PURPOSE: The studies concerning the clinical features of patients with anaphylaxis, who meet the newly established diagnostic criteria, are reported in Korea, but comparative studies regarding the clinical features of children and adult patients with anaphylaxis are lacking. The purpose of this study is to compare the clinical features of the children and adults with anaphylaxis, who meet the new diagnostic criteria at a single hospital. METHODS: We reviewed the medical records of patients who were diagnosed with anaphylaxis, anaphylactic shock, urticaria, and angioedema, including inpatients, outpatients and emergency room visited patients, at the National Medical Center from July, 2005 to August, 2011. The clinical characteristics of children and adults, who met the new diagnostic criteria for anaphylaxis, were analyzed. RESULTS: We identified 91 patients with anaphylaxis. Sixteen were children and 75 were adults. The sex ratio (male:female) and the mean age were 1:1.7 and 9.6 years among children, respectively, and 1:2.3 and 42.3 years, respectively, among adults. The most common cause of anaphylaxis based on clinical history was foods in 15 children (93.7%) and 35 adults (46.7%). Twelve children (75%) and 36 adults (48%) were rediagnosed with anaphylaxis. Patients with cardiovascular symptoms and severe severity were 1 (6.3%) and 1 (6.3%), respectively, among children, and 28 (37.3%) and 23 (30.3%), respectively, among adults. CONCLUSION: We rediagnosed some cases of anaphylaxis, using the new diagnostic criteria and most of the cases were diagnosed initially as urticaria or angioedema. The adults had more severe and more cardiovascular symptoms than children. In the future, a nationwide, multiinstitutional research will be necessary for the prevalence and the clinical features of anaphylaxis by the new diagnostic criteria in Korea.
Adult ; Anaphylaxis ; Angioedema ; Child ; Emergencies ; Humans ; Inpatients ; Korea ; Medical Records ; Outpatients ; Prevalence ; Sex Ratio ; Urticaria

PURPOSE: It is widely known that allergic diseases progress through a sequential course known as the allergic march. However, there have been no recent reports in Korea regarding the progress of allergic diseases based on the medical claim data of the National Health Insurance Corporation. METHODS: Medical claim data of 2005 and 2008 from the National Health Insurance Corporation were used. Data was classified according to the administrative districts of metropolitan cities and provinces, and divided according to age in increments of 5 years. RESULTS: According to the nationwide survey on the prevalence of allergic diseases according to region, the prevalence of allergic diseases increased in 2008 compared to 2005. Especially, the prevalence of allergic rhinitis significantly rises in all regions. When comparing the prevalence of allergic diseases according to age, there was no significant difference in the prevalence of atopic dermatitis and asthma between 2005 and 2008. In contrast, allergic rhinitis demonstrated a rise of more than 5% in all age groups. CONCLUSION: According to the nationwide survey on the prevalence of allergic diseases using the medical claim data from the National Health Insurance Corporation, the prevalence of allergic rhinitis had significantly increased in 2008 compared to 2005. More survey studies should be conducted in the future using the medical claim data of the National Health Insurance Corporation.
Asthma ; Dermatitis, Atopic ; Korea ; National Health Programs ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial

Vitamin D deficiency and asthma are common public health problems worldwide. Recently, newer physiologic functions for vitamin D have been identified. Several studies suggest vitamin D plays a vital and complex role in immune system function and regulation. Asthma is one of the most common chronic diseases worldwide and has been increasing in prevalence over the last decades. Common risk factors for both asthma and vitamin D deficiency, such as an urbanized, westernized lifestyle and obesity have led to a hypothesized link between asthma and vitamin D. The purpose of this review is to present the evidence for a role of vitamin D in asthma.
Aluminum Hydroxide ; Asthma ; Carbonates ; Chronic Disease ; Hypersensitivity ; Immune System ; Life Style ; Obesity ; Prevalence ; Public Health ; Risk Factors ; Vitamin D ; Vitamin D Deficiency ; Vitamins

No abstract available.

The funding acknowledgment in this article was omitted as published.

