• Journal of Yeungnam Medical Science
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• 제14권2호
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• pp.329-336
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• 1997

만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두(100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명 중 3명(23.1%)에서만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되면 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성 전환의 동반이 흔한 것으로 나타났다.

• Clinical and Experimental Pediatrics
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• 제57권4호
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• pp.164-170
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• 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

• The Korean Journal of Pain
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• 제7권1호
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• pp.106-112
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• 1994

45세 여자 환자에서 요하지통의 치료를 위해 triamcinolone 40 mg과 0.125% bupivacaine 10 ml를 경막외로 주입한후 24시간에 걸쳐 하지마비 및 해리성 감각소설이 발생하였다. 그 원인은 분명하지 않으나 선행절환의 악화, 급성 횡단성 척수염, 전척수동맥증후군, 그리고 신경독성등이 추정된다.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• Tuberculosis and Respiratory Diseases
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• 제51권6호
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• pp.530-539
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• 2001

연구배경 : 기관지 천식은 기도의 재구성과 관련된 기도의 염증성 질환이다. Vascular endothelial growth factor(VEGF) 는 혈관생성과 염증반응에 관여하는 강력하고 다양한 기능의 사이토카인이며 Matrix metalloproteinase-9(MMP-9)은 기관지 천식에서 기도의 재구성을 일으키는 주요 단백분해 효소이다. 그러나, 아직 급성 기관지 천식에서 VEGF의 역할 및 VEGF와 MMP-9의 관련성등에 관한 보고는 거의 없다. 저자들은 급성 기관지 천식에서 VEGF가 기관지 염증반응에 관여하는지를 조사하였고 또한 객담내 VEGF 발현 정도와 MMP-9의 관련성도 같이 알아보고자 하였다. 방 법 : 저자들은 안정상태 및 급성천식상태 환자에서 객담내 VEGF와 MMP-9의 양을 효소 면역측정과 zymography 분석으로 측정하였고 또한 기관지 천식의 자발 발작시에도 측정하였다. 결 과 : 기관지 천식 환자군에서 안정상태의 천식환자군이나 건강 대조군보다 객담내 VEGF 양이 유의있게 높음을 알 수 있었고 또한 천식 발작시에는 안정시보다 더 유의있게 높았으며 천식치료후 점차 감소하였다. 급성 천식 환자들에서 객담내 VEGF농도는 호중구및 호산구들 수와 의의있게 관련이 있었고 또한 객담내 VEGF와 MMP-9의 농도사이에 유의있는 상관관계가 있음을 알 수 있었다. 결 론 : 급성 기관지 천식 환자에서 VEGF의 과도발현은 기도 염증반응과 관련이 있으며 또한 MMP-9과도 밀접한 연관성이 관련성이 있는 것으로 사료된다.

• 대한한의학방제학회지
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• 제21권2호
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• pp.81-89
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• 2013

Objectives : The purpose of this study is to observe the effect of Coptidis Rhizoma (CCE-extract of C. chinensis Rhizome) in induction of immune protein on mouse macrophages. Methods : To analyze cytokines interleukin(IL)-$1{\alpha}$, IL-3, IL-9, IL-12p40, IL-13, IL-17, Monocyte Chemoattractant Protein(MCP)-1 induced by macrophages, mouse macrophages were incubated with CCE and was measured. Results : IL-$1{\alpha}$ measurement, CCE showed significant inhibition only at concentration level of 200 ${\mu}g/mL$. IL-3, MCP-1 measurement, CCE showed significant inhibition only at concentration level of 100, 200 ${\mu}g/mL$. IL-9 measurement, CCE showed significant inhibition only at concentration level of 50 ${\mu}g/mL$. IL-13 measurement, CCE showed significant inhibition only at concentration level of 50, 100, 200 ${\mu}g/mL$. The IL-12p40, IL-17 levels indicated no changes at 25, 50, 100, 200 ${\mu}g/mL$ on mouse macrophages. Conclusions : CCE did not significantly increased inflammatory cytokines IL-$1{\alpha}$, IL-3, IL-9, IL-12p40, IL-13, IL-17, Monocyte Chemoattractant Protein(MCP)-1 on mouse macrophages. It was verified CCE does not trigger cytokine related hypersensitivity reaction of organism or exacerbation of acute/chronic inflammatory disease.

