Increased B cell-activating factor (BAFF) level in the sputum of children with asthma

지혜미,최봉석,김경원,손명현,한만용,김규언 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.8

Purpose: B cell-activating factor (BAFF) is a tumor-necrosis factor (TNF) superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is observed in naïve cells as well as in effector/memory T cells. We aimed to explore whether BAFF in sputum is expressed at elevated levels in asthmatic airways and associated with eosinophilic inflammation, pulmonary function, and bronchial hyperresponsiveness in children. Methods: One hundred and fifty-four asthmatic children and 98healthy children were enrolled in the study. Sputum supernatants were collected and sputum BAFF and eosinophil cationic protein (ECP)levels were measured. We performed pulmonary function tests and methacholine challenge tests, while measuring total eosinophil count,total serum IgE, and serum ECP in all subjects. Results: Asthmatic children had significantly higher levels of BAFF in induced sputum [26.50 (10.50-100.27) pg/mL] compared to healthy children [18.32 (7.68-44.63) pg/mL; P=0.011]. Sputum BAFF positively correlated with sputum eosinophils (γ=0.406, P<0.001) and sputum ECP (γ=0.789, P<0.001). Significant negative correlations were found between sputum BAFF and FEV1 (γ=-0.291, P<0.001) or postbronchodilator FEV1 (γ=-0.334, P<0.001), whereas nonsignificant correlations were found between sputum BAFF and bronchial hyperresponsiveness, serum eosinophil count, and serum ECP. Conclusion: These findings suggest that BAFF may play a role in childhood asthma, and BAFF levels in sputum could be a supportive marker that represents airway inflammation, especially eosinophilic inflammation.

알레르기비염과 위생가설

지혜미,김민지,김현희,김효빈,나영호,박 양,성명순,신윤호,염혜영,이경석,이용주,전윤홍,최봉석,최선희,박용민,대한 소아알레르기 호흡기학회 비염 연구회 대한 소아알레르기 호흡기학회 2024 Allergy Asthma & Respiratory Disease Vol.12 No.1

The hygiene hypothesis, first proposed in 1989, suggested that reduced exposure to infections in early life leads to allergic diseases by the defects in the establishment of immune tolerance. Although many studies provided evidence that some exposure conditions, including family size, antibiotics, probiotics, and viral or bacterial infections, are strongly related to the prevalence of allergic diseases, thereby supporting the hygiene hypothesis, some evidence does not provide acceptable results for the hygiene hypothesis. Further, most studies have focused on patients with asthma or atopic dermatitis, not allergic rhinitis. In this review, we summarize the recent studies for and against the ‘hygiene hypothesis’ and identify causal association with the prevalence of allergic rhinitis. .

Effects of Regularly Performed Walking on the Bilateral Limb Compositions of Post-Stroke Korean Men

지혜미 국제물리치료연구학회 2018 Journal of International Academy of Physical Ther Vol.9 No.1

The purpose of this study was to examine the effects of hemispheric damage in body composition of male adults with stroke experiences. The Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES) with body composition results obtained from the DXA (dual-energy X-ray absorptiometry) assessments were used for this study. Survey data of 18 post-stroke men and 28 healthy controls were obtained. Both the lean and fat masses of the upper and lower limbs were utilized to compare for the compositions between the limbs in post-stroke subjects. In addition, the effect of exercise habit was also observed for the influence of physical activity in body composition. Mixed results in left and right limb compositions were shown between the groups. When the subjects were further divided based on walking days per week, sedentary (walk ≤2 d/wk) post-stroke group showed significantly greater fat mass and less lean mass than the physically active people (walk ≥ 3d/wk). In comparison to the healthy sedentary and physically active controls, two post-stroke groups showed greater variations. The results indicate that physical activity maintains or improve the quality of both the upper and lower limb composition in patients with post-stroke men.

