• 제목/요약/키워드: Provocation test

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알레르기 검사의 실제 (Allergy tests in clinical practice)

  • 이재천
    • Journal of Medicine and Life Science
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    • 제15권1호
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    • pp.1-5
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    • 2018
  • 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.

Drug eruption by antihistamine mistaken for chronic urticaria in a child

  • Lee, Gun Moo;Chu, Shou-Yu;Kang, Sung Yeon;Kim, Hyo-Bin;Park, Jin-Sung;Kim, Ja Kyoung
    • Clinical and Experimental Pediatrics
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    • 제62권2호
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    • pp.75-78
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    • 2019
  • Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

Relationship of trunk muscle atrophy and provocation position in patients with chronic low back pain

  • Shin, Doo Chul;Song, Chang Ho
    • Physical Therapy Rehabilitation Science
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    • 제1권1호
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    • pp.28-32
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    • 2012
  • Objective: The purpose of this study is to compare chronic low back pain patients' pain provocation position so as to identify the relevance with lumbar stabilizing muscles atrophy and pain provocation position. Design: Cross-sectional study. Methods: Fifty five chronic low back pain patients were participated in this study. Subjects were eligible for study participation if they were 35-55 years old and had experienced low back pain for more than 3 months. Subjects were questioned about pain and pain provocation test were done. And then they were inspected their cross sectional area (CSA) of lumbar muscles (erector spinae, iliopsoas, and multifidus) by using computed tomography. Analyze the relevance through the result data with painful area, aspect of pain and pain provocation position. Results: CSA of erector spinae showed significant decrease on ipsilateral extension position (p<0.05). Iliopsoas muscle showed significant decrease on contralateral position (p<0.05). Multifidus showed significant decrease on the position of contralateral extension and contralateral flexion (p<0.05). Conclusions: Based on the results of our study, it may be possible to evaluate muscle atrophy by assessing causing position.

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Technetium-99m hand perfusion scintigraphy (Raynaud's scan) as a method of verification in hand arm vibration syndrome: a review

  • Taewoong Ha;Hyeoncheol Oh;Jungwon Kim
    • Annals of Occupational and Environmental Medicine
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    • 제34권
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    • pp.26.1-26.13
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    • 2022
  • It is important to assess the blood flow of fingers in the verification of hand-arm vibration syndrome. In the Republic of Korea, most assessments of the blood flow in the fingers are performed using a cold provocation test with finger skin color change. However, this test is a non-objective method with a relatively low sensitivity, leading to possible social and legal problems. Thus, we reviewed the characteristics of several tests that assess the blood flow in the fingers. Among these tests, using the radioactive isotope method, Raynaud's scan has a relatively higher sensitivity and specificity than other tests, provides objective results, and is approachable in many hospitals. So we suggest using Raynaud's scan as an alternative test when cold provocation test with finger skin color change is negative in vibration exposed worker.

Usefulness of drug provocation tests in children with a history of adverse drug reaction

  • Na, Hye-Ran;Lee, Jeong-Min;Jung, Jo-Won;Lee, Soo-Young
    • Clinical and Experimental Pediatrics
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    • 제54권7호
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    • pp.304-309
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    • 2011
  • Purpose: There are very few reports of adverse drug reactions (ADR) and almost no study of drug provocation test (DPT) in Korean children. We aimed to assess the role of DPT in children with unpredictable ADRs, and compare the causative drugs and clinical characteristics between detailed history of ADRs and result of DPTs. Methods: We included 16 children who were experienced ADRs referred to pediatric allergy clinic at Ajou University Hospital (January 2006 to December 2009). With various suspected drugs, 71 DPTs were done in 16 patients using our own protocol, and skin tests to antibiotics were combined in ADRs to antibiotics in medical history. Results: There were 17 (23.9%) positive DPTs results out of 71 individual DPTs, and 11 patients (68.8%) from 16 patients were positive to at least one drug. Drugs causing positive reactions were acetaminophen in 5 (31%), Non-steroidal anti-inflammatory drugs in 4 (25%), penicillin in 3 (19%), cephalosporin in 2 (13%), and cotrimoxazole, macrolide and lactose in 1 each. Conclusion: DPT seems a safe and useful procedure to confirm causative drug and identify safely administering alternative drugs in children with ADR.

북한 핵테러 위협 대비방안 연구; '선제적 자위권' 보장을 중심으로 (A study on measure of North Korea's nuclear terror threat; Focusing on the guarantee of 'anticipatory self-defense')

  • 김연준
    • 융합보안논문지
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    • 제16권3_2호
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    • pp.13-23
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    • 2016
  • 북한은 최근 4차 핵실험과 대륙간탄도미사일 발사 실험을 실시하며, 한반도와 국제사회를 대상으로 핵 도발을 감행하였다. 북한에서 진행 중인 핵과 미사일 실험은 핵전력의 기술적 수준에 있어서 표준화, 경량화, 다종화의 완성단계에 도달하였다고 판단된다. 이에 북한은 한반도와 국제사회를 대상으로 조만간 핵도발이 현실이 될 것이라는 예상된다. 핵폭탄은 그 엄청난 파괴력으로 인하여 상대방의 제1격을 허용한 다음에 반격을 하겠다는 논리가 적용될 수 없는 절대무기이다. 따라서 핵을 보유하게 된 북한을 상대로 하는 우리는 최소한의 생존권을 보장하기 위해서 '선제적 자위권' 행사는 선택이 아닌 필수적인 대응개념일 수밖에 없다. 조만간 북한의 핵도발이 예상되는 현시점에서 선제타격 시행에 대한 국민적 공감대를 형성하여 도발의 원점지역을 타격할 있는 역량을 구비해야 한다. 또한 향후 예상되는 북한의 5차 핵실험에 대비하여 '핵무장 선택권' 확보할 수 있도록 국가적 역량을 결집해야 한다.

