• 항공우주의학회지
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• 제31권1호
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• pp.17-20
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• 2021

As the coronavirus disease 2019 (COVID-19) pandemic continues, doctors face many difficulties in managing patients with respiratory allergies. As research continues, much new knowledge has emerged about the link between COVID-19 infection and respiratory allergies. Studies to date have shown that there is no significant increase in the risk of COVID-19 infection in patients with respiratory allergies. However, in patients undergoing treatment for moderate to severe asthma or allergic rhinitis, more severe clinical manifestations, increased hospitalization period, and increased mortality may occur, so patients need to be managed with more care. In addition to personal efforts, social consideration should be accompanied to prevent deterioration in patients' quality of life with respiratory allergies due to COVID-19. Lastly, as clinical doctors, we should treat patients with respiratory allergies to protect ourselves appropriately by actively utilizing remote medical treatment and minimizing tests that generate droplets. Also, by appropriately educating patients and continuing drug treatment, efforts should be made to ensure that patients receive the best treatment even in a pandemic situation.

• 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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• 제69권4호
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• pp.265-270
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• 2010

Background: Psychological factors are increasingly recognized for their influence on the course of asthma, on a worldwide basis. The aim of this study was to assess the presence of depression, anxiety, and asthma-related quality of life in patients with asthma and to evaluate their impact on severity and control of asthma. Methods: We assessed the severity of asthma by comparing patients' current medications to GINA guideline. The patients were classified into the controlled group (asthma patients with controlled disease) or into the uncontrolled group (asthma patients with uncontrolled disease), which included partly controlled and uncontrolled patients, again based on GINA guideline 2004. Patient-reported depressive symptoms, anxiety, and asthma-related quality of life were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and Korean asthma quality of life (KAQLQ). Results: One hundred and twenty patients were enrolled (mean age, $55{\pm}1$ years; 65% women). Among the 120 patients, 14 (12%) patients were classified as having mild asthma, 88 (73%) as having moderate asthma, and 18 (15%) as having severe asthma. Eighty-one (67%) of the 120 patients were controlled. The asthma-related quality of life showed the difference according to severity of asthma (p=0.002). The prevalence of depression was lower (10% vs 26%, p=0.024) and the asthma-related quality of life was higher (59.951 (29~75) vs 35.103 (18~72), $p{\leq}0.001$) in the controlled group. Higher trait anxiety score and lower asthma-related quality of life were associated with depression (p<0.001, p=0.002, respectively). Conclusion: Psychological factors, such as anxiety and depression, are strongly associated with asthma control. Therefore, screening and management of depression is needed in patients with asthma.

• IMMUNE NETWORK
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• 제7권1호
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• pp.18-25
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• 2007

Background: Although glucocorticoids (GCs) are effective in controlling asthma in the majority of patients, a subset of asthmatics fails to demonstrate a satisfactory response, even to systemic GC therapy. This population is referred to as being "steroid-resistant". The actual mechanism underlying steroid resistance in asthma remains to be elucidated. Methods: We have investigated how dexamethasone (DEX) regulates asthmatic phenotypes in a murine model of asthma, in which mice received i.p. immunization twice, followed by two bronchoprovocations with aerosolized OVA with a one-week interval, which we have recently described. Results: Pretreatment with DEX resulted in an inhibition of NF-${\kappa}B$ activation in asthmatic lungs, and also inhibited bronchoalveolar lavage (BAL) levels of NF-${\kappa}B$-dependent cytokines such as TNF-${\alpha}$ and CC chemokines [eotaxin and monocyte chemotactic protein (MCP)-1]. DEX was effective in suppressing airway hyperresponsiveness (AHR) at 10 h, Th2-dependent asthmatic phenotypes such as airway eosinophilia, BAL levels of Th2 cytokines (IL-5 and IL-13), and mucin production. However, DEX failed to suppress BAL levels of CXC chemokines [macrophage inflammatory protein-2 (MIP-2) and keratinocyte-derived chemokine (KC)] and airway neutrophilia. Conclusion: Airway neutrophilia is among the phenomena observed in patients with severe GC-resistant asthma. This study will provide insight into the molecular basis for airway neutrophila seen in steroid-resistant asthma. Further studies are required to delineate the underlying mechanism of CXC chemokine expression in asthma.

