• Title/Summary/Keyword: 경향연구

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Acute and Chronic Eosinophilic Pneumonia; Clinical and Laboratory Findings (급성 및 만성 호산구성 폐렴의 임상적 고찰)

  • Hyun, D.S.;Yeo, D.S.;Kim, J.W.;Lee, S.H.;Lee, S.Y.;Kim, S.C.;Seo, J.Y.;Song, S.H.;Kim, C.H.;Moon, H.S.;Song, J.S.;Park, S.H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.795-804
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) is interstitial lung disease characterized by multiple infiltration on radiographic study, accumulation of eosinophils in the alveolar space and interstitium of the lung, chronic persistent symptoms and possible relapse. Acute eosinophilic pneumonia(AEP) is a recently described illness, characterized by rapid clinical course, acute respiratory insufficiency and no relapse. Method : To better characterize acute and chronic eosinophilic pneumonia, we studied the clinical and laboratory features of 16 patients(AEP : 7 patients, CEP : 9 patients), which were clinico-pathohistologically diagnosed and not to be associated with organic disorders producing peripheral blood eosinophilia. Results: The mean age was higher for patients with CEP than for patients with AEP ($55.4{\pm}15.1$ vs. $24.6{\pm}7.9$ years, p<0.05). High fever(above $38^{\circ}C$) was presented in all patients of AEP and in one patient(11%) of CEP. All patients of AEP and eight patients (89%) of CEP showed bilateral pulmonary infiltrates, and 6 patients(86%) of AEP and 2 patients(22%) of CEP showed pleural effusion in chest radiograph. The mean white blood cell count of AEP and CEP were $17,186/mm^3$ and $12,867/mm^3$, respectively. The mean peripheral blood eosinophil count of AEP and CEP were $939/mm^3$ and $2,104/mm^3$, respectively. The mean eosinophil fraction of BAL fluid of AEP and CEP were 32.4% (range: 18~47%) and 35.8% (range: 15.3~88.2%), respectively. The mean $PaO_2$ was lower for patients with AEP than for patients with CEP ($44.1{\pm}15.5$ vs. $62.7{\pm}6.9$mmHg, p<0.05). All patients of AEP and CEP were initially treated with antibiotics. All patients of CEP and one patients of AEP were finally required systemic steroid therapy. 6 patients of AEP were improved without steroid therapy. Relapse was observed in 3 patients(33%) of CEP. Conclusion : Compair with of chronic eosinophilic pneumonia, acute eosinophilic pneumonia was characterized by relatively young age, acute onset, high fever, severe hypoxemia, diffuse pulmonary infiltrates with pleural effusion, steroid therapy is effective but spontaneous improvement with conservative therapy was frequent.

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Effects of Molecular Weight of Polyethylene Glycol on the Dimensional Stabilization of Wood (Polyethylene Glycol의 분자량(分子量)이 목재(木材)의 치수 안정화(安定化)에 미치는 영향(影響))

  • Cheon, Cheol;Oh, Joung Soo
    • Journal of Korean Society of Forest Science
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    • v.71 no.1
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    • pp.14-21
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    • 1985
  • This study was carried out in order to prevent the devaluation of wood itself and wood products causing by anisotropy, hygroscopicity, shrinkage and swelling - properties that wood itself only have, in order to improve utility of wood, by emphasizing the natural beautiful figures of wood, to develop the dimensional stabilization techniques of wood with PEG that it is a cheap, non-toxic and the impregnation treatment is not difficult, on the effects of PEG molecular weights (200, 400, 600, 1000, 1500, 2000, 4000, 6000) and species (Pinus densiflora S. et Z., Larix leptolepis Gordon., Cryptomeria japonica D. Don., Cornus controversa Hemsl., Quercus variabilis Blume., Prunus sargentii Rehder.). The results were as follows; 1) PEG loading showed the maximum value (137.22%, Pinus densiflora, in PEG 400), the others showed that relatively slow decrease. The lower specific gravity, the more polymer loading. 2) Bulking coefficient didn't particularly show the correlation with specific gravity, for the most part, indicated the maximum values in PEG 600, except that the bulking coefficient of Quercus variabilis distributed between the range of 12-18% in PEG 400-2000. In general, the bulking coefficient of hardwood was higher than that of softwood. 3) Although there was more or less an exception according to species, volumetric swelling reduction was the greatest in PEG 400. That is, its value of Cryptomeria japonica was the greatest value with 95.0%, the others indicated more than 80% except for Prunus sargentii, while volumetric swelling reduction was decreased less than 70% as the molecular weight increase more than 1000. 4) The relative effectiveness of hardwood with high specific gravity was outstandingly higher than softwood. In general, the relative effectiveness of low molecular weight PEG was superior to those of high molecular weight PEG except that Quercus variabilis showed more than 1.6 to the total molecular weight range, while it was no significant difference as the molecular weight increase more than 4000. 5) According to the analysis of the results mentioned above, the dimensional stabilization of hardwood was more effective than softwood. Although volumetric swelling reduction was the greatest at a molecular weight of 400. In the view of polymer loading, bulking coefficiency reduction of swelling and relative effectiveness, it is desirable to use the mixture of PEG of molecular weight in the range of 200-1500. To practical use, it is recommended to study about the effects on the mixed ratio on the bulking coefficient, reduction of swelling and relative effectiveness.

