Background: While asthma control is defined as the extent to which the various manifestations of asthma are reduced by treatment, current guidelines of asthma recommend assessment of asthma control without consideration of airway inflammation. Our aim was to investigate the relationships between fractional exhaled nitric oxide (FeNO), a reliable marker of airway inflammation, and levels of asthma control in patients treated with inhaled corticosteroids (ICS). Methods: We enrolled 71 adult patients with asthma who had been treated with ICS for more than four months. FeNO was measured and spirometry was performed at the time of enrollment. Asthma control was assessed (a) by the physician based on the Global Initiative for Asthma guidelines, (b) by the patients, and (c) by using the Asthma Control Test (ACT). Statistical analyses were done to analyze the relationships between (i) FeNO and (ii) measures of asthma control and clinical indices for asthma manifestations. Results: There was no significant difference in FeNO levels between the three groups according to levels of asthma control (controlled, partly controlled and uncontrolled) as determined by the physician (p=0.81), or by the patients (p=0.81). In addition, FeNO values were not significantly correlated with the ACT scores (r=0.031, p=0.807), while FeNO showed a correlation with peripheral blood eosinophil counts (p<0.001). Conclusion: These findings demonstrate that FeNO levels are not associated with measures of asthma control in patients treated with ICS. Information on airway inflammation from FeNO concentrations seems to be unrelated to levels of asthma control
Purpose. This study was designed to examine the effect of asthma management education program applied to allergic asthma patients receiving immunotherapy due to house dust mite on their stress and compliance with health care regimens. Methods. A quasi experimental design with non-equivalent control group and non-synchronized design was used. The subjects of this study were 61 patients who were receiving immunotherapy at intervals of a week after their symptoms were diagnosed as house dust mite allergic asthma at the pulmonary department of a university hospital in Seoul. They were divided into an experimental group of 29 patients who received asthma management education and a control group of 32 patients. The asthma management education pro-gram was composed of group education (once) and reinforcement education (three times) with environmental therapy and immunotherapy to house dust mite. Results. Stress significantly decreased in the experimental group compared to that in the control group. Compliance with health care regimens significantly increased in the experimental group compared to that in the control group. Conclusions. The results suggested that the asthma management education program is effective for the management of stress and the improvement of compliance in patients with allergic asthma to house dust mite.
Journal of Physiology & Pathology in Korean Medicine
/
v.20
no.5
/
pp.1159-1165
/
2006
This study was done to investigate the effects of Gamisojaganggi-tang(GSGT) on immunopathologic changes in OVA-induced asthma model of mice. Pathologic indicators associated with this immune disease, which include cytokines, the number of immune-cells, immunoglobin E (IgE), were examined, and histological changes of bronchial tissues were also examined. The administration of GSGT significantly reduced the lung weight compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the number of total cells in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the number of eosinophil in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT insignificantly increased the number of monocyte in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the number of lymphocyte in BAL compared with control mice of OVA-induced asthma model. The administration of GSGT significantly reduced the gene expression of eotaxin in lung tissue compared with control mice of OVA-induced asthma model. The administration of GSGT insignificantly reduced the IL-4 and IL-5 production in BALF compared with control mice of OVA-induced asthma model. The administration of GSGT insignificantly reduced the levels of total IgE and ovalbumin-specific IgE in BALF. The administration of GSGT significantly reduced the levels of ovalbumin-specific IgE whereas the serum levels of total IgE were insignificantly reduced compared with control mice of OVA-induced asthma model. The administration of GSGT moderately reduced bronchial alveolar narrowing, bronchiovascular edema and increase in the size of alveolar space, which shown in control mice of OVA-induced asthma model, in a dose dependent manner. Furthermore, GSGT reduced invasion of inflammatory cells, and proliferation of smooth muscle cells in bronchial tissue. These results suggested that GSGT has suppressive effects on pathologic changes associated with disease progression in asthma through the modulation of immune system. GSGT has potential to use as an anti-asthmatic agents.
