Asthma l Brief Medical Study

Allergology and Clinical Immunology

A STEP TOWARDS PEACE Asthma l Brief Medical Study Triggers Risk factors Prevalence Diagnosis Definition COVID-19 Clinical Immunology Asthma-like Symptoms Asthma Allergology

After starting school on Monday, I took four classes. COVID-19 has replaced all of them with online lectures. I took two courses in allergology and clinical immunology.

Today, I’m going to summarize a little bit about asthma.

Prevalence

  • 300 million people worldwide
  • Global prevalence: 1 – 18% of population
  • Childhood (M > F), after puberty (M < F), adulthood (M < F)
  • Asymptomatic during adolescence → return during adult

Definition

  • Sx: dyspnea, cough, wheezing, chest tightness
  • Chronic airway inflammation
  • Reversible airflow obstruction
  • Airway hyperresponsiveness (AHR)
  • Heterogeneous disease
  • Syndrome

Risk factors

  • Atopy
  • Genetic predisposition
  • Infection [respiratory syncytial virus (RSV), atypical bacteria]
    → hygiene hypothesis
  • Diet (low in antioxidants & omega-3 polyunsaturated fats, high in sodium & omega-6 polyunsaturated fats, vitamin D deficiency)
  • Air pollution
  • Allergens
  • Occupational exposure
  • Obesity

Triggers

  • Allergen
  • Virus infection (rhinovirus, RSV, coronavirus)
    → Atypical bacteria
  • Pharmacologic agent [beta blocker, angiotensin-converting enzyme
  • inhibitor (ACEI), aspirin]
  • Exercise
  • Physical factor (cold air, hyperventilation, laughter, hot weather, weather change, strong smells, perfume)
  • Food additive (metabisulfite, tartrazine)
  • Air pollution
  • Occupational factor
  • Hormones (premenstrual worsening of asthma, thyrotoxicosis & hypothyroidism)
  • Gastroesophageal reflux (GERD)
  • Stress (not very severe stress)

Asthma-like Symptoms

  • Do you often catch a cold?
  • Do you cough for more than a month if you catch a cold?
  • Do you cough and wake up at 1 or 2 AM?
  • Is it accompanied by a wheezing during normal breathing or prolonged phase of forced exhalation?
  • Do you have difficulty breathing when you exercise?
  • Nose : rhinitis, sinusitis, nasal polyps
  • Do you have a family history for allergic diseases?

If this medical information violates copyright, I’ll have it erased immediately. I wrote it down for personal study, so please be generous.

In fact, most of them come out when you search for them. If you have symptoms like asthma, make sure to visit a nearby hospital!

If you need professional knowledge,
https://www.niaid.nih.gov/clinical-trials/asthma-studies
https://ginasthma.org/

Peace is up to you :0 Good luck!

Medical Student VLOGs on Youtube

A STEP TOWARDS PEACE Medical Student VLOGs on Youtube 갱이Gani Sydney University SNU Medicine Sebastian Pirie Medical student vlogs medical student King's College London Kharma Medic

These are the vlogs I sometimes watch. Something motivates me, and it makes me feel good. I hope it will be the same experience for you.

1. 갱이Gani (eng sub), SNU Medicine

She is really pretty. There is a saying as a joke. Pretty actors, like Seo Hyunjin, Lee Sungkyung, appear in “Romantic Doctor, Teacher Kim,” a popular Korean drama.

While watching the drama, I wondered if there would be anyone who can be a doctor with this look, but there really was… lol

2. Kharma Medic, King’s College London

It’s a video that has a visual beauty. He is a sensible artist.

3. Sebastian Pirie, Sydney University

He is funny and humorous. He also often gives useful information. 🙂

Don’t you hate too much? I like simplicity best! I will end it here!

Peace is up to you :0 Good luck!

Family Medicine : My Hope, My Dream

What is Family Medicine?

A STEP TOWARDS PEACE Family Medicine : My Hope, My Dream WONCA Why do Family Medicine GP FP FM Family Medicine     In wikipedia, Family medicine (FM), formerly family practice (FP), is a specialty devoted to comprehensive health care for people of all ages; the specialist is named a family physician or family doctor. Family practice is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. For family doctor, the patient is not just people who have disease. For example, otorhinolaryngologist(ear-nose-and-throat department) can see only nose of patients. But it doesn’t mean that it really is. It’s just a figure of speech. Family doctor can see the patients in the context of the human, the family and the community.

The greatest disease in the West today is not TB or leprosy; it is being unwanted, unloved, and uncared for. We can cure physical diseases with medicine, but the only cure for loneliness, despair, and hopelessness is love. There are many in the world who are dying for a piece of bread but there are many more dying for a little love. The poverty in the West is a different kind of poverty — it is not only a poverty of loneliness but also of spirituality. There’s a hunger for love, as there is a hunger for God.
― Mother Teresa, A Simple Path: Mother Teresa

Why do Family Medicine? Possibilities.

