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Allergy asthma & respiratory disease update

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2권3호(2014) |수록논문 수 : 13
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2권3호(2014년) 수록논문
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1천식과 정신질환

저자 : 고영일 ( Young Il Koh )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 151-152 (2 pages)

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2REVIEW : Treatment of mild asthma: Is it necessary to keep regular inhaled corticosteroids?

저자 : 이병재 ( Byung Jae Lee )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 153-156 (4 pages)

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The main goal of asthma treatment is an adequate control of symptoms and a reduction in future exacerbations. To achieve the goal, international guidelines recommend daily use of controllers, such as inhaled corticosteroids (ICSs), even in patients with mild asthma. However, poor adherence is an unavoidable issue in the management of mild asthma. In addition, there is concern about possible adverse reactions and economic burden by unnecessary treatment. Recently, several studies have shown that as-needed use of ICSs has similar effects as regular use of ICSs on the prevention of acute asthmatic exacerbations. However, daily regular use of ICSs seems to be superior in terms of symptom-free days or airway inflammation suppression. Further studies are needed to determine whether symptom-driven use of ICSs can be an effective strategy for the management of mild asthma. Also, it is necessary to develop proper methods that can predict mild asthmatics who experience frequent exacerbations if they stop regular ICSs.

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3백신 성분 알레르기반응

저자 : 양현종 ( Hyeon Jong Yang )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 157-164 (8 pages)

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Vaccine contains active components, adjuvants, stabilizers, preservatives, and trace components. Adverse reactions to vaccines are rarely reported. However, all of vaccine components may elicit adverse reaction including life-threatening event in susceptible individuals, therefore raising concerns regarding safety of vaccine still continue up to date. Hypersensitivity reaction to vaccines can be classified as allergic reaction to the vaccine component, pseudo-allergic reaction, and exacerbation of allergic diseases. Hypersensitivity reactions to vaccine components rarely occurred in the population-level, while severe hypersensitivity reaction such as anaphylaxis may be consequent result in susceptible individuals. Some of components such as ovalbumin, gelatin, yeast, and latex were considered as common causes of allergic reactions to the vaccine. However, the incidence or causes of vaccine related hypersensitivity reaction in Korea were not well known. The aims of this article are to review the literatures with hypersensitivity reactions related with vaccine components, to provide detailed information about major components of vaccines commonly used in Korea, and to provide the best way of vaccination in susceptible individuals.(Allergy Asthma Respir Dis 2014;2:157-164)

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4소아 천식 환자에서 전신 염증 유형에 따른 천식의 특성

저자 : 설인숙 ( In Suk Sol ) , 김윤희 ( Yoon Hee Kim ) , 이희선 ( Hee Seon Lee ) , 김민정 ( Min Jung Kim ) , 한윤기 ( Yoon Ki Han ) , 박영아 ( Young A Park ) , 김경원 ( Kyung Won Kim ) , 손명현 ( Myung Hyun Sohn ) , 김규언 ( Kyu Earn Kim )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 165-170 (6 pages)

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Purpose: Asthma is a chronic airway inflammation. We evaluated whether systemic inflammatory patterns could reflect the nature of airway inflammation. We assessed characteristics of asthma according to systemic inflammatory patterns. Methods: A total of 413 children with asthma were enrolled in the study. Four systemic inflammatory patterns were classified according to eosinophil and neutrophil counts in peripheral blood. Children with neutrophil count≥5,000/μL were defined as the NEUhi group, those with neutrophil count <2,720/μL as the NEUlo group. The intermediate group with neutrophil count between 2,720/μL and 5,000/uL was excluded from the study. Children with eosinophil≥650/μL were defined as the EOShi group, those with eosinophil count<240/μL as the EOSlo group. The remaining patients were excluded from the study. The characteristics of asthma include pulmonary function test results, bronchodilator response, airway hyperresponsiveness, and atopy. Results: The EOShi group had a lower PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second [FEV1]), a lower FEV1, and a higher immunoglobulin E level rather than the EOSlo groups, although there were no significant differences between the NEUhi and NEUlo groups. The eosinophil percentages of the induced sputum samples were higher in the EOShi group than the EOSlo group and correlated with blood eosinophil counts. Conclusion: Eosinophilic inflammation was related to characteristics of asthma and sputum eosinophils. However, neutrophilic inflammation reflected neither asthma features, sputum neutrophils, nor eosinophilic inflammation. Further studies on blood neutrophils involving asthma phenotypes in terms of more specific characteristics of asthma should be needed in children.(Respir Dis 2014;2:165-170)

