• 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.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.290-297
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• 1997

Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

• Journal of Acupuncture Research
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• v.24 no.5
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• pp.185-195
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• 2007

목적 : 부신피질 스테로이드약을 포함한 약물치료에도 조절되지 않았던 기관지천식 환자 6 증례에 대하여 침구치료를 행하여，연구방법의 하나인 조건반전법(N-of-1)을 이용하여 침치료의 효과를 검토하였다. 방법 : 연구디자인 : 조건반전법으로 침치료 기간(A기간)과 침치료 휴지기간(B기간)을 서로 반복하였다. A기간은 10주간으로 하고 1주간에 1회의 침치료를행하였다. 실시장소 : 메이지 침구대학부속병원 내과와 부속침구센터 대상 : 기관지천식의 표준적인 약물치료를 행하여도 천식발작이 충분히 개선되지 않았던 중등증에서 중증의 천식환자 6 증례를 대상으로 하였다. 평가 기관치천식에 대한 침치료의 효과를 아래의 항목을 이용하여 평가하였다. (1) 발작상태를 천식일지에 의해 평가 (2) 호흡곤란감을 VAS(Visual Analogue Scale)에 의해 평가 (3) 호흡기능검사 (4) 말초혈호산구수 (5) 스테로이드약의 투여량 (6) 중증도 효과 : A기간에 동시적으로 모든 예에서 천식발작과 호흡곤란감의 개선이 인정되었다. 한편 B기간에서는 6례 중 5례에서 천식발작의 재연이 확인되었다. 또한 천식발작의 개선에 수반하여 모든 예에서 중증도의 개선도 인정되었으며，6례 중 4례에서 스테로이드약의 감량이 가능하게 되었다. 결론 : 약물치료로 조절되지 않았던 기관지천식 환자에 대하여 침치료를 행한 결과, 환자의 천식발작, 자각증상, 호흡기능의 개선에 유효하였다고 생각된다.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.766-771
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• 2005

Purpose : Cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma; therefore interruption of cysteinyl leukotrienes by leukotriene receptor antagonists improves clinical symptoms in the management of patients with mild to moderate asthma. We evaluated whether clinical response to montelukast, a leukotriene receptor antagonist, in childhood asthma was predicted by genotypes of leukotriene $C_4$ synthase($LTC_4S$) promoter gene polymorphism. Methods : An 8-week prospective, open trial of montelukast was carried out in 161 children with mild to moderate asthma. Genotyping of $LTC_4S$ gene polymorphism was determined by restriction fragment length polymorphism. Results : The distribution of the $LTC_4S$ genotypes AA, AC, and CC was 70.8 percent, 23.6 percent, and 5.6 percent, respectively in asthma group and 74.0 percent, 22.6 percent, and 3.4 percent, respectively in control group. A statistically significant difference in the distribution of $LTC_4S$ genotype was not observed between the asthma and the control groups, and there was no significant difference between the $LTC_4S$ genotype and asthma severity. The responders to montelukast were significantly prevalent in the mild asthma group(P<0.05). There was no significant difference in the distribution of the responders compared to non-responders within genotype in the total asthma group or the moderate asthma group. However, the responsiveness for montelukast was significant difference within genotype for both AA and AC/CC in the mild asthma group : The AA genotype was more included in the responder group(P<0.05). Conclusion : In the mild persistent asthma group, the A allele of $LTC_4S$ polymorphism may be regarded as a predictable factor for clinical response to montelukast. However, LTC4S polymorphism was not significantly associated with the clinical response to montelukast in asthmatic children.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.35 no.3
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• pp.234-239
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• 2012

