• 대한한방소아과학회지
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• 제21권1호
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• pp.1-9
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• 2007

Objectives : The purpose of this study is to investigate oriental medical treatment of pediatric bronchial asthma. Method : Chinese medical journals which is about pediatric bronchial asthma were analyzed for a reference. Result : Oriental medical treatment can be classified into three ways; internal treatment, external treatment, and combination treatment which means combining with Chinese and Western ways of treatments. Conclusion : Oriental medical treatment of pediatric bronchial asthma is more effective therapy than Western's.

• 대한한방소아과학회지
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• 제16권1호
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• pp.133-148
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• 2002

Objective : This study was to investigate more effective oriental medical treatment for Pediatric Bronchial Asthma Method : Aroma therapy and Herbal medicine was given to 28 pediatric bronchial asthma patients(19 males and 9 females) for about 5months from the First, August 1999 The Fifth, January 2002. Results: 1. Demographic factor : The sample consisted of 28 persons among whom 19 were male, 9 were female. The age ranges from 1 year old to 6 year old. Less than 2 year old were 4 and 2-6 year old were 20. 2.Residence : Apartment and villar dwellers were 19(67.9%), Residential street divellers were 9(32.1%). 3.Age distribution at on set : 6(21.4%) fell ill befor 1 year old and 22(78.6%) fell ill after 1 year old 4. The period of illness : 9(32.2%) suffered during 1-3 year and 6(21.4%) suffered during 6 mouth-1year and 6(21.4%) suffered during more than 3 year. 5. Frequency of the symptoms : The symptoms appeared 2-3 times a year in the case of 16(57.2%), one time a year in the case of 1, 4 times a year in the case of 6(21.4%). 6. Concomitance symptoms : All experienced coughing sign, wheezing, 23(82.1%) experienced epistaxis, nose dripping, 13(46.4%) got fever, anorexia. 7. Past history of illness : 16(57.1%) got brochiolitis, brochitis, 12(42.9%) suffered pneumonia, 9(32.1%) had allergic rhinitis. 2 had allergic rhinitis, sinusitis, atopic dermatitis, bronchial asthma, 3 got atopic dermatitis, bronchial asthma and 7 had allergic rhinitis, sinusitis, bronchial asthma, 8. Family disease : In the case of family disease, 21(75%) had allergic dermatitis, 9(42.9%) had bronchial asthma, 8(38.1%) had allergic dermatitis. 9. The symptoms became very severe in the change of season in the case of 13(46.4%) and in the case of 11(39.3%), the change of season made no difference 10. Associated caused of induction symtoms : 28(100%) got sick by common cold, infectional disease, 8(28.6%) got sick by cold food, cold air 11.The kind of therapy : 15(53.6%) got oriental therapy after occidental therapy, 11(39.3%) took only oriental therapy. 12. Improvement degree of each symptoms : In the case of cough and wheeze that are the main symptoms of bronchial asthma, 78.6% and 64.3% of the patients replied < improvement > and in the case of dyspnea, tachypnea 41.7% of the patients replied . In other symptoms, all replied 13. Degree of satisfaction : 19(67.9%) replied , 2(7.1%) replied . Conclusion : Herbal medicine and aroma therapy proved to be a very effective oriental medical treatment for pediatric bronchial asthma.

• Clinical and Experimental Pediatrics
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• 제45권5호
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• pp.568-574
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• 2002

• Clinical and Experimental Pediatrics
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• 제58권5호
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• pp.190-193
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• 2015

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to bronchial colonization of Aspergillus fumigatus that occurs in susceptible patients with asthma or cystic fibrosis. A 10-year-old girl was referred to the Department of Pediatric Pulmonology for persistent consolidations on chest radiography. Pulmonary consolidations were observed in the right upper and left lower lobes and were not resolved with a 4-week prescription of broad-spectrum antibiotics. The patient had a history of atopic dermatitis and allergic rhinitis but no history of asthma. She had no fever but produced thick and greenish sputum. Her breathing sounds were clear. On laboratory testing, her total blood eosinophil count was $1,412/mm^3$ and total serum IgE level was 2,200 kU/L. Aspergillus was isolated in the sputum culture. The A. fumigatus-specific IgE level was 15.4 kU/L, and the Aspergillus antibody test was also positive. A chest computed tomography scan demonstrated bronchial wall thickening and consolidation without bronchiectasis. An antifungal agent was added but resulted in no improvement of pulmonary consolidations after 3 weeks. Pulmonary function test was normal. Methacholine provocation test was performed, revealing bronchial hyperreactivity ($PC_{20}=5.31mg/mL$). Although the patient had no history of asthma or bronchiectasis, ABPA-seropositivity was suspected. Oral prednisolone (1 mg/kg/day) combined with antifungal therapy was started. Pulmonary consolidations began decreasing after 1 week of treatment and completely resolved after 1 month. This is the first observed and treated case of seropositive ABPA in Korean children without previously documented asthma.