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5초등학생 기도과민성의 유병률과 연관 인자

저자 : 김미숙 ( Mi Suk Kim ) , 김영호 ( Young Ho Kim ) , 서동인 ( Dong In Suh ) , 고영률 ( Young Yull Koh ) , 김병주 ( Byoung Ju Kim ) , 김효빈 ( Hyo Bin Kim ) , 이소연 ( So Yeon Lee ) , 송대진 ( Dae Jin Song ) , 김우경 ( Woo Kyung Kim ) , 장광천 ( Gwang Cheon Jang ) , 심정연 ( Jung Yeon Shim )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 171-178 (8 pages)

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Purpose: We investigated the prevalence of bronchial hyperresponsiveness (BHR) and its associated factors in population-based elementary school children. Methods: Methacholine bronchial provocation tests were performed on 1,151 elementary school children and BHR was defined as PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second [FEV1]) ≤8 mg/mL. We analyzed the prevalence of BHR according to age and sex. The Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, skin prick test, pulmonary function test, and blood tests were performed to determine associated factors for BHR. Results: A total of 1,106 students eligible for provocation tests were included in the analysis. The overall prevalence of PC20 ≤8 mg/mL was 11.5% (95% confidence interval, 10.6-13.4) and BHR decreased with age (P-value for trend <0.001). Younger age (adjusted odds ratio [aOR], 0.860; P=0.032), higher blood eosinophil % (aOR, 1.151; P=0.001), lower predictive % of FEV1 (aOR, 0.977; P=0.029), fraction of exhaled nitric oxide (FeNO) ≥25 ppb (aOR, 2.118; P=0.025), and sensitization to mites (aOR, 1.705; P=0.034) were associated with BHR. Preterm birth (aOR, 2.056; P=0.068) showed borderline significance. The associated factors for BHR with atopy were lower body mass index (aOR, 0.838; P=0.005), preterm birth (aOR, 4.361; P=0.003), and FeNO ≥25 ppb (aOR, 2.161; P=0.043). Younger age (aOR, 0.810; P=0.037) and higher blood eosinophil % (aOR, 1.296; P<0.001) were associated with BHR without atopy. Conclusion: The prevalence of BHR decreased with age in elementary school children. Younger age, preterm birth, eosinophilia, sensitization to mites, lower lung function, and higher FeNO level were independently associated with BHR.(Allergy Asthma Respir Dis 2014;2:171-178)

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6학동기 및 사춘기 아토피피부염 환아에서 메타콜린 기도과민성에 영향을 미치는 요인에 대한 분석

저자 : 성명순 ( Myong Soon Sung ) , 최진욱 ( Jin Wook Choi ) , 황영진 ( Young Jin Hwang ) , 김성원 ( Sung Won Kim )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 179-186 (8 pages)

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Purpose: Many studies have shown the importance for bronchial hyperresponsiveness (BHR) in children with bronchial asthma and allergic rhinitis. However, studies have not been done in BHR in school age and adolescence with atopic dermatitis (AD). Methods: The patients with history of bronchial asthma were excluded and methacholine challenge test (MCT) was performed in 103 children with atopic dermatitis. The positive of MCT result is defined as provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second (PC20)≤8 mg/mL. According of the level of PC20, the patients were divided into two groups. Results: The group 1 (BHR+) was observed in 43 of all patients (41.7%). Of two groups, significant differences were observed in age, body mass index. No significant differences were observed in the number of male, SCORing Atopic Dermatitis (SCORAD) index, admission history, smoking exposure history, other allergic disease, parental allergic disease. The group 1 (BHR+) have higher levels of total eosinophil count compared with the group 2 (BHR-) (629.8±360.5/μL vs. 470.2±253.9/μL, P=0.01). But no significant association was found between severity of BHR and SCORAD score, total immunoglobulin E, total eosin ophil count and eosinophil cationic protein (r=0.008, P=0.961; r=-0.217, P=0.162; r=0.225, P=0.147; r=-0.032, P=0.841). The list of allergen is that the house dust mite, tree, weed, food, animal hair, and fungus. The house dust mite has correlation with bronchial hypersensitivity statistically and the any of allergen groups, either. Conclusion: No significant relationship was observed between degree of BHR and allergy laboratory finding, severity of AD.

