1.Association of nasal inflammation and lower airway responsiveness in schoolchildren based on an epidemiological survey.
Jun Ho MYUNG ; Hyun Jeong SEO ; Soo Jeong PARK ; Bo Young KIM ; Il Sang SHIN ; Jun Hak JANG ; Yun Kyung KIM ; An Soo JANG
The Korean Journal of Internal Medicine 2015;30(2):226-231
BACKGROUND/AIMS: We sought to increase our understanding of the rhinitis-asthma relationship and improve strategies for the treatment of patients with these diseases. The aim of this study was to identify a connection between upper airway inflammation and lower airway responsiveness. METHODS: We counted eosinophils on nasal smears, and performed spirometry, allergic skin tests, and methacholine challenge tests in 308 schoolchildren plus a questionnaire on respiratory symptoms. The methacholine concentration causing a 20% fall in forced expiratory volume in 1 second (PC20 < 25 mg/mL) was used as the threshold of bronchial hyperresponsiveness (BHR). RESULTS: In total, 26% of subjects had positive nasal eosinophils on a smear, and 46.2% of subjects had BHR at < 25 mg/mL methacholine PC20. Nasal symptoms were higher in subjects with than without nasal eosinophils (p = 0.012). Asthma symptoms did not differ between subjects with and without nasal eosinophils. Nasal eosinophils were higher in subjects with atopy than those without (p = 0.006), and there was no difference in PC20 methacholine according to atopy (15.5 +/- 1.07 vs. 17.5 +/- 0.62; p > 0.05). No difference in BHR was detected when comparing subjects with and without nasal eosinophils. There were significant differences in the PC20 between subjects with greater than 50% nasal eosinophils and without nasal eosinophils (11.01 +/- 2.92 mg/mL vs. 17.38 +/- 0.61 mg/mL; p < 0.001). CONCLUSIONS: These findings demonstrated that nasal eosinophilic inflammation might contribute to lower airway responsiveness in schoolchildren, based on an epidemiological survey.
Adolescent
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Age Distribution
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Age Factors
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Asthma/diagnosis/*epidemiology/physiopathology
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Bronchial Hyperreactivity/diagnosis/*enzymology/physiopathology
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Bronchial Provocation Tests
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Child
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Eosinophilia/diagnosis/*epidemiology/immunology
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Eosinophils/immunology
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Female
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Health Surveys
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Humans
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Intradermal Tests
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Leukocyte Count
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Lung/*physiopathology
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Male
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Nasal Mucosa/*immunology
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Republic of Korea/epidemiology
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Rhinitis/diagnosis/*epidemiology/immunology
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Spirometry
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Surveys and Questionnaires
2.Seroprevalence of Tissue Invading Parasitic Infections Diagnosed by ELISA in Korea.
Mi Kyung LEE ; Sung Jong HONG ; Hye Ryoun KIM
Journal of Korean Medical Science 2010;25(9):1272-1276
Seroprevalence of the IgG antibodies for Clonorchis sinensis, Paragonimus westermani, Taenia solium metacestode (cysticercus), and Spirometra erinacei plerocercoid (sparganum) was measured using enzyme-linked immunosorbent assay (ELISA) in sera of patients in Korea from 1993 to 2006. A total of 74,448 specimens referred nationwide from 121 hospitals revealed an IgG positive rate of 7.6% for the 4 parasites. The IgG positive rate (18.7%) for the 4 parasites in 1993 decreased gradually to 6.6% in 2006. Individual positive rate decreased from 5.2% (1993) to 1.6% (2006) for C. sinensis, from 2.8% (1993) to 1.1% (2006) for P. westermani, from 8.3% (1993) to 2.2% (2006) for cysticercus, and from 2.6% (1993) to 1.6% (2006) for sparganum. The positive rate was highest (21.2%) in the group of patients who ranged in age from 50-59 yr old, and in the group that was referred from the Seoul area (55.9%). In conclusion, our results suggest that tissue invading parasitic infections should always be included in differential diagnosis for patients with eosinophilia associated lesions of the central nervous system, liver, and lungs in Korea.
Adolescent
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Adult
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Age Factors
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Aged
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Aged, 80 and over
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Animals
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Antibodies, Helminth/*blood
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Child
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Child, Preschool
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Clonorchiasis/diagnosis/*epidemiology
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Clonorchis sinensis/immunology/isolation & purification
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Cysticercosis/diagnosis/*epidemiology
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Cysticercus/immunology/isolation & purification
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Diagnosis, Differential
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Enzyme-Linked Immunosorbent Assay
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Eosinophilia/immunology
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Female
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Humans
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Immunoglobulin G/blood
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Infant
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Male
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Middle Aged
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Paragonimiasis/diagnosis/*epidemiology
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Paragonimus westermani/immunology/isolation & purification
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Republic of Korea/epidemiology
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Seroepidemiologic Studies
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Sparganosis/diagnosis/*epidemiology
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Sparganum/immunology/isolation & purification
3.Impact of Toxocariasis in Patients with Unexplained Patchy Pulmonary Infiltrate in Korea.