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A Study on the Liturgical Vestments of Catholic-With reference to the Liturgical Vestments Firm of Paderborn and kevelaer in Germany (카톨릭교 전례복에 관한 연구-독일 Paderborn 과 kevelaer의 전례복 회사를 중심으로)

  • Yang, Ri-Na
    • The Journal of Natural Sciences
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    • v.7
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    • pp.133-162
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    • 1995
  • Paderborn's companies, Wameling and Cassau, produce the liturgical vestments, which have much traditional artistic merit. And Kevelaerer Fahnen + Paramenten GmbH, located in Kevelater which is a place of pilgrimage of the Virgin Mary, was known to Europe, Africa, America and the Scandinavia Peninsula as the "Hidden Company" of liturgical vesments maker up to now. Paderborn and Kevelaer were the place of the center of the religious world and the Catholic ceremony during a good few centries. The Catholic liturgical vestiments of these 3 companies use versatile design, color, shape and techniques. These have not only the symbolism of religion, but also can meet our's expectations of utilization of modern textile art, art clothing and wide-all division of design. These give the understanding of symbolic meanings and harmony according to liturgical vestments to the believers. And these have an influence on mental thinking and induction of religious belief to the non-believers as the recognition and concerns about the religious art. The liturgical vestments are clothes which churchmen put on at the all ceremonial function of a mass, a sacrament, performance and a parade according to rules of church. These show the represen-tation of "Holy God" in silence and distinguish between common people and churchmen. And these represent a status and dignity of churchmen and induce majesty and respect to churchmen. Common clothes of the beginning of the Greece and Rome was developed to Christian clothes with the tendency of religion. There were no special uniforms distinguished from commen people until the Christianity was recognized officially by the Roman Emperor Constantinus at A.D.313. The color of liturgical vestments was originally white and changed to special colors according to liturgical day and each time by the Pope Innocentius at 12th century. The color and symbolic meaning of the liturgical vestments of present day was originated by the Pope St. Pius(1566-1572). Wool and Linen was used as decorations and materials in the beginnings and the special materials like silk was used after 4th century and beautiful materials made of gold thread was used at 12th century. It is expected that there is no critical changes to the liturgical vestments of future. But the development of liturgical vestments will continues slowly by the command of conservative church and will change to simple and convenient formes according to the culture, the trend of the times and the fashion of clothes. The companies of liturgical vestments develop versatile design, embroidery technique and realization of creative design for distinction of the liturgical vestments of each company and artistic progress. The cooperation of companies, artists and church will make the bright future of these 3 companies. We expect that our country will be a famous producing center of the liturgical vestments through the research and development of companies, participation of artists in religeous arts and concerts of church.