Objective: We performed this study to determine the association between childhood asthma and residential environment risk factors including VOCs and formaldehyde exposure. Methods: We selected an asthma group (30) and a control gorup (30) through physicain diagnosis and assessed the VOCs and formaldehyde levels of exposure of elementary school children in Seoul. Results: In the results, there were no significant differences in socioeconomic factors between case and control groups. However, there were significant differences in family asthma history, amount of sunlight, level of humidity and number of household residents (p < 0.05). The level of VOC (toluene, ethylbenzene, stylene, m,p-xylene) exposure level of the case group was significantly higher than that of the control group (p < 0.05) and the result of logistic regression showed that asthma family history, amount of humidity and number of household residents were significant predictors of childhood asthma (p < 0.05). Conclusion: Some residential environments such as lower amounts of sunlight, greater amounts of humidity and smaller numbers of household residents and VOC exposure were determinded as risk factors for childhood asthma.
Exhaled nitric oxide (NO) has been extensively investigated as a noninvasive marker of airway inflammation in asthma. The increased NO expression induced by inflammatory mediators in airways can be monitored easily in exhaled air from asthmatic children. Based on the relationship between the increased NO expression and eosinophilic airway inflammation, fractional exhaled nitric oxide (FeNO) measurements become an important adjunct for the evaluation of asthma. In addition, the availability of portable devices makes it possible to measure FeNO more easily and frequently in the routine pediatric practice. Despite various confounding factors affecting its levels, FeNO can be applicable in diagnosing asthma, monitoring treatment response, evaluating asthma control, and predicting asthma exacerbations. Thus, although pulmonary function tests are the standard tools for objective measurements of asthmatic control, FeNO can broaden the way of asthma monitoring and supplement standard clinical asthma care guidelines.
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.
Purpose: This study was conducted to develop an asthma management education program for preschool children using Roy's adaptation theory as a framework and examining the effects of this program on adaptation to asthma treatment. Methods: A non-equivalent control group pre-post-test design was used with 43 preschool children diagnosed with asthma and required to be hospitalized for inhalation therapy. An intervention group (n=23) participated in the educational program and a control group (n=20) received regular treatment. The education program was conducted and evaluated from June 30 to October 31 2012, a maximum 3 times every 24 hours during hospitalization. Two nurses conducted the program using the teaching method of Gagn$\acute{e}$ and Briggs; instruction design theory through questionnaires to measure perception of disease, behavior of adaptation to treatment with inhalation therapy. Results: Effects of asthma management education program; scores for face-pain rating decreased and time of adaptation to treatment increased significantly in the experimental group compared to the control group but no significant differences were found for perception of the disease's cause and treatment. Conclusion: Results indicate that the asthma management education program has positive effects on adaptation to asthma treatment of preschoolers.
Background: Psychological factors are increasingly recognized for their influence on the course of asthma, on a worldwide basis. The aim of this study was to assess the presence of depression, anxiety, and asthma-related quality of life in patients with asthma and to evaluate their impact on severity and control of asthma. Methods: We assessed the severity of asthma by comparing patients' current medications to GINA guideline. The patients were classified into the controlled group (asthma patients with controlled disease) or into the uncontrolled group (asthma patients with uncontrolled disease), which included partly controlled and uncontrolled patients, again based on GINA guideline 2004. Patient-reported depressive symptoms, anxiety, and asthma-related quality of life were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and Korean asthma quality of life (KAQLQ). Results: One hundred and twenty patients were enrolled (mean age, $55{\pm}1$ years; 65% women). Among the 120 patients, 14 (12%) patients were classified as having mild asthma, 88 (73%) as having moderate asthma, and 18 (15%) as having severe asthma. Eighty-one (67%) of the 120 patients were controlled. The asthma-related quality of life showed the difference according to severity of asthma (p=0.002). The prevalence of depression was lower (10% vs 26%, p=0.024) and the asthma-related quality of life was higher (59.951 (29~75) vs 35.103 (18~72), $p{\leq}0.001$) in the controlled group. Higher trait anxiety score and lower asthma-related quality of life were associated with depression (p<0.001, p=0.002, respectively). Conclusion: Psychological factors, such as anxiety and depression, are strongly associated with asthma control. Therefore, screening and management of depression is needed in patients with asthma.