Young Soon YOON ; Chang Hoon LEE ; Young Ae KANG ; Sung Youn KWON ; Ho Il YOON ; Jae Ho LEE ; Choon Taek LEE
Journal of Korean Medical Science 2009;24(1):40-45
Toxocariasis is one of the causes of pulmonary eosinophilic infiltrate that is increasing in Korea. This study was designed to identify the prevalence of toxocara seropositivity in patients with unexplained pulmonary patchy infiltrate and to evaluate associated factors. We evaluated 102 patients with unexplained pulmonary patchy infiltrate on chest computed tomography (CT) scan. As a control set, 116 subjects with normal chest CT were also evaluated. History of allergic disease, drug use, parasitic disease and raw cow liver intake were taken. Blood eosinophil count and total IgE level were measured. Specific serum IgG antibody to Toxocara canis larval antigen and specific IgG antibodies to 4 other parasites were measured by enzymelinked immunosorbent assay (ELISA). In the infiltrate group, 66.7% subjects were toxocara seropositive whereas 22.4% of the control group were seropositive (p< 0.001). In the infiltrate group, patients with a history of eating raw cow liver (odds ratio [OR], 7.8) and patients with eosinophilia (OR, 5.2) had a higher incidence of toxocara seropositivity. Thirty-five percent of toxocara seropositive patients with infiltrate exhibited migrating infiltrate and 48% had decreased infiltrate on the follow- up CT. We recommend that toxocara ELISA should be performed in patients with unexplained pulmonary patchy infiltrate, and that the eating of raw cow liver should be actively discouraged.
Adult
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Aged
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Animals
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Case-Control Studies
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Female
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Humans
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Immunoglobulin E/blood
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Korea
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Leukocyte Count
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Liver/parasitology
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Male
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Middle Aged
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Pulmonary Eosinophilia/diagnosis/*etiology/immunology
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Seroepidemiologic Studies
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Tomography, X-Ray Computed
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Toxocara/immunology
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Toxocariasis/*complications/diagnosis/epidemiology
4.Clinical Features of Eosinophilic Bronchitis.
Jae Hak JOO ; Sang Joon PARK ; Sung Woo PARK ; June Hyuk LEE ; Do Jin KIM ; Soo Taek UH ; Yong Hoon KIM ; Choon Sik PARK
The Korean Journal of Internal Medicine 2002;17(1):31-37
BACKGROUND: Eosinophilic inflammation of the airway is usually associated with airway hyper-responsiveness in bronchial asthma. However, there is a small group of patients which has the eosinophilic inflammation in the bronchial tree with normal spirometry and no evidence of airway hyper-responsiveness, which was named eosinophilic bronchitis. The objectives of this study are 1) to investigate the incidence of eosinophilic bronchitis in the chronic cough syndrome and 2) to evaluate the clinical features and course of eosinophilic bronchitis. METHODS: We evaluated 92 patients who had persistent cough for 3 weeks or longer. In addition to routine diagnostic protocol, we performed differential cell count of sputum. Eosinophilic bronchitis was diagnosed when the patient had normal spirometric values, normal peak expiratory flow variability, no airway hyper-responsiveness and sputum eosinophilia (>3%). RESULTS: The causes of chronic cough were post-nasal drip in 33%, cough variant asthma in 16%, chronic bronchitis in 15% and eosinophilic bronchitis in 12% of the study subjects. Initial eosinophil percentage in the sputum of patients with eosinophilic bronchitis was 26.8+/-6.1% (3.8-63.7%). Treatment with inhaled steroid is related with a subjective improvement of cough severity and a significant decrease of sputum eosinophil percentage (from 29.1+/-8.3% to 7.4+/-3.3%). During the follow-up period, increase in sputum eosinophil percentage with aggravation of symptoms were found. CONCLUSION: Eosinophilic bronchitis is one of the important cause of chronics cough. Assessment of airway inflammation by sputum examination is important in investigating the cause of chronic cough. Cough in eosinophilic bronchitis is effectively controlled by inhaled corticosteroid, but may follow a chronic course.
Adult
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Aged
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Anti-Inflammatory Agents, Steroidal/therapeutic use
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Asthma/complications/epidemiology
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Bronchitis/*complications/diagnosis/drug therapy/epidemiology
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Budesonide/therapeutic use
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Chronic Disease
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Cough/epidemiology/*etiology
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Eosinophilia/*complications/diagnosis/drug therapy/epidemiology
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Female
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Gastroesophageal Reflux/complications/epidemiology
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Human
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Male
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Middle Age
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Respiratory Function Tests
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Severity of Illness Index
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Sputum/chemistry/immunology