황사(Asian dust storm, ADS)란 중국이나 몽골 등 중앙아시아 지역의 사막 지대의 작은 모래나 황토 또는 먼지가 하늘에 떠다니다가 상층풍을 타고 멀리까지 날아가 떨어지는 현상을 말하며, 주로 봄철에 우리나라를 비롯한 동아시아 지역에 영향을 준다. 이와 같은 황사에 영향을 받는 지역에서는 거주민들의 건강에 부정적인 영향을 미치는 것으로 알려져 있다. 본 연구는 2005년도에서 2008년도까지 4년간 서울지역 거주민들 사이에서 황사현상이 천식질환에 미치는 영향을 분석하고자 한다. 이를 위해 황사발생일(기준일 또는 index day)과 기준일 대비 7일 전후(비교일 또는 comparison day) 황사가 발생하지 않은 날에 병의원에서 진료를 받은 천식환자 수를 황사예보의 정확도에 따라 비교 분석하였다. 그 결과 24시간 전 제공된 황사예보가 황사발생을 정확히 예측한 경우라 하더라도 비교일 대비 기준일의 천식환자 수가 여전히 더 많다는 사실을 알 수 있었다. 다만, 증가 정도는 통계적으로 유의한 수준은 아니었다는 점에서 정확한 황사예보가 최소한 어느 정도는 천식질환 발생을 저감시키는 효과는 분명히 가지고 있다고 판단할 수 있다. 반면에 24시간 전 황사예보가 황사발생을 정확하게 예측하지 못한 경우에는 비교일 대비 기준일에서 5~6일 후에 진료 받은 천식환자 수가 통계적으로 유의할 수준까지 높게 나타났다. 하지만, 기준일 및 기준일 다음 날의 경우에는 오히려 천식환자 수가 감소하는 경향을 보였다. 본 연구를 통해 황사예보 및 황사발생의 다양한 경우에 따라 천식환자 수의 일정한 변화패턴이 발견되었으며, 이와 같은 연구결과는 황사 관련 의료서비스 체계를 보다 효율적으로 설계하는데 활용될 수 있을 것으로 기대된다.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.182-189
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• 1996

Background : RANTES is associated with chemotaxis and activation of eosinophils. RANTES is up-regulated in allegic inflammation and play a critical role in the pathogenesis of allegic inflammation. Recently, circulating form of RANTES have been identified in the peripheral blood. Method : In the present study, we measured soluble RANTES levels in 17 patients with atopic brochial asthma (8 patients: early response to allegen challenge, 8 patients : early and late response to allergen challenge) on 30mins, 2hrs and 8 hrs after allergen challenge with house dust mite, prechallenge period. Result : RANTES levels in sera from patients with bronchial astma in prechallenge conditions were higher than in normal control subjects. But, RANTES levels in sera from patients with bronchial asthma in 30mins, 2hrs and 8hrs after challenge were no significantly higher than prechallenge conditions. Conclusion : These results suggest that RANTES plays a role in the pathogenesis of patients with atopic bronchial asthma and may be related to persistence of subclinical allergic inflammation.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.90-98
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• 1998

Background : The CD4+ T-helper cells comprise functionally distinct subsets of Th1 and Th2 cells that are distinguished on the basis of differential cytokines production Th1 cells secrete interferon-$\gamma$, lymphotoxin, interleukin-2. Th2 cells produce interleukin-4, interleukin-5, interleukin-10. A previous study shown that Th2 cells and their cytokines increased in patients with atopic asthma. We compared cytokines(IL-4, IFN-$\gamma$) activity and subpopulation of T-lymphocytes in peripheral blood from atopic asthmatics versus non-asthmatics. Method: Fifteen patients with atopic asthma(nine men, six women), twelve patients with chronic bronchitis(six men, six women), five healthy persons(three men, two women) were studied. Activity of IL-4, IFN-$\gamma$ and T-cell subpopulation in peripheral blood were estimated. Results: Patients had a median age of 55yr. The mean activity of IL-4 of asthmatics was significantly increased(control $0.75{\pm}1.1pmol/L$, atopic asthmatics $3.50{\pm}0.75pmol/L$, chronic bronchitis $2.01{\pm}1.2pmol/L$), but IFN-$\gamma$ was not significantly increased. In the T lymphocyte sunsets the percent of CD62L+ T-lymphoeytes of asthmatics was not significantly increased (control $16.7{\pm}16.4%$, atopic asthmatics $24.8{\pm}23.6%$, chronic bronchitis $17.0{\pm}16.9%$). Conclusion: In this study elevated production of IL-4 was observed in atopic asthmatics. CD62L+T-lymphoeytes was not increased in atopic asthma.

• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.587-590
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• 2009