• 한국치위생학회지
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• 제22권4호
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• pp.225-230
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• 2022

Objectives: Patients with excessive tooth wear should first be diagnosed for the etiology of the tooth wear. Causes of tooth wear include bruxism, clenching, and taking medications for systemic diseases. After identifying the cause of tooth attrition, the final prosthesis should be restored with an appropriate vertical dimension. Methods: A 79-year-old man with worn out teeth desired a whole dental treatment. He was on medications for high blood pressure and asthma. The treatment proceeded with a consultation with a medical doctor. The medications for asthma evoked multiple teeth wear and a loss of the vertical dimension. After recovery of 3 mm of vertical dimension, 2 months of evaluation was followed by an interim prosthesis. Results: The increased vertical dimension caused no problem in function and esthetics, and the final restoration was performed with a full monolithic zirconia crown. Group function, adequate anterior guidance, and the occlusal plane were determined. Conclusions: After the final restoration, the patient was both esthetically and functionally satisfied, and a night guard splint was delivered to prevent prosthesis fracture. The patient was informed about the potential tooth wear associated with asthma drugs and educated to visit the clinic regularly.

• 대한한의학방제학회지
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• 제15권1호
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• pp.49-105
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• 2007

Objectives : Select and analyze the case record of dyspnea and wheezing asthma recorded in Xu Ming Yi Lei An that is the most abundant and wide in contents in existing case records that are systematic, comprehending relatively modern Traditional Chinese Medicine to secure more deep and objective basis of Traditional Chinese Medicine approach for dyspnea and wheezing asthma to analyze and review possibility for clinical application in this study. Methods: The study was conducted with the case records of dyspnea and wheezing asthma in whole Xu Ming Yi Lei An. Pattern identify and classify selected case records and again classified with deficiency syndrome and excess syndrome. Also analyzed prescriptions and herbs used in the case records. Nature of herbs and properties and flavors that were used in the case records were classified and frequency of each nature of herbs were analyzed. Applicable case records were interpreted and suggested prescriptions, pulse feelings, pattern classification were analyzed and described. Results : Among the 5254 case records stated on the complete collection, it is researched that there are 63 case records for the symptom complex of dyspnea as 1.2% of the whole case records, and the case records on the symptom complex of wheezing asthma are 14 as the 0.27% of the total examples. 63 case record examples related with symptom complex of dyspnea were pattern identified and classified. As a result, deficiency syndrome of the Kidney(33 %), deficiency syndrome of the Spleen(26.0%), Wind-Cold(12.3%), phlegm turbidity(12.3%), Heat in the Lung(8.2%), asthenia of the Lung(8.2%) were investigated as above order. 14 case record examples related with wheezing asthma were pattern identified and classified. As a result, phlegm-Heat(26.3%), upper excess and lower deficiency(26.3%), external affections Wind-Cold(15.8%), Dampness-phlegm(10.5%), Lung asthenia(10.5%), Cold phlegm(5.3%), mutual deficiency and detriment of Heart and Kidneys(5.3%) were investigated as above order. Symptom complex of dyspnea has 67.1% of deficiency syndrome, 32.9% of excess syndrome resulting more deficiency syndrome than excess syndrome. Symptom complex of wheezing asthma has 42.1 % of deficiency syndrome and 57.9% of excess syndrome resulting more excess syndrome than deficiency syndrome. In case of symptom complex of dyspnea prescription used in the case record, the order of frequency is as following. Palmijihwang-tang, Bojung-ikgitang, Yungmijihwang-tang, Ijintang, Sojaganggitang, Igongsan. In case of symptom complex of wheezing asthma prescription in the case record, Yungmijihwang-tang, Ohotang, Dodamtang were mostly used. Herbs used in case records of symptom complex of dyspnea are Ginseng Radix, Poria, Glycyrrhizae Radix, Aconiti Iateralis Preparata Radix, Atractylodis Macrocephalae Rhizoma, Dioscoreae Rhizoma, Angelicae Gigantis Radix, Rehmanniae Radix Preparat, Pinelliae Rhizoma, Zingiberis Rhizoma Recens are mostly used. Nature of herb properties used for symptom complex of dyspnea and symptom complex of wheezing asthma are herbs that are warm properties. When the symptom complex of dyspnea and the symptom complex of wheezing asthma were treated. if the patient felt tenderness at Pyesu, doctors conducted pricking blood around the opposite Pyesu or Sipseon acupoint. when the patient didn't have tenderness at Pyesu by soft press, pricking blood was performed both sidees, right and left Pyesu. In case of the treatment of symptom complex of dyspnea and symptom complex of wheezing asthma, when they got treatment, when the symptom complex of disease is severe, a doctor cauterized the opposite Pyesu while the other Pyesu felt tenderness, and decided how the above treatment is performed whether the degree of the symptom compolex of disease is severe or not. In case of the treatment of symptom complex of dyspnea and symptom complex of wheezing asthma, if the person felt tenderness at Pyesu and is caught by the Wind-Cold pathogen, slight acupuncture is treated at relevant Pyesu with Fire needling. When patient with symptom complex of dyspnea and symptom complex of wheezing asthma cannot hawk sputum up from the oral and laryngopharynx, suction method is treated. Conclusion : With this study, actual traditional and clinical pattern identification form and characteristics of symptom complex of dyspnea and symptom complex of wheezing asthma were recognized. Modern case report utilizing in clinical application need to be secured and an incurable disease asthma need to be diagnosed and improvement for treatments have to be searched through other case records.