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Preparation of Vitamin E Acetate Nano-emulsion and In Vitro Research Regarding Vitamin E Acetate Transdermal Delivery System which Use Franz Diffusion Cell (Vitamin E Acetate를 함유한 Nano-emulsion 제조와 Franz Diffusion Cell을 이용한 Vitamin E Acetate의 경표피 흡수에 관한 In Vitro 연구)

  • Park, Soo-Nam;Kim, Jai-Hyun;Yang, Hee-Jung;Won, Bo-Ryoung;Ahn, You-Jin;Kang, Myung-Kyu
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.35 no.2
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    • pp.91-101
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    • 2009
  • in the cosmetics and medical supply field as a antioxidant material. The stable nano particle emulsion of skin toner type containing VEA was prepared. To evaluate the skin permeation, experiments on VEA permeation to the skin of the ICR outbred albino mice (12 weeks, about 50 g, female) and on differences of solubility as a function of receptor formulations was performed. The analysis of nano-emulsions containing VEA 0.07 % showed that the higher ethanol contents the larger emulsions were formed, while the higher surfactant contents the size became smaller.In this study, vitamin E acetate (VEA, tocopheryl acetate), a lipid-soluble vitamin which is widely used A certain contents of ethanol in receptor phase increased VEA solubility on the nano-emulsion. When the ethanol contents were 10.0 % and 20.0 %, the VEA solubility was higher than 5.0 % and 40.0 %, respectively. The type of surfactant in receptor solution influenced to VEA solubility. The comparison between three kind surfactants whose chemical structures and HLB values are different, showed that solubility of VEA was increased as order of sorbitan sesquioleate (Arlacel 83; HLB 3.7) > POE (10) hydrogenated castor oil (HCO-10; HLB 6.5) > sorbitan monostearate (Arlacel 60; HLB 4.7). VEA solubility was also shown to be different according to the type of antioxidant. In early time, the solubility of the sample including ascorbic acid was similar to those of other samples including other types of antioxidants. However, the solubility of the sample including ascorbic acid was 2 times higher than others after 24 h. Franz diffusion cell experiment using mouse skin was performed with four nano-emulsion samples which have different VEA contents. The emulsion of 10 wt% ethanol was shown to be the most permeable at the amount of 128.8 ${\mu}g/cm^2$. When the result of 10 % ethanol content was compared with initial input of 220.057 ${\mu}g/cm^2$, the permeated amount was 58.53 % and the permeated amount at 10 % ethanol was higher 45.0 % and 15.0 % than the other results which ethanol contents were 1.0 and 20.0 wt%, respectively. Emulsion particle size used 0.5 % surfactant (HCO-60) was 26.0 nm that is one twentieth time smaller than the size of 0.007 % surfactant (HCO-60) at the same ethanol content. Transepidermal permeation of VEA was 54.848 ${\mu}g/cm^2$ which is smaller than that of particlesize 590.7 nm. Skin permeation of nano-emulsion containing VEA and difference of VEA solubility as a function of receptor phase formulation were determined from the results. Using these results, optimal conditions of transepidermal permeation with VEA were considered to be set up.

A Study on Food Habits and Nutrient Intakes according to BMI in Food and Nutrition Major and Non-major Female Students in Kyungnam University (식품영양전공과 비전공 여대생의 BMI에 따른 식습관 및 영양소 섭취 상태에 관한 연구 -경남대학교를 중심으로-)

  • Seo, Eun-Hee
    • Korean Journal of Community Nutrition
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    • v.19 no.4
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    • pp.297-316
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    • 2014
  • Objectives: This study was performed to investigate the body image, food habits, nutrition knowledge, food intake frequency, nutrient intakes of female university students in Masan. Methods: Two groups (n = 302, nutrition major: 147, non-major: 155) were classified into underweight, normal weight and overweight/obesity groups according to BMI respectively. Results: Height and weight of all subjects were 161.5 cm, 53.2 kg and were 161.5 cm, 55.1 kg, 161.5 cm, 51.3 kg in major and non-major female students, respectively. The BMI and body weight were significantly different (p < 0.001). Significantly higher proportions of underweight students in both study groups had perceived as 'normal' or 'fat' (p < 0.001). Higher proportion of the subjects skipped breakfast and main reason was no time to eat. Nutrition knowledge score was significantly higher in major than in non-major subjects (p < 0.001). Fish intake frequency score was significantly higher in non-majors, while the vegetable intake frequency score was significantly higher in majors. Nutrient intakes were significantly higher the majors compared to non-majors, particularly the intake of calcium (p < 0.05), zinc (p < 0.001), vitamin C (p < 0.001) and vitamin E (p < 0.01). Subjects in both groups did not have adequate nutrient intakes compared to KDRIs. BMI showed a positive correlation with body image, body weight and nutrition knowledge score (p < 0.01). Conclusions: These results suggest that systematic nutrition education program which can be applied in real life is important for the formation of correct choices of food and good eating habits.

