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Study for Treatment Effects and Prognostic Factors of Bronchial Asthma -Follow Up Over 2 Years- (2년 이상 관찰중인 성안 기관지 천식환자의 치료 효과 및 예후인자에 관한 연구)

  • Choung, Bo-Young;Park, Jung-Won;Kim, Sung-Kyu;Hong, Chein-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.559-573
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    • 1997
  • Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

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Clinical Manifestations of the Lung Involvement in Behçet's Syndrome (Behçet 증후군에서 폐침범의 임상양상에 관한 고찰)

  • Park, Kwang Joo;Park, Seung Ho;Kim, Sang Jin;Kim, Hyung Jung;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.763-773
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    • 1996
  • Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.

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Double Tension Band Osteosynthesis in Intra-articular Fractures of the Distal Humerus (AO type C) in Elderly Osteoporotic Patients (고령 환자의 상완골 원위부 AO-C형 골절에서 이중 강선 장력대 고정술)

  • Cheon, Sang Jin;Lee, Dong Ho;Goh, Tae Sik
    • Clinics in Shoulder and Elbow
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    • v.16 no.1
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    • pp.33-39
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    • 2013
  • Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.

Response of 1-methylcyclopropene Treatment on Early season 'Hanareum' and Mid-season 'Manpungbae' Asian Pears (Pyrus pyrifolia Nakai) (동양배(Pyrus pyrifolia Nakai)인 조생종 '한아름' 및 중생종 '만풍배'에 대한 1-methylcyclopropene 처리 반응)

  • Lee, Ug-Yong;Oh, Kwang-Suk;Bae, Tae-Min;Chun, Jong-Pil
    • Journal of Bio-Environment Control
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    • v.23 no.3
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    • pp.212-220
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    • 2014
  • This study was conducted to investigate the effect of 1-methylcyclopropene (1-MCP), a known ethylene action inhibitor, on fruit quality and incidence of physiological disorders during simulated marketing period in Asian pears (Pyrus pyrifolia Nakai) of early-season cultivar 'Hanareum' and mid-season cultivar 'Manpungbae'. Flesh firmness was decreased abruptly at 15 days after shelf-life in untreated fruit of early-season cultivar 'Hanareum' which showed less than 19N, although those of 1-MCP-treated fruits were kept high value (>28N) during 15 days of shelf-life. However, there were no distinct firmness changes during 30 days of shelf-life in mid-season cultivar 'Manpungbae' pear. Two pear cultivars did not show any considerable differences in quality indices such as soluble solids content, titratable acidity and skin color during the shelf-life regardless of 1-MCP treatment. The reduction of ethylene production level by 1-MCP treatment did not appeared in 'Hanareum' pear. Meanwhile, 1-MCP treated 'Hanareum' pears showed significantly low respiration rate during shelf-life. On the other hand, the inhibitory effect of 1-MCP was not remarkable in mid-season 'Manpungbae' pears. 1-MCP treatment completely blocked the incidence of physiological disorders including core browning and mealiness symptom during shelf-life only in early-season 'Hanareum' pears, and reduced considerably the pithiness disorder regardless of 1-MCP concentration. Consequently, we concluded that the treatment efficacy of 1-MCP is largely cultivar-dependent and the use of $1{\mu}L{\cdot}L^{-1}$ 1-MCP was recommended for the keeping quality and the prevention of physiological disorders only in early-season Asian pear 'Hanareum'.

