• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.11
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• pp.616-628
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• 2016

The purpose of this study was to examine symptom experiences, sleep quality, and quality of life in asthma patients and investigate any correlation among these factors. The study was conducted on 146 asthma patients that visited the Internal Medicine Department of Allergies at a hospital in Korea from March to June, 2015. Tools that were originally developed by Oh (1999) were used to measure the symptom experience of asthma patients. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) while quality of life was measured by the Short Form 36-Items Heath Survey (SF-36). The dates were analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using the SPSS 20.0 program. Symptom experiences of asthma patients showed a positive relation with sleep quality (r=.468, p<.001) and negative relationship with quality of life; PCS (r=-495, p<.001) and MCS (r=-.411, p<.001). The symptom experiences of an asthma patient along with sleep quality and quality of life turned out to be correlated. Therefore, this study is expected to be utilized as a basis for the development of assessment tools and arbitration programs to elucidate symptom experiences of asthma patients from various aspects and enhance their sleep quality and quality of life.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.18-29
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• 2000

호흡기 바이러스 감염은 모든 연령층의 천식에 상당한 영향을 미치는 데 영아에서 RSV는 천명을 야기하고 대부분 일시적이나 재발성 일수도 있다. 어릴 때 바이러스 감염은 면역체계 형성에 영향를 미쳐 알러지와 천식의 위험을 완하할 수있다고 한다. 또한 소아와 성인 천식에서 RV같은 감기 바이러스는 천식의 급성 증상을 유발한다. 호흡기 바이러스 감염에 대한 면역반응이, 기관지로 부터 바이러스 제거 기능외에 기도수축과 호흡기 증상에 관여한다고 한다. 이러한 변화가 일어나는 기전은 호흡기 바이러스가 proinflammatory 사이토카인과 매개체 생성을 유도하는 능력과 연관성이 있는 것 같고 이들이 상하기도 호흡기 증상 및 기도반응 변화에 관여하는 것으로 생각된다. 호흡기 바이러스 감염에 대한 면역반응을 요약하면 바이러스 감염으로 상피세포, 내피세포, 과립백혈구가 활성화되며, 상피세포는 사이토카인, 키모카인, 매개체들을 분비하여 항 면역 반응를 주도하다. 이와 같은 상피세포와 다른 기관지 세포들의 조기 활성화로 내피 세포에 유착분자 표현을 증가시켜 백혈구 동원 증가 및 혈관 투과성을 증가시켜 부종과 분비물을 증가시킨다. 바이러스 또는 바이러스 유발 사이토카인에 의해 활성화된 과립 백혈구, 대식세포, T세포들도 기도염증 증가, 기도폐쇄를 야기하고 기도반응을 증가시킨다. 세포독성 임파구에 의한 바이러스 감염세포의 분해, TGF-$\beta$ IL-10 같은 사이토카인에 의해 부분적으로 염증억제, 기도 remoldeling에 의한 기도구조의 재생등이 바이러스 감염후 기관지 기능의 지속적 변화를 결정한다. 끝으로 천식환자에서 RV 감염의 병인에 관한 기본적 문제는 RV감염이 정상인에서는 경한 증상을 나타내는 데 천식환자에서는 왜 심한 임상증상을 나타내는지 아직 완전히 밝혀지지 않았다. 항 바이러스에 대한 면역반응이 천식환자에서 손상되었는지 또는 천식환자에서 RV감염에 의한 중증의 임상증상은 어떤 다른 세포가 관여하는지? 이들에 대한 답은 기도염증이 천식에서 어떻게 조절되는지 또한 바이러스 감염에 의한 악화된 증상을 어떻게 치료할 것인가에 대한 방향을 제시해줄 것이다.

• Journal of Digital Convergence
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• v.14 no.1
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• pp.437-443
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• 2016

Purpose of this study was to develop a self-care program for patients with asthma and test its effects on self-efficacy, compliance, Quality of Life. One group pretest and posttest design was used to test the effects of the intervention. Sixteen asthma patients were recruited conveniently from C university hospital. Date were collected from February 1st to Spring 30th, 2011. Self-care program was composed asthma related education and demonstration of usage of MID & PEFR. The data were analyzed using Wilcoxon signed Rank test by SPSS 18.0. There was a significant increased in self-efficacy(Z=-3.26, p=.001), compliance(Z=-3.52, p<.001), QOL(Z=-3.41, p=.001). Based on data, we recommened the refinement of the intervention in the following areas for future studies: duration, research design, sample size.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.529-535
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• 1998