2006년 초등학생의 알레르기 질환 유병률의 전국적 역학조사

지혜미,김경원,김창수,손명현,신동천,김규언 대한 소아알레르기 호흡기학회 2009 Allergy Asthma & Respiratory Disease Vol.19 No.2

Purpose : The prevalence and morbidity of asthma, allergic rhinitis and atopic dermatitis are increasing worldwide. The International Study of Asthma and Allergies in Childhood (ISAAC) was a standardized method to evaluate the prevalence of these diseases, and to compare it between countries. Using the standardized protocol, proposed by ISAAC Steering Committee, the prevalence of allergic diseases in Korean children was reported in 1995 and 2000. In this study, we aimed to evaluate the prevalence and changing patterns of morbidity of allergic diseases in Korean children for recent 10 years. Methods : From October 2006 to November 2006, Korean ISAAC written questionnaires were completed by the parents of 37,365 children attending 438 elementary schools in Seoul and 14 provinces. The questionnaires consisted of the questions about wheezing, rhinitis and eczema. Results : The prevalences of "wheeze, ever", "wheezing, last 12 months", "diagnosis of asthma, ever" and "treatment of asthma, last 12 months" were 10.53%, 4.7%, 7.81% and 2.51%, respectively. The prevalences of "rhinitis, ever", "rhinitis, last 12 months", "diagnosis of allergic rhinitis, ever" and "treatment of allergic rhinitis, last 12 months" were 37.7%, 32.8%, 27.94% and 21.44%, respectively. And prevalences of "itchy eczema, ever", "itchy flexural eczema, last 12 months", "diagnosis of atopic dermatitis, ever" and "treatment of atopic dermatitis, last 12 months" were 20.99%, 15.91%, 28.22% and 13.91%, respectively. Conclusion : From the results of this study, the prevalence of asthma decreased slightly compared to previous studies. In contrast, the prevalences of allergic rhinitis and atopic dermatitis are still increasing in Korean children in 2006. 목 적 : 세계적으로 최근 알레르기질환의 발생이 증가추세를 보이고 있으며 이에 국가 간의 유병률 비교를 위한 국제적 ISAAC 연구가 진행되었다. 국내에서도 국제 ISAAC 연구에 동참하여 1995년과 2000년에 초등학생과 중학생을 대상으로 전국적 역학조사를 수행하였다. 본 연구는 2006년 전국적 역학조사를 통하여 우리나라 초등학생의 알레르기질환의 유병률과 그 변화추이를 알아보고자 하였다. 방 법 : 2006년 가을철(10-11월)에 전국 15개 지역 438개교 초등학생 37,365명을 대상으로 천식, 아토피피부염, 비염에 대하여 ISAAC 연구와 동일한 내용의 설문지를 이용하여 역학조사를 시행하였다. 설문지는 대상 초등학생의 학부모가 답변하도록 하였다. 결 과 : 설문조사의 응답률은 66.5%였다. 설문조사에 응답한 초등학생의 연령은 6세에서 13세(평균 10.65±1.34세)였으며 남아가 43.62%, 여아가 56.38%였다. 천식의 경우 “일생 동안 천명의 유병률”은 10.53%, “지난 12개월 동안 천명”의 유병률은 4.7%, “일생 동안 천식 진단”의 유병률은 7.81%, “최근 1년간 천식 치료”의 유병률은 2.51%였다. 아토피피부염의 경우 “일생 동안 아토피피부염의 가려운 증상”의 유병률은 20.99%, “지난 12개월 동안 접히는 부위의 가려운 피부염 증상” 유병률은 15.91%, “일생 동안 아토피피부염의 진단” 유병률은 28.22%, “최근 1년간 아토피피부염으로 치료”받은 유병률은 13.91%를 나타내었다. 비염의 경우 “일생 동안 비염 증상”의 유병률은 37.7%,“지난 12개월 동안 비염 증상”의 유병률은 32.8%, “일생 동안 알레르기비염 진단” 유병률은 27.94%, “최근 1년간 알레르기비염 치료” 유병률은 21.44%를 나타내었다. 결 론 : 2006년 우리나라 초등학생의 천식의 유병률은 이전에 비해 감소하였고 알레르기비염과 아토피피부염의 유병률은 증가하였다. 이는 전세계적인 알레르기 질환의 유병률 변화추이와 유사한 결과를 보였다.

Physical activity trajectories of different grade levels of male adolescents in association of academic performance and mental health

