Nedocromil sodium is an anti-inflammatory medication for the treatment of mild to moderate asthma. The most common side effect of the nedocromil sodium is an unpleasant and bitter taste. However it is rare, less than 3%, to stop the treatment because of this side effect. Other side effects includes cough, headache, throat irritation and nausea which are reported as mild and transient. A 7-year-old female had a severe headache and dizziness during the treatment of asthma with nedocromil sodium. The symptoms subsided after nedocromil sodium was replaced by budesonide. We experienced a case of a severe headache and dizziness due to nedocomil sodium that lead to withdraw of the nedocromil sodium.
Asthma ; Budesonide ; Child ; Cough ; Dizziness* ; Female ; Headache* ; Humans ; Nausea ; Nedocromil* ; Pharynx ; Sodium

PURPOSE: Patient education is an important part of asthma management. This study was designed to evaluate the role of education program for asthmatic children and their parents. In the western countries, the effectiveness of patient education on improving self-management of asthma has been well documented. However, data from Korean population is lacking. METHODS: We performed the study to evaluate the efficacy of a hospital based education program aimed at improving self-management skills and reducing morbidity. Twenty patient and their parents attending Korea University Ansan Hospital allergy clinic were enrolled in the study. They were instructed 4 times of 10-15 minutes session with every 3 month interval on the pathophysiology of asthma, treatment and the appropriate use of medication including proper inhaler technique and the self-management of their diseases. The instructions were reinforced by three more education session at subsequent outpatient clinic attendance. RESULT: After twelve months, morbidity was assessed by the numbers of hospitalization, emergency department attendance and outpatient clinic attendance, use of oral steroids and steroid inhalation and impairment of quality of life. The efficacy of the education was demonstrated by significant reduction in the number of hospitalization(P<0.005), emergency department visit(P<0.005), outpatient clinic visit(P<0.05) and reduction of oral steroid use(P<0.001). There were also reduction of outpatient department attendance and improvement in steroid inhalation and quality of life. CONCLUSION: The result of this study suggest that a proper patient education is essential in reduction of asthma morbidity and improving in quality of life.
Ambulatory Care Facilities ; Asthma* ; Child ; Education* ; Emergency Service, Hospital ; Gyeonggi-do ; Hospitalization ; Humans ; Hypersensitivity ; Inhalation ; Korea ; Nebulizers and Vaporizers ; Outpatients ; Parents* ; Patient Education as Topic ; Quality of Life ; Self Care ; Steroids

No abstract available.
Down Syndrome* ; Primary Myelofibrosis*

PURPOSE: The increased prevalence of childhood asthma in Korea from 3.4% in 1964 to 15% in 1995 might be very important for morbidity and mortality in children. Recognition of this led to consider the necessity of new management strategies emphasizing patient education. We developed the educational program including asthma-specific play game called 'Malgunsum asthma game' to improve the child's interest and evaluated its educational effect. METHOD: Twenty asthmatic children between the age seven to fifteen were attended Malgunsum Asthma Camp. The Children were randomly assigned to 5 groups, and each player had to move the horse by answering the questions on the card. The first one who reaches the goal wins the game. RESULTS: All the children well followed the play rule and were interested to the game. CONCLUSION: This educational game model will achieve better control of asthma by leading the patients to understand the nature of asthma, how to identify and control the aggravating factors, how to recognize symptoms and appropriate steps for asthma, and the importance of daily maintenance therapy with anti-inflammatory medications.
Asthma* ; Child ; Horses ; Humans ; Korea ; Mortality ; Patient Education as Topic ; Prevalence

PURPOSE: Appropriate reference values are needed for assessment of pulmonary function during childhood. We performed pulmonary function test with simple computerized spirometry to establish reference values of air flow rates in healthy Korean children. METHODS: We examined 1,317 children aged 6 to 15 years at their schools by standardized method during May, 2001. The children with poor cooperation, respiratory symptom, and chronic disease were excluded. Regression analysis was applied for FVC, FEV1, PEF, FEF25-75% predicted from sex, age, standing height, weight, and body surface area. RESULTS: In 1,317 children(Male : 716, Female : 601), the distribution of height was from 106.7 cm to 173.5 cm, weight was from 16.5 kg to 75.5 kg. We could get regression equations and determinant coefficients between anthropometric parameters and air flow rates. In both sexes, height showed very close correlation with lung function variables, and FEV1 showed very close correlation with all anthropometric parameters. Reference values of pulmonary function test were generally higher in boys than in girls. CONCLUSION: After performing the pulmonary function test in healthy Korean children, we report their normal values of air flow rates and regression equations for the predicted values. Among anthropometric parameters, height showed most close correlation with lung function variables in both sexes.
Body Surface Area ; Child* ; Chronic Disease ; Female ; Humans ; Lung* ; Reference Values* ; Respiratory Function Tests ; Spirometry

