• Title/Summary/Keyword: 기관지천식

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Clinical Investigation of 11 Cases of Chronic Eosinophilic Pneumonia Reported in Korea (국내에서 보고된 만성 호산구성 폐렴 11예에 대한 임상적 고찰)

  • Woo, Ka-Eun;Chang, Jung-Hyun;Choi, Young-Ah;Joo, Mi-Soon;Seo, Ki-Youl;Shin, Tae-Rim;Cheon, Sean-Hee;Cho, Young-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.107-115
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) presents with profound systemic symptoms, including fever, malaise, night sweats, weight loss, and anorexia together with localized pulmonary manifestations such as cough, wheeze, and sputum. It is an illness occurring predominantly in women. The chest radiogragh shows fluffy opacities that often have a characteristic peripheral configuration. The hallmark of CEP is the peripheral blood eosinophilia and a prompt response to oral corticosteroid therapy. We investigated characteristics of eleven patients of chronic eosinophilic pneumonia, reported in Korea. Method: There were eleven reports of CEP from 1980 to 1996, including three cases experienced in our hospital. The journals were analysed in respects of clinical history, laboratory, and radiographic findings. Results: 1) Male vs. female ratio is 3 : 8. The peak incidence occurred in forty and fifty decades. The atopic diseases were present in 6 cases. Asthma was the commonest manifestation 2) The presenting symptoms were as follows: cough, dyspnea, sputum, weight loss, fever, general weakness, night sweats, urticaria with the descending incidence. 3) Peripheral blood eosinophilia was present in all patients(mean ; 38.4%) and serum IgE level was elevated in nine patients(mean ; 880IU/ml). Conclusion: The diagnosis of chronic eosinophilic pneumonia is based on classic symptoms, including fever, night sweats, weight loss with a typical roentgenogram of peripheral pulmonary infiltrates and peripheral blood eosinophilia, and that is confimed by lung biopsy and/or bronchoalveolar lavage. Chronic eosinophilic pneumonia is responsive to corticosteroid promptly and recommended at least 6 months of therapy to prevent relapse.

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The Effect of Dexamethasone on Airway Goblet Cell Hyperplasia and Inflammation in $TiO_2$-Treated Sprague-Dawley Rats ($TiO_2$로 처치된 백서에서 기도내 배상세포 증식과 염증에 대한 Dexamethasone의 효과)

  • Lim, Gune-Il;Kim, Do-Jin;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.37-48
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    • 2000
  • Backgrounds : The pathophysiology of chronic airflow obstruction, such as bronchial asthma, is characterized by mucus hypersecretion, goblet cell hyperplasia(GCH), smooth muscle hypertrophy, and inflammatory cells infiltration. In fatal asthma patients, one distinct findings is mucus hypersecretion due to GCH. However, the mechanisms of GCH in these hypersecretory diseases remain still unknown. In this study, a rat model was rapidly induced with GCH by instillation of $TiO_2$, intratracheally. We intend to confirm GCH and association of concomitant inflammatory cells infiltration and to observe the effect of potent antiinflammatory agent, that is dexamethasone, on GCH with inflammatory cells. Methods : Twenty-one 8-weeks-old male Sprague-Dawley rats were divided into three groups. Endotoxinfree water was instilled intratracheally in group 1(control) ; $TiO_2$, was instilled in the group 2 ; and dexamethasone was injected intraperitoneally to group 3 before $TiO_2$ instillation. After 120 hours, all rats were sacrificed, and trachea, bronchi, and lungs were resected respectively. These tissues were made as paraffin blocks and stained as PAS for goblet cells and Luna stain for eosinophils. We calculated the ratio of goblet cell to respiratory epithelium and number of infiltrated eosinophils from each tissue. Results : (1) Fraction of goblet cells was significantly increased in group 2 than in group 1 in the trachea and in the main bronchus. (10.19$\pm$11.33% vs 4.09$\pm$8.28%, p<0.01 and 34.09$\pm$23.91% vs 3.61$\pm$4.84%, p<0.01, respectively). (2) Eosinophils were significantly increased in the airway of group 2 than that of group 1. (5.43$\pm$3.84% vs 0.17$\pm$0.47 in trachea and 47.71$\pm$16.91 vs 2.71$\pm$1.96 in main bronchi). (3) There was a positive correlation between goblet cells and eosinophils(r=0.719, p=0.001). (4) There was significant difference in the decrease of goblet cells after dexamethasone injection between group 2 and group 3 (p<0.01). Also, infiltration of eosinophils was suppressed by dexamethasone. Conclusion : We made an animal model of $TiO_2$-induced goblet cell hyperplasia. GCH was observed mainly in the main bronchi with concomitant eosinophilic infiltration. Both goblet cell hyperplasia and eosinophilic infiltration were suppressed by dexamethasone. This animal model may serve as a useful tool in understanding of the mechanism of GCH in chronic airway diseases.

