The incidence of allergic disease in pediatric outpatient department of a hospital, where primary care is undertaking, was studied from Apr. 1, 1989 to Mar. 32, 1990. The results were as follows, 1) The incidence of respiratory tract disease was the highest with the value of 57.2% of the total patients, followed by gastrointestinal tract disease(13.9%), infectious disease (6.7%), visit for preventive medicine (6.7%), allergic disease (3.0%), neurologic disease (2.9%), cardiovascular disease (2.8%) etc. 2) The allergic patients were 3.0% of total patient and sex ratio was M:F=1.4:1. 3) The allergic patients were most prevalent in1~3 years of age group (46.6%)followed by under 1 year old group (22.4%), and 4~6 years of group (21.3%). 4) The allergic disease was most prevalent in fall (42.8%), followed by spring (20.4%), and winter(19.0%). 5) Among the allergic disease, asthma was most frequent (67.4%), followed by allergic rhinitis(11.8%), atopic dermatitis (10.6%), urticaria (9.3%). 6) Bronchial asthma was most prevalent among 1~3 years of age group (51.9%) and in fall (50.0%) 7) Allergic rhinitis was most frequent among 1~3 years of age group (40.9%) and in fall (34.8%). 8) Atopic dermatitis was most frequent among under 1 year of age group(64.4%)and in spring and winter(28.8%). 9) Urticaria was most frequent among 1~3 years of age group (36.5%) and in summer (32.7%). 10) The percentage of each allergic disease to the total outpatient was as follows; asthma (2.0%), allergic rhinitis(0.40%), atopic dermatitis(0.3%), urticaria (0.3%). 11) Sex ratio of each allergic disease was as follows; asthma (1.5:1), allergic rhinitis(1.6:1), atopic dermatitis (1.1:1), urticaria (1.4:1). With these findings, we ovserved that allergic disease is the fifth most common disease group among the pediatric out patients, covering 3.0% of total patients. Recently, we have had the idea that the prevalence of allergic disease is increasing remarkably. The findings of this study can be used as one of basic data for the study of prvalence and increase of allergic disease with further similar trials afterward.
Asthma ; Cardiovascular Diseases ; Communicable Diseases ; Dermatitis, Atopic ; Gastrointestinal Tract ; Humans ; Incidence* ; Mortuary Practice ; Outpatients* ; Prevalence ; Preventive Medicine ; Primary Health Care ; Respiratory Tract Diseases ; Rhinitis ; Sex Ratio ; Urticaria

Although basic mechanisms of atopic dermatitis remain largely speculative, many studies on pathogenesis suggest the importance of food and inhalent allergens. To evaluate the frequency of food and house dust mite hypersensitivity and differences in this frequency according to ages, we measured the levels of specific IgE antibodies to egg white, egg yolk, milk, soy, and house dust mites in 119 children with atopic dermatitis. The results showed that 53% of patients had positive RAST to any one kind of allergens. The frequency of food and house dust mite hypersensitivity were 34.5%, 30.3 %, respectively. Among allergens, house dust mites and egg white are the most prevalent allergens in all atopic dermatitis patients. The Prevalence of egg white is most common under the age of 2 years, but those of house dust mites are the dust mites are the highest in the ages of 5-12 years. In conclusion, we recommend an egg restriction diet in atopic dermatitis patients who are less than 2 years old when their symptoms do not improve with general skin care.
Allergens ; Antibodies ; Antigens, Dermatophagoides ; Child* ; Child, Preschool ; Dermatitis, Atopic* ; Diet ; Dust* ; Egg White ; Egg Yolk ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mites ; Ovum ; Prevalence ; Pyroglyphidae* ; Skin Care ; Soy Milk

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

Allergy skin prick test and intradermal test represent one of the major tools in the diagnosis of IgE- mediated diseases like as atopic asthma, allergic rhinitis, atopic dermatitis, food and drug allergy, and insect bite when properly performed. Skin tests are of particular importance in fields such as allergen standardization, pharmacology, and epidemiology. Even if skin tests seem easy to perform, adequate and proper interpretation requires well-trained physicians who can recognize the numerous factors that may modify the results of skin tests.
Asthma ; Dermatitis, Atopic ; Diagnosis ; Drug Hypersensitivity ; Epidemiology ; Hypersensitivity ; Insect Bites and Stings ; Intradermal Tests ; Pharmacology ; Rhinitis ; Skin Tests* ; Skin*

