PURPOSE: Influenza virus is one of the most important viruses that cause the respiratory infection seasonally. In April 2009, H1N1 was detected in America and Mexico and then there was pandemic in Korea. We investigated the difference of clinical and laboratory findings between the infections of H1N1 and Influenza B. METHODS: We have retrospectively studied the patients under age of 15 years who visited Inje University Sanggye Paik Hospital from August 2009 to April 2010. Evaluation for influenza infection was performed by rapid antigen test or multiplex reverse transcriptase polymerase chain reaction. Complete blood count with differential counts, C-reactive protein and chest X-ray were checked. RESULTS: Enrolled patients were 2,226 in H1N1-infected group and 288 in influenza B-infected group. Seasonal variation was that H1N1 in autumn and winter but influenza B in spring. The male-to-female sex ratio was same as 1.23 in each group. The mean age of H1N1-infected group was higher than influenza B-infected group (P<0.001). Fever was developed similarly in both groups (P=0.114). However, cough, sputum, rhinorrhea, vomiting, diarrhea, and headache were more prevalent in influenza B infection compared to H1N1 infection (P<0.001). Pneumonia development and admission rate were higher in influenza B infection compared to H1N1 infection (P<0.001, respectively). CONCLUSION: Although H1N1 infection spread rapidly, H1N1 caused not so severe symptoms than influenza B. Because of the possibility that influenza epidemic will develop repeatedly in the future, we need to evaluate more about different characteristics depending on the virus subtype and prepare for them.
Americas ; Blood Cell Count ; C-Reactive Protein ; Cough ; Diarrhea ; Fever ; Headache ; Humans ; Influenza, Human ; Korea ; Mexico ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons ; Sex Ratio ; Sputum ; Thorax ; Viruses ; Vomiting

PURPOSE: Respiratory syncytial virus(RSV) bronchiolitis is believed to be associated with later development of asthma and wheezing. This study was conducted to determine the relationship between the age of the first RSV bronchiolitis episode, the development of later wheezing and asthma, and the related other factors. METHODS: We studied 255 infants admitted with their first episode of RSV bronchiolitis. Epidemiological and clinical data were collected retrospectively from medical records and through telephone interviews. The patients were divided into < or =3 months, 4 to 12 months, and 13 to 24 months. RESULTS: Eighty-one infants were < or =3 months, 115 were 4 to 12 months, and 59 were 13 to 24 months old. The gender ratios (Male:Female) were 1:1, 1.6:1, and 3.2:1. Familial and personal history of allergic diseases and disease severity did not significantly differ according to the age of the first RSV bronchiolitis episode. The occurrence of wheezing was associated with the presence of a familial and personal history of allergic diseases, but not with gender (male) or disease severity. The risk for asthma increased when the infants had their first RSV bronchiolitis episode at an older age. A personal history of allergic diseases was associated with an increased risk for asthma. CONCLUSION: Asthma was more frequently diagnosed in older infants. The most important risk factors for recurrent wheezing and asthma were a familial and personal history of allergic diseases. Therefore, it was thought that RSV bronchiolitis is not the cause of recurrent wheezing and asthma, but that infants with a genetic predisposition to asthma have an increased risk for RSV bronchiolitis.
Asthma ; Bronchiolitis ; Genetic Predisposition to Disease ; Humans ; Infant ; Interviews as Topic ; Medical Records ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Retrospective Studies ; Risk Factors

PURPOSE: We investigated the change in serum total immunoglobulin E (IgE) and allergen-specific IgE according to allergic diseases and age. METHODS: Allergic markers of children under 18 years of age with allergic diseases for the last 5 years were collected from 12 hospitals nationwide. The total data was 9,710. Data about levels of serum total IgE and allergen-specific IgE to 15 common allergens were collected. RESULTS: In children with asthma, serum total IgE was higher in older age than in younger age until age 7 to 12 years, at which time the level was highest (paper radioimmunosorbent test, 526.7 IU/mL; UniCAP, 339.9 IU/mL). The level was lower in older age than that during younger age. This change was similar to that in children with allergic rhinitis and atopic dermatitis. The level was highest at ages 7 to 12 years in children with allergic rhinitis, and at age 10 to 12 years in children with atopic dermatitis. In children with both asthma and allergic rhinitis, as well as in children with all three diseases, the change in serum total IgE was similar to that of children with an isolated disease. The highest level in children with all three diseases was higher than that in children with an isolated disease. The analysis of allergen-specific IgE positivity showed that food allergens were dominant before the age of 2 years, and that aeroallergens such as house dust mites were dominant. CONCLUSION: Serum total IgE in Korean children with allergic diseases was higher in older age than in younger age until the ages of 7 to 12 years, and then the change in total IgE by age was the opposite.
Allergens ; Asthma ; Child ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Immunoglobulin E ; Immunoglobulins ; Korea ; Pyroglyphidae ; Radioimmunosorbent Test ; Rhinitis ; Rhinitis, Allergic, Perennial

