• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.1-5
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• 2018

Asthma, remains symptomatic despite ongoing treatment with high doses of inhaled corticosteroids (ICS) in conjunction with long-acting beta-agonists (LABA), is classified as "severe" asthma. In the course of caring for those patients diagnosed with severe asthma, stepping up from ICS/LABA to more aggressive therapeutic measures would be justified, though several aspects have to be checked in advance (including inhaler technique, adherence to therapy, and possible associated comorbidities). That accomplished, it would be advisable to step up care in accordance with the Global Initiative for Asthma (GINA) recommendations. Possible strategies include the addition of a leukotriene receptor antagonist or tiotropium (to the treatment regimen). The latter has been shown to be effective in the management of several subgroups of asthma. Oral corticosteroids have commonly been used for the treatment of patients with severe asthma in the past; however, the use of oral corticosteroids is commonly associated with corticosteroid-related adverse events and comorbidities. Therefore, according to GINA 2017 these patients should be referred to experts who specialize in the treatment of severe asthma to check further therapeutic options including biologics before starting treatment with oral corticosteroids.

• 감성과학
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• 제23권2호
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• pp.13-22
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• 2020

본 연구는 국민건강영양조사(2017) 자료를 이용하여 의사로부터 천식 진단을 받은 대상자의 자가 건강인지도, 스트레스, 2주 연속 우울감 등의 심리적 요인과 생리적 건강지표인 혈액 검사 자료를 비교하고 관련 위험요인들을 분석하였다. 연구에 사용된 국민건강영양조사(2017) 전체 대상자 수는 8,127명이며, 그 중의 성인(19세 이상) 5,852명을 대상으로 자료를 분석하였다. 일반적 특성 중 나이에 따른 천식 발생의 위험도는 65세 이상에서 높이 나타났으며(OR=1.48), 학력(OR=1.89)과 소득(OR=2.07)이 낮을수록 천식질환 발생 위험도가 증가하는 것으로 관찰되었다. 또한, 결혼 상태에서는 유배우자 동거와 비교하면 미혼(OR=1.62)과 무 배우자(사별, 이혼; OR=2.30)에서 천식 발생확률이 증가하였으며, 천식 진단군은 활동 제한(OR=2.39)이 높은 것으로 확인되었다. 심리적 요인에 있어서는 건강이 나쁘다고 인식할수록 천식 발생 유병률이 증가하였으며(OR=3.45), 우울감을 느끼는 경우도 증가하였지만(OR=1.78), 스트레스는 천식 발생 관련 위험요인이 아닌 것으로 확인되었다. 객관적 검사자료인 생리적 지표에서는 고감도 C-반응성 단백질 수치가 증가할수록 천식 발생 위험도가 증가함이 확인되었다(OR=1.12). 따라서 자가 건강인지도 및 우울감 같은 심리적 요인과 생리적 건강지표 중 하나인 고감도 C-반응성 단백질은 성인천식 질환의 잠재적 위험요인으로 인지되며, 이를 바탕으로 성인천식 질환 관리에 있어서 일반적 특성뿐만 아니라 심리적 요인 및 생리적 건강지표를 고려한 성인건강 관련 프로그램이 필요할 것으로 생각된다.

• 디지털융복합연구
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• 제15권6호
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• pp.297-304
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• 2017

본 연구의 목적은 한국 청소년 천식 환자의 천식 악화와 항산화 식품 섭취와의 연관성을 알아보는 것이다. 이 연구는 제11차 청소년건강행태 온라인조사 참여자 중 천식으로 진단받은 1,578명의 자료를 이용하여 시행하였다. 알려진 천식 악화의 위험인자들과 사회인구적 변수들과 모든 식품 섭취 행태관련 변수들을 통계적으로 분석하였다. 항산화 식품섭취와 천식 악화와의 연관성을 추정하기위해 로지스틱 회귀분석을 최종적으로 사용하였다. 분석결과 남성 및 흡연경험은 천식악화와 관련이 있었고, 적은 항산화 식품 섭취 또한 천식악화를 의미 있게 높이는 것으로 나타났다. 따라서 천식 청소년을 대상으로 금연과 항산화식이섭취 교육이 중요하다. 과일과 야채를 적절히 섭취하도록 권장하는 것이 필요하다.

• Environmental Analysis Health and Toxicology
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• 제27권
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• pp.6.1-6.8
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• 2012

