• Title/Summary/Keyword: allergy asthma

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Lung Function Trajectory Types in Never-Smoking Adults With Asthma: Clinical Features and Inflammatory Patterns

  • Kim, Joo-Hee;Chang, Hun Soo;Shin, Seung Woo;Baek, Dong Gyu;Son, Ji-Hye;Park, Choon-Sik;Park, Jong-Sook
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.614-627
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    • 2018
  • Purpose: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. Methods: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year. First, a hierarchical cluster analysis was performed using Ward's method to generate a dendrogram for the optimum number of clusters using the complete post-FEV1 sets from 448 subjects. Then, a trajectory cluster analysis of serial post-FEV1 sets was performed using the k-means clustering for the longitudinal data trajectory method. Next, trajectory clustering for the serial post-FEV1 sets of a total of 1,679 asthmatics was performed after imputation of missing post-FEV1 values using regression methods. Results: Trajectories 1 and 2 were associated with normal lung function during the study period, and trajectory 3 was associated with a reversal to normal of the moderately decreased baseline FEV1 within 3 months. Trajectories 4 and 5 were associated with severe asthma with a marked reduction in baseline FEV1. However, the FEV1 associated with trajectory 4 was increased at 3 months, whereas the FEV1 associated with trajectory 5 was persistently disturbed over 1 year. Compared with trajectory 4, trajectory 5 was associated with older asthmatics with less atopy, a lower immunoglobulin E (IgE) level, sputum neutrophilia and higher dosages of oral steroids. In contrast, trajectory 4 was associated with higher sputum and blood eosinophil counts and more frequent exacerbations. Conclusions: Trajectory clustering analysis of FEV1 identified 5 distinct types, representing well-preserved to severely decreased FEV1. Persistent airflow obstruction may be related to non-atopy, a low IgE level, and older age accompanied by neutrophilic inflammation and low baseline FEV1 levels.

KAAACI Standardization Committee report on the procedure and application of induced sputum examination (유도객담검사의 시행과 해석: 전문가 의견서)

  • Kim, Min-Hye;Kim, Mi-Yeong;Lim, Kyung-Hwan;Yang, Min-Suk;Song, Woo-Jung;Lee, Jeongmin;Suh, Dong In;Shin, Yoo Seob;Kwon, Jae-Woo;Kim, Sae-Hoon;Kim, Sang-Heon;Lee, Byung-Jae;Cho, Sang-Heon;Jung, Jae-Woo;Academy of Asthma, Allergy and Clinical Immunology Standardization Committee
    • Allergy, Asthma & Respiratory Disease
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    • v.5 no.6
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    • pp.307-311
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    • 2017
  • Induced sputum and sputum cell count analysis is a test for the diagnosis of various respiratory diseases. In particular, it has long been used as an important biomarker in the diagnosis or characterization of asthma or eosinophilic bronchitis. Despite a relatively long history of this test, there has been no consensus report for conducting and interpreting the analyses in Korea. Based on this awareness and necessity, the Korean Academy of Asthma, Allergy and Clinical Immunology launched the Standardization Committee to review the international guidelines and the literature and to develop a consensus report on the diagnostic procedure and interpretation of the sputum induction test.

Pneumatosis Intestinalis Complicated by Pneumoperitoneum in a Patient with Asthma

  • Choi, Joon Young;Cho, Sung Bae;Kim, Hyun Ho;Lee, In Hee;Lee, Hea Yon;Kang, Hye Seon;Lee, Hwa Young;Lee, Sook Young
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.219-222
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    • 2014
  • Pneumatosis intestinalis (PI) is a very rare condition that is defined as the presence of gas within the subserosal or submucosal layer of the bowel. PI has been described in association with a variety of conditions including gastrointestinal tract disorders, pulmonary diseases, connective tissue disorders, organ transplantation, leukemia, and various immunodeficiency states. We report a rare case of a 74-year-old woman who complained of dyspnea during the management of acute asthma exacerbation and developed PI; but, it improved without any treatment.