Congenital short trachea is a rare congenital anomaly in which the trachea is composed of reduced number of cartilage rings, which result in an abnormally high position of the carina and an abnormal course of the main bronchi. Hazards of congenital short trachea in infants and children include inadvertent bronchial intubation, because it causes bronchiostenosis, pulmonary interstitial emphysema, pneumomediastinum, pneumothorax, and ipsilateral atelectasis. Laryngeal cleft is a rare condition, as well. Symptoms range from mild stridor to massive aspiration and respiratory distress, depending on the severity of the cleft. Until now, a case with combination of these two rare congenital defects has not been reported. Herein, we report a 13 month-old boy who has congenital short trachea with laryngeal cleft.
Bronchi ; Cartilage ; Child ; Congenital Abnormalities ; Emphysema ; Humans ; Infant ; Intubation ; Larynx ; Mediastinal Emphysema ; Pneumothorax ; Pulmonary Atelectasis ; Respiratory Sounds ; Trachea

PURPOSE: Atopic dermatitis (AD) is a genetically determined, chronic relapsing skin disease. The pathogenesis of AD is complex and the course is unpredictable. Atopy is an important risk factor for the development of AD. Cysteinyl leukotrienes (Cys-LTs) were implicated in the pathophysiology of allergic diseases, and are being targeted for their diagnosis and treatments. Early detection of tissue inflammation of target organ is important to enable early prevention and management of allergic diseases. The aim of our study is to evaluate the differences in urinary leukotrienes E4 (LTE4) levels, according to AD symptom score and aeroallergen sensitization in children with AD by using noninvasive techniques. METHODS: We recruited 46 children with AD, using predetermined criteria. Clinical features of AD were evaluated by a physician, using scoring atopic dermatitis (SCORAD) index. Aeroallergen sensitization was measured by using a skin prick test and UniCap. Urine samples were also collected on day of the 1st and 2nd visits, and were analyzed for LTE4 with an enzyme-linked immunoassay kit. RESULTS: SCORAD indeces of children with AD were correlated with urinary LTE4 levels. Total immunoglobulin E (IgE) and eosinophil counts also had significant correlation with urinary LTE4 levels. Especially, aeroallergen sensitization of atopic AD significantly correlated with urinary LTE4 of these patients. CONCLUSION: Urinary LTE4 levels significantly correlated with serum total IgE and number of sensitized aeroallergen in children with AD. Clinical features of AD evaluated with SCORAD index related with urinary LTE4 level. Urinary LTE4 might be a valuable, noninvasive marker for different pathogenesis of AD.
Child ; Dermatitis, Atopic ; Eosinophils ; Humans ; Immunoassay ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Leukotriene E4 ; Leukotrienes ; Risk Factors ; Skin ; Skin Diseases

PURPOSE: Pandemic influenza viruses have caused significant morbidity and mortality. Pandemic influenza A (H1N1) was detected in April 2009 and caused worldwide outbreak. We investigated the differences in clinical characteristics and courses between pandemic and seasonal influenzas. METHODS: We reviewed the medical records of pediatric patients, (< or =18 years) with influenza hospitalized to Gachon University Gil Medical Center from the 1 April 2009 to the 31 August 2011. RESULTS: Two hundred twenty-six patients with pandemic influenza and 118 patients with seasonal influenza were included. Age, sex, and proportion of underlying diseases were similar between the two groups. Hypoxemia, shortness of breath, and tachypnea were more common in pandemic influenza.(P<0.05) Oxygen supplementation and radiologically confirmed pneumonia were more common in pandemic influenza.(P<0.005) However, there were no significant differences in the mean duration of hospitalization, proportion of patients admitted to the intensive care unit, need for mechanical ventilation, and death. CONCLUSION: Pandemic influenza caused more frequently lower respiratory tract infection and pneumonia. However, the courses of pandemic influenza were not different from those of seasonal influenza; probably, due to the effects of several factors, including antiviral therapy.
Anoxia ; Dyspnea ; Hospitalization ; Humans ; Influenza, Human ; Intensive Care Units ; Medical Records ; Orthomyxoviridae ; Oxygen ; Pandemics ; Pediatrics ; Pneumonia ; Respiration, Artificial ; Respiratory Tract Infections ; Seasons ; Tachypnea