• Clinical and Experimental Pediatrics
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• 제64권5호
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• pp.229-238
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• 2021

Background: Bronchial hyperresponsiveness (BHR), an important physiological feature of asthma, is a prognostic marker of childhood asthma. Purpose: We aimed to investigate the factors associated with BHR in adolescents with childhood asthma. Methods: Two hundred and fifteen adolescents (≥13 years of age; 149 males, 66 females) who were diagnosed with asthma during childhood were enrolled, underwent methacholine challenge tests, and were divided into the BHR group (<25 mg/mL of provocation concentration causing a 20% fall in forced expiratory volume in 1 second [FEV₁] [PC₂₀], n=113) or non-BHR group (≥25 mg/mL of PC₂₀, n=102). We examined longitudinal changes in BHR and the risk factors for its persistence in the 108 adolescents for whom baseline data, including methacholine PC₂₀ at age 6 years, were available. Multivariate logistic regression analyses were performed to assess the factors associated with BHR in adolescents. Results: Mold sensitization (adjusted odds ratio [aOR], 5.569; P=0.005) and increased blood eosinophil count (aOR, 1.002; P=0.026) were independently associated with BHR in boys but not girls. The odds of BHR decreased by 32% with each 1-year increase in age in boys (aOR, 0.683; P=0.010) but not girls. A reduced FEV₁/forced vital capacity ratio (<90%) was independently related with BHR in female patients only (aOR, 7.500; P=0.007). BHR decreased with age throughout childhood. A low methacholine PC₂₀ at age 6 years was independently associated with persistent BHR throughout childhood in male and female patients, whereas early mold sensitization was a risk factor for persistent BHR in male patients only (aOR, 7.718; P=0.028). Conclusion: Our study revealed sex-specific differences in the factors associated with BHR in adolescents with childhood asthma. Our findings suggest the risk factors that might affect asthma transition from childhood to adolescence and adulthood.

• Clinical and Experimental Pediatrics
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• 제64권2호
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• pp.60-67
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• 2021

Eosinophils are a type of granulocyte with eosinophilic granules in the cytoplasm that play an important role in allergic and parasitic diseases. Eosinophils are important in the pathogenesis of asthma, and many studies have examined the relationship between them. In allergic eosinophilic asthma, eosinophils act not only as important effector cells but also as antigen-presenting cells in allergic inflammatory reactions. In nonallergic eosinophilic asthma, type 2 innate lymphoid cells in the airways play an important role in eosinophil activation. Direct methods, including bronchial biopsy, bronchoalveolar lavage, and the induced sputum test, are used to evaluate eosinophilic inflammatory reactions in patients with asthma, however, because of difficulty with their implementation, they are sometimes replaced by measurements of blood eosinophils, fraction of exhaled nitric oxide, and serum periostin level. However, these tests are less accurate than direct methods. For the treatment of patients with severe eosinophilic asthma, anti-interleukin-5 preparations such as mepolizumab, reslizumab, and benralizumab have recently been introduced and broadened the scope of asthma treatment. Although eosinophils are already known to play an important role in asthma, we expect that further studies will reveal more details of their action.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1038-1049
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• 2005

Asthma is characterized by a chronic inflammatory disorder of the airways that leads to tissue injury and subsequent structural changes collectively called airway remodelling. Characteristic changes of airway remodelling in asthma include goblet cell hyperplasia, deposition of collagens in the basement membrane, increased number and size of microvessels, hypertrophy and hyperplasia of airway smooth muscle, and hypertrophy of submucosal glands. Apart from inflammatory cells, such as eosinophils, activated T cells, mast cells and macrophages, structural tissue cells such as epithelial cells, fibroblasts and smooth muscle cells can also play an important effector role through the release of a variety of mediators, cytokines, chemokines, and growth factors. Through a variety of inflammatory mediators, epithelial and mesenchymal cells cause persistence of the inflammatory infiltrate and induce airway structural remodelling. The end result of chronic airway inflammation and remodelling is an increased thickness of the airway wall, leading to a increased the bronchial hyperresponsiveness and fixed declined lung function.

• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.581-588
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• 2006

Asthma is a chronic inflammation of the airway associated with increased bronchial hyperresponsiveness that leads to recurrent episodes of cough, wheezing, breathless, chest tightness. According the recent studies, repeated airway inflammation leads to structural changes so called 'airway remodeling' and associated with decreased pulmonary function. Airway remodeling begins form the early stage of asthma and the early diagnosis and management is very important to prevent airway remodeling. Medication for asthma can be classified into acute symptom reliever and chronic controller. Short acting beta2 agonist is a well-known reliever that reduced asthma symptoms within minutes. Controllers should be taken daily as a long-term basis to control airway inflammation. Inhaled corticosteroid(ICS) is the most effective controller in current use. However, in some patients ICS monotherapy is not sufficient to control asthma. In those cases, other medications such as long acting beta2 agonist, leukotriene modifier or sustained-release theophylline should be added to ICS, which called Add-on-Therapy. Combination inhaler devices are easy to use. Oral leukotriene modifier has a good compliance especially in children. Finally, as asthma is a chronic disease, the development of on-going partnership among health care professionals, the patients, and the patients' family is necessary for the effective management of asthma.

