Background : Salmeterol, a new ${\beta}_2$-adrenergic receptor agonist, is a long-acting bronchodilator and benefits patients with asthma who have nocturnal symptoms. We wished to assess the efficacy of inhaled salmeterol ($50{\mu}g$ bid) compared to inhaled salbutamol ($200{\mu}g$ qid) for the treatment of bronchial asthma, particularly nocturnal asthma. Method : We randomly assigned 35 patients (25 female and 10 male patients, 15 to 50 years old) to one of two treatment groups : one group received $50{\mu}g$ of salmeterol twice daily and another did $200{\mu}g$ salbutamol four times per day. And this study was performed as an open-label and the 6 weeks inhalation period. Results : Analysis of symptam score ; Day and night time symptom score showed significant difference between salmeterol and salbutamol Group (p<0.05). Number of days for additional bronchodilator requirements; The number of days and puffs for additional bronchodilator were lower in the salmeterol group in either day and night time (p<0.05). Pulmonary function test ; $FEV_1$ showed significant increase in salmeterol group compared to salbutamol group after 2 and 4 weeks inhalation period. Adverse effects ; We found no evidence of tolerance to the bronchodilating effects of salmeterol, and adverse reactions to all the treatments were infrequent and mild. Conclusion : For the management of bronchial asthma, salmeterol given twice daily is superior to salbutamol given four times daily.
Recently, the problem of air pollution has become a global concern due to industrialization and overcrowding. Air pollution can cause various adverse effects on human health, among which respiratory diseases such as asthma, which have been of interest in this study, can be directly affected. Previous studies have used clinical data to identify how air pollutant affect diseases such as asthma based on relatively small samples. This is high likely to result in inconsistent results for each collection samples, and has significant limitations in that research is difficult for anyone other than the medical profession. In this study, the main focus was on predicting the actual asthmatic occurrence, based on data on the atmospheric environment data released by the government and the frequency of asthma outbreaks. First of all, this study verified the significant effects of each air pollutant with a time lag on the outbreak of asthma through the time-lag Pearson Correlation Coefficient. Second, train data built on the basis of verification results are utilized in Deep Learning algorithms, and models optimized for predicting the asthmatic occurrence are designed. The average error rate of the model was about 11.86%, indicating superior performance compared to other machine learning-based algorithms. The proposed model can be used for efficiency in the national insurance system and health budget management, and can also provide efficiency in the deployment and supply of medical personnel in hospitals. And it can also contribute to the promotion of national health through early warning of the risk of outbreak by atmospheric environment for chronic asthma patients.
Kim, San;Sung, Byung-Gon;Lee, Sung-Jin;Lim, Kyu-Sang
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.19
no.2
/
pp.1-18
/
2006
Objective : Although management of asthma has become increasingly effective, its cure remains elusive, necessitating a new modality to prevent or eliminate causes triggering clinical progress. Based in the clinical experiences, a novel decoration Cheongsangbiyeum (CSB), has been developed to treat asthma, which consists of Polyporus, Semen Myristicae, Pericarpium citri Reticulatae, Rhizoma Cimicifugae, Cortex Albizziae, Fructus Rubi, Rhizoma Zedoariae, and Rhizoma Rhei. In the current study, its anti-asthmatic efficacy was evaluated using a mouse model of asthma. Methods : Experimental allergic asthma was induced by repeated intraperitioneal sensitization and intranasal challenge of ovalbumin (OVA). Water extract of CSB (1 mg/mouse/day) was administrated orally whereas control mice on given with identical volume of phosphate-buffered saline (PBS) for 5 days during the course of antigen challenge. When airway hyperreactivity(AHR) measured by ${\bata}-methacoline-induced$ airflow obstruction was compared, AHR of CSB-treated mice was significantly lower than those of control mice, indicating that CM extract can attenuate an asthmatic symptom. Airway recruitment of leukocytes and eosinophils was also markedly reduced by CSB treatment suggesting that oral treatment of CSB can alleviate the airway inflammation. For a better understanding of possible mechanisms underlying anti-asthmatic effet of CSB, cytokine (IL-4, IL-5, IL-13 and $IFN{\gamma}$ levels in bronchoalveola lavage fluid (BALF) and lung tissues were determined. Results : The results showed that cytokine levels were significantly lowered by CSB treatment. Additionally, number of draining lymph node cells was significantly lower than those of control mice. These data indicate that CSB suppress in vivo allergen-specific response. However, notably, levels of type 2 cytokines such as IL-5 and IL-13 were more profoundly influenced. Moreover, in vitro OVA-specific proliferative response and type 2 cytokine (IL-4, IL-5 and IL-13) production lymph node cells was markedly decreased in CSB-treated mice, whereas their $IFN{\gamma}$ production was not significantly altered Thrse data clearly showed a preferential inhibition of type 2 T cell (Th2) response by CSB treatment. This finding was also supported by serum antibody data showing that levels of OVA-specific type 2 antibodies, IgE and IgG1, in CSB-treated mice were significantly lower than in control mice, while type 1 antibody, IgG2a level m rather higher than controls, although the difference was in significant. Conclusions : In conclusion, oral administration of CSB attenuates asthmatic manifestations including AHR ad airway recruitment of eosinophils in a mouse model which possibly results from selective inhibition of Th2 cell response to allergen. Our data suggest a potential clinical application of CSB for control of allergic asthma.
