• Title/Summary/Keyword: Atopic asthma

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Increased risk of refractory Mycoplasma pneumoniae pneumonia in children with atopic sensitization and asthma

  • Shin, Jeong Eun;Cheon, Bo Ram;Shim, Jae Won;Kim, Deok Soo;Jung, Hae Lim;Park, Moon Soo;Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.271-277
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    • 2014
  • Purpose: A nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory characteristics between children with refractory MP requiring steroid treatment and those with macrolide-responsive MP and evaluated the risk factors associated with refractory MP. Methods: We investigated 203 children who were admitted to our institution with MP from June to November 2011. Refractory MP was defined by persistent fever over $38.3^{\circ}C$ with progressive pulmonary consolidation or pleural effusion despite administration of appropriate macrolide antibiotics for 5 days or longer after admission. Steroid therapy was initiated on the fifth day after admission for refractory cases. Results: There were 26 patients with refractory MP requiring steroid therapy. The mean duration of steroid therapy was 5.4 days and most of the patients were afebrile within 24 hours after initiation of steroid therapy. The prevalence of refractory MP was higher in patients with pleural effusion, lobar pneumonia affecting more than 2 lobes, higher levels of serum lactate dehydrogenase, increased oxygen requirements, and longer duration of hospitalization. Atopic sensitization and history of asthma were also associated with refractory MP after adjusting for age and gender. Conclusion: Children with refractory MP had more severe pneumonia. Atopic sensitization and history of asthma may be risk factors for refractory MP requiring steroid therapy in Korean children.

Recent Progress in the Care of Atopic Disease in Children (아토피성 질환관리의 최신 동향)

  • Shin, Yeong-Hee
    • Child Health Nursing Research
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    • v.14 no.1
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    • pp.53-60
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    • 2008
  • Background: Atopic dermatitis starts as an early childhood type I hypersensitivity to environmental allergens and is often the first step in the atopic march to develop into asthma and allergic rhinitis. Despite progress that has been achieved in management, this health problem remains poorly controlled and cause great pain and suffering for many children and their parents To introduce nurses to recent progress in pathophysiology, management and preventive measure of atopic disease. Search method: Systemic search was done using the PubMed and CINAHL from 1980 to 2005. In addition, historical references were taken from standard medical textbook. Results: In total, 30 relevant publications were located including primary research and review articles that cover the pathophysiology, management, and preventive measure of atopy. The evidence emerging from literature indicate that non-medical approaches such as breastfeeding and probiotics would improve management outcomes. Conclusion: The review suggests that breastfeeding and probiotic approaches would be the most effective preventive measures for children with atopic diseases.

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Dietary Prevention of Allergic Diseases in Children (영아기 영양과 소아 알레르기질환의 예방)

  • Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup1
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    • pp.1-6
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    • 2008
  • Previous infant feeding guidelines recommended a delayed introduction of solids to beyond 6 months of age to prevent atopic diseases. However, scientific evidence supporting a delayed introduction of solids for prevention of atopic diseases is scarce and inconsistent. Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation in the prevention of atopic disease. In studies of infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein decreases the incidence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. For infants at high risk of developing atopic disease who are not breastfed exclusively for 4 to 6 months, there is modest evidence that atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cow milk formula, in early childhood. There is no convincing evidence that a delayed introduction of solid foods beyond 4 to 6 months of age prevents the development of atopic disease. For infants after 4 to 6 months of age, there are insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.

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Experiences of Stress among Mothers of Preschoolers with Atopic Dermatitis (학령전기 아토피피부염 아동 어머니의 스트레스 경험)

  • Kwen, Hwayoung;Shin, SungRae
    • Child Health Nursing Research
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    • v.24 no.2
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    • pp.166-177
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    • 2018
  • Purpose: The purpose of this study was to explore and describe the meaning and essence of experiences of stress in mothers of preschoolers with atopic dermatitis. Methods: This study employed a qualitative research design. Seven mothers of preschoolers with atopic dermatitis were interviewed and the data were analyzed using Giorgi's phenomenological method. Results: Five main themes and 12 theme clusters emerged. The 5 main themes were 1) the mother's enduring heartache from the conflict that arise among family members, 2) the complete loss of daily happiness, 3) the steady stream of emotional fluctuations, 4) struggling to bear the heavy financial burden, and, 5) a life of hope accompanied by stress. Conclusion: The results of this study provide an in-depth understanding of stress among mothers of preschoolers with atopic dermatitis. These results can be used in the development of nursing interventions to provide psychological and emotional support for mothers and family members.

