• 한국환경보건학회지
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• 제46권6호
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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.

• 대한후두음성언어의학회지
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• 제18권1호
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• pp.39-43
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• 2007

Background and Objectives: There are few studies reported that specifically examine the phonetic characteristics and voice handicap index (VHI) in patients with Allergic Rhinitis. This study was designed to examine phonetic characteristics and VHI in adult patients with allergic rhinitis. Materials and Methods: Forty-two male patients diagnosed as allergic rhinitis were given skin-prick test and others, aged from 20 to 56 years, and were compared with a 16 male control group with no pathology and in the same age group. The VHI was used to measure the changes of patient's perception. Acoustic and aerodynamic analysis test were done, and a nasalance test performed to measure rabbit, baby, and mother passage. Acoustic rhionometry (AR) was performed to evaluate nasal volume and nasal crosssectional area. Statistical analysis was done using independent sample t-test. Results: VHI showed significantly different score in the studied group, higher than that of control group. AR graph showed that there was no significant differences of nasal volume and nasal cross-sectional area. The Shimmer and SFF value in the group of allergic patients were higher than in the control group. MPT value in the group of allergic patients was lower than in the control group. Nasalance in allergic patients showed hypernasality all passage. Conclusion: We suggest that patients with allergic rhinitis have considerable voice problems. Most of them have hypernasality, which may be a compensatory mechanism by nasal obstruction.

• Clinical and Experimental Pediatrics
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• 제46권4호
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• pp.370-375
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• 2003

목 적 : 출생 후 영아기에 알레르겐에 대한 노출 여부가 추후 감작과 알레르기질환의 발생에 중요한 것으로 알려져 왔다. 우리나라에서는 집먼지진드기가 알레르기질환의 주요 흡입 알레르겐으로, 집먼지진드기 항원량은 계절적으로 가을에 가장 높은 것으로 보고되었다. 이에 저자들은 소아 호흡기 알레르기 환자에서 집먼지진드기에 대한 감작 여부에 따라서 출생 월 분포의 차이가 있는지 알아보기 위해 본 연구를 시행하였다. 방 법 : 1995년 1월부터 2002년 5월까지 만성 호흡기 증상으로 서울대학교병원 어린이병원을 방문하여 알레르기 피부단자시험과 메타콜린 유발시험을 시행 받은 환아 1,327명을 대상으로 집먼지진드기에 대한 감작 여부와 출생 월을 조사하여, 집먼지진드기 감작 유무에 따라 출생 월 분포를 비교하였다. 결 과 : 한 가지 이상의 알레르겐에 피부시험 양성을 보인 아토피군은 864명(65.1%)이고 비아토피군은 463명(34.9%)이었다. 아토피군에서 집먼지진드기에 양성을 보인 환아의 수는 787명(91.1%)이고 집먼지진드기를 제외한 나머지 피부시약에 양성반응을 보인 수는 77명(8.9%)이었다. 집먼지진드기 아토피군과 비아토피군의 출생 월별 분포를 기대 환자수와 비교했을 때 집먼지진드기 알레르기를 가진 환아들은 계절적으로 8월에서 11월까지 기대 환자수 보다 유의하게 많이 출생하였고(P=0.03) 비아토피군에서는 상기와 같은 출생 월 분포를 보이지 않았다. 천식으로 진단된 환아는 총 543명(40.9%)이었고 이중 아토피성 천식 환아는 421명(77.5%)이었고 비아토피성 천식 환아가 122명(22.5 %)이었다. 아토피성 천식 환아 중 집먼지진드기 아토피성인 환아는 387명(91.9%)이었다. 집먼지진드기 아토피성 천식과 비아토피성 천식 환아에서 출생 월의 계절별 비교에서 8월에서 11월까지 집먼지진드기 아토피성 천식 환아가 비아토피성 천식 환아보다 유의하게 많이 출생하였다(P=0.002). 결 론 : 출생 월은 알레르겐에 대한 감작 여부에 연관이 있는 것으로 보이며, 우리나라에서는 8월에서 11월까지의 출생이 집먼지진드기에 대한 감작의 위험이 큰 시기로 보인다.

