• Tuberculosis and Respiratory Diseases
• /
• 제43권2호
• /
• pp.182-189
• /
• 1996

연구목적 : 기관지 천식은 기도의 염증반응, 기관지 과민 반응의 증가및 가역적인 기도의 수축을 특징으로 하는 질환으로, 기관지 염증반응의 단계중에서도 호산구등의 염증세포들이 혈관벽을 통과한후 염증 부위로의 이동 및 활성화에 관여하는 RANTES의 농도를 특이 항원으로 유발후 측정하여 기관지 천식의 병인과의 관계를 알아보고자 하였다. 대상 및 방법 : 1994년 3월부터 1995년 3월까지 전북대학교 병원 내과에 내원한 환자중 알레르기 피부시험과 비특이적 기관지유발 시험에서 양성반응을 보인 아토피성 기관지 천식 환자 16명과 정상 대조군 8명을 대상으로 RANTES를 측정하였다. 결과 : 1) 특이 항원 기관지 유발 검사 전 혈청내 RANTES농도는, 조기 천식반응군이 57740pg/ml, 이중 천식반응환자군이 54430pg/ml으로 정상 대조군의 31087pg/ml에 비해 기관지 천식 환자군에서 유의있게 증가하였으나(P<0.05), 조기 천식환자군에 비해 이중 천식환자군에서 유의한 증가는 볼수 없었다. 2) 기관지 천식환자에서 특이 항원 유발후 30분, 2시간 8시간후에 측정한 RANTES농도는 조기 천식반응군이 각각 51508, 51288, 그리고 52264pg/ml으로 유발전에 비해 유의있는 관찰할수 없었으며, 이중 천식환자군역시 각각 51723, 50110, 그리고 55674pg/ml으로 유발전에 비해 유의있는 변화는 관찰할수 없었다. 결론 : 아토피성 기관지 천식 환자의 병인에 RANTES 농도의 증가가 중요한 역할을 하며, 특히 천식의 만성 염증성 변화에 깊히 관여한다고 생각된다.

• Tuberculosis and Respiratory Diseases
• /
• 제84권4호
• /
• pp.326-332
• /
• 2021

Background: The association of invasive tracheobronchial aspergillosis (ITBA) with invasive pulmonary aspergillosis (IPA) is not well established. We aimed to compare clinical characteristics between patients who exhibited ITBA with IPA and those who exhibited isolated ITBA (iITBA). Additionally, the usefulness of serum or bronchial galactomannan (GM) tests in diagnosing ITBA was evaluated. Methods: This retrospective single-center case-control study was conducted over a period of 4 years. Fifteen patients were enrolled after confirming the presence of ITBA using bronchoscopy-guided biopsy (iITBA, 7 vs. ITBA+IPA, 8). Clinical characteristics of patients and results obtained from serum or bronchial GM tests were compared between the two groups. Mortality was assessed using data collected from a 6-month follow-up period. Results: The ITBA+IPA group showed a higher prevalence of hematologic malignancy (75% vs. 14%, p=0.029), a greater number of patients with multiple bronchial ulcers (75% vs. 14%, p=0.029), lower platelet counts (63,000/μL vs. 229,000/μL, p<0.001), and a mortality rate which was significantly higher (63% vs. 0%, p=0.026) than the iITBA group. In the ITBA+IPA group, 57% of patients tested positive according to the serum GM assay, whereas in the iITBA group, all patients tested negative (p=0.070). The bronchial GM level was high in both groups, but there was no significant difference between them. Conclusion: Patients with ITBA+IPA had a greater number of hematologic malignancies with lower platelet counts and a poorer prognosis than patients diagnosed with iITBA. Findings obtained from bronchoscopy and bronchial GM tests were more useful in diagnosing ITBA than the serum GM test results.

