PURPOSE: The incidence of endobronchial tuberculosis in children is unknown, due to the inconsistent implementation of bronchoscopy in pediatric patients with pulmonary tuberculosis. In this study, our aim was to determine the incidence and clinical course of endobronchial tuberculosis in children. METHODS: We performed a retrospective chart review of patients less than 18 years of age, who was diagnosed with endobronchial tuberculosis via fiberoptic bronchoscopy. RESULTS: Out of the 101 patients with pulmonary tuberculosis, 16 patients had endobronchial tuberculosis. The median age at diagnosis was 11.2 years (range, 5 months to 16.1 years). Tuberculin skin test was positive in 9 cases (56.2%), and 6 patients (37.5%) had a history of household contact with tuberculosis. Consolidation lesion was common in the simple chest radiographs of patients with endobronchial tuberculosis. According to the bronchoscopic finding, actively caseating type was most common (43.8%). Nine of the 16 patients of endobronchial tuberculosis progressed to bronchial obstruction and 4 patients underwent pneumonectomy or lobectomy. Fibrostenotic and tumorous type tend to progress to endobronchial obstruction compared with actively caseating type. CONCLUSION: The incidence of endobronchial tuberculosis in pediatric pulmonary tuberculosis was 15.8%. Early detection and effective treatment of endobronchial tuberculosis are important to decrease the secondary complication, such as bronchial obstruction.
Bronchoscopy ; Child ; Family Characteristics ; Humans ; Incidence ; Pneumonectomy ; Retrospective Studies ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.
Dermatitis, Atopic

Hereditary angioedema (HAE) is a rare autosomal dominant disease that usually occurs in adolescence and early adulthood. It is characterized by recurrent non-pitting edema involving the skin and intestinal tract, especially the extremities and face. It is not associated with urticaria and pruritus. The cause is known to be the deficiency of C1 inhibitor. We herein report a 7-year-old girl with HAE who had recurrent episodes of swelling of the extremities and face without urticaria and pruritus. Her great grandmother had suffered from the same symptoms. The level of serum C4 was 8.01 mg/dL (normal: 10-40 mg/dL). The level of C1 inhibitor was 5.0 mg/dL (normal: 18-40 mg/dL). To our knowledge, this is the first pediatric case with typical clinical symptoms of HAE and C1 esterase inhibitor deficiency in Korea.
Adolescent ; Angioedema ; Angioedemas, Hereditary ; Complement C1 Inhibitor Protein ; Edema ; Extremities ; Humans ; Korea ; Pruritus ; Skin ; Urticaria

No abstract available.
Food Hypersensitivity*

Mast cells