천식 환자들의 삶의 질에 대한 연구

홍천수(Chein Soo Hong),윤영연(Yeong Yeon Yun),김철우(Cheol Woo Kim),박중원(Jung Won Park),노현정(Hyun Jung Rho),박무석(Moo Suk Park),서지연(Ji Yeon Suh),김동기(Dong Ki Kim) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.2

N/A Background: The effectiveness of treatment of asthma has been assessed by lung function test, airway responsiveness and symptoms. But, they rarely capture the emotional and social impairment. Recently, questionnaires that reflect the quality of life(QOL) in asthma patients were developed. In this study, we evaluated the impairment on quality of life in Korean adult asthmatic patients cross-sectionally by using the QOL questionnaires of Juniper EF. Methods : One hundred eighty nine adult patients with over 1 year history of asthma were enrolled. The patients were asked to choose the five most important daily activities among 40 daily activities which were important in Korea. The QOL questionnaire was composed of 32 items in 4 domains(activity, symptom, emotion and exposure to environmental stimuli) and the response option was scored on a 7-point scale. Results 45.5% of patients who participated in this study were men, and 48.3% had atopy. The disease severities of asthma evaluated by physician were mild intermittent(31%), mild persistent(35%), moderate persistent(21%) and severe persistent(12%). Among 40 items of general daily activities, 19 items were chosen by more than 20 patients. Among them, running, walking uphills, hurried movement were most impaired daily activities. The QOL of our asthma patients showed statistical difference on disease severity, control state and symptom status during the last 3 months. The QOL was not influenced by sex, age or atopy score. Occupational asthma showed the lowest score on QOL in all 4 domains. On grouping with medications, the group with oral steroid noted statistically lower scores of QOL in all domains. The QOL score of asthma was well correlated with average symptom attacks during the last 3 months. Conclusion : According to our study, rapid control of asthma and lowering of the disease severity are essential for improvement of QOL. A QOL questionnaire in Korea should be developed in Korea.

급성 천식발작의 응급치료 성적 분석

김도영(Do Young Kim),김대중(Dae Jung Kim),신장열(Jang Yel Shin),박효경(Hyo Kyoung Park),김진석(Jin Suk Kim),윤영연(Yeong Yeon Yun),김철우(Cheol Woo Kim),박중원(Jung Won Park),홍천수(Chein Soo Hong) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.1

N/A Background and objective .There has been little clinical data on the treatment outcome of pa- tients with acute asthma attack in Korea. We designed a management protocol of acute asthma, and analyzed clinical parameters obtained from this protocol. Method: A total of 32 cases with acute asthma were treated with oxygen, β2 agonist, and methylprednisolone. Ipratropium was added in cases of severe attack. After 90 minutes, intravenous aminophylline was given to the patients with poor response. Result: Beta2 agonist and methylprednisolone were sufficient for symptom control in 17 cases. Ipratropium and aminophylline were added in 6 and 9 cases, respectively. There was no difference in improvement of PEF, heart rate, respiratory rate, PaO2, PaCO2, and SaO2 at 90 minutes and 8 hours between agonist inhalation and subcutaneous group. Serum potassium concentration levels significantly decreased in patients treated with ipratropium or aminophylline (n=15, 4.17+0.45 vs. 3.99±0.35mM/L, p<0.05), compared with patients using only agonist and methylprednisolone (n=17, 3.89+0.30 vs. 4.14+0.46mM/L, p>0.05). Conclusion Subcutaneous agonist may be an alternative to inhalant 0z agonist for the emergency treatment of acute asthma, and we think that a consensus regarding use of aminophylline in the emergency room should be made.

신이식후 진단된 원발성 알도스테론증

윤영연,오기원,김정아,양철우,진동찬,김용수,윤영석,방병기,고용복 大韓移植學會 1993 Korean Journal of Transplantation Vol.7 No.1

대엽성 폐렴의 양상을 보인 폐 Cryptococcosis 1예

박석영,윤영연,오귀염,권낙기 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2

A 26 year old lady was admitted due to fever and productive coughing of 10 days duration. She had been working at the office treating stuffs of oriental herb medicine without any problem in her health by then. Chest films revealed consolidative changes involving Lt. lower lobe and she was given systemic antibacterial antibiotics, but her illness was not improved. On 19th hospital day needle biopsy was performed and cryptococcosis was diagnosed involving both alveoli and intertitium. Antifungal agent, itraconazole, was prescribed for 10 weeks and the lesion was resolved completely without remnant change. We discussed this case with review of literatures.

