• Title/Summary/Keyword: Asthma Management

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Relationship between cord blood level of IL-12 in preterm newborns and development of wheezing (34주 미만 미숙아 제대혈청 내 interleukin-12 농도와 영아기 천명 발생과의 관계)

  • Yu, Hyo Jung;Park, Eun Ae;Kim, Ji Young;Cho, Soo Jin;Kim, Young Ju;Park, Hye Sook;Ha, Eun Hee
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.754-759
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    • 2008
  • Purpose : Abnormal activation patterns of Th1/Th2-cells have been suggested to increase the prevalence of allergic diseases. Prevention is regarded as an important corner stone in the management of allergic diseases. In this study, we have investigated the relationship between cord blood levels of IL-4, IL-10, and IL-12 in preterm newborns and the development of allergic respiratory diseases in infancy Methods : Forty-six preterm newborns born at the Ewha Womans University Mokdong Hospital between January 2003 and July 2005, were enrolled for this study, and consent was obtained to test their cord blood samples. Clinical history was obtained from the hospital records. Cord blood was obtained at birth and kept frozen until it was tested. The levels of IL-4, IL-10, and IL-12 were determined by enzyme-linked immunosorbent assay (ELISA). Results : All infants were followed-up for a median of $16.0months{\pm}13.2d$ (range, 12.0 to 36.0 months). Eighteen infants who developed wheezing showed lower cord blood levels of IL-12 ($366.60{\pm}140.40$ vs $435.09{\pm}91.20pg/mL$, P=0.009). Cord blood levels of IL-4 and IL-10 showed no significant difference between the two groups. Four newborns who later developed asthma, and infants with asthma showed lower IL-12 level in the cord blood than other groups. Conclusion : Lower concentration of cord blood levels of IL-12 in newborns who later developed wheezing and asthma suggested that they had abnormal activation patterns of Th1/Th2-cells at the time of birth, and cord blood IL-12 level can be used as a predictor of allergic respiratory diseases.

The Effect of 6 Weeks of Treatment with Inhaled Budesonide on Bronchial Hyperresponsiveness and Adrenal Function in Asthmatic Patients (흡입용 스테로이드인 Budesonide 6주 치료가 기관지 천식환자의 기관지 과민반응과 부신피질기능에 미치는 영향)

  • Kim, Kwan-Hyoung;Oh, Yong-Seok;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.219-227
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    • 1992
  • Background: Acute and chronic airway inflammation are important in the pathogenesis of bronchial asthma. Corticosteroids have proved to be very effective in the management of asthma. Although the mechanism by which they produce this effect is still debated, suppression of the inflammatory response is thought to be the most likely. Although inhaled steroids are known to be safe and have less side effects than oral steroids, the extent which inhaled steroids have beneficial and the detrimental effects in the treatment of asthma has remained open to question. Budesonide is a recently developed corticosteroid for inhalation treatment with a strong local effect combined with rapid inactivation in the systemic circulation. We set out to look in more detail at the time course of change in bronchial reactivity, clinical symptoms and the effects on the adrenal function during 6 weeks of treatment with budesonide (800 ug per day). Methods: Clinical symptoms, pulmonary function test, histamine $PC_{20}$, serum ACTH and cortisol (8 AM and 4 PM) were measured in 23 allergic asthmatic patients before and after 6 weeks of treatment with budesonide. Results: 1) Pulmonary function test; PEFR, FEV1 and FVC after 6 weeks of treatment with budesonide were higher than those before treatment. 2) Clinical symptoms; Clinical symptoms were significantly improved after 3 weeks and 6 weeks of treatment with budesonide. 3) Histamine provocation; Histamine $PC_{20}$ after 6 weeks of treatment with budesonide was significantly higher than that before treatment. 4) Adrenal function; 6 weeks of budesonide therapy did not significantly affect the level of serum ACTH and cortisol. Conclusion: From these results, it is concluded that budesonide therapy improved the clinical symptoms, pulmonary function and bronchial hyperreactivity after 3 weeks of treatment and the improvement after 6 weeks of treatment was higher than that after 3 weeks of treatment. During 6 weeks of treatment with budesonide, the inhibitory effect on the adrenal function was not obvious.

