• Clinical and Experimental Pediatrics
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• v.63 no.7
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• pp.278-283
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• 2020

Background: Major questions remain regarding the agestratified trends of allergic diseases and asthma in Korea. Purpose: To identify the estimated recent prevalence and 10-year trends in asthma, allergic rhinitis, and atopic dermatitis among the Korean population from 2008 to 2017. Methods: This nationwide cross-sectional survey (Korean National Health and Nutrition Examination Survey) over 10 years (2008-2017) examined representative samples of the Korean population (n=85,006) including 2,131 infants, 4,352 preschool children, 12,919 school-age children, 44,200 adults, and 21,404 elderly adults. Results: In the 2016 to 2017 population, the estimated prevalence of asthma was 0.9% in infants, 2.3% in preschool children, 4.1% in school-age children, 2.3% in adults, and 4.1% in the elderly. The estimated prevalence of allergic rhinitis was 9.0%, 20.2%, 27.6%, 17.1%, and 6.9%, respectively. The estimated prevalence of atopic dermatitis was 5.9%, 11.3%, 14.6%, 3.9%, and 1.6%, respectively. Ten-year trends revealed a significant decrease in asthma prevalence in infants, preschool children, and the elderly. and in atopic dermatitis prevalence in infants and preschool children (P<0.05 for all trends). Furthermore, 10-year trends demonstrated a significant increase in allergic rhinitis prevalence in school-age children, adults, and the elderly, and in atopic dermatitis prevalence in school-age children and the elderly (P<0.05 for all trends). Conclusion: These results improve our understanding of the age-stratified epidemiology of allergic diseases in Korea and suggest the need for the development of tailored and precise strategies to prevent allergic diseases in different age groups.

• Kosin Medical Journal
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• v.33 no.2
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• pp.171-180
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• 2018

Objectives: We investigated whether asthma attacks in asthmatic children were caused by short-term exposure to particulate $matter(PM)_{2.5}$. Methods: Subjects were 411 patients who received inhalation therapy in National Fukuoka Hospital, from March to May 2013. All subjects were outpatients. We surveyed the air quality measurement results in the stations closest to the address of the patients. Data were used from the City of Fukuoka website data on air pollution. We carried out a case-crossover study and compared $PM_{2.5}$ concentration between 7 days after asthma attack occurred and the day asthma attack occurred and 1, 2 and 3 days before asthma attack occurred. Results: Highest hourly concentration of the day (OR 1.013, 95%CI 1.000-1.025) showed a significant association with 1 day before $PM_{2.5}$ concentration statistically. And 0-1 year-old infants were more vulnerable to the highest concentration of 1 day before $PM_{2.5}$ concentration(P < 0.05). Average concentration of $NO_2$ and $O_3$ and asthma attack also showed a significant association. Conclusions: Maximal daily $PM_{2.5}$ concentrations within 24 hours prior to the attack affect asthma exacerbation. 0-1 year-old infants are particularly vulnerable to $PM_{2.5}$ concentration. Asthma exacerbation is aggravated by $NO_2$ and $O_3$ concentration on the day of the asthma attack.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.763-768
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• 2006

Purpose : We investigated the risk of aspiration using the lipid-laden macrophage index(LLMI) from laryngeal lavages in infants with bronchiolitis. Methods : Laryngeal lavages from 22 infants with acute bronchiolitis caused by respiratory syncytial virus(RSV) were evaluated during the acute stage. Repeat studies were performed at 3 to 4 weeks after the initial study(remission stage). Lavage cell counts and differentials were determined. The amount of lipid per single macrophage was evaluated and the LLMI was determined by evaluating 100 cells. Comparisons between acute stage and remission stage were made. Twenty-four hour pH monitoring(pHm) was performed in 12 patients. Results : The total cell number was significantly higher in the acute stage compared with the remission stage(P<0.05). The LLMIs in the acute stage were significantly higher than those in the remission stage(P<0.05). The neutrophils percentage of laryngeal lavage correlated with the LLMI(r=0.69, P<0.001). Four children had positive pHm recordings(pH-positive infants) and eight had negative pHm recordings(pH-negative infants). The pH-positive infants had higher LLMI and higher neutrophils percentage than those of the pH-negative infants(P<0.05). Conclusion : These findings suggest that there is a transient increased risk of aspiration during bronchiolitis. The LLMI from laryngeal lavage may be a useful marker for pulmonary aspiration in infants with bronchiolitis.

