated in Oriental Gynecology, Kyunghee Oriental Medical Center and Women medical center, Kangnam Koreana hospital from May 1, 2006 to October 20, 2006. All patients were asked to answer a questionnaire. After careful I examination to rule out other disease which may affect Digital Infrared Thermal Imaging(DITI) and HRV data, patients were taken thermography for the diagnosis of cold hypersensitivity Based on the result of thermography, the patients were divided into two groups(Objective cold hypersensitivity and Subjective cold hypersensitivity). Then, these two groups were compared using HRV data which was measured in the supine position for 5 minutes. Results: 1. For most patients, cold hypersensitivity first developed during puberty. 2. The parts of the body that felt cold first time were hands and feet. 3. The cold sensation was increased in winter or at bedtime Showing that the sensation can be changed according to the level of coldness. 4. Among women who sufferfrom cold hypersensitivity, very few of them were treated. 5. More than half of cold hypersensitivity patients's family member also had a cold hypersensitivity. 6. The decrease in mean values of LF/HF ratio was observed in objective cold hypersensitivity group than subjective cold hypersensitivity group and the decrease was significant(P=0.014) when examined by Student t-test. Conclusions : It is necessary that the cold hypersensitivity patients should be treated carefully considering the facts mentioned above. And it can be suggested that dysautinomia be related with cold hypersensitivity and be evaluated by HRV.

치주수술 후 상아질 지각과민증에 대한 저수준 레이저 처치의 임상적 효과

김남윤,임성빈,정진형,Kim, Nam-Yun,Lim, Sung-Bin,Chung, Chin-Hyung 대한치주과학회 1996 Journal of Periodontal & Implant Science Vol.26 No.1

Root surface exposure due to gingival recession after periodontal surgery, dentin exposure after root planing elicit pain response when exposed to mechanical, heat, chemical or osmotic stimulation. Especially, patients treated with periodontal surgery, show high frequency and there have been reports showing the 1 out of 7 patients have dentin hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentin hypersensitivity. but, none could provide absolute clinical efficacy. In this study, 45 teeth from 30 patients, who had had periodontal surgery and showed dentin hypersensitivity after surgery were chosen for the experimental group and they were illuminated with laser, 15teeth were chosen for the control group and they were not exposed to laser. After this dentin hypersensitivity was elicited by tactile, compressed air, cold water and then, the degree was evaluated using NRS(Numerical Rating Scale). And during LLLT(Low Level Laser Therapy) semiconductor laser using Gallium - Arsenide as a diode was illuminated for 180 seconds at a frequency of 7(500Hz). This therapy was done 10 times, and each time the changes in dentin hypersensitivity was evaluated using NRS. The results were as follows : 1. After treat with LLLT on dentin hypersensitivity due to periodontal surgery, 22.2% showed total loss of dentin hypersensitivity, 60.0% showed loss of tactile dentin hypersensitivity, 48.8% showed loss of compressed air dentin hypersensitivity, 22.2% showed loss of cold water dentin hypersensitivity. 2. As a result of clinical evaluation of dentin hypersensitivity using NRS, there was significant increase in improvement of dentin hypersensitivity in the experimental group compare to the control group(P<0.05). And there was almost no natural loss of dentin hypersensitivity in the control group. 3. In comparison of the stages of evaluation, there was significant difference in between experimental and control group. after the second visit(P<0.05), and the difference increased with each visit.

Cytokine Profile and Immunoglobulin E-mediated Serological Food Hypersensitivity in Patients With Irritable Bowel Syndrome With Diarrhea

( Ryo Katsumata ),( Manabu Ishii ),( Suni Lee ),( Yukiko Handa ),( Takahisa Murao ),( Minoru Fujita ),( Hiroshi Matsumoto ),( Takemi Otsuki ),( Akiko Shiotani ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.3

