• Clinical and Experimental Pediatrics
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• v.64 no.2
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• pp.60-67
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• 2021

Eosinophils are a type of granulocyte with eosinophilic granules in the cytoplasm that play an important role in allergic and parasitic diseases. Eosinophils are important in the pathogenesis of asthma, and many studies have examined the relationship between them. In allergic eosinophilic asthma, eosinophils act not only as important effector cells but also as antigen-presenting cells in allergic inflammatory reactions. In nonallergic eosinophilic asthma, type 2 innate lymphoid cells in the airways play an important role in eosinophil activation. Direct methods, including bronchial biopsy, bronchoalveolar lavage, and the induced sputum test, are used to evaluate eosinophilic inflammatory reactions in patients with asthma, however, because of difficulty with their implementation, they are sometimes replaced by measurements of blood eosinophils, fraction of exhaled nitric oxide, and serum periostin level. However, these tests are less accurate than direct methods. For the treatment of patients with severe eosinophilic asthma, anti-interleukin-5 preparations such as mepolizumab, reslizumab, and benralizumab have recently been introduced and broadened the scope of asthma treatment. Although eosinophils are already known to play an important role in asthma, we expect that further studies will reveal more details of their action.

• Journal of Korean Academy of Nursing
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• v.48 no.1
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• pp.96-108
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• 2018

Purpose: This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary. Methods: Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Results: Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%. Conclusion: Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.221-225
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• 2017

Since 2015, the Health Insurance Review and Assessment Service (HIRA) has performed annual qualitative assessments of asthma management provided by all medical institutions that care for asthma patients in Korea. According to the third report of qualitative assessment of asthma management in 2017, the assessment appears to have contributed to improving the quality of asthma care provided by medical institutions, especially primary clinics. However, there is still a gap between the ideal goals of asthma management and actual health care policies/regulations in real clinical settings, which leads to the state of standstill with respect to the quality of asthma management despite considerable efforts such as the qualitative assessment of asthma management by national agencies such as the HIRA. At this point, a harmonized approach is needed to raise the level of asthma management among several components including medical policies, efforts of academic associations such as education and distribution of the guideline for management, and reliable financial support by the government.

• Child Health Nursing Research
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• v.22 no.2
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• pp.87-96
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• 2016

Purpose: This study was done to identify the level of knowledge and practice of self-management on asthma of school-aged children and to provide data for the development of an intervention program to improve self-management on asthma Methods: The participants were 100 school-aged children who were treated currently for asthma in J city located in G province. Data were collected from 25th August to 30th October 2014. Results: The mean scores were 14.37 of 20 for self-management knowledge (percentage of correct answer 71.9%), 21.65 of 30 for self-management practice. There were significant differences in knowledge according to grade, diagnosed age, food allergy, education on asthma and hardship in school life, and in practice according to gender and economic status, hardship in school life and experience of first-aid on asthma. There were positive correlations between knowledge and practice. Conclusion: Results indicate that school-aged children' knowledge and practice in self-management of asthma were not sufficient enough to perform accurate management of asthma. Therefore, to improve self-management ability of school-aged children to manage effectively asthma, educational strategies that focus on increasing knowledge need to be developed.

• Journal of Korean Biological Nursing Science
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• v.10 no.1
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• pp.53-61
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• 2008

Purpose: This study was conducted to estimate the prevalence of asthma and its risk factors in childhood asthma. Method: Random samples of 10,236 were selected from 43 kindergarten (1,418) and 57 elementary (8,718) in K city between september and November (2007). 1,079 (kindergarten children) and 7,271 (elementary children) were in the final analysis. The Korean-translated modified version of the questionnaire for the International Study of Asthma and Allergies in Childhood was used in this cross-sectional survey. Parents were surveyed to answer for the questionnaire. Result: The lifetime and 12-month prevalence of wheezing were 11.50%; 11.06% in kindergarten children and 19.24%; 4.80% in elementary children. The lifetime prevalence of asthma diagnosis and the 12-month prevalence of asthma treatment were 11.59%; 4.43% in kindergarten children and 4.43%; 10.78% in elementary children. The 12-month prevalence of night cough and exercise-induced wheezing were 12.90%; 3.33% in kindergarten children and 20.72%; 4.74% in elementary children. Risk factors analysis showed that age, paternal and maternal asthma, allergic disease, carpet use, monthly income, indoor environment were associated with a higher risk of asthma. Conclusion: The study suggests that prevalence of asthma has increased among the community children. These data have been used to manage a possible role of risk factors as predictors of childhood asthma.