• Journal of the Korean Data and Information Science Society
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• v.24 no.4
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• pp.679-688
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• 2013

This study figured out the influential factors of region-based characteristic factors in our country upon asthmatic occurrence. Research subjects were 2,266,451 people who were confirmed the diagnosis of asthma (J45~J46) among patients in national health insurance for the year in 2010. The influence in each of factors upon the asthmatic occurrence was analyzed through hierarchical regression after comparing difference in asthmatic occurrence by basic local government. As a result of hierarchical regression, the whole asthmatic occurrence had significant difference in infants ratio, $SO_2$,Temperature, basin and dam area. The asthmatic occurrence had significant difference in subjective awareness of health level, $SO_2$, basin and dam area. A case of asthmatic occurrence had significant difference in infants ratio, temperature, $NO_2$ and coastal area. Diverse characteristic factors by region were indicated to have influence upon the asthmatic occurrence by causing or weakening asthma through mutually complex action. Accordingly, a region-based customized environmental health measure will need to be arranged that infants and elderly people, who are vulnerable classes, can be protected and prevented from harmful environment of asthma.

• Clinical and Experimental Pediatrics
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• v.55 no.9
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• pp.309-315
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• 2012

Human respiratory syncytial virus (HRSV) is a major cause of severe respiratory tract illnesses in infants and young children worldwide. Despite its importance as a respiratory pathogen, there is currently no licensed vaccine for HRSV. Following failure of the initial trial of formalin-inactivated virus particle vaccine, continuous efforts have been made for the development of safe and efficacious vaccines against HRSV. However, several obstacles persist that delay the development of HRSV vaccine, such as the immature immune system of newborn infants and the possible Th2-biased immune responses leading to subsequent vaccine-enhanced diseases. Many HRSV vaccine strategies are currently being developed and evaluated, including live-attenuated viruses, subunit-based, and vector-based candidates. In this review, the current HRSV vaccines are overviewed and the safety issues regarding asthma and vaccine-induced pathology are discussed.

• 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.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.2
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• pp.10-22
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• 2016

Objectives This study is to analyze current guidelines for health check-ups in infants and children, and to develop better guidelines based on oriental medicine. Methods We analyzed The Manual of 2015's Health Examination for Infants and Children which is a Korean Developmental Screening Test for Infants and Children (K-DST). The statistics from the test was collected from 2010 to 2014 to figure out the problems of Health Examinations for Infants and Children. 20 articles from 2000 to 2014 from RISS, NDSL were also analyzed. Results The current guidelines for health examinations in infants and children didn't include major pediatric diseases such as allergy and asthma. Also, the pediatrics health education materials were mainly focused on hypernutrition but not so much on nutrition deficiency. The number of the centers for Health Examinations for Infants and Children was 52.2% of the number of NIP-Participating medical institutions for infants and children. Conclusions Oriental medicine can be useful to prevent major pediatric diseases and to promote general health in pediatrics. By legislating 'Geon-a-beop', which is a law for infants and children, we can increase the number of medical centers for infants and children to get health check-ups. Currently, there are 9,769 Korean medical institutions, and the rate of traditional medical doctors of public health doctors was 25.5%. Weak Children Questionnaire is developed, considered to be more useful when it is developed with 5-point scale rather than 2.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.2
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• pp.561-566
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• 2007

