A number of structural changes occur in the airway wall in asthma. The most characteristic is thickening of the subepithelial lamina reticularis which is observed in bronchial tissue even in patients with mild disease. This pathophysiological change which was the result of deposition of interstitial collagens by increased numbers of myofibroblasts is likely to be directed by growth factors having fibropoliferative and profibrotic effect. The acivation of the epithelial-mesenchymal unit involves reciprocal activities of growth factors belonging to the fibroblast growth (FGF), epidermal growth factor (EGF), and transforming growth factor-beta families. Among them FGF is a member of family of heparin binding growth factors that affect the growth and differentiation of a large number of cell types. Especially basic FGF involved in morphogenesis, wound repair, inflammation, angiogenesis, and tumor growth and invasion, and require the glycosaminoglycan side chains of heparan sulphate, proteoglycans for high affinity binding to their specific receptors. Few studies suggested bFGF would be an important regulator of airway remodeling by means of paracrine control of bronchial myofibroblasts in response to cell damage and repair.
Airway Remodeling* ; Asthma* ; Collagen ; Epidermal Growth Factor ; Fibroblast Growth Factors ; Fibroblasts ; Heparin ; Humans ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Morphogenesis ; Myofibroblasts ; Proteoglycans ; Wounds and Injuries

PURPOSE: The prevalence rate of atopic dermatitis which is a common disease as is 10-20%. By the questionnaire survey, many patients used or have been used complementary medicine which has not been verificated. We review to look around the studies in complementary medicine of atopic dermatitis. METHODS: We searched the journals through Entrez Pubmed within the limits: recent 5 years and atopic dermatitis complementary/alternative medicine. And then, we selected and reviewed the journals which introduced treatment for atopic dermatitis by drugs or herbs within terms which was not overlapped. RESULTS: There were 4 randomized clinical trials about Chinese herbs that had possible effects on relieving symptoms and self-satisfaction, but they were inconsistent. Examinations would be required through well-designed and clinical trials with a large sample size. There were relatively a lot of studies of homeopathy in the foreign countries, but had no consistent and definite effects. Especially, there were few studies of homeopathy in atopic dermatitis patients. In addition, experimental studies in extracts from plants such as flavonoids have proceeded mostly (ex. chemical experiment), but there were few clinical trials which were well-designed or sufficient sample size. CONCLUSION: Complementary medicine has been used by many people for scientific verification, and economic costs for it were so considerable that systematic approaches from experimental trials to clinical trials would be needed.
Asian Continental Ancestry Group ; Complementary Therapies ; Dermatitis, Atopic ; Flavonoids ; Homeopathy ; Humans ; Prevalence ; Surveys and Questionnaires ; Sample Size

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases, with a prevalence of up to 15%-20% in children and 2%-10% in adults. Patients with AD have genetically determined risk factors that affect the barrier function of the skin and immune responses that interact with environmental factors. Recently, there has been increasing awareness of the importance of vitamin D, a potential factor, in the development and progression of atopic diseases including AD. Furthermore, some reports suggested that vitamin D deficiency impairs epithelial integrity, leading to increased and inappropriate mucosal exposure to antigens promoting sensitization. Even though numerous studies favor strong associations of vitamin D deficiency during pregnancy and infancy with allergies, high vitamin D intake might be harmful according to conflicting results of other trials. The growing body of the literature indicates an inverse relationship between the severity of AD and vitamin D levels. Animal studies, case reports, randomized clinical trials, and birth cohort studies have suggested that vitamin D may alleviate the symptoms of AD through immune-modulation of the innate and adaptive immune system. Moreover, some studies have shown that in individuals with AD with low vitamin D level, repletion of vitamin D results in decreased severity of diseases. However, all these results have prompted the question of which time, dose, duration, or mode of application of vitamin D might be appropriate in children with AD. Further large cohort studies and clinical trials are warranted to assess the role of vitamin D in the prevention and treatment of AD in children.
Adult ; Animals ; Child* ; Cohort Studies ; Dermatitis, Atopic* ; Humans ; Hypersensitivity ; Immune System ; Parturition ; Pregnancy ; Prevalence ; Risk Factors ; Skin ; Skin Diseases ; Vitamin D Deficiency ; Vitamin D*

Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia is needed to decide empiric antibiotic treatment. Antibiotics effective against the expected bacterial pathogens should be instituted where necessary. The role of emerging pathogens and the effect of pneumococcal resistance and heptavalent conjugate pneumococcal vaccines are to be considered in practice. There are reports supporting the valid and highly efficacious use of penicillin as a first-line drug for treating CAP. This review raises the issue of the overuse of unnecessary antibiotics in viral CAPs and the use of second or third-line antibiotics for non-complicated pneumonias in most clinical settings.
Anti-Bacterial Agents ; Child ; Humans ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Pneumonia, Bacterial ; Streptococcus pneumoniae