Macrostomia is a relatively rare malformation. There have been many surgical methods for the correction of macrostomia. The old method, a simple straight line closure , did not include reconstruction of the orbicularis oris muscle. Postoperatively, a depressed scar and severe contraction on the cheek were found, especially with animation. As a result, many authors have known that reconstruction of the orbicularis oris muscle was very important to avoid a depressed scar for the correction of macrostomia. The tendency toward lateral displacement of the reconstructed commissure has been attributed to linear scar contraction, and Z-plasty is advocated to prevent this deformity. However, we found that the Z-plasty scar may be conspicuous when the patient smiles. So we performed reconstruction of the orbicularis oris muscle to avoid a depressed scar, and straight line closure to avoid a conspicuous scar. In order to prevent linear scar contracture due to straight line closure, we overcorrected the new commissure. We treated 6 cases of macrostomia form May 1, 1996 to April 30, 1999 using straight line closure and reconstruction of the orbicularis oris muscle. Periods of follow-up were from 12 months to 35 months, with an average of 20,2 months. Every patient was analyzed clinically by ordinary scale method and anthropometrically by the ratio of abnormal distances to normal distances between cheilion and crista philtri. In 3 clinical assessments : symmetry of the commissure was excellent: degree of the scar at rest was good: and degree of depression with animation was excellent. The anthropometrical ratio was 1:1.05. Despite the fact that the linear scars were perpendicular to the minimal skin tension lines, the scars were inconspicuous. The muscle repair provided reconstruction to the modiolus and gave a natural appearance to the commissure, however it did not seem to provide sufficient bulkiness around the commissure. The straight line skin closure and repair of the orbicularis oris muscle provide effective functional and aesthetic reconstruction.
Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Depression ; Follow-Up Studies ; Humans ; Macrostomia* ; Skin

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.
Anti-Bacterial Agents ; Child ; Communicable Diseases ; Drainage ; Epidural Abscess* ; Fever ; Humans ; Lateral Sinus Thrombosis ; Masks ; Mastoid* ; Mastoiditis* ; Otitis Media ; Streptococcus pneumoniae*

Pulmonary function test is one of the most important tools in the management of patients with respiratory tract diseases and allergic diseases. As with the difficulties in performing the test, it has been seldom used in pediatric field. But with the advent of simple, computerized tools, pediatric pulmonologist and allergist try to manage the patients using PFT. Still the normal predicted values are variable among the reports. So it is important to have normal predicted value in Korean children. From April to July 1992, pulmonary function test was performed in 965(male: 490, female: 475) primary school-aged children except <3 or >97 percentile of Korean-children Physical developemental standards with history of allergic diseases and respiratory tract diseases ay SungNam, KyongKiDo. We evaluated the predicted normal values of the FEV1.0, FVC and PEFR and logarithmic regression equation setting the predicted values by using the microspirometer of Micromedical Ltd. England that could that could be easily applied to children. 1) Predicted values of pulmonary function test items were generally higher in boys than those of girls. 2) Correlation coefficient to the parameters examined was the highest in height 0.78, then age 0.75, weight 0.70 and chest circumference 0.61.
Child* ; England ; Female ; Gyeonggi-do ; Humans ; Peak Expiratory Flow Rate ; Reference Values ; Respiratory Function Tests* ; Respiratory Tract Diseases ; Thorax

