• Clinical and Experimental Pediatrics
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• v.56 no.10
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• pp.439-445
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• 2013

Purpose: Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort. Methods: The levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia. Results: The median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0-74.9 nmol/L, and 53 (10.1%) showed concentrations of ${\geq}75.0$ nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend=0.0004). Conclusion: The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.

• 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.

• The Journal of Korean Academic Society of Nursing Education
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• v.11 no.2
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• pp.252-259
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• 2005

Purpose: Asthma is the most common chronic disease of childhood. It's important mother's caring for management of children with asthma. This study was to provide the evidenced data for preparing an educational program by identifying the knowledge level and educational demand about pediatric asthma of mothers of children with asthma. Method: The subjects were 91 mothers of children with asthma who admitted at 3 hospital in Busan. The data were collected through a self-reporting questionnaire from Feburary to May, 2005. The data was analyzed by SPSS 10.0 program. Results: The total mean percentage of correct answer of knowledge about pediatric asthma was 55.6% and the total mean $score{\pm}SD$ of educational demand about pediatric asthma was $4.40{\pm}0.50$. The knowledge level was statistically different by recurrence number(F=3.08, p=.049). There was not correlation between knowledge level and eucational demand. Conclusions: The mothers of children with asthma had a medium knowledge level and a high educational demand. Based on the results, mothers' knowledge is an important part of children with asthma management. Therefore nursing intervention program for mothers of children with asthma should be developed and the mothers should cope with asthma effectively.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.173-181
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• 1996

Background : Several studies have suggested that impaired mucociliary clearance plays a role in the pathophysiology of bronchial asthma. Cough productive of mucoid sputum is common, and mucous plugs in the airways are frequently observed. These clinical features are in keeping with the histologic lesions of asthma, which involve primarily the epithelial and mucous-producing structures of the conducting airways. Some studies have shown that the mucociliary clearance is impaired in adult asthma, but it has not been studied in childhood asthma. The objectives of this study were to examine whether the mucociliary clearance is impaired in childhood asthma and to estimate the degree of impairment in comparison with that of immotile cilia syndrome. Method : Thirteen children with mild stable asthma and eight patients with immotile cilia syndrome completed this study. Ten healthy children were recruited as a normal control group. The whole-lung mucociliary clearance was measured by the radioaerosol technique. Aerosols, tin colloid particles tagged with the radionuclide technetium-99m($^{99m}Tc$), were generated by means of nebulizer, and inhaled via a mouthpiece. The retention of radioactivity was measured at 30, 60, 90 and 120 minutes by gamma camera, and mucociliary clearance was calculated as percent retention at each time. Results: 1) In each subject, the percent retention decreased variably with the lapse of time. 2) The percent retention of radionuclide decreased at each time in order of normal control, bronchial asthma and immotile cilia syndrome and the percent retention of immotile cilia syndrome was significantly higher than that of normal control at each time(p<0.05). 3) At two hours, the percent retention of bronchial asthma($65.0{\pm}1.8$(SE)%) was significantly higher than that of the normal control($54.4{\pm}3.5%$, p<0.05), and significantly lower than that of immotile cilia syndrome($73.3{\pm}1.4%$, p<0.01). 4) When the percent retention was analyzed according to $PC_{20}$ in the children with bronchial asthma, they had no relationship with each other. Conclusion: Mucociliary clearance in the children with bronchial asthma was significantly lower than normal control. This finding indicates that impaired mucociliary clearance operates in childhood asthma as well, and suggests that it may be one contributing factor in the pathogenesis of asthma. The degree of impairment, however, was not so severe as immotile cilia syndrome.

• Child Health Nursing Research
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• v.6 no.1
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• pp.89-102
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• 2000

Asthma is one of the most common chronic disease of childhood. Although an improved understanding of the pathophysiology of asthma has had a positive impact on the treatment and management of the disease, there has been a gradual but significant increase in asthma mortality. Also, mother's caring type is the essential factor in management of the child with asthma. The purpose of this study is to identify and understand the caring patterns of mathers of children with Athma by Q methodology. As a research method, 35 Q-statements were collected through individual interviews and review of related literatures. 37 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. The were 3 different caring types classified as follows : Type I was the therapeutic compliance obeying type, compliancing medication and preventing cold etc. Type II was the physical strengthening type, taking Chinese medicine and folk remedy etc. Type III was the environment control type, managing house and environment clearly and ventilating room air etc. Therefore, it needs considering above each type in nursing care of the family and children with asthma.

• Clinical and Experimental Pediatrics
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• v.59 no.8
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• pp.319-327
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• 2016

Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards. Unfortunately, the underlying mechanisms remain largely unknown. Despite the continuing efforts worldwide, the etiologies and rising prevalence remain unclear. Thus, it is important to identify and control risk factors in the susceptible individual for the best prevention and management. Genetic susceptibility or environments may be a potential background for the development of allergic disease, however they alone cannot explain the rising prevalence worldwide. There is growing evidence that epigenetic change depends on the gene, environment, and their interactions, may induce a long-lasting altered gene expression and the consequent development of allergic diseases. In epigenetic mechanisms, environmental tobacco smoke (ETS) exposure during critical period (i.e., during pregnancy and early life) are considered as a potential cause of the development of childhood allergic diseases. However, the causal relationship is still unclear. This review aimed to highlight the impact of ETS exposure during the perinatal period on the development of childhood allergic diseases and to propose a future research direction.

