Eosinophilic myelitis (EM) or atopic myelitis is a rare disease characterized by a myelitic condition in the spinal cord combined with allergic process. This disease has specific features of elevated serum IgE level, active reaction to mite specific antigen and stepwise progression of mostly the sensory symptoms. Toxocariasis can be related with a form of EM. This report describes two cases of cervical eosinophilic myelitis initially considered as intramedullary tumors. When a differential diagnosis of the intramedullary spinal cord lesion is in doubt, evaluation for eosinophilic myelitis and toxocariasis would be beneficial.
An, Tai Joon;Kim, Jin Woo;Choi, Eun Young;Jang, Seung Hun;Lee, Hwa Young;Kang, Hye Seon;Koo, Hyeon-Kyoung;Lee, Jong Min;Kim, Sung-Kyung;Shin, Jong-Wook;Park, So Young;Rhee, Chin Kook;Moon, Ji-Yong;Kim, Yee Hyung;Lee, Hyun;Kim, Yong Hyun;Kim, Je Hyeong;Lee, Sang Haak;Kim, Deog Kyeom;Yoo, Kwang Ha;Kim, Dong-Gyu;Jung, Ki-Suck;Kim, Hui Jung;Yoon, Hyoung Kyu;Cough Study Group of the Korean Academy of Tuberculosis and Respiratory Diseases
Tuberculosis and Respiratory Diseases
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제83권1호
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pp.31-41
/
2020
Background: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines. Methods: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, exsmokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines. Results: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response. Conclusion: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.
Particulate matter (PM) is suspended dust that has a diameter of <10 ㎛ and can be inhaled by humans and deposited in the lungs, particularly the alveoli. Recent studies have shown that PM has an adverse effect on respiratory diseases. The aim of this article is to review respiratory diseases associated with PM. According to existing studies, PM is associated with chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases and increases the mortality rates of these diseases. Moreover, increased exposure in the high concentration of atmospheric PM is associated with the development of lung cancer. The most simple and common way to protect an individual from airborne PM is to wear a face mask that filters out PM. In areas of high concentration PM, it is recommended to wear a face mask to minimize the exposure to PM. However, the use of N95 or KF94 masks can interfere with respiration in patients with chronic respiratory diseases who exhibit low pulmonary function, leading to an increased risk of respiratory failure. Conclusionally, reduction of the total amount of PM is considered to be important factor and strengthening the national warning notification system to vulnerable patients and proper early management of exacerbated patients will be needed in the future.
Objectives : The purpose of this study is to analyze the current trends of various herbal medicine research on allergic disease with dysbiosis. Methods : Electronic searches were performed using Pubmed, Research Information Sharing Service(RISS), Korean studies Information Service System(KISS), Oriental medicine Advanced Searching Integrated System(OASIS). Results : We analyzed ten studies on the effect of herbal medicine on allergic disease with dysbiosis. Eight studies were animal experimental studies, and two were randomized clinical trial(RCT) study and one-group pretest-posttest research, respectively. Among the studies, three studies were on atopic dermatitis, two on allergic rhinitis, and five on asthma. All different herbal medicines were used in the studies. Changes in gut microbiota composition were observed in nine studies except for 1 RCT study. In eight animal experimental studies, there was significant reduction in allergy-related inflammatory markers. Six studies evaluated the change of metabolites related to gut microbiota and three of them showed significant increase in short-chain fatty acids(SCFA). Conclusion : This study provides current trends of studies on herbal medicine research on allergic disease with dysbiosis. Most research is conducted using animal experiments, and this is a relatively recent trend. These studies offer basic knowledge on the correlation between herbal medicine, gut microbiota, and anti-inflammatory effects in allergic disease.
The worldwide prevalence and severity of allergic diseases including atopic and contact dermatitis has increased dramatically over the past decade, especially in developed countries. Mast cells are important effector cells in allergic reactions. The purpose of this study was undertaken to investigate the anti-allergic and anti-pruritic effects of Diospyros lotus leaf extract (DLE). DLE was prepared by extracting with distilled water. In the present study, we investigated the effect of DLE on the production of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-$1{\alpha}$) and histamine in rat peritoneal mast cells (RPMCs), and on the skin lesion, leukocyte infiltration and scratching behavior in mice. Phorbol 12-myristate 13-acetate (PMA) plus calcium ionophore A23187 significantly increased TNF-${\alpha}$ and IL-$1{\beta}$ production compared with media control. However, TNF-${\alpha}$ and IL-6 production increased by PMA plus A23187 treatment were significantly inhibited by DLE in a dose-dependent manner. DLE also inhibited the histamine release from RPMCs stimulated by compound 48/80, which promotes histamine release. Moreover, DLE administration had an inhibitory effects on the scratching behavior induced by pruritogen (compound 48/80, histamine) in ICR mice. Furthermore, DLE inhibited the skin lesions, inflammatory and mast cells in hairless mice sensitized by 2,4-dinitrofluorobenzene (DNFB). DLE administration reduced the IL-4 and IgE production induced by DNFB sensitization in hairless mice. These results suggest that DLE has a potential use as a herb medicine for treatment against allergy and pruritus-related disease.
Lee, Suh-Young;Kim, Kyungjoo;Park, Yong Bum;Yoo, Kwang Ha
Tuberculosis and Respiratory Diseases
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제85권1호
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pp.11-17
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2022
Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.
