• YAKHAK HOEJI
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• v.47 no.4
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• Journal of Environmental Health Sciences
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• v.26 no.2
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• pp.80-90
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• 2000

To determine the effect of air pollutants in Taejon City, we used medical insurance claim data for asthma and the data monitored from telemetry system of Ministry of Environment for air pollutants and meteorological factors. From November 1st, 1997 to October 31th, 1998, 95,629 asthma patients were covered by medical insurance at Taejon City. Subjects were composed of 49,563 males (51.8%) and 46.336 females(48.2%), and among the subjects, the proportion under 15 years old was 62.8% of the total. During the study period, daily mean concentrations of each air pollutants-So2, No2, CO, O3 and TSP-were 9.8 ppb, 17.6 ppm, 1.414 pp, 17.3 ppb and 60.6 $\mu\textrm{g}$/㎥, respectively, which were lower than each of the environmental recommended exposure levels, Through the simple correlation analysis between each air pollutants and meteorological factors, O3 was positively correlated with temperature, but negatively with relative humidity. TSP, SO2, NO2, CO were negatively correlated with meteorological factors, and these air pollutants except O3 were positively correlated with each other, O3 was correlated with TSP positively but the others negatively. Estimating relative risks of each air pollutant with the baseline general additive model, daily mean concentrations of TSP(Lag 0, 1, 4, 5day) were significantly associated with the increase of the asthma admission. Two age subgroups, under 15 and 15~54 have shown various association of all air pollutants concentration with the asthma admission. However, in case of over 54 age subgroup, only TSP(Lag 0 day) among all air pollutants was associated with the asthma admission. Each of ambient outdoor pollutant concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations were much lower than the environmental recommended exposure levels. Therefore, continuous effort lowering air pollutant concentration and introducing an active environmental conservation policy should be implanted for preventing hazardous health effects. Considering major proportion of asthma admissions, high susceptibility and less confounding factors among the age subgroup under 15 will be a useful target population for assessing such health effect monitoring.

• Proceedings of the Korea Contents Association Conference
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• 2018.05a
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• pp.409-410
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• 2018

Background: Asthma is one of the most common chronic diseases and can be affected by environmental factors. It has been reported that exposure to indoor environmental factors can cause infantile asthma during infancy and childhood, but the previous studies are not yet clear. Climate change has recently been shown to increase indoor mold. Exposure to fungi is known to be directly related to the development of aggravation. Methods: This study was conducted from July 20, 2016 to September 30, 2016. The study was conducted on 90 household with children under the age of 7 who attend atopy school. The questionnaire surveyed allergic symptoms, social and demographic characteristics, and environmental characteristics. Environmentally hazardous substances were measured such as temperature, humidity, fine dust, volatile organic compounds, formaldehyde, bacteria, fungus, house dust mite, endotoxin. Results: According to the survey results, 9 patients (10%) were treated with asthma, 6 (6.7%) were asthmatic patients during the past 12 months, and 4 patients (4.4%) were asthmatic patients during the past 12 months. There were statistically significant differences in the direct effect of smokers in the family (P=0.0328). High-filter vacuum cleaners collected $0.4222CFU/m^3$ in subjects without asthma, and $0.2222CFU/m^3$ in subjects with asthma. In addition, various results confirmed that asthma exacerbated by mold exposure. Conclusions: The results of this study suggest that exposure to fungal by infants and toddlers may play an important role in the development of asthma. In this study, we investigated the relationship between asthma and fungal concentration.

• Allergy, Asthma & Immunology Research
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• v.10 no.6
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• pp.686-697
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• 2018

Purpose: Several markers for eosinophilic inflammation have been proposed to predict response to asthma treatment. However, definitive criteria for treatment decisions have not yet been established. We investigate a potentially useful relatively non-invasive biomarker, eosinophil-derived neurotoxin (EDN), to predict favorable responses to budesonide or montelukast, common treatment for children with asthma. Methods: Young children (1 to 6 years old) were enrolled in this randomized, parallel, 2-group, open-label trial. Criteria for eligibility included: 1) being symptomatic during the run-in period; and 2) having a serum EDN (sEDN) level ${\geq}53ng/mL$, with positive specific immunoglobulin E to house dust mite. Eligible patients were randomly placed into 2 groups: the BIS group received budesonide inhalation suspension (BIS) 0.5 mg once daily; the MONT group received montelukast 4 mg once daily. Ineligible patients were invited to receive montelukast 4 mg once daily (OBS group). Treatment period was 12 weeks. Results: Asthma control days increased significantly in the BIS and MONT groups (P < 0.000) over the 12-week study period. There was no significant change in sEDN in the BIS group but there was a significant decrease in the MONT group (P < 0.000). Patients in the OBS group with high EDN levels (> 53 ng/mL) showed a significant decrease due to MONT treatment (P = 0.023). Rescue medication usage significantly decreased in the BIS and MONT groups (P < 0.000). Conclusions: EDN is a useful relatively non-invasive biomarker for predicting responses to montelukast and budesonide treatment of preschool children with beta2-agonist responsive recurrent wheeze and multiple-trigger wheeze (Trial registry at UMIN Clinical Trials Registry, UMIN000008335).

