• Journal of Environmental Health Sciences
• /
• v.46 no.6
• /
• pp.685-693
• /
• 2020

Objectives: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. The aim of this study was to investigate relationships between indoor mold concentrations and pulmonary function parameters in asthmatic children with mold sensitization. Methods: Asthmatic subjects who had a positive result in skin-prick testing to more than one mold allergen, such as Alternaria, Aspergillus, or Penicillium, were enrolled. Their pulmonary function and methacholine challenge test results were collected. Measurements of blood eosinophil, serum IgE, and fractional exhaled nitric oxide (FeNO) were taken. Indoor levels of VOC, CO2, PM10 and PM2.5 in each subject's house were measured. We counted mold and bacteria colonies from the subjects' house air samples. Results: The mean levels of FEV1, FVC, FEV1/FVC, and FEF25-75 were 82.8±19.7, 87.3±17.9, 85.8±8.3, and 82.3±28.9%, respectively. The mean FeNO level was 19.8±11.2 ppb and the geometric mean (range of one SD) of methacholine PC20 was 3.99 mg/mL (0.67-23.74 mg/mL). The average indoor air pollutant levels were below the recommended levels set by the Ministry of Environment for multiplex buildings. Indoor mold levels showed a significant inverse correlation with methacholine PC20, but not with the baseline pulmonary function parameters. Conclusion: Indoor mold concentrations are a risk factor for increased bronchial hyperresponsiveness among asthmatic children with mold sensitization. Targeted environmental intervention should be considered for selected asthmatic children with mold sensitization for avoiding severe airway hyperresponsiveness.

• Current Research on Agriculture and Life Sciences
• /
• v.7
• /
• pp.231-235
• /
• 1989

The effects of choline and choline esters(acetylcholine, methacholine, carbachol, bethanechol) on motility of isolated rabbit jejunum segment were examined and $pD_2$ values of each drugs were compared. The results were as follows. In choline, there were revealed that maximum effective concentration was $10^{-2}M$, $ED_{50}$ was $2.4{\times}10^{-3}M$, and $pD_2$ value was 2.619. In acetylcholine, there were revealed that maximum effective concentration was $10^{-4}M$, effect was hardly showin in $10^{-9}M$ concentration, $ED_{50}$ was $0.5{\times}10^{-5}M$, and $pD_2$ value was 5.154. In methacholine, there were revealed that maximum effective concentration was $10^{-5}M$, effect was hardly shown in $10^{-9}M$ concentration, $ED_{50}$ was $9{\times}10^{-7}M$, and $pD_2$ value was 6.045. In carbachol, there were revealed that maximum effective concentration was $10^{-5}M$, effect was hardly shown in $10^{-11}M$ concentration, $ED_{50}$ was $5.7{\times}10^{-7}M$, and $pD_2$ value was 6.244. In bethanechol, there were revealed that maximum effective concentration was $10^{-4}M$, effect was hardly shown in $10^{-8}M$ concentration, $ED_{50}$ was $3.3{\times}10^{-6}M$, and $pD_2$ value was 5.480. Choline and choline esters caused contraction on motility of isolated rabbit jejunum segment. The order of $pD_2$ values of drugs was carbachol, methacholine, bethanechol, acetylcholine and choline (in the descending order of potency).

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.6
• /
• pp.813-822
• /
• 1995

Background: Bronchial hyperresponsiveness and abnormal response such as a loss of distensibility are pathophysiologic characteristics if bronchial asthma. The only means of direct in vivo measurement of airway size had been a tantalium bronchography, until high-resolution computed tomography(HRCT) enabled to measure noninvasively two dimensional airway area more accurately and reliably. Method: To investigate airway area responses to bronchial provocation with methacholine and evaluate the major sites of bronchial constriction in patients with bronchial asthma. We examined HRCT scans in five patients with bronchial asthma who had significant bronchoconstriction(20% or more decrease in $FEV_1$) using CT scanner(5,000T CT, Shimadzu Co, Japan) before and in 3~5 min. after methacholine inhalation. Airways which were matched by parenchymal anatomic landmarks in each patient before and after methacholine inhalation were measured using film scanner(TZ-3X scanner; Truvel Co. Chatsworth CA, USA) and a semiautomated region growing method. Results: 1) We identified 9 to 12 airways in each patient which were matched by parenchymal anatomic landmarks before and after methacholine inhalation. 2) Airway responses to methacholine are quite different even in a patient. 3) The constriction of small airways(average diameter <2 mm; area < $3.14mm^2$) was 48.7%(8.3; SEM, n=43), being more prominant than that of large airways(average diameter >2 mm; area > $3.14mm^2$), 53.8% (4.4;SEM, n=10), but not significantly different(p>0.05). 4) There was no significant difference in the degree of constriction between upper(44.3% +5.8; mean + SEM, n=30) and lower lung regions(56.7% +4.5, n=23). Conclusions: Thus airway responses to methacholine bronchoprovocation is quite variable in a patient with bronchial asthma and has no typical pattern in patients with bronchial asthma.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.3
• /
• pp.559-573
• /
• 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.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.1
• /
• pp.24-36
• /
• 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.

