• Title/Summary/Keyword: 천식환자

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A Case Report on Cardiac Asthma due to Congestive Heart Failure (울혈성 심부전으로 인한 심장성 천식환자 치험 1례)

  • Jung Wun-Suk;Shin Jeong-In;Sea Un-Kyo
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1093-1102
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    • 2003
  • Congestive heart failure is a cardiac dysfunction that can't supply sufficient amount of blood. The disorder usually causes hypertension, ischemic cardiac disease and give rise to pulmonary congestion and pulmonary epileptic edema. The symptoms of the disease are dyspnea, palpitation, edema, etc. We treated a 82 year-old female patient who had severe dyspnea, nausea, and dizziness. At the point of differentiation of syndromes(辨證), the case was diagnosed as Su-Cheon(水喘) induced by Yang-deficiency of Both Spleen and Kidney(脾腎陽虛) and was administered Yerunpang(胃?湯). After two weeks of the treatment, we witnessed improvement in the symptoms of CHF and general depressed condition. This report describes the process and contents about the way the patient was treated.

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The Relationship between Indoor Air Pollutants and Pulmonary Function in Asthmatic Children with Mold Sensitization (곰팡이에 감작된 소아 천식 환자 가정내 환경유해물질 농도와 폐기능의 상관관계)

  • Yoon, Wonsuck;Lim, Jaehoon;Park, Sang Hyun;Lee, Mingyu;Yoo, Young
    • Journal of Environmental Health Sciences
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    • v.46 no.6
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    • pp.685-693
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    • 2020
  • Objectives: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. The aim of this study was to investigate relationships between indoor mold concentrations and pulmonary function parameters in asthmatic children with mold sensitization. Methods: Asthmatic subjects who had a positive result in skin-prick testing to more than one mold allergen, such as Alternaria, Aspergillus, or Penicillium, were enrolled. Their pulmonary function and methacholine challenge test results were collected. Measurements of blood eosinophil, serum IgE, and fractional exhaled nitric oxide (FeNO) were taken. Indoor levels of VOC, CO2, PM10 and PM2.5 in each subject's house were measured. We counted mold and bacteria colonies from the subjects' house air samples. Results: The mean levels of FEV1, FVC, FEV1/FVC, and FEF25-75 were 82.8±19.7, 87.3±17.9, 85.8±8.3, and 82.3±28.9%, respectively. The mean FeNO level was 19.8±11.2 ppb and the geometric mean (range of one SD) of methacholine PC20 was 3.99 mg/mL (0.67-23.74 mg/mL). The average indoor air pollutant levels were below the recommended levels set by the Ministry of Environment for multiplex buildings. Indoor mold levels showed a significant inverse correlation with methacholine PC20, but not with the baseline pulmonary function parameters. Conclusion: Indoor mold concentrations are a risk factor for increased bronchial hyperresponsiveness among asthmatic children with mold sensitization. Targeted environmental intervention should be considered for selected asthmatic children with mold sensitization for avoiding severe airway hyperresponsiveness.

Relationship Between Orthodontic Root Resorption and Asthma, Allergy, and Psychological Stress (교정치료와 관련된 치근흡수와 천식, 앨러지 및 심리적 스트레스와의 상관성에 관한 연구)

  • Shim, Youn-Soo;Davidovitch, Ze'ev
    • Journal of dental hygiene science
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    • v.3 no.1
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    • pp.33-38
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    • 2003
  • One aspect of undesirable outcomes in orthodontic treatment includes excessive resorption of dental roots with mechanotherapy. The aim of this study is to demonstrate whether diseases affecting the immune system adversely are prevalent in orthodontic patients who manifest excessive resorption of dental roots with orthodontic tooth movement. The records of 51 orthodontic patients (25 males and 26 females, $16.1{\pm}3.3$ yr old) and 51 pair-matched controls ($1.5.4{\pm}4.1$ yr old) were analyzed retrospectively. The pretreatment questionnaires and the treatment records disclosed that the incidence of asthma, allergy, and signs indicative of psychological stress, was significantly higher in the root resorption cohort. The immune system is either altered or adversely affected in all these conditions. Since the progenitors of osteoclasts and odontoclasts are derived from mononucleated cells of monocyte and macrophage lineage, which are prominent cellular members of the immune system, the study leaded to the conclusion that excessive root resorption may occur in orthodontic patients who are psychologically stressed, or who have asthma and allergy, or any other conditions that may adversely affect and modify the immune system, and a careful examination and interpretation of a patient's medical history may be beneficial to both patient and practioner.