According to the World Organization of Family Doctors (WONCA), the aim of family medicine is to provide personal, comprehensive, and continuing care for the individual in the context of the family and the community. My hope and dream is to visit every house for treating. If going home, I can know about more of the patients. I can have a deeper understanding of a patient’s life and can pinpoint the cause. “It is not only when you are sick that you should see a doctor.” It is the era of prevention and early detection beyond just treatment. It is so hard to go to every one of them, but I think it will be a new way of medicine!

I swear to fulfill, to the best of my ability and judgment, this covenant: I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.” – Hippocratic Oath

Peace is up to you :0 Good luck!

Antibiotics for Clostridium Difficile Colitis

What is C. Difficile Colitis?

Clostridium difficile (also called C. difficile) is a bacteria which can cause inflammation. It is known as ‘colitis’ in the large intestine or colon. If you get antibiotics, you can maybe get ‘C. difficile Colitis’. It can be said ‘Opportunistic infection‘. It means an infection caused by pathogens that take advantage of an opportunity not normally available, such as a host with a weakened immune system. C. difficile is infectious. C. difficile Colitis is common in old patients who are in hospitals and who are getting chemotherapy for cancer. I will show you antibiotics more in detail.

Medicine is not only a science; it is also an art. Its does not consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided.” – Paracelsus

Causing antibiotics

A STEP TOWARDS PEACE Antibiotics for Clostridium Difficile Colitis Vancomycin Red man syndrome Pseudomembranous colitis Ototoxicity Opportunistic infection Nephrotoxicity MSSA MRSA Methicillin Fidaxomicin Clindamycin chemotherapy for cancer C. difficile Colitis antibiotics   Clindamycin and Methicillin have side effects that can cause C. difficile Colitis. I will introduce action mechanisms, characteristics and side effects of each antibiotics. First, Clindamycin binds to 23S rRNA of 50S(bacterial ribosome) to reduce synthesis of protein to. It can treat Anaerobic bacteria infection. Its side effect is, we already know,  a C. difficile Colitis. Second, Methicillin irreversibly binds to transpeptidase of bacteria to inhibit cross linking of murein polymer. It is a 2nd generation penicillin which can be used for Skin and soft tissue and MSSA(Methicillin-sensitive Staphylococcus aureus). Its side effects are ‘Hypersensitivity’, ‘Neurotoxicity’ and ‘C. difficile Colitis'(by Oral).

Treating antibiotics

A STEP TOWARDS PEACE Antibiotics for Clostridium Difficile Colitis Vancomycin Red man syndrome Pseudomembranous colitis Ototoxicity Opportunistic infection Nephrotoxicity MSSA MRSA Methicillin Fidaxomicin Clindamycin chemotherapy for cancer C. difficile Colitis antibiotics   Vancomycin and Fidaxomicin can treat C. difficile Colitis. Action mechanisms, characteristics and side effects are here. First, Vancomycin inhibits Murein polymerization to inhibit synthesis of cell wall. It can be used for Gram (+) bacteria. Its effects depend on IV and Oral administration. With IV administration, It can treat MRSA(Methicillin-resistant Staphylococcus aureus). With Oral administration, It can treat ‘Pseudomembranous colitis’ of C. difficile. Side effects are ‘Red man syndrome’, ‘Nephrotoxicity’ and ‘Ototoxicity’. Second, Fidaxomicin binds to RNA polymerase to inhibit ‘initiation stage’ of RNA synthesis. It can treat C. difficile Colitis and its side effects are ‘Nausea’, ‘Vomiting’ and ‘Abdominal pain’.

I swear to fulfill, to the best of my ability and judgment, this covenant: I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.” – Hippocratic Oath

Peace is up to you :0 Good luck!

Tuberculosis treatment is not difficult

Tuberculosis treatment

Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB). The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. Tuberculosis is spread through the air when people cough, speak or sneeze. The problem is that one-third of the world’s population is thought to be infected with TB. Being infected does not mean that you get tuberculosis. About 30 percent of the people who contact become infected and 10 percent of the infected people become tuberculosis patients, while the remaining 90 percent of the infected people stay healthy. More than 95% of deaths occurred in developing countries.

