ABSTRACT
BACKGROUND: During the past few decades, the prevalence of allergic disorders has increased worldwide. We attempted to reveal the sensitization rate of dust mite allergens, which is one of the most important allergens in Korea, and the prevalence of mite-sensitized asthma in healthy young women who had no history of allergic diseases. METHODS: We performed the skin prick test with two mites (Dermatophagoides farinae, Df; Dermatophagoides pteronnyssinus, Dp) in 24-26 years old 172 women who had no history of allergic diseases. We also performed the methacholine bronchial provocation test (MBPT) and the questionnaire survey of positive skin responders. RESULTS: The 55.2% of subjects showed positive skin responses to house dust mites. The positive rate to MBPT was 54.7% with average PC20 of 15.97+/-7.68 mg/ml and 48.4% had asthma symptoms in the questionnaire survey. Among the methacholine positive population, 6.3% had no asthma symptoms. The history of 3-week cough after upper airway infection was most important, but the most specific item was wheezing. CONCLUSION: The prevalence of dust mite-sensitive bronchial asthma in healthy young women is 26.7%, which is higher than that of previous studies.
Subject(s)
Female , Humans , Allergens , Asthma , Bronchial Provocation Tests , Cough , Dust , Korea , Methacholine Chloride , Mites , Prevalence , Pyroglyphidae , Respiratory Sounds , Skin , Surveys and QuestionnairesABSTRACT
BACKGROUND: Asthma is a chronic inflammatory disease of the bronchial mucosa and is associated with excess production of Th2 cytokines (IL-4, IL-5) relative to Th1 cytokine (IFN-V). The NK cell and TNK cell are supposed to be involved in the pathogenesis of allergic inflammation by cytokine regulation. OBJECTIVES: The aim of this study was to investigate the effect of allergen (Der p 2) on the production of IFN-V by CD3+T cell, CD56+NK cell and CD3+CD56+TNK cells in patients with mild persistent asthma. METHOD: Peripheral blood mononuclear cells (PBMCs) from patients with mild persistent asthma (n=12) who were sensitive to dust mite, were cultured with or without Der p 2 for 3 days, and phorbol ester plus calcium ionophore and intracellular protein transport inhibitor were added 4 hours before staining. A three-color flow cytometric analysis was done to detect intracytoplasmic IFN-V, surface DC3 and CD56 antigen simultaneously. RESULTS: When PBMCs were cultured only in media, there were no significant differences in the percentage of IFN-V positive CD3+T cell, CD56+NK cell and CD3+CD56+TNK cells between asthmatic patients and normal subjects. However, there were significant decreases in the percent change of IFN-V positive CD3+T cell, CD56+NK cell and CD3+CD56+TNK cell in asthmatic patients comparde to normal subjects after stimulation of PBMCs with Der p 2. CONCLUSION: This study suggests that NK cell and TNK cell may participate in allergic reaction by IFN-V regulation.
Subject(s)
Humans , CD56 Antigen , Asthma , Calcium , Cytokines , Dust , Hypersensitivity , Inflammation , Interferons , Killer Cells, Natural , Mites , Mucous Membrane , Protein TransportABSTRACT
Hepatopulmonary syndrome consists of a triad of liver dysfunction, intrapulmonary vascular dilatation, and hypoxemia. This is one of the main causes of arterial hypoxemia in patients with chronic liver disease. The vascular abnormalities are precapillary dilatation, direct arterial-venous communication, and dilated pleural vessels. In this article, we report a case of hepatopulmonary syndrome in a 62-year-old woman who had complained progressively worsening dyspnea, platypnea, and orthodeoxia. She had huge splenomegaly, clubbing fingers and cyanosis of lip and fingers. Arterial blood gas analysis showed refractory arterial hypoxemia and orthodeoxia suggesting right-to-left "shunting". Chest X-ray showed increased interstitial markings on the lower part of right lung, In 99mTc-labeled macroaggregated albumin (MAA) lung perfusion scan, there was no perfusion defect in the lung, but labeled radionuclide were taken up in the intraabdominal organs, kidney, liver and spleen. The amount of shunted radionuclide were about 58 percent. In contrast echocardiography, microbubbles which were injected via cephalic vein were visualized in the left atrium at 4 cardiac cycles after leaving the right ventricle indicating intrapulmonary right-to-left "shunting" rather than intracardiac shunt. Pulmonary angiographic finding revealed diffuse blotchy arterial dilatation on both lung fields, especially lower lobes of both lungs. Current modalities of treatment of hepatopulmonary syndrome are the therapeutic embolization of direct arterial-venous communication for focal vascular dilatations, and TIPSS (Transjugular intrahepatic porto-systemic shunt) or liver transplantation for diffuse intrapulmonary vascular dilatations. Despite our recommendation of TIPSS, she refused the procedure and is under home oxygen therapy.
Subject(s)
Female , Humans , Middle Aged , Hypoxia , Blood Gas Analysis , Cyanosis , Dilatation , Dyspnea , Echocardiography , Embolization, Therapeutic , Fingers , Heart Atria , Heart Ventricles , Hepatopulmonary Syndrome , Kidney , Lip , Liver , Liver Cirrhosis , Liver Diseases , Liver Transplantation , Lung , Microbubbles , Oxygen , Perfusion , Portasystemic Shunt, Transjugular Intrahepatic , Spleen , Splenomegaly , Thorax , VeinsABSTRACT
The relationship between neoplastic disease and thromboembolic disorders has been recognized since 1865, when Armand Trousseau first reported a high incidence of venous thrombosis in a series of patients with gastric carcinoma. The overall incidence of thromboembolic disease in patients with cancer has been reported to vary 1% to 15%. In a prospective study, Ambrus and associates reported that thrombosis and/or bleeding was the second most common cause of death in hospitalized cancer patients. We report a case who presented as a thromboembolic disease and subsequently confirmed to have an underlying lung malignancy. This 45 years old male patient visited our hospital with abdominal pain and distention of 3 days duration. Abdominal CT scan revealed multiple splenic and renal infarctions. On 20th hospital day, drowsy mental status was developed and hemorrhagic cerebral infarction was noted in brain CT scan. Chest CT scan revealed a 4cm sized spiculated mass on left lung apex and multiple paratracheal lymph adenopathy. With surgical biopsy of left supraclavicular lymph nodes, this patient was confirmed to have adenocarcinoma.