• Title/Summary/Keyword: Asthma Management

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Evaluation of Distribution and Inflammatory Effects of Airborne Fungus in Korea (국내 실외공기의 곰팡이 분포 및 노출에 따른 염증영향평가)

  • Yoon, Wonsuck;Lim, Jaehoon;Kim, Dasarang;Kim, Seunghyun;Lee, Hyo-sun;Kim, Chae-Bong;Kang, Ju-Wan;Lee, Keun-Hwa;Oh, Inbo;Kim, Yangho;Seo, Jung-Wook;Hong, Young-Seoub;Yoo, Young
    • Journal of Environmental Health Sciences
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    • v.45 no.6
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    • pp.638-645
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    • 2019
  • Objectives: For the risk management of airborne fungal diseases, our aim was to evaluate airborne fungi and study the toxicity associated with fungal allergic diseases using fungal species native to Korea. Methods: Fungi were isolated from outdoor air samples collected from Seoul, Incheon, Cheonan, Gwangju, Ulsan, Busan, and Jeju and tested for their cytotoxicity potential and their ability to induce proliferation and secretion of macrophage-derived chemokine (MDC) in human mast cells (HMC-1). Results: More than 18 species of fungi were collected from outdoor air in Korea over one year, and the strains were identified and systematically analyzed. The results showed that the Cladosporium (59%) and Alternaria (22%) strains are the most common in outdoor air. Three of the collected strains (Fusarium, Trichoderma, and Penicillium) showed mild toxicity in cells involved in allergic inflammation, and twelve induced cell proliferation in HMC-1 cells. More importantly, many strains (Edgeworthia, Trametes, Emmia, Irpex, Talaromyces, Penicillium, Periconia, Epicocum, Bipolaris) induced the MDC protein in activated HMC-1 cells. Conclusion: Nineteen percent of the tested strains caused cytotoxicity in mast cell lines, whereas, most of the non-toxic strains contributed to cell activity. Among the tested strains, more than 80% increased the expression of MDC protein, which contributes to the severity of atopic dermatitis, asthma, and rhinitis. It is, in fact, one of the markers for these conditions. Therefore, airborne fungus could be considered as an important marker for environmental risk management for allergic diseases in Korea.

A Study on the Management of Non-Communicable Disease in Fiji (피지에서의 만성병 관리)

  • Kim, Daeseon;Romakin, Pablo;Rafai, Eric;Lee, Chulwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.163-173
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    • 2020
  • For the successful execution of an ODA project, it is necessary to know what areas are weak and necessary to the country of demand exactly. The health sector is also a top priority in most of developing countries. This study was carried out to introduce non-communicable disease (NCD) in Fiji for ODA projects planning. The major causes of death in Fiji in 2016 are diabetes, ischemic heart disease, cerebrovascular disease, chronic kidney disease, lower respiratory infect, asthma in ranking. The major causes of death in Korea in same year are cancer, ischemic heart diseases, cerebrovascular diseases, pneumonia, suicide, diabetes in the order of ranking. The chronic disease as non-communicable disease (NCD) has been increasing continuously due to changes in lifestyle and consumption patterns and population aging in prevalence rate. This global trend is also apparent in Fiji and Korea, reflected in increasing mortality and personal costs for the treatment and management of NCD. The need for a sustained comprehensive treatment tailored for individual patients has suggested from many studies and the development of a systematic program to manage NCD patients to provide such care have been recommended. The Fiji government developed Non-communicable Diseases Strategic Plan 2015-2019 and has tried to reduce the prevalence rate of non-communicable diseases by factors. The WHO global action plan guiding national-level NCD policies requires an NCD prevention and control model at the community level, presenting strategic goals and detailed options for the introduction and application of the approach to communities. It is necessary to develop an NCD prevention and control model, consisting of a strategy of community intervention, education for students and NCD patients, and the legal enactment of NCD that adequately meets the needs of community members.

Effect of Inhaled Steroids on the Cortisol Concentration by Different Dosage or Delivery Method (흡입성 스테로이드 제제의 투여용량 및 방법이 기저 코르티솔농도에 미치는 영향)

  • Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.888-899
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    • 1995
  • Background: Topical inhaled steroids, budesonide(Bu) and beclomethasone dipropionate (BOP), are now established as effective drugs in the management of chronic asthma. These drugs have high topical anti-inflammatory effect with low systemic activity. This study was performed to determine the effects of two inhaled corticosteroids, Bu and BOP, on the adrenocortical supression in 44 patients with bronchial asthma or chronic obstructive pulmonary disease. Methods: The adrenocortical function was assessed by measurement of serum cortisol concentration at 8 o'clock in morning and free cortisol in 24-hour urine collection at interval in 44 patients. No steroid was administered during the pretreatment period of 10 days and the final 6 days of the study. Each subject inhaled BOP or Bu, in daily doses of 800 or 1,600 micrograms for 12 days. The dose was delivered by metered dose inhaler (MDI) or diskhaler or large spacing device attached to MDI. Results: The levels of serum cortisol and 24-hour urinary free cortisol were decreased during the treatment period in patients inhaled Bu delivered by MDI in daily doses of 800 and 1,600 micrograms. In contrast, serum cortisol level was decreased on 6 and 12th day of treatment period in patients with BDP diskhaler in daily doses of 800 micrograms. In daily doses of 1,600 micrograms, the serum cortisol and 24hour urine free cortisol levels were decreased on 6, 9 and 12th day of treatment period in patients with BDP disk haler. The serum cortisol and 24-hour urinary free cortisol levels were not significantly decreased during the treatment period in patients inhaled Bu delivered by large spacing device attached to a MDI. Conclusion: These results showed that 1) the endogenous cortisol secretion was suppressed after inhalation of BDP and Bu in daily doses of 800 and 1,600micrograms, 2) Bu with MDI suppressed the adrenocortical function more than BDP with diskhaler, in daily doses of 1600 micrograms. and 3)large spacing device attached to a MDI might decrease the risk of suppression in the hypothalamic -pituitary- adrenal axis.

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Clinical Characteristics of Chronic Cough in Korea

  • An, Tai Joon;Kim, Jin Woo;Choi, Eun Young;Jang, Seung Hun;Lee, Hwa Young;Kang, Hye Seon;Koo, Hyeon-Kyoung;Lee, Jong Min;Kim, Sung-Kyung;Shin, Jong-Wook;Park, So Young;Rhee, Chin Kook;Moon, Ji-Yong;Kim, Yee Hyung;Lee, Hyun;Kim, Yong Hyun;Kim, Je Hyeong;Lee, Sang Haak;Kim, Deog Kyeom;Yoo, Kwang Ha;Kim, Dong-Gyu;Jung, Ki-Suck;Kim, Hui Jung;Yoon, Hyoung Kyu;Cough Study Group of the Korean Academy of Tuberculosis and Respiratory Diseases
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.31-41
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    • 2020
  • Background: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines. Methods: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, exsmokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines. Results: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response. Conclusion: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.

Surgical Management of Idiopathic Tracheal Stenosis -Three case reports- (특발성 기관 협착증(Idiopathic Tracheal Stenosis)의 외과적 치험 -3예 보고-)

  • Kim, Hyung-Tae;Choi, Ho;Yoon, You-Sang
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.439-443
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    • 2003
  • A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.

Clinical Manifestations, Management, and Natural Course of Infants with Recurrent Bronchiolitis or Reactive Airways Disease (반복적인 모세기관지염, 과반응 기관지염을 보인 영유아의 임상양상, 치료와 자연경과)

  • Park, Hyoun Jin;Kim, Joo Hyun;Chun, Yoon Hong;Lee, Soo Young;Kim, Sang Yong;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.21 no.1
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    • pp.37-42
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    • 2014
  • Purpose: The purpose of this study was to investigate the clinical manifestations and 5-year natural course of recurrent bronchiolitis or reactive airways disease (RAD) in infants. Methods: We reviewed the medical records of infants with recurrent bronchiolitis from January 2007 to December 2007 at The Catholic University of Korea St. Mary's Hospital in Incheon, South Korea. Additionally, we telephoned their parents to confirm their present medical statuses. Results: Sixty-three subjects with recurrent bronchiolitis were identified. The mean age at admission was 8.1 months and the number of males was 44 (69.8%). Of the 63 infants with recurrent bronchiolitis, inhaled corticosteroids, bronchodilators, and antibiotics were given to 62 (98.4%), 53 (84.1%), and 40 (63.5%), respectively. Among the total 63 subjects, we were able to contact the parents of 45 children by telephone. None of these children had been hospitalized during the previous one year period due to respiratory infections or for other medical reasons. Of the 45 subjects we were able to contact, 38 (84.4%) had not experienced any further respiratory difficulties at all. Five (11.1%) had been diagnosed with allergic rhinitis while two (4.4%) were being managed for asthma. Conclusion: Most children who presented with recurrent episodes of bronchiolitis in infancy did not show any further respiratory difficulties after five years of age.