PURPOSE: The purpose of this study is to examine the causes of Pleural effusion (PE) in cancer patients and to compare the clinical characteristics between malignant PE (MPE) and non-MPE. METHODS: All consecutive cancer patients with PE who underwent diagnostic thoracentesis from January 1, 2008 to March 31, 2011 were analyzed retrospectively. RESULTS: A total of 719 patients were included; mean age was 58.4+/-13.6 years and 44.5% were female. The most common cause of PE was MPE (57.7%), followed by parapneumonic or empyema in 16.3%. However, the etiology was significantly different according to primary tumor origin and subtypes of lung cancer. While MPE was most common in lung, breast, and gynecologic cancer, hepatic hydrothorax was the main cause in Hepatocellular carcinoma (HCC). MPE accounted for 85.2% in adenocarcinoma, and 30.2% and 58.8% in squamous cell and small cell carcinomas, respectively. Patients with MPE were younger (57.0 vs. 60.2 years) and female-dominant (55.4% vs. 29.6%) compared to those with non-MPE. MPE had the large size (53.5% vs. 34.9%) and left location of PE (31.3% vs. 19.4%) more frequently than non-MPE, and fewer neutrophils (15.4% vs. 30.6%) and more lymphocytes (32.2% vs. 28.2%), higher levels of pH (7.33 vs. 7.29), and lower levels of glucose (111.5 vs. 129.7 mg/dL) than non-MPE (p<0.001 for all). CONCLUSION: Overall, MPE was the most common cause of PE in cancer patients. However the etiology of PE was significantly different according to primary tumor origin and subtypes of lung cancer. A difference in age, gender, size and location of PE, cell count, pH, and glucose was observed between MPE and non-MPE.
Adenocarcinoma ; Breast ; Carcinoma, Hepatocellular ; Carcinoma, Small Cell ; Cell Count ; Empyema ; Female ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hydrothorax ; Liver Neoplasms ; Lung ; Lung Neoplasms ; Lymphocytes ; Neutrophils ; Pleural Effusion* ; Retrospective Studies

PURPOSE: This study was undertaken to investigate changes in cardiac performance in early neo-natal life by observing the changes of left ventricular(LV) function and volume according to the size of ductus arteriosus. METHODS: The study group consisted of 21 full-term Cesarean section neonates who were admitted to the nursery of Korea University Hospital. We serially investigated the patency and size of the ductus at 2, 24, 120 hours after birth by two-dimensional echocardiography. The standard two-dimensional tracings of LV volume were obtained under the guidance of apical two- and four-chamber views. LV end-diastolic and end-systolic volumes were calculated using a biplanar Simpson's method. RESULTS: LV end-diastolic volume was highest(3.44>0.4mm) at 2 hours of age(P<0.01), being constant from 24 to 120 hours. LV contractility, indicated by the mean normalized systolic ejection rate, remained constant during the whole period of investigation. The size of the ductus arteriosus was maximal at 2 hours after birth, and decreased significantly at 24 hours of age (P<0.01). The size of ductus arteriosus demonstrated a close linear correlation with the left ventricular end-diastolic volume(y=0.17x+2.92, r=0.59: P<0.01). CONCLUSION: Changes in LV end-diastolic volume soon after birth depend on changes in ductus arteriosus flow, which in turn is affected by ductal diameter. Upon patency of the ductus arteriosus, the newborn left ventricle operates at maximal performance with only a limited capacity to increase contractility.
Cesarean Section ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Infant, Newborn ; Korea ; Nurseries ; Parturition ; Pregnancy ; Ventricular Function, Left

BACKGROUND: Although leptin and its principal mediators, neuropeptide Y (NPY) and -melanocyte stimulating hormone (MSH) are postulated to play a pivotal role in the energy balance in experimental animals, the physiologic roles of leptin and its molecular targets are not fully identified in cases of human obesity. METHODS: The subjects consisted of 16 obese women (mean BMI 35.6 kg/m2) before and after weight loss that was induced by a 2 week-very low caloric diet (800 kcal/day) and 14 normal weight women (who had a mean BMI of 20.4 kg/m2). We evaluated the plasma and cerebrospinal fluid (CSF) leptin, NPY and alpha -MSH levels and their relationship in normal weight and obese women. Additionally, changes of these peptides during a negative energy balance (800 kcal/day) were assessed in causes of human obesity. RESULTS: Obese subjects exhibited a 6.3-fold higher plasma leptin level (21.9+/-1.2 vs 3.5+/-0.4 ng/mL, p<0.05) and a 2.8-fold higher CSF leptin level (0.29+/-0.02 vs 0.10+/-0.01 ng/mL, p<0.05) compared to control subjects. The CSF/plasma leptin ratio in normal weight subjects was 2.3-fold higher than that in obese subjects. After a weight loss in obese subjects, the plasma leptin level decreased by 40% and the CSF level decreased by 51%. The CSF/plasma leptin ratio was slightly lower than the baseline level. There was a positive linear correlation between CSF and plasma leptin level at the baseline in obese subjects (r= 0.74, p<0.05) and a positive logarithmic correlation in normal weight subjects and in obese subjects after a weight loss (r= 0.66, p<0.05). The BMI negatively correlated with the CSF/plasma leptin ratio (r=-0.86, p<0.05) in any subjects. Neither the baseline plasma levels nor the baseline CSF levels of NPY were different between the normal weight subjects and obese subjects. After a weight loss the CSF NPY level decreased significantly compared to the baseline values in obese subjects. The alpha -MSH levels in plasma and CSF did not differ significantly from controls in obese subjects at the baseline or after a weight loss. The baseline CSF leptin level neither correlated with the baseline CSF NPY level nor the baseline CSF alpha -MSH level. CONCLUSION: These results demonstrated that the efficiency of leptin delivery to the CNS is reduced in human obesity and that the CNS leptin uptake involves the combination of saturable and unsaturable mechanisms. A marked reduction in the CSF leptin levels compared to the plasma level after a weight loss in obese subjects can be a potent stimulus for the body to regain weight. In contrast to the results that were observed in experimental animals, the CSF NPY and alpha -MSH did not differ from the controls in human obesity and there was no significant correlation between the CSF leptin and CSF of these neuropeptides. This could have resulted from leptin resistance in cases of human obesity although the mechanisms for this resistance remain to be determined.
alpha-MSH ; Animals ; Cerebrospinal Fluid* ; Diet ; Female ; Humans ; Leptin* ; Neuropeptide Y ; Neuropeptides ; Obesity ; Peptides ; Plasma* ; Weight Loss*