D-Penicillamine 이 연 배설농도에 미치는 영향 (Effect of oral D-penieillamine in Urinary excretion of lead)

  • 박정일
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.87-94
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    • 1976
  • In order to study the chelating action of d-penicillamine on lead and the possibility of its application to the provocation test for diagnosis of lead poisoning, urinary excretion of lead was measured from 24-hour urine samples before, during and after administration of d-penicillamine by oral route for 5 days on 18 lead workers. The results were as follows: 1. Oral d-penicillamine 600 mg/day raised the excretion of urinary lead by approximately 3 times as compared with initial urinary lead level. 2. Initial urinary lead level was the better indicator of urinary lead excretion in d-penicillamine administration than initial blood lead ${\delta}-ALA$ and hemoglobin level. 3. Oral d-penicillamine may be quite useful in provocation test for lead poisoning.

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Role of Methacholine PC20 in FEF25-75% for the Diagnosis of Bronchial Asthma

  • Son, Kyeong Min;Jang, Seung Hun;Kang, Hye Ryun;Han, Bo Ram;Kim, Joo Hee;Kim, Hyun Sung;Park, Sung Hoon;Hwang, Yong Il;Kim, Dong Gyu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • 제67권4호
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    • pp.311-317
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    • 2009
  • Background: The methacholine bronchial provocation test is a useful tool for evaluating asthma in patients with normal or near normal baseline lung function. However, the sensitivity of this test is 82~92% at most. The purpose of this study is to evaluate the clinical usefulness of $FEF_{25-75%}$ in identification of airway hyperresponsiveness in patients with suspected asthmatic symptoms. Methods: One hundred twenty-five patients who experienced cough and wheezing within one week prior to their visiting the clinic were enrolled. Results: Sixty-four subjects showed no significant reduction of $FEV_{1}$ or $FEF_{25-75%}$ on the methacholine bronchial provocation test (Group I). In 24 patients, $FEF_{25-75%}$ fell more than 20% from baseline without a 20% fall of $FEV_{1}$ during methacholine challenge (Group II). All patients who had more than 20% fall of $FEV_{1}$ (n=37) also showed more than 20% of reduction in $FEF_{25-75%}$ (Group III). Baseline $FEV_{1}$/FVC (%) and $FEF_{25-75%}$ (L) were higher in group II than group III (81.51${\pm}$1.56% vs. 75.02${\pm}$1.60%, p<0.001, 3.25${\pm}$0.21 L vs. 2.45${\pm}$0.21 L, p=0.013, respectively). Group II had greater reductions of both $FEV_{1}$ and $FEF_{25-75%}$ than group I at 25 mg/mL of methacholine (p<0.001). The provocative concentration of methacholine causing a 20% fall in $FEF_{25-75%}$ in group II was about three-fold higher than that in group III. Conclusion: A 20% fall of $FEF_{25-75%}$ by methacholine provocation can be more sensitive indicator for detecting a milder form of airway hyperresponsiveness than $FEV_{1}$ criteria.

승모판 심장질환 환자에서 기관지 반응성에 대한 연구 (Bronchial Responsiveness in Patients with Mitral Valvular Heart Disease)

  • 김호철;김민구;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제42권5호
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    • pp.752-759
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    • 1995
  • 연구배경: 심부전 환자에서 기관지 과민성의 여부를 확인하고 이러한 기관지 과민성과 혈역학적 지표사이의 상관관계를 알기위해 메타콜린을 이용하여 기관지 유발검사를 실시하였다. 방법: 1994년 3월부터 8월까지 본원에 내원하여 흉부 X선 촬영, 심에코도 검사, 심도자술로 승모판 심장질환이 진단되고 호흡곤란의 정도가 NYHA 기능적 분류 2인 11명의 환자를 대상으로 PARI nebulizer I을 이용하여 메타콜린 용액의 농도를 올리면서 기관지 유발검사를 시행하여 최대호기 유속이 20%이상 감소를 보이면 양성반응으로 간주하였다. 또한 각각의 환자는 심도자술을 통해서 혈역학적인 지표와 기관지 과민반응과의 상관 관계를 알아보고저 하였다. 결과: 1) 11명의 환자중 남자 2명 여자 9명이였으며 평균연령은 38.0세이였고 흡연력은 1명이외에는 없었다. 2) 각 환자의 호흡곤란 정도는 NYHA 기능적 분류 2였고 승모판 협착증만 있는 환자는 5명이였고 이외는 승모판 질환과 대동맥 판막질환이 동반되어있었다. 3) 환자들의 평균폐동맥압과 평균폐모세혈관 쐐기압은 각각 21.72mmHg(${\pm}8.55$), 15.45mmHg(${\pm}8.69$)로 정상보다 높았고 심장지수와 좌심실분획률은 각각 2.64L/min/m2(${\pm}0.41$), 61.81%(${\pm}7.21$)로 정상범위이였다. 4) 11명의 환자중 1명만 메타콜린 기관지 유발검사에 양성이었다. 결론: NYHA 기능적 분류 2인 승모판 심장질환이 있는 심부전환자 11명중 1명만 기관지 과민반응이 관찰되었으며 그 이유로 지속적인 심부전의 치료에 의한 간질성 폐부종의 소설로 인해 기관지의 반응성이 증가되지 않았다고 사료되며 NYHA 기능적 분류 3 또는 4인 승모판 심장질환 환자를 대상으로 기관지 과민 반응에 대한 추후의 검사가 필요할 것으로 생각된다.

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