• 대한한방내과학회지
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• 제11권1호
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• pp.61-75
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• 1990

According to the research, the Estern and Western medical literatural records about the causes and symptoms of the heart failure, the results as follows are concluded. 1. The asthma, suceptibility to fright and severe palpitation are generally revealed from the left heart failure. The causes of it are belong to the Yang and Yeum deficiency which are mainly caused by primordial energy deficiency. 2. The symtoms of asthma which are derived from left heart failure are related to the gasping that contain dyspnea, asthma due to the accumulation of phlegm and severe palpitation and related to shortness of breath due to fluid retention (水喘) that make asthma. 3. In the right heart failure, the edema which is derived from the congestion of vein, is revealed as stoppage of main channel that is mainly caused by the Yang or the Yeum deficiency. 4. The edema which is caused by the right heart failure, is mainly related to the symptoms of Yeum type edema, also it is related to the five viscera-fluid, moreover to the heart-fluid (心水), lung-fluid (肺水) and liver-fluid (肝水). 5. In heart failure, the pathologic symptoms which are derived from the stoppage of blood circulation, are phlegm-retention disease (痰飮), diffuse fluid-retention syndrom (溢飮), fluid-retention syndrome characterized by dyspnea and edema (支飮).

• IMMUNE NETWORK
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• 제22권5호
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• pp.40.1-40.24
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• 2022

Mesenchymal stem cells (MSCs) are attractive alternatives to conventional anti-asthmatic drugs for severe asthma. Mechanisms underlying the anti-asthmatic effects of MSCs have not yet been elucidated. This study evaluated the anti-asthmatic effects of intravenously administered MSCs, focusing on macrophages and monocytes. Seven-week-old transgenic (Tg) mice with lung-specific overexpression of IL-13 were used to simulate chronic asthma. MSCs were intravenously administered four days before sampling. We examined changes in immune cell subpopulations, gene expression, and histological phenotypes. IL-13 Tg mice exhibited diverse features of chronic asthma, including severe type 2 inflammation, airway fibrosis, and mucus metaplasia. Intravenous administration of MSCs attenuated these asthmatic features just four days after a single treatment. MSC treatment significantly reduced SiglecF^-CD11c^-CD11b⁺ monocyte-derived macrophages (MoMs) and inhibited the polarization of MoMs into M2 macrophages, especially M2a and M2c. Furthermore, MSCs downregulated the excessive accumulation of Ly6c^- monocytes in the lungs. While an intravenous adoptive transfer of Ly6c^- monocytes promoted the infiltration of MoM and Th2 inflammation, that of MSC-exposed Ly6c^- monocytes did not. Ex vivo Ly6c^- MoMs upregulated M2-related genes, which were reduced by MSC treatment. Molecules secreted by Ly6c^- MoMs from IL-13 Tg mice lungs upregulated the expression of fibrosis-related genes in fibroblasts, which were also suppressed by MSC treatment. In conclusion, intravenously administered MSCs attenuate asthma phenotypes of chronic asthma by modulating macrophages. Identifying M2 macrophage subtypes revealed that exposure to MSCs transforms the phenotype and function of macrophages. We suggest that Ly6c^- monocytes could be a therapeutic target for asthma management.

• 동국한의학연구소논문집
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• 제2권2호
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• pp.57-68
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• 1993

In humans, an immediate allergic response to an allergen snay appear as either bronchial asthma unaccompanied by anaphylaxis or a severe bronchial constriction and spasm accompanied by anaphylaxis. Much experimental evidence with isolated asthmatic tissues has shown that histamine is released during the allergic reaction. Paradoxically, antihistamine treatment is ineffective in reversing bronchial asthma or anapllylaxis in a man. The present study objective is to search for protective agents(In-Sam-Yun-Pai-San-Ga-Gam-Bang) against bronchial constriction in treating a anaphylaxis. The result from this study is as follows. A single dose of In-Sam-Yun-Pai-San-Ga-Gam-Bang extract(3ml/kg body weight) 2 hrs prior to histamine-induced bronchial constriction test demonstrated significant protection. Based on the above result, It is considered that In-Sam-Yun-Pai-San-Ga-Gam-Bang can be used in bronchial asthma.