After researching on infantile diseases in Hyungsang medicine, the writer got the conclusions as follows. The infants who are excess of the Yang energy need to nourish the Eum- blood. The main causes of the infantile disorders are congenital defect and malfunction of internal organs by nature, as results of these they suffer from mental disorders or being undergrown. And after birth they get ill from internal injury or external affections, mainly epilepsy by retention of undigested food, fever, cough, asthma, nasal obstruction, dermatopathia, and affection by cold, etc. In Hyungsang medicine Dam-body is apt to get ill from deficiency of Eum-blood and bangkwang-body from deficiency of Yang-energy. And infants are hare to be moderate in food, so they become to diseases of the Spleen and stomach, especially infants with Yangmyung type get to epilepsy, cough, skin disorders, and obese for the reasonof overeating. Among main infantile symptoms congenital defects, infantile mental disorders, and convulsive diseases come from congenital defect and malfunciton of internal organs, so it must be treated the symptoms following the reasons. Above all infantile mental disorders are treated not to separate the spirit from the body. And fever, cough and asthma, affection by cold, skin diseases, poor appetite, and obese come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach. In order to prevent from infantile diseases right antenatal training, taking medicine rightly, exercise and eating good habits are needed to give guidance. Seeing through the clinical cases in Hyungsang medicine, we come to know that the infantile mental disorders come out primarily for the reasons of the congenital defect, and the infantile epilepsy come from malfunction of internal organs, and the nasal obstruction and skin diseases come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.230-235
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• 2003

Purpose : Lower respiratory tract infections in infant and young children are often due to a virus, especially the Respiratory syncytial(RS) virus. Chest X-ray findings in bronchiolitis and bronchopneumonia are different. The radiographic hallmark of bronchiolitis is pulmonary hyperinflation and similar to that of bronchial asthma. Bronchiolitis is predisposed to later development of bronchial asthma. To evaluate the difference of immuno-pathophysiology between bronchiolitis and bronchopneumonia, we measured $IFN-{\gamma}$(Th1 cytokine), IL-5(Th2 cytokine) and ECP. We also investigated whether X-ray findings in infants with viral infected respiratory disease are useful in predicting the development of asthma. Methods : We measured IL-5, ECP, $IFN-{\gamma}$ levels in serum from 21 infants with bronchiolitis and 21 infants with bronchopneumonia and 16 infants without pulmonary viral diseases. Results : IL-5 levels of bronchiolitis and bronchopneumonia were significantly higher than those of the control(P=0.02, P=0.042). IL-5 levels of bronchiolitis were higher than those of bronchopneumonia but there was no significant difference. $IFN-{\gamma}$ levels of bronchopneumonia were higher than those of bronchiolitis but there was no significant difference. ECP levels of bronchiolitis and bronchopneumonia were higher than those of the control but only those of bronchiolitis were significantly higher than those of the control(P=0.045). IL-5 and ECP levels did not show any significant correlation in bronchiolitis, bronchopneumonia and control groups. Conclusion : We cannot prove the distinct differences in serum Th1/Th2 cytokine profiles between bronchiolitis and bronchopneumonia in infants. These results suggest that the different findings on chest X-ray between bronchiolitis and bronchopneumonia could not be a predictor of later development of asthma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.1-6
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• 2008

Previous infant feeding guidelines recommended a delayed introduction of solids to beyond 6 months of age to prevent atopic diseases. However, scientific evidence supporting a delayed introduction of solids for prevention of atopic diseases is scarce and inconsistent. Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation in the prevention of atopic disease. In studies of infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein decreases the incidence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. For infants at high risk of developing atopic disease who are not breastfed exclusively for 4 to 6 months, there is modest evidence that atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cow milk formula, in early childhood. There is no convincing evidence that a delayed introduction of solid foods beyond 4 to 6 months of age prevents the development of atopic disease. For infants after 4 to 6 months of age, there are insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.