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Effects of FK224, a $NK_1$ and $NK_2$ Receptor Antagonist, on Plasma Extravasation of Neurogenic Inflammation in Rat Airways (미주 신경의 전기적 자극으로 유발된 백서의 기도내 혈장 유출에 대한 FK224의 효과)

  • Shim, Jae-Jeong;Lee, Sang-Yeub;Lee, Sang-Hwa;Park, Sang-Myun;Seo, Jeong-Kyung;Cho, Jae-Yun;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.744-751
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    • 1995
  • Background: Asthma is an inflammatory disease because there are many inflammatory changes in the asthmatic airways. Axon reflex mechanisms may be involved in the pathogenesis of asthma. Sensory neuropeptides are involved in this inflammation, which is defined as neurogenic inflammation. Substance p, neurokinin A, and neurokinin B may be main neuropeptides of neurogenic inflammation in airways. These tachykinins act on neurokinin receptors. Three types of neurokinin receptors, such as $NK_1$, $NK_2$, and $NK_3$, are currently recognized, at which substance p, neurokinin A, and neurokinin B may be the most relevant natural agonist of neurogenic inflammation in airways. The receptor subtypes present in several tissues have been characterized on the basis of differential sensitivity to substance p, neurokinin A, and neurokinin B. Plasma extravasation and vasodilation are induced by substance p more potently than by neurokinin A, indicating NK1 receptors on endothelial cells mediate the response. But airway contraction is induced by neurokinin A more potently than by substance P, indicating the $NK_2$ receptors in airway smooth muscles. These receptors are used to evaluate the pathogenesis of brochial asthma. FK224 was identified from the fermentation products of Streptomyces violaceoniger. FK224 is a dual antagonist of both $NK_1$ and $NK_2$ receptors. Purpose: For a study of pathogenesis of bronchial asthma, the effect of FK224 on plasma extravasation induced by vagal NANC electrical stimulation was evaluated in rat airway. Method: Male Sprague-Dawley rats weighing 180~450gm were anesthetized by i.p. injection of urethane. Plasma extravasation was induced by electrical stimulation of cervical vagus NANC nerves with 5Hz, 1mA, and 5V for 2 minutes(NANC2 group) and for sham operation without nerve stimulation(control group). To evaluate the effect of FK224 on plasma extravasation in neurogenic inflammation, FK224(1mg/kg, Fujisawa Pharmaceutical Co., dissolved in dimethylsulphoxide; DMSO, Sigma Co.) was injected 1 min before nerve stimulation(FK224 group). To assess plasma exudation, Evans blue dye(20mg/kg, dissolved in saline) was used as a plasma marker and was injected before nerve stimulation. After removal of intravascular dye, the evans blue dye in the tissue was extracted in formamide($37^{\circ}C$, 24h) and quantified spectrophotometrically by measuring dye absorbance at 629nm wavelength. Tissue dye content was expressed as ng of dye per mg of wet weight tissue. The amount of plasma extravasation was measured on the part of airways in each groups. Results: 1) Vagus nerve(NANC) stimulation significantly increased plasma leakage in trachea, main bronchus, and peripheral bronchus compared with control group, $14.1{\pm}1.6$ to $49.7{\pm}2.5$, $17.5{\pm}2.0$ to $38.7{\pm}2.8$, and $12.7{\pm}2.2$ to $19.1{\pm}1.6ng$ of dye per mg of tissue(mean ${\pm}$ SE), respectively(p<0.05). But there was not significantly changed in lung parenchyma(p>0.05) 2) FK224 had significant inhibitory effect upon vagal nerve stimulation-induced airway plasma leakage in any airway tissues of rat,such as trachea, main bronchus, and peripheral bronchus compared with vagus nerve stimulation group, 49%, 58%, and 70%, respectively(p<0.05). Inhibitory effect of FK224 on airway plasma leakage in neurogenic inflammation was revealed the more significant in peripheral bronchus, but no significant in lung parenchyma. Conclusion: These results suggest that FK224 is a selective NK receptor antagonist which effectively inhibits airway plasma leakage induced by the endogenous neurotransmitters relased by neurogenic inflammation in rat airway. Tachykinin receptor antagonists may be useful in the treatment of brochial asthma.