• BMB Reports
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• v.38 no.1
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• pp.77-81
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• 2005

The monocyte chemotactic protein-3 (MCP3), on chromosome 17q11.2-q12, is a secreted chemokine, which attracts macrophages during inflammation and metastasis. In an effort to discover additional polymorphism(s) in genes whose variant(s) have been implicated in asthma, we scrutinized the genetic polymorphisms in MCP3 to evaluate it as a potential candidate gene for asthma host genetic study. By direct DNA sequencing in twenty-four individuals, we identified four sequence variants within the 3 kb full genome including 1,000bp promoter region of MCP3; one in promoter region (-420T>C), three in intron (+136C>G, +563C>T, +984G>A) respectively. The frequencies of those four SNPs were 0.020 (-420T>C), 0.038 (+136C>G), 0.080 (+563C>T), 0.035 (+984G>A), respectively, in Korean population (n = 598). Haplotypes, their frequencies and linkage disequilibrium coefficients (|D'|) between SNP pairs were estimated. The associations with the risk of asthma, skin-test reactivity and total serum IgE levels were analyzed. Using statistical analyses for association of MCP3 polymorphisms with asthma development and asthma-related phenotypes, no significant signals were detected. In conclusion, we identified four genetic polymorphisms in the important MCP3 gene, but no significant associations of MCP3 variants with asthma phenotypes were detected. MCP3 variation/haplotype information identified in this study will provide valuable information for future association studies of other allergic diseases.

• Journal of Korean Society for Atmospheric Environment
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• v.17 no.5
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• pp.425-437
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• 2001

This study is based on the uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies between air pollutants exposure and childhood asthma. Studies for this meta-analysis were conducted by reviewing previous results and by asking researcher active in this field for recommendations. Overall, 10 cases of air pollutants exposures and childhood asthma were reviewed. A variety of statistical methods for meta-analysis have been used to assess the combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on air environmental epidemiologic studies are reported for (1) aggravation of childhood asthma by a 50 ppb increase SO$_2$(6 individual studies); (2) aggravation of childhood asthma by a 50 ppb increase NO$_2$(5 individual studies); (3) aggravation of childhood asthma by a 50 ppb increase $O_3$(7 individual studies); (4) aggravation of childhood asthma by a 10$\mu\textrm{g}$/m$^3$increase PM$_{10}$ (4 individual studies); (5) aggravation of childhood asthma by a 1 ppm increase CO (2 individual studies); and (6) comparison of results between a Korean study results and this meta-analytic study. Results of this study indicated that an inverse-variance weighted pooling of the hospital admission risk at a 1ppm increment of CO levels was 1.12% (95% CI : 1.01 ~ 1.24). The hospital admission risk was estimated to increase 5% (95% CI : 1.02~1.08), 6%(95% CI : 1.04~1.09), and 5% (95% CI : 1.02~1.09) with each 50ppb increase of SO$_2$, NO$_2$, and $O_3$, respectively. In addition, our results lead to a small but significant elevation in risk of 2% (RR = 1.02, 95% CI = 1.01~1.04) with each 10$\mu\textrm{g}$/m$^3$increase of PM$_{10}$ among 4 individual studies. We found a small elevation in risk of childhood asthma, and pooled results of 10 epidemiologic studies of childhood asthma using increase a cut-off-point levels of air pollutants showed a few pieces of evidence. The results of this meta-analysis suggested that air pollution associated with an increased incidence of childhood asthma. According to this study, relationship between exposure to air pollutants and childhood asthma in Korea seem to be high than results of this meta-analysis.sis.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.428-436
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• 1997

Objectives : The purpose of this paper is to estimate the completeness of the Korean Medical Insurance Data in childhood asthma. Methods : Capture-recapture method was used to estimate the prevalence of childhood asthma and case ascertainment rate(completeness) of Korean Medical Insurance Data using two source model, 'Korean Medical Insurance Committee Data (KMICD)' and 'Nationwide Study of Asthma and Allergies in Korean Children'. The asthma cases were restricted to those who were born from 1981 to 1989 and were identified by their Resident Register Number. Asthma cases in Korean Medical Insurance Data were defined as cases coded by ICD-9 493 and ICD-10 J45. In 'Nationwide Study of Asthma and Allergies in Korean Children', asthma cases were defined as the children who had been diagnosed asthma and had experienced symptoms of asthma during the past 12 months. The defined cases in two data sources were matched by 13 digits Resident Register Number. The numbers of matched patients in two data sources were 245 of 32,825 eligible total subjects. Chapman and Wittes' nearly unbiased estimation was used for capture-recapture analysis of two data sources. Results : Observed prevalence rate of childhood asthma was 5.3% and estimated prevalence rate by capture-recapture analysis was 11.6%. The highest prevalence rate was observed in 6-7 age group and the older the rate decreased. The completeness (the proportion of cases ascertained by KMICD to the total observed cases by two data sources) was 20.6%, and ranged form 10.8% to 28.8% by area. Conclusions : Invalid diagnosis of cases might overestimate the prevalence of child-hood asthma and might underestimate the completeness of Korean Medical Insurance Committee Data in this study.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.5
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• pp.1159-1165
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• 2006