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Comparisons of 12-Hour and 24-Hour Sustained-Release Theophyllines in the Management of Asthma (천식치료에서 서방형 Theophylline의 1일 1회 제형과 1일 2회 제형의 비교)

  • Lee, Yang-Deok;Park, Seoung-Ju;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.293-299
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    • 2001
  • Background : Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. The development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. Method : A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation($Etheophyl^{(R)}$) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. The patients were subsequently switched to the once-daily preparation($Uniphyl^{(R)}$) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. Results : The mean serum levels of theophylline were $8.18{\pm}1.66\;{\mu}g/ml$ in the $Etheophyl^{(R)}$-treated period and $8.00{\pm}1.75\;{\mu}g/ml$ in the $Uniphyl^{(R)}$-treated period. ln addition, the $FEV_1$ showed $71.40{\pm}7.48$ percent in the $Etheophyl^{(R)}$-treated and $69.18{\pm}9.00$ percent in the $Uniphyl^{(R)}$-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. Conclusion : The results indicated little clinical differences between the two medications. The two drugs are equally effective in controlling asthma over the four weeks of treatment.

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Relationships between Respiratory Diseases and Safety of Pediatric Dental Sedation (소아의 호흡기 질환과 안전한 치과진정법의 연관성)

  • Chung, Woojin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.327-330
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    • 2015
  • The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

The Management of Systemic Voice Disorders (전신질환과 관련된 음성장애의 치료)

  • Woo, Joo Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.5-10
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    • 2016
  • Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

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Particulate-Matter Related Respiratory Diseases

  • Kyung, Sun Young;Jeong, Sung Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.116-121
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    • 2020
  • Particulate matter (PM) is suspended dust that has a diameter of <10 ㎛ and can be inhaled by humans and deposited in the lungs, particularly the alveoli. Recent studies have shown that PM has an adverse effect on respiratory diseases. The aim of this article is to review respiratory diseases associated with PM. According to existing studies, PM is associated with chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases and increases the mortality rates of these diseases. Moreover, increased exposure in the high concentration of atmospheric PM is associated with the development of lung cancer. The most simple and common way to protect an individual from airborne PM is to wear a face mask that filters out PM. In areas of high concentration PM, it is recommended to wear a face mask to minimize the exposure to PM. However, the use of N95 or KF94 masks can interfere with respiration in patients with chronic respiratory diseases who exhibit low pulmonary function, leading to an increased risk of respiratory failure. Conclusionally, reduction of the total amount of PM is considered to be important factor and strengthening the national warning notification system to vulnerable patients and proper early management of exacerbated patients will be needed in the future.

Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation

  • Tomas Franquet;Teri J. Franks;Jeffrey R. Galvin;Edson Marchiori;Ana Gimenez;Sandra Mazzini;Takeshi Johkoh;Kyung Soo Lee
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1416-1435
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    • 2021
  • Non-infectious granulomatous lung disease represents a diverse group of disorders characterized by pulmonary opacities associated with granulomatous inflammation, a relatively nonspecific finding commonly encountered by pathologists. Some lesions may present a diagnostic challenge because of nonspecific imaging features; however, recognition of the various imaging manifestations of these disorders in conjunction with patients' clinical history, such as age, symptom onset and duration, immune status, and presence of asthma or cutaneous lesions, is imperative for narrowing the differential diagnosis and determining appropriate management of this rare group of disorders. In this pictorial review, we describe the pathologic findings of various non-infectious granulomatous lung diseases as well as the radiologic features and high-resolution computed tomography imaging features.

Factors influencing health and quality of life among allergy and asthma patients: With specific focus on self-efficacy, social support and health management (건강과 삶의 질에 영향을 주는 요인에 대한 분석: 자기효능감, 사회적 지원 및 질병관리를 중심으로)

  • Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.11 no.2
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    • pp.143-181
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    • 2005
  • This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.