The Effect of Pleural Thickening on the Impairment of Pulmonary Function in Asbestos Exposed Workers (석면취급 근로자에서 늑막비후가 폐기능에 미치는 영향)

  • Kim, Jee-Won;Ahn, Hyeong-Sook;Kim, Kyung-Ah;Lim, Young;Yun, Im-Goung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.923-933
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    • 1995
  • Background: Pleural abnormality is the the most common respiratory change caused by asbestos dust inhalation and also develop other asbestos related disease after cessation of asbestos exposure. So we conducted epidemiologic study to investigate if the pleural abnormality is associated with pulmonary function change and what factors are influenced on pulmonary function impairment. Methods: Two hundred and twenty two asbestos workers from 9 industries using asbestos in Korea were selected to measure the concentration of sectional asbestos fiber. Ouestionnaire, chest X-ray, PFT were also performed. All the data were analyzed by student t-test and chi-square test using SAS. Regressional analysis was performed to evaluate important factors, for example smoking, exposure concentration, period and the existence of pleural thickening, affecting to the change of pulmonary function. Results: 1) All nine industries except two, airborn asbestos fiber concentration was less than an average permissible concentration. PFT was performed on 222 workers and the percentage of male was 88.3%, their mean age was $41{\pm}9$ years old, and the duration of asbestos exposure was $10.6{\pm}7.8$ yrs. 2) The chest X-ray showed normal(89.19%), pulmonary Tb(inactive)(2.7%), pleral thickening (7.66%), suspected reticulonodular shadow(0.9%). 3) The mean values of height, smoking status, concentration of asbestos fiberwere not different between the subjects with pleural thickening and others, but age, cumulative pack-years, the duration of asbestos exposure were higher in subjects with pleural thickening. 4) All the PFT indices were lower in the subjects with pleural thickening than in the subjects without pleural thickening. 5) Simple regression analysis showed there was a significant correlation between $FEF_{75}$ which is sensitive in small airway obstruction and cumulative smoking pack-years, the duration of asbestos exposure and the concentration of asbestos fiber. 6) Multiple regression analysis showed all the pulmonary function indices were decreased as the increase of cumulative smoking pack-years and especially in the indices those are sensitive in small airway obstruction. Pleural thickening was associated with reduction in FVC, $FEV_1$, PEFR and $FEF_{25}$. Conclusion: The more concentration of asbestos fiber and the more duration of asbestos exposure, the greater reduction in $FEF_{50}$, $FEF_{75}$. Therefore PFT was important in the evaluation of early detection for small airway obstruction. Furthermore pleural thickening without asbesto-related parenchymal lung disease is associated with reduction in pulmonary function.

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Comparision of Chest Radiographs and Pulmonary Function in Coal Workers' Pneumoconiosis and Welders' Lung (탄광부 진폐증과 용접공 폐증에 있어 흉부-X선 소견과 폐기능의 비교)

