Purpose: Respiratory virus infection is a common cause of hospitalization in children. Rapid testing for respiratory viruses, such as the FilmArray method, can be clinically useful. However, insufficient evidence exists to support its use in standard clinical care. Methods: We retrospectively analyzed data from children under 18 years old who received the multiplex real-time polymerase chain reaction array (multiplex RT-PCR) method in 2017 and by FilmArray respiratory panel (FilmArray RP) in 2018. Results: Between January, 2017 and December, 2018, we reviewed data from 1,480 hospitalized children. The number of children with virus detection in respiratory viral PCR was 523 in the multiplex RT-PCR method and 419 in the FilmArray method. Seasonal virus outbreak patterns were similar to those of Korea Centers for Disease Control and Prevention in both groups. There was no difference between the 2 groups in the mean length of hospital stay. The time from admission to isolation by influenza infection was significantly shorter in the FilmArray group than in the multiplex RT-PCR group among patients who were not diagnosed with influenza infection by rapid antigen test at the time of admission. Conclusion The use of FilmArray method for respiratory viruses did not diminish length of hospital stay. However, the FilmArray method may quickly detect the prevalence of respiratory infection and aid in clinical treatment. In addition, it was related with a reduced time from admission to isolation by influenza infection in hospitalized children who were not identified with influenza infection by rapid antigen test at the time of admission.

PURPOSE: Transglutaminase type 2 (TG2) is an extracellular matrix crosslinking enzyme with a pivotal role in kidney fibrosis. We tested whether quantification of urinary TG2 may represent a noninvasive method to estimate the severity of kidney allograft fibrosis. METHODS: We prospectively collected urine specimens from 18 deceased donor kidney transplant recipients at 1-day, 7-day, 1-month, 3-month, and 6-month posttransplant. In addition, kidney allograft tissue specimens at 0-day and 6-month posttransplant were sampled to analyze the correlation of urinary TG2 and kidney allograft fibrosis. RESULTS: Thirteen recipients had increased interstitial fibrosis and tubular atrophy (IFTA) scores at the 6-month protocol biopsy (IFTA group). The mean level of urinary TG2 in the IFTA group was higher compared to that of 5 other recipients without IFTA (no IFTA group). Conversely, the mean level of urinary syndecan-4 in the IFTA group was lower than levels in patients without IFTA. In the IFTA group, double immunofluorescent staining revealed that TG2 intensity was significantly upregulated and colocalizations of TG2/heparin sulfate proteoglycan and nuclear syndecan-4 were prominent, usually around tubular structures. CONCLUSION: Urinary TG2 in early posttransplant periods is a potent biomarker for kidney allograft inflammation or fibrosis.
Allografts ; Atrophy ; Biomarkers ; Biopsy ; Extracellular Matrix ; Fibrosis ; Humans ; Inflammation ; Kidney Transplantation ; Kidney ; Methods ; Prospective Studies ; Proteoglycans ; Syndecan-4 ; Tissue Donors ; Transplant Recipients

PURPOSE: The increased incidence of asthma due to rising allergic diseases requires the prevention of worsening asthma. It is necessary to develop a patient-tailored asthma prediction model. METHODS: We developed causative factors for the asthma forecast system: infant and young children (0–2 years), preschool children (3–6 years), school children and adolescents (7–18 years), adults (19–64 years), old aged adult (>64 years). We used the Emergency Department code data which charged the short-acting bronchodilator (Salbutamol sulfate) from Health Insurance Review and Assessment Service for the development of asthma prediction models. Three kinds of statistical models (multiple regression models, logistic regression models, and decision tree models) were applied to 40 study groups (4 seasons, 2 sex, and 5 age groups) separately. RESULTS: The 3 kinds of models were compared based on model assessment measures. Estimated logistic regression models or decision tree models were recommended as binary forecast models. To improve the predictability, a threshold was used to generate binary forecasts. CONCLUSION: We suggest the binary forecast models as a patient-tailored asthma prediction system for this category. It may be needed the extended study duration and long-term data analysis for asthmatic patients for the further improvement of asthma prediction models.
Adolescent ; Adult ; Asthma* ; Child ; Child, Preschool ; Decision Trees ; Emergency Service, Hospital ; Humans ; Incidence ; Infant ; Insurance, Health ; Logistic Models ; Models, Statistical ; Seasons ; Statistics as Topic

According to the author's request, in this paper, the eighth author's (Bong-Seong Kim) affiliation should be corrected.

