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.

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

PURPOSE: Tracheostomy is used to aid airway management in perdiatric respiratory care. This study was designed to review causes and outcomes of pediatric tracheostomy. METHODS: We performed a retrospective chart review of 153 patients, less than 18 years of age, who underwent tracheostomy between January 1995 and July 2010. Age at tracheostomy, indications, durations, complications and mortality were evaluated. RESULTS: Subglottic stenosis (19%) was the most common indication for tracheostomy. The median age at tracheostomy was 1.3 years (range, 22 days to 17.8 years). Seventy-three (47.7%) tracheostomies were performed in children under 1 year of age. Respiratory diseases were significantly more prevalent in patients under 1 year of age, while neuromuscular disease were more frequently found in patients older than 1 year (P=0.013). Stoma or tracheal granuloma formation (36.6%) was the most common complication of pediatric tracheostomy. Decannulation was accomplished in 61 (39.9%) patients with median cannulation time of 141 days (range, 1 to 2,529 days). Overall mortality rate was 10.5% (n=16), but only one patient (0.7%) died from tracheostomy-related complications. CONCLUSION: Respiratory diseases, such as subglottic stenosis and neuromuscular disease, are the main cause of pediatric tracheostomy. Although complications, like stoma or tracheal granuloma formation occur, tracheostomy in children is a safe way to aid airway management.
Airway Management ; Catheterization ; Child ; Constriction, Pathologic ; Granuloma ; Humans ; Neuromuscular Diseases ; Retrospective Studies ; Tracheostomy

PURPOSE: Fractional exhaled nitric oxide (FeNO) has been widely reported as a marker for airway inflammationin, and FeNO have shown increased levels in the non-asthmatic patients with other atopy related diseases, such as rhinitis. Bronchial hyperresponsiveness is a characteristic feature of asthma, which is often associated with airway inflammationin allergic rhinitis. It has been suggested that asthma is associated with rhinitis, which is a link between the upper and the lower airways, beyond allergy associated inflammation in the respiratory tract. To evaluate the usefulness of FeNO measurement, as a risk factor of allergic and nonallergic rhinitis in children with asthma. METHODS: Fifty-three children included in this study were diagnosed as asthma from April through August 2005 in the Department of Pediatrics, Kyung Hee University School of Medicine. They conducted FeNO monitoring, total eosinophil count and serum immunoglobulin E at that time. We put a question to the participants' parents about the doctor diagnosed participants' manifestations (sneezing, nasal congestion, nasal itching, rhinorrhea), via a telephone interview survey or at the outpatient department in July 2011. Statistical analyses were performed using IBM SPSS ver. 18.0. RESULTS: The overall prevalence of rhinitis, among the 53 children, was 67.9%. The means of FeNO differed significantly between the two groups, being higher in children who have rhinitis symptoms and lower in asymptomatic children. (mean+/-SD, 29.4+/-24.6 to 13.6+/-11.8 parts per billion; P=0.003; T-test) CONCLUSION: To take the measurement of FeNO value in asthmatics may be a tool in the predictor of the causes of rhinitis.
Aluminum Hydroxide ; Asthma ; Carbonates ; Child ; Eosinophils ; Estrogens, Conjugated (USP) ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Interviews as Topic ; Nitric Oxide ; Outpatients ; Parents ; Pediatrics ; Prevalence ; Pruritus ; Respiratory System ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors

PURPOSE: Preschoolers complete forced expiration in a short time, sometimes more quickly than in 1 second, and therefore the importance of forced expiatory volume in 0.75 seconds (FEV0.75) or forced expiatory volume in 0.5 seconds (FEV0.5) has been raised. The purpose of this study is to evaluate the clinical usefulness of DeltaFEV0.75 and DeltaFEV0.5. METHODS: We analyzed 401 subjects of an asthma group, and 150 subjects of a control group under 7 years of age. RESULTS: DeltaFEV1, DeltaFEV0.75 and DeltaFEV0.5 values of the asthma group were significantly higher than those of the control group, respectively (P<0.0001). DeltaFEV1 (0.60; 95% confidence interval [CI], 0.57 to 0.62), DeltaFEV0.75 (0.61; 0.58 to 0.65), and DeltaFEV0.5 (0.60; 0.56 to 0.64) showed no significant difference in the diagnostic ability of asthma when airway reversibility is defined as DeltaFEVt> or =12%. Cutoff values for asthma were 8.6% in DeltaFEV1, 7.9% in DeltaFEV0.75 and 14.2% in DeltaFEV0.5. DeltaFEV0.75 (0.91; 0.88 to 0.94) showed significantly higher area under curve (AUC) than DeltaFEV0.5 (0.77; 0.73 to 0.82) when stratified by 12%, in predicting airway reversibility defined as DeltaFEV1> or =12%. Cutoff values were 12.3% in DeltaFEV0.75, and 13.4% in DeltaFEV0.5. When airway reversibility is defined as DeltaFEV1> or =8.6%, DeltaFEV0.75 (0.90; 0.87 to 0.92) also showed significantly higher AUC than DeltaFEV0.5 (0.79; 0.75 to 0.82), and Cutoff values were 8.4% in DeltaFEV0.75, and 11.3% in DeltaFEV0.5. CONCLUSION: DeltaFEV0.75 or DeltaFEV0.5 can be a means to replace DeltaFEV1 for diagnosis of asthma and assessment of airway reversibility in preschool children.
Area Under Curve ; Asthma ; Child, Preschool ; Forced Expiratory Volume ; Humans ; Spirometry

PURPOSE: To evaluate the clinical characteristics and radiologic patterns of adolescents with pulmonary tuberculosis (TB), and to assess whether they are related with primary TB or reactive TB. METHODS: Among the enrolled patients who were diagnosed with pulmonary TB from March 2000 to May 2011, 36 with plain radiography and/or chest computed tomography (CT) were reviewed. We reviewed retrospectively their medical charts to collect clinical data and past history. Among these 36 patients, plain radiography of the 36 patients and chest CT of the 34 patients were retrospectively evaluated. RESULTS: The patients consisted of 18 males and 18 females, and their median age was 14 years old. The most common clinical presentation was cough and fever. Half of them had chronic cough for more than two weeks. Ten patients had history of close contact with adult patients with active pulmonary TB: 7 patients with their parents, 2 patients with friends, 1 patient with their grandmother. The most frequent pattern of plain radiography was pleural effusion (16/36). In the chest CT findings, all cases showed parenchymal lesions and lymphadenopathy. In addition, 91% of the cases showed acinar nodules. The pattern of pleural effusion revealed associated ipsilateral pleural lymph node and subpleural nodule. Rim enhancement and calcification of the lymph node demonstrated 9% (3/34) and 12% (4/34), respectively. Only two of them showed typical hilar lymphadenopathy in chest X ray and CT. CONCLUSION: The radiologic findings of adolescents with pulmonary TB show patterns for rather reactive than primary TB. For diagnosis of adolescent pulmonary TB, chest CT is more helpful than that of plain radiography.
Adolescent ; Adult ; Cough ; Female ; Fever ; Friends ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Male ; Parents ; Pleural Effusion ; Retrospective Studies ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: In this study, we attempted to analyze the effectiveness of the atopic dermatitis camp for primary school students in the Seoul area. METHODS: Seoul city's atopy camp 2010 was conducted 10 times from May 22nd to October 24th for primary school students at an atopy friendly school and their parents. A total of 374 atopic dermatitis patients participated in the camp and questionnaires for 363 were analyzed, except 11 participants who had left several questions unanswered. In a 3-month follow-up survey, 167 participants out of 374 responded to the mailing questionnaire to evaluate the efficiency of the camp. The response rate was 44.7%. RESULTS: Satisfaction with the educational program of the camp was higher for lower grade students than for higher grade students.(P<0.001) Before camp, higher grade students (P<0.001) or students with severe symptoms were more knowledgeable of atopic dermatitis.(P<0.01) After the camp, the higher the grade, the more the knowledge the student had about atopic dermatitis.(P<0.001) Three months after the camp, there was positive change in the lifestyle of atopic dermatitis patients.(P<0.001) CONCLUSION: Knowledge on atopic dermatitis increased and the lifestyle of atopic dermatitis patients was improved due to the camp. Consequently, Seoul city's atopy camp can be utilized as a method to improve the quality of life of atopic dermatitis patients and their family. And Seoul city's atopy camp is expected to be a model for atopy camps in other local communities.
Dermatitis, Atopic ; Follow-Up Studies ; Humans ; Life Style ; Parents ; Patient Education as Topic ; Postal Service ; Quality of Life ; Surveys and Questionnaires