Relationship between the non-spinning syndrome of silkworm, Bombyx mori and pesticides (누에 미화용 증상과 농약 관련성)

  • Park, Kyung-Hun;Kim, Byung-Seok;Park, Yeon-Ki;Lee, Hee-Dong;Jeong, Mi-Hye;You, Are-Sun;Sohn, Bong-Hee;Kang, Pil-Don;Kyung, Kee-Sung
    • The Korean Journal of Pesticide Science
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    • v.11 no.4
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    • pp.238-245
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    • 2007
  • This survey was performed to elucidate whether pesticide can cause the non-spinning syndrome of silkworm, Bombyx mori in Yecheon and Sangju 2002. We primarily focused to Insect Growth Regulator Pesticides(IGR) used in that areas. In the result of the survey to the retail pesticide store at Yecheon and Sangju, seven pesticides of the total 12 IGR pesticides sold were used during spring sericuitural season. 7 pesticides might effect on silkworm in consideration of possibility of exposure according to the characteristics of used amount, spray drift, volatility and treatment time. Five chitin synthesis inhibitor involving diflubenzuron of 7 IGR pesticides were known as very toxic to silkwork after exposure by skin and feeding but no non-spinning syndrome was observed from several papers. Methoxyfenozide and tebufenozide also has used at sericultural season, but are ecdysone agonist. One of the most feasible suspect of non IGR pesticide, was molinate in consideration of its volatility property and wide spread use in the sericultural area. But it's symptom after exposure of molinate was not the same as the non-spinning syndrome broke out at the sericultural farm in Yecheon and Sangju.

A Clinical Study of Children Who Showed Benign Hemophagocytic Histiocytes in Bone Marrow Examination (골수 검사상 양성 혈구 탐식 조직구가 나타난 소아의 임상적 고찰)

  • Park, Jin A;Park, Joo Young;Park, Ji Min;Park, Seat Byoul;Kim, Heung Sik;Jeon, Dong Seok
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1007-1015
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    • 2002
  • Purpose : The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination. Methods : We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells. Results : The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes. Conclusion : Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.

Clinicopathological evaluation of Childhood Henoch-$Sch{\ddot{o}}nlein$ Purpura(HSP) Nephritis with Nephrotic Syndrome (신증후군을 동반한 Henoch-$Sch{\ddot{o}}nlein$ 신염 환아의 임상병리 적 고찰)

  • Kang Hyeon-Ho;Yoon Kyung-Leem;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.111-119
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    • 2000
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a common pediatric discase presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. Method : Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998. Results : 1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4$\%$, gross hematuria 17.6$\%$, microscopic hematuria 50$\%$. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C). Conclusion : Among the 디le patients with Henoch-$Sch{\ddot{o}}nlein$ purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.

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Study on Incidence and Improvement of Food Allergies for Prevention of Damage in Adolescents and Adults (청소년과 성인의 식품 알레르기 예방을 위한 식품 알레르기 발생 실태 및 개선안 연구)

  • Kim, Mi Jung;Sim, Ki Hyeon
    • Journal of the East Asian Society of Dietary Life
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    • v.24 no.4
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    • pp.514-528
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    • 2014
  • This study examined the actual state and future improvement of food allergies in adolescents and adults in order to prevent damage. In this survey, proportions of females, people in their 40s, college graduates, and office workers and housewives with allergies were higher than other groups. Exactly 41.1% of participants responded that they had experienced food allergies while 58.9% responded that they had not. According to their responses, the most common food allergy symptom involved the skin while whole-body allergic reactions were rare. Most respondents answered that frequency of their food allergies was two or three times. There was a variety of allergenic foods, including fast food, eggs, mackerel and milk, and instant food was ranked as the most allergenic food. Therefore, in order to protect consumers from damage caused by food allergens, the food allergen labeling system must be improved. A better food allergen labeling system should be implemented to avoid potential risks of allergic reactions and ensure national food safety.

