• Clinical and Experimental Pediatrics
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• 제56권1호
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• pp.8-12
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• 2013

Asthma is associated with increased levels of eosinophils in tissues, body fluids, and bone marrow. Elevated levels of eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) have been noted in asthma patients. Higher levels of EDN and ECP are also associated with exacerbated asthmatic conditions. Thus, EDN, along with ECP, may aid the diagnosis and monitoring of asthma. Several groups have suggested that EDN is more useful than ECP in evaluating disease severity. This may partially be because of the recoverability of EDN (not sticky, 100% recovery rate), as ECP is a sticky and more highly charged protein. In terms of clinical utility, EDN level is a more accurate biomarker than ECP when analyzing the underlying pathophysiology of asthma. As a monitoring tool, EDN has shown good results in children with asthma as well as other allergic diseases. In children too young to fully participate in lung function tests, EDN levels may be useful as an alter native measurement of eosinophilic inflammation. EDN can also be used in adult patients and in multiple specimen types (e.g., serum, sputum, bronchoalveolar lavage fluid, and nasal lavage fluid). These results are repeatable and reproducible. In conclusion, EDN may be a novel biomarker for the diagnosis, treatment, and monitoring of asthma/allergic disease.

• Clinical and Experimental Pediatrics
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• 제56권10호
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• pp.424-430
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• 2013

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.

• Korean Journal of Clinical Pharmacy
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• 제9권2호
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• pp.97-102
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• 1999

The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

• Journal of Korean Academy of Nursing
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• 제47권5호
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• pp.613-623
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• 2017

Purpose: This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma. Methods: Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables. Results: There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL. Conclusion: This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

• International Journal of Contents
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• 제4권2호
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• pp.1-6
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• 2008

Pre schools with state of the art facilities that would provide not just academic excellence but also ensure the safety and provide efficient healthcare to their pupils relative to Atopic Dermatitis with Asthma is the main objective of this research One of the most promising applications of sensor networks is for human healthcare monitoring. Due to recent technological advances in sensor, low power microelectronics and miniaturization, and wireless networking enable the design and proliferation of this wireless sensor networks capable of autonomously monitoring and controlling environments. Thus, this research presents the utilization of such microelectronic sensor and plots the hardware and software architecture of a wireless sensor network system with real-time pupil monitoring that integrates vital sign sensors, location sensor and allergen sensor. This proposed architecture for wearable sensors can be used as active tags which can track pupil's location within the school's premises, identify possible atopic dermatitis with asthma allergens, it would monitor and generate a health status report of the pupil.

• Journal of the Korean Electrochemical Society
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• 제25권1호
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• pp.13-21
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• 2022

There is an increasing interest in monitoring of specific biomarker for determining progression of a disease or efficacy of a treatment. Conventional method for quantification of specific biomarkers as enzyme linked immunosorbent assay (ELISA) has high material costs, long incubation periods, requires large volume of samples and involves special instruments, which necessitates clinical samples to be sent to a lab. This paper reports on the development of an electrochemical biosensor to measure total immunoglobulin E (IgE), a marker of asthma disease that varies with age, gender, and disease in concentrations from 0.3-1000 ng/mL with consuming 20 µL volume of whole blood sample. The sensor provides rapid, accurate, easy, point-of-care measurement of IgE, also, sequential monitoring of total IgE with ovalbumin (OVA) induced mice is another application of sensor. Taken together, these results provide an alternative way for detection of biomarkers in whole blood with low volumes and long-term ex-vivo assessments for understanding the progression of a disease.

• Clinical and Experimental Pediatrics
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• 제46권5호
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• pp.495-499
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• 2003

Purpose : Eosinophil is one of the important inflammatory cell involved in the airway inflammation in childhood asthma. It has been demonstrated that markers of eosinophil activation, including eosinophil cationic protein or eosinophil protein X(EPX), are increased in childhood asthma. Furthermore, they are related to disease activity and are assumed to be helpful in monitoring the treatment effect as urinary EPX(U-EPX) can be obtained easily and in a noninvasive way in children of all ages. Methods : Twenty-five children(22 male and three female) aged $11.87{\pm}3.82$ years with stable asthma were challenged with methacholine and urine was collected from each child during the following periods; before methacholine challenge test(MCT); 0-3 hr after the end of MCT; 4-7 hr after the end of MCT; and 8-24 hr after the end of MCT. Bronchial reactivity was determined by using Dosimeter( Jeager, Germany) with serially diluted methacholine from 0.05 to 25.0 mg. The $FEV_1$ less than 80% of baseline value were classified into positive MCT. U-EPX was measured with a sensitive and specific radioimmunoassay(Pharmacia & Upjohn AB, Uppsala, Sweden). Results were expressed as ${\mu}gEPX/mmol$ creatinine. Results : An early airway response after MCT was associated with an increase of U-EPX excretion for 0-3 hr after methacholine inhalation in comparison with beseline values. Most subjects showed a small increase in U-EPX excretion during late asthmatic response for 4-7 hr, which then decreased to normal level in 8-24 hr. Also, a tendency for a higher increase of U-EPX was associated with a lower threshold of methacholine challenge and a longer duration of asthma. Conclusion : Measurement of EPX in urine is a noninvasive and easy method to assess the severity of airway inflammation in asthmatic children. It may be a helpful index of the events underlying the airway inflammatory responses during nonspecific bronchial challenge, and in monitoring asthma management.