Background/Aims Food interaction, including food hypersensitivity, plays a key role in the pathogenesis of irritable bowel syndrome with diarrhea (IBS-D). Since only a few studies have been reported about the relationship between food hypersensitivity and IBS-D, we elucidate the prevalence of serological food hypersensitivity in patients with IBS-D and the characteristics of gastrointestinal symptoms and serum cytokine profiles in patients with IBS-D and serological food hypersensitivity. Methods Immunoglobulin E (Ig E)-mediated serological food hypersensitivity and serum cytokine levels were evaluated using the multiple allergen simultaneous test evaluating food allergen-specific serum IgE and Luminex Milliplex Panel containing multiple fluorescencelabeled beads. Class 2 or above was considered as IgE-mediated food hypersensitivity positive. The gastrointestinal symptom rating scale was used to evaluate symptoms. Results We enrolled 92 subjects, including 60 with IBS-D and 32 healthy controls. The percentages of patients with IgE-mediated serological food hypersensitivity were not significantly different between the groups (controls = 28.1% and IBS-D = 33.3%). Serum IL-1β, IL- 6, IL-8, macrophage inflammatory protein-1alpha, and TNF-α levels were higher in patients with IBS-D than in controls. Serum concentration of TNF-α (43.4 vs 21.8 pg/mL, P = 0.009) was higher in patients with IBS-D without IgE-mediated serological food hypersensitivity than those with food hypersensitivity. Conclusions One-third of Japanese patients with IBS-D showed IgE-mediated serological food hypersensitivity. The serum cytokine profile differed and was characterized by lower inflammatory cytokine levels in IBS-D with IgE-mediated serological food hypersensitivity. Serological test regarding IgE-mediated food hypersensitivity can detect a certain cluster of IBS-D. (J Neurogastroenterol Motil 2018;24:415-421)

Comparative Study on Pre-and Post-treatment of Cold Hypersensitivity Using D.I.T.I

Lee,Kyung-sub,Song,Byoung-key,Lee,Jin-moon INSTITUTE OF ORIENTAL MEDICINE KYUNG-HEE UNIVERSIT 1996 JOURNAL OF ORIENTAL MEDICINE Vol.1 No.1

Cold hypersensitivity is feeling cold at a temperature when one should not feel cold, and it is characterized by specialized areas of the body being excessively cold, to the extent that it is difficult to lead a normal life, as described by the Cold Hypersensitivity Syndrome. Hithero-up until now, the diagnosis, treatment effects, and observation of progress has depended only on the subjective expressions of the patients and the objectivity had been neglected. Recently, the objective diagnosis of Cold hypersensitivity has been made possible through the use of D.I.T.I.(Digital Infrared Thermographic Imaging). The purpose of this study is to objectify the changes of pre- and post-treatment of Cold hypersensitivity and visualize the effects of the treatment. The subjects were outpatients with Cold hypersensitivity who had visited the gynecology dept. of Boondang Oriental Hospital of Kyunghee Univ. from April 1995 to December 1995. Herbal treatment was mainly done, as well as Acupunture treatment and Moxibustion. The improvement of the clinical symptoms, the changes on D.I.T.I. of pre- and post-treatment and the correlation between them were studied. The results were as follows: The effect of treatment on Cold hypersensitivity in hands, feet assessed by D.I.T.I. was above Good in 68%, and in abdomen was above Good in 77%. The clinical results, after treatment, was above Good in 77% in the cases of Cold hypersensitivity in the hands and above Good in 76% in the case of Cold hypersensitivity in the feet, and above Good in 68% in the case of Cold hypersensitivity in the abdomen. D.I.T.I. had close correlations to clinical symptoms, in Cold hypersensitivity in hands, feet, and abdomen, of 82%, 84%, 91% respectively. These results suggest that D.I.T.I. is available in the objective determination of the observation of progress, and the effect of treatment in Cold hypersensitivity.

Contrast media-associated hypersensitivity reactions in Korea

( Hyun Jin Kang ),( Hyo Jin Park ),( Hyun Joon Chang ),( In Hye Choi ),( Kyung Ho Lee ),( Chul Jong Park ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Contrast media have been widely used for the diagnosis of numerous diseases. And the reported number of hypersensitivity reactions to contrast media has increased annually. Objectives: We aimed to investigate the incidence of hypersensitivity reactions due to intravenous nonionic contrast media and whether the risk of contrast media-associated hypersensitivity is increased by specific types of contrast agents. Methods: We performed a retrospective review of patients who had hypersensitivity reactions after enhanced computed tomography scans in our hospital, from January 2016 to December 2019. We classified hypersensitivity reactions into immediate (<1 hr) or delayed (≥1 hr) reactions. All data were obtained from the electronic medical records. Results: Among the 262 cases of hypersensitivity reactions to contrast media, 199 cases (76.0%) were immediate type while delayed type accounted for 63 cases (24.0%). The immediate hypersensitivity reaction incidence was not significantly different among contrast agents, but the incidence of the delayed type was significantly different. (ranging from 0.02% of iomeprol to 0.25% of iodixanol, P<0.05). Conclusion: Immediate hypersensitivity reaction occurred at a higher rate compared to that of delayed hypersensitivity. The incidence of delayed hypersensitivity reaction was significantly greater in patients who received iodixanol than those who received the other types.