기관지천식 환자에서 혈중 eosinphil cationic protein 의 임상적 의의

홍천수,박중원,윤영연 대한알레르기학회 1998 천식 및 알레르기 Vol.18 No.4

Objective: The aim of this study was to investigate the usefulness of serum ECP as a marker of the severity of asthma and extent of airway inflammation. Methods: We investigated 108 patients suffering from bronchial asthma, who were classified as mild intermittent(n=19), mild persistent(n=27), moderate persistent(n=42), and severe persistent(n=20) and 10 healthy controls. Atopy was defined as those who showed $gt;2+ responses on skin prick test. Serum ECP, peripheral blood eosinophil, sputum eosinophil, and PEFR were measured on the same date and meth~acholine PC20 were determined within 2 weeks. Results: Serum ECP levels were 10.1+- 2.0 ug/L in controls, and 29.1 ± 23.6 ug/L in asthmatic patients. According to symptom severity, serum ECP levels were 22.9 ±15.6 ug/L, 28.6 ±24.1 ug/L, 29.5 ± 22.2 ug/L, and 34.6 ±31.2 ug/L in mild intermittent, mild persistent, moderate persistent and severe persistent asthmatic patients, respectively and there were no significant differences among four groups(p$gt;0.05). Serum ECP levels correlated with peripheral blood eosinophil counts(r=0.48, p$lt;0.01), but not with sputum eosinophil, PEFR, and methacholine PC20 levels. There was no significant difference in serum ECP level between atopic and non-atopic asthma(p$gt;0.05). Conclusion: Single measurevment of ECP level at clinic could not represent the severity of asthma.

수술후 발생한 양측성 후복막강 농양 1예

양진모,노희정,윤영연,오용석,변재영,정해억,김창섭,홍관수,안석주,최상욱 대한감염학회 1994 감염 Vol.26 No.2

저자들은 50세의 남자에서 수술후 발생한 양측성 후복막강 농양에 대해 경피적 배농술로 성공적으로 치료한 1예를 문헌 고찰과 함께 보고하는 바이다. Retroperitoneal abscesses are complicated serious surgical infections marked by an insidious, occult process leading to considerable mortality and morbidity. Knowledge of the anatomy of the retroperitoneal spaces as well as an increased awareness of the symptoms, physical findings, and causes of these abscesses are the keys to prompt and efficient therapy. Recently percutaneous guided catheter drainage has changed the traditional surgical therapeutic approach to this disease in the majority of cases. We report a case of postoperative complicated bilateral retroperitoneal abscess successfully treated with percutaneous guided catheter drainage combined with medical control.

아세트아미노펜 아나필락시스 1례

홍천수,박중원,윤영연 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.1

Heterogeneity in clinical features and pathogenesis of non-steroidal anti-inflammatory agent (NSAIDs) hypersensitivity have been reported. NSAIDs can cause bronchial constriction in asthmatics or hives and angioedema in patients with chronic urticaria, in which case causative drugs show cross-reactivity with other NSAIDs. Normal subjects without allergic diseases may develop urticaria angioedema or anaphylaxis after ingestion of a specific NSAID. In this type of reaction, cross-reactivity between causative drugs and other NSAIDs does not occur. We experienced a case of acetaminophen anaphylaxis without aspirin sensitivity in a 38-year-old male, which was confirmed by oral provocation test. An oral challenge with 150mg of acetaminophen induced urticaria in lower legs, and erythema, with febrile sensation in ears. With a dose of 600mg acetaminophen, urticaria developed in trunk and extremities with facial angioedema. An oral provocation test with 650mg of aspirin was well tolerated without any adverse reactions. We report acase of acetaminophen anaphylaxis, which occurred in a normal individual at a small dose(150mg) without cross-reactivity with aspirin. This type of reaction supports heterogenei~ty of NSAIDs hypersensitivity and it may be caused by an other mechanism, not by cyclooxygenase inhibition.