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7한국 정상 소아의 폐기능검사 추정 정상치

저자 : 박철휘 ( Chul Hyue Park ) , 김효빈 ( Hyo Bin Kim ) , 정영호 ( Young Ho Jung ) , 이은 ( Eun Lee ) , 양송이 ( Song I Yang ) , 서주희 ( Ju Hee Seo ) , 권지원 ( Ji Won Kwon ) , 김형영 ( Hyung Young Kim ) , 김병주 ( Byoung Ju Kim ) , 이소연 ( So Yeon Lee ) , 송대진 ( Dae Jin Song ) , 장광천 ( G

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 187-193 (7 pages)

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Purpose: Pulmonary function tests are useful and important methods for evaluating patients with respiratory diseases. To assess lung function, we need to establish normal values of lung function, which vary according to population, age, gender and growth, particularly in children. This study was undertaken to establish normal predicted values of pulmonary function tests and to predict renewed reference values by spirometry in Korean school children. Methods: Spirometric forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow at 25% to 75% of FVC (FEF25%-75%), and peak expiratory flow rate (PEFR) were measured in 406 healthy elementary school children (age, 6-12 years old) in May, 2012. Multiple linear regression analysis was performed for each spirometric parameter against age, height, weight and body surface area (BSA) separately for boys and girls, and derived reference equations and coefficients for all the spirometric parameters. Results: All the measured spirometric parameters were significantly correlated with age, height, weight, and BSA. FVC was higher in boys aged 6-10 years than girls at ages matched. Height showed the highest correlation coefficient for all the spirometric parameters followed by BSA, weight and age in both genders. The normal predicted values of FVC and FEV1 at 130 cm in this study using renewed reference equations were approximately in the middle compared to previous studies. Conclusion: We reported here the renewed reference equations for normal predicted values of pulmonary function tests with high coefficients of determination based on updated data in healthy Korean children.

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8노인 천식 환자의 우울과 불안의 특성

저자 : 박은경 ( Eun Kyoung Park ) , 조은정 ( Eun Jung Jo ) , 이승은 ( Seung Eun Lee ) , 이승근 ( Seung Geun Lee ) , 목정하 ( Jeong Ha Mok ) , 김미현 ( Mi Hyun Kim ) , 이광하 ( Kwang Ha Lee ) , 김기욱 ( Ki Uk Kim ) , 전두수 ( Doo Soo Jeon ) , 김윤성 ( Yun Seong Kim ) , 이민기 ( Min Ki Lee ) , 박혜

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 194-199 (6 pages)

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Purpose: The prevalence of asthma among the elderly has increased in the aging society. However, limited studies have been conducted regarding the characteristics of elderly asthmatics. In this study, we aimed to evaluate control of asthma, comorbidities, depression and anxiety state, and quality of life in elderly asthmatics. Methods: A total of 281 patients who were diagnosed with asthma and treated more than 1 year were enrolled. We evaluated not only clinical characteristics, but also depression, anxiety, and quality of life by using the Beck Depression Inventory-Korean version (K-BDI), the State-Trait Anxiety Inventory, and Korean asthma quality of life (KAQLQ), respectively. Results: Diabetes mellitus (15.2% vs. 6.6%, P=0.020), hypertension (45.5% vs. 18.7%, P<0.001), and heart disease (18.2% vs. 6.0%, P=0.001) were more prevalent comorbidities in elderly asthmatics than young asthmatics. However, there were no differences in the degree of asthma control and lung function between elderly and young asthmatics. K-BDI scores were higher (12.32 vs. 10.99, P=0.020) and KAQLQ was lower (66.60 vs. 68.83, P=0.046) in the elderly asthmatics than in the young asthmatics. Moreover, the low score of asthma control test was significantly associated with depression in the elderly asthmatics (P=0.01). Conclusion: Elderly asthmatics had a higher degree of depression and a lower quality of life. Inadequate control of asthma was associated with depression. To achieve adequate control of asthma, it would be necessary to assess depression in the elderly asthmatics.