• Tuberculosis and Respiratory Diseases
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• 제61권2호
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• pp.178-183
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• 2006

61세 만성폐쇄폐질환 남자 환자로 호흡곤란을 주소로 내원하여 만성폐쇄성폐 질환 급성 악화 진단 하에 입원치료를 시작하였다. 입원치료 도중 다량의 자발성 피하공기증이 생기면서 호흡곤란이 악화되어 다수의 16 gauge 정맥용 도관 을 빗장중간선에 삽입하고 배출을 시도하였다. 그러나 피하공기증이 더욱 악화되어 wall suction으로 지속적인 흡인을 하였고 이후 피하공기증의 관해를 확인 할 수 있었다. 저자들은 16 gauge 정맥용 도관을 이용한 지속흡인으로 비침습 적이고 간편하게 피하공기증을 치료하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제77권5호
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• pp.219-222
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• 2014

Pneumatosis intestinalis (PI) is a very rare condition that is defined as the presence of gas within the subserosal or submucosal layer of the bowel. PI has been described in association with a variety of conditions including gastrointestinal tract disorders, pulmonary diseases, connective tissue disorders, organ transplantation, leukemia, and various immunodeficiency states. We report a rare case of a 74-year-old woman who complained of dyspnea during the management of acute asthma exacerbation and developed PI; but, it improved without any treatment.

• 동의생리병리학회지
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• 제28권1호
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• pp.82-88
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• 2014

This study is a single group before-and-after study aimed to evaluate the effectiveness of additional acupuncture therapy for lung cancer patients being treated with chemotherapy. Acupuncture therapy was conducted twice a day at least for a week. The effectiveness outcome measures were the Korean Functional Assessment of Cancer Therapy (FACT-L) and the Korean Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at the baseline, discharge and four weeks after discharge, and visual analogue scale(VAS) checked daily from the baseline to discharge. Ten patients were enrolled, one patient had excluded due to acute exacerbation of lung cancer. The data of nine patients showed some improvement in all of FACT-L, FACIT-F and VAS, however, there were no statistical significance. Additional acupuncture therapy for lung cancer patients treated with chemotherapy might be beneficial to improve the quality of life(QoL) and to improve fatigue. Prospective trials with complex traditional Korean medicine interventions are needed to further investigation.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.132-137
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• 2018

Background: The pathophysiology of chronic obstructive pulmonary disease (COPD) includes inflammation, oxidative stress, an imbalance of proteases and antiproteases and apoptosis which has been focused on lately. Abnormal apoptotic events have been demonstrated in both epithelial and endothelial cells, as well as in inflammatory cells including neutrophils and lymphocytes in the lungs of COPD patients. An increased propensity of activated T lymphocytes to undergo apoptosis has been observed in the peripheral blood of COPD patients. Therefore, the apoptosis of T lymphocytes without activating them was investigated in this study. Methods: Twelve control subjects, 21 stable COPD patients and 15 exacerbated COPD patients were recruited in the study. The T lymphocytes were isolated from the peripheral blood using magnetically activated cell sorting. Apoptosis of the T lymphocytes was assessed with flow cytometry using Annexin V and 7-aminoactinomycin D. Apoptosis of T lymphocytes at 24 hours after the cell culture was measured so that the T lymphocyte apoptosis among the control and the COPD patients could be compared. Results: Stable COPD patients had increased rates of $CD4^+$ T lymphocyte apoptosis at 24 hours after the cell culture, more than the $CD4^+$ T lymphocyte apoptosis which appeared in the control group, while the COPD patients with acute exacerbation had an amplified response of $CD4^+$ T lymphocyte apoptosis as well as of $CD8^+$ T lymphocyte apoptosis at 24 hours after the cell culture. Conclusion: Stable COPD patients have more apoptosis of $CD4^+$ T lymphocytes, which can be associated with the pathophysiology of COPD in stable conditions.