Objectives: Childhood allergic diseases are a major concern because they lead to a heavy economic burden and poor quality of life. The purpose of this study was to investigate the prevalence of childhood atopic dermatitis, asthma, allergic rhinitis, and the comorbidity of allergic diseases in Seoul, Korea. Methods: We conducted a cross-sectional survey between May and October 2010 to evaluate the prevalence of childhood allergic diseases, including atopic dermatitis, asthma, and allergic rhinitis, using a questionnaire from the International Study of Asthma and Allergies in Childhood group. Each questionnaire was completed by the parent or guardian of a child. Results: In the 31,201 children studied, the prevalence of atopic dermatitis symptoms in the past 12 months was 19.3% in children 0 to 3 years of age, 19.7% in children 4 to 6 years of age, 16.7% in children 7 to 9 years of age, and 14.5% in children 10 to 13 years of age (p for trend < 0.001). The prevalence of asthma in these age groups was 16.5%, 9.8%, 6.5%, and 5.4%, respectively (p for trend < 0.001). The prevalence of allergic rhinitis in these age groups was 28.5%, 38.0%, 38.5%, and 35.9%, respectively (p for trend = 0.043). The percentage of subjects with both atopic dermatitis and asthma, both asthma and allergic rhinitis, or both atopic dermatitis and allergic rhinitis was 2.5%, 4.7%, and 8.7%, respectively. The prevalence of comorbid allergic diseases decreased with age (p for trend < 0.001). Conclusions: Our study revealed that the prevalence of some allergic diseases, such as atopic dermatitis and asthma, was relatively high in very young children and that all of the principal allergic diseases in children often co-exist.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.11-17
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• 2022

Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

• International Journal of Advanced Culture Technology
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• 제8권3호
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• pp.275-279
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• 2020

Due to the recent rapid industrialization worldwide, the number of pediatric asthma patients is increasing. And the fine dust containing heavy metals is linked to the characteristics of high toxic lead due to the increase heating in factory operation and automobile driving. It is the reason of arsenic increasing. In the treatment of pediatric asthma patients, drug administration, oral drug entry, and HMPC (Home Management Plan of Care) are used. In this paper, we analyze the relationship between the onset of asthma and the method of prescription for specific childhood asthma in the United States using EM (Expectation Maximization) and MDL (Minimum Description Length) algorithms. And the association is also analyzed by comparing the nature of specific congestion between the past prevalence of digestive asthma and the recent prevalence of environmental pollution.

• Tuberculosis and Respiratory Diseases
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• 제59권6호
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• pp.591-599
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• 2005

Asthma is the most common disease of the lungs, and one that poses specific challenges for the physicians including radiologist. This article reviews for the clinical diagnosis, Radiologic features, and differential diagnosis of asthma, and outlines the radiologic features of the complications of asthma. Bronchial wall thickening and hyperinflation characterize the chest radiograph of the patients with asthma. On CT scan one may see airway wall thickening, thickened centrilobular structures, and focal or diffuse hyperlucency. Apparent bronchial dilatation may be seen, but the diagnosis of bronchiectasis should be made with caution. Quantification of changes in the airway wall and lung parenchyma may be valuable in understanding the mechanisms of asthma and in evaluating the effects of treatment. The challenge for the physician evaluating the images of a patient with asthma is to find complications.

• Advances in Traditional Medicine
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• 제7권1호
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• pp.11-25
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• 2007

Bronchial asthma is a major public health problem worldwide and the morbidity and mortality of asthma have increased in last few decades. There is high prevalence of usage of alternative traditional system of medicines for the treatment of asthma. Large numbers of medicinal plant preparations have been reported to possess anti-asthmatic effects. Plant cells are now considered to be the chemical factories synthesizing a large variety of chemical compounds. Further, Ayurvedic system of medicine has an elaborate description of asthma from the earliest times describing it as 'Shwasa' meaning disease pertaining to breathing. This review classifies the antiasthmatics herbs based on the possible mechanism of action reported. Thus, these plants can be used to obtain a polyherbal formulation which contains various herbs acting at particular sites of the pathophysiological cascade of asthma for prophylaxis as well as for the treatment of asthma.

• Advances in Traditional Medicine
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• 제8권1호
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• pp.1-16
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• 2008

Immunity is responsible for the defense mechanism of the body but in case of autoimmune diseases, its role gets diverted. Like so many other diseases, asthma is also considered as one of the most common autoimmune diseases to be occurring in community. Asthma is defined as a chronic inflammatory airway disease that is characterized by airway hyper reactivity and mucus hypersecretion that result in intermittent airway obstruction. The incidence of allergic asthma has almost doubled in the past two decades. Although, precise causative mechanism of asthma is unknown, but several mechanisms have been proposed that is immunological, pharmacological and genetic mechanisms, and airway and neurogenic inflammation. The inflammatory process observed in the asthmatic patients is the final result of a complex network of interactions between various immunological cell lineages, its mediators and secreted substances. Thus, among the mechanisms proposed, the immunological one plays a key role. Through this article, we have tried to provide some insight into immunological mechanisms in pathogenesis of asthma.

• The Korean Journal of Pain
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• 제8권2호
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• pp.331-335
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• 1995

Asthma is a disease of the airways that is characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli. A number of causes have been postulated for the increased airway reactivity of asthma is conservative as beta-adrenergic agonist, methylxanthines, glucocorticoids, anticholinergics and mast cell stabilizing agent. Stellate ganglion block for the treatment of bronchial asthma has its controversies. Stellate ganglion block was performed for the treatment of 3 patients with bronchial asthma. After stellate ganglion blocks, dyspnea, coughing and wheezing was markedly reduced. Lung function test improved with 1 st case. Two asthma cases were able to discontinue medication for asthma. No severe aggrevation of bronchial symptoms were noted after stellate ganglion blocks. It suggested that stellate ganglion block can be safely performed on bronchial asthmatic patients.