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Clinical Analysis of Acute Respiratory Tract Infections by Influenza Virus in Children (인플루엔자 바이러스에 의한 소아 급성 호흡기 감염증의 유행 및 임상 양상)

  • Kwon, Min Kyoung;Kim, Mi Ran;Park, Eun Young;Lee, Kon Hee;Yoon, Hae Sun;Kim, Kwang Nam;Lee, Kyu Man
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1519-1527
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    • 2002
  • Purpose : Although influenza virus is one of the most important causes of acute respiratory tract infections(ARTIs) in children, virus isolation is not popular and there are only a few clinical studies on influenza in Korea. We evaluated the epidemiologic and clinical features of ARTIs by influenza virus in children. Methods : From February 1995 to August 2001, nasopharyngeal aspirations were obtained and cultured for the isolation of influenza virus in children admitted with ARTIs. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Respiratory viruses were isolated in 997(22.0%) out of 4,533 patients examined, and influenza virus was isolated in 164 cases(3.6%). Influenza virus was isolated year after year mainly from December to April of next year. The ratio of male and female was 1.9 : 1 with a median age of 15 months. The most common clinical diagnosis of influenza virus infection was pneumonia, and fever and cough developed in most patients. There was no difference between influenza A and B infection in clinical diagnoses and symptoms. All patients recovered without receiving antiviral treatment except for one patient diagnosed with pneumonia who had underlying disease of Down syndrome with ventricular septal defect. Conclusion : ARTIs caused by influenza virus developed every winter and spring during the period of study. Because fatal complication can develop in the high risk group, prevention, early diagnosis and proper management of influenza should be emphasized.

The effects of pear phenolic compound and herbal drugs on tension of the tracheal smooth muscle, eosinophil and interleukin-4 in mouse model of allergic bronchial asthma induced by ovalbumin (배(리(梨)) 추출 Phenolic Compound 및 길경(桔梗) 행인(杏仁) 배합 투여가 Ovalbumin으로 유발된 천식 동물 모델에서 기관지 평활근 장력, 호산구 및 IL-4에 미치는 영향)