천식환자의 폐활량 측정 및 관리는 정기적으로 검사되어 관리될 필요가 있는 매우 중요한 관리 항목이다. 본 연구는 천식환자의 폐활량을 정기적으로 관리할 수 있도록 PC-기반 폐활량기를 이용한 천식환자의 폐활량 측정 및 관리 시스템의 설계 및 구현에 관한 연구이다. 폐활량 검사는 크게 3종류 구성되며, 본 연구는 노력성 폐활량 검사(Forced Vital Capacity Test)를 1차적으로 설계 및 구현 방법을 제안하였다. FVC 검사의 목적은 폐질환의 진단, 중증도 그리고 치료효과 판정, 기관지 천식의 진단 및 관리, 수술시 마취방식의 결정 등으로 무엇보다 정확한 검사와 정기적인 검사를 필요로 하는 중요한 검사이다. FVC 검사는 검사과정에서 천식환자에게 많은 노력을 필요로 하는 힘든 검사로서 검사자의 도움이 필수적이므로 폐활량 검사 프로그램 개발에 있어 고려되어 알고리즘이 효율적으로 개발되어야 한다. 본 시스템은 휴대형 폐활량기(Spirometer)를 PC에 연결하고, 폐활량을 측정할 수 있도록 구성되었고, 검사 내용은 PC의 DB에 저장하고, 추후에 정기적으로 서버의 DB로 전송함으로서 보다 더 폭넓은 관리를 가능하도록 하며 천식환자는 서버가 제공하는 웹 사이트를 이용함으로서 자신의 건강관리를 가능하도록 구성된다. FVC 검사 프로그램은 정확한 검사와 편리한 사용자 인터페이스를 제공하도록 설계 및 구현하였고 따라서 자체 개발된 폐활량기를 PC-기반 프로그램으로 제어 가능함으로서 추후 다양한 임상실험의 데이터 확보, 기능의 확장과 성능의 개선을 할 수 있고, 좀 더 편리하고, 정확한 폐활량측정이 가능 할 것이다.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.464-470
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• 2000

Background : The recognition of bronchial asthma as an inflammatory disease led to the search for soluble markers that would be useful in assessing airway inflammation. Interleukin-6 (IL-6) is a representative proinflammatory cytokine that has been shown to be connected with various inflammatory diseases. IL-6 acts via specific receptors that consist of the IL-6 binding glycoprotein gp80 and the signal transducer gp130. In the search for markers of airway inflammation, delete the role of soluble interleukin-6 receptor (sIL-6R) and IL-6 in acute asthma were investigated. Methods : Serum levels of sIL-6R and IL-6 were measured in 78 acute asthmatics, in 15 patients with asymptomatic asthma and in 10 healthy control subjects by a specific ELISA using a murine antihuman IL-6R, IL-6 mAb ($Quantikine^{(R)}sIL$-6R, IL-6). Results : Serum levels of IL-6 in acute asthmatics significantly exceeded those of control subjects. The levels of sIL-6R in acute asthmatics were also significantly increased compared to those of control subjects. The serum concentrations of IL-6 obtained in acute asthmatics were elevated compared with those in asymptomatic asthmatics. However, association between eosinophilic count/IgE and IL-6/sIL-6R in acute asthma could not be found. Conclusion : Our results suggest that IL-6 may be involved in the pathogenesis of acute asthma, and serum levels of IL-6 and sIL-6R may reflect the severity of airway inflammation.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.77-89
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• 1998

Background: Genetic and environmental factors are known to affect the incidence and severity of asthma. Stimulation of $\beta_2$-Adrenergic Receptor ($\beta_2$AR) results in smooth muscle relaxation, leading to decrease in resistance of airflow. The gene encoding the $\beta_2$AR has recently been seguenced. The $\beta_2$AR genotype at the polymorphic loci of codons 16, 27, 34, and 164 was known to cause changes in the amino acids. The relationships between the structure of the $\beta_2$AR and its functions are being elucidated. Purpose : The gene encoding the $\beta_2$AR was carried out to assess the frequency of polymorphisms in bronchial asthma, to determine wheather these polymorphisms have any relation to the severity, or nocturnal symptoms in bronchial asthma. Methods: The subjects studied were 103 patients with bronchial asthma, which consisted of 30 mild episodic, 32 mild persistent, 17 moderate, and 24 severe asthma patients. The polymorphisms of the $\beta_2$AR gene were detected by mutated allele specific amplification (MASA) method at the codons 16,27,34, and 164. Results: The most frequent polymorphism was arginine 16 to glycine. The other two polymorphisms, valine 34 to methionine and glutamine 27 to glutamic acid occured in 11 and 6 patients respectively. The polymorphism of threonine 164 to isoleucine was not found in our enrolled patients. The homozygous polymorphism of $\beta_2$AR gene was found in only arginine 16 to glycine (12.6%). The heterozygous polymorphisms of $\beta_2$AR gene were in arginine 16 to glycine, valine 34 to methionine, and glutamine 27 to glutamic acid, as 65.1 %,10.7%, and 5.8% respectively in asthma patients. The presence of agrginine 16 to glycine heterozygous or/and homozygous polymorphism was associated in severe asthma (p=0.015), but there was no association between the other three polymorphisms and the severity of asthma. The frequency of the $\beta_2$AR gene polymorphisms was no relation in nocturnal asthma as compared with non-nocturnal asthma. Conclusion: The arginine 16 to glycine polymorphism of the $\beta_2$AR gene is the most frequently found in asthma patients and association with severe asthma. But there was no association between the polymorphism of the $\beta_2$AR gene and nocturnal asthma.