• Tuberculosis and Respiratory Diseases
• /
• 제67권6호
• /
• pp.536-544
• /
• 2009

Background: A combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) is commonly prescribed for COPD patients but there is little data on their effectiveness, particularly in COPD patients with bronchial hyperresponsiveness. This study compared the spirometric improvement based on the change in $FEV_1$, $FEV_1$/FVC, and IC as well as the clinical outcomes of the therapeutic strategies with SFC and TIO versus the individual components in patients with severe COPD and bronchial hyperresponsiveness. Methods: This study examined the spirometric data and clinical outcomes of 214 patients with COPD and hyperresponsiveness, who were divided into three groups according to the therapeutic regimen (TIO only, SFC only, and a triple therapy regimen). Results: All regimen groups showed early improvement in the $FEV_1$ and IC (at 3- and 6 months after treatment). However, long-term beneficial effects were observed only in the SFC group (at 24 months after treatment). However, these beneficial effects decreased after a 36-month follow up. In all spirometric results, the 12-, 24-, and 36-months data showed a similar degree of improvement in the three groups. The triple therapy group showed higher St. George's Respiratory Questionnaire scores and lower acute exacerbations and hospitalization. Conclusion: SFC can be a more important component in the pharmacological treatment of severe COPD patients with hyperresponsiveness than TIO, particularly in the spirometric and clinical outcomes.

• Tuberculosis and Respiratory Diseases
• /
• 제80권1호
• /
• pp.83-89
• /
• 2017

Background: Previous studies report that apoptosis and autophagy are involved in the pathogenesis of emphysema, and macroautophagy is one of the processes regulating the apoptosis pathway. However, few studies have evaluated whether chaperone-mediated autophagy (CMA) contributes to the regulation of apoptosis. In this study, we investigated the impact of autophagy, including both macroautophagy and CMA, on the apoptosis in bronchial epithelial cells. Methods: Cigarette smoke extract (CSE) was injected intratracheally into C57BL/6 mice, and emphysema and apoptosis were evaluated in the lungs. After treatment with CSE, apoptosis, macroautophagy, and CMA were measured in BEAS2-B cells, and the impact of autophagy on the apoptosis was evaluated following knockdown of autophagy-related genes by short interfering RNAs (siRNAs). Results: Intratracheal CSE injection resulted in the development of emphysema and an increase in apoptosis in mice. CSE increased the apoptosis in BEAS2-B cells, and also elevated the expression of proteins related to both macroautophagy and CMA in BEAS2-B cells. The knockdown experiment with siRNAs showed that macroautophagy increases apoptosis in BEAS2-B cells, while CMA suppresses apoptosis. Conclusion: The intratracheal injection of CSE induces pulmonary emphysema and an increase in apoptosis in mice. CSE also induces apoptosis, macroautophagy, and CMA of bronchial epithelial cells. Macroautophagy and CMA regulate apoptosis in opposite directions.

• 한국환경보건학회지
• /
• 제34권2호
• /
• pp.117-123
• /
• 2008

Allergic diseases have been dramarically increased over recent years, especially in industrialized countries. Oxidative stress has been believed to playa significant role in the occurrence of the allergic inflammatory responses. Although previous studies concerning oxidative stress and systemic inflammation have been reported, few data is available, and other allergic diseases, except for asthma, are hardly studied about the association with oxidative stress. This study evaluated the relationship between allergic disease and Malondialdehyde (MDA) as an indicator of oxidative stress. The study population was 197 male adults living in an industrial area. The ISAAC questionnaire was used to confirm wheezing and rhinitis, and atopy was evaluated by skin prick test. MDA was analyzed by spectrophotometer. To examine bronchial hyperresponsiveness (BHR), methacholine test was performed, and the index of bronchial responsiveness (BR index) was calculated. We used multivariate logistic regression model and general linear model with SAS program. We found significant associations of MDA with brindex (p=0.023), rhinitis (p=0.016), atopy (p=0.03), adjusted by age, smoking, and body mass index (BMI). On the contrary, there was no significant difference of MDA with the status of asthma. Our result suggests that oxidative stress may playa major role in the occurrence of allergic response in male adults.