Associations between HLA-A, -B, and -C alleles and iodinated contrast media– induced hypersensitivity in Koreans

김은영,최석진,Jong-Lyul Ghim,김미영,설정은,Minkyung Oh,Chan Sun Park,신재국 대한임상약리학회 2021 Translational and Clinical Pharmacology Vol.29 No.2

A common cause of drug hypersensitivity reactions is iodinated contrast media (ICM). ICM-induced hypersensitivity had been considered to be a non-immunological reaction,but evidence for an immunological mechanism has increased recently. Thus, we evaluatedwhether HLA-A, -B, and -C alleles were associated with ICM-induced hypersensitivity. Intotal, 126 patients who underwent contrast-enhanced computed tomography studies throughoutpatient clinics at a tertiary referral hospital between 2008 and 2012 were assessed. Sixty-one patients experienced ICM-induced hypersensitivity and the remainder, 65, wereICM-tolerant patients (control). ICM-induced hypersensitivity patients showed 51 withimmediate, 7 with non-immediate, 3 with both or mixed type. HLA-A, -B, and -C genotypingwas performed using a PCR sequence-based typing method. Four kinds of ICM were used:iopromide, iohexol, iobitridol, and iodixanol. The most used ICM among the hypersensitivitypatients was iopromide. Significant difference in the frequency of HLA-B*58:01 (odds ratios[OR], 3.90; p = 0.0200, 95% confidence interval [CI], 1.16–13.07) was observed betweenICM-induced immediate hypersensitivity and control. There were statistically significantdifferences in the frequencies of the HLA-B*38:02 (OR, 10.24; p = 0.0145; 95% CI, 1.09–96.14)and HLA-B*58:01 (OR, 3.98; p = 0.0348; 95% CI, 1.03–15.39) between iopromide-inducedimmediate hypersensitivity and control. The mechanism of ICM-induced hypersensitivityremains unknown, but this study showed associations, although weak, with HLA-B*58:01 allelesfor ICM-induced immediate hypersensitivity and HLA-B*38:02 and HLA-B*58:01 for iopromideinducedimmediate hypersensitivity as risk predictors. Further studies are needed to validate theassociations in larger samples and to identify the functional mechanism behind these results.

소아 급성 림프구성 백혈병 환자에서 치료 변경을 요하는 L-asparaginase 과민반응 발생률 및 관련 인자

노은의,이유진,홍석민,김성환,서성연,조윤숙,박현진,김보경,홍경택,최정윤,강형진,이주연 한국병원약사회 2023 병원약사회지 Vol.40 No.2

Background : Asparaginase is an important therapeutic agent in pediatric patients with acute lymphoblastic leukemia (ALL), but asparaginase-induced hypersensitivity reaction is one of the barriers to treatment completion. However, there have been limited studies investigating asparaginase-induced hypersensitivities in pediatric patients. The aim of this study was to investigate the incidence proportion and related factors of asparaginase- induced hypersensitivity reactions requiring treatment modification among pediatric patients with ALL. Methods : This cross-sectional study analyzed the pediatric ALL patients who received asparaginase treatment according to an in-hospital protocol between 2004-2021 at a single institution. The study calculated incidence proportions and treatment changes due to hypersensitivity reactions to different types of L-asparaginase. Risk factors of hypersensitivity were identified using generalized estimation equations. Results : Among the 269 eligible patients, 73 patients (27.1%) discontinued native E.coli asparaginase due to hypersensitivity. Hypersensitivity was observed with positive prior skin test before administration in 64 patients (23.8%) and allergic reaction after administration in 9 patients (3.3%). All of these patients switched to Erwina asparaginase but 10 patients (13.7%) among them showed hypersensitivity reactions to Erwina asparaginase. The related factors of asparaginase-induced hypersensitivity were identified as consolidation stage (odds ratio (OR) 14.70, 95% CI 1.70 – 126.99), long administration interval (OR 1.02, 95% CI 1.00 – 1.03), and high risk group for ALL (OR 3.35, 95% CI 1.21 – 9.27). Conclusion : The incidence proportion of hypersensitivity requiring treatment modification to Erwina asparaginase in pediatric patients was approximately 27%, and hypersensitivity reactions occurred in approximately 14% of patients after change to Erwina asparaginase. Consolidation stage, long administration interval, and high risk group for ALL were identified as related factors. Therefore, monitoring hypersensitivity reactions after asparaginase administration should be strengthened.

