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

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*

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

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*

Daily low-dose inhaled corticosteroid in preschool children with asthma is recommended to prevent the development of asthma symptom and sign based on many asthma management guidelines. But the retarded growth after long-term steroid inhalation has been concerned. Recently the method of intermittent high-dose (suspension, 1,000 microg, 2 times a day for 7 days) budesonide inhalation when the initial phase to develop the asthma exacerbation was studied to compare the efficacy and safety with daily low-dose budesonide (500 microg) inhalation regimen in preschool children positive with modified asthma predictive index in recurrent wheezer during the study period with 52 weeks. There were no significant difference between two regimen with respect to the frequency of exacerbations, the time to the first exacerbation and to the second exacerbation, and the frequency of treatment failure. The total exposure to budesonide over the period was less in the intermittent high-dose regimen than in the daily low-dose regimen. There were no significant difference in change in height. But the change in height from baseline in intermittent high-dose regimen group was 8.01 cm and in daily low-dose was 7.76 cm. We need the more clinical studies in preschool children with persistent moderate and severe asthma and in various country and nations. It is suggested the intermittent high-dose budesonide inhalation regimen in preschool children with freqeunt wheezing may be a very good alternative to control the allergic inflammation and symptoms of asthma without concerning the adverse effect of steroid.
Asthma ; Budesonide ; Child ; Child, Preschool ; Humans ; Inflammation ; Inhalation ; Respiratory Sounds ; Treatment Failure

PURPOSE: To get the normal predicted value of airway resistance in Korean kindergarten children by using a flow interrupter technique which is simple and easy enough to be applicable even to young children. METHODS: Two hundred and fifty children (male 126, female 124) were enrolled from two kinderdargen in Inchon. Excluded children were out of normal range of Korean growth standard, without any history and/or on-going symptom and sign of airway diseases. One medical doctor, well trained to the Microlab 4000 (Micromedical Co., England, educated those children in advance and carried out all the procedure. the Rint (airway resistance by interrupter technique) was checked 5 times. After the exclusion of both the highest and the lowest values, we got the average of remaining 3 values as the Rint (in both inspiratory and expiratory phases). The mean, standard deviation, regression equation, correlation coefficient for each group of age, height, weight, and chest circumference in both sex were investigated. RESULTS: 1) Age ranged from 3 to 5 years. 3-year-old boys' Rint were 1.89+/-0.76 kPa.l(-1).s and 1.78+/-0.71 kPa.l(-1).s in inspiratory and expiratory phase, respectively. Those for girls were 1.94+/-0.73 kPa.l(-1).s and 1.72+/-0.73 kPa.l(-1).s. The Rint was decreased as the children got older. 2) Height ranged from 91 to 120 cm. Rint of boys from 96 to 100 cm in height were 1.86+/-0.70 kPa.l(-1).s and 1.54+/-0.49 kPa.l(-1).s in inspiratory and expiratory phase, respectively. Those for girls were 1.68+/-0.72 kPa.l(-1).s and 1.71+/-0.77 kPa.l(-1).s. The Rint was decreased as the children got taller. 3) Weight ranged from 13 to 27 kg. Rint of boys from 13 to 15 kg in weight were 1.49+/-0.76 kPa.l(-1).s and 1.55+/-1.00 kPa.l(-1).s in inspiratory and expiratory phase, respectively. Those for girls were 1.78+/-0.83 kPa.l(-1).s and 1.82+/-0.76 kPa.l(-1).s. The Rint was decreased as the children got heavier. 4) Chest circumference ranged from 46 to 70 cm. Rint of boys from 51 to 55 cm in chest circumference were 1.69+/-0.84 kPa.l(-1).s and 1.52+/-0.74 kPa.l(-1).s in inspiratory and expiratory phase, respectively. Those for girls were 1.63+/-0.81 kPa.l(-1).s and 1.52+/-0.74 kPa.l(-1).s. The Rint was decreased as the children's chest circumference was increased. 5) Regression equations and correlation coefficients were calculated by each group of age, height, weight, and chest circumference for both boys and girls and in both inspiratory and expiratory phases. The correlation coefficient with age was around 0.5, which was the highest among them. CONCLUSION: The normal predicted value of airway resistance by flow interrupter technique was measured. It can be used for evaluating lung condition, progression of lung disease, and the effectiveness of drugs in lung disease.
Airway Resistance* ; Child* ; Child, Preschool ; England ; Female ; Humans ; Incheon ; Lung ; Lung Diseases ; Reference Values ; Respiratory Function Tests ; Thorax