  • Jeong, Jong-Gil;Youn, Dae-Hwan;Na, Chang-Su
    • The Korea Journal of Herbology
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    • v.22 no.2
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    • pp.25-33
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    • 2007
  • Objectives : Oriental pear was used as treatment of asthma, control of blood pressure, diabetes in oriental medicine. The aim of this study was to observe the effects of Phenolic compound extracted from pear and herbal drugs to treat asthma. Methods : In order to study the effect of oral administration of phenolic compound extracted from pear and herbal drugs(Platycodon grandiflorum, Prunus armeniaca) on allergic asthma, mice were pre-treated by oral administration of the solution before antigen sensitization four times for 8 days. 2 days later, mice were actively sensitized with a subcutaneous injection of ovalbumin and 13 days later, they were provoked with ovalbumin aerosols. The animals were divided into four groups; Saline, orally administered saline. PC-A, orally administered Phenolic compound extracted from pear peel 10mg/kg/ml. PC-B, orally administered Phenolic compound extracted from pear peel and flesh 10mg/kg/ml. PC-C, orally administered pear 10m/kg/ml, Platycodon grandiflorum 24.4 mg/kg/ml and Prunus armeniaca 33.3 mg/kg/ml. Serum level of IgE, IL-4, cell numbers in the bronchoalveolar lavage fluid(BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to acetylcholine(ACh, $0.1-1000{\mu}M$), KCl were measured. Results : Contractile responses of TSM to ACh were decreased in PC-A group at Ach 0.1, 0.3, 1 ${\mu}M$, decreased in PC-B at 0.1 ${\mu}M$ and decreased in PC-C at 0.1, 0.3, 1, 10, 30 ${\mu}M$. The maximal contractile response of TSM to KCl was decreased in PC-C group, The cell numbers of eosinophil in BALF were decreased in PC-C group, and those of macrophages in BALF were decreased in PC-A and PC-C group. Interleukin-4 in BALF was decreased in PC-A, PC-B, PC-C group. Conclusion : Based on the above results it is assumed that oral administration of phenolic compound extracted from pear and herbal drugs can help the treatment of deficiency allergic Asthma.

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Effects of Phyto-Extract Mixture (PEM381) in Type I Allergic Reaction-Induced Mice (제 I 형 알레르기 반응이 유도된 생쥐에서 식물추출 복합물(PEM381)의 효과)

  • Kim, Kyung-Bum;Park, Jeong-Su;Jeong, Jong-Moon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.11
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    • pp.1377-1384
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    • 2007
  • A previous study suggested that the phyto-extract mixture (PEM381) containing Camellia sinensis (leaf), Psidium guajava (leaf), and Rosa hybrida (flower) inhibited not only arachidonic acid cascade-related enzymes (5-lipoxygenase and cyclooxygenase) in vitro but also degranulation and histamine release from rat peritoneal mast cells. In this study, the same PEM381 was used to investigate its inhibitory effects on the syntheses of leukotrienes and prostaglandins as well as on serum concentration of histamine and eosinophils infiltration in type I allergic reaction-induced mice. The PEM381 could decrease concentrations of serum cysteinyl leukotrienes from mice activated by anti-DNP IgE and DNP-albumin. The concentration of serum histamine by oral administration of PEM381 (25, 50, and 100 mg/kg of body weight) in type I allergic reaction-induced mice was $395.93{\pm}190.37$ nM, $315.59{\pm}164.23$ nM, and $325.07{\pm}112.02$ nM, respectively, while that of positive control (promethazine hydrochloride 10 mg/kg of body weight) was $270.12{\pm}24.02$ nM. In addition, the PEM381 also showed inhibitory effect on the eosinophils infiltration in the nasal mucosa of mice which were sensitized with ovalbumin. However, the effect of PEM381 on the syntheses of prostaglandins seemed to be insignificant. Consequently, these results suggest that PEM381 may be useful for the prevention and treatment of type I allergy-related diseases.

Effects of Erythromycin and New Macrolides on the Serum Theophylline Level and Clearance (혈중 Theophylline 농도 및 청소율에 대한 Erythromycin과 New Macrolides 항생제의 영향)

  • Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.546-552
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    • 1998
  • Background: Up to 90% of a theophylline dose is biotransformed, by interaction with one or more the variants of the cytochrome P-450 drug metabolism system. Macrolides affect the elimination of theophylline by influencing on the microsomal enzyme systems. We evaluate the effect of erythromycin and new macrolides on the serum theophylline level and clearance. Method : Subjects consisted of moderate asthmatic patients with normal renal and hepatic functions. All subjects were non-smokers and treated with oral theophylline 400 mg per day. We randomly assigned 53 patients into four groups. Each group was treated with one macrolides, the first group erythromycin(n:19, 500 mg bid), second roxithromycin (n:14. 150 mg bid), third clarithromycin (n:10, 250 mg bid) and fourth azithromycin(n:10, 250 mg bid). We measured the serum theophylline level and clearance at three intervals, at pretreatment, after the first and fourth week after receiving the following macrolides, erythromycin, roxithromycin and clarithromycin. When azithromycin was administered, the serum theophylline level was measured at pretreatment and after one week of treatment They were measured by a computerized program of Bayesian method. Results : When compared with control, erythromycin and roxithromycin-treated groups had a significantly elevated serum theophylline level and decreased clearance. However, there were no significant changes of the serum theophylline level and clearance in clarithromycin and azithromycin-treated groups. Conclusion : These results suggest that theophylline dose may need to be readjusted and have periodic drug monitoring when erythromycin or roxithromycin is administered concurrently.

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Effects of Several Treatments on Seedling Growth of Veronica rotunda var. subintegra T.Yamaz. (몇 가지 처리가 산꼬리풀 유묘의 생육에 미치는 영향)

  • Yeon, Soo Ho;Lee, Seung Yeon;Lee, Cheol Hee
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2018.10a
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    • pp.62-62
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    • 2018
  • 산꼬리풀(Veronica rotunda var. subintegra T.Yamaz.)은 다년생 초본류로 달성이라는 꽃말을 가진 우리나라에만 자생하는 특산식물이다. 줄기는 곧게 서며, 줄기 끝에 보라색의 꽃이 총상화서로 피어 관상가치도 우수하다. 또한, 전초를 일지향이라 불리우며, 중약대사전에는 천식과 기침, 감기, 기관지염 등에 효능이 있다고 보고되었다. 이러한 산꼬리풀의 육묘 체계의 확립을 위하여 2017년 6월 2일부터 7월 31일까지 약 8주간 육묘하였다. 종자 육묘기술 개발을 위한 공통조건은 200구 트레이에 원예상토를 충진한 다음 셀 당 4립씩 파종하여 55% 차광막이 설치된 배드에 배치하였으며, 이후 4, 6주차에 Hyponex $500mg{\cdot}L^{-1}$을 처리하였다. 토양실험은 원예상토 단용[$300-200-200mg{\cdot}L^{-1}$(N-P-K)], 피트모스:펄라이트(3:1) 및 코코피트:펄라이트(3:1) 혼용토를 사용하였다. 피트모스와 코코피트의 혼용토는 원예상토의 비료농도를 기준으로 0-0-0, 300-200-200, $600-400-400mg{\cdot}L^{-1}$의 비료를 첨가하였다. 파종 립수별 실험은 셀탕 1, 2, 4 및 6립으로 하였으며, 추비는 hyponex(6.5-6-19) 0, 500, $1000mg{\cdot}L^{-1}$를 증류수에 희석하여 2회 분무기로 살포하였다. 차광 실험은 0, 55, 75% 등의 차광막이 설치된 곳에서 수행하였다. 연구의 결과, 산꼬리풀의 육묘는 원예상토를 사용하는 것이 다른 토양에 비해 우수한 결과를 보였다. 초장, 경직경 및 엽수는 원예상토를 이용하는 것이 가장 효과적이었으며, 다음으로 피트모스:펄라이트 혼용토 순이었다. 근장의 경우, 피트모스 혼용토에서 비료 농도와 관계없이 원예상토에 비해 유의적으로 길었다. 파종립수에 따른 초장과 경직경은 1, 2립 파종구에서 가장 양호하였으며, 파종량이 적을수록 길고 굵어지는 경향이었다. 엽수도 셀 당 파종량이 적을수록 많아지는 경향이었으나, 유의적인 큰 차이는 확인되지 않았다. 추비는 지상부의 경우 hyponex $500mg{\cdot}L^{-1}$ 처리 시 생육의 증가 효과가 있었지만, 비교적 고농도인 $1000mg{\cdot}L^{-1}$ 처리구에서는 생육에 효과가 없거나 억제되는 결과를 보였다. 한편, 근장은 처리농도가 높을수록 증가하는 경향이었고, hyponex $1000mg{\cdot}L^{-1}$ 처리구(9.9 cm)에서 가장 길었다. 산꼬리풀의 유묘 재배 시 차광처리는 경직경과 근장을 감소시키는 결과를 보였으며, 초장과 엽수는 처리에 따른 유의적인 차이는 없었다.