• Journal of the Korean association of regional geographers
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• v.16 no.6
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• pp.706-723
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• 2010

The impervious surface was frequently employed as a proxy of the total environmental burden in the urban area. The impervious surface was extracted from a satellite image and the GIS (Geographical Information System) database for childhood asthma hospitalizations was generated for a total of 62,136 children using the National Health Insurance database of South Korea. Children living in an impervious environment do result in almost twice as many hospitalizations (26.58%) for asthma, as compared to the sub-urban pervious living (15.82%). Furthermore, the risk zones with persistently high hospitalizations for three years were specifically identified over the impervious sub-district alone. The impervious zone showed a small inter-year variation of hospitalizations (r: 0.937) while the sub-urban pervious fringe was found to display a yearly variation(r: 0.371). The strong temporal autocorrelation means that the impervious areas have frequent long-lived hospitalizations for asthma, thus children living in impervious areas were likely to have had more chronic asthma attacks than those living in pervious areas. These experimental results indicate that an impervious surface as thematic parameter of analysis is a crucial explanatory variable for asthma hospitalizations and its longer persistence among children.

• Research in Community and Public Health Nursing
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• v.26 no.3
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• pp.230-237
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• 2015

Purpose: This study aimed to assess the prevalence of asthma, allergic rhinitis, and atopic dermatitis in elementary school students according to the body mass index. Methods: This study was conducted as cross-sectional descriptive research using a structured questionnaire. Data were collected from 6,398 students at 15 elementary schools located in Y City in Korea. The cross-sectional survey used the Korean version of International Study of Asthma and Allergies in Childhood questionnaire. Logistic regression analysis was performed to estimate the odds ratios of body mass index. Results: The symptom prevalence of asthma, allergic rhinitis, and atopic dermatitis in the last 12 months was 12.4%, 49.5%, and 24.5%, respectively. The symptom prevalence of asthma was significantly higher in the obesity group. The number of those without any asthma symptom in lifetime was significantly smaller in the overweight (OR=0.70, p=.004) and obesity (OR=0.57, p=.005) groups than in the healthy weight group. Conclusion: These results suggest that asthma, allergic rhinitis, and atopic dermatitis prevention programs for elementary school students should include weight control intervention.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.1
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• pp.32-42
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• 2014

Objectives The purpose of this study is to establish relationship between allergic diseases and functional gastrointestinal disorders in children and adolescents using objective criteria and questionnaires. Methods This study surveyed 237 children and adolescents who visited the department of Pediatrics of ${\bigcirc}{\bigcirc}$ Korean Medicine Hospital from September 23rd, 2013 to December 26th, 2013. The Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Korean-translated Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-Rome III) were used. We analyzed the data by using PASW Statistics 18.0 with Chi-square test, Fisher's exact test and Linear by linear association. Results There was no significant difference between prevalence of allergic diseases and functional gastrointestinal disorders. Also, there was no strong relationship between the number of allergic diseases and the functional gastrointestinal disorders. However, some parts showed significant relationships - such as asthma symptoms ever and belch; asthma symptoms last 12 months and belch; allergic rhinitis diagnosis ever and belly aches and abdominal pain around and below the belly button; allergic rhinitis treatment last 12 months and belly aches and abdominal pain around and below the belly button; and atopic dermatitis diagnosis ever and irritable bowel syndrome (respectively; p=0.046, p=0.008, p=0.004, p=0.029, p=0.035). And as the number of allergic diseases increases, the prevalence of functional gastrointestinal disorders are 19.4%, 31.3%, 41.7%, 31.0% respectively. Conclusions Although there was no significant relationship between allergic diseases and functional gastrointestinal disorders, some gastrointestinal symptoms were related to allergic diseases.

• Clinical and Experimental Pediatrics
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• v.55 no.6
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• pp.185-192
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• 2012

The prevalence of allergic diseases has increased worldwide, a phenomenon that can be largely attributed to environmental effects. Among environmental factors, air pollution due to traffic is thought to be a major threat to childhood health. Residing near busy roadways is associated with increased asthma hospitalization, decreased lung function, and increased prevalence and severity of wheezing and allergic rhinitis. Recently, prospective cohort studies using more accurate measurements of individual exposure to air pollution have been conducted and have provided definitive evidence of the impact of air pollution on allergic diseases. Particulate matter and ground-level ozone are the most frequent air pollutants that cause harmful effects, and the mechanisms underlying these effects may be related to oxidative stress. The reactive oxidative species produced in response to air pollutants can overwhelm the redox system and damage the cell wall, lipids, proteins, and DNA, leading to airway inflammation and hyper-reactivity. Pollutants may also cause harmful effects via epigenetic mechanisms, which control the expression of genes without changing the DNA sequence itself. These mechanisms are likely to be a target for the prevention of allergies. Further studies are necessary to identify children at risk and understand how these mechanisms regulate gene-environment interactions. This review provides an update of the current understanding on the impact of air pollution on allergic diseases in children and facilitates the integration of issues regarding air pollution and allergies into pediatric practices, with the goal of improving pediatric health.