Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What do all of these individuals have in common? An
active 13-year-old becomes breathless shortly after her soccer games and coughs
on a cold winter's night. A young woman has a dry, hacking cough that has
persisted for a year after her last "cold." A teenager sleeps poorly and is
awakened early every morning with chest tightness and difficulty breathing. What these individuals
have in common is the possibility that they all may have asthma.
Patients suffering from episodes of asthma do not always have the
typical symptoms of asthma such as shortness of breath, chest tightness, and
wheezing (symptoms of airway narrowing). Instead, patients can have symptoms
that may not appear to be related to asthma. These "unusual" asthma symptoms
noises emanating from the chest usual during exhalation.
To complicate matters, symptoms of asthma are not consistent and often vary
from time to time in an individual. In some patients, symptoms are influenced by
diurnal factors; for example, some patients experience asthma primarily at night
(nocturnal asthma) rather than during the day. Furthermore, episodes of asthma
can be triggered by many different factors such as allergens, dust, smoke,
air, exercise, infections, medications, and acid reflux. Finally, other illness
such as heart failure, bronchitis, and dysfunction of the vocal cords can cause
symptoms that mimic those of asthma. For these reasons, accurately diagnosing
and treating asthma can be a challenge.
For a comprehensive review of symptoms, causes, and treatments of asthma, and
for a better understanding of the normal anatomy of the airways (trachea,
bronchi, bronchioles and the lung), please visit the asthma article.
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Scientists and physicians have noticed that the rates of asthma have
been increasing in recent decades. This has been especially true in
developed countries such as the United States. In fact, the American
Lung Association has reported that asthma prevalence has risen from
34 cases/1000 people in the general population in 1982 to 56
cases/1000 in 1994.
Research into the causes of this striking increase in asthma has led
to a number of possible explanations being proposed, but there has yet
to be unanimous agreement on the reasons.
A study reported in the American
Journal of Respiratory and Critical Care Medicine (1999; 159:125-29)
evaluated a group of patients at two points in time, 30 years apart.
The study performed by doctors in Scotland detected a significant
increase in symptoms of allergic asthma and levels of antibodies to
environmental allergic factors, such as dust mites, pets, and air
pollutants over the three decades. Importantly, the researchers
noted that there was an increase in the signs and symptoms of
allergy, even in people without a family history of allergy!
Research conducted by Edward Calvin Kendall at the Mayo Clinic in the medical use of cortisone lead to a Nobel Prize in 1950. The drug simulated cortisol, a naturally occurring, anti-inflammatory hormone produced by the"...