Kawasaki disease is a form of vasculitis, mainly in small and medium arteries of unknown origin, occurring frequently in childhood. It is the leading form of childhood-onset acquired heart disease in developed countries and leads to complications of coronary artery aneurysms in approximately 25% of cases if left untreated. Although more than half a century has passed since Professor Tomisaku Kawasaki's first report in 1957, the cause is not yet clear. Currently, intravenous immunoglobulin therapy has been established as the standard treatment for Kawasaki disease. Various treatment strategies are still being studied under the slogan, “Ending powerful inflammation in the acute phase as early as possible and minimizing the incidence of coronary artery lesions,” as the goal of acute phase treatments for Kawasaki disease. Currently, in addition to immunoglobulin therapy, steroid therapy, therapy using infliximab, biological products, suppression of elastase secretion inside and outside the neutrophils, inactivated ulinastatin therapy and cyclosporine therapy, plasma exchange, etc. are performed. This chapter outlines the history and transition of the acute phase treatment for Kawasaki disease.
Aneurysm ; Arteries ; Biological Products ; Coronary Vessels ; Cyclosporine ; Developed Countries ; Heart Diseases ; Immunization, Passive ; Incidence ; Inflammation ; Infliximab ; Mucocutaneous Lymph Node Syndrome ; Neutrophils ; Pancreatic Elastase ; Plasma Exchange ; Prednisolone ; Vasculitis

Air pollution, climate change, and reduced biodiversity are major threats to human health with detrimental effects on a variety of chronic noncommunicable diseases in particular respiratory and cardiovascular diseases. The extent of air pollution both outdoor and indoor air pollution and climate change including global warming is increasing-to alarming proportions particularly in the developing world especially rapidly industrializing countries worldwide. In recent years, Asia has experienced rapid economic growth and a deteriorating environment and increase in allergic diseases to epidemic proportions. Air pollutant levels in many Asian countries especially in China and India are substantially higher than are those in developed countries. Moreover, industrial, traffic-related, and household biomass combustion, indoor pollutants from chemicals and tobacco are major sources of air pollutants, with increasing burden on respiratory allergies. Here we highlight the major components of outdoor and indoor air pollutants and their impacts on respiratory allergies associated with asthma and allergic rhinitis in the Asia-Pacific region. With Asia-Pacific comprising more than half of the world's population there is an urgent need to increase public awareness, highlight targets for interventions, public advocacy and a call to action to policy makers to implement policy changes towards reducing air pollution with interventions at a population-based level.
Administrative Personnel ; Air Pollutants ; Air Pollution ; Air Pollution, Indoor ; Allergy and Immunology ; Asia ; Asian Continental Ancestry Group ; Asthma ; Biodiversity ; Biomass ; Cardiovascular Diseases ; China ; Climate Change ; Climate ; Consumer Advocacy ; Developed Countries ; Economic Development ; Family Characteristics ; Global Warming ; Humans ; Hypersensitivity ; India ; Rhinitis, Allergic ; Tobacco

There remains a misperception that non-communicable diseases (NCDs) are predominantly an issue for developed countries and are not major public health problems in low-income countries. North Korea is also often considered as a country with a disease structure that is typical of a low-income country. Infectious diseases and nutritional problems, including tuberculosis and pneumonia, are still major sources of medical discussion. The authors challenge this misperception by reviewing empirical data on epidemiologic and demographic transitions of North Korea and show that the current NCD burden is the main public health issue in North Korea. In result, it can be said that epidemiologic transition and demographic transition of North Korea preceded prior to economic hardship. It is necessary for the international community, including South Korea, to advance in a new direction of medical support for North Korea.
Communicable Diseases ; Democratic People's Republic of Korea ; Developed Countries ; Korea ; Pneumonia ; Population Dynamics ; Public Health ; Tuberculosis

This extensive review summarizes clinical evidence on immunotherapy and targeted therapy currently available for endometrial cancer (EC) and reports the results of the clinical trials and ongoing studies. The research was carried out collecting preclinical and clinical findings using keywords such as immune environment, tumor infiltrating lymphocytes, programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) expression, immune checkpoint inhibitors, anti-PD-1/PD-L1 antibodies and others' on PubMed. Finally, we looked for the ongoing immunotherapy trials on ClinicalTrials.gov. EC is the fourth most common malignancy in women in developed countries. Despite medical and surgical treatments, survival has not improved in the last decade and death rates have increased for uterine cancer in women. Therefore, identification of clinically significant prognostic risk factors and formulation of new rational therapeutic regimens have great significance for enhancing the survival rate and improving the outcome in patients with advanced or metastatic disease. The identification of genetic alterations, including somatic mutations and microsatellite instability, and the definition of intracellular signaling pathways alterations that have a major role in in tumorigenesis is leading to the development of new therapeutic options for immunotherapy and targeted therapy.
Antibodies ; Biological Therapy ; Carcinogenesis ; Developed Countries ; Endometrial Neoplasms ; Female ; Humans ; Immunotherapy ; Lymphocytes, Tumor-Infiltrating ; Microsatellite Instability ; Molecular Targeted Therapy ; Mortality ; Risk Factors ; Survival Rate ; Uterine Neoplasms