Research on the Actual State of Environmental Disease and Health Education at Middle and High School Students (일 지역 중.고등학생들의 환경성 질환 및 보건교육 실태 조사)

  • Jung, Jong-Hyeon;Moon, Ki-Nai;Seo, Bo-Soon;Kim, Chang-Tae;Lee, Jae-Hong
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.3
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    • pp.65-87
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    • 2011
  • Objectives: The purpose of this study was to perform basic study on environmental and respiratory diseases in Ulsan and vicinities. Also, this study evaluated the actual state of environmental disease and health education at middle and high schools in Ulsan and surroundings. Methods: For this study, we conducted a survey on the health of the general public, environmental effects, and investigated the characteristics of environmental disease, health and hygiene education, etc. The populations of this study were middle and high school students in Ulsan, Korea. This study investigated the knowledge of environmental disease and health education at schools in Ulsan and vicinities from November 2009 to December 2009. All statistical calculations were performed with Statistical Package for Social Sciences (SPSS) for Windows, and gained the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA. Results: As more and more environmental diseases are increased, the interest of the people has been increasing on this. The incidence rates of asthma and atopy were represented the top 25% of the country in Korea. The source of heavy metal, PAHs and VOCs in Ulsan includes the Petrochemical Complex at Nam-gu and Ulju-gun, the Nonferrous Metal Industrial Complex at Onsan-eup, Ulju-gun, and the Heavy Industrial Complex at Dong-gu and Buk-gu. Especially, there are a number of fossil fuel combustion facilities such as waste incineration plants and boilers at Nam-gu and the Onsan Industrial Complex. It may help greatly to investigate the characteristics of environmental pollutants such as environmental air pollutant and indoor contaminant to better manage the local student's health. Conclusions: It has been revealed that the hazardous chemicals and environmental contaminants are main substances of cause for asthma, atopy, dermatitis, and allergy disease. Therefore, through with collecting basic data such as environmental disease of inhabitants, health education, conscious and knowledgeable level in parents of students and students, We have to exert to improve knowledge and prevention with health life in school through development of health education program systematically for preventing of environmental disease.

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A Study on Nursing Needs and Respiratory Self-care Practice Degree in Elderly Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환 노인의 호흡기 자가간호 실천정도와 간호요구)

  • Noh, Hyun-Sook;Min, Hye-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.1
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    • pp.17-29
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    • 2003
  • This study investigated the degree of self-care practice to maintain the stable respiratory function and the required respiratory nursing needs upon the elderly with chronic obstructive pulmonary diseases. The research subjects were 115 elderly people over 60 years old, who were diagnosed to have chronic obstructive pulmonary diseases (the mixed type, chronic bronchitis, bronchial asthma, emphysema) and were hospitalized in 3 university hospitals in Busan or treated as outpatient, and the data was collected over the period between June 1, 2002 and September 30, 2002. In order to measure the respiratory self-care practice degree and nursing needs of the subjects, the instrument on the self-care practice and the instrument on nursing needs were developed by the researcher. The research results are as follows: 1. The mean of respiratory self-care practice degree by the subjects was 2.41 out of 4 for each clause, and the degree of practicing general management was the highest(2.70), and nutrition control(2.66), respiratory exercise(2.65), expectoration of sputum (2.63), oxygen therapy(2.60), environment control(2.50), and medication control(2.36) succeeded. 2. The degree of self-care practice had a significant difference depending on age(F=2.82, P=0.02), frequency of hospitalization(F=3.11, P=0.01), and diagnosed disease(F=15.66, P=0.00). 3. The subjects nursing needs of respiratory system were 3.07 on the average out of 4.00, and 'I want to know how to prevent the infection of respiratory system such as cold scored the highest 3.83, while the clauses like 'want to know how to face the respiratory disorder properly'(3.77) and 'want the specific explanation of the symptoms of my disease'(3.66) also had scored high points. 4. The nursing needs of the respiratory system had a significant difference depending on diagnosed disease such as mixed type of chronic obstructive pulmonary diseases, emphysema, bronchitis, and asthma (F=6.70, P=0.00). The research showed that the subjects degree of self-care practice of respiratory system was low on the whole, while the nursing needs for managing respiratory organ were relatively high. Therefore, specific education concerning the nursing of the disease and self-care upon the elderly having chronic obstructive pulmonary disease is necessary.

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