BACKGROUND AND OBJECTIVE: It is generally accepted that one third of children with food allergy lose their clinical activity if the responsible food allergen can be identified and completely eliminated from their diet. But buckwheat allergy rarely lose clinical activity. So, we have produced hypoallergenic buckwheat(HBW) according to Ikezawa's method, and characterized the allergenicity by immunoblot method using monoclonal antibodies to raw buckwheat. MATERIAL AND METHODS: HBW was prepared from raw buckwheat by salting with 0.5 M NaCl. 18 monoclonal antibodies to raw buckwheat were made according to standard polyehtylene glycol method. We performed SDS-PAGE of HBW and transferrd to nitrocellulose membranes, which were immunoblotted by selected 3 monoclonal antibodies to raw buckwheat. RESULTS: The protein concentration of HBW was 47.3 microgram/microliter. As the result of SDS-PAGE of HBW the protein bands of 50, 36, 13 kD of raw buckwheat disappeared. 3 monoclonal antibodies were selected due to their higher specificities in ELISA. Immunoblot study showed that 2 among 3 monoclonal antibodies bind to HBW. CONCLUSION: The SDS-PAGE of HBW showed less protein bands in comparison to raw buckwheat. But the allergic component of HBW still remained. So further studies are required to eliminate the residual allergenicity of hypoallergenic food.
Antibodies, Monoclonal* ; Child ; Collodion ; Diet ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Fagopyrum* ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Membranes

PURPOSE: Food allergies can affect the growth and nutritional status of children with atopic dermatitis (AD). This study was conducted to determine the association between the number of sensitized food allergens and the growth and nutritional status of infants and young children with AD. METHODS: We studied 165 children with AD, aged 5 to 47 months, and who visited the Atopy Clinic of the Seoul Medical Center. We recorded the birth weight, time at which food weaning began, scoring of atopic dermatitis (SCORAD) index, eosinophil counts in peripheral blood, and total serum IgE and specific IgE to six major allergens (egg white, cow's milk, soybean, peanut, wheat, and fish). The height and weight for age and weight for height were converted to z-scores to evaluate their effects on growth and nutritional status. Specific IgE levels > or =0.7 kUA/L, measured via the CAP assay, were considered positive. RESULTS: As the number of sensitized food allergens increased, the mean z-scores of weight and height for age decreased (P=0.006 and 0.018, respectively). The number directly correlated with the SCORAD index (r=0.308), time at which food weaning began (r=0.332), eosinophil counts in peripheral blood (r=0.266), and total serum IgE (r=0.394). Inverse correlations were observed with the z-scores of weight for age (r=-0.358), height for age (r=-0.278), and weight for height (r=-0.224). CONCLUSIONS: A higher number of sensitized food allergens was associated with negative effects on the growth and nutritional status of infants and young children with AD. Therefore, a thorough evaluation of both growth and nutritional status, combined with adequate patient management, is crucial in pediatric AD patients presenting with numerous sensitized food allergies.
Aged ; Allergens ; Birth Weight ; Child ; Dermatitis, Atopic ; Eosinophils ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Infant ; Milk ; Nutritional Status ; Soybeans ; Triticum ; Weaning

PURPOSE: Hemodynamically significant patent ductus arteriosus (PDA) may increase the mortality of premature infants who received ventilator care by aggravating hypoxia, acidosis, pulmonary edema and hypotension. The risk factors for PDA in premature infants are low gestational age, infusion of excessive fluid, and severity of neonatal respiratory distress syndrome. We studied the risk factors of PDA in very low birth weight infants (VLBW) to establish a guideline for the treatment. METHODS: VLBW infants who were born at Severance Hospital, Yonsei Medical Center from January, 1989 through December, 1995 and survived for at least 5 days with ventilator care were recruited for this study. Patent ductus arteriosus was diagnosed according to the clinical diagnostic criteria of Yeh (Yeh et al, 1981b). Thirty six infants had diagnosed as PDA (PDA group), and thirty seven infants who had not PDA were selected as control. Both groups of infants received restrictive fluid therapy. RESULTS: 1) Gestational age, sex, Apgar score, administration of surfactant, mode of delivery, toxemia and use of antenatal dexamethasone were similar between PDA and control infants. 2) In PDA group, ventilatory index and duration of vetilator care were significantly greater (P<0.05), and a/ApO2 was significantly lower than control group (P<0.05). There was no difference in peak inspiratory pressure at initial setting, the highest peak inspiratory pressure and mean airway pressure during ventilator care. 3) During the first 3 days of life, the urine output was similar between groups. On the 4th and 5th days of life, PDA group had significantly reduced urine ouput compared with control (on day 4; 2.6+/-1.1 ml/kg/h vs. 3.2+/-1.2ml/kg/h, P<0.05; on day 5, 2.9+/-1.4ml/kg/h vs. 3.6+/-1.6ml/kg/h, P<0.05) . 4) The percent weight loss compared to birth weight was siginificantly lower in PDA group (12.5% vs. 15.1%, P<0.05). 5) The PDA group had higher incidences of bronchpulmonary dysplasia and intraventricular hemorrhage (P<0.05). CONCLUSION: Among Vlnfants who received restrictive fluid therapy during the first 5 days of life, infants with PDA had reduced urine output and percent weight loss than control group.
Acidosis ; Anoxia ; Apgar Score ; Birth Weight ; Dexamethasone ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Fluid Therapy ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Mortality ; Pulmonary Edema ; Respiratory Distress Syndrome, Newborn ; Risk Factors* ; Toxemia ; Ventilators, Mechanical ; Weight Loss