  • Park, Dong-Youl;Hwang, Joo-Ho;Kang, Byung-Son;Chung, Chan-Su;Kim, Wha-Jo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.713-722
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    • 1995
  • Background: Chest X-ray of coal workers' pneumoconiosis and shipyard welders' lung show similar and regular opacities mostly, it is very difficult that we distinguish the former from the latter by only chest X-ray. so we performed this study to understand the progression of the disease and to provide the disease by considering pulmonary function and other factors in proportion to the profusion of small regular opacities of chest X-ray in both groups. Method: 430 coal workers' pneumoconiosis were compared with 311 shipyard welders' lung by the number, the age, the duration of dust exposure, %vital capacity(%VC), %FEV1.0, the type of ventilatory impairment, the combined pulmonary disease according to the profusion of small regular opacities on the chest radiographs, which were classified into category 0/1, category 1, and category 2. Result: 1) the percent of category 2 in coal workers' pneumoconiosis was 54.4%. the percent of category 1, and category 2 in welders' lung were 60.0%, 7.4%. the progression to the category 2 was higher in coal workers' pneumoconiosis than in welders' lung 2) The mean age was higher in coal workers' pneumoconiosis than in welders' lung, significantly increased in proportion to the progresion of profusion of small regular opacities in both groups 3) There was no difference in the duration of dust exposure by category 1/0, but the duration of dust exposure by category 1, 2 in coal workers' pneumoconiosis more significantly increased than in welders' lung. the duration in the proportion of category 2 to category 0/1, 1 significantly increased in the proportion to small regular opacities in coal workers' pneumoconiosis. but there was no significant difference in the proportion to small regular opacities in duration of dust exposure in welders' lung. 4) There was no significant difference of mean values of %VC(%vital capacity)in both groups except for category 1. the mean values of %VC had no relationship between the progression of small regular opacities in both groups. 5) The mean values of %FEV1.0 decreased more significantly in coal workers' pneumoconiosis than in welders' lung except for category 0/1. and decreased significantly in proportion to the profusion of small regular opacities in coal workers' pneumoconiosis. there was significant difference of %FEV1.0 in the proportion of category 2 to category 011 in welders' lung. 6) there were no significant difference of %FEV1.0, %VC in smoker and nonsmoker in both groups. 7) With regard to the type of ventilation in both groups in coal workers' pneumoconiosis 21.4 percent of patients belonged to the restrictive type, 11.6 percent to the obstructive type, 5.6 percent to the combined type, but in welders' lung 21.8 percent to the restrictive type, 2.9 percent to the obstructive type, 1.9 percent to the combined type. 8. in the pulmonary disease, the incidence of the pulmonary tuberculosis was the most in both groups, was more in coal workers' pneumoconiosis than welders' lung Conclusion: If we compare coal workers' pneumoconiosis with electric arc welders'lung by considering pulmonary function and other factors in proportion to the profusion of chest X-ray, I think that we will have the better result in understanding the progression of the disease and provision of the disease in both groups.

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The Effect of Heat Shock Response on the Tumor Necrosis Factor-$\alpha$-induced Acute Lung Injury in Rats (Tumor Necrosis Factor-$\alpha$로 유도되는 백서의 급성 폐손상에 열충격반응이 미치는 효과)

  • Koh, Youn-Suck;Lim, Chae-Man;Kim, Mi-Jung;Cho, Won-Kyung;Jeoung, Byung-O;Song, Kyu-Young;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1343-1352
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    • 1997
  • Background : Heat-treated cells are known to be protected from lysis by TNF, which is considered to play a central role in the pathogenesis of sepsis-induced acute lung injury. The objective of the study was to investigate the effect of heat shock response by heat-pretreatment on the acute lung injury of the rats induced by intratracheally administered TNF-$\alpha$, Methods : We intratracheally instilled either saline or TNF (R&D, 500ng) with and without heat pretreatment in Sprague-Dawley rats weighing 250~350 g. The heated rats were raised their rectal temperature to $41^{\circ}C$ and was maintained thereafter for 13 minutes at 18 h before intratracheal administration of saline or TNF. After 5 h of intratracheal treatment, lung leak, lung myeloperoxidase activity (MPO) and heat shock proteins were measured in rats. Lung leak index was defined as counts per minute of $I^{25}$ in the right lung divided by counts per minutes of $I^{25}$ in 1.0 ml of blood. All data are expressed as means ${\pm}$SE. Results : There is no difference in acute lung leak index ($0.099{\pm}0.024$ vs $0.123{\pm}0.005$) among the rats given saline intratracheally with and without heat pretreatment, but MPO activity showed a decreased tendency in heat-pretreated rats ($4.58{\pm}0.79\;U/g$) compared with heat-unpretreated rats ($7.32{\pm}0.97\;U/g$) (P=0.064). Rats administered TNF intratracheally with heat-pretreatment had decreased lung leak index ($0.137{\pm}0.012$) and lung MPO activity ($5.51{\pm}1.04\;U/g$) compared with those of heat-unpretreated and TNF-administered rats ($0.186{\pm}0.016$, $14.34{\pm}1.22\;U/g$) (P<0.05 in each). There were no significant difference of lung leak index and MPO activity between TNF-treated rats with heat-pretreatment and saline-treated rats with and without heat-pretreatment. Conclusion : The heat shock response attenuated neutrophil recruitment and acute lung leak induced by intratracheal instillation of TNF-in rats.