Clinical Analysis of Primary Varicose Vein - review of 209 cases - (원발성 하지정맥류의 임상적 고찰 - 209례 보고 -)

  • Lee, Yuen-Jae;Park, Chul;Kim, Jong-Seok;Kim, Han-Yong;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.909-916
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    • 2001
  • Background : Varicose vein is a very common vascular disease and has recently become a matter of concern for thoracic and cardiovascular surgens. Material and Method : We analyzed 209 cases or 269 feet with varicose vein retrospectively, which had been treated in our hospital from April 1999 to December 2000. Result : Male : Female ratio was 1:3(Male : 52 cases, Female : 157 cases), mean age was 42.2$\pm$9.7 years old, mean duration of varicosities was 12.2$\pm$9.7 years, and mean follow up was 14.8$\pm$6.1 months from July 2001. Most common symptom was leg pain(122 cases, 58.4%). Long standing job(44 cases), pregnancy(37 cases), and family history related to varicose vein came to 79.9% as the major predisposing or precipitating factors. Anatomic classifications of main lesion were GSV (greater saphenous vein,126 cases), LSV(lesser saphenous vein,18 cases), and reticular veins and telangiectasias(65 cases). Main treatments were stripping of GSV, stab avulsion, ligation of saphenofemoral junction, sclerotherapy, and conservative treatment. Comparing A group (stripping of GSV) with B group(sclerotherapy of GSV), A group had more complications than B group; however, A group had less recurrences than B group(p 0.05). Comparing C group(stab avulsion of LSV) with D group(sclerotherapy of LSV), there were 2 cases of recurrence in D group; however, there were no statistical differences between the two groups in complication and recurrence(p>0.05). Comparing B group(sclerotherapy of GSV) with E group(sclerotherapy of reticular vein and telangiectasia), there were no differences in complication; however, B group had more recurrences than E group. Post-stripping complications were ankle numbness and tingling(2 cases), ankle pain(2 cases),ankle swelling(2 cases), and wound pain(1 case). Postsclerotherapy complications were thrombophlebitis(1 case) and skin ulcer(1 case). Conclusion: Sclerotherapy for varicose vein involving GSV had more recurrences than stripping for lesions involving GSV. Sclerotherapy for reticular vein and telangiectasia had less recurrences than sclerotherapy for lesion involving GSV. Sclerotherapy is a very convenient method without operation and admission, thus further research is demanded in case of varicose vein involving GSV.

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Effects of GA3 Dipping of Time and Concentration on the Rachis Growth and Fruit Quality in 'Campbell Early' Grapevine (포도 '캠벨얼리'에서 GA3의 침지 시기와 농도에 의한 화수(花穗)생장 및 과실품질)

  • Moon, Byung-Woo;Lee, Young-Cheul;Nam, Ki-Woong;Moon, Young-Ji
    • Journal of Practical Agriculture & Fisheries Research
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    • v.16 no.1
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    • pp.55-66
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    • 2014
  • This study has been conducted to investigate the treatment time and concentration of GA3 solution dipping for labor saving in 'Campbell Early' grapevine. The rachis growth at harvest was reduced by GA3 solution dipping before 5 days flowering, and increased significantly by GA3 solution dipping treatment at full bloom and after 5 days full bloom. GA3 5, 10, 20 mg·L-1 dipping treatment before 5 days flowering and GA3 20 mg·L-1 treatment of full bloom and after 5 days full bloom showed a rachis twist phytotoxicity symptom. The optimum GA3 concentrations for rachis growth promotion without phytotoxicity were 5 mg·L-1 and 10 mg·L-1. The degree of compact berry, bloom, skin color, SSC and acidity at harvest by GA3 solution dipping treatment time between concentration were not different from those of control. But the fruit berry weight was decreased by before 5 days flowering treatment when compared with control. There were no differences in full bloom and after 5 days full bloom treatment. The occurrence percent of berry cracking at before 5 days flowering and after 5 days full bloom treatment were significantly increased by GA3 treatment. The bitter rot occurrence of berry at harvest was not affected by GA3 treatment. Total rachis length of fruit cluster was increased by full bloom and 5 days after full bloom treatment. The length of rachis increased without reference to them position at full bloom and 5 days after bloom treatment. Accordingly, GA3 5 mg·L-1 solution dipping treatment at full bloom and 5 days after full bloom were can be effectively for rachis growth promotion.