Parental burden of food-allergic children's parents and influencing factors (식품알레르기 아동 부모의 양육부담과 영향요인)

  • Lee, EunSun;Kim, KyooSang
    • Journal of Nutrition and Health
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    • v.51 no.2
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    • pp.140-152
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    • 2018
  • Purpose: Recently, there has been a worldwide increase in the prevalence of food allergies in children and it may cause nutritional imbalance and poor quality of life for growing children due to dietary restrictions. This study was conducted to quantitatively measure the life burden and related factors of mothers who are the primary caretakers of food-allergic children. Moreover, we generated data for use as a scientific basis for the development of a disease management program to reduce the burden on life from raising food-allergic children. Methods: Mothers of 2,005 children aged 2 years or older and enrolled in Seoul Metropolitan Atopy Free Schools in 2016 who have had diagnosis of food allergy in their lifetime were surveyed. The burden on life of parents with food-allergic children was measured using 17 questions from the Food Allergy Quality of Life-Parental Burden (FAQL-PB) questionnaire, and subjects were asked to respond with a scale of 1 ~ 7. Results: We analyzed the effects of sociodemographic factors of parents and children and the accompanying allergic disease factors on the lives of parents. The number of restricted food items due to food allergy of a child and accompanying diagnosis of atopic dermatitis had a positive (+) effect on the life burden of the parents. Conclusion: Accurate oral food challenge for food allergies should be administered to prevent excessive restriction of food intake. Moreover, efforts should be taken to prevent morbidity accompanying food allergy and relieve symptoms of asthma, allergic rhinitis and atopic dermatitis.

Bioequivalence of Azela Tablet to Azeptin Tablet (Azelastine Hydrochloride 1 mg) (아젭틴 정(염산아젤라스틴 1 mg)에 대한 아젤라 정의 생물학적 동등성)

  • Cho, Hea-Young;Yun, Ji-Hun;Seo, Yu-Lee;Oh, In-Joon;Lee, Sung-Kwan;Moon, Jai-Dong;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.31 no.1
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    • pp.57-62
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    • 2001
  • Azelastine, a phthalazinone derivative, is an antiallergic agent which demonstrates histamine $H_1-receptor$ antagonist activity and also inhibits histamine release from mast cells following antigen and non-antigen stimuli. Thus, azelastine may be useful in the management of both asthma and allergic disorders. The purpose of the present study was to evaluate the bioequivalence of two azelastine hydrochloride tablets, $Azeptin^{TM}$ (Bu Kwang Pharmaceutical Co., Ltd.) and $Azela^{TM}$ (Kyung Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Eighteen normal male volunteers, $22.44{\pm}2.01$ years in age and $61.99{\pm}6.18\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After two tablets containing 1 mg of azelastine hydrochloride per tablet were orally administered, blood was taken at predetermined time intervals and the concentrations of azelastine in serum were determined using HPLC with fluorescence detector. Pharmacokinetic parameters such as $AUC_t$, $C_{max}\;and\;T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters. The results showed that the differences in $AUC_t$, $C_{max}\;and\;T_{max}$ between two tablets were -6.45%, -2.60% and -7.14%, respectively, when calculated against the $Azeptin^{TM}$ tablet. The powers $(1-{\beta})$ for $AUC_t\;and\;C_{max}$ were 96.65% and 88.47%, respectively. Minimum detectable differences $({\Delta})$ at ${\alpha}=0.05$ and $1-{\beta}=0.8$ were less than 20% (e.g., 14.40% and 17.65% for $AUC_t\;and\;C_{max}$, respectively). The 90% confidence intervals were within ${\pm}20%$ (e.g., $-14.87{\sim}1.97$ and $-12.92{\sim}7.72$ for $AUC_t\;and\;C_{max}$, respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that $Azela^{TM]$ tablet is bioequivalent to $Azeptin^{TM}$ tablet.

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A Case of Tracheal Hamartoma (기관내 과오종 1예)

  • Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Sung, Sook-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.383-388
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    • 1999
  • Background: Tracheal hamartoma is a very rare cause of upper airway obstruction. Its clinical features can mimic medical conditions, such as bronchial asthma, chronic bronchitis, and so on. Case; This report presents the case of a 65 year old man whose major symptom was dyspnea. We found a tumor in his distal tracheal lumen, and the tumor was removed with success using rigid bronchoscope. The tumor was histologically proven to be a hamartoma, and his symptoms were much improved. Conclusion: It is important to distinguish it from other conditions because medical management is often not helpful. Surgical correction-with or without thoracotomy-is inevitable.

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Dietary Factors Associated with Attention Deficit Hyperactivity Disorder (ADHD) in School-aged Children (학동기 어린이 주의력결핍 과잉행동장애에서 식이요인의 역할 규명)

  • An, Minji;An, Hyojin;Hwang, Hyo-Jeong;Kwon, Ho-Jang;Ha, Mina;Hong, Yun-Chul;Hong, Soo-Jong;Oh, Se-Young
    • Korean Journal of Community Nutrition
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    • v.23 no.5
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    • pp.397-410
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    • 2018
  • Objectives: An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited. Methods: We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: "Plant foods & fish," "Sweets," "Meat & fish," "Fruits & dairy products," and "Wheat based." Results: The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the "Sweets" category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between "Fruits & dairy products" and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1). Conclusions: Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.