• Clinical and Experimental Pediatrics
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• 제45권4호
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• pp.519-523
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• 2002

목 적: 기관지 천식으로 입원한 환아에서 시행된 단순 흉부 방사선에서 이상 소견을 조사하고, 관찰된 무기폐를 자세히 분석하고자 하였다. 방 법 : 4년간 가톨릭대학교 대전성모병원에 기관지 천식으로 입원한 144명의 357례의 흉부 방사선에서 무기폐를 포함한 폐의 이상 소견과 임상상, 혈액학적 소견 등을 후향적으로 분석하였다. 결 과 : 144례의 환아의 남녀비는 2.1 : 1, 평균 나이는 4.8세, 평균 입원 횟수 2.5회, 평균 입원일 5.0일, 평균 IgE 치 387 IU/mL, 평균 호산구 수 $362/mm^3$ 이었다. 357례의 단순 흉부 방사선 이상 소견으로 과?창 314례(88.0%), 폐침윤 127례(35.0%), 무기폐 19례(5.3%), 중격동기종 1례(0.3%)가 관찰되었다. 19례의 무기폐는 대부분 폐구역성 또는 폐소엽성으로 모두 우측 폐에서 발생하였으며 2세 이하와 남아에서 발생이 많았다. 또한 2세 이하에서는 우상엽에서, 7세 이상에서는 우하엽에서 주로 발생하였다. 결 론 : 천식으로 입원한 환아에서 흉부 방사선 사진에서 무기폐(5.3%)를 포함한 이상 소견을 보이는 경우가 적지 않으며 이에 따른 적절한 치료 방침을 결정해야 할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제50권6호
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• pp.556-564
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• 2007

목 적 : 본 연구에서는 현증 천식 환자의 BHR에는 기도 염증이 중요한 요인으로 작용하기 때문에 ${\beta}_2$-아드레날린 수용체 유전자와의 연관성이 나타나지 않지만, 청소년기 천식 관해 상태에서 지속되는 BHR에는 상대적으로 유전적인 영향이 강하기 때문에 ${\beta}_2$-아드레날린 수용체 유전자와의 연관성이 나타날 것이라는 가설을 세우고, 이를 검증해 보고자 하였다. 방 법 : 장기간 천식 관해 상태(최근 2년간 천식 증상이 없고 치료가 필요 없었던 경우)에서 BHR이 지속되는 청소년 202명(천식 관해군), 현증 천식 청소년 182명(현증 천식군), 정상군 200명을 대상으로, 메타콜린 기관지 유발검사와 피부단자시험을 시행하였으며 혈청 총 IgE를 측정하였다. ${\beta}_2$-아드레날린 수용체 유전자의 일배체형 분석을 위해 아미노산 16번과 27번을 포함하고 있는 ${\beta}_2$-아드레날린 수용체 유전자 부위를 polymerase chain reaction(PCR)으로 증폭한 뒤, 16번 유전형은 allele specific PCR, 27번 유전형은 PCR-restriction fragment length polymorphism (RFLP) 방법으로 분석하였다. 결 과 : Gly 동형접합자(homozygote)의 빈도는 정상군에서 14.5%, 현증 천식군에서 18.1%, 천식 관해군에서 24.2%로 증가하는 경향이 관찰되었으며(P=0.01), 현증 천식군과 정상군 사이에서는 차이가 없었지만 천식 관해군과 정상군 사이에서는 유의한 차이가 관찰되었다(P=0.01). Gly16-Gln27 일배체형 빈도는 정상군에서 36.5%, 현증 천식군에서 40.4%, 천식 관해군에서 44.6%로 증가하는 경향이 관찰되었으며(P=0.02), 현증 천식군과 정상군 사이에서는 차이가 없었지만 천식 관해군과 정상군 사이에서는 유의한 차이가 관찰되었다(P=0.02). 천식 관해군에서 Gly16-Gln27 일배체형의 수가 증가함에 따라 $PC_{20}$ 기하 평균값이 유의한 차이를 보임으로써(P=0.02) Gly16-Gln27 일배체형과 $PC_{20}$ 사이의 연관성이 관찰되었으나 현증 천식군에서는 이러한 연관성이 관찰되지 않았다. 결 론 : ${\beta}_2$-아드레날린 수용체 유전자가 BHR을 유발하는 유전자적 배경을 가지면서 천식 질병을 조절하는 역할을 하고 있음을 시사한다.