In an attempt to investigate the psycho-social environment of, and to identify contributing factors to asthma, an explorative study was designed. An in-depth interviews of thirteen mothers nth asthmatic children on their child-rearing experiences were carried out from May through October, 1992. Data were gathered and analysed concurrently. The child-rearing experiences were classified into five categories; perceiving the attributes of, perceiving the health status of, affective interactions with, socialization of, and health management of asthmatic children. Thus, a comprehensive approach for the care of asthmatic children, and studies of family on multi-dimensional contributing factors on asthma are strongly recommended.
Hypersecretion of pulmonary mucus is a major pathophysiological feature in allergic and inflammatory respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD). Overproduction and/or oversecretion of mucus cause the airway obstruction and the colonization of pathogenic microbes. Developing a novel pharmacological agent to regulate the production and/or secretion of pulmonary mucus can be a useful strategy for the effective management of pathologic hypersecretion of mucus observed in COPD and asthma. Thus, in the present review, we tried to give an overview of the conventional pharmacotherapy for mucus-hypersecretory diseases and recent research results on searching for the novel candidate agents for controlling of pulmonary mucus hypersecretion, aiming to shed light on the potential efficacious pharmacotherapy of mucus-hypersecretory diseases.
Cholesterol, the main structural molecule of cell membranes, is involved in essential functions of the human body. Dyslipidemia is an established risk factor for cardiovascular diseases (CVDs) that is observed even in childhood. To reduce the risk of CVDs in children, several clinical guidelines have been published for the management of pediatric dyslipidemia. However, pediatric dyslipidemia is also associated with several health problems other than CVDs. This article reviews the current data on dyslipidemia-related pediatric health issues. There is strong evidence that low serum vitamin D levels, asthma, and mental health problems may be associated with dyslipidemia in the pediatric population regardless of body mass index. This review also highlights the need for further large-scale population-based studies in the Korean pediatric population to establish effective strategies for promoting children's health.
Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
Tuberculosis and Respiratory Diseases
/
v.80
no.2
/
pp.169-178
/
2017
Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.
Purpose : Asthma is characterized by reversible airway obstruction and bronchial hyperresponsiveness result from airway inflammation. Fraction of nitric oxide in expired air (FeNO) has recently been investigated as a noninvasive measure of airway inflammation. FeNO has been reported to correlate with induced sputum eosinophilia and methacholine challenge test that it is represent severity of asthma. The purpose of this study was to analyze the relationship of FeNO with pulmonary function tests in patients with intermittent asthma. Methods : Eighty children included in this study were diagnosed as asthma from April through August, 2005 in Department of Pediatrics, College of Medicine, Kyunghee University. They aged from 4 to 15 years who were able to conduct spirometry and FeNO monitoring. They did not have upper respiratory tract infection and did not use an asthma controller which contain corticosteroids within 4 weeks. Pulmonary function test was done and FeNO was measured with online tidal breathing method using a chemiluminescence NO analyzer (CLD 88 sp, Eco Medics, Duernten, Switzerland). The correlations between pulmonary function test and FeNO were analyzed using Spearman correlation coefficient method. Results : The mean of FeNO of subject was 16.88 parts per billion (ppb). The mean of forced expiratory volume in 1 second ($FEV_1$) was $0.890{\pm}0.455L$ and forced vital capacity (FVC) was $1.071{\pm}0.630L$. The mean of predicted $FEV_1%$ ($FEV_1%pred$) was $98.39{\pm}34.27%$ and $FEV_1/FVC$ was $88.53{\pm}19.49$. FeNO was significantly correlate with $FEV_1$ (r=0.345, P<0.01) and FVC (r=0.244, P<0.05). FeNO did not correlate with $FEV_1%pred$ or $FEV_1/FVC$. Conclusion : The measurement of FeNO could be a useful marker in the management of childhood asthma and it is evolving to provide a complementary role alongside existing pulmonary function test. We propose that measuring technique and establishment of normal reference range are important area for future research.
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.
Purpose: The aim of this study was to analyze health promotion programs utilizing forests by reviewing regional healthcare program plans in Korea. Methods: We analyzed 227 regional healthcare program plans from 2011 to 2014; seven health promotion programs of the 16 major healthcare programs were prescribed by public health law. Results: Our analysis revealed that only 35 health promotion programs from 29 sites were utilizing forests. Furthermore, of 21 known categories of health promotion programs, only nine incorporated the use of forests. Atopy-asthma healthcare programs were the most common forest health promotion programs, which also included specialized disease management programs (e.g., for atopy prevention and healing, patients with metabolic syndrome or cancer) and specialized mental health management programs (e.g., for addiction or dementia prevention). Others included programs on the development of forest roads or industrial development using forest products. Conclusion: Health programs using forests in Korea are still very limited and primarily comprise atopy-asthma prevention/management, health behavioral change, and mental health programs. This study provided useful information for developing health policies and forest health promotion programs further in Korea.
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