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Determination of Minimal Pressure Support Level During Weaning from Pressure Support Ventilation (압력보조 환기법으로 기계호흡 이탈시 최소압력보조(Minimal Pressure Support) 수준의 결정)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.380-387
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    • 1998
  • Background: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation While the lower applied level of pressure support compared to PSmin could induce respiratory muscle fatigue, the higher level than PSmin could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation PSmin has been usually applied in the level of 5~10 cm$H_2O$, but the accurate level of PSmin is difficult to be determinated in individual cases. PSmin is known to be calculated by using the equation of "PSmin = peak inspiratory flow rate during spontaneus ventilation$\times$total ventilatory system resistance", but correlation of calculated PSmin and measured PSmin has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5~10 cm$H_2O$ would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured PSmin and calculated PSmin. Method : 1) Measurement of PSmin : Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary monitor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured PSmin was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin : Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(O cm$H_2O$). Thereafter PSmin was calculated by using the equation "PSmin = peak inspiratory flow rate$\times$R, R = (Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation". Results: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(${\pm}14$) years, and the mean of total ventilation times was 9(${\pm}4$) days. All patients except one were males. The measured PSmin of the subjects ranged 4.0~12.5cm$H_2O$ in 14 patients. The mean level of PSmin was 7.6(${\pm}2.5\;cmH_2O$) in measured PSmin, 8.6 (${\pm}3.25\;cmH_2O$) in calculated PSmin Correlation between the measured PSmin and the calculated PSmin is significantly high(n=9, r=0.88, p=0.002). The calculated PSmin show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured PSmin/calculated PSmin was 0.81(${\pm}0.05$). Conclusion: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cm$H_2O$. Because the equation-driven calculated PSmin showed a good correlation with measured PSmin, the application of equation-driven PSmin would be then appropriate compared with conventional application of 5~10 cm$H_2O$ in patients under difficult weaning process with pressure support ventilation.

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Clinical Impact of Bronchial Reactivity and Its Relationship with Changes of Pulmonary Function After Asthmatic Attack Induced by Methacholine (기관지 반응성의 임상적 의의 및 메타콜린으로 유도된 천식 발작시 폐기능 변화와의 관계)

  • Ryu, Yon-Ju;Choi, Young-Ju;Kwak, Jae-Jin;Lee, Ji-A;Nam, Seung-Hyun;Park, Chang-Han;Chaon, Saon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.24-36
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    • 2002
  • Background: Bronchial reactivity is known to be a component of airway hyperresponsiveness, a cardinal feature of asthma, with bronchial sensitivity, and is increments in response to induced doses of bronchoconstrictors as manifested by the steepest slope of the dose-response curve. However, there is some controversy regarding methods of measuring bronchial reactivity and clinical impact of such measurements. The purpose of this study was to evaluate the clinical significance and assess the clinical use by analyzing the relationship of the bronchial sensitivity, the clinical severity and the changes in pulmonary function with bronchial reactivity. Method: A total of 116 subjects underwent a methacholine bronchial provocation test. They were divided into 3 groups : mild intermittent, mild persistent, moderate and cough asthma. Severe patients were excluded. Methacholine PC20 was determined from the log dose-response curve and PC40 was determined by one more dose inhalation after PC20. The steepest slope of log dose-response curve, connecting PC20 with PC40, was used to calculate the bronchial reactivity. Body plethysmography and a single breath for the DLCO were done in 43 subjects before and after methacholine test. Results: The average bronchial reactivity was 38.0 in the mild intermittent group, 49.8 in the mild persistent group, 61.0 in the moderate group, and 41.1 in the cough asthma group. There was a weak negative correlation between PC20 and bronchial reactivity. A heightened bronchial reactivity tends to produce an increased clinical severity in patients with a similar bronchial sensitivity and basal spirometric pulmonary function. There were significant correlations between the bronchial reactivity and the initial pulmonary function before the methacholine test in the order of sGaw, Raw, $FEV_1$/FVC, MMFR. There were no correlations between the bronchial sensitivity and the % change in the pulmonary function parameters after the methacholine test. However, there were significant correlations between the bronchial reactivity and the PEF, $FEV_1$, DLCO. Conclusion: There was weak significant negative correlation between the bronchial reactivity and the bronchial sensitivity, and the bronchial reactivity closely reflected the severity of the asthma. Accordingly, measuring both the bronchial sensitivity and the bronchial reactivity can be of assistance in assessing of the ongoing disease severity and in monitoring the effect of therapy.