PURPOSE: Pediatric asthma is the most common chronic disease in children. It negatively affects the health-related quality of life (QoL) in children with this disease and of their caregivers. This study evaluated the relationship between clinical disease severity and the QoL of patients with asthma and their caregivers. METHODS: The study included 247 patients with asthma and their caregivers. The patients and caregivers completed the Korean Pediatric Asthma Quality of Life Questionnaire and the Korean Pediatric Asthma Caregivers Quality of Life Questionnaire, respectively, during clinic visits. The results were expressed as the mean score for each domain. All items were rated from 1 to 5: 1, low QoL; and 5, satisfactory QoL. RESULTS: The emotion and activity QoL scores of boys were significantly higher than those of girls (P=0.001). The QoL of both patients and their caregivers was correlated more with the patients' subjective symptom scores than with the clinical severity of asthma or with lung function. CONCLUSION: The QoL of patients with asthma and their caregivers decreased as asthmatic symptoms became worse. Controlling asthma symptoms is important for improving the QoL of both patients and their caregivers. Patients and their caregivers need to be evaluated and counseled during asthma treatment to improve their QoL.
Ambulatory Care ; Asthma ; Caregivers ; Child ; Chronic Disease ; Humans ; Lung ; Quality of Life ; Surveys and Questionnaires

PURPOSE: To investigate utilization patterns and cost of medical treatment of complementary alternative therapy in children with atopic dermatitis. METHODS: A self-reported questionnaire concerning utilization pattern and cost of medical treatment of complementary alternative therapy was completed by 196 children <12-year-of-age diagnosed with atopic dermatitis for over 1 year. Descriptive, t-test, and analysis of variance analyses were performed. RESULTS: About 70% of children reported the use of alternative therapy methods including, in order of frequency, bath, herbal medicine, supplemental foods, aroma therapy, massage, and acupuncture. During the previous 12 months, direct costs for these hospital treatments averaged 596,300 Korean Won (KRW, the currency of South Korea). The time cost averaged 657,000 KRW and transportation expenses averaged 598,000 KRW of indirect cost of hospital treatment. The direct cost for complementary alternative therapy averaged 741,000 KRW. The time cost averaged 340,000 KRW and transportation expenses averaged 810,000 KRW of indirect cost of complementary alternative therapy. There was a statistically significant relationship between direct cost of complementary alternative therapy and family income. CONCLUSION: The cost of complementary alternative therapy exceeded the cost of hospital treatment, and indirect costs exceeded direct costs. Analyses of cost-effectiveness of patient treatment should include complementary alternative therapy.
Acupuncture ; Aromatherapy ; Baths ; Child ; Dermatitis, Atopic ; Herbal Medicine ; Humans ; Massage ; Surveys and Questionnaires ; Transportation

PURPOSE: Rapid antigen test (RAT) is used to screen influenza rapidly. The clinical sensitivity of RAT was poor for 2009 H1N1 influenza. The aim of this study was to identify the correlation of time gap (TG) between fever onset and the sensitivity of RAT for 2009 H1N1 influenza. METHODS: Data were collected retrospectively during the pandemic H1N1 2009 influenza season between October 2009 and February 2010. The RAT was done by using SD Bioline influenza antigen (Standard Diagnostics Inc.) in nasopharyngeal swab. The 2009 H1N1 influenza was confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens were categorized according to the TG between fever onset and performance of RAT. They were classified into <24 hours (TG1), 24 to 48 hours (TG2), 48 to 72 hours (TG3), 72 to 96 hours (TG4), 96 to 120 hours (TG5), >120 hours (TG6). RESULTS: The overall sensitivity of RAT was 69.9%. The TG dependent sensitivity of RAT at TG1, TG2, TG3, TG4, TG5, and TG6 was 64.3%, 73.3%, 61.1%, 88.9%, 83.3%, and 61.1% respectively. The sensitivity of RAT was the highest when the TG was 72 to 96 hours. But this result was not statistically significant. CONCLUSION: Correlation of TG between fever onset and the sensitivity of RAT for 2009 H1N1 influenza was not statistically significant. But our study suggested that 72 to 96 hours after fever onset is the most sensitive time of RAT. Timely optimal performance of the RAT could have a significant impact on improving results. Further evaluation for better sensitivity would be needed.
Animals ; Fever ; Influenza, Human ; Pandemics ; Rats ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons

Oral food challenge is a definitive diagnostic test for immediate and occasionally delayed adverse reaction to foods. The gold standard for diagnosing food allergy is still the double-blind, placebo-controlled food challenge, but it is time-consuming, expensive and troublesome for physician and patients. Open oral food challenge controlled by trained personnel is useful and sufficient methods when concern of bias is low. We aimed to provide a practical guideline for oral food challenge in children for the diagnosis of suspected food allergy or the evaluation of food tolerance. We considered reasons, types, indications, contraindications, risks, benefits, detailed methods, practical performance, interpretations of test results, and treatments for the adverse reactions of oral food challenge.
Bias (Epidemiology) ; Child ; Diagnostic Tests, Routine ; Food Hypersensitivity ; Humans

No abstract available.
Asthma ; Quality of Life

Zinc deficiency can result from acrodermatitis enteropathica, an inadequate dietary intake, malabsorption, increased body loss, or intravenous feeding. Unlike acrodermatitis enteropathica, breast feeding-induced acrodermatitis is transient and improves when nursing ends. Breast feeding-induced acrodermatitis is caused by a ZnT-2 transporter dysfunction in the mother's mammary glands. We report a case of a 6-month-old male infant who presented with erythematous patches and plaques involving the perioral, perineal, and acral areas and loose stools since 2 weeks after birth. Atopic dermatitis was considered initially, but the lesions did not respond to topical antibiotics, corticosteroids, or maternal dietary restriction from allergenic food. The patient's serum zinc concentration was low, and the mother's serum and milk had low zinc levels. The differential diagnosis for atopic dermatitis is extensive. Physicians should be alert for the possibility of zinc deficiency dermatitis in breast milk fed infants that mimics atopic dermatitis.
Acrodermatitis ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Breast ; Dermatitis ; Dermatitis, Atopic ; Diagnosis, Differential ; Humans ; Infant ; Male ; Mammary Glands, Human ; Milk ; Milk, Human ; Parenteral Nutrition ; Parturition ; Zinc

PURPOSE: The incidence of endobronchial tuberculosis in children is unknown, due to the inconsistent implementation of bronchoscopy in pediatric patients with pulmonary tuberculosis. In this study, our aim was to determine the incidence and clinical course of endobronchial tuberculosis in children. METHODS: We performed a retrospective chart review of patients less than 18 years of age, who was diagnosed with endobronchial tuberculosis via fiberoptic bronchoscopy. RESULTS: Out of the 101 patients with pulmonary tuberculosis, 16 patients had endobronchial tuberculosis. The median age at diagnosis was 11.2 years (range, 5 months to 16.1 years). Tuberculin skin test was positive in 9 cases (56.2%), and 6 patients (37.5%) had a history of household contact with tuberculosis. Consolidation lesion was common in the simple chest radiographs of patients with endobronchial tuberculosis. According to the bronchoscopic finding, actively caseating type was most common (43.8%). Nine of the 16 patients of endobronchial tuberculosis progressed to bronchial obstruction and 4 patients underwent pneumonectomy or lobectomy. Fibrostenotic and tumorous type tend to progress to endobronchial obstruction compared with actively caseating type. CONCLUSION: The incidence of endobronchial tuberculosis in pediatric pulmonary tuberculosis was 15.8%. Early detection and effective treatment of endobronchial tuberculosis are important to decrease the secondary complication, such as bronchial obstruction.
Bronchoscopy ; Child ; Family Characteristics ; Humans ; Incidence ; Pneumonectomy ; Retrospective Studies ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary