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안강모 한국피부장벽학회 2014 한국피부장벽학회지 Vol.16 No.2
The pathogenesis of atopic dermatitis (AD) is attributed to both genetic and environmental factors. With regard to a genetic basis, the genes encoding filaggrin (FLG) has been most consistently replicated in more than 20 different studies. The loss-of-function mutation in FLG gene has been frequently reported in European populations, and the other responsible genes remain to be elucidated. Recent increase in the prevalence of AD suggests that the environmental factors are likely to be more important in the development of AD, because there is no evidence of abrupt genetic alterations. In terms of environmental factors, contact with endotoxin in utero or during the first year of life, i.e. hygiene hypothesis, has a protective effect on the development of asthma, hay fever and allergic sensitization, although this effect is not evident in AD. In contrast, altered distribution in gut flora during infancy seems to influence the development of AD. Moreover, recent evidences suggest that air pollution might cause AD in a susceptible individual. For example, the exposure to a variety of indoor and outdoor air pollutants such as environmental tobacco smoke, volatile organic compounds, nitrogen dioxide, and particulate matter has been reported to develop AD. It appears to be mediated by oxidative stress, which induces skin barrier dysfunction or immune dysregulation. Further investigations to examine the role of air pollution in the development of AD are needed to establish better strategy for primary prevention of AD.
2010년 한국 어린이·청소년의 천식, 알레르기 비결막염, 아토피피부염 증상 유병률 조사: 복합표본설계를 이용한 전국 서베이
안강모,김지현,권호장,채유미,함명일,이기재,박용민,이소연,김우경,한만용 대한의사협회 2011 대한의사협회지 Vol.54 No.7
To investigate the prevalence of asthma, allergic rhinitis, and eczema, we did a cross-sectional survey of 4,003 children aged 6-7 years (students in the 1st year of elementary school) and 4,112students aged 13-14 years (students in the 1st year of middle school), chosen from a random sample of 45 primary and 40 middle schools across the nation. The Korean-translated modified version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used in this survey. The weighted 12-month prevalence of asthma symptoms from the questionnaires was 10.3%(95% confidence interval [CI], 9.2 to 11.4) for children aged 6-7 years and 8.3% (95% CI, 7.4 to 9.2)for children aged 13-14 years. The weighted 12-month prevalence of allergic rhinoconjuctivitis symptoms was 18.9% (95% CI, 17.5 to 20.4) for children aged 6-7 years and 19.2% (95% CI, 17.9 to 20.6) for children aged 13-14 years. The weighted 12-month prevalence of eczema symptoms was 17.9% (95% CI, 16.6 to 19.3) for children aged 6-7 years and 11.2% (95% CI, 10.1 to 12.3) for children aged 13-14 years. Compared with results from a 2000 ISAAC study, the 12-month prevalence of asthma increased from 5.8% to 10.3% in children aged 6-7 years, but there was little change (from 8.7% to 8.3%) in children aged 13-14 years. The prevalence of allergic rhinoconjunctivitis and eczema has increased considerably in both age groups.
안강모,박화영,이지현,이민구,김정호,강임주,이상일 대한의학회 2005 Journal of Korean medical science Vol.20 No.1
Cystic fibrosis (CF) is inherited as an autosomal recessive trait, and the mutations in cystic fibrosis transmembrane conductance regulator (CFTR) gene contributes to the CF syndrome. Although CF is common in Caucasians, it is known to be rare in Asians. Recently, we experienced two cases of CF in Korean children. The patients were girls with chronic productive cough since early infancy. Chest computed tomog-raphy showed the diffuse bronchiectasis in both lungs, and their diagnosis was con-firmed by the repeated analysis of a quantitative pilocarpine iontophoresis test (QPIT). The sweat chloride concentrations of the first patient were 108.1 mM/L and 96.7 mM/L. The genetic analysis revealed that she was the compound heterozygote of Q1291X and IVS8 T5 -M470V. In the second case, the sweat chloride concentrations were 95.0 mM/L and 77.5 mM/L. Although we performed a comprehensive search for the coding regions and exon-intron splicing junctions of CFTR gene, no obvious disease-related mutations were detected in the second case. To our knowledge, this is the first report of CF in Korean children identified by a QPIT and genetic analysis. The possibility of CF should be suspected in those patients with chronic respiratory symptoms even in Korea. Cystic fibrosis (CF) is inherited as an autosomal recessive trait, and the mutations in cystic fibrosis transmembrane conductance regulator (CFTR) gene contributes to the CF syndrome. Although CF is common in Caucasians, it is known to be rare in Asians. Recently, we experienced two cases of CF in Korean children. The patients were girls with chronic productive cough since early infancy. Chest computed tomog-raphy showed the diffuse bronchiectasis in both lungs, and their diagnosis was con-firmed by the repeated analysis of a quantitative pilocarpine iontophoresis test (QPIT). The sweat chloride concentrations of the first patient were 108.1 mM/L and 96.7 mM/L. The genetic analysis revealed that she was the compound heterozygote of Q1291X and IVS8 T5 -M470V. In the second case, the sweat chloride concentrations were 95.0 mM/L and 77.5 mM/L. Although we performed a comprehensive search for the coding regions and exon-intron splicing junctions of CFTR gene, no obvious disease-related mutations were detected in the second case. To our knowledge, this is the first report of CF in Korean children identified by a QPIT and genetic analysis. The possibility of CF should be suspected in those patients with chronic respiratory symptoms even in Korea.