BACKGROUND AND OBJECTIVE: TDI is known to be the most prevalent cause of occupational asthma ( OA ) in Korea. However, the pathogenesis of TDI - induced occupational asthma still remains to be further clarified. So, we evaluated clinical significance of serum specific IgG and IgE antibodies to TDI - HSA conjugate in TDI - induced occupational asthma. Subjects and METHODS: Serum specific IgG and IgE antibodies to TDI - HSA conjugate were measured by enzyme linked immunosorbent assay. Serum was collected from 50 TDI- induced OA patients ( classified as group I ), and was compared with that from 13 asthmatic subjects with negative TDI - bronchoprovocation test ( BPT, group II ), allergic asthmatics ( group III ), and unexposed healthy controls ( group IV ). RESULTS: The prevalence of specific IgG was significantly higher in group I than in group II (p = 0.01) or group III (p <0.01). No significant difference was noted between group II and group III (p> 0.05). However, the prevalence of specific IgE was not different between group I and group II (p> 0.05 ) or group II and group III( p> 0.05 ). There was no significant difference in prevalence of specific IgG according to the asthmatic response during TDI bronchoprovocation test ( p> 0.05 ). No statistical significance was noted between specific IgG and IgE antibodies in group I subjects ( p> 0.05 ). CONCLUSION: These findings demonstrate that presence of specific IgG to TDI - HSA conjugate is closely related to TDI - BPT results and it may contribute to the development of TDI - induced asthma.
Antibodies* ; Asthma ; Asthma, Occupational* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunoglobulin E* ; Immunoglobulin G* ; Korea ; Prevalence ; Serum Albumin* ; Toluene 2,4-Diisocyanate* ; Toluene*

BACKGROUND: It has been reported that the results of second renal transplantation are inferior to that of first transplantation and affected by several factors. The purpose of this study is to suggest guidelines for successful retransplantion by evaluating the factors which might affect the clinical courses and graft survival rates in the second renal transplantation. METHODS: Between March 1969 and February 2005, 1476 kidneys were transplanted in Kangnam St Mary's hospital. Among these, 77 cases were retransplantation (72 cases were second transplantation, 5 cases were third transplantation). Especially for the second transplantation, we retrospectively analysed the clinical courses of grafted kidneys and sought the factors which might be related to the long term graft survival. RESULTS: Among second transplant patients, male were 52 cases, female were 20 cases. The mean age at retransplantation was 38.4+/-11 years. Living donor were 62 cases and cadaver donor were 10 cases. The mean duration between primary graft failure and second transplantation was 20.1+/-36 months. The 1 yr, 3 yr, 5 yr survival rates of the second grafts were 86.4%, 78%, 71% respectively, and it is not significantly inferior to that of total primary transplantation at our center. Multivariate analysis showed that the duration of the first graft survival and the postoperative recovery pattern significantly predicted graft survival in the second renal transplantation. CONCLUSIONS: This study suggests retransplantation can be considered for patients who lost primary graft function. And the longer the duration of the first graft survival and the earlier the postoperative graft function recovery, the prognosis of retransplanted graft would be better.
Cadaver ; Female ; Graft Survival* ; Humans ; Kidney ; Kidney Transplantation ; Living Donors ; Male ; Multivariate Analysis ; Prognosis ; Recovery of Function ; Retrospective Studies ; Risk Factors* ; Survival Rate ; Tissue Donors ; Transplants*

BACKGROUND: Since asthma caused by toluene diisocyanate (TDI) was reported at a polyurethane paint factory, occupational asthma there has been increasing concern of in both allergic and occupational health. However, the statistics of occupational asthma did not reflected its seriousness because of many barriers related to legal reporting. Since fild a voluntary report from a clinician sent directly to a surveillance center would allow more cases to be filed without any disadvantage to workers and employers, we developed a surveillance system to facilitate the reporting of occupational asthma. METHODS: Allergists and pulmonary physicians were asked to report to the Occupational Asthma Surveillance Center (OASC) using a mail, fax or e-mail if work-related asthma was diagnosed. A claimed case for occupational asthma to the Occupational Health Research Institute was also included. The OASC contacted the workers by phone and investigated the workplace if necessary. The reported cases from October, 1998 to November, 1999 were analysed. RESULTS: Thirty-three cases were reported with 29 males and four females. The mean age was 44 and the mean latency period was 5.4 years. Twenty-one cases were caused by a known allergen inducer with objective evidence. The causative agents included TDI in 45.5 % (15), followed by reactive dye in 24.2 % (8), welding fume (2), formaldehyde (1), paint (1), toluene (1), styrene (1), exhaustive gas (1), and wood dust (1). Among these cases, there were seven dyers, four painters, three machine operators and furniture finishers, two assemblers and tanneries. Eighteen cases had claimed Workers Compensation Insurance and all were accepted. The reasons for not claiming Insurance included ignorance (28.5 %), feat of job dismissal (23.8%), other reasons (9.5 %), agreement with the employer (14.3 %) and employer himself (9.5 %). CONCLUSION: The OASC by allergists was an effective system to find unreported cases and to provide a prevention strategy of occupational asthma. Occupational asthma was mostly caused by TDI and reactive dye. Painters and dyers were the most common occupations causing occupational asthma. Only half of occupational asthma patients claimed compensation because of workers' ignorance and fear of being fired.
Academies and Institutes ; Asthma ; Asthma, Occupational* ; Compensation and Redress ; Dust ; Electronic Mail ; Female ; Fires ; Formaldehyde ; Humans ; Insurance ; Interior Design and Furnishings ; Korea* ; Latency Period (Psychology) ; Male ; Occupational Health ; Occupations ; Paint ; Polyurethanes ; Postal Service ; Styrene ; Toluene ; Toluene 2,4-Diisocyanate ; Welding ; Wood ; Workers' Compensation

