• Clinical and Experimental Pediatrics
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• 제53권2호
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• pp.129-135
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• 2010

Human rhinoviruses (HRVs) is a nonenveloped, single stranded RNA virus belonging to the family Picornavirudae. Transmission by direct contact such as hand-to-hand, hand-to-nose, and hand-to-eye has been readily demonstrated in experimental settings. HRV are the most frequent causes of common cold infection, however, they are also known to replicate in the lower respiratory tract and associated with more severe respiratory illnesses such as asthma. New technique such as reverse transcriptase polymerase chain reaction and molecular typing in HRV has been developed and our understanding of the importance of these respiratory viruses. HRVs consisted of 101 serotypes that are classified into groups A and B according to sequence variations. And there is a newly identified set of HRVs, called Group C, and it is currently under investigation. In recent study using PCR techniques, HRVs accounted for approximate 50-80% of common colds and 85 % of childhood asthma exacerbations and in more than half of adult exacerbations. However, the mechanisms of HRV- induced asthma exacerbations are poorly understood. This review discusses the association between HRVs and childhood asthma.

• The Korean journal of internal medicine
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• 제39권2호
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• pp.215-227
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• 2024

Asthma is characterized by airway obstruction and inflammation, and presents significant diagnostic and treatment challenges. The concept of endotypes has improved understanding of the mechanisms of asthma and has stimulated the development of effective treatment strategies. Sputum profiles may be used to classify asthma into two major inflammatory types: type 2-high (T2H) and type 2-low (T2L) asthma. T2H, characterized by elevated type 2 inflammation, has been extensively studied and several effective biologic treatments have been developed. However, managing T2L is more difficult due to the lack of reliable biomarkers for accurate diagnosis and classification. Additionally, conventional anti-inflammatory therapy does not completely control the symptoms of T2L; therefore, further research is needed to identify effective biologic treatments. This review provides new insights into the clinical characteristics and underlying mechanisms of severe T2L and investigates potential therapeutic approaches to control the disease.

• 항공우주의학회지
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• 제31권1호
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• pp.17-20
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• 2021

As the coronavirus disease 2019 (COVID-19) pandemic continues, doctors face many difficulties in managing patients with respiratory allergies. As research continues, much new knowledge has emerged about the link between COVID-19 infection and respiratory allergies. Studies to date have shown that there is no significant increase in the risk of COVID-19 infection in patients with respiratory allergies. However, in patients undergoing treatment for moderate to severe asthma or allergic rhinitis, more severe clinical manifestations, increased hospitalization period, and increased mortality may occur, so patients need to be managed with more care. In addition to personal efforts, social consideration should be accompanied to prevent deterioration in patients' quality of life with respiratory allergies due to COVID-19. Lastly, as clinical doctors, we should treat patients with respiratory allergies to protect ourselves appropriately by actively utilizing remote medical treatment and minimizing tests that generate droplets. Also, by appropriately educating patients and continuing drug treatment, efforts should be made to ensure that patients receive the best treatment even in a pandemic situation.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• Parasites, Hosts and Diseases
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• 제62권3호
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• pp.365-377
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• 2024

Exposure to storage mite (SM) and house dust mite (HDM) allergens is a risk factor for sensitization and asthma development; however, the related immune responses and their pathology have not been fully investigated. The HDMs Dermatophagoides farinae and Dermatophagoides pteronyssinus and SM Tyrophagus putrescentiae are potent allergens that induce asthma. Most SM-related studies have focused on the allergic reactions of individuals by measuring their immunoglobulin (Ig)E expression. Considering the limited research on this topic, the present study aims to investigate the differences in the immune responses induced by HDMs and SMs and histologically analyze lung tissues in a mouse asthma model to understand the differential effects of HDM and SM. The results revealed that all mite species induced airway inflammation. Mice challenged with T. putrescentiae had the highest airway resistance and total cell, eosinophil, and neutrophil counts in the bronchoalveolar lavage fluid (BALF). The SM-sensitized groups showed more severe lesions and mucus hypersecretions than the HDM-sensitized groups. Although the degree of HDM and SM exposure was the same, the damage to the respiratory lung tissue was more severe in SM-exposed mice, which resulted in excessive mucin secretion and increased fibrosis. Furthermore, these findings suggest that SM sensitization induces a more significant hypersensitivity response in mucosal immunity than HDM sensitization in asthma models.

