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1.
Article in English | WPRIM | ID: wpr-875469

ABSTRACT

Background/Aims@#Recent evidence suggests an association between allergic sensitization and metabolic markers. However, this association has rarely been examined in the elderly. Retinol-binding protein-4 (RBP-4) is a recently identified adipokine that acts on the muscle and liver affecting insulin sensitivity. We evaluated the association between metabolic parameters and allergic sensitization in the elderly. @*Methods@#We analysed the database of the Korean Longitudinal Study on Health and Aging cohort study conducted during 2005 to 2006. Atopy was identified by inhalant allergen skin prick test. Metabolic conditions were assessed using anthropometric indices and serum biomarkers such as fasting glucose, lipid, adiponectin, and RBP-4. @*Results@#Among the 854 elderly subjects, 17.2% had atopy. Plasma RBP-4 levels were significantly higher in the atopic elderly than nonatopic elderly (p = 0.003). When RBP-4 percentiles were categorized as under three groups, the prevalence of atopy and current rhinitis increased significantly with percentiles of RBP-4 levels (p = 0.019 and p = 0.007, respectively). Log RBP-4 was associated with atopy (odds ratio [OR], 4.10; p = 0.009) and current rhinitis (OR, 2.73; p = 0.014), but not with current asthma (OR, 1.17; p = 0.824). Higher RBP-4 level in atopic elderly was also observed in current rhinitis patients. Atopy, but not current rhinitis, showed significant relationships with log RBP-4 levels in multivariate analyses adjusted for other metabolic markers including body mass index. @*Conclusions@#RBP-4 positively associated with atopy in the general elderly population irrespective of other metabolic markers.

2.
Article in English | WPRIM | ID: wpr-913319

ABSTRACT

Anaphylaxis is an acute serious systemic allergic reaction that can lead to death, requiring immediate diagnosis and treatment. In particular, food is the most common cause in children, adolescents, and young adults. In addition to physical contact between food and skin, anaphylaxis can also be induced by exposure other than ingestion, such as inhalation of aerosolized food proteins. Korean males undergo medical screening prior to a compulsory military service. A history of possible food allergy requires referral to a specialized allergy clinic. A 19-year-old male patient enlisted in the military was referred to the allergy clinic for an oral provocation test. It was confirmed that anaphylaxis was caused not only by walnut intake, but also by skin contact or by inhaling walnut particles. We report the case with the literature review.

3.
Article | WPRIM | ID: wpr-831481

ABSTRACT

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are the most severe cutaneous drug hypersensitivity reactions, which are unpredictable adverse drug reactions. SJS/TEN is associated with significant mortality and morbidity; however, effective treatment is difficult. Mesenchymal stem cells (MSCs) are well-known for their anti-inflammatory and tissue regeneration properties. The purpose of the present study was to verify whether MSCs could be applied for the treatment of SJS/TEN. We developed an SJS/TEN mouse model using peripheral blood mononuclear cells from a lamotrigine-induced SJS patient. MSCs were injected into the model to verify the treatment effect. In SJS model mice treated with MSCs, ocular damage rarely occurred, and apoptosis rate was significantly lower. We demonstrated a therapeutic effect of MSCs on SJS/TEN, with these cells presenting a potential novel therapy for the management of this disorder.

4.
Article in Korean | WPRIM | ID: wpr-762201

ABSTRACT

PURPOSE: Anaphylaxis and asthma exacerbation could be life-threatening medical emergencies. The 119 (911 in the United States) rescue teams are at the forefront of such emergency conditions. Early recognition and proper prehospital management by 119 rescuers are important. We evaluated the awareness of 119 rescuers of anaphylaxis and asthma exacerbation in Korea. METHODS: Between May 17 and June 28 of 2018, a total of 180 rescuers were recruited from Gyeonggi-do province, Korea. The 90-minute educational sessions on anaphylaxis and asthma exacerbation were provided by an allergy specialist, which included some lectures and a hands-on workshop on self-injectable epinephrine autoinjector. A questionnaire survey with the same content was performed before and after education to assess the improvement in awareness. It had 2 domains: anaphylaxis awareness and asthma awareness. RESULTS: After education, awareness score for anaphylaxis increased from an average of 3.1 (51.7%) to 5.5 (91.7%). Particularly, the effect of education on the use of epinephrine, the most crucial treatment for anaphylaxis, was greatest. The awareness score for asthma after education increased from an average of 21.3 (78.9%) to 25.1 (93%). The effect of education on treatment and management of asthma was greatest. CONCLUSION: The 119 rescuers could be the first medical personnel at the forefront of anaphylaxis and asthma exacerbation. Hence, it is important to increase their awareness of anaphylaxis and asthma exacerbation. A simple educational activity can dramatically change the level of awareness.