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Efficacy of Interferon-Gamma Treatment in Bronchial Asthma (기관지천식에서 Interferon-Gamma 치료의 효과)

  • Kim, Kwan-Hyoung;Kim, Seok-Chan;Kim, Young-Kyoon;Kwon, Soon-Seog;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jung-Sup;Park, Sung-Hak;Lee, Choong-Eon;Byun, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.822-835
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    • 1997
  • Background : There have been many in vitro evidences that interleukin-4(IL-4) might be the most important cytokine inducing IgE synthesis from B-cells, and interferon-gamma(IFN-$\gamma$) might be a main cytokine antagonizing IL-4-mediated IgE synthesis. Recently some reports demonstrated that IFN-$\gamma$ might be used as a new therapeutic modality in some allergic diseases with high serum IgE level, such as atopic dermatitis or bronchial asthma. To evaluate the in vivo effect of IFN-$\gamma$ in bronchial asthma we tried a clinical study. Methods : Fifty bronchial asthmatics(serum IgE level over 200 IU/ml) who did not respond to inhaled or systemic corticosteroid treatment, and 17 healthy nonsmoking volunteers were included in this study. The CD 23 expressions of peripheral B-cells, the IL-4 activities of peripheral T-cells, the serum soluble CD23(sCD23) levels, and the superoxide anion(${O_2}^-$) generations by peripheral PMN were compared between bronchial asthmatics and normal subjects. The IL-4 activities of peripheral T-cells were analyzed by T-cell supernatant (T-sup)-induced CD23 expression from tonsil B-cells. In bronchial asthmatics the serum IgE levels and histamine $PC_{20}$ in addition to the above parameters were also compared before and after IFN-$\gamma$ treatment. IFN-$\gamma$ was administered subcutaneously with a weekly dose of 30,000 IU per kilogram of body weight for 4 weeks. Results : The ${O_2}^-$ generations by peripheral PMNs in bronchial asthmatics were higher than normal subjects($8.23{\pm}0.94$ vs $5.00{\pm}0.68\;nmol/1{\times}10^6$ cells, P<0.05), and significantly decreased after IFN-$\gamma$ treatment compared to initial values($3.69{\pm}0.88$ vs $8.61{\pm}1.53\;nmol/1{\times}10^6$ cells, P<0.05). CD23 expression of peripheral B-cells in bronchial asthmatics was higher than normal subjects($47.47{\pm}2.96%$, vs $31.62{\pm}1.92%$, P<0.05), but showed no significant change after IFN-$\gamma$ treatment. The serum sCD23 levels in bronchial asthmatics were slightly higher than normal subjects($191.04{\pm}23.3\;U/ml$ vs $162.85{\pm}4.85\;U/ml$), and 11(64.7%) of 17 patients showed a decreasing pattern in their serum sCD23 levels after IFN-$\gamma$ treatment. However the means of serum sCD23 levels were not different before and after IFN-$\gamma$ treatment. The IL-4 activities of peripheral T-cells in bronchial asthmatics were slightly higher than normal subjects($22.48{\pm}6.81%$ vs $18.90{\pm}2.43%$), and slightly increased after IFN-$\gamma$ treatment($27.90{\pm}2.56%$). Nine(60%) of 15 patients showed a decreasing pattern in their serum IgE levels after IFN-$\gamma$ treatment. And the levels of serum IgE were significantly decreased after IFN-$\gamma$ treatment compared to initial values ($658.67{\pm}120.84\;IU/ml$ vs $1394.32{\pm}314.42\;IU/ml$, P<0.05). Ten(83.3%) of 12 patients showed an improving pattern in bronchial hyperresponsiveness after IFN-$\gamma$ treatment, and the means of histamine $PC_{20}$ were significantly increased after IFN-$\gamma$ treatment compared to initial values ($1.22{\pm}0.29mg/ml$ vs $0.69{\pm}0.17mg/ml$, P<0.05). Conclusion : Our results suggest that IFN-$\gamma$ may be useful as well as safety in the treatment of bronchial asthmatics with high serum IgE level and that in vivo effects of IFN-$\gamma$ may be different from its in vitro effects on the regulations of IgE synthesis or the respiratory burst of PMN.

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Effect of Pilocarpine Mouthwash on Xerostomia (구강건조증에 대한 필로카핀 구강양치액의 효과)

  • Kim, Ji-Hyun;Park, Ju-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.21-24
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    • 2011
  • Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

Airway Responses to Bronchoprovocation Using High-Resolution Computed Tomography in Patients with Bronchial Asthma (기관지천식환자에 있어서 고해상도 전산화단층촬영술을 이용한 기관지유발에 대한 기도의 반응)