BACKGROUND: The prevalence of allergy among Surabaya school children is currently unknown. OBJECTIVE: To identify the prevalence of the common allergic sensitization and allergic diseases among school children and undergraduate students in suburban of Surabaya by epidemiologic data collection. METHODS: A multistage simple random sampling was done to select 5 primary schools, 8 secondary schools (4 of junior high schools and senior high schools, respectively), and 1 university from 5 districts in Surabaya city. Out of 550 invited respondents, 499 (128 primary school, 221 secondary school, and 150 undergraduate) respondents gave their consent. A complete personal history, allergic symptoms, environmental exposure of common allergens was obtained from interview and the physical examinations were performed. Skin prick test (SPT) was done using 45 different allergen extracts. Total serum IgE and specific IgE radioallergosorbent test levels were measured for respondents with allergic manifestations. RESULTS: There was an increasing SPT positivity among study respondents, from primary school, secondary school, to undergraduate students (21.90%, 28.95%, to 45.30% respectively). Cockroach (42.85%) and fungi/mold spore (42.85%) were the most common allergens in primary school children. House dust mites was the most common allergen in secondary school (63.16%) and undergraduate students (58.82%). Urticaria and rhinitis were the commonest allergic diseases manifestation. History of atopy was positive in 60.79% of the allergic respondents. CONCLUSION: The prevalence of allergic sensitization among school children and undergraduate students in Surabaya suburb areas were increased compared to previous estimates in 1998. While house dust mites are known as important allergens, surprisingly cockroach was the common allergen among the younger school children.
Allergens ; Child ; Cockroaches ; Data Collection ; Developed Countries ; Environmental Exposure ; Epidemiologic Studies ; Humans ; Hypersensitivity ; Immunoglobulin E ; Indonesia ; Physical Examination ; Prevalence ; Pyroglyphidae ; Radioallergosorbent Test ; Rhinitis ; Skin ; Spores ; Surveys and Questionnaires ; Urticaria

Early childhood caries is a global healthcare concern in developing and industrialized countries. If left untreated, it leads to immediate and long-term complications that affect the well-being and quality of life of concerned families. Therefore, many preventive and treatment approaches are available to the healthcare provider to curb this virulent form of caries. After behavioral interventions, general anesthesia is used in specific settings when a young patient presents with extensive teeth damage and exhibits a lack of cooperation that is incompatible with conventional dental office care. However, without proper follow-up, any positive results might be lost over time.
Anesthesia, General ; Child, Preschool ; Delivery of Health Care ; Dental Caries ; Dental Offices ; Developed Countries ; Follow-Up Studies ; Health Personnel ; Humans ; Oral Health ; Quality of Life ; Tooth

BACKGROUND/OBJECTIVES: Globally, it has been projected that there will be 2 billion overweight and 1 billion obese individuals by 2030. In Korea, the prevalence of adult obesity (BMI>25) increased from 29.7% in 2009 to 32.4% in 2015. Moreover, childhood obesity, which leads to adulthood obesity, has increasingly become a social problem. The purpose of this review is to summarize the scientific basis for the development of effective models and policies aimed at preventing obesity over a lifetime based on research modeling obesogenic environments. MATERIALS/METHODS: The review focuses on the characteristics of obesity prevalence and trends in 3P analysis (papers, patents, and products) as well as government-funded projects in Korean obesity obesogenic environments over the last 10 years. RESULTS AND DISCUSSION: As a result of the 3P analysis, studies on obesity risk factors were frequently carried out, according to two data bases RISS (4.9%) and PubMed (24.7%). Since there were only 17% patents related to the mechanism of preventing obesity in 7,951 Korean patents related to obesity, new paradigms of technologies to dominate the global obesity markets are needed. After government-funded projects were analyzed, communication and cooperation in multi-governmental departments were suggested to elucidate the characteristics of Korean obesity. Government should also produce short- and long-term road maps to develop a practical, successful outcome. Although the rate of obesity in Korea is currently lower than in other developed countries according to WHO criteria, without adequate governmental intervention, obesity rates will approach those of the top countries with high incidence rates of obesity within the next 10 years.
Adult ; Developed Countries ; Humans ; Incidence ; Korea ; Obesity ; Overweight ; Pediatric Obesity ; Prevalence ; Risk Factors ; Social Problems