Objectives: The purpose of this study was to evaluate the association between asthma and dental caries by using data from the Korean National Health and Nutrition Examination Survey (KNHANES), from 2013 to 2015. Methods: The study included 11,731 subjects who were ${\geq}19$ years of age and analyzed their demographic-, socioeconomic-, health-, and oral health care-related data. The chi-squared test and logistic regression analysis were conducted using complex sample analyses to examine the relationship between asthma and dental caries. Results: Compared with the control group, the risk for dental caries in the asthma group was 1.207 times higher, regardless of various confounding factors (p<0.001). In the asthma group, the mean DMFT score was significantly higher than that in the control group (p<0.001). After adjusting for confounding factors, the mean number of DMFT in subjects with asthma was 7.67, which was higher than that in subjects without asthma (7.28) (p<0.001). Conclusions: The study results show that asthma may be a risk factor for dental caries. Therefore, in order to prevent dental caries in asthma patients, oral hygiene education is important.
Kim Ji Yun;Park Dong il;Kim Jong Dae;Kam Cheol Woo
Journal of Physiology & Pathology in Korean Medicine
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v.17
no.6
/
pp.1453-1462
/
2003
In order to study the effect of oral administration of Mawhangyounpye-tang against to asthma, astham was induced to allergy-sensitive Balb/c mouse with ovalbumin using method of Hatfield et al (1997). The changes of diameter lumen of upper portion of the trachea, lung weight, gross appearance of lung, histological profiles of lung and trachea, numbers of cellular compartments in the bronchoalveolar lavage fluid (BALF), numbers and morphology of the mast cells in the trachea, numbers of mucus-secretory cell in the broncus, morphology of the bronchus, ultramicroscopical appearance of surface of trachea and number of cilia and mucous-secretory cells by scanning electron microscope. Obtained results were as follows. 1. The diameters of trachea lumen were significantly decreased in asthma induced control groups and these decreasing were result from hypertrophy of mucous membrane. However, these phenomena were dramatically recovered in the Mawhangyounpye-tang dosing groups. 2. Lung weights and black spots, which were result from infiltration of inflammatory cells, were significantly increased in asthma induced control groups but these phenomena were dramatically recovered in the Mawhangyounpye-tang dosing groups. 3. Hypertrophy of mucous membrane of trachea and bronchus and !bronchioles in the lung, peritracheal, peribronchus and peribronchiolar inflammatory cell infiltration, and mucoid exudate deposit in the lumen were observed in asthma induced control groups but these phenomena were dramatically recovered in the Mawhangyounpye-tang dosing groups. 4. Cellular compartments including neutrophil and eosinophil were dramatically increased in the BALF of asthma induced control groups but these phenomena were dramatically recovered in the Mawhangyounpye-tang dosing groups. 5. Mast cell degranulation and decreasing of the numbers of mast cells were detected in the trachea of asthma induced control groups. However, these phenomena were dramatically recovered in the Mawhangyounpye-tang dosing groups. 6. Shed, decreasing of cilia cell and increasing of mucous-secretory cells in the surface of the trachea of asthma induced control groups but these phenomena were dramatically recovered in the Mawhangyounpye-tang dosing groups. In conclusion, it Is considered that Mawhangyounpye-tang has somewhat favorable effect on the asthma because the asthma specific series of abnormalities in respiratory system were decreased after oral administratin of Mawhangyounpye-tang in this study. In future, it is needed that the toxicological and dosagespecific study of Mawhangyounpye-tang to use against asthma with safe.
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