Stellate Ganglion Block for the Treatment of Atopic Dermatitis -A case report- (아토피성 피부염 환자의 성상신경절 차단 -증례보고-)

  • Kim, Seong-Kon;Lee, Kyu-Chang;Kang, Po-Sun;Woo, Nam-Sik;Lee, Ye-Chul
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.124-126
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    • 1995
  • Atopic allergy implies a familial tendency to manifest alone or in combination such as asthma, rhinitis, urticaria and atopic dermatitis. The patient with atopic dermatitis shows a variety of humoral and cell-mediated immune dysfunction, including an elevation of serum IgE level, multiple positive immediate skin tests to a variety of antigen. A 30 year old female patient suffering from an atopic dermatitis on face, has been administered a stellate ganglion block(SGB) with a 1% mepivacaine 5cc. She complained of bronchial hyperresponsivness such as cough, soreness, and inspiration difficulty for 5 days following the treatment, so we have reduced 1% mepivacaine dose from 5cc to 3cc. She had no complain of bronchial hyperresponsivenss and the lesion of atopic dermatitis was improved. From our result we conclude that SGB appears to be a good choice for the treatment of the atopic dermatitis and only 1% mepivacaine 3cc is possible in complete SGB.

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Effects of Herbal Prescriptions on the Immunological Parameter in Patients with Atopic & Allergic Diseases; Clinical Observational Study (아토피와 알러지에 대한 한의학적 약물치료의 혈액면역학적 개선효과)

  • Jo, Hyun-Ik;Shin, Byung-Cheul;Kim, Hyung-Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1646-1654
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    • 2007
  • The aim of this study was to investigate the effects of several herbal prescriptions in patients with allergy or atopic disease, such as atopic dermatitis, asthma and allergy rhinitis and others, on the blood immunological parameters and to verify the safety of long-term use of herbal medicine. Eighty one patients with allergy or atopy disease who taken herbal medicine at least for 2 months were compared with patients who taken same medicine with no allergy & atopy disease (n=14) and normal healthy subjects (n=22). According to the comparison of immunological parameters change, the data showed that herbal medicine decreased IgE (P=0.003), Eosinophil ratio (P<0.001) and count (P<0.001) of White Blood Cell (WBC) and did not affect to the liver cell enzymes in blood. This results indicated that herbal medicine decreased immune hypersensitivity and improved chronic inflammation related to blood immunological parameters of allergy or atopy diseases. In addition, herbal medicine seemed to be safe to the liver function for long-term use.

NLRP3 Inflammasome as Therapeutic Targets in Inflammatory Diseases

  • Annamneedi Venkata Prakash;Il-Ho Park;Jun Woo Park;Jae Pil Bae;Geum Seon Lee;Tae Jin Kang
    • Biomolecules & Therapeutics
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    • v.31 no.4
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    • pp.395-401
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    • 2023
  • Innate immunity is a first line defence system in the body which is for sensing signals of danger such as pathogenic microbes or host-derived signals of cellular stress. Pattern recognition receptors (PRR's), which present in the cell memebrane, are suspect the infection through pathogen-associated molecular patterns (PAMP), and activate innate immunity with response to promote inflammation via inflammatory cells such as macrophages and neutrophils, and cytokines. Inflammasome are protein complexes which are part of innate immunity in inflammation to remove pathogens and repair damaged tissues. What is the important role of inflammation in disease? In this review, we are focused on the action mechanism of NLRP3 inflammasome in inflammatory diseases such as asthma, atopic dermatitis, and sepsis.