PURPOSE: There are a number of reports suggesting that widespread propagation of weeds and high concentration of weed pollen have been contributed to climate change. We investigated the interrelationship between allergenic pollen concentration, allergic symptom and meteorological factor. METHODS: We collected data of pollen concentration and meteorological factors in 7 stations nationwide during between 1998 and 2012. We recruited total 297 allergic patients sensitized to weed pollens from each station, conducted a survey about allergic symptom, and calculated symptom index. We surveyed the vegetation area of ragweed and Japanese hop. Based on these data, we performed the long-term trend analysis (X11-ARIMA, autoregressive integrated moving average) on regional pollen concentration, and correlation analysis to investigate the interrelation between weed pollen concentration, allery symptom index and meteorological factor. We have also done regression analysis on vegetation area and maximal pollen concentration. RESULTS: Long-term trend analysis showed the increasing trend of pllen concentration in Seoul. Weed pollen concentration, allergy symptom index and each meteorological factor were not correlated significantly. Regression analysis revealed that increase of weed vegetation area results in increase of weed pollen concentration. Through this regression equation, we estimated the vegetation area that can product pollen concentration triggering allergenic risk. CONCLUSION: Meteorological factors, pollen concentration and allergic symptoms should be consistently assessed and the relationship between each factor should be analyzed, considering climate change. It is necessary to verify the equation for pollen estimation by vegetation area and set up a policy for vegetation control focused on the reduction of allergenic pollen.
Ambrosia ; Asian Continental Ancestry Group ; Climate Change ; Humans ; Humulus ; Hypersensitivity ; Meteorological Concepts ; Plant Weeds ; Pollen ; Rhinitis, Allergic, Seasonal* ; Seoul

PURPOSE: This study assessed the association between the ratio of leukotriene E4 (LTE4) to fractional exhaled nitric oxide (FENO) in the response of children with exercise-induced bronchoconstriction (EIB) enrolled in a therapeutic trial with montelukast or inhaled corticosteroid (fluticasone propionate [FP]). METHODS: Children aged 6 to 18 years with EIB were randomized in a 4-week, placebo-controlled, double-blinded trial with montelukast or FP. Before and after treatment, treadmill exercise challenges were performed. The LTE4 levels in the induced sputum and urine and the FENO levels were measured in subjects before and 30 minutes after the exercise challenges. The same tests were conducted after treatment. RESULTS: A total of 24 patients completed the study: 12 in the montelukast group and 12 in FP group. Both study groups displayed a similar postexercise maximum decrease in forced expiratory volume in one second (FEV1) before treatment as well as after treatment. However, there were significant differences in the magnitude of change between the two (Delta; -18.38+/-14.53% vs. -4.67+/-8.12% for the montelukast and FP groups, respectively; P=0.021). The Delta logarithmic sputum baseline and postexercise LTE4/FENO ratio were significantly lower in the montelukast group than in the FP group (baseline; -0.09+/-0.21 vs. -0.024+/-0.03, P=0.045; postexercise, -0.61+/-0.33 vs. -0.11+/-0.28, P=0.023). CONCLUSIONS: These data indicate that the efficacy of montelukast for preventing a maximum decrease in FEV1 after exercise is significantly higher than that of FP, and the high LTE4/FENO ratio is associated with a greater response to montelukast than to FP for EIB therapy. These results suggest that LTE4 may play an important role in EIB.
Acetates ; Aged ; Bronchoconstriction ; Child ; Diethylpropion ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Nitric Oxide ; Quinolines ; Sputum

The old calendar of pollens did not reflect current pollen distribution and concentrations that can be influenced by changes of weather and environment of each region in South Korea. A new pollen calendar of allergenic pollens was made based on the data on pollen concentrations obtained in eight regions nationwide between 1997 and 2009. The distribution of pollen was assessed every day at 8 areas (Seoul, Guri, Busan, Daegu, Jeonju, Kwangju, Kangneung, and Jeju) for 12 years between July 1, 1997 and June 30, 2009. Pollens were collected by using Burkard 7-day sampler (Burkard Manufacturing Co Ltd, UK). Pollens which were stained with Calberla's fuchsin staining solution were identified and counted. Pine became the highest pollen in May, and the pollen concentrations of oak and birch also became high. Ragweed appeared in the middle of August and showed the highest pollen concentration in the middles of September. Japanese hop showed a high concentration between the middle of August and the end of September, and mugwort appeared in the middles of August and its concentration increased up until early September. In Kangneung, birch appeared earlier, pine showed a higher pollen concentration than in the other areas. In Daegu, Oriental thuja and alder produced a large concentration of pollens. Pine produced a large concentration of pollens between the middle of April and the end of May. Weeds showed higher concentrations in September and mugwort appeared earlier than ragweed. In Busan the time of flowering is relatively early, and alder and Oriental thuja appeared earliest among all areas. In Kwangju, Oriental thuja and hazelnut appeared in early February. Japanese cedar showed the highest pollen concentration in March in Jeju. In conclusion, update information on pollen calendar in South Korea should be provided for allergic patients through the website to manage and prevent the pollinosis.
Allergens ; Alnus ; Ambrosia ; Artemisia ; Asian Continental Ancestry Group ; Betula ; Corylus ; Cryptomeria ; Flowers ; Humans ; Humulus ; Pollen ; Republic of Korea ; Rhinitis, Allergic, Seasonal ; Rosaniline Dyes ; Thuja ; Weather