Tuberculosis treatment : 4 First line drugs
  • Ethambutol(EMB)
  • Pyrazinamide(PZA)
  • Isoniazid(INH)
  • Rifampin(RIF)

Action mechanism, Characteristics, side effects

A STEP TOWARDS PEACE Tuberculosis treatment is not difficult Tuberculosis treatment side effects Rifampin(RIF) Pyrazinamide(PZA) NAG-arabinogalactan Isoniazid(INH) First line drugs FAS-1 Ethambutol(EMB) Action mechanism     EthambutolPyrazinamide and Isoniazid inhibit the synthesis of cell wall. Mycobacteria has NAG-arabinogalactan and mycolic acid. Ethambutol inhibits the synthesis of NAG-arabinogalactan. Pyrazinamide inhibits FAS-1 and Isoniazid inhibits FAS-2. Synthetic mechanism of mycolic acid composed of FAS-1 and FAS-2. Rifampin combines with ‘DNA dependent RNA polymerase’ to inhibit translation. Side effect of Pyrazinamide, Isoniazid and Rifampin is ‘hepatotoxicity’. Particularly, Isoniazid inhibits cytochrome-P450 and hence acts as a source of free radicals. So we should beware Drug-Drug interaction. It is not difficult. 🙂

Stopping TB requires a government program that functions every day of the year, and that’s hard in certain parts of the world. And partly it’s because of who tuberculosis affects: It tends to affect the poor and disenfranchised most” – Tom Frieden

Peace is up to you :0 Good luck!

Medical services for Foreigner need “Emotional support”

Medical services in Korea

A STEP TOWARDS PEACE Medical services for Foreigner need "Emotional support" physical labor medical team Medical services medical bills language barriers foreign workers emotional support cultural performance Attention     I heard some good news from home country. 1,000 foreigners attend and get medical treatment and counseling at the sites of medical services conducted at a total of 25 districts. For them, a total of 250, medical team such as doctors, oriental medical doctors, dentists, pharmacists, nurses, physical therapists and preliminary medical staffs such as  college students went into service and volunteer interpreters and 2,000 staffs participated. Most of them who receive the services are legal foreign workers, but some day workers failed to sign up for health insurance. It means they can’t get proper treatment for medical bills.


Those who live from hand to mouth can’t afford to go for hospital, if they are not seriously ill.


Meaning of Medical services

A STEP TOWARDS PEACE Medical services for Foreigner need "Emotional support" physical labor medical team Medical services medical bills language barriers foreign workers emotional support cultural performance Attention     Workers at the factory also spoke their mind that it was difficult to visit hospitals because of tight working hours and language barriers. I feel sorry that we can not solve all these problems at once. The medical team provided counseling and medical checkup such as blood sugar, blood pressure, body composition and physical therapy. Foreign workers suffered from musculoskeletal system disease a lot because most of them are doing physical labor. Last year, they discovered colon cancer as treating a worker from Bangladesh. I hope that the service which have good intentions is not transient. Of course, I am very thankful for their services.

Attention and emotional support

A STEP TOWARDS PEACE Medical services for Foreigner need "Emotional support" physical labor medical team Medical services medical bills language barriers foreign workers emotional support cultural performance Attention
A chimney with fire inside

 What foreign workers who have been discriminated due to their country and race need most is attention and emotional support. The volunteers are also counseling them to have healthy thoughts and minds, not only doing medical services. The medical team leader said, “Many foreign workers are doing simple labor. So their health has deteriorated often for lack of proper treatment. They are deeply wounded by national or racial discrimination. We need a lot of attention to respect their rights to live and human rights.” I suggest cultural performance to be able to melt down the heart. It can amuse them.

The art of medicine consists in amusing the patient while nature cures the disease” – Voltaire

Peace is up to you :0 Good luck!

Is it possible Aspirin treat Cancer?

The willow tree & Aspirin

A STEP TOWARDS PEACE Is it possible Aspirin treat Cancer? The willow tree platelet Owen McCarty Oregon State University NSAID COX-1&2 Cancer c-MYC Aspirin action of mechanism Aspirin     The poor soul sat sighing by a sycamore tree, sing all a green willow: Her hand on her bosom, her head on her knee, sing willow, willow, willow. (William Shakespeare) The willow tree! You maybe know its health effect. It is known for at least 2,400 years ago. Aspirin, also known as acetylsalicylic acid (ASA), is a medication used to treat pain, fever, or inflammation. It is a sort of nonsteroidal anti-inflammatory drug (NSAID).

Aspirin action of mechanism

Aspirin inhibits COX-1&2. COX(Cyclooxygenase) makes ‘Arachidonic acid’ become ‘Prostaglandin(PG)’. PG  induces ultimately your fever.  It plays a role in pain, fever, swelling. If aspirin inhibits COX, we can’t produce PG. So it works. Anti-inflammation is not the only effect of Aspirin. It also helps cardiovascular disorders. Why? It related COX-1&2. COX-1 makes TXA2(thromboxane A2) and COX-2 makes PGI2(Prostacyclin). TXA2 activates platelets to aggregate and induces vasoconstriction. But Prostacyclin is a thrombolytic vasodilator. Is it in collision with? Nope. Low dose of Aspirin only inhibits COX-1. So it can be helpful.

