• The Journal of Internal Korean Medicine
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• v.38 no.6
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• pp.955-970
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• 2017

Objectives: The aim of this observational study was to identify and analyze the patterns to compare the characteristics of asthma patients. Methods: The subjects were 40 asthma patients who had satisfied the inclusion and exclusion criteria. They were divided into deficiency syndrome and excess syndrome groups, and cold syndrome and heat syndrome groups. Their quality of life was measured by the quality of life questionnaire for adult Korean asthmatics (QLQAKA) and VAS. Heart rate variability (HRV) was measured, and the degree of obesity was evaluated by body mass index (BMI). Hematological, biochemical, and immunoglobulin (Ig) E laboratory tests were included. Results: Based on pattern identification, the 40 asthma patients could be divided into two categories of groups: 1) the deficiency syndrome (N=18) and the excess syndrome (N=22) groups: 2) the cold syndrome (N=35) and the heat syndrome (N=5) groups. The mean value of HF differed significantly between the deficiency and excess syndrome groups. The mean value of IgE in blood tests of asthmatics was greater than four times the reference value. For BMI, the subjects were classified into three groups: normal weight (N=12), overweight (N=12), and obese (N=16). Conclusions: Development of a more accurate asthma-specific pattern identification tool could play a crucial role in asthma control. In addition, good control of asthma can improve the quality of life. Obesity is one of the factors associated with asthma exacerbation.

• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.80-87
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• 2018

Background: Asthma is a disease of chronic airway inflammation with heterogeneous features. Neutrophilic asthma is corticosteroid-insensitive asthma related to absence or suppression of $T_H2$ process and increased $T_H1$ and/or $T_H17$ process. Macrolides are immunomodulatory drug that reduce airway inflammation, but their role in asthma is not fully known. The purpose of this study was to evaluate the role of macrolides in neutrophilic asthma and compare their effects with those of corticosteroids. Methods: C57BL/6 female mice were sensitized with ovalbumin (OVA) and lipopolysaccharides (LPS). Clarithromycin (CAM) and/or dexamethasone (DXM) were administered at days 14, 15, 21, 22, and 23. At day 24, the mice were sacrificed. Results: Airway resistance in the OVA+LPS exposed mice was elevated but was more attenuated after treatment with CAM+DXM compared with the monotherapy group (p<0.05 and p<0.01). In bronchoalveolar lavage fluid study, total cells and neutrophil counts in OVA+LPS mice were elevated but decreased after CAM+DXM treatment. In hematoxylin and eosin stain, the CAM+DXM-treated group showed less inflammation additively than the monotherapy group. There was less total protein, interleukin 17 (IL-17), interferon ${\gamma}$, and tumor necrosis factor ${\alpha}$ in the CAM+DXM group than in the monotherapy group (p<0.001, p<0.05, and p<0.001). More histone deacetylase 2 (HDAC2) activity was recovered in the DXM and CAM+DXM challenged groups than in the control group (p<0.05). Conclusion: Decreased IL-17 and recovered relative HDAC2 activity correlated with airway resistance and inflammation in a neutrophilic asthma mouse model. This result suggests macrolides as a potential corticosteroid-sparing agent in neutrophilic asthma.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.