지혜미 한국운동재활학회 2023 JER Vol.19 No.5

Regularly performed daily moderate to vigorous physical activity (PA) is recommended to promote physical and mental health in adolescents. However, sedentary behavior has been reported with ever-increasing demand for competition without clear understanding of the relationship between PA and mental health and academic performance. Therefore, this study observed the changes in the amount PA in 6 grade levels in relation to mental health and academic performance. This study analyzed the amount of moderate and vigorous PA, sedentary time, mental health, and academic performance in male adolescents of 6 middle to high school grade levels by sedentary group (SG: 2 or less min/wk) and physical activity group (PG: 3 or more min/wk) groups depending on the days of weekly PA. The most weekly moderate and vigorous PA duration significant reduced by 29.4% (*P< 0.01) and -43.8% (*P< 0.01) for H2 in comparison to M1 in SG. The greatest increase in sitting duration 744.95±470.27 min/wk (*P<0.01) was shown by SG. Significant increase in loneliness degree was shown throughout the grade levels of M3 to H3 (2.41±1.08 to 2.50±1.06, *P<0.01) in SG. Degree of stress also significantly increased from M3 to H3 (2.69±0.98, *P<0.01 to 2.90±0.96, *P<0.01) in SG. Finally, perceived academic performance by the days of PA did not show clear difference between SG and PG. In conclusion, regularly performed PA male adolescents showed greater duration of moderate and vigorous PA without negatively influencing mental health and academic performance. Moreover, well controlled academic performance and sitting duration were shown.

Comparisons of Quality of Life and Asymmetric Atrophy in Regularly Walking Elderly Female Stroke Survivors

지혜미 국제물리치료연구학회 2018 Journal of International Academy of Physical Ther Vol.9 No.4

Regularly participating in physical activity is known to improve quality of life and body composition in elderly with stroke. However, comparatively less physical activity is performed by the stroke survivors. The factors related to inactivity in elderly female stroke survivors have not been elucidated. Therefore, this study aims to compare the quality of life factors and limb compositions between the active and inactive elderly female stroke survivors. Forty nine subjects between the ages of 65 to 75 years were selected from the KNHANES data between the years 2009 to 2011. In addition, 186 agematched healthy peers were also selected for limb composition comparisons. The subjects were groups based on walking days per week: walkers; 3 days or more, non-walkers; less than 3 days per week. BMI and waist circumference were within the obesity ranges for both the non-walkers and walkers. As results, the trend for greater fat (±10%) and lean mass (±30%) differences were observed for non-walker and walkers, respectively. Significantly greater reasons for function limitation by stroke and hypertension were reported with significantly greater self-care difficulty was shown by the walkers. In conclusion, elderly female stroke survivals may require customized motivation and continuous support to participate in physical activity regularly.

항원특이면역요법을 위한 집먼지진드기 알레르기비염 마우스 모델의 효용성

지혜미 대한 소아알레르기 호흡기학회 2022 Allergy Asthma & Respiratory Disease Vol.10 No.4

. 알레르기비염은 아토피피부염, 천식 등과 함께 대표적인 알레르기질환 중 하나이다. 일반 인구의 10%–25%가 알레르기비염을 가지고 있는 것으로 보고되고 있으며, 콧물, 코막힘, 코가려움, 재채기 등이 주 증상이다.1 여러 알레르기질환은 유사한 발병기전, 증상 등을 보이면서 서로 연관되어 있는 특성이 있으며 알레르기비염을 가지고 있는 소아에서 천식으로 이행될 확률이 약 40% 정도로 보고되고 있다.2,3 따라서 하나의 치료가 여러 알레르기질환에 공통된 발병 기전을 억제하게 되면 동시에 여러 질환을 조절하기에 상당히 도움이 될 수 있다. 예를 들어, 천식이 동반된 알레르기비염 환자에서 류코트리엔조절제(leukotriene receptor antagonist) 복용은 두 질환에 모두 효과를 기대할 수 있어 천식과 알레르기비염 치료 가이드라인에서 모두 권장하고 있는 치료 방법이다.4

영유아 감기치료 약물의 효과와 안전성

지혜미,최선희,한만용 대한의사협회 2010 대한의사협회지 Vol.53 No.1

Common cold is a conventional term for a mild upper respiratory illness characterized by symptoms of nasal stuffiness, rhinorrhea, sneezing, sore throat, and cough. Management of the common cold is intended to provide temporary relief of symptoms until the cold completes its natural history, as well as to reduce the risk of complications. However, most studies for cold preparations focus on adults, and there are limited and conflicting evidences for children. Various preparations for cough/cold are available, which include antihistamines, decongestants,antitussives, expectorants, analgesics/antipyretics, and some combination products. Nonpharmacologic therapies are also important and it is generally agreed that such supportive cares should form the mainstay of treatment for children with common colds. Adverse effects of the specific types of cold preparations should be considered carefully for very young children. In addition, it is very important to educate parents about the natural course of common cold, along with appropriate use correct dosages and potential adverse effects of cold preparations.

