• 대한의생명과학회지
• /
• 제20권3호
• /
• pp.111-116
• /
• 2014

Human neutrophils play an essential role in the innate immune response and are involved in the pathogenesis of the severe and corticosteroid-resistant asthma. Asthma is characterized by an infiltration of inflammatory cells into the lung and by a cytokine release. The aim of this study is to investigate the effects of a bronchoalveolar lavage fluid (BALF) on the chemotaxis and apoptosis of neutrophils which were isolated from healthy subjects. The BALF of subjects with asthma induces the blood neutrophil chemotaxis in the opposite of that in normal subjects. The IL-8, IL-6, and monocyte chemoattractant protein-1 (MCP-1) levels in BALF were higher in subjects with asthma than in normal subjects. The BALF of normal and asthmatic subjects has no effect on neutrophil apoptosis of BALF. MCP-1 delays the constitutive apoptosis of normal blood neutrophils, but has no effect in normal BALF neutrophils. These results may indicate that inflammatory factors secreted by the lung tissue of patients with asthma trigger the neutrophil chemotaxis and also induce the neutrophil dysregulation.

• Tuberculosis and Respiratory Diseases
• /
• 제70권5호
• /
• pp.416-422
• /
• 2011

Background: Inhaled corticosteroids (ICSs) are the most essential medication for asthma control. Many reports suggest that the usage of ICSs improves not only the control of asthma symptoms but also prevents exacerbation. We investigated whether increases in ICS prescriptions are associated with decreases in asthma exacerbation in the clinical practice setting. Methods: We retrospectively analyzed the database of adult asthma patients who had visited a tertiary referral hospital, the Asan Medical Center between January 2000 and December 2009. The number of emergency department (ED) visits, admissions, intensive care unit (ICU) care, deaths, and ICS prescriptions were analyzed to evaluate the time trend of asthma exacerbation as a function of the ICS prescription rate during the ten years. Results: The numbers of ED visits, admissions, and episodes of ICU care decreased during the ten years (p<0.001, p=0.033, p=0.001, respectively) while the number of ICS prescriptions increased (p<0.001). We found a correlation between the number of ICS prescriptions and the number of ED visits, admissions, or ICU care. For these outcomes, the correlation coefficients were r=-0.952, p<0.001; r=-0.673, p=0.033; r=-0.948, p<0.001, respectively. Conclusion: The number of ICS prescriptions increased during the past ten years while the number of asthma exacerbations decreased. Our results also showed a negative correlation between the ICS prescription rate and asthma exacerbation in the clinical practice setting. In other words, an increase in ICS prescription may be a major cause of a decrease in asthma exacerbations.

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

• Tuberculosis and Respiratory Diseases
• /
• 제41권5호
• /
• pp.568-573
• /
• 1994

저자들은 급성 기관지 천식환자에서 치료제로 사용하는 hydrocortisone을 투여 후 유발된 기관지 수축이 발생한 예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
• /
• 제57권4호
• /
• pp.164-170
• /
• 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

• 한국환경보건학회지
• /
• 제46권6호
• /
• pp.685-693
• /
• 2020

Objectives: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. The aim of this study was to investigate relationships between indoor mold concentrations and pulmonary function parameters in asthmatic children with mold sensitization. Methods: Asthmatic subjects who had a positive result in skin-prick testing to more than one mold allergen, such as Alternaria, Aspergillus, or Penicillium, were enrolled. Their pulmonary function and methacholine challenge test results were collected. Measurements of blood eosinophil, serum IgE, and fractional exhaled nitric oxide (FeNO) were taken. Indoor levels of VOC, CO2, PM10 and PM2.5 in each subject's house were measured. We counted mold and bacteria colonies from the subjects' house air samples. Results: The mean levels of FEV1, FVC, FEV1/FVC, and FEF25-75 were 82.8±19.7, 87.3±17.9, 85.8±8.3, and 82.3±28.9%, respectively. The mean FeNO level was 19.8±11.2 ppb and the geometric mean (range of one SD) of methacholine PC20 was 3.99 mg/mL (0.67-23.74 mg/mL). The average indoor air pollutant levels were below the recommended levels set by the Ministry of Environment for multiplex buildings. Indoor mold levels showed a significant inverse correlation with methacholine PC20, but not with the baseline pulmonary function parameters. Conclusion: Indoor mold concentrations are a risk factor for increased bronchial hyperresponsiveness among asthmatic children with mold sensitization. Targeted environmental intervention should be considered for selected asthmatic children with mold sensitization for avoiding severe airway hyperresponsiveness.