The prevalence of allergic diseases in children has increased for several decades. We evaluated the correlation between pollen count of weeds and their sensitization rate in Seoul, 1997-2009. Airborne particles carrying allergens were collected daily from 3 stations around Seoul. Skin prick tests to pollen were performed on children with allergic diseases. Ragweed pollen gradually increased between 1999 and 2005, decreased after 2005 and plateaued until 2009 (peak counts, 67 in 2003, 145 in 2005 and 83 grains/m3/day in 2007). Japanese hop pollen increased between 2002 and 2009 (peak counts, 212 in 2006 and 492 grains/m3/day in 2009). Sensitization rates to weed pollen, especially ragweed and Japanese hop in children with allergic diseases, increased annually (ragweed, 2.2% in 2000 and 2.8% in 2002; Japanese hop, 1.4% in 2000 and 1.9% in 2002). The age for sensitization to pollen gradually became younger since 2000 (4 to 6 yr of age, 3.5% in 1997 and 6.2% in 2009; 7 to 9 yr of age, 4.2% in 1997 and 6.4% in 2009). In conclusion, sensitization rates for weed pollens increase in Korean children given increasing pollen counts of ragweed and Japanese hop.
Adolescent ; Allergens/*immunology ; Ambrosia/immunology/*metabolism ; Asthma/epidemiology/immunology ; Child ; Child, Preschool ; Female ; Humans ; Hypersensitivity/*epidemiology/immunology ; Male ; Pollen/*immunology ; Prevalence ; Republic of Korea/epidemiology ; Rhinitis, Allergic, Seasonal/epidemiology/immunology ; Skin Tests

The prevalence of allergic diseases in children has increased for several decades. We evaluated the correlation between pollen count of weeds and their sensitization rate in Seoul, 1997-2009. Airborne particles carrying allergens were collected daily from 3 stations around Seoul. Skin prick tests to pollen were performed on children with allergic diseases. Ragweed pollen gradually increased between 1999 and 2005, decreased after 2005 and plateaued until 2009 (peak counts, 67 in 2003, 145 in 2005 and 83 grains/m3/day in 2007). Japanese hop pollen increased between 2002 and 2009 (peak counts, 212 in 2006 and 492 grains/m3/day in 2009). Sensitization rates to weed pollen, especially ragweed and Japanese hop in children with allergic diseases, increased annually (ragweed, 2.2% in 2000 and 2.8% in 2002; Japanese hop, 1.4% in 2000 and 1.9% in 2002). The age for sensitization to pollen gradually became younger since 2000 (4 to 6 yr of age, 3.5% in 1997 and 6.2% in 2009; 7 to 9 yr of age, 4.2% in 1997 and 6.4% in 2009). In conclusion, sensitization rates for weed pollens increase in Korean children given increasing pollen counts of ragweed and Japanese hop.
Adolescent ; Allergens/*immunology ; Ambrosia/immunology/*metabolism ; Asthma/epidemiology/immunology ; Child ; Child, Preschool ; Female ; Humans ; Hypersensitivity/*epidemiology/immunology ; Male ; Pollen/*immunology ; Prevalence ; Republic of Korea/epidemiology ; Rhinitis, Allergic, Seasonal/epidemiology/immunology ; Skin Tests

PURPOSE: Exercise-induced bronchoconstriction (EIB) affects daily activities as well as school performance in children. Exhaled nitric oxide (eNO) is a noninvasive test that measures airway inflammation in asthmatics. The aim of this study was to address the relationship between eNO and childhood EIB. METHODS: Our study consisted of 101 children aged 6 to 18 years belonging to one of three groups, asthmatic children with EIB (n=31), asthmatic children without EIB (n=28), or healthy controls (n=42). After children were taken off drugs that treated their asthma, baseline (pre-exercise) eNO and biomarkers of inflammation were measured. All subjects underwent spirometry and the bronchial challenge by methacholine inhalation and outdoor free running. RESULTS: eNO levels in asthmatic children with EIB were significantly greater than those in both asthmatic children without EIB (P=0.012) and controls (P<0.001). The median eNO (interquartile range) levels were 26.0 (15.0 to 46.0) parts per billion (ppb) in asthmatic children with EIB, 16.0 (12.5 to 28.0) ppb in asthmatic children without EIB, and 12.0 (10.0 to 15.3) ppb in controls. Post-exercise decrease of forced expiratory volume in 1 second correlated positively with eNO (r=0.637, P<0.001; r, partial correlation coefficient adjusted for age and height). The cutoff value for prediction of significant EIB was 20 ppb, and the overall sensitivity, specificity, positive predictive value, and negative predictive values were 61.3%, 80.0%, 57.6%, and 82.4%, respectively. The area under the receiver operating characteristic curve was 0.767 (95% confidence interval, 0.661 to 0.874). CONCLUSION: Baseline eNO levels correlate with the post-exercise decrease of forced expiratory volume in 1 second, suggesting that eNO may be a tool in the prediction of EIB.
Aged ; Asthma ; Biomarkers ; Bronchoconstriction ; Child ; Forced Expiratory Volume ; Humans ; Inflammation ; Inhalation ; Methacholine Chloride ; Nitric Oxide ; ROC Curve ; Sensitivity and Specificity ; Spirometry