• Tuberculosis and Respiratory Diseases
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• 제69권4호
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• pp.265-270
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• 2010

Background: Psychological factors are increasingly recognized for their influence on the course of asthma, on a worldwide basis. The aim of this study was to assess the presence of depression, anxiety, and asthma-related quality of life in patients with asthma and to evaluate their impact on severity and control of asthma. Methods: We assessed the severity of asthma by comparing patients' current medications to GINA guideline. The patients were classified into the controlled group (asthma patients with controlled disease) or into the uncontrolled group (asthma patients with uncontrolled disease), which included partly controlled and uncontrolled patients, again based on GINA guideline 2004. Patient-reported depressive symptoms, anxiety, and asthma-related quality of life were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and Korean asthma quality of life (KAQLQ). Results: One hundred and twenty patients were enrolled (mean age, $55{\pm}1$ years; 65% women). Among the 120 patients, 14 (12%) patients were classified as having mild asthma, 88 (73%) as having moderate asthma, and 18 (15%) as having severe asthma. Eighty-one (67%) of the 120 patients were controlled. The asthma-related quality of life showed the difference according to severity of asthma (p=0.002). The prevalence of depression was lower (10% vs 26%, p=0.024) and the asthma-related quality of life was higher (59.951 (29~75) vs 35.103 (18~72), $p{\leq}0.001$) in the controlled group. Higher trait anxiety score and lower asthma-related quality of life were associated with depression (p<0.001, p=0.002, respectively). Conclusion: Psychological factors, such as anxiety and depression, are strongly associated with asthma control. Therefore, screening and management of depression is needed in patients with asthma.

• IMMUNE NETWORK
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• 제7권1호
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• pp.18-25
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• 2007

Background: Although glucocorticoids (GCs) are effective in controlling asthma in the majority of patients, a subset of asthmatics fails to demonstrate a satisfactory response, even to systemic GC therapy. This population is referred to as being "steroid-resistant". The actual mechanism underlying steroid resistance in asthma remains to be elucidated. Methods: We have investigated how dexamethasone (DEX) regulates asthmatic phenotypes in a murine model of asthma, in which mice received i.p. immunization twice, followed by two bronchoprovocations with aerosolized OVA with a one-week interval, which we have recently described. Results: Pretreatment with DEX resulted in an inhibition of NF-${\kappa}B$ activation in asthmatic lungs, and also inhibited bronchoalveolar lavage (BAL) levels of NF-${\kappa}B$-dependent cytokines such as TNF-${\alpha}$ and CC chemokines [eotaxin and monocyte chemotactic protein (MCP)-1]. DEX was effective in suppressing airway hyperresponsiveness (AHR) at 10 h, Th2-dependent asthmatic phenotypes such as airway eosinophilia, BAL levels of Th2 cytokines (IL-5 and IL-13), and mucin production. However, DEX failed to suppress BAL levels of CXC chemokines [macrophage inflammatory protein-2 (MIP-2) and keratinocyte-derived chemokine (KC)] and airway neutrophilia. Conclusion: Airway neutrophilia is among the phenomena observed in patients with severe GC-resistant asthma. This study will provide insight into the molecular basis for airway neutrophila seen in steroid-resistant asthma. Further studies are required to delineate the underlying mechanism of CXC chemokine expression in asthma.

• 한국치위생학회지
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• 제22권4호
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• pp.225-230
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• 2022

Objectives: Patients with excessive tooth wear should first be diagnosed for the etiology of the tooth wear. Causes of tooth wear include bruxism, clenching, and taking medications for systemic diseases. After identifying the cause of tooth attrition, the final prosthesis should be restored with an appropriate vertical dimension. Methods: A 79-year-old man with worn out teeth desired a whole dental treatment. He was on medications for high blood pressure and asthma. The treatment proceeded with a consultation with a medical doctor. The medications for asthma evoked multiple teeth wear and a loss of the vertical dimension. After recovery of 3 mm of vertical dimension, 2 months of evaluation was followed by an interim prosthesis. Results: The increased vertical dimension caused no problem in function and esthetics, and the final restoration was performed with a full monolithic zirconia crown. Group function, adequate anterior guidance, and the occlusal plane were determined. Conclusions: After the final restoration, the patient was both esthetically and functionally satisfied, and a night guard splint was delivered to prevent prosthesis fracture. The patient was informed about the potential tooth wear associated with asthma drugs and educated to visit the clinic regularly.

• 대한한의학방제학회지
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• 제15권1호
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• pp.49-105
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• 2007