Background: Interleukin-4 plays an important role in pathogenesis of asthma, especially in developing atopy by means of switching B lymphocytes to produce IgE. It has been shown that there is polymorphism in the Interleukin-4 promoter region, transversion of cytosine to thymine at-598 from translation initiation site of IL-4 gene. There has also been quite a few works to reveal the role of the polymorphism of IL-4 gene in patients with asthma. We performed this investigation to determine the role of the polymorphism in the severity of symptoms of patients with asthma. We also examined the frequency and the type of the polymorphism in asthmatics compared with non-asthmatics as well. Method: The subjects enrolled in this study were 49 asthmatics and 33 non-asthmatics. All the asthmatics were classified as mild and moderate to severe by the NHLBI/WHO Workshop. DNA from both asthmatics and non-asthmatics was extracted, then performed ARMS(Amplification Refractory Mutation System) as well as RFLP using BsmFl restriction enzyme in order to confirm the polymorphism of Il-4 gene. Results: There was no significant difference in the occurrence of polymorphism of the IL-4 promoter sequence between asthm and non-asthma groups(P=0.7). Among those with polymorphisms, the number of C/C type was slightly more than C/T type in both asthmatics and non-asthmatics, 26 vs 21 in asthmatics and 18 vs 15 in non-asthmatics, which was, however, insignificant statistically. No significant relationship between the severity of asthma and the polymorphism was found(P=0.7). Conclusion: There was no significant difference between the severity of asthma and the IL-4 promoter polymorphism(P=0.709). Interestingly, the frequency of the polymorphism in both asthmatics as well as non-asthmatics was found to be even higher than that occurred in Caucasians. However, no significant difference in the frequency of the polymorphism was found in both groups.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.203-209
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• 2000

Background: Exercise is a very common precipitant of asthma. Bronche-constriction associated with exercise can occur in 75~90% of individuals with asthma The estimated prevalence(30~85%) of gastroesophageal reflux(GER) in patients with asthma is significantly higher than in general population. We performed pH monitoring during the exercise in order to evaluate whether exercise induced asthma(EIA) could be related to GER and acid reflux-induced esophagobronchial reflex-mediated bronchospasm might be a factor for EIA. Method: Following an overnight fast, 18 patients with a suspected EIA(6 men, 12 women) were studied. Monitoring of intraesophageal pH, ECG and spirometry was done for 1 hour before treadmill exercise. After baseline monitoring, subjects underwent symptom-limited treadmill exercise with Bruce protocol and continuous monitoring for 60 min after exercise. Spirometry was done at baseline prior to exercise, and repeated every 10 min after full exercise for 60 min. Results: Exercise-induced bronchoconstriction was noted in 15 patients, who performed MBPT and 12 patients confirmed for bronchial asthma and 3 patients were diagnosed exercise-induced astham. Five of 15 EIA patients demonstrated a pathologic degree of GER. Conclusion: We suggest that GER may be one of pathophysiologic factors of EIA and evoke further concentration on the GER in the EIA patients.

• Tuberculosis and Respiratory Diseases
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• v.61 no.4
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• pp.339-346
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• 2006

Background: There has no known epidemiologic survey on the frequency of complementary-alternative medicine (CAM) use in the treatment of adult asthma in Korea. This study examined the current use of CAM by asthma patients in Korea. Methods: One hundred adults with asthma, who had been admitted to Kyunghee university hospital between January 2000 and December 2003, were enrolled in this survey. They received a structured questionnaire interview and a clinical assessment of prevalence and pattern of CAM use. Results: 53% patients had an experience of at least one type of CAM during their asthma management. Users of CAM had more hospital visits than those who had never used CAM($1.46{\pm}0.68$ vs. $2.11{\pm}1.20$, p=0.001). Those in their $50^{th}$ decades had more experience of CAM (80%) than the other age groups. The methods of CAM used by our patients are as follows: Diet/nutritional therapy in 35 patients(69%), herbal therapy in 28 patients(53%), acupuncture in 9 patients(17%), moxa treatment in 6 patients(11%), breathing exercises in 1 patient(2%). Conclusions: More than 50% of patients with bronchial asthma have used CAM. A more detailed and large scaled study will be needed to define the actual status of the use of CAM in the treatment for asthma. Inaddition, further research on the scientific validation of the clinical efficacy of CAM in asthma management should be followed.

