• Clinical and Experimental Pediatrics
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• v.56 no.9
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• pp.369-376
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• 2013

A complex interplay between genetic and environmental factors partially contributes to the development of allergic diseases by affecting development during prenatal and early life. To explain the dramatic increase in the prevalence of allergic diseases, the hygiene hypothesis proposed that early exposure to infection prevented allergic diseases. The hygiene hypothesis has changed to the microbial hypothesis, in which exposure to microbes is closely linked to the development of the early immune system and allergic diseases. The intestinal flora may contribute to allergic disease through its substantial effect on mucosal immunity. Based on findings that exposure to microbial flora early in life can change the Th1/Th2 balance, thus favoring a Th1 cell response, probiotics may be beneficial in preventing allergic diseases. However, evidence from clinical and basic research to prove the efficacy of probiotics in preventing allergy is lacking. To date, studies have yielded inconsistent findings on the usefulness of probiotics in allergic diseases. It is difficult to demonstrate an exact effect of probiotics on asthma, allergic rhinitis, and food allergy because of study limitations, such as different first supplementation period, duration, different strains, short follow-up period, and host factors. However, many studies have demonstrated a significant clinical improvement in atopic dermatitis with the use of probiotics. An accurate understanding of the development of human immunity, intestinal barrier function, intestinal microbiota, and systemic immunity is required to comprehend the effects of probiotics on allergic diseases.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7547-7554
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• 2015

Background: The use of smokeless tobacco (SLT) among women is increasing in India, especially among those with limited education and resources. Preventing the initiation of SLT among women is critical since it has known negative consequences for oral and reproductive health. Most research on tobacco initiation in India focuses on adolescents. This paper addresses the unrecognized issues of post marital initiation among women of reproductive age, highlighting the importance of reproductive stages in women's tobacco initiation. The objective is to examine the correlates of SLT initiation among low income women in Mumbai from pre-marriage through early marriage, first pregnancy and beyond, using case examples to illustrate initiation during each of these stages. Materials and Methods: In 2011-2012, cross-sectional community level survey data were collected from a representative sample of 409 daily SLT-using married women aged 18-40 years in a low income community in Mumbai. Information on socio-demographics, initiation by reproductive stage, types of tobacco use, childhood exposure to tobacco, learning to use, and initiation influences and reasons were collected through a researcher-administered survey. Univariate and bivariate analysis assessed factors influencing initiation of SLT use by reproductive stage. In addition 42 narratives of tobacco use were collected from a purposive sample of pregnant and non-pregnant married women addressing the same questions in detail. Narratives were transcribed, translated, and coded for key concepts including initiation of tobacco use. Results: Thirty-two percent of women initiated SLT use before marriage, 44% initiated after marriage but before pregnancy, 18.1% initiated during their first pregnancy and the remainder started after their first pregnancy. Mean age of marriage among women in this study was 16 years. Younger women (i.e. age at time of the interview of less than 30 years) were 0.47 [95% CI (0.32, 0.87)] percent less likely to initiate after marriage than women aged more than 30 years. Women who got married before 18 years of age were 2.34 [95% CI (1.40, 3.93)] times more likely to initiate after marriage than their counterparts. Childhood exposure was a predictor for initiating SLT use prior to marriage but not after. Women reporting tooth and gum pain were 1.85 times more likely to initiate after marriage than their counterparts. Husband and neighbours were the most significant influences on post-marital initiation. Narratives highlighted differences in processes of initiation pre and post marriage and during pregnancy. Conclusions: Most tobacco prevention interventions are directed to adolescents in school. This study suggests that especially for low literate or illiterate women, school based interventions are ineffective. To be effective strategies to prevent SLT initiation must reach women in urban areas at or immediately after marriage and during their first pregnancy. Messages must negate culturally rooted beliefs about the health benefits of SLT in order to prevent initiation and onset of daily use.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.32 no.4
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• pp.381-392
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• 2022

Objectives: Objective of this study is to review briefly exposure characteristics, monitoring instruments and threshold limit values for extremely low frequency-magnetic field (ELF-MF) methods. This study was undertaken through brief literature review. We performed a literature search in PubMed to identify ELF-MF studies conducted in workplaces. Initial search keywords such as 'extremely low frequency-magnetic field (ELF-MF)' and 'electromagnetic fields (EMF)' combined or singly. We limited our review to occupational rather than general nonworkplace environmental exposures. Methods: The contents we reviewed: key industry and occupations generating ELF-MF, several direct-reading instruments monitoring ELF-MF and threshold limit values (TLV) preventing health effects may be caused by the exposure to ELF-MF. Results: The industries related to the generation and supply of electricity, electrolytic installations, welding, and induction heating and more were regarded as high ELF-MF exposure industries. All jobs handling or employed performed in power cable lines, electrical wiring, and electrical equipment are found to be exposed to ELF-MF. Threshold or ceiling limit, 1,000 µT, is established to prevent acute effects of exposure to low-frequency EMFs on the nervous system: the direct stimulation of nerve and muscle tissues and the induction of retinal phosphenes. The International Agency for Research on Cancer (IARC) has classified ELF-MF as possibly carcinogenic to humans chiefly based on epidemiological studies on childhood leukemia. However, a causal relationship between magnetic fields and several types of cancer including childhood leukemia has not been established nor has any other long-term effects. Risk management using precautionary measures, has been initiated by the US and EU to prevent chronic health effects related to ELF-MF exposure in workplaces. Conclusion: This study recommends the implementation of various measures such as theestablishment of occupational exposure limit values for ELF-MF and precautionary principle to prevent potential chronic occupational health effects may be caused by ELF-MF in Korea.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.157-167
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• 2009