Oriental Medical Approach on the Allergic Disease (알레르기성 질환에 대한 한의학적 접근)

  • Im Gwang Mo;Jeong Hyun Woo;Kim Hee Sung;Jeong Woo Yeal
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.5
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    • pp.831-839
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    • 2002
  • Allergy has a born predominant cause of atopy in body and react oversenstively several meterial. The cause of allergy are tick, house dust, egg, milk, bean, cosmetics, virus, bacteria, flesh and meat in Western medicine. While, Oriental medicine did not have an application on the allergy, but recognized that allergy is connected with fetal toxicosis, heat-syndrome in new born, syndrome characterized by dyspnea, sneezing, stuffy nose, nasal discharge and phlegm. Therefor, We knowed method of medical treatment following cause of disease and pathogenesis against allergy. Allergic disease(atopic dermatitis, bronchial asthma, rhinitis) were related with lung, spleen, kidney. To prevent allergic disease in born, Oriental medicine taked a serious view of fetal education. In Western medicine, The cause of allergy applied to exopathogen of Oriental medicine. In Oriental medicine, Treatment of allergy used generally strengthening the body resistance to eliminate pathogenic factors.

Prediction of Brobchodilator Response by Using $FEF_{25{\sim}75%}$ in Adult Patient with a Normal Spirometry Result (정상 폐활량을 보이는 성인 환자에서 $FEF_{25{\sim}75%}$를 통한 기관지확장제 반응의 예견)

  • Park, Se-Hwan;Lee, Seung-Yup;Kang, Seung-Mo;Seon, Choon-Sik;Kim, Hyun-Kyung;Lee, Byoung-Hoon;Lee, Jae-Hyung;Kim, Sang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.188-194
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    • 2011
  • Background: When patients with chronic respiratory symptoms have a normal spirometry result, it is not always easy to consider bronchial asthma as the preferential diagnosis. Forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25{\sim}75%}$) is known as a useful diagnostic value of small airway diseases. However, it is not commonly used, because of its high individual variability. We evaluated the pattern of bronchodilator responsiveness (BDR) and the correlation between $FEF_{25{\sim}75%}$ and BDR in patients with suspicious asthma and normal spirometry. Methods: Among patients with suspicious bronchial asthma, 440 adult patients with a normal spirometry result (forced expiratory volume in one second [$FEV_1$]/forced vital capacity [FVC] ${\geq}70%$ & $FEV_1%$ predicted ${\geq}80%$) were enrolled. We divided this group into a positive BDR group (n=43) and negative BDR group (n=397), based on the result of BDR. A comparison was carried out of spirometric parameters with % change of $FEV_1$ after bronchodilator (${\Delta}FEV_1%$). Results: Among the 440 patients with normal spirometry, $FEF_{25{\sim}75%}%$ predicted were negatively correlated with ${\Delta}FEV_1%$ (r=-0.22, p<0.01), and BDR was positive in 43 patients (9.78%). The means of $FEF_{25{\sim}75%}%$ predicted were $64.0{\pm}14.5%$ in the BDR (+) group and $72.9{\pm}20.8%$ in the BDR (-) group (p<0.01). The negative correlation between $FEF_{25{\sim}75%}%$ predicted and ${\Delta}FEV_1%$ was stronger in the BDR (+) group (r=-0.38, p=0.01) than in the BDR (-) group (r=-0.17, p<0.01). In the ROC curve analysis, $FEF_{25{\sim}75%}$ at 75% of predicted value had 88.3% sensitivity and 40.3% specificity for detecting a positive BDR. Conclusion: BDR (+) was not rare in patients with suspicious asthma and normal spirometry. In these patients, $FEF_{25{\sim}75%}%$ predicted was well correlated with BDR.

Prevalence of and Coping Patterns for Allergic Diseases in Preschool and School-age Children in Nam-gu, Ulsan (울산광역시 남구 지역의 미취학 및 학령기 아동의 알레르기질환 유병률 및 대처 양상)

  • Im, Dasom;Pyo, Jeehee;Ock, Minsu
    • Journal of the Korean Society of School Health
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    • v.34 no.3
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    • pp.133-150
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    • 2021
  • Purpose: The epidemiologic understanding of allergic diseases, including prevalence and risk factors, is needed for allergy management. This study identified the prevalence of and coping patterns for various types of allergies, such as asthma, allergic rhinitis (AR), atopic dermatitis (AD), allergic conjunctivitis (AC), food allergy (FA), and drug allergy (DA), in Nam-gu, Ulsan, one of the most industrialized districts in Korea. Methods: A cross-sectional study was performed using a self-report multiple choice questionnaire. The International Study of Asthma and Allergies in Childhood (ISAAC) and other measures were reviewed to develop the questionnaire. Data was collected from May 9th to November 30th of 2018. Descriptive and frequency analyses were performed to apprehend the prevalence of symptoms, diagnostic rates, diagnosis dates, treatment history, and others. Results: By randomized sampling, 9,102 children from 25 nurseries, 25 kindergartens, and 15 elementary schools participated in the study. The prevalence of asthma, AR, AD, AC, FA, and DA were 11.1%, 48.7%, 15.5%, 17.6%, 15.1%, and 2.0%, respectively. The respective rate of ever being diagnosed with asthma, AR, AD, AC, FA, and DA were 4.2%, 38.4%, 25.5%, 23.3%, 9.7%, and 1.1%, respectively. Last year's allergy related school absenteeism rates were 10.8%, 4.1%, and 1.3% for asthma, AR, and AD, respectively. Lastly, 59.2% of the participants considered air pollution as the most challenging factor in allergy management. Conclusion: This study comprehensively investigated the current state of various allergic diseases in Nam-gu, Ulsan. The study's findings are expected to be applied to strategies for decreasing the socioeconomic burden of allergic diseases.