• The Korean Journal of Pharmacology
• /
• v.12 no.1
• /
• pp.57-62
• /
• 1976

Using modified technique of Schmidt et al, as described previously (Korean J. Pharmacol 9 : 17, 1973), the stomach of female rats were perfused with physiological saline under urethane anesthesia. The acid-secretory response of the perfused stomach to i.v. hypertonic glucose (50%), casein hydrolysate (20%) or saline (6%) solution were studied with or without histamine or methacholine stimulation. A significant decrease of acid secretion from the rat stomach was induced by i.v. hypertonic glucose or saline solution. The histamine-stimulated acid secretion was also decreased by simultaneous administration of the hypertonic glucose or saline. However, methacholine-stimulated acid response was not affected by the hypertonic glucose. Intravenous infusion of 20% casein hydrolysate solution resulted in an increase in acid output from the stomach under histamine stimuli. These results lead to the conclusion that the inhibitory responses of acid secretion due to i.v. hypertonic glucose solution are brought through the effect of histaminergic, not cholnergic mechanism(s) in the gastric secretion.

• Journal of Preventive Medicine and Public Health
• /
• v.29 no.1 s.52
• /
• pp.103-112
• /
• 1996

We studied the association of nonspecific bronchial hyperresponsiveness with general characteristics, exposure concentration, respiratory symptoms, chest x-ray findings, past histories and pulmonary function. We determined bronchial hyperresponsiveness by methacholine challenge test. And we conducted a respiratory symptom questionnaire and performed spirometry on 111 workers occupationally exposed to isocyanates in various industries. About 21.6% of subjects had bronchial hyperresponsiveness. No significant differences were observed between the hyperresponsive and non-responsive group with respect to age, sex, employment period, height, and smoking histories. Cough and breathlessness were significantly associated with the bronchial hyperresponsiveness. The hyperresponsive group had more experience of bronchitis and asthma in the past than the non-responsive group. The lower $FEV_1\;and\;FEV_1%$ were closely related with bronchial hyperresponsiveness. Bronchial hyperresponsiveness seems to be associated with some of respiratory symptoms, past histories and pulmonary function parameters in workers exposed to isocyanates.

• The Journal of Internal Korean Medicine
• /
• v.37 no.2
• /
• pp.368-373
• /
• 2016

Objective: This case reports on the efficacy of herbal medicine treatment for trimethylaminuria.Method: A 29-year-old female Korean patient with trimethylaminuria received herbal medicine treatment for three months. We evaluated her symptoms with the methacholine challenge test and OralChroma.Results: The odor intensity shown in the methacholine challenge test demonstrated improvement.Conclusion: Herbal medicine treatment could improve trimethylaminuria symptoms.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1126-1131
• /
• 2005

Purpose : Bronchial hyperresponsiveness(BHR) is considered a hallmark of asthma. Increased levels of eosinophil cationic protein(ECP) have been identified in serum of asthma patients. Several studies have examined the relationship between serum ECP and bronchial responsiveness, expressed as methacholine $PC_{20}$ in asthmatic patients, with conflicting results. The aims of this study were to examine the relationship between serum ECP and ${\Delta}FVC$, another index of bronchial responsiveness, which reflects increased maximal airway response. Methods : Six to 8-year-old children with asthma(n=109) underwent methacholine bronchoprovocation testing. The $PC_{20}$ dose of methacholine and ${\Delta}FVC$ were calculated for each individual from the methacholine dose response curves. Serum ECP levels and blood total eosinophil counts were also measured. Results : Serum ECP correlated with ${\Delta}FVC$(r=0.217, P=0.023), as well as $PC_{20}$(r=-0.208, P=0.030). However, blood eosinophil counts failed to show any correlations with ${\Delta}FVC$(r=0.085, P=0.378) or $PC_{20}$(r=-0.148, P=0.125). ${\Delta}FVC$ did not correlate with $PC_{20}$(r=-0.079, P=0.417). Conclusion : Blood eosinophil activation is associated with both components of BHR including increased sensitivity and increased maximal response in 6-8 year old children with asthma.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.5
• /
• pp.752-759
• /
• 1995

Background: Bronchial asthma is characterized by noctunal dyspnea, cough and wheezing because of airway hyperresponsiveness to nonspecific stimuli. These symptoms and signs are also observed in patients with congestive heart failure. Therefore, this is so called "cardiac asthma". There are lots of experimental and clinical datas to suggest that airway dysfunctions occur in acute and chronic congestive heart failure. However, it is still controversial whether bronchial hyperresponsiveness is present in patients with congestive heart failure. To assess whether bronchial hyperresponsiveness is present in patients with congestive heart failure and to demonstrate the relationship between bronchial responsiveness and vascular pressure, we performed methacholine provocation test in 11 patients with mitral valvular heart disease. Methods: All patients were in the New York Heart Association functional class II and treated continuously with digoxin and/or dichlozid and/or angiotensin converting enzyme inhibitor except one patient. All patients were undergone right and left side heart catheterization for hemodynamic measurements. A 20 percent fall of peak expiratory flow rate were considered as positive response to methacholine provocation test. Results: 1) Only one patient who has normal pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index was positive in methacholine provocation test. 2) Their mean pulmonary artery pressure, pulmonary capillary wedge pressure were $21.72{\pm}9.70mmHg$, $15.45{\pm}8.69mmHg$ respectively which were significantly higher. Conclusion: It is speculated that in stable congestive heart failure patients, bronchial responsiveness as assessed by methacholine provocation test may not be increased.