OBJECTIVES: Gestational diabetes mellitus (GDM) affects 2%-4% of the all pregnant women, and it is a major risk factor for development of type 2 DM. We performed this cross-sectional study to determine whether there were defects in insulin secretory capacity or insulin sensitivity in women with previous GDM. METHODS: On 6-8 weeks after delivery, 75 g oral glucose tolerance test was performed in 36 women with previous GDM and 19 non-pregnant control women matched with age and weight. Intravenous glucose tolerance test was performed on 10-14 weeks after delivery. Insulin secretory capacity measured as the acute insulin response to glucose (AIRg) and insulin sensitivity as minimal model derived sensitivity index (S(I)) were obtained. AIRg x S(I) (beta-cell disposition index) was used as an index of beta-cell function. RESULTS: Women with previous GDM were classified into normal glucose tolerance (postpartum-NGT, n=19) and impaired glucose tolerance (postpartum-IGT, n=17). Postpartum fasting glucose levels were significantly higher in postpartum-IGT compared to postpartum-NGT and control (P<0.05). AIRg x S(I) was significantly lower in postpartum-IGT compared to control (P<0.05). S(I) was lower in postpartum-NGT and postpartum-IGT compared to control, but the difference did not have the statistical significance. Frequency of parental history of type 2 diabetes was significantly greater in postpartum-IGT compared to postpartum-NGT (P<0.05). CONCLUSION: Women with previous GDM showed impaired insulin secretion although their glucose tolerance states were restored to normal. It suggests impaired early insulin secretion may be a major pathophysiologic factor for development of type 2 DM, and this defect may be genetically determined.
Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Diabetes, Gestational* ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Insulin Resistance ; Insulin* ; Insulin-Secreting Cells ; Parents ; Postpartum Period ; Pregnancy ; Pregnant Women ; Risk Factors

Little is known about the prevalence of naturally acquired IgG antibodies to the capsular polysaccharides of Streptococcus pneumoniae (pneumococcal IgG) in Korea. In the present study, we investigated transplacental transfer and age-related levels of pneumococcal IgG to provide background seroepidemiologic data for S. pneumoniae in Korea. One hundred thirty eight sera were assayed by ELISA for IgG to pneumococcal polysaccharide capsular serotypes 14 and 19, the predominant serotypes for under 15 yr of age in Korea. The subjects were divided into 7 subgroups according to age. The cord/maternal geometric mean titer of pneumococcal were 4.47+/-5.88/5.21 +/- 5.88 for serotype 14, and 4.68 +/- 5.55/6.55 +/- 6.92 for serotype 1 9 (mean +/- standard deviation, microg/mL). After birth, the geometric mean titers of pneumococcal IgG for serotypes 14 and 19 expressed in microg/mL were 1.18+/-2.12 and 1.41+/-2.17 in the 0-6 months group, 0.27+/-0.19 and 0.69+/-0.93 in 7-12 months, 0.21+/-0.22 and 0.64+/-1.32 in 1-2 yr, 0.69+/-0.78 and 2.65+/-2.46 in 3-6 yr, 2.52+/-2.72 and 8.29+/-4.24 in 7-10 yr, respectively. In conclusion, reduced transplacental transfer and very low serum concentrations of pneumococcal IgG may contribute to the susceptibility of neonates, infants, and young children to S. pneumoniae infection.
Age Factors ; Antibodies, Bacterial/metabolism* ; Bacterial Capsules/immunology* ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; IgG/metabolism* ; IgG/blood ; Infant ; Infant, Newborn ; Male ; Maternal-Fetal Exchange* ; Pneumococcal Vaccines/immunology ; Pregnancy ; Streptococcus pneumoniae/immunology* ; Vaccines, Conjugate/immunology