PURPOSE: The measurement of fraction of nitric oxide (FeNO) is a noticeable tool that reflects airway inflammation in asthmatic patients. We wanted to find out the relationship between pulmonary function, bronchial hyperresponsiveness (AHR), blood eosinophilic inflammatory markers and FeNO level before and after methacholine bronchoprovocation test in asthmatic patients. METHODS: Fifty-five children, who visited the Allergy Clinic of Korea University Anam Hospital from March 2011 to February 2012, due to asthmatic symptoms, such as history of episodic wheezing or dyspnea during the previous year and resolved after using bronchodilators, were enrolled. We performed the baseline pulmonary function and methacholine bronchoprovocation test in the enrolled patients. Blood eosinophil counts and blood eosinophil cationic protein (ECP) were measured. FeNO levels were measured before and after the methacholine bronchoprovocation test. RESULTS: The mean FeNO levels (36.3 ppb) fell after methacholine bronchoprovocation test (25.7 ppb). Forced expiratory volume in one second (FEV1) %pred inversely correlated both with FeNO level before (R2=0.07, P=0.029) and after (R2=0.059, P=0.01) methacholine bronchoprovocation test. The provocative concentration, causing a 20% decrease in FEV1 to methacholine (methacholine PC20) inversely correlated both with FeNO levels before (R2=0.086, P=0.001) and after (R2=0.141, P=0.001) the challenge. FeNO level measured at bronchoconstriction state significantly correlated with blood eosinophil counts (R2=0.112, P=0.028). Serum ECP levels correlated FeNO level, neither before nor after bronchoprovocation. CONCLUSION: The baseline FeNO levels were higher in asthmatic children. However, FeNO levels rather decreased after methacholine induced bronchoconstriction. Repeated spirometry maneuver was considered to have an effect on reducing FeNO levels. FeNO correlated with pulmonary function, airway AHR and blood eosinophil counts.
Asthma ; Bronchoconstriction ; Bronchodilator Agents ; Child ; Dyspnea ; Eosinophil Cationic Protein ; Eosinophils ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Inflammation ; Korea ; Methacholine Chloride ; Nitric Oxide ; Respiratory Sounds ; Spirometry

PURPOSE: It has been identified that eosinophilic bronchitis (EB) in adults can progress to asthma or fixed airway obstruction. In the present study, we evaluated the clinical course and prognosis of EB in children and their relationship with accompanying rhinosinusitis. METHODS: A total of 55 children with EB followed up for over than a year after the diagnosis were enrolled for the present study. We classified the subjects into two groups according to the prognosis and the presence of rhinosinusitis, respectively, and compared them with respect to clinical characteristics, eosinophil percentage in induced sputum, fractional exhaled nitric oxide (FeNO) and pulmonary function test. The poor prognostic group was defined as the children with asthma or asthma-like symptoms, or persistent or recurrent chronic cough in the long-term follow-up. RESULTS: The poor prognosis was achieved in 12 children (22%), and 3 children (5%) amongst them were diagnosed with asthma. There were no significant differences in clinical characteristics, eosinophil percentages in induced sputum, FeNO, spirometry and IOS according to the prognosis and the presence of rhinosinusitis. Additionally, the children with rhinosinusitis did not show any poorer outcome than those without rhinosinusitis. CONCLUSION: There were some limitations of this study for which the relationship between EB and rhinosinusitis in children was evaluated. However, in case of either poor short-term response to inhaled corticosteroids or elevated eosinophilic inflammation in airways or abnormal airway reversibility in impulse oscillometry, the long-term prognosis of EB in children needs to be considered, regardless of the presence of rhinosinusitis.
Adrenal Cortex Hormones ; Adult ; Airway Obstruction ; Asthma ; Bronchitis ; Child ; Cough ; Eosinophils ; Humans ; Inflammation ; Nitric Oxide ; Oscillometry ; Prognosis ; Respiratory Function Tests ; Spirometry ; Sputum