Baek, Ae Rin;Lee, Ji Min;Seo, Hyun Jung;Park, Jong Sook;Lee, June Hyuk;Park, Sung Woo;Jang, An Soo;Kim, Do Jin;Koh, Eun Suk;Uh, Soo Taek;Kim, Yong Hoon;Park, Choon Sik
Tuberculosis and Respiratory Diseases
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제79권3호
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pp.143-152
/
2016
Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal lung disease characterized by the accumulation of excessive fibroblasts and myofibroblasts in the extracellular matrix. The transforming growth factor ${\beta}1$ (TGF-${\beta}1$)-induced epithelial-to-mesenchymal transition (EMT) is thought to be a possible source of fibroblasts/myofibroblasts in IPF lungs. We have previously reported that apolipoprotein A1 (ApoA1) has anti-fibrotic activity in experimental lung fibrosis. In this study, we determine whether ApoA1 modulates TGF-${\beta}1$-induced EMT in experimental lung fibrosis and clarify its mechanism of action. Methods: The A549 alveolar epithelial cell line was treated with TGF-${\beta}1$ with or without ApoA1. Morphological changes and expression of EMT-related markers, including E-cadherin, N-cadherin, and ${\alpha}$-smooth muscle actin were evaluated. Expressions of Smad and non-Smad mediators and TGF-${\beta}1$ receptor type 1 ($T{\beta}RI$) and type 2 ($T{\beta}RII$) were measured. The silica-induced lung fibrosis model was established using ApoA1 overexpressing transgenic mice. Results: TGF-${\beta}1$-treated A549 cells were changed to the mesenchymal morphology with less E-cadherin and more N-cadherin expression. The addition of ApoA1 inhibited the TGF-${\beta}1$-induced change of the EMT phenotype. ApoA1 inhibited the TGF-${\beta}1$-induced increase in the phosphorylation of Smad2 and 3 as well as that of ERK and p38 mitogen-activated protein kinase mediators. In addition, ApoA1 reduced the TGF-${\beta}1$-induced increase in $T{\beta}RI$ and $T{\beta}RII$ expression. In a mouse model of silica-induced lung fibrosis, ApoA1 overexpression reduced the silica-mediated effects, which were increased N-cadherin and decreased E-cadherin expression in the alveolar epithelium. Conclusion: Our data demonstrate that ApoA1 inhibits TGF-${\beta}1$-induced EMT in experimental lung fibrosis.
An, Tai Joon;Rhee, Chin Kook;Kim, Ji Hye;Lee, Young Rong;Chon, Jin Young;Park, Chan Kwon;Yoon, Hyoung Kyu
Tuberculosis and Respiratory Diseases
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제81권1호
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pp.80-87
/
2018
Background: Asthma is a disease of chronic airway inflammation with heterogeneous features. Neutrophilic asthma is corticosteroid-insensitive asthma related to absence or suppression of $T_H2$ process and increased $T_H1$ and/or $T_H17$ process. Macrolides are immunomodulatory drug that reduce airway inflammation, but their role in asthma is not fully known. The purpose of this study was to evaluate the role of macrolides in neutrophilic asthma and compare their effects with those of corticosteroids. Methods: C57BL/6 female mice were sensitized with ovalbumin (OVA) and lipopolysaccharides (LPS). Clarithromycin (CAM) and/or dexamethasone (DXM) were administered at days 14, 15, 21, 22, and 23. At day 24, the mice were sacrificed. Results: Airway resistance in the OVA+LPS exposed mice was elevated but was more attenuated after treatment with CAM+DXM compared with the monotherapy group (p<0.05 and p<0.01). In bronchoalveolar lavage fluid study, total cells and neutrophil counts in OVA+LPS mice were elevated but decreased after CAM+DXM treatment. In hematoxylin and eosin stain, the CAM+DXM-treated group showed less inflammation additively than the monotherapy group. There was less total protein, interleukin 17 (IL-17), interferon ${\gamma}$, and tumor necrosis factor ${\alpha}$ in the CAM+DXM group than in the monotherapy group (p<0.001, p<0.05, and p<0.001). More histone deacetylase 2 (HDAC2) activity was recovered in the DXM and CAM+DXM challenged groups than in the control group (p<0.05). Conclusion: Decreased IL-17 and recovered relative HDAC2 activity correlated with airway resistance and inflammation in a neutrophilic asthma mouse model. This result suggests macrolides as a potential corticosteroid-sparing agent in neutrophilic asthma.
This study aimed to investigate the effects of Sesami Semen on the itching and anti-allergic inflammation mechanism related with cytokine, chemokine, histamine, $\beta$-hexosaminidase, NF-$\kappa$B, and free radical, and it was concluded as follows : 1. Sesami Semen did not show any cytotoxicity at the range of con-centration (1-250 ${\mu}g/m\ell$) on the human fibroblast cell (hFCs). 2. Sesami Semen reduced the gene expressions of IL-8, TNF-$\alpha$, IL-6 mRNA comparing with control. 3. Sesami Semen reduced the levels of IL-6, IL-8, MCP-1 within THP-1 cell depending on the concentration, and especially significantly reduced the the levels of IL-6, MCP-1 at all the concentration. 4. Sesami Semen significantly decreased the histamine secretion on HMC-1 at all the concentration. 5. Sesami Semen decreased the $\beta$-Hexosaminidase secretion 6.2% at 10 ${\mu}g$/ml conc., 58.3% at 100 ${\mu}g$/ml conc. and 63.2% at 200 ${\mu}g$/ml conc., respectively. And IC50 (${\mu}g$/ml) was 158.25 ${\mu}g$/ml. 6. Sesami Semen significantly suppressed the activity of NF-$\kappa$B promoter depending on the concentration. 7. Sesami Semen decreased the production of reactive oxygen species (ROS) and DPPH generation depending on the concentration. As judged with above results, the effects of Sesami Semen on the anti-allergic inflamation would be recognized, and it could be applied on the medicinal sources for prevention or treatment of several allergy disease. And more studies are needed furthermore with the seperation of effective materials.
Purpose: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. Methods: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. Results: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was $12.7{\pm}3.2$ years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). Conclusion: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.
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