PURPOSE: Atopy is an important cause of asthma. Few data on the prevalence of atopy or comparisons with clinical characteristics of asthma in Korean patients have been published. We evaluated the effects of atopy on clinical profiles and airway inflammation in Korean asthmatics. METHODS: We retrospectively enrolled 1,492 asthmatics from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) cohort who had undergone skin prick tests for aeroallergens. The patients' clinical characteristics, lung function, PC20, and sputum and blood inflammatory cell counts were compared based on the presence or absence of atopy. Atopy was defined as one or more positive reactions (A/H ratio >1) on a skin prick test. RESULTS: Among 11 aeroallergens, house dust mites (Dermatophagoides farinae and Dermatophagoides pteronyssinus) were the most prevalent cause of a positive skin prick test. As compared with non-atopic asthmatics, atopic asthmatics showed early onset of the disease. Atopic patients with asthma had a higher FEV1, FVC, and FEV1/FVC as compared with non-atopic patients with asthma. In addition, asthmatics without atopy had more uncontrolled asthma (P=0.001) and severe rhinitis (P<0.05) as compared with atopic asthmatics. Smoking, as measured in pack years, was higher in the non-atopic asthmatics than in the atopic asthmatics. The erythrocyte sedimentation rate was higher in non-atopic asthmatics than in the atopic asthmatics and patients with non-atopic asthma had a higher sputum neutrophil count than did those with atopic asthma. CONCLUSIONS: Our data indicate that atopic asthmatics had an early onset of disease and high IgE levels, while the non-atopic asthmatics had decreased lung function and a high sputum neutrophil count, suggesting that a different approach is needed to treat atopic asthma.
Adult ; Allergens ; Asthma ; Blood Sedimentation ; Cell Count ; Cohort Studies ; Humans ; Immunoglobulin E ; Inflammation ; Korea ; Lung ; Neutrophils ; Prevalence ; Pyroglyphidae ; Retrospective Studies ; Rhinitis ; Rhinitis, Allergic, Perennial ; Skin ; Smoke ; Smoking ; Sputum

BACKGROUND AND OBJECTIVE: Assessment of quality of life (QOL) of patients with chronic illness requires reasonable tools which reflect the patients' cultural and behavioral properties. We developed the quality of life questionnaire for adult Korean asthmatics (QLQAKA) on the basis of the Korean life style and evaluated its reliability and validity. METHODS: The QLQAKA consisted of four domains; symptoms (six items), daily activity (five items), emotion (three items) and reaction to environmental stimuli (three items). Patients answered each item according to a five-response scale. The reproducibility and validity of the questionnaire was estimated from the responses of 244 patients who visited the clinics in 15 institutes within a 2-week interval. RESULTS: Items with the most frequent complaints were dyspnea (87%), difficulty in sputum discharge or throat clearing (87%), limitation in strenuous activity (84%) and coughing (82.4%). The QLQAKA reflected the changes of patients' status very well. The value of minimal important differences, such as the clinically significant minimal change in the QOL score, was 0.5. The questionnaire was also highly reproducible with the value of intraclass correlation coefficiency and intraclass standard deviation as 0.940 (p<0.001) and 0.180, respectively. The changes of mean total QLQAKA score correlated weakly with the changes of FEV1 and PEFR values. CONCLUSION: The adult version of QLQAKA was valid and may be a reproducible tool for evaluating and monitoring Korean adult asthma patients.
Academies and Institutes ; Adult* ; Asthma ; Chronic Disease ; Cough ; Dyspnea ; Humans ; Life Style ; Peak Expiratory Flow Rate ; Pharynx ; Quality of Life* ; Reproducibility of Results ; Sputum ; Surveys and Questionnaires