PURPOSE: To identify relationship of behavioral problems, parenting practice and school life in children with atopic dermatitis. METHODS: The participants were parents of 102 school-aged children with atopic dermatitis. The instruments used were a self-reported questionnaire on K-CBCL, Childrearing Behavior Questionnaire, and measurements of relationship with friends and teachers. Descriptive, Pearson correlation and multiple regression analyses were performed. RESULTS: There was no statistically significant relationship between behavior problems for gender, age, parent's age, parent's educational level, family structure, academic achievement, and duration and severity of illness. There were significant differences in internalizing (F=3.471, P<0.05) and externalizing problems (F=3.227, P<0.05) according to economic status. In bivariate analysis, rejection-nonintervention maternal parenting practice (r=0.293, P<0.05), the relationship with friends (r=-0.297, P<0.05) and the relationship with teachers (r=-0.252, P<0.05) were significantly correlated with internalizing problems and rejection-nonintervention maternal parenting practice (r=0.257, P<0.05), rejection-nonintervention paternal parenting practice (r=0.274, P< 0.05), the relationship with friends (r=-0.275, P<0.05) and the relationship with teachers (r= -0.263, P<0.05) were significantly correlated with externalizing problems. However, the results of multiple regression analysis showed that only the relationship with friends (beta=-1.412, P<0.05) was significantly associated with internalizing problems and rejection-nonintervention maternal parenting practice (beta=-0.458, P<0.05), the relationship with friends (beta=0.402, P<0.05) were significantly associated with externalizing problems. CONCLUSION: School-aged children with atopic dermatitis who reported lower socioeconomic status, reported higher rejection-nonintervention parenting practice and had a poor relationship with friends and teachers showed higher internalizing and externalizing problems. A comprehensive intervention program for children with atopic dermatitis is recommended to promote the development of positive relationships with parents, friend and teachers.
Achievement ; Child ; Dermatitis, Atopic ; Friends ; Humans ; Parenting ; Parents ; Surveys and Questionnaires ; Social Class

Epidemiological evidence suggests that the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is lesser and morbidity and mortality rates are lower in children than in adults. Although respiratory viral infections are major triggers of asthma exacerbations in children, the association between asthma and SARS-CoV-2 infection remains unclear. We describe a previously healthy 13-year-old male adolescent who developed severe acute asthma exacerbation following coronavirus disease 2019 (COVID-19) infection. This case report describes new-onset asthma as severe exacerbation following COVID-19 infection and highlights the importance of ongoing surveillance of the wide spectrum of COVID-19 manifestations in children.

PURPOSE: Cat is the pet which many of us quite frequently contact without any specific precautions. According to the allergy skin tests conducted in children, cat antigen shows a comparatively high positive reaction, and past history also shows that there are many patients who suffer allergies from cat contacts. Therefore, once it is diagnosed as an allergy caused by cat, it is important that patients be isolated in order to restrict their contact with cat. In this context, this study was conducted for the purpose of finding out how serious and how frequent the allergies by cat contacts are. METHODS: Forty five children patients who visited to the Allergy Clinic for Children, Severance Hospital annexed to the Medical College, Yonsei University were enrolled in this study. Some of patients had shown a positive reaction against cat antigen in the allergy skin test, and others had a past history of developing symtoms when contacted by cat. The patients were isolated from cat for seven days, and then contacted with cats for 30 minutes and observed the provocated symptoms. RESULTS: 1) Among the tested patients, the number of cases who were provocated by the symptoms after cat contact were 18 (40%). 2) Among those patients who were shown to be positive only in allergy skin test, only 24.2% proved to be provocated by the symptoms, while 90.0% of those who had a past history in addition to allergy skin test proved to be provocated by the symptoms. 3) Symptoms provocated after cat contact showed allergic rhinitis patients 88.2% which was the highest ratio, bronchical asthma, 35.3%, urticaria, 29.4%, and allergic conjunctivitis, 23.5%, respectively. 4) The onset and duration of symptoms provcated were under 10 minutes and from 30 to 60 minutes, which included most cases in the test. 5) Total IgE and eosinophil count of patients did not show any meaningful differences between the group which was provocated and that which was not provocated. CONCLUSION: It was shown that 40% patients who were suspected of cat allergy had a positive reaction to the cat contact provocation test. Ninety percents of patients who showed both positive allergy skin test and past history were provocated after cat contact.
Animals ; Asthma ; Cats* ; Child ; Conjunctivitis, Allergic ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Rhinitis ; Skin Tests ; Urticaria