Objectives : Select and analyze the case record of dyspnea and wheezing asthma recorded in Xu Ming Yi Lei An that is the most abundant and wide in contents in existing case records that are systematic, comprehending relatively modern Traditional Chinese Medicine to secure more deep and objective basis of Traditional Chinese Medicine approach for dyspnea and wheezing asthma to analyze and review possibility for clinical application in this study. Methods: The study was conducted with the case records of dyspnea and wheezing asthma in whole Xu Ming Yi Lei An. Pattern identify and classify selected case records and again classified with deficiency syndrome and excess syndrome. Also analyzed prescriptions and herbs used in the case records. Nature of herbs and properties and flavors that were used in the case records were classified and frequency of each nature of herbs were analyzed. Applicable case records were interpreted and suggested prescriptions, pulse feelings, pattern classification were analyzed and described. Results : Among the 5254 case records stated on the complete collection, it is researched that there are 63 case records for the symptom complex of dyspnea as 1.2% of the whole case records, and the case records on the symptom complex of wheezing asthma are 14 as the 0.27% of the total examples. 63 case record examples related with symptom complex of dyspnea were pattern identified and classified. As a result, deficiency syndrome of the Kidney(33 %), deficiency syndrome of the Spleen(26.0%), Wind-Cold(12.3%), phlegm turbidity(12.3%), Heat in the Lung(8.2%), asthenia of the Lung(8.2%) were investigated as above order. 14 case record examples related with wheezing asthma were pattern identified and classified. As a result, phlegm-Heat(26.3%), upper excess and lower deficiency(26.3%), external affections Wind-Cold(15.8%), Dampness-phlegm(10.5%), Lung asthenia(10.5%), Cold phlegm(5.3%), mutual deficiency and detriment of Heart and Kidneys(5.3%) were investigated as above order. Symptom complex of dyspnea has 67.1% of deficiency syndrome, 32.9% of excess syndrome resulting more deficiency syndrome than excess syndrome. Symptom complex of wheezing asthma has 42.1 % of deficiency syndrome and 57.9% of excess syndrome resulting more excess syndrome than deficiency syndrome. In case of symptom complex of dyspnea prescription used in the case record, the order of frequency is as following. Palmijihwang-tang, Bojung-ikgitang, Yungmijihwang-tang, Ijintang, Sojaganggitang, Igongsan. In case of symptom complex of wheezing asthma prescription in the case record, Yungmijihwang-tang, Ohotang, Dodamtang were mostly used. Herbs used in case records of symptom complex of dyspnea are Ginseng Radix, Poria, Glycyrrhizae Radix, Aconiti Iateralis Preparata Radix, Atractylodis Macrocephalae Rhizoma, Dioscoreae Rhizoma, Angelicae Gigantis Radix, Rehmanniae Radix Preparat, Pinelliae Rhizoma, Zingiberis Rhizoma Recens are mostly used. Nature of herb properties used for symptom complex of dyspnea and symptom complex of wheezing asthma are herbs that are warm properties. When the symptom complex of dyspnea and the symptom complex of wheezing asthma were treated. if the patient felt tenderness at Pyesu, doctors conducted pricking blood around the opposite Pyesu or Sipseon acupoint. when the patient didn't have tenderness at Pyesu by soft press, pricking blood was performed both sidees, right and left Pyesu. In case of the treatment of symptom complex of dyspnea and symptom complex of wheezing asthma, when they got treatment, when the symptom complex of disease is severe, a doctor cauterized the opposite Pyesu while the other Pyesu felt tenderness, and decided how the above treatment is performed whether the degree of the symptom compolex of disease is severe or not. In case of the treatment of symptom complex of dyspnea and symptom complex of wheezing asthma, if the person felt tenderness at Pyesu and is caught by the Wind-Cold pathogen, slight acupuncture is treated at relevant Pyesu with Fire needling. When patient with symptom complex of dyspnea and symptom complex of wheezing asthma cannot hawk sputum up from the oral and laryngopharynx, suction method is treated. Conclusion : With this study, actual traditional and clinical pattern identification form and characteristics of symptom complex of dyspnea and symptom complex of wheezing asthma were recognized. Modern case report utilizing in clinical application need to be secured and an incurable disease asthma need to be diagnosed and improvement for treatments have to be searched through other case records.

• 대한한방내과학회지
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• 제11권1호
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• pp.61-75
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• 1990

According to the research, the Estern and Western medical literatural records about the causes and symptoms of the heart failure, the results as follows are concluded. 1. The asthma, suceptibility to fright and severe palpitation are generally revealed from the left heart failure. The causes of it are belong to the Yang and Yeum deficiency which are mainly caused by primordial energy deficiency. 2. The symtoms of asthma which are derived from left heart failure are related to the gasping that contain dyspnea, asthma due to the accumulation of phlegm and severe palpitation and related to shortness of breath due to fluid retention (水喘) that make asthma. 3. In the right heart failure, the edema which is derived from the congestion of vein, is revealed as stoppage of main channel that is mainly caused by the Yang or the Yeum deficiency. 4. The edema which is caused by the right heart failure, is mainly related to the symptoms of Yeum type edema, also it is related to the five viscera-fluid, moreover to the heart-fluid (心水), lung-fluid (肺水) and liver-fluid (肝水). 5. In heart failure, the pathologic symptoms which are derived from the stoppage of blood circulation, are phlegm-retention disease (痰飮), diffuse fluid-retention syndrom (溢飮), fluid-retention syndrome characterized by dyspnea and edema (支飮).