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9천식 환자에서 재조합 Fibroblast growth factor 2의 안정성과 효능에 관한 전임상 연구

저자 : 김윤섭 ( Youn Seup Kim ) , 장용호 ( Yong Ho Jang ) , 전지현 ( Ji Hyun Jeon ) , 서지희 ( Ji Hee Seo ) , 강수형 ( Soo Hyung Kang ) , 지영구 ( Young Koo Jee )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 200-207 (8 pages)

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Purpose: Fibroblast growth factor 2 (FGF2) has been shown to inhibit airway inflammation, mucus production, and airway hyperresponsiveness in mouse model of asthma. The aim of this study was to evaluate the safety and efficacy of inhaled recombinant FGF2 in asthmatic patients. Methods: Eight asthmatics were eligible for the study. All patients were admitted to a hospital, and recombinant FGF2 was administered using a nebulizer at a concentration of 4.5 ng/mL three times a day for one week. Pulmonary function test, methacholine bronchial provocation test, induced sputum analysis, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ) were performed at the beginning of wash-out period, before and after the treatment, and at the end of study. And all these parameters were compared before and after FGF2 treatment. Results: There were no serious adverse events associated with recombinant FGF2 during five-week study period. Daytime and nocturnal symptoms improved after the treatment (P=0.028 and P=0.012, respectively). AQLQ and ACT also improved after the treatment (P=0.017 and P=0.011, respectively). However, lung function, airway hyperresponsiveness, and airway inflammation showed no significant difference before and after the treatment. Conclusion: Inhaled recombinant FGF2 was safely used to eight asthmatics without any serious adverse events, and improved daytime and nocturnal symptoms, and quality of life in adult asthmatics. FGF2 may be a potential drug in the treatment of asthma.

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10소아 환자에서의 괴사성 폐렴의 임상적 고찰

저자 : 박경미 ( Kyung Mi Park ) , 손승국 ( Seung Kook Son ) , 김혜영 ( Hye Young Kim ) , 김용우 ( Yong Woo Kim ) , 황재연 ( Jae Yeon Hwang ) , 박희주 ( Hee Ju Park )

발행기관 : 대한천식알레르기학회(구 대한알레르기학회) 간행물 : Allergy asthma & respiratory disease 2권 3호 발행 연도 : 2014 페이지 : pp. 208-212 (5 pages)

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Purpose: Necrotizing pneumonia (NP) is a complication of invasive pneumonia. Few studies have reported on the clinical features of NP in children. Methods: Nineteen patients with NP who were admitted to Pusan National University Hospital and Pusan National University Children``s Hospital between December 2008 and March 2013, were studied in terms of sex, age at diagnosis, clinical characteristics, detected organisms, radiologic findings, treatments and clinical outcomes. Results: Twelve patients (63.2%) were males and seven patients (36.8%) were female. Eight patients (44.4%) were younger than 5 years of age, seven patients (38.9%) were at 6-10 years of age and four patients (21.1%) were older than 11 years of age. Most patients had fever and cough at the time of diagnosis. Minorganism were identified in 9 cases (47.4%): Mycoplasma pneumonia in 4 (21.1%), Streptococcus pneumonia in 1(5.3%), Staphylococcus aureus in 1 (5.3%), G+cocci in 1 (5.3%), and M. pneumonia + S. pneumoniae coinfection in 2 (10.5%). The diagnosis of NP was established by computerized tomography. Cavitary necrosis was shown in all patients, and pleural effusion was shown in 15 patients (78.9%). Six patients (31.6%) presented local atelectasis and 2 patients (10.5%) presented pneumothorax. Five patients (26.3%) treated with only antibiotics were cured completely. Invasive treatment was needed by 14 patients (73.7%): 10 patients (52.6%) needed chest tubing, and 5 patients (26.3%) needed surgery. Only one patient (5.3%) expired. Conclusion: NP is a rare complication of pneumonia in children and has a good prognosis, typically resolving completely with medical treatment alone. However, patients who present with the worsening of clinical status or pleural complications despite the use of appropriate antibiotics should be evaluated for surgical indications.

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