• Journal of Environmental Health Sciences
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• 제26권2호
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• pp.80-90
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• 2000

To determine the effect of air pollutants in Taejon City, we used medical insurance claim data for asthma and the data monitored from telemetry system of Ministry of Environment for air pollutants and meteorological factors. From November 1st, 1997 to October 31th, 1998, 95,629 asthma patients were covered by medical insurance at Taejon City. Subjects were composed of 49,563 males (51.8%) and 46.336 females(48.2%), and among the subjects, the proportion under 15 years old was 62.8% of the total. During the study period, daily mean concentrations of each air pollutants-So2, No2, CO, O3 and TSP-were 9.8 ppb, 17.6 ppm, 1.414 pp, 17.3 ppb and 60.6 $\mu\textrm{g}$/㎥, respectively, which were lower than each of the environmental recommended exposure levels, Through the simple correlation analysis between each air pollutants and meteorological factors, O3 was positively correlated with temperature, but negatively with relative humidity. TSP, SO2, NO2, CO were negatively correlated with meteorological factors, and these air pollutants except O3 were positively correlated with each other, O3 was correlated with TSP positively but the others negatively. Estimating relative risks of each air pollutant with the baseline general additive model, daily mean concentrations of TSP(Lag 0, 1, 4, 5day) were significantly associated with the increase of the asthma admission. Two age subgroups, under 15 and 15~54 have shown various association of all air pollutants concentration with the asthma admission. However, in case of over 54 age subgroup, only TSP(Lag 0 day) among all air pollutants was associated with the asthma admission. Each of ambient outdoor pollutant concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations were much lower than the environmental recommended exposure levels. Therefore, continuous effort lowering air pollutant concentration and introducing an active environmental conservation policy should be implanted for preventing hazardous health effects. Considering major proportion of asthma admissions, high susceptibility and less confounding factors among the age subgroup under 15 will be a useful target population for assessing such health effect monitoring.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.61-72
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• 2001

Objectives : To evaluate the hypothesis that increasing ambient levels of ozone or particulate matter are associated with increased emergency room visits for asthma and to quantify the strength of association, if any, between these. Methods : Daily counts of emergency room visits for asthma, air quality, and weather data were collected from hospitals with over 200 beds and from monitoring Stations in Seoul, Korea from 1994 through 1997. Daily counts of emergency mom visits for asthma attack were analyzed using a general additive Poisson model, with adjustment for the effects of secular trend, seasonal variation, Sunday and holiday, temperature, and humidly, according to levels of ozone and particulate matter. Results : The association between daily counts of emergency room visits for asthma attack and ozone levels was statistically significant in summer(from June to August), and the RR by unit inclement of 100 ppb ozone was 1.30(95% CI = $1.11\sim1.52$) without lag time. With restriction of the period from April to September in 1996, the RR was 1.37(95% CI = $1.06\sim1.76$), and from June to August in 1995, the RR was 1.62(95% CI = $1.12\sim2.35$). In the data for children$(5\sim14yr)$, the RR was 2.57(95% CI = $1.31\sim5.05$) with restriction of the period from April to September in 1997. There was no Significant association between TSP levels and asthma attacks, but a slight association was seen between PM10 levels and asthma attacks in a very restricted period. Conclusion : There was a statistically significant association between ambient levels of ozone and daily counts of emergency room visits for asthma attack. Therefore, we must make efforts to effectively minimize air pollution, in order to protect public health.

• Journal of Preventive Medicine and Public Health
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• 제39권4호
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• pp.309-316
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• 2006

Objectives: Korean epidemiological studies have used reduced samples according to the subject's characteristics, such as the health services provided, the historical note with asthma, and age, to examine the acute effect of air pollution on asthma using the Korean National Health Insurance records. However, there have been few studies on whether the effects shown in these reduced samples are different from those of all samples. This study compared the effects of air pollution on asthma attacks in three reduced samples with those of entire samples. Methods: The air pollution data for $PM_{10},\;CO,\;SO_2,\;NO_2,\;and\;O_3$, and weather conditions including temperature, relative humidity, and air pressure in Seoul, 2002, were obtained from outdoor monitoring stations in Seoul. The emergency hospital visits with an asthma attack in Seoul, 2002 were extracted from the Korean National Health Insurance records. From these, the reduced samples were created by health service, historical notes with asthma, and age. A case-crossover design was adopted and the acute effects of air pollution on asthma were estimated after adjusting for weather, time trend, and seasonality. The model was applied to each reduced sample and the entire sample. Results: With respect to the health service, the effects on outpatients were similar to those for the total sample but were different for inpatients. These similar effect sizes were also observed in the reduced samples according to the historical note with asthma and age. The relative risks of $PM_{10},\;CO,\;SO_2,\;NO_2,\;and\;O_3$, among the reduced and entire samples were 1.03, 1.04-1.05, 1.02-1.03, 1.04-1.06, and 1.10-1.17, respectively. Conclusions: There was no clear evidence to show a difference between the reduced samples and the entire samples.