• 대한기관윤리심의기구협의회지
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• 제1권1호
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• pp.5-21
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• 2019

Purpose: Institutional review board (IRB) classifies risks of clinical trials into less than minimal risk, minor increase over minimal risk, and more than minimal risk. Based on classification and evaluation for risk, IRB decides whether permitting consent exemption or asking additional protection for clinical research subject or not. The purpose of this study is to analyze how IRB members evaluate minimal risk by sending questionnaire survey with 12 predetermined scenarios. Methods: IRB members and researchers (pediatrician, gastroenterologist, neurologist, and neurosurgeon) in 11 different hospitals were asked to answer survey questions via email or online. We analyzed the differences of answers among several subgroups in each predetermined scenarios. Result: Responders were 212 personnel(110 researchers and 102 IRB members) from 11 centers. There were significant differences between IRB members and researchers in response such as blood sampling, skin prick test, one time catheterization in a girl, spinal tapping in child, non-enhance MRI in child, non-enhance MRI with chrolal hydrate in a child, spinal tapping without anesthesia in adult, bioequivalence test, gastric endoscopy, and non-enhance CT. significant differences between medical IRB members and non-medical members were also revealed in one time catheterization in a girl, spinal tapping in a child, non-enhance MRI in a child, bioequivalence test. Depending on researchers' department, they responded differently in several questionnaires as well. Conclusions: We have found that IRB members and researchers evaluate the risks differently. Researchers compared to IRB members, medical IRB members compared to non-medical members answered less than minimal risk in many cases. In assessing and evaluating the risks associated with the study, medical IRB members answered predetermined scenarios as less dangerous compared to non-medical IRB members. Difference among researchers where also revealed significantly. Researchers answered predetermined scenarios as less dangerous compare to other department researchers, especially in predetermined scenarios containing procedures they are familiar with.

• Nutrition Research and Practice
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• 제7권2호
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• pp.115-121
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• 2013

We examined the characteristics of food allergy prevalence and suggested the basis of dietary guidelines for patients with food allergies and atopic dermatitis. A total of 2,417 patients were enrolled in this study. Each subject underwent a skin prick test as well as serum immunoglobulin E (IgE) measurement. A double-blind, placebo-controlled food challenge was conducted using milk, eggs, wheat, and soybeans, and an oral food challenge was performed using beef, pork, and chicken. Food allergy prevalence was found among 50.7% in patients with atopic dermatitis. Among patients with food allergies (n = 1,225), the prevalence of non-IgE-mediated food allergies, IgE-mediated food allergies, and mixed allergies was discovered in 94.9%, 2.2%, and 2.9% of the patients, respectively. Food allergy prevalence, according to food item, was as follows: eggs = 21.6%, milk = 20.9%, wheat = 11.8%, soybeans = 11.7%, chicken = 11.7%, pork = 8.9% and beef = 9.2%. The total number of reactions to different food items in each patient was also variable at 45.1%, 30.6%, 15.3%, 5.8%, 2.2%, and 1.0% for 1 to 6 reactions, respectively. The most commonly seen combination in patients with two food allergies was eggs and milk. The clinical severity of the reactions observed in the challenge test, in the order of most to least severe, were wheat, beef, soybeans, milk, pork, eggs, and chicken. The minimum and maximum onset times of food allergy reactions were 0.2-24 hrs for wheat, 0.5-48 hrs for beef, 1.0-24 hrs for soybeans, 0.7-24 hrs for milk, 3.0-24 hrs for pork, 0.01-72 hrs for eggs, and 3.0-72 hrs for chicken. In our study, we examined the characteristics of seven popular foods. It will be necessary, however, to study a broader range of foods for the establishment of a dietary guideline. Our results suggest that it may be helpful to identify food allergies in order to improve symptoms in patients with atopic dermatitis.

• Tuberculosis and Respiratory Diseases
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• 제71권1호
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• pp.24-29
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• 2011

Background: The rising prevalence of asthma worldwide may be associated with the rising prevalence of obesity in developed nations. Although several studies have suggested a relationship between asthma and obesity, controversy still remains. The aim of this study was to examine the relationship between obesity and asthmatic factors such as atopy, eosinophilia, serum total Ig E and bronchial hyperresponsiveness in chronic cough patients. Methods: This study was a retrospective, observational study in two centers done between January 2007 and June 2008. The subjects included individuals who had a chronic cough. We examined body mass index (BMI) to measure obesity and pulmonary function. We did a metacholine provocation test for airway hyperresponsiveness (AHR), a skin prick test for atopy, and tests for blood eosinophils and serum IgE. Results: A total of 1022 subjects were included. Airway hyperresponsiveness was not related with obesity (p=0.06), and atopy incidence was significant higher in non obese patients (p=0.00). There was no significant difference in serum IgE and blood eosinophil counts between obese and non obese patients. Forced expiratory volue in one second ($FEV_1$)/forced vital capacity (FVC) was significantly reduced in obese patients (p=0.03), but FEV1 and FVC were no significant difference between obese and non obese patients. Conclusion: There is no relationship between obesity and bronchial hyperresponsiveness. The nonobese group appears to have more atopy. The relationship between obesity and bronchial hyperresponsiveness and atopy need further investigation.

