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: 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: Bronchial hbyperresponsiveness (BHR) is a key feature of asthma, and may precede the development of asthma. Genetically determined and acquired factors may contribute to development of BHR. OBJECTIVE: To evaluate expression of bronchial responsiveness to methacholine according to age, sex, smoking habit, and atopy in general population without bronchial asthma, a cross sectional study was performed. METHOD: A total of 1,190 general population who composed of 408 subjects with age less than 19 years (young age group), 621 subjects with age from 20 to 40 years (middle age group), and 161 subjects with age more than 41 years (old age group) were enrolled. Evaluations were made by a questionnaire, serum IgE level and skin prick test to common inhalant allergens, and methacholine bronchial provocation test (MBPT). Bronchial responsiveness were evaluated by positive rate of MBPT (PC,p-methacholine 4 25mg/ml), and slope of dose- response curve (slope, %fall of FEV, / log[last concentration of methacholine, mg/ml]). RESULT: Positive rate of MBPT was 11.0%, and slope (mean+SE) was 10.6+0.2 %/mg/ml. Postive rate of MBPT was more prevalent in the young age group than in middle and old age groups (19.6% vs. 6.6% vs. 6.2%, p<0.05), and slope was higher in young age group than in other groups (14.4+0.4 vs. 8.6+0.3 vs. 8.9+0.5 %/mg/ml, p<0.05). No significant differences in positive rate of MBPT and slope were noted according to sex in young and old age groups. However, in the middle age group, slope was higher in females than in males (9.5+0.4 vs. 7.9+ 0.3 %/mg/ml, p<0.05). No significant differences of slope was observed according to smoking habit in males of middle age group, but in males of old age group, the slope was higher in subjects with smoking habit than those without it (9.6+0.8 vs. 6.5+0.9 %/mg/ml, p<0.05). Significant relationship was observed between geometric value of serum IgE level and slope(r=0. 152, p=0.009). The postive rate of MBPT and slope were significantly higher in subjects with positive skin rea,ctivity to common inhalant allergens than those without it (14.3% vs. 8.6%, p ( 0.05; 11.8+0.4 vs. 9.8+0.3 %/mg/ml, p<0.05). The difference of bronchial responsiveness according to skin reactivity was observed in young and middle age groups, but not in old age group. CONCLUSION: Bronchial responsiveness to methacholine is significantly higher in children than in adults, in middle-aged females than in middle-aged males. Atopy and smoking may have a dif ferent role to determine the bronchial responsiveness depending upon age and sex.
Adult ; Allergens ; Asthma* ; Bronchial Provocation Tests ; Child ; Female ; Humans ; Immunoglobulin E ; Male ; Methacholine Chloride* ; Middle Aged ; Skin ; Smoke ; Smoking ; Surveys and Questionnaires

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