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

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*

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

OBJECTIVE: To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis in patients who had failed medical management. METHODS: A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. RESULTS: There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from 3.78+/-0.78 preoperatively to 4.78+/-0.35 at final follow up and mean VAS score was improved from 7.43+/-0.54 to 2.07+/-1.12. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. CONCLUSION: According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.
Anti-Bacterial Agents ; Bone Transplantation ; Coinfection ; Debridement ; Decompression ; Discitis ; Female ; Follow-Up Studies ; Humans ; Liver Diseases ; Male ; Military Personnel ; Mycobacterium tuberculosis ; Spine ; Staphylococcus ; Transplants ; Tuberculosis ; Tuberculosis, Pulmonary

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

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: 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

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