수종의 치근면 처치 방법에 따른 상아질 지각 과민 변화 및 표면 특성에 관한 연구

권순영,임성빈,정진형,Kwon, Soon-Young,Lim, Sung-Bin,Chung, Chin-Hyung 대한치주과학회 1999 Journal of Periodontal & Implant Science Vol.29 No.1

Exposure of the root surface due to gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical or osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate the effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed thet tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, and the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.

수부 냉증 정도와 Heart Rate Variability(HRV)의 상관성 연구

남은영 ( Eun Young Nam ),유수정 ( Su Jeoung Yoo ),김형준 ( Hyung Jun Kim ) 대한한방부인과학회 2015 大韓韓方婦人科學會誌 Vol.28 No.4

Objectives: Cold hypersensitivity has been regarded to be associated with Autonomic Nervous System (ANS). This study aims to investigate the indicator of cold hypersensitivity of hands and evaluate the correlation between indicator of coldness of hands and Heart Rate Variability (HRV). Methods: We studied 55 patients with cold hypersensitivity of hands who visited in SeMyung University Hospital from 17 August 2015 to 21 August 2015. Thermometer and VAS scale were used for the diagnosis of cold hypersensitivity. After careful examination to rule out other disease which may affect thermometer and HRV data, patients were taken thermometer, those with thermal difference between upper arm (L4) and palm(P8), also asked to answer a VAS scale of cold hypersensitivity of hands, VAS more than 4 were enrolled for evaluation. Results: There was significant correlation between L4-P8 temperature difference and VAS score of cold hypersensitivity. In HRV data, normalized high frequency (HF normal) was significantly correlated with L4-P8 temperature difference, which was objective indicator of cold hypersensitivity of hands. Conclusions: L4-P8 temperature difference using thermometer is objective indicator of cold hypersensitivity, based on VAS scale. Cold hypersensitivity is highly related with ANS, regulating body heat and temperature. HRV is considered to be widely used in cold hypersensitivity in hands for evaluation of ANS.

Standardization of diagnosis of cold hypersensitivity of hands and feet by D.I.T.I.

Lee, Kyung-Sub 대한한방체열의학회 2004 대한한방체열의학회지 Vol.3 No.1

Cold hypersensitivity means a condition feeling cold at a temperature when one should not feel so. Cold hypersensitivity has been diagnosed based on the patient's subjective complaints. But these days, cold hypersensitivity can be diagnosed by the help of D.I.T.I.(Digital Infrared Thermal Imaging) This study is designed to verify the validity of diagnosis of cold hypersensitivity by D.I.T.I. Thermographic findings of 100 outpatients who visited the Kangnam Korean Hospital, KyungHee University, Seoul, Korea, from June 2000 to November 2000 were analyzed. The experimental group consisted of 50 patients who complained cold hypersensitivity, and for the control group, 50 patients who did not complain cold hypersensitivity. For the diagnosis of cold hypersensitivity of the hands, thermographic measurements were performed on two pairs of areas(palm-upper arm and back of hand-upper arm). And for that of the feet, other two pairs of areas(anterior thigh-top of the feet and posterior thigh-heel). When the criterion for thermal deviation between the palm and the upper arm was appointed as higher than $0.3^{\circ}C$, the sensitivity was 94.0% and the specificity, 90.0%. And when the criterion for that between the anterior thigh and the top of feet was appointed higher than $2.0^{\circ}C$, the sensitivity was 94.0% and the specificity, 76.0%. Through this study, the diagnostic standard for cold hypersensitivity of hands and feet could be presented.