The incidence of childhood cancer is greatest in the first year of life. Early diagnosis and advances in medicine have significantly improved outcomes of treatment resulting in higher survival rate; however, this progress comes at the expense of a higher incidence of adverse side effects because of more aggressive antineoplastic treatment strategies. The oral cavity, a trauma-prone environment, is extremely sensitive to toxicities from antineoplastic agents. Oral health care specialists, including pediatric and hospital dentists can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment, and assisting and/or managing oral complications from cancer therapy. This article covers the considerations in the dental management of pediatric patients undergoing cancer treatment, specifically chemotherapy, radiotherapy, and hematopoietic stem cell transplantation.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.146-150
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• 1999

With the improved cure rates for childhood malignant conditions in the past decade, late effects of cancer therapy must be recognized to minimize their impact on the quality of life in long-term survivors. Chemoradiation therapy is a major part of pediatric oncology treatment and is implicated in causing tooth agenesis, microdontia, root shortening, early apical closure, and coronal hypocalcification. Dental development may be affected by illness, trauma, chemotherapy, or radiation therapy at any point prior to complete maturation. Treatment given during the first 3.5 years of life was more likely to affect the dental lamina and crown formation and result in a small tooth. Dental treatment affected by chemoradiation damage to developing teeth includes orthodontic tooth movement, prosthetic abutment consideration, periodontal health, space maintenance, requirement for home fluoride regimens to protect hypomineralized teeth, and enodontic procedures. Dental abnormalities are common in patients treated for cancer, and these children require aggressive dental follow-up. Meticulous surveillance may facilitate detection of abnormalities, enabling the dental practitioner to intervene earlier in promoting a more aggressive regimen of oral care, thus reducing the morbidity associated with dental sequelae of oncotherapy, specifically periodontal disease and malocclusion. In this case, we report microdontia of all permanent second premolar and second molar in an 8 year old boy treated with chemotherapeutic agents during period of active dental development(14 months to 38 months of age).

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9495-9498
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• 2014

Background: The difference in prognosis of adult and childhood acute lymphoblastic leukemia (ALL) can be attributed largely to variation in cytogenetic abnormalities with age groups. Cytogenetic analysis in acute leukemia is now routinely used to assist patient management, particularly in terms of diagnosis, disease monitoring, prognosis and risk stratification. Knowing about cytogenetic profile at the time of diagnosis is important in order to take critical decisions in management of the patients. Aim and Objectives: To determine the frequency of cytogenetic abnormalities in Pakistani adult patients with ALL in order to have insights regarding behavior of the disease. Materials and Methods: A retrospective analysis of all the cases of ALL (${\geq}15$years old) diagnosed at Aga Khan University from January 2006 to June 2014 was performed. Phenotype (B/T lineage) was confirmed in all cases by flow cytometry. Cytogenetic analysis was made for all cases using the trypsin-Giemsa banding technique. Karyotypes were interpreted using the International System for Human Cytogenetic Nomenclature (ISCN) criteria. Results: A total of 166 patients were diagnosed as ALL during the study period, of which 151 samples successfully yielded metaphase chromosomes. The male to female ratio was 3.4:1. The majority (n=120, 72.3%) had a B-cell phenotype. A normal karyotype was present in 51% (n=77) of the cases whereas 49% (n=74) had an abnormal karyotype. Of the abnormal cases, 10% showed Philadelphia chromosome; t(9;22)(q34;q11.2). Other poor prognostic cytogenetic subgroups were t(4;11)(q21;q23), hypodiploidy (35-45 chromosomes) and complex karyotype. Hyperdiploidy (47-57 chromosomes) occurred in 6.6%; all of whom were younger than 30 years. Conclusions: This study showed a relatively low prevalence of Philadelphia chromosome in Pakistani adults with ALL with an increase in frequency with age (p=0.003). The cumulative prevalence of Philadelphianegative poor cytogenetic aberrations in different age groups was not significant (p=0.6).