Aspirin in cancer prevention

A STEP TOWARDS PEACE Is it possible Aspirin treat Cancer? The willow tree platelet Owen McCarty Oregon State University NSAID COX-1&2 Cancer c-MYC Aspirin action of mechanism Aspirin     There are many studies that Aspirin is effective against cancer. Is it a cure-all? But for a decade, they didn’t know how it worked. On 1 January 2017, Researchers from Oregon Health & Science University and Oregon State University found that Aspirin doesn’t affect cancer cell, but affect plateletOwen McCarty said “During their transit in the blood, circulating tumor cells interact with platelets, which spur tumor cell survival by activating oncoproteins such as c-MYC. The inhibition of platelets with aspirin therapy reduces this signaling between platelets and tumor cells, thus indirectly reducing tumor cell growth.”

Peace is up to you :0 Good luck!

Universal flu vaccine Strategy is Evolving

Why do you get a flu shot every year?

A STEP TOWARDS PEACE Universal flu vaccine Strategy is Evolving WHO universal flu vaccine swine influenza Spanish Flu seasonal influenza virus H5N1 H1N1 flu vaccine strategy CDC avian influenza   Doesn’t it bother you? On the other hand, aren’t you nervous? Sometimes I’m worried about ‘what if something go wrong because of the vaccine?’. In fact, researchers don’t want to bother you but they can’t help getting a flu shot. Because Influenza virus is evolving from moment to moment. So vaccine that you got last year had no effect. Even so, influenza virus is nothing to sneeze. According to CDC(Centers for Disease Control and Prevention), only in America 200,000 people go into a hospital for seasonal influenza virus. And 36,000 are died. So WHO(World Health Organization) made 3~4 vaccines that are predicted to be prevalent in advance on spring. So we need a universal flu vaccine.

Universal flu vaccine Strategy

For your understanding, watch this video. It is a good video to easily understand. As you already know, I’m a medical student. That antibody will protect you. But as previously stated, Virus mutation occurred frequently. Where is mutation? Surface proteins of Virus(Hemagglutinin, Neuraminidase) are changed. So we often know H1N1(Spanish Flu, swine influenza), H5N1(avian influenza). Often head of Hemagglutinin is a target of antibody.

  Hemagglutinin is composed of two, head and stem. Head mutates a lot, but stem does low. So if you make an antibody that attacks stem of influenza virus, you don’t need to get a vaccine every year. This fact was known in the early 2000s, but there is a problem. But in 2015, two studies which overcome the limitations in innovative ways were published.(professional information Later posting)

Dr Barney S Graham team in NIAID & Janssen

Peace is up to you :0 Good luck!

“Bugs in the Brain” Neuroscience for public knowledge

What is Neuroscience?

A STEP TOWARDS PEACE "Bugs in the Brain" Neuroscience for public knowledge soul Neuroscience mind Deep learning AlphaGo AI     Have you heard ‘neuroscience‘? How do you feel? You maybe think AlphaGo. I am sure that everyone has heard about the amazing GO match between Lee Se-dol and AlphaGo. It’s a thrilling sceneAlphaGo is famous for ‘Deep learning’. Deep learning is the application to learning tasks of artificial neural networks(ANN).  Its purpose is to learn for itself like human. Human brain found the pattern from a lot of information to distinguish objects. It’s on the same principle. Human brain has CNS(central nervous system), PNS(peripheral nervous system) and ANS(Autonomic nervous system). Countless neurons works harder. Neuroscience is the study of these things.

 Where is the mind?

A STEP TOWARDS PEACE "Bugs in the Brain" Neuroscience for public knowledge soul Neuroscience mind Deep learning AlphaGo AI     In the past, we don’t know well about us. We have asked a lot of questions each other. Let’s go into the past. “Where is the mind and soul?” It is a important question. One say ‘It is in the brain’ and other say ‘It is in the heart’. What do you think? Neither? Hold on to your hat! Hippocrates and his teacher Plato said ‘Brain’ and Aristotle told ‘heart’. Even if you hear names, Isn’t it surprising? They’re giants who set a new milestone in the academic world. Descartes, a philosopher, claimed ‘The soul is in the pineal body‘. It is anterior of cerebellum. Isn’t it interesting?


Someone says ‘In medicine there are two thing that human can’t find out. One is Cancer and the other is Neuroscience


Actually, AI(artificial intelligence) really want to keep up with human. They want to do like human. Are we really aware about our values? It’s your turn. You can be a giant.

Peace is up to you 🙂 Good luck!