• Tuberculosis and Respiratory Diseases
• /
• 제49권5호
• /
• pp.585-593
• /
• 2000

연구배경 : 기관지천식의 치료는 증상(천식 증세의 빈도, 야간천식 증상의 빈도), $FEV_1$ %. PEFR%의 일중변동률을 기준으로 중증도를 4단계로 나누어 단계별 치료를 하는 것이 중요하다. 실제 중증도를 결정하는 지표들 간에 단계가 일치하지 않는 경우가 많아 치료 단계를 결정하기 어려울 때가 많다. 본 연구에서는 지표들이 얼마나 일치하는 지 분석하고, 차이가 있는 경우 이에 관여하는 요인을 알아보고자 하였다. 방법 : NIH 의 기관지천식 지침서를 기준으로 환자의 주관적인 증세를 기준으로 한 중증도와 폐기능($FEV_1$ %) 검사에 의한 중증도가 얼마나 일치하는 지, 또 PEFR %와 $FEV_1$ %에 의한 중증도가 얼마나 일치하는 지 알아보고, 각 지표들간에 단계의 차이를 보이는 경우에 이에 환자의 연령, 기관지천식의 이환기간, $PC_{20}$, $FEV_1$ % 등의 요인이 관여하는 지 분석하였다. 결과 : $FEV_1$ %를 기준으로 한 중증도와 PEFR%를 기준으로 한 중증도가 일치하지 않는 경우가 23.4%이었고, 이중 $FEV_1$ %에 의한 기준으로는 경증군이면서 PEFR%에 의한 중증도에서 중등도군으로 분류된 경우가 가장 많았다. 이러한 환자군은 그 반대인 환자, 즉 PEFR%를 기준으로 한 중증도보다 $FEV_1$ %를 기준으로 한 중증도가 심한 환자에 비해 환자의 연령이 많았고, 이환기간은 짧았다. 또 $FEV_1$ %와 증상에 의한 중증도가 다른 경우가 42.9% 이었으며, 이 중 63.0%가 증상에 의한 중증도가 $FEV_1$ %를 기준으로 한 중증도에 비해 심하게 분류되었다. 폐기능을 기준으로 한 중증도가 증상에 의한 중증도보다 심한 환자군은 기도과민반응 정도가 심하였으며 기도폐쇄 정도도 심한 경향을 보였다. 결론 : 기관지천식 환자의 중증도를 결정할 때에는 어느 한 지표에 의존하지 말고 연령, 이환기간, 기도과민반응 정도, 기도폐쇄정도 등의 요인을 고려해서 여러 지표들을 종합적으로 분석하는 것이 필요하다.

• Tuberculosis and Respiratory Diseases
• /
• 제54권4호
• /
• pp.386-394
• /
• 2003

연구배경 : 만성폐쇄성폐질환과 기관지 천식은 만성 기도 염증과 기류 장애를 특징으로 하고 있으며, 일부에서는 합병되어 나타나기도 한다고 알려져 있으나 그 정도에 대한 연구는 미미한 실정이다. 저자는 두 질환의 병태 생리의 차이와 합병 정도를 평가하기 위하여 본 연구를 시행하였다. 방 법 : 만성폐쇄성폐질환과 기관지 천식의 진단은 미국 흉부학회의 지침서 기준에 의하였고, 대상 환자들에게는 폐기능 검사, 최대호기유속 측정, 속효성 ${\beta}_2$-항진제에 대한 기관지 반응성, methacholine 유발 반응 검사, 객담내 호산구치 및 ECP, 혈청내 총 IgE치, 알레르기 피부반응 검사 등을 시행하였다. 결 과 : 대상 환자 59명중 남자가 49명, 평균 연령은 66.46세, 흡연자가 42명이었다. 속효성 ${\beta}_2$-항진제에 대한 양성 반응을 보인 경우는 37.3%였으며, 최대 호기유속 측정상 일중 변이성을 보인 경우는 47.5%이었고, 두 가지 검사에 모두 양성을 보인 경우는 27.1%이었다. 만성폐쇄성폐질환과 기관지 천식이 합병된 환자의 유도객담은 호산구와 ECP농도의 유의한 상승을 보였다. 그러나 기관지 천식이 합병되지 않은 만성폐쇄성폐질환 환자의 유도 객담에서는 중성구의 유의한 상승을 관찰할 수 있었다. 또한 중증의 만성폐쇄성폐질환 환자에서 최대호기유속의 변화율은 현저히 감소하였지만 천식의 합병과 만성폐쇄성폐질환의 중증도간에는 상관관계를 보이지 않았다. 결 론 : 이상의 결과를 요약하면 중등도와 중증의 환기장애를 동반한 만성폐쇄성폐질환 환자의 약 27% 정도에서 기관지 천식이 동반되었으나, 환기장애의 중증도와 기관지 천식의 합병률 간에는 유의한 차이가 없었다.

• Clinical and Experimental Pediatrics
• /
• 제51권4호
• /
• pp.343-350
• /
• 2008

Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

• 정신신체의학
• /
• 제1권1호
• /
• pp.45-51
• /
• 1993

Stress perception was investigated in 53 outpatients with extrinsic type of bronchial asthma, using GARS scale and other questionnaires. 40% of the patients were found to be psychosomatic. The patients were more likely to consider their physical symptoms as severe than the allergist Severity of symptoms rated by the allergist had significantly positive correlation with scores of stress perception related to changes in relationship. However, no significant correlation was found between severity of symptoms rated by patients and scores of stress perception. Psychosomatic group was significantly higher in scores of stress perception related to illness and injury, financial burden, and change or no change in routine than non-psychosomatic group. Female. older age, higher education. presence of religion. and presence of psychological stressors at onset and/or aggravation of the illness were found to increase stress perception. These findings indicate ant extrinsic asthmatics an less likely to perceive psychological stress than physical symptoms, and that they are less vulnerable to psychological stressors than patients with other diseases.