• Clinical and Experimental Pediatrics
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• v.60 no.8
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• pp.254-260
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• 2017

Purpose: Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. Methods: A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews. The participating parents were asked to rank their agreement with each statement of the survey questionnaire on a scale from 1 (strongly disagree) to 5 (strongly agree), and the scores between pre- and postintervention were compared. Results: Before the educational intervention, 105 out of 639 participants reported not to agree to vaccinate their children against influenza. After the intervention, 46 out of the 105 parents changed their opinions about childhood vaccination. The physicians' recommendation received the highest agreement score and was the most important driver to vaccination, whereas the cost of vaccination was the strongest factor for not vaccinating children. In general, the participants significantly changed the agreement scores between pre- and postintervention. However, the unfavorable opinions about vaccination and the convenience of receiving the influenza vaccine did not change significantly. Conclusion: The results of this study indicate that a specific educational intervention involving caregivers is very effective in increasing the influenza vaccination coverage of children aged less than 60 months.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7583-7587
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• 2015

Epstein-Barr virus (EBV) is an extremely common herpesvirus that may cause asymptomatic infection or various diseases, including infectious mononucleosis, certain lymphoproliferative diseases and several types of neoplasms. Vaccine development is an important strategy to reduce the burden of EBV-associated diseases and the timing of vaccinations should be before primary infection occurs. In the past, more than 90% of Thai children were infected with EBV in early childhood. Now, due to the improved healthcare system in Thailand, we aim to determine current prevalence of EBV infection among people in different age groups. A total of 538 sera were collected from residents of Khon Kaen province in northeastern Thailand for detecting anti-EBV IgG. Sera of infants under 2-years-old were also tested for anti-EBV IgM and EBV-DNA. The prevalence of anti-EBV IgG was 47.1% (95% CI: 23.3-70.8) in infants aged 0-6 months, 34.9% (95% CI: 23.1-46.7) in those aged 6-24 months, 87.9% (95% CI: 79.5-96.3) in children aged 3-5 years and then maintained at above 95% through adulthood. These seropositivity rates among Thai children remain similar to those found in a previous study conducted 20 years ago. Thai children are still exposed to EBV from an early age. Therefore, a prophylactic vaccine should be given within the first two years of life.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7555-7559
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• 2015

Background: CML includes 30% of all leukemias, and occurs from childhood to old age. The present study was a retrospective analysis of chronic phase CML patients registered to a Hematology Clinic in Kermanshah, Iran, with checking of treatment options. Materials and Methods: Between 2002 and 2014, 85 CML patients referred to our hematology clinic were enrolled in our study. We surveyed age, sex, B-symptoms, splenomegaly, Sokal score, Hasford score, treatment and survival in all patients. Philadelphia chromosome analysis was conducted for each patient by conventional cytogenetics. We compared treatment in the patients with three drugs, imatinib, hydroxyurea (HU) and interferon alpha (IFN-${\alpha}$). Results: The mean age of the patients at diagnosis was $47.5{\pm}14.5years$ (range, 23-82 years), with 43 (50.6%) being male. Some 13 (15.3%) were referred to our clinic for the first time with B-symptoms and 44 patients (51.8%) had splenomegaly. The Sokal score for 77 (90.6%) was low, 4 (4.7%) was intermediate and 4(4.7%) was high, but Hasford (Euro) scores for all patients were low. The 5-year survival rate for treated patients with imatinib, imatinib plus HU and imatinib plus HU plus IFN-${\alpha}$ was 90.5%, 81.1% and 55.6%, respectively Conclusions: The results show that imatinib therapy alone provides better survival in CML patients compared to HU or IFN-${\alpha}$. Combinations of IFN-${\alpha}$ and/or HU with imatinib probably reduce survival.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6663-6668
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• 2015

Background: Treatment failure in leukemia is due to either pharmacokinetic resistance or cell resistance to drugs. Materials and Methods: Gene expression of multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP) and low resistance protein (LRP) was assessed in 45 pediatric ALL cases and 7 healthy controls by real time PCR. The expression was scored as negative, weak, moderate and strong. Results: The male female ratio of cases was 2.75:1 and the mean age was 5.2 years. Some 26/45 (58%) were in standard risk, 17/45(38%) intermediate and 2/45 (4%) in high risk categorie, 42/45 (93%) being B-ALL and recurrent translocations being noted in 5/45 (11.0%). Rapid early response (RER) at day 14 was seen in 37/45 (82.3%) and slow early response (SER) in 8/45 (17.7%) cases. Positive expression of MDR-1, LRP and MRP was noted in 14/45 (31%), 15/45 (33%) and 27/45 (60%) cases and strong expression in 3/14 (21%), 11/27 (40.7%) and 8/15 (53.3%) cases respectively. Dual or more gene positivity was noted in 17/45 (38%) cases. 46.5 % (7/15) of LRP positive cases at day 14 were in RER as compared to 100% (30/30) of LRP negative cases (p<0.05). All 8 (100%) LRP positive cases in SER had strong LRP expression (p=<0.05). Moreover, only 53.3% of LRP positive cases were in haematological remission at day 30 as compared to 100% of LRP negative cases (p=<0.05). Conclusions: Our study indicated that increased LRP expression at diagnosis in pediatric ALL predicts poor response to early treatment and hence can be used as a prognostic marker. However, larger prospective studies with longer follow up are needed, to understand the clinical relevance of drug resistance proteins.