This study was done to investigate the effects of Gamisojaganggi-tang(GSGT) on immunopathologic changes in OVA-induced asthma model of mice. Pathologic indicators associated with this immune disease, which include cytokines, the number of immune-cells, immunoglobin E (IgE), were examined, and histological changes of bronchial tissues were also examined. The administration of GSGT significantly reduced the lung weight compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the number of total cells in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the number of eosinophil in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT insignificantly increased the number of monocyte in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the number of lymphocyte in BAL compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the gene expression of eotaxin in lung tissue compared with control mice of OVA-induced asthma model. The administration of GSGT insignificantly reduced the IL-4 and IL-5 production in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT insignificantly reduced the levels of total IgE and ovalbumin-specific IgE in BALF. The administration of GSGT significantly reduced the levels of ovalbumin-specific IgE whereas the serum levels of total IgE were insignificantly reduced compared with control mice of OVA-induced asthma model. The administration of GSGT moderately reduced bronchial alveolar narrowing, bronchiovascular edema and increase in the size of alveolar space, which shown in control mice of OVA-induced asthma model, in a dose dependent manner. Furthermore, GSGT reduced invasion of inflammatory cells, and proliferation of smooth muscle cells in bronchial tissue. These results suggested that GSGT has suppressive effects on pathologic changes associated with disease progression in asthma through the modulation of immune system. GSGT has potential to use as an anti-asthmatic agents.

• Journal of Life Science
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• v.17 no.3 s.83
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• pp.396-401
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• 2007

This research investigated whether exposure of diesel exhaust particulate (DEP) and particulate metter (PM) effect on intercellular. adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression in asthma-induced Balb/c and IL-10 knock out (KO) mouse. Mouse was sensitized with intraperitoneal injection with ovalbumin, followed by challenges with intranasal ovalbumin. After induction of asthma mouse placed in the inhalation chamber and exposed to DEP and PM (10 $mg/m^3$). The evidences of pulmonary inflammation were assessed by immunohistochemical stain and westen blot against ICAM-1 and VCAM-1 in the lung tissue. In the immunohistochemical stain, positive reactions for ICAM-1 and VCAM-1 were much stronger in asthma-induced groups and asthma-induced group with DEP or PM than control groups. Although mild positive reactions were appeared in asthma-induced IL-10 KO mice groups, positive reactions were very strong in the asthma-induced group with DEP or PM. In Western blot, expression of VCAM-1 was increased in asthma-induced group with DEP or PM than asthma-induced groups. In the IL-10 KO mouse, ICAM-1 and VCAM-1 expression were increased in asthma-induced group with DEP or PM than asthma-induced groups. DEP and PM exposure have additive effects on the aggravation of inflammatory signs in the asthma-induced murine model. These results suggest that inhalation of DEP and PM in asthmatic patients may aggravate clinical symptoms.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.3
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• pp.249-256
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• 2021

Asthma is a chronic inflammatory airway disease. There are many factors including genetic and environmental factors that influence asthma. The mitogen-activated protein kinase (MAPK) pathway is involved in maintaining the T helper cells 1 and 2 (Th1/Th2) balance and plays an important role in the development of asthma. In this study, the correlation between the NDFIP2 gene that regulates the MAPK pathway and asthma was analyzed. The genetic polymorphism of the NDFIP2 gene was analyzed between 193 asthma patients and 3,228 healthy controls in Korea. As a result, 4 single nucleotide polymorphisms (SNPs) showed a significant correlation (P<0.05) and high relative risk with asthma. Among them, rs2783122 of NDFIP2 showed a statistically significant association with asthma (P-value=9.76×10^-6, odds ratio (OR)=1.67, 95% confidence interval (CI)=1.33~2.10). In the SNP imputation on the NDFIP2, 16 SNPs were discovered, and all of them showed significant correlation with asthma and high odds ratio. The genotype-based mRNA expression analysis revealed that the group of minor alleles of rs1408049 showed increased mRNA expression. Increased NDFIP2 expression causes the activation of the MAPK pathway, and this may influence the development of asthma. In conclusion, the polymorphisms of NDFIP2 are associated with asthma development and this can provide the basis for new guidelines for the management of asthma in the Korean population.