• Tuberculosis and Respiratory Diseases
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• 제45권1호
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• pp.77-89
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• 1998

서 론: $\beta_2$ 교감신경 수용체 유전자에는 여러 종류의 다형성(polymorphism)가 존재하며, 천식 환자에서 $\beta_2$ 교감신경 수용체의 대표적인 변이는 $\beta_2$ 교감신경 수용체의 아미노산이 대치된 부분으로 Arg16-Gly, Gln27-Glu, Val34-Met 및 Thr164-Ile 등인 것으로 알려져 있다. 지속적인 $\beta_2$ 교감신경 유도체의 자극에 대하여 세포표면으로 부터 세포내의 전달과정이 둔화되어 점차 세포전달이 없어질 수도 있는 desensitization 또는 수용체와 수가 감소하는 downregulation이 존재하는 것으로 알려져 있다. 천식환자에서 $\beta_2$ 교감신경 수용체의 desensitization 또는 downregulation 뿐만 아니라 천식 표현형과 $\beta_2$ 교감신경 수용체 유전자 다형성의 상관 관계에 대한 연구가 이루어지고 있으나 논란이 많다. 이에 본 연구는 기관지 천식환자에서 $\beta_2$ 교감신경 수용체의 가장 흔한 16, 27, 34 및 164 의 아미노산에 해당하는 유전자의 다형성을 MASA (Mutated Allele Specific Amplification)법으로 시행하여 각각의 다형성의 발생 빈도와 천식의 심한 정도와 연관이 있는 가를 확인하였다. 대상 및 방법: 대상 환자는 천식 환자 103명이었으며, 이중 남자는 54명, 여자는 49명으로 평균 연령은 46.6세 (19~80세)였고 이환 기간은 4.7년이었다. 대상 환자는 경미하고 간헐적 증상을 보인 30명, 지속적인 경미한 천식 환자는 32명으로 경미한 천식은 모두 62명이었으며, 중등증의 천식 증상은 17명 및 중종의 천식증상을 보인 환자는 24명이었다. 이중 1년 중에 6개월 이상 전신적 스테로이드를 투여하는 환자는 39명이었으며, 투약 중에도 야간 발작이나 야간 기침이 발생되었던 환자는 44명이었다. 대상 환자로부터 10cc의 전혈구를 체취 하여 분리된 림파구에서 분리된 DNA를 이용하여 MASA 방법으로 $\beta_2$ 교감신경 수용체 16번, 27번, 34번 및 164번째 아미노산의 다형성을 검색하였고, 천식의 심한 정도 따른 $\beta_2$ 교감신경 수용체 유전자의 다형성의 분포와 야간 천식의 발작이나 증상의 유무에 따른 $\beta_2$ 교감신경 수용체 유전자의 다형성의 분포를 확인하였다. 결 과: 16 번째 Arginine이 Glycine으로 변이는 heterozygous 변이가 67명, homozygous 변이가 13명으로 heterozygous 변이가 65.1%로 가장 많았다. 27번째 Glutamine이 Glutamate로 변이는 heterozygous만 11명으로 10.7%였으며, 34번째 Valine이 Methionine으로 변이를 일으키는 100번째 핵산의 경우도 heterozygous만 6명으로 5.8%였다. 27 번째와 34번째 아미노산의 변이를 일으키는 homozygous 변이와 164번째 아미노산의 변이는 대상 환자 중에는 없었다. 천식 증상의 심한 정도를 경종 및 중등증, 중중으로 2 구분하여 $\beta_2$ 교감신경 수용체 다형성의 발생빈도를 관찰한 결과 중증의 천식환자에서 16번째 아미노산의 변이의 빈도는 많았으나 (p=0.015), 27번, 34번 및 164번째의 아미노산의 변이는 천식 증상의 정도와는 연관성이 없었다. 야간 천식 증상의 유무에 따른 $\beta_2$ 교감신경 수용체 다형성은 16, 27, 34 및 164번째 아미노산의 핵산의 변이와 연관성이 없었다. 결 론: 이상의 결과로 기관지 천식 환자에서 $\beta_2$ 교감신경 수용체 다형성은 Arg 16, Gln 27 및 Val 34의 변이가 존재하고, Arg 16이 가장 많았으며, Thr 164는 없었다. 기관지 천식 환자에서 증상이 심한 중증 천식은 $\beta_2$ 교감 신경 수용체의 다형성중 Arg 16의 변이는 중증 천식과 연관성이 있었다. 그러나 야간 천식 발작이나 증상과 $\beta_2$ 교감신경 수용체 다형성은 서로 상관이 없었다.