Activity of Cytokines and Expression of CD62L in Patients with Bronchial Asthma (기관지 천식환자에서 CD62L의 발현 및 싸이토카인의 변화)

  • Song, Kwang-Seon;Lee, Won-Yeon;Hong, Ae-Ra;Kim, Hee-Sun;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.90-98
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    • 1998
  • Background : The CD4+ T-helper cells comprise functionally distinct subsets of Th1 and Th2 cells that are distinguished on the basis of differential cytokines production Th1 cells secrete interferon-$\gamma$, lymphotoxin, interleukin-2. Th2 cells produce interleukin-4, interleukin-5, interleukin-10. A previous study shown that Th2 cells and their cytokines increased in patients with atopic asthma. We compared cytokines(IL-4, IFN-$\gamma$) activity and subpopulation of T-lymphocytes in peripheral blood from atopic asthmatics versus non-asthmatics. Method: Fifteen patients with atopic asthma(nine men, six women), twelve patients with chronic bronchitis(six men, six women), five healthy persons(three men, two women) were studied. Activity of IL-4, IFN-$\gamma$ and T-cell subpopulation in peripheral blood were estimated. Results: Patients had a median age of 55yr. The mean activity of IL-4 of asthmatics was significantly increased(control $0.75{\pm}1.1pmol/L$, atopic asthmatics $3.50{\pm}0.75pmol/L$, chronic bronchitis $2.01{\pm}1.2pmol/L$), but IFN-$\gamma$ was not significantly increased. In the T lymphocyte sunsets the percent of CD62L+ T-lymphoeytes of asthmatics was not significantly increased (control $16.7{\pm}16.4%$, atopic asthmatics $24.8{\pm}23.6%$, chronic bronchitis $17.0{\pm}16.9%$). Conclusion: In this study elevated production of IL-4 was observed in atopic asthmatics. CD62L+T-lymphoeytes was not increased in atopic asthma.

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Phenotypes of allergic diseases in children and their application in clinical situations

  • Lee, Eun;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.325-333
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    • 2019
  • Allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, are common heterogeneous diseases that encompass diverse phenotypes and different pathogeneses. Phenotype studies of allergic diseases can facilitate the identification of risk factors and their underlying pathophysiology, resulting in the application of more effective treatment, selection of better treatment responses, and prediction of prognosis for each phenotype. In the early phase of phenotype studies in allergic diseases, artificial classifications were usually performed based on clinical features, such as triggering factors or the presence of atopy, which can result in the biased classification of phenotypes and limit the characterization of heterogeneous allergic diseases. Subsequent phenotype studies have suggested more diverse phenotypes for each allergic disease using relatively unbiased statistical methods, such as cluster analysis or latent class analysis. The classifications of phenotypes in allergic diseases may overlap or be unstable over time due to their complex interactions with genetic and encountered environmental factors during the illness, which may affect the disease course and pathophysiology. In this review, diverse phenotype classifications of allergic diseases, including atopic dermatitis, asthma, and wheezing in children, allergic rhinitis, and atopy, are described. The review also discusses the applications of the results obtained from phenotype studies performed in other countries to Korean children. Consideration of changes in the characteristics of each phenotype over time in an individual's lifespan is needed in future studies.

Association of wheezing phenotypes with fractional exhaled nitric oxide in children

  • Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.57 no.5
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    • pp.211-216
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    • 2014
  • Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level is a noninvasive, reproducible measurement of eosinophilic airway inflammation that is easy to perform in young children. As airway inflammation precedes asthma attacks and airway obstruction, elevated FeNO levels may be useful as predictive markers for risk of recurrence of asthma. This review discusses FeNO measurements among early-childhood wheezing phenotypes that have been identified in large-scale longitudinal studies. These wheezing phenotypes are classified into three to six categories based on the onset and persistence of wheezing from birth to later childhood. Each phenotype has characteristic findings for atopic sensitization, lung function, AHR, or FeNO. For example, in one birth cohort study, children with asthma and persistent wheezing at 7 years had higher FeNO levels at 4 years compared to children without wheezing, which suggested that FeNO could be a predictive marker for later development of asthma. Preschool-aged children with recurrent wheezing and stringent asthma predictive indices also had higher FeNO levels in the first 4 years of life compared to children with wheezing and loose indices or children with no wheeze, suggesting that FeNO measurements may provide an additional parameter for predicting persistent wheezing in preschool children. Additional large-scale longitudinal studies are required to establish cutoff levels for FeNO as a risk factor for persistent asthma.