PURPOSE: The tests of Serum IgE and allergen specific antibodies are important for screening and diagnosis of allergic disease. This study was conducted find out the distributions of allergic diseases, level of IgE, and usual allergen specific antibodies in healthy well-being preschool childrenin Inchon city. METHODS: We gained the level of serum IgE and RAST (radioallergosorbent test : D. pteronyssinus, D. farinae, Egg white and Cow milk) for 274 (Male 130, Female 144) preschool children in Inchon city during January through June in 1997. The history of allergic diseases (allergic asthma, allergic rhinitis, atopic dermatitis, food allergy and urticaria) was taken by each children's parent over telephone interviews. The personal computer SAS program was used for data analysis. RESULTS: 1) The 274 preschoolers (female 144, male 130 F:M=1:0.9) were composed of 74 (female 44, male 30) 3 year-old, 99 (female 52, male 47) 4 year-old, and 101 (female 48, male 53) 5 year-old children. 2) 30.1% of the children were with history of allergic diseases. 3) The mean and standard deviation of serum IgE levels were 215.8+/-171.0 IU/mL with a history of allergic diseases and 60.4+/-73.2 IU/mL without a history of allergic diseases for 3 year-old; 237.0+/-233.5 IU/mL and 48.5+/-74.4 IU/mL for 4 year-old; and 223.6+/-247.5 IU/ml and 45.2+/-41.9 IU/mL for 5 year-old children (P<0.001), respectively. 4) The rate of positive RAST (D. pteronyssinus, Dp) was 66.7% with a history of allergic diseases and 2.6% without a history of allergic diseases for 3 year-old girls, and 41.7% and 5.6% for 3 year-old boys; 58.3% and 2.5% for 4 year-old girls, and 53.8% and 2.9% for 4 year-old boys; and 61.1% and 3.3% for 5 year-old girls, and 54.5% and 0.0% for 5 year-old boys (P<0.001), respectively. 5) The rate of positive RAST (D. farinae, Df) was 66.7% with a history of allergic diseases and 0.0% without a history of allergic diseases for 3 year-old girls, and 16.7% and 0.0% for 3 year-old boys; 50.0% and 0.0% for 4 year-old girls, and 46.2% and 5.9%, for 4 year-old boys; and 55.6% and 3.3% for 5 year-old girls, and 54.5% and 0.0% for 5 year-old boys (P<0.001), respectively. 6) The rate of positive RAST (Egg white, F1) was 66.7% with a history of allergic diseases and 21.1% without a history of allergic diseases for 3 year-old girls, and 66.7% and 38.9% for 3 year-old boys; 75.0% and 15.0% for 4 year-old girls, and 46.2% and 5.9% for 4 year-old boys; and 38.9% and 13.3% for 5 year-old girls, and 50.0% and 19.4% for 5 year-old boys (P<0.001), respectovely. 7) The rate of positive RAST (Cow milk F2) was 0.0% for 3, 4 and 5 year-old and boys both with and without a history of allergic diseases. CONCLUSION: We conclude that serum IgE level and RAST (Dp, Df, F1) are important screening methods for allergic disease of preschool children, and milk allergy is little over 3 year-old children in Inchon. Further studies will be needed.
Antibodies ; Asthma ; Child ; Child, Preschool* ; Dermatitis, Atopic ; Diagnosis ; Egg White* ; Female ; Food Hypersensitivity ; Humans ; Immunoglobulin E* ; Incheon ; Interviews as Topic ; Male ; Mass Screening ; Microcomputers ; Milk ; Milk Hypersensitivity ; Ovum* ; Parents ; Rhinitis ; Statistics as Topic

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