OBJECTIVES: Different factors are responsible for the silent epidemic of diabetes mellitus in developing and developed countries. This study aimed to determine the role of demographic factors, lipid profile, family history (the estimation of genetic association) and anthropometric factors on diabetes onset. METHODS: Data from the enrolment phase of the Tabari Cohort study was applied for this study and included 10,255 participants aged between 35–70 years. Anthropometric variables were measured by trained staff using standard tools. Blood specimens were collected for lipid profile and blood glucose measurements. Data analyses were performed using SPSS version 24, with univariate and multivariate logistic regression. RESULTS: The prevalence of diabetes mellitus was estimated to be 17.2% in the cohort population, 15.6% in men, and 18.3% in women. The adjusted odds ratios (95% confidence intervals) for age groups 40–49, 50–59 and over 60 were 2.58 (2.20–3.69), 5.80 (4.51–7.48) and 8.72 (6.67–11.39), respectively. In addition, the odds ratios (95% confidence intervals) for 2 (or more), and 1 affected family member were 4.12 (3.55–4.90) and 2.34 (2.07–2.65), respectively. Triglyceride concentrations more than 500, and abnormal high-density lipoprotein levels increased the odds of diabetes mellitus by 3.29- and 1.18-fold, respectively. CONCLUSION: The current study showed that old age and a family history were strong predictors for diabetes mellitus.
Blood Glucose ; Body Mass Index ; Cohort Studies ; Demography ; Developed Countries ; Diabetes Mellitus ; Female ; Humans ; Lipoproteins ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Statistics as Topic ; Triglycerides

BACKGROUND: Workforce health is one of the primary and most challenging issues, particularly in industrialized countries. This article aims at modeling the major factors affecting accidents in the workplace, including general health, work-family conflict, effortereward imbalance, and internal and external locus of control. METHODS: A cross-sectional study was conducted in Esfahan Steel Company in Iran. A total of 450 participants were divided into two groups—control and case—and the questionnaires were distributed among them. Data were collected through a 7-part questionnaire. Finally, the results were analyzed using SPSS 22.0 and Amos software. RESULTS: All the studied variables had a significant relationship with the accident proneness. In the case group, general health with a coefficient of −0.37, work-family conflict with 0.10, effort-reward imbalance with 0.10, internal locus of control with −0.07, and external locus of control with 0.40 had a direct effect on occupational stress. Occupational stress also had a positive direct effect on accident proneness with a coefficient of 0.47. In addition, fitness indices of control group showed general health (−0.35), work-family conflict (0.36), effort-reward imbalance (0.13), internal locus of control (−0.15), and external locus of control (0.12) have a direct effect on occupational stress. Besides, occupational stress with a coefficient of 0.09 had a direct effect on accident proneness. CONCLUSION: It can be concluded that although previous studies and the present study showed the effect of stress on accident and accident proneness, some hidden and external factors such as workefamily conflict, effortereward imbalance, and external locus of control that affect stress should also be considered. It helps industries face less occupational stress and, consequently, less occurrence rates of accidents.
Accident Proneness ; Accidents, Occupational ; Cross-Sectional Studies ; Developed Countries ; Internal-External Control ; Iran ; Steel

Japan and Korea follow a unique trend in which, despite reporting two of the highest life expectancies (LEs) among the Organization for Economic Co-operation and Development (OECD) countries, the proportion of people with good self-rated health (SRH) is disproportionately low. We sought to explain this high-LE-low-SRH paradox by examining associations among LE, the prevalence of good SRH, and healthcare utilization. Our hypothesis was that countries with more frequent healthcare use would demonstrate poorer SRH and that SRH would not show a meaningful association with LE among developed countries. This study extracted data from Health at a Glance 2017 by the OECD for 26 countries with valid and comparable information on LE, SRH, and the number of doctor consultations per capita. Correlations among LE, good SRH, and number of doctor consultations per capita were analyzed. The number of annual doctor consultations per capita and the prevalence of good SRH were closely correlated (correlation coefficient=−0.610); excluding outliers produced a higher correlation coefficient (−0.839). Similar patterns were observed when we replaced good SRH with poor SRH. Meanwhile, the correlation coefficient between annual per capita doctor consultations and LE was quite low (−0.216). Although good SRH is closely related to better LE at the individual level, this was not true at the national level. Frequent use of healthcare in Japan and Korea was strongly correlated with poorer SRH, without any meaningful correlation with LE.
Delivery of Health Care ; Developed Countries ; Japan ; Korea ; Life Expectancy ; Organisation for Economic Co-Operation and Development ; Prevalence ; Referral and Consultation ; Republic of Korea