소아 요로감염에서 Escherichia coli의 빈도와 항생제 감수성에 대한 연구

지혜미,곽재혁,이준호,박혜원,Chi Hye-Mi,Kwahk Jae-Hyok,Lee Jun-Ho,Park Hye-Won 대한소아신장학회 2006 Childhood kidney diseases Vol.10 No.1

목적 : 요로감염은 조기 진단 및 치료를 적절히 하지 않으면 비가역적 신손상, 패혈증 등을 유발하므로 원인 균주를 알기 전에 경험적 항생제 요법을 시행하는 것이 중요하다. 따라서 경험적 항생제의 적절한 선택을 위하여 원인 균주의 분포와 임상특징을 알아보고, 원인 균주의 대부분을 차지하는 E. coli의 항생제 감수성 정도에 대해 알아보고자 하였다. 방법 : 2004년 2월부터 2005년 2월까지 발열을 주소로 분당차병원 응급실과 소아과 외래를 방문하여 요로감염으로 진단된 환아 103명을 대상으로 요 배양검사 결과, 성별, 연령, DMSA 신스캔상 결손 유무, 방광 요관 역류 유무, 6개월이내 재발 여부 등을 후향적으로 조사하고 원인 균주 중 가장 흔한 균인 E. coli에 대해 항생제 감수성 정도를 분석하였다. 결과 : 103명의 환아 중 92명(89.3%)이 E.coil에 의한 요로감염이었으며 ESBL 생성 E.coli는 3명(3.3%)에서 동정되었다. E. coli의 항생제 감수성 조사 결과 AMP, AMS, SXT는 각각 27.2%, 34.8%, 65.2%로 낮은 감수성을 보였으며 cephalosporin계 항생제는 1세대 cephalosporin인 cefazoline이 91.3%, 2세대인 cefoxitin이 100%, 3세대인 ceftriaxone 97.8%를 보여 대부분 매우 높은 감수성을 나타내었다. 또한 AMP와 SXT의 경우 연령이 1세 이상일 경우 1세 미만인 경우에 비해 내성의 위험이 증가하였다. 결론 : 1세 이상의 환아에서는 소아과 외래에서 흔히 사용하는 AMP, SXT에 대한 내성발생의 위험이 증가하므로 3세대 cephalosporin계 항생제를 초기 경험적 치료에 사용하는 것이 권장되나, ESBL 생성 E. coli에 대한 지속적인 조사와 발생 위험 요인에 대한 연구가 더욱 필요하다. Purpose : Empirical antimicrobial treatment is indicated before bacteriological results are available for young children with febrile UTI to minimize renal scarring. To ensure appropriate therapy, knowledge of the prevalence of causative organisms and their susceptibility patterns to antimicrobials is mandatory. We performed a retrospective analysis investigating the local prevalence and resistance patterns of uropathogens, primarily E. coli, isolated from community-acquired UTIs. Methods : A total of 103 positive urine cultures from children with febrile UTI collected at Bundang CHA General Hospital from February 2004 to February 2005 were analyzed. Inclusion criteria were fever higher than $37.5^{\circ}C$, significant bacteriuria with single strain growth of at least 10s colony forming units/mL urine, and leukocyturia >5/HPF. Results : E. coli(89.3%) was the leading uropathogen followed by Enterococcus spp.(3.9%) Klebsiella spp.(2.9%), Citrobctcter spp.(1.9%) and Enterobacter spp.(1.9%). E. coli strains revealed a low proportion of antimicrobial susceptibility to ampicillin(AMP; 27.2%) ampicillinsulbactam(AMS; 34.8%) and trimethoprim-sulfamethoxazole(SXT; 65.2%). Susceptibility patterns to cephalosporins were as follows; cefazolin(1st generation; 91.3%), cefoxitin(2nd; 100%), ceftriaxone(3rd; 97.8%) and cefepime(4th; 97.8%). Three E. coli isolates produced ex tended - spectrum beta-lactamase(ESBL). Conclusion : Empirical treatment with AMP, AMS and SXT, which are commonly used in pediatric clinics, is not recommended for childhood UTI due to high incidence of resistance. The high level of susceptibility to cephalosporins makes these drugs reasonable alternatives. However the emergence of ESBL-producers, even though they are quite few, may have an impact on cephalosporin treatment in the future. (J Korean Soc Pediatr Nephrol 2006;10:18-26)

Development and Application of Biological Age Prediction Models with Physical Fitness and Physiological Components in Korean Adults

지혜미,전병환,박재현,진영수 KARGER 2012 Gerontology Vol.58 No.4