• Clinical and Experimental Pediatrics
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• v.63 no.3
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• pp.104-109
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• 2020

Background: It is challenging to diagnose asthma in preschool children. The asthma predictive index (API) has been used to predict asthma and decide whether to initiate treatment in preschool children. Purpose: This study aimed to investigate the association between questionnaire-based current asthma with API, pulmonary function, airway hyperreactivity (AHR), fractional expiratory nitric oxide (FeNO), and atopic sensitization in preschool children. Methods: We performed a population-based cross-sectional study in 916 preschool children aged 4-6 years. We defined current asthma as the presence of both physician-diagnosed asthma and at least one wheezing episode within the previous 12 months using a modified International Study of Asthma and Allergies in Childhood questionnaire. Clinical and laboratory parameters were compared between groups according to the presence of current asthma. Results: The prevalence of current asthma was 3.9% in the study population. Children with current asthma showed a higher rate of positive bronchodilator response and loose and stringent API scores than children without current asthma. The stringent API was associated with current asthma with 72.2% sensitivity and 82.0% specificity. The diagnostic accuracy of the stringent API for current asthma was 0.771. However, no intergroup differences in spirometry results, methacholine provocation test results, FeNO level, or atopic sensitization rate were observed. Conclusion: The questionnaire-based diagnosis of current asthma is associated with API, but not with spirometry, AHR, FeNO, or atopic sensitization in preschool children.

• Tuberculosis and Respiratory Diseases
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• v.77 no.5
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• pp.209-214
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• 2014

Background: Bronchiectasis and asthma are different in many respects, but some patients have both conditions. Studies assessing the effect of bronchiectasis on asthma exacerbation are rare. The aim of this study is to investigate the effect of bronchiectasis on asthma exacerbation. Methods: We enrolled 2,270 asthma patients who were followed up in our hospital. Fifty patients had bronchiectasis and asthma. We selected fifty age- and sex-matched controls from the 2,220 asthma patients without bronchiectasis, and assessed asthma exacerbation and its severity based on the annual incidence of total asthma exacerbation, annual prevalence of steroid use, and frequency of emergency room visits and hospitalizations due to asthma exacerbation in each group. Results: Fifty patients (2.2%) had bronchiectasis and asthma. The annual incidence of asthma exacerbation was higher in patients with asthma and bronchiectasis than in patients with asthma alone ($1.08{\pm}1.68$ vs. $0.35{\pm}0.42$, p=0.004). The annual prevalence of steroid use ($0.9{\pm}1.54$ vs. $0.26{\pm}0.36$, p=0.006) and the frequency of emergency room visits ($0.46{\pm}0.84$ vs. $0.02{\pm}0.13$, p=0.001) due to asthma exacerbation were also higher in patients with asthma and bronchiectasis than in patients with asthma alone. Conclusion: Bronchiectasis is associated with difficult asthma control.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.361-367
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• 2010

Background: Difficult-to-treat asthma afflicts a small percentage of the asthma population. However, these patients remain refractory to treat, and account for 40% to 50% of the health costs of asthma treatment, incurring significant morbidity. We conducted a multi-center cross-sectional study to characterize difficult-to-treat asthma in Korea. Methods: Subjects with difficult-to-treat asthma and subjects with controlled asthma were recruited from 5 outpatient clinics of referral hospitals. We reviewed medical records of previous 6 months and obtained patient-reported questionnaires composed of treatment compliance, asthma control, and instruments for stress, anxiety, and depression. Results: We recruited 21 subjects with difficult-to-treat asthma and 110 subjects with controlled asthma into the study. The subjects with difficult-to-treat asthma were associated with longer treatment periods, more increased health care utilization, more medication (oral corticosteroids, number of medication), and more anxiety disorder compared to those of well-controlled asthmatics. There was no difference in age, gender, history of allergy, serum IgE, blood eosinophil count, or body mass index between the 2 groups. Conclusion: Difficult-to-treat asthma is characterized by increased health care utilization and more co-morbidity of anxiety.

• The Journal of Korean Society for School & Community Health Education
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• v.19 no.3
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• pp.15-27
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• 2018

Objectives: This study aims to investigate the estimated proportion for influenza vaccination and to identify factors associated with influenza vaccination in Korean adults aged 50 and older with asthma. Methods: Data from 2010-2015 Community Health Survey(n=23,662) was used. A chi-square test was performed to investigate the estimated proportion for influenza vaccination, and a multiple logistic regression analysis was used to identify the factors associated with self-reported influenza vaccination. Results: In men, 42.3-49.5% of asthma patients 50-64 years of age, and 78.5-90.2% of elderly (over 65 years of age) asthma patients received influenza vaccination. In women, 49.7-61.9% of asthma patients 50-64 years of age, and 82.7-89.7% of elderly asthma patients received influenza vaccination(p<0.0001). Low education level, non-smoking, non-drinking, hypertension, diabetes and use of public center were related to high influenza vaccination in 50-64 years old men with asthma. Low education level, non-smoking, bad health status, hypertension, diabetes and use of public center were related to high influenza vaccination in 50-64 years old women with asthma. Non-smoking and use of public center were related to high influenza vaccination in over 65 years old men with asthma. White-collar jobs, smoking, absence of hypertension and use of public center were related to low influenza vaccination in over 65 years old women with asthma. Conclusions: Influenza vaccination remains relatively low in asthma patients 50-64 years of age. It is necessary to recommend vaccination to asthma patients, provide them with information, and devise other strategies to improve vaccination.