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Clinical Significance of Airway Resistance Curve by the Body Plethysmograph (Body Plethysmograph를 이용한 Airway Resistance Curve의 임상적 의의)

  • Cheon, Seon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.218-225
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    • 1995
  • Background: Airway resistance(Raw) is measured with the body plethysmograph by displaying the relationship between airflow and alveolar pressure($V/P_A$). If the resistance curve on $V/P_A$ tracing is curved or looped, the estimation of Raw is difficult. This study was designed to examine wheather there is any correlation between the shape of resistance curve and the clinical status and the pulmonary function of patients. Methods: The 146 pulmonary disease patients with increased Raw were included in this study. The shapes of resistance curves on $V/P_A$ tracing with body plethysmograph during quiet breathing were analyzed and compared with pulmonary function. Results: The results were as follows ; 1) The shapes of resistance curves were summarized in 5 categories; type 1: linear, type 2: ovoid, type 3: sigmoid, type 4: scoop, type 5: paisley. The type 3 except 1 case, type 4 and type 5 were found to have loop mainly in expiratory phase. 2) Although the shapes of resistance curves were not typical for specific disease, the resistance curves of acute disease tended to belong to type 1 or 2 and those of chronic airflow obstruction tended to belong to type 3, 4 or 5. But resistance curves of bronchial asthma and destructive lung with tuberculosis showed all types in proportion to degree of airflow obstruction or destruction of parenchyme. 3) In the cases of resistance curves going to type 5 rather than type 1 and those with looping, airflow obstuction tended to be severe and airway resistance and residual volume tended to increase. Conclusions: Analysis of resistance curve on $V/P_A$ tracing measuring airway resistance is helpful for judging degree of airflow obstruction and air trapping. Although the shape of resistance curve is not typical for specific disease, there is a close association between looping and airway obstruction.

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Association Study in Endothelin 1 (EDN1) Gene Polymorphism and Excess or Deficiency Syndrome in Korean Asthmatic Patients (한국인 기관지 천식 허증(虛證), 실증(實證) 환자와 EDN1 유전자 다형성과의 상관성 연구)

  • Yoem, Yu-rim;Kim, Kwan-il;Baek, Hyun-jung;Kim, Mi-a;Lee, Beom-joon;Kim, Jin-ju;Kim, Su-kang;Chung, Joo-ho;Jung, Hee-jae;Jung, Sung-ki
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.47-64
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    • 2016
  • Objectives: In the present study, a genetic analysis was conducted to investigate the association of the expression of SNPs of EDN1 gene polymorphism with the clinical phenotype in bronchial asthma patients with either excess or deficiency syndrome.Methods: Ninety-four healthy control subjects and 52 asthma patients were included in this study. The asthma patients were divided into two groups: those with deficiency syndrome and those with excess syndrome. We searched the exonic and promoter areas of the EDN1 gene in the NCBI website SNPs with <0.01 minor allele frequency (MAF) and <0.01 heterozygosity. Pro programs were performed to obtain the odds ratio, 95% confidence interval, and p-value. Multiple logistic regression models were conducted to analyze the genetic data.Results: In our genotype and allele analyses, there were significant differences in the codominant 2 model of the rs3087459 SNP genotype and also in the CGG haplotype between the control group and the asthma group. Genotype and allele analyses were conducted between the deficiency and excess syndrome group. There were significant differences in the dominant and log-additive model and also in the frequency of C-alleles of rs3087459 SNP genotype. There were significant differences in codominant 1, dominant and log-additive model and T-allele of rs5370 SNP genotype. The AGG haplotype also revealed significant differences.Conclusions: EDN1 SNPs (rs3087459, rs5370) showed a significant association with symptomatic excess syndrome in Korean asthmatic patients.