  • Choi, Byoung-Whui;Kang, Yoon-Jeong;Ko, Hyung-Ki;Park, In-Won;Hue, Sung-Ho;Kim, Yang-Soo;Kim, Young-Goo;Kim, Kun-Sang;Kim, Jong-Hyo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.813-822
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    • 1995
  • Background: Bronchial hyperresponsiveness and abnormal response such as a loss of distensibility are pathophysiologic characteristics if bronchial asthma. The only means of direct in vivo measurement of airway size had been a tantalium bronchography, until high-resolution computed tomography(HRCT) enabled to measure noninvasively two dimensional airway area more accurately and reliably. Method: To investigate airway area responses to bronchial provocation with methacholine and evaluate the major sites of bronchial constriction in patients with bronchial asthma. We examined HRCT scans in five patients with bronchial asthma who had significant bronchoconstriction(20% or more decrease in $FEV_1$) using CT scanner(5,000T CT, Shimadzu Co, Japan) before and in 3~5 min. after methacholine inhalation. Airways which were matched by parenchymal anatomic landmarks in each patient before and after methacholine inhalation were measured using film scanner(TZ-3X scanner; Truvel Co. Chatsworth CA, USA) and a semiautomated region growing method. Results: 1) We identified 9 to 12 airways in each patient which were matched by parenchymal anatomic landmarks before and after methacholine inhalation. 2) Airway responses to methacholine are quite different even in a patient. 3) The constriction of small airways(average diameter <2 mm; area < $3.14mm^2$) was 48.7%(8.3; SEM, n=43), being more prominant than that of large airways(average diameter >2 mm; area > $3.14mm^2$), 53.8% (4.4;SEM, n=10), but not significantly different(p>0.05). 4) There was no significant difference in the degree of constriction between upper(44.3% +5.8; mean + SEM, n=30) and lower lung regions(56.7% +4.5, n=23). Conclusions: Thus airway responses to methacholine bronchoprovocation is quite variable in a patient with bronchial asthma and has no typical pattern in patients with bronchial asthma.

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Influence of Yellow Sand Dust on the Distribution of $PM_{2.5}$ Concentrations in Seoul (서울시 일부지역에서의 $PM_{2.5}$ 농도에 대한 황사의 영향)

  • 백효경;김현욱;성재혁
    • Proceedings of the Korea Air Pollution Research Association Conference
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    • 2002.11a
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    • pp.199-201
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    • 2002
  • 입자상 물질은 폐렴으로 인한 사망률을 증가시키며, 호흡기 및 심혈관계 질환과 관련된 외래환자 수를 증가시키고, 천식 증상을 악화시키며, 폐 기능 저하 둥을 유발한다고 알려져 있다(U.S.EPA, 2001). 황사는 발원지의 기상 및 토양상태에 따라 다르지만 한반도와 일본에서 관측된 황사의 크기는 1-10$\mu\textrm{m}$ 정도이며 중금속 성분 등 오염물질이 포함되어 있어, 시정악화, 농작물 및 활엽수의 생육장애, 인체 호흡기관으로 깊숙이 침투하여 폐 질환 유발 및 안 질환 등을 유발시켜 대기환경을 오염시킬 뿐만 아니라 인체에도 매우 유해하다. (중략)

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Relationship between Exposure to Air Pollutants and Childhood Asthma : A Meta-Analysis (대기오염물질 노출과 소아 천식 환자 발생에 관한 메타분석)

  • Cho, Yong-Sung;Hyun, Yeon-Ju;Kim, Ho;Kim, Yoon-Sin;Lee, Jong-Tae
    • Proceedings of the Korea Air Pollution Research Association Conference
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    • 2000.11a
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    • pp.289-290
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    • 2000
  • 산업혁명 이후 대기오염이 건강에 미치는 유해성 연구는 산발적으로 이루어져오다가 영국 London 스모그사건과 미국 Donora 및 LA 스모그사건 이후 인체에 미치는 영향에 대하여 선진국을 중심으로 집중적인 연구가 이루어져 왔다. 또한, 최근에는 각국의 대기오염 기준치 이하에서도 단기간 건강에 영향을 준다는 연구들이 발표되면서 각국은 대기오염 수준을 강화하고 있으며, 이러한 결과들은 각국마다 일관된 결과를 나타내고 있다. (중략)

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A CASE OF SQUAMOUS CELL CARCINOMA OF THE TRACHEA (기관에 발생한 편평상피암 1례)

  • 박윤석;엄재욱;박춘근
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.18.3-18
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    • 1987
  • 기관의 원발성 종양은 매우 드물며 그 수술적 치료법 또한 확고히 되어 있지 않은 실정이다. 저자들은 기관지 천식으로 오진한 제1, 제2 기관륜 부위에 발생하여 윤상 연골까지 침범한 편평 세포암을 제1, 제2 기관륜을 포함하여 윤상 연골의 부분 절제후 6500 rad. 조사 후 좋은 경과를 보이고 있는 44세 여자 환자에 대해 문헌 고찰과 아울러 보고하는 바이다.

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Peripheral Blood Eosinophil Counts and Serum ECP in Adolescents with Long-term Asthma Remission and Persistent Bronchial Hyperresponsiveness : Comparison with Adolescents with Symptomatic Asthma (기관지 과민성을 가진 장기간 천식 관해 상태의 청소년에서 혈액 내 호산구와 혈청 호산구 양이온 단백에 대한 연구)

  • Kang, Hee;Yoo, Young;Yu, Jinho;Park, Yang;Koh, Young Yull
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1013-1018
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    • 2003
  • Purpose : Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP). Methods : We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in $FEV_1(PC_{20})$ with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between $PC_{20}$ and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups. Results : Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group($273{\pm}108$ vs. $365{\pm}178/{\mu}L$; $16.3{\pm}9.4$ vs. $26.5{\pm}15.1{\mu}g/L$, both, P<0.05). $PC_{20}$ was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159). Conclusion : BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.