• Tuberculosis and Respiratory Diseases
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• 제69권6호
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• pp.426-433
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• 2010

Background: Persistent cough has recently been found to be associated with Chlamydia pneumoniae infection. We aimed to investigate the infection rate of C. pneumonia in adult patients with chronic cough. Methods: We recruited 68 patients with persistent cough lasting in excess of 3 weeks, who visited Kangdong Sacred Heart Hospital from January 2005 to August 2005. On the first visit, chest and paranasal sinuses radiography, skin prick test of common allergens, and induced sputum samples for C. pneumoniae were performed in all of patients. Further evaluation for diagnosis included a methacholine provocation test and eosinophil counts in induced sputum. Results: The most common cause of chronic cough was upper airway cough syndrome (UACS) (26.5%), followed by eosinophilic bronchitis (20.6%) and cough variant asthma (16.2%). Idiopathic chronic cough was the cause in 33.8% of patients. The mean duration of cough was 11.7 months. C. pneumoniae was isolated by polymerase chain reaction (PCR) from one patient who had upper respiratory air way syndrome. Conclusion: Chlamydia pneumoniae appears to have a minor role as a cause of chronic cough in patients.

• Tuberculosis and Respiratory Diseases
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• 제46권3호
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• pp.372-385
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• 1999

연구배경: 만성기침이란 기침이 적어도 3주 이상 지속되는 경우로, 원인으로는 후비루 증후군, 기관지천식, 위식도역류, 기관지 확장증, 만성기관지염, 안지오텐신 전환 효소 길항제 사용 등이 있다. 하지만 특별한 원인을 발견할 수 없고, 다른 증상 없이 단지 만성기침만 있는 경우에 대해서는 그 임상상과 조직병리소견이 아직도명확하게 규명되어 있지 않다. 이에 저자 들은 특별한 원인을 밝힐 수 없고, 다른 호흡기 증상이 없이 만성기침만을 호소하는 환자를 대상으로 임상상과 조직소견을 조사하여, 그 병인기전과 원인을 규명하고자 본 연구를 시행하였다. 방 법: 대상환자는 3주 이상 만성기침 외에 다른 호흡기 증상이 없는 25명의 환자들이었고, 후비루증후군, 위식도 역류, 약물 복용력 및 흉부질환, 심혈관 질환, 전신질환이 없었으며, 과거에 기관지 천식을 진단 받은 병력이 없었고, 폐기능 검사, 흉부 X-선 검사상 특이 소견이 없었다. 남자 10명 여자 15명으로 평균연령은 39.8세였고, 흡연가가 5명, 비흡연가가 20명이었다. 폐기능 검사, 메타콜린 유발검사, 알레르기 피부 단자 검사, 기관지 내시경하 점막 조직 생검을 시행하였고, 조직 비교를 위하여 정상 대조군 5명에 대해서도 기관지 내시경하 점막 조직 생검을 시행하였다. 모든 검사가 끝난 후, prednisolone 20~30 mg/일을 1~2주간 투여하였고, cough score로 치료반응 여부를 확인하였다. 결 과: 정상 대조군의 조직소견과 비교해 볼 때, 염증세포의 분포에 따라 대상군은 호산구 침윤이 저명한 경우(호산구 침윤군), 림프구 침윤이 저명한 경우(림프구 침윤군)의 두 군으로 구분이 되었다. 호산구 침윤군이 21예로, 호산구 수는 펑균 89.8 $cells/mm^2$였고, 정상 대조군은 평균 0.4 $cells/mm^2$였다 (P=0.005). 림프구 침윤군은 4예였으며, 림프구 수는 평균 84.3 $cells/mm^2$였고, 정상 대조군은 평균 28.4 $cells/mm^2$였다(P=0.026). 정상 대조군의 기저막 두께가 평균 $3.50\pm1.37\;{\mu}m$ 였던데 비하여, 대상군에서는 평균 $14.20\pm5.20{\mu}m$로 의미있게 두꺼운 소견을 보였다(p=0.001). 메타콜린 유발검사와 병리소견으로 대상군의 만성기침의 원인을 유추해보면, 호산구 침윤군 21예 중 메타콜린 유발검사 양성인 경우는 7예로, 기침형 천식으로 진단할 수 있었고, 14예는 메타콜린 유발검사가 음성으로, 호산구성 기관지염으로 진단할 수 있었다. 림프구 침윤균 4예는 모두 메타콜린 유발검사가 음성으로, 림프구 침윤에 의한 기관지염이었다. 호산구성 기관지염 14예 중 3예(21.4%)에서 아토피 양성이었다. 대상환자 25예중 22예(88.0%)에서 스테로이드 투여 후 증상지수가 호전되었다. 호산구성 기관지염 14예 중 12예(85.7%), 기침형 천식 7예 중 7예(100%), 림프구 침윤에 의한 기관지염 4예 중 3예(75.0%)에서 증상지수가 호전되었다. 병리소견으로 호산구 침윤군과 림프구 침윤군으로 구분했을 때, 증상지수가 호전된 경우가 각각 90.5%, 75.0%로 염증세포의 종류에 따른 차이는 없었다. 결 론: 흉부 X-선 및 폐기능 검사가 정상이며, 다른 증상이 없는 만성기침은 호산구 또는 림프구 침윤에 의한 기도염증과 연관이 있었다. 메타콜린 유발검사와 기관지 조직검사로 유추해 볼 때, 그 원인으로는 호산구성 기관지염, 기침형 천식, 림프구 침윤에 의한 기판지염이었다(이상 빈도순). 스테로이드 치료에 88%에서 증상지수가 호전되었다.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.501-506
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• 2011