호산구증다증과 동반된 맥관부종 1례

조상호,홍천수,박중원,고원기,윤영연,강혜윤 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.3

Episodic angioedema with eosinophilia was described by Gleich, et al. as a distinct entity characterized by recurrent angioedema, urticaria, leukocytoeis with remarkable eosinophilia, fever and periadically increased body weight. Since then, several cases of this disorder have been reported in the United States, Europe and Japan. We present a Korean patient whose clinical, histopathologic, and laboratory findings are consistent with the syndrome of episodic angioedema with eosinophilia. This case supports the previous study that revealed some differences between Asian and Caucasian patients.

다종 꽃가루에 대한 피부반응 양성 환자들에서 꽃가루간의 교차반응에 관한 연구

홍천수,박중원,고시환,윤영연 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.4

Objective : The aim of this study was to evaluate cross-reactivity between pollens in patients with strong skin reactivity to multiple pollens. Methods : A pool of sera from 20 patients who showed strong skin responses(≥3+) to all three kinds of pollens (tree, grass, and weed) was used. Oak, ryegrass, mugwort, ragweed and hop Japanese pollens were chosen for the subject of study. The level and pattern of bound IgE to each pollen and cross-reactivity between pollens were investigated by ELISA and immunoblot experiments. Results : In ELISA, the IgE of a pool of sera reacted to ryegrass and ragweed in 100%, to mugwort in 95%, to oak in 75%, and to hop Japanese in 65%, respectively. In inhibitory ELI-SA, more than 50% of bound IgE was mutually inhibited in oak vs ryegrass, oak vs mugwort, mugwort vs ryegrass and mugwort vs hop Japanese. In immunoblot, the IgE binding rate to major allergens of each pollen was 95% for hop Japanese, 75% for ragweed, 50% for ryegrass, 35% for mugwort, and 30% for oak, repectively. In inhibitory immunoblot, the mutually inhibited bound IgE could not be observed between major allergens of each pollen, but some minor allergens of oak pollen were mutually inhibited by ryegrass. Conclusion : Cross-reactivity between major allergens of oak, ryegrass, mugwort, ragweed and hop Japanese pollens was not observed at all, but some minor allergens of oak pollen cross-re- acted with ryegrass and mugwort, and so did those of mugwort pollen with ryegrass and hop Japanese.

호흡기 알레르기 환자에서 광촉매플라스마 정전기 흡착식 공기정화기의 효과

홍영기,홍천수,박중원,김철우,이성화,고시환,윤영연,이기영 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.1

Objective: To evaluate the clinical efficacy of a new air cleaning device (LG Electronics, Korea) equipped with electrostatic precipitator (EP) and photocatalytic plasma filter (PCP) in 24 respiratory allergic subjects. Material and method: Air cleaning conditioner and air cleaner were placed in living room and bedroom. Both EP and PCP (EP/PCP) filters were used for the first 4 weeks and for another 4 weeks, PCP without EP filter (PCP) was used. We measured symptom scores of asthma and rhinitis, peak expiratory flow rate (PEFR), serum eosinophil cataionic prote in? in ECP, Dermatophagoides farinae (DF) specific IgE and IgG in sera, concentrations of major allergens of DF in floor dust of living room, bedroom and in airborne dust. Results: Both asthma and rhinitis symptom scores were significantly improved not only with EP/PCP filters but also with PCP filter. The morning PEFR was significantly improved with EP/PCP filters, but not with PCP filter. Frequency of salbutamol inhalation by air cleaner with EP/PCP filter tended to de crease(p=0.051), with no significant difference in serum ECP concentration. DF specific IgE significantly decreased at the 8th week with no differences in specific IgG. However, the mean Der f I levels in floor dust of bedroom (1, 128 vs. 374 ng/gm dust, p$lt;0.01) and living room (1,516 vs 812 ng/gm dust, p$lt;0.01) decreased, Der f1 in airborne dust measured only in 8 out of 22 subjects, and they decreased significantly with the trial of EP/PCP filter (172.2 pg/4.5m³ vs. 62.1 pg/4.5m³, p$lt;0.01). Conclusion: These results suggest that the EP/PCP air cleaner may be an effective tool for environmental control in respiratory allergic subjects.