Subject(s)
Anaphylaxis , Asthma , Education , Emergencies , Epinephrine , Hypersensitivity , Korea , Lecture , Rescue Work , Specialization
5.
Article in English | WPRIM | ID: wpr-716004

ABSTRACT

PURPOSE: The prevalence and burden of asthma is increasing worldwide. In this study, we analyzed 3 different Korean national health survey datasets to determine the general features of adult asthma in Korea and to obtain basic information that would support future strategies for better management of adult asthma. METHODS: The surveys used in this study included the Korea National Health and Nutrition Examination Survey (KNHANES), Korea Community Health Survey (KCHS) and National Health Insurance Service-National Sample Cohort (NHIS-NSC). We investigated annual asthma prevalence, evaluating the rate and risk factors of asthma exacerbation by age and sex, and clinical data of 1,832 patients with asthma who were registered in the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) were analyzed to elucidate risk factors for asthma exacerbation. We also analyzed another asthma cohort and added it as replication data. RESULTS: In the KNHANES database, annual asthma prevalence rates varied from 1.2% to 3.1%. In the KCHS database, overall prevalence increased, with significant regional differences (1.6%–2.1%). The NHIS-NSC indicated a gradual increase in annual asthma prevalence from 4.5% to 6.2%. Interestingly, all 3 surveys indicated the highest prevalence of asthma among elderly women. In addition, elderly women with asthma had a significantly higher risk of asthma exacerbation (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.19–2.93; P=0.006). Approximately 11% of patients were classified as having severe asthma. An asthma cohort analysis identified female sex, low baseline pulmonary function, longer treatment duration, high variability in pulmonary function and significant changes in Asthma Control Test scores as risk factors for asthma exacerbation. CONCLUSIONS: The prevalence of asthma in Korea is consistently high among elderly and female populations. These results should lay the foundation for strategies for effective asthma prevention and management; elderly female patients with asthma should receive particular attention.


Subject(s)
Adult , Aged , Asthma , Cohort Studies , Dataset , Female , Health Surveys , Humans , Incidence , Korea , National Health Programs , Nutrition Surveys , Prevalence , Risk Factors
6.
Korean Journal of Medicine ; : 306-310, 2018.
Article in Korean | WPRIM | ID: wpr-715340

ABSTRACT

Pyrazinamide (PZA) is an anti-tuberculosis drug and an essential component of the standard four-drug regimen for tuberculosis. Here, we report a case of immediate angioedema secondary to PZA administration intended for pulmonary tuberculosis treatment. A previously healthy 48-year-old woman was diagnosed with pulmonary tuberculosis and tuberculous lymphadenitis. Thirty minutes after taking the first dose of isoniazid, rifampicin, pyrazinamide, and ethambutol, the patient developed facial edema, generalized rash, and dizziness. An oral provocation test was performed on the four drugs, and 1,000 mg pyrazinamide showed a positive result characterized by 50 minutes of urticaria, angioedema, and hypotension. As the prevalence of tuberculosis increases, prescriptions for anti-tuberculosis drugs may increase as well. Clinicians should be aware of the possibility of immediate hypersensitivity as well as delayed hypersensitivity to anti-tuberculosis drugs.


Subject(s)
Angioedema , Dizziness , Drug Hypersensitivity , Edema , Ethambutol , Exanthema , Female , Humans , Hypersensitivity, Delayed , Hypersensitivity, Immediate , Hypotension , Isoniazid , Middle Aged , Prescriptions , Prevalence , Pyrazinamide , Rifampin , Tuberculosis , Tuberculosis, Lymph Node , Tuberculosis, Pulmonary , Urticaria
7.
Article in English | WPRIM | ID: wpr-98408

ABSTRACT

Tumor necrosis factor (TNF) inhibitors are increasingly used in treatment of rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis, and inflammatory bowel diseases including Crohn's disease and ulcerative colitis. Rarely, anti-TNF therapy is associated with neurological complications, including both central and peripheral nervous system disorders. To the best of our knowledge, only one case of infliximab-associated multifocal motor neuropathy with conduction block in a patient with spondyloarthropathy has been reported to date in Korea. Here, we report on the case of a 58-year-old Korean woman affected by RA who developed multifocal motor neuropathy after infliximab treatment.


Subject(s)
Arthritis, Psoriatic , Arthritis, Rheumatoid , Colitis, Ulcerative , Crohn Disease , Female , Humans , Inflammatory Bowel Diseases , Infliximab , Korea , Middle Aged , Peripheral Nervous System Diseases , Spondylarthropathies , Spondylitis, Ankylosing , Tumor Necrosis Factor-alpha
8.
Article in English | WPRIM | ID: wpr-60380

ABSTRACT

Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.


Subject(s)
Glucocorticoids , Humans , Immunoglobulins , Inflammation , Methylprednisolone , Middle Aged , Prednisone , Retroperitoneal Fibrosis
9.
Article in Korean | WPRIM | ID: wpr-164820

ABSTRACT

Necrotizing pancreatitis is associated with high rates of morbidity and mortality. Managing necrotizing pancreatitis is challenging, and minimally invasive treatment modalities recently replaced traditional open necrosectomy. Percutaneous catheter drainage and endoscopic necrosectomy are now widely used because they are less invasive, safer, and can more effectively remove necrotic materials. Various methods and novel techniques have been introduced to manage walled-off necrosis. Herein, we report a case series of patients with necrotizing pancreatitis who were successfully treated using fully covered esophageal metal stent and endoscopic necrosectomy via the percutaneous approach. Percutaneous endoscopic necrosectomy using a fully covered esophageal stent is an effective endoscopic treatment for patients with walled-off necrosis that extends along both sides of the paracolic gutter, reduces the number of necrosectomy sessions, and improves disease status faster than conventional treatment.


Subject(s)
Catheters , Drainage , Humans , Mortality , Necrosis , Pancreatitis , Stents
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