• Tuberculosis and Respiratory Diseases
• /
• 제43권1호
• /
• pp.108-112
• /
• 1996

저자들은 약 1년전에 산불진화작업중에 무엇인가 목으로 넘어가는 것을 감지하였으나 별 증상이 없이 지내던 중 내원 3개월 전부터 간헐적인 발열을 주소로 입원한 환자에서, 기관지내시경상 우측 상엽 후분절에 위치한 나뭇가지로 인한 폐염 1예를 경험하였가에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제74권3호
• /
• pp.111-119
• /
• 2013

Background: Hemoptysis due to pulmonary tuberculosis (TB) frequently develops in Korea where the prevalence of TB is intermediate. The effect of bronchial artery embolization (BAE) on the control of massive hemoptysis has been well known. This study is designed to identify the risk factors contributing to rebleeding after BAE in patients with TB. Methods: We retrospectively evaluated risk factors and the time for rebleeding after BAE in 72 patients presenting with hemoptysis. Results: The overall immediate success rate of BAE was 93.1% (67 of 72 patients). Of the 29 patients (40.3%) who showed rebleeding after BAE, 13 patients experienced rebleeding within 1 month, and 14 patients between 1 month to 1 year. The existence of a shunt in angiographic finding, aspergilloma, and diabetes mellitus were risk factors of rebleeding after BAE in multivariate analysis. Conclusion: BAE was very effective for obtaining immediate bleeding control in hemoptysis associated with active TB or post-TB sequelae. It is important to observe whether or not rebleeding occurs up to 1 year of BAE especially in TB patients with aspergilloma, DM, or a shunt. Even rebleeding can be managed well by second BAE.

• Tuberculosis and Respiratory Diseases
• /
• 제66권1호
• /
• pp.58-61
• /
• 2009

기관지 Dieulafoy 질환은 기관지 점막 하부에 위치하는 일종의 동맥기형으로서, 일반적인 방사선적 및 기관지 내시경 검사에서 원인 불명의 대량 객혈 환자에서 감별 진단에 고려되어야 할 질환이다. 기관지 동맥 조영술이 진단에 도움이 될 수 있으며, 객혈의 조절을 위해 우선적으로 시도될 수 있지만, 반복적인 대량 객혈의 위험으로 외과적 절제술이 가장 효과적인 치료 방법이다. 저자들은 대량객혈로 내원하여 외과적 절제술 후 기관지 Dieulafoy 질환으로 확진된 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제53권2호
• /
• pp.209-215
• /
• 2002

중증의 객혈에 대한 치료로써 기관지동맥 색전술을 시행한 후 일시적인 양측 시력 상실이 관찰되었으나 2-3일이 지나면서 점차적으로 호전되었다. 이는 혈관조영술상 보이지 않는 우좌단락을 통한 색전성 뇌허혈 또는 조영제의 신경독성에 의한 후두엽 손상으로 발생된 일시적인 피질맹으로써, 보존적인 치료 후 호전되었기에 문헌고찰과 함께 보고한다.

• Tuberculosis and Respiratory Diseases
• /
• 제63권2호
• /
• pp.194-199
• /
• 2007

기관에 발생한 림프절 외 변연부 B-세포 림프종(BALT lymphoma)은 폐에서 원발하는 비호지킨스 림프종의 70% 이상을 차지하지만 전체 림프종의 1% 미만을 차지할 만큼 드문 질환으로 흉부 단순 촬영에서 우연히 발견되는 경우가 많고, 예후는 비교적 양호하나 아직 확립된 치료법은 없는 상태이다. 저자들은 흉부 방사선 촬영 상 지속되는 폐침윤 소견을 주소로 내원 후 리포이드 폐렴으로 오인되어 진단과 치료가 늦어 골수 침범까지 진행된 폐에 발생한 림프절 외 변연부 B-세포 림프종을 1예를 경험하여 보고하는 바이다.