Purpose: A high level of air pollutants can increase the number of patients with allergy-related diseases such as asthma and allergic rhinitis (AR). To analyze the association between air pollution and allergic disease, we investigated 2 areas in Korea: Incheon, an industrial area, and Jeju, a non-industrialized area. Methods: Second grade students at elementary schools (11 schools in Incheon and 45 schools in Jeju) were examined in a cross-sectional study. A questionnaire was used and a skin prick test was performed. The levels of $NO_2$, $CO_2$, $O_3$, particulate matter (PM) $PM_{10/2.5}$, formaldehyde, tVOCs, and dust mites in the classrooms and grounds were determined. Results: The levels of outdoor CO, $PM_{10}$, and $PM_{2.5}$ were significantly higher in Incheon (P<0.01). The levels of indoor CO, $CO_2$, $PM_{10}$, $PM_{2.5}$ were significantly higher in Incheon (P<0.01). The prevalence rates of AR symptoms at any time, AR symptoms during the last 12 months, diagnosis of rhinitis at any time, and AR treatment during the last 12 months were significantly higher in Incheon (P<0.01). The prevalence rate of wheezing or whistling at any time, and wheezing during the last 12 months were significantly higher in Incheon (P<0.01). Conclusion: We found that the children living in Incheon, which was more polluted than Jeju, had a higher rate of AR and asthma symptoms compared to children in Jeju. To determine the effect of air pollution on the development of the AR and asthma, further studies are needed.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.432-435
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• 2007

Purpose: The jejunal free flap has the shorter ischemic time than other flap and requires a laparotomy to harvest it. As the evaluation of the perfusion the buried flap is very important, the perfusion of the buried jejunal free flap requires monitoring for its salvage. We tried to improve the monitoring flap method in the jejunal free flap and examined its usefulness. Methods: From March 2002 to March 2006, the monitoring flap method was applied to 4 cases in 8 jejunal free flaps for the pharyngeal and cervical esophageal reconstructions. The distal part of the jejunal flap was exposed without suture fixation through cervical wound for monitoring its perfusion. The status of perfusion was judged by the color change of jejunal mucosa and mesentery. If necessary, pin prick test was performed. Doppler sonography was applied to mesenteric pedicle of the monitoring flap in case of suspicious abnormal circulation. Results: The monitoring flap shows no change in 3 cases, but the congestion happened in one case at the 12 hours after the operation. This congestion was caused by the twisting or kinking of the mesenteric pedicle of the monitoring flap. So, we fixed up the monitoring flap close to adjacent cervical skin for prevention of rotation. Finally, the main part of transferred jejunal flap was intact. Conclusion: The success of a jejunal free flap depends on close postoperative monitoring and early detection of vascular compromise. So, various monitoring methods have been tried, for instance, direct visualization using a fiberoptic pharyngoscope, through a Silastic window placed in the neck flap, or external surface monitoring with an Doppler sonography, use of a buried monitoring probe. But, all of the above have their own shortcomings of simplicity, non-invasiveness, reliability and etc. In our experience, monitoring flap can be a accurate and reliable method.