• Proceedings of the Korea Contents Association Conference
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• 2006.05a
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• pp.156-159
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• 2006

Self management of chronic asthma is of great importance, since the disease could lead the patient into an emergent situation. In the present study, we describe design and implementation of a personal digital assistant(PDA) based asthma management system for personal application including symptom and medication to prevent from the potential exacerbation of the disease. The software program was written by the Visual C++ tool in the mobile computing environment and Object Store was applied for data management. User friendly GUI environment was provided for the patient to input his/her daily condition and self treatment such as medication for successful management. The input screen design substituted for keyboard input to a mouse in order to easy to select an item and minimize the keyboard input. The implementation results of this system., Real-time data collection and process were possible and be able to have been carried effectively out a continuous symptom, a medication of asthma patients, risk management.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.697-704
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• 1998

Background: Asthma is a chronic inflammatory disease of the airways characterized by a marked infiltration of eosinophils in the bronchial mucosa. Asthmatic bronchial mucosa produces many factors described as being chemotactic for inflammatory cells. IL-5, RANTES, and MCP-1 alpha are the chemotactic factors for eosinophils, but their roles are controversial. Recently eotaxin that is a potent eosinophil chemoattractant cytokine was detected in a guinea-pig model of allergic airway inflammation, and human eotaxin was cloned. Eotaxin is a specific chemoattractant for eosinophils, but its role in asthma is not confirmed. We examined the in vivo expression of eotaxin in bronchi of asthmatic patients. Methods : 11 asthmatics and 2 normal controls were enrolled. All subjects were underwent bronchoscopy with bronchial biopsies in 2nd or 3rd carina. RNA extraction from biopsy samples was done by acid-guanidium method. Semi-quantitaive RT-PCR was done for evaluation of eotaxin mRNA expression The extent of eosinophil infiltration was evaluated by counting the eosinophils in submucosa in HPF of microscope. Results : Eotaxin mRNA expressed in symptomatic, uncontrolled asthma. Steroid inhibited expression of eotaxin mRNA in asthma. Expression of eotaxin mRNA correlated with eosinophil infiltration in bronchial tissues. Conclusion: Expression of eotaxin mRNA increases in uncontrolled asthma and eotaxin is involved in the recruitment of eosinophils.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.836-843
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• 1997

Background : The prevalence of Gastro-esophageal reflux(GER) in patients with asthma is estimated to be 50~60% and treatment of GER has been shown to improve asthma symptoms in Western. But GER has been known to be less common in Eastern and GER prevalence rates in asthmatics are not available in Korea. Method : We compared the prevalence rate of GER in 42 patients with asthma to that in 20 healthy normal controls and examed the efficacy of new prokinetic drug, cisapride(40mg/day, 8weeks) in patients with GER and asthma. For acid GER to be considered pathological, 24 hour esophageal pH monitoring should reveal values exceeding upper limit of 95 percentile for at least one of 6 parameter of DeMesseter's table. Result : The results showed GER was more common in patients with asthma(11/42, 26.2%) than normal controls(3/20, 15%) and asthmatics group showed a significant longer supine time pH<4(%) and total time pH<4(%), and more reflux episodes as compared with normal control group. After 4 asthmatics with GER were treated with cisapride, their asthma symtom scores, FEV1 and composite scores of pH monitoring were improved. Conclusion : GER is more common in asthmatics than in normal controls in Korea and prepulsid reduces asthma symptoms in patients with GER and asthma.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.548-554
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• 1999

Background : Asthma is the most common respiratory crisis encountered in clinical practice, occurring in up to 4% of all pregnancies. Pregnancy often appears to alter the course of asthma. But the mechanisms responsible for variable changes in the asthma course during pregnancy remain unknown. Poor control and exacerbations of asthma during pregnancy may result in serious maternal and fetal complications. To investigate the course of asthma during pregnancy in korean women, we did a retrograde study of 27 pregnant women who had been admitted to Korea University Hospital for asthma worsened. Method: Twenty seven pregnant women who had been visited to Korea University Hospital for asthma worsened were enrolled in our retrospective study. We reviewed medical recordings and interviewed patients with asthma. Results: Twenty seven pregnant women with asthma were evaluated, and 25 patients were enrolled to our study. Two patients experienced abortions at 6 weeks and 25 weeks gestation, respectively. The period of asthma worsened was commonly during weeks 20 to 28 of gestation. And all patients wosened were improved during the last 4 weeks of pregnancy. Twenty(80%) of 25 women whose asthma worsened during pregnancy reverted toward their prepregnancy status after delivery(p<0.002). The causes of asthma worsened during pregnancy are reduction or even complete cessaton of medication due to fears about its safety(40%), worsening after upper respiratory infection (28%), and unknown(32%). There were no adverse perinatal outcomes in 25 pregnant asthma subjects. Conclusions: A major problem of therapy for asthma during pregnancy is reduction or even complete cessation of medication due to fears of fetal effects. Therefore, maternal education and optimal clinical and pharmacologic management is necessary to mitigate maternal and fetal complications.