Current Status and Food Allergy Related-Dietary Behaviors of Atopy and Asthma-Friendly Elementary School Students in the Chungnam Area (충남 지역 아토피 안심 초등학교 학생들의 식품알레르기 및 식생활 현황)

  • Jeong, Kyung Jin;Ly, Sun Yung
    • Korean Journal of Human Ecology
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    • v.24 no.1
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    • pp.123-135
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    • 2015
  • In order to examine allergic disease experience rates of students at atopy and asthma friendly elementary schools located in Chungcheongnam-do and investigate their dietary behaviors, a survey on 250 parents of first to third grade students at four rural-type atopy and asthma friendly elementary schools was conducted. The number of students who had experienced allergic symptoms (allergic group) was 102 (40.8%). their breastfeeding duration was shorter than that of the non-allergic group (p<.001) and the former's weaning foods-feeding had started earlier than the latter's (p<.01). Regarding the eating habits, the non-allergic group was found to have breakfast and dinner better than the allergic group (p<.001). The number of students eating fruits as snacks was largest in the allergic group at 73 (71.6%), and as for the non-allergic group, their rate of eating fruits, milk and dairy products, and cookies and fries was at 25.7%, 22.3%, and 20.3%, respectively. A high percentage of the allergic group ate three times or less per month the animal food groups and dairy products (p<.001). Accordingly, for improvement in dietary behaviors of students who have allergy against food, nutrition education on regular eating, balanced intake of food, adequate intake of snacks and meals for proper growth and development and precise diagnosis of allergy-triggering food are necessary. In particular, as education on food allergy, implementation of practical education such as appropriate nutrition counseling by nutrition teachers is urgent beyond the one-way educational method of school newsletters.

Phenotypes and endotypes of severe asthma in children

  • Yoo, Young
    • Clinical and Experimental Pediatrics
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    • v.56 no.5
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    • pp.191-195
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    • 2013
  • Severe childhood asthma is a complicated and heterogeneous disorder with distinct phenotypes. Children with severe asthma have more persistent symptoms despite receiving treatment, more atopy, greater airway obstruction, and more air trapping than those with mild-to-moderate asthma. They also have higher morbidity and substantial airflow limitations that persist throughout adulthood. Identification of the phenotype clusters and endotypes of severe asthma can allow further modulation of the natural history of severe asthma and may provide the pathophysiologic rationale for appropriate management strategies.

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.

Assessment of the Environmental Conditions in Patient's Houses with Allergy by Use of a Fungal Index - A Case Study (곰팡이 센서(Fungal detector)를 이용한 알러지 환자 가정의 실내 환경 평가 - 사례연구)

  • Lee, Jun-Hyup;Kim, Young-Hwan;Moon, Kyong-Whan
    • Journal of Environmental Health Sciences
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    • v.36 no.1
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    • pp.27-32
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    • 2010
  • The indoor environmental condition was assessed in houses with allergy (asthma and atopy) patients by use of a fungal detector. The fungal index was calculated from the growth rate of the sensor fungi in a fungal detector encapsulating the spores, Alternaria alternata S-78, Eurotium herbariorum J-183 and Aspergillus penicillioides K-712. Fungal indices were higher in asthma patient's houses than in control houses and Eurotium herbariorum showed the highest growth response among the sensor fungi. Dust mites allergen, Der f1, was also significantly high in allergy patient's houses where fungal indices above 10 were detected. A correlation was observed between the fungal indices and dust mite allergen proliferations in examined houses. Therefore, the fungal index can be a useful tool as an indirect indication for detecting chronic dampness that brings both contaminations by fungi and dust mite.