Idiopathic myelofibrosis (IMF), which is characterized by marrow fibrosis, leukoerythroblastic anemia, teardrop poikilocytosis and splenomegaly due to extrumedullary hematopoiesis, has known to have no form of therapy. On the ground of the possibility of reversing collagen deposion in IMF using 1, 25dihydroxycholecalciferol [1, 25(OH)2D3], we report here our observations of 5 patients (M:F=1:4) with IMF before and after treatment with 0.5 microgram/day of alfacalcidol, precursor of 1, 25(OH)2D3. In 3 fo 5 patients the hemoglobin rose and in 4 of 5 the platelet count increased. Follow-up marrow examination revealed that marrow trephine reticulin fibrosis decreased according as the amelioration of clinical and laboratory findings. But these did not persist except one patient in spite of the sustained use of alfacalcidol. Our results suggest that alfacalcidol may have a therapeutic role in some patients with IMF. More extensive studies will be clarify the action of alfacalcidol in IMF.
Anemia, Myelophthisic ; Bone Marrow ; Child* ; Collagen ; Fibrosis ; Follow-Up Studies ; Hematopoiesis ; Humans ; Platelet Count ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

Adequate first web space is essential for web space expansion, thumb abduction, and a wide range of thumb mobility and hand function activities. First web space contracture is caused by burns, trauma, infection, arthritis, ischemia, paralysis, spastic conditions, improper splinting, Dupuytren's contracture, or congenital anomaly. We have treated 18 cases of first web space contracture from Nov. 1, 1996 to Apr. 30, 2000 using 23 various flaps. Four measurements such as maximal abduction angle, maximal abduction distance, radial abduction angle, and palmar abduction angle were examined preoperatively and postoperatively. We have classified first web space contracture as mild, moderate, or severe depending upon the magnitude of contracture and scarring of the first web contents (skin, fascia, muscle and joint capsule). We have performed hree Z-plasty, three double opposing Z-plasty, and two 4 flap Z-plasty in 6 mild contracture. We have performed two Z-plasty and F.T.S.G, two dorsal rectangular flap and F.T.S.G, two F.T.S.G, and two S.T.S.G in 5 moderate contracture. We have performed two distant flaps and five free flaps in 7 severe contracture. Periods of follow-up were from 12 months to 35 months with an average of 15 months. Every patient was analyzed by the ratio of postoperative measurements to preoperative measurements. The mean ratios of mild, moderate, and severe contracture were 1.33, 1.28, and 1.38 respectively. Although first web space contracture was severe, its ratio was more improved than that of mild or moderate contracture because of complete release and abundant soft tissue coverage such as first web space free flap. The proper methods of first web space contracture release in accordance with the classification allowed to achieve excellent results.
Arthritis ; Burns ; Cicatrix ; Classification* ; Contracture* ; Dupuytren Contracture ; Fascia ; Follow-Up Studies ; Free Tissue Flaps ; Hand ; Humans ; Ischemia ; Joints ; Muscle Spasticity ; Paralysis ; Splints ; Thumb

Medial canthoplasty is required to correct congenital anomaly and acquired deformity after trauma, especially nasoethmoid orbital fracture and to correct epicanthal fold. Several medial canthal surgical procedures have been used, but the postoperative results have not always been estimated. Between January 1, 1986 and April 30, 2000, 55 medial canthoplasties were performed in 32 patients. We report the experiences with 55 medial canthoplasties and analyze and compare each methods. The patients who underwent medial canthoplasty were analyzed anthropometrically by the ratio of left to right palpebral fissure dimension, the ratio of postoperative to preoperative palpebral fissure dimension and the ratio of postoperative to preoperative intercanthal distance. And every patient was analyzed clinically by ordinary scale method. Of several singly performed medial canthoplasties, del Campo technique was excellent because the ratio was much improved anthropometrically and the clinical assessments were 'excellent'. Of several singly performed medial canthopexies, transnasal wiring was excellent anthropometrically and clinically. Of simultaneously performed medial canthoplasties, del Campo technique with transnasal wiring were excellent because the ratio was much improved anthropometrically and the clinical assessments were 'excellent'. And the results of simultaneously performed medial canthoplasties group was better than that of singly performed medial canthoplasties group. And so, we concluded that del Campo technique with transnasal wiring for severe cases were recommendable for medial canthoplasty.
Anthropometry ; Congenital Abnormalities ; Humans ; Orbital Fractures