No abstract available.
Adult* ; Asthma* ; Humans

A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

Exposure to fungal spores occurs frequently in indoor as well as in outdoor. Residential area, office, factory and farm fields are the common places of fungal spore exposure. Role of fungal spores as the causes of hypersensitivity reactions, bronchial asthma, allergic rhinitis and hypersensitivity pneumonitis was underestimated due to the lack of intensive research on the allergenicity of fungal spores. As the knowledge on fungal spores is accumulating, it is necessary to reevaluate the role of fungal spores in the field of allergic diseases.
Alveolitis, Extrinsic Allergic ; Asthma ; Fungi ; Hypersensitivity ; Rhinitis ; Spores ; Spores, Fungal*

Exposure to fungal spores occurs frequently in indoor as well as in outdoor. Residential area, office, factory and farm fields are the common places of fungal spore exposure. Role of fungal spores as the causes of hypersensitivity reactions, bronchial asthma, allergic rhinitis and hypersensitivity pneumonitis was underestimated due to the lack of intensive research on the allergenicity of fungal spores. As the knowledge on fungal spores is accumulating, it is necessary to reevaluate the role of fungal spores in the field of allergic diseases.
Alveolitis, Extrinsic Allergic ; Asthma ; Fungi ; Hypersensitivity ; Rhinitis ; Spores ; Spores, Fungal*

IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria

Despite the substantial amount of asthma-related information available on the internet, little is known about the quality of such information. We assessed asthma-related information on the Korean internet intended as an educational material for asthma patients. By entering the key word, 'asthma', into 4 popular search engines, 32 web sites were identified and categorized with respect to authorship. The core asthma educational concepts and Health On the Net Code of Conduct principles were used to evaluate informational value and justifiability of unreliable information. Eight of 32 web sites were categorized as western physician, seventeen as oriental physician, four as commercial, and three as others. The mean number of core asthma educational concepts on the whole web sites was 2.7 out of 8. By type of authorship, 1.7 on the commercial sites, 2.1 on the oriental physician sites, 3.5 on the western physician sites, and 5.0 on the others sites in decreasing order. One of the western physician sites, two of the commercial sites, and all of the oriental physician and others sites contained unreliable information. However all of them except one site failed to satisfy our criteria of justifiability. Asthma-related information currently available on the Korean internet is highly variable in quality and lacks core asthma educational concepts and justifiability.
Asthma/*diagnosis/*therapy ; Health Education ; Human ; Internet ; Korea ; Medical Informatics ; Patient Education/*methods ; Quality Control

BACKGROUND: Exercise can aggravate asthmatic symptoms in many patients with bronchial asthma. It is caused by that inhaled air bypasses nasal cavity and goes directly to the lower airways through open mouth dring exercise. Although the pathogenetic mechanisms of exercise-induced asthma(EIA) have not been clarified yet, there is evidence that chemical mediators, released from the inflammatory cells triggered by airway cooling or drying, might be responsible for induction of bronchoconstriction. However, it has been controversial which chemical mediators or cells are involved in such process. Objectiye . The aim of this study was to evaluate the role of activated mast cells in the pathogenesis of EIA and find out whether or not sulfidopeptide leukotrienes (LTC4/d4/E4) are involved in the exercise-induced bronchoconstriction. MATERIAL AND METHOD: Eleven asthmatics with documented exercise-induced bronchoconstriction and 10 control subjects were studied. Before and 6 hours after free running for 6 minutes, forced expiratory volume in 1 second (FEV,) and the concentrations of N- methylhistamine, LTE4, and creatinine in unine collected for 6 hours after exercise were determined. RESULT: Urinary concentrations of N-methylhistamine(mean+SE, ng/mg creatinine) of EIA patients before and after exercise were 159+40 and 450+75, respectively. Those of control subjects were 208+ 54 and 275+ 62, respectively. Uninary N-methylhistamine levels of EIA group increased significantly after exercise, while those of control group did not change. Urinary concentrations of LTE,(mean+SE, pg/mg creatinine) of EIA patients before and after exercise were 15.6 k2.6 and 22.2+5.8, respectively. Those of control subjects were 10.4+ 4.0, 18.2 +7.0, respectively. The concentrations of LTE4 in the urine samples collected before exerise revealed no difference between EIA and control subjects (p=0.07). There was no change after exercise in both groups. Percent fall of FEV, was 29.1+8.0% (mean+SD) in EIA group and 3.4 + 4.0% in control group, respectively. There was no correlation between reduction of FEV, and change in urinary concentrations of N-methyl-histmine after exercise. CONCLUSTION: Chemical mediators of activated mast cells may be involved in exercise-induced bronchoconstriction, but there is little evidence for enhanced sulfidopeptide leukotriene generation as assessed by urinary LTE4.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Creatinine ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Leukotrienes ; Mast Cells ; Mouth ; Nasal Cavity ; Running

BACKGROUND: Although occupational asthma is defined as a reversible airway obstruction causally related to exposure in the working environment, many occupational asthmatics complain of asthmatic symptoms despite avoidance of the causative agent. Subjects and methods. Twenty-nine patients with occupational asthma who had been confirmed by specific bronchial challenge with reactive dye or isocyanates and had avoided the causative agent for at least 6 months were included in this study. A questionnaire about asthmatic symptoms and medication requirements, a lung functiontest, and a methacholine bronchial provocation test were performed. RESULTS: Asthmatic symptoms at follow-up were remitted in seven (41.2%) isocyanate-induced asthmatics, but none with reactive dye-induced asthma were remitted. At follow-up, the symptom-medication score and FEV1 were significantly improved in isocyanate-induced asthmatics than in those with reactive dye-induced asthma, but the geometric mean of PC20-methacholine was not different between the two groups. Among 17 isocyanate-induced asthmatics, a duration from symptom onset to avoidance was significantly shorter in the remission group than in the nonremission group, although the symptom-medication scores, FEV1 (% predictive value) and logPC20-methacholine at an initial diagnosis, and follow-up period defined as duration from avoidance to follow-up, showed no difference between the two groups. CONCLUSION: The outcome of occupational asthma may be determined by the causative agents and the duration from onset of asthmatic symptoms to avoidance.
Airway Obstruction ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Diagnosis ; Follow-Up Studies ; Humans ; Isocyanates ; Lung ; Methacholine Chloride ; Prognosis ; Surveys and Questionnaires

Sometimes, it is difficult to distinguish Churg-Strauss syndrome from idiopathic hypereosinophilic syndrome and there may be overlap syndrome in the differential diagnosis of systemic vasculitis with hypereosinophilia. Recently, we experienced a 42-year-old female patient who presented signs and symptoms of cardiac failure and neuropathy with peripheral hypereosinophilia. She had no history of asthma. She had erythematous skin lesions and distal digit necrosis. The cause of hypereosinophilia could not be identified. Skin and nerve biopsy revealed vasculitis with eosinophilic infiltration. Cardiac failure improved dramatically with steroid, inotropics and diuretics. Other symptoms including digital necrosis also improved. During steroid, tapering peripheral eosinophilia recurred. For maintenance therapy, we added daily cyclophosphamide to every-other-day prednisolone therapy. We report the case with a review of the literature.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Cyclophosphamide ; Diagnosis, Differential ; Diuretics ; Eosinophilia ; Eosinophils ; Female ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Necrosis ; Prednisolone ; Skin ; Systemic Vasculitis ; Vasculitis

BACKGROUND: Allergic rhinitis is often associated with bronchial asthma, and intranasal treatment with topical corticosteroids reduces bronchial responsiveness. OBJECTIVE: In this study, it was evaluated that the bronchial responsiveness to methacholine increased in non-asthmatic adults with house dust mites (HDM)-sensitive allergic rhinitis compared to those without, chronic nasal symptoms. SUBJECTS AND METHODS: A questionnaire, skin prick t,est to common inhalant allergens, and methacholine bronchial provocation test (MBPT) were performed in a total of 216 subjects, who were composed of 40 non-asthmatic subjects with HDM-sensitive allergic rhinitis (HAR), 63 HDM-sensitive subjects without nasal symptoms (HS), and 113 non-atopic subjects without nasal symptoms (NHS). The bronchial responsiveness was evaluated by positive rate of MBPT (PC,-methacholine200mg/ml), provocative concentration of methacholine at which FEV, decline to 15% compared to baseline value (PC,-methacholine), and slope of dose-response curve (%fall of FEV, / log[last concentrat,ion of methacholine, mg/ml]). RESULTS: Positive rate of MBPT was significantly increased in HAR than in HS and NHS, and there was no difference between HS and NHS (77.9% vs. 50.7% vs. 38.0%). Log PC[5- methacholine was lower in HAR than in HS and NHS, and lower in HS than in NHS (mean+ SE, 1.568+0.126 vs. 2.05+0.085 vs. 2.277+0.047). Slope of dose-response curve was higher in HAR than in HS and NHS, and there was no difference bet,ween HS and NHS (mean+SE, 22.7 + 11.3 vs. 7.3+ 1.2 vs. 4.9+ 0.5%/mg/ml); CONCLUSION: In non-asthmatic adults with HDM-sensitive allergic rhinitis, the bronchial responsiveness to methacholine increased compared to those without chronic rhinitis.
Adrenal Cortex Hormones ; Adult ; Allergens ; Asthma ; Bronchial Provocation Tests ; Dust* ; Humans ; Methacholine Chloride* ; Pyroglyphidae* ; Rhinitis ; Skin ; Surveys and Questionnaires