만성 기침으로 내원한 환자에서 원인 질환 및 빈도에 관한 전향적 연구

지영구,오형태,이계영,김건열,조상헌,민경업,김유영 (Young Koo Jee,Hyung Tae Oh,Kye Young Lee,Keun Yeol Kim,Sang Heon Cho,Kyung Up Min,You Young Kim) 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.2

Background: Chronic cough is commonly defined as a persistent or recurrent cough exceeding 3 weeks duration and the prevalence of chronic cough is reported to range from 14-23% among non-smoking adults. Irwin et al previously reported that common causes of chronic cough are postnasal drip syndrome asthma, and gastroesophageal reflux using the anatomic and diagnostic protocol. Objective: To determine the spectrum and frequency of chronic cough and to aid establishing algorithmic approach for chronic cough. Materials and metkod: We prospectively evaluated 105 consecutive and unselected immunocompetent patients complaining of chronic cough utilizing modified anatomic and diagnostic protocol proposed by Irwin et al. Initial diagnosis was made by history, physical examination and laboratory test including spirometry, methacholine provocation test, and 24 hour pH monitoring. Specific treatment was done based upon initial diagnosis and cough score was compared before and after treatment. Reassessment was done in case of treatment failure. Resalt: The causes of cough were determined in 100 of 105 patients(95% ). Cough was due to one condition in 94.8% and two in 15.2%. 121 causes of cough were identified and their spectrum and frequency were found to be postnasal drip syndrome (39.3% ), asthma (32.2% ), gasteroesophageal reflux (14.1%), chronic bronchitis (5.0%), others (4.1%: drug-induced, bronchiolitis, endobronchial tuberculosis, and lung cancer). History about nasal symptoms was useful, but history about gastroesophageal reflux were not useful for the diagnosis. Conclusion: The results suggest that anatomic and diagnostic approach for evaluating chronic cough is also useful in Korea and the most common causes of chronic cough are postnasal drip syndrome, asthma and gastroesophageal reflux.

한국 소아와 청소년의 비염 유병률에 관한 역학적 연구

김윤근,김유영,조상헌,손지웅,이병재,김우경,이상록,박재경,민경업,하미나,안윤옥,지영구,이상일 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.3

Background: Allergic rhinitis and asthma are the most prevalent allergic diseases and a num- ber of studies have shown an increase in prevalence of both diseases all over the world in recent years. Although we reported the asthma prevalence in Korea, little is known about the prevalence of rhinitis in Korea. Objective: The purpose of this study was to elucidate the prevalence of childhood rhinitis including allergic and non-atopic rhinitis in Korea. Methods: We performed questionnaire survey and allergy skin prick test with 10 common inhalant allergens among 3,219 subjects aged 7-19 years in Seoul and Chungju. Subjects were asked whether they were troubled by sneezing, runny nose, itchy nose and/or nasal blockage in the last year, which were not related to common cold. Rhinitis was diagnosed when the subjects complained of 3 or more symptoms on questionnaire. Skin-prick test was regarded as positive when the wheal caused by allergen was same or larger than that caused by histamine. Results: The average prevalence of rhinitis was 13.0%. We could not find any significant age or sex differences in the prevalence of rhinitis. There was no regional difference between Seoul (12.7%) and Chungju (13.2%). The positive rate of skin prick test in subjects with rhinitis was 59.6%, which means the prevalence of allergic rhinitis was 7.8% and that of non-atopic rhinitis was 5.2%. The common allergens of allergic rhinitis were Dermatophagoides farinae (62.5%), Dematophagoides pteronyssinus (55.8%), cat fur (46.9%), cockroach (18.9%) and mugwort pollens (10.1%). Conclusion: The prevalence of childhood rhinitis in Korea was 13.0% and those of allergic rhinitis and non-atopic rhinitis was 7.8% and 5.2%, respectively.

영유아천명후 기관지천식으로의 이행에 미치는 부모이 아토피와 기관지과민성의 영향

정진화,김유영,김윤근,이명현,민경업,지영구,조상헌,고영률 대한알레르기학회 1998 천식 및 알레르기 Vol.18 No.4

Background: Many young children suffer from wheezing illness during viral respiratory infection, and some of them experience wheezing many years later and ultimately develop bronchial asthma. It is not clear whether atopy or bronchial hyperresponsiveness in the family is a significant risk factor for asthma in this clinical setting. Objective: To examine the genetic basis for the development of asthma after early childhood wheezing. Materials and methods : A measurement of serum total IgE concentration, skin prick test to common inhalant allergens, and methacholine bronchial provocation test were performed in 29 asthmatic children and their parents, and 22 non-asthmatic children with the past history of wheezing illness during the first three years of age and their parents. A questionnaire was performed to assess the presence of asthma and allergic rhinitis in the parents. Results : Positive skin test response to common inhalant allergens was more prevalent in asthmatics than in non-asthmatics(67.8% vs. 27.2%). Serum total IgE concentration was significantly higher in asthmatics than in non-asthmatics(geometric mean: 173 vs. 83 IU/ml). Positive skin test response to comman inhalant allergens was more prevalent in parents of asthmatics than in thoae of non-asthmatics(51.7% vs. 25.0%), but serum total IgE level was not different between the two groups(geometric mean: 132 vs. 120 IU/ml). Positive rate of methacholine bronchial provocation test, geometric mean of PC20-methacholine, and BR index were not different between the parents of asthmatics and non-asthmatics (18.1% vs. 13.9%; 164 vs. 180 mg/ml; 1.154 ±0.077 vs. 1.055 ±60.068, respectively). Conclusion : It is suggested that personal atopy is important in the development of asthma after early childhood wheezing, and parental atopy rather than bronchial hyperresponsiveness is a risk factor for the development of childhood asthma in this clinical setting.

제주도 농촌지역 초등학생의 귤응애 항원에 대한 감작 현황과 귤응애에 대한 환경폭로가 감작에 미치는 영향

이명현,김우경,홍성철,김유영,이상록,김윤근,박해심,장윤석,이병재,김희연,민경업,지영구,조상헌,손지웅,배종면,정재원 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.6

Background : We have demonstrated recently that citrus red mite(Panonychus citri) is the most important allergen in citrus-cultivating farmers with asthma and/or rhinitis. Objective : A cross-sectional survey was performed to evaluate the sensitizat,ion to the citrus red mite and the effect of environmental exposure on the specific sensitization among primary school children living in rural areas of Cheju Island. Material and methods : A total of 4,490 children (from ages 7 to 12 years) living in rural are as were enrolled in this study. Each subject was evaluated by a questionnaire developed by International Study of Allergy and Asthma in Childhood (ISAAC), and a skin prick test with 11 common inhalant allergens including citrus red mite. Results : On skin prick tests, the most common sensitizing allergen was Dermatophagoides pteronyssinus(7-9 years : 22.7%, 10-12 years : 25.5%), followed by D. farinae(20.4%, 21.8%), cockroach(9.6%, 12.8%), and citrus red mite(8.8%, 12.6%). The sensitization rate to citrus red mite was higher in older children than in younger ones. When age factor was corrected, the positive skin response to citrus red mite was higher among childen with a history of visiting citrus farms or those living near citrus farms than among those without visiting history or those living far from citrus farms (p$gt;0.05, respectively). Conclusion : Citrus red mite is a common sensitizing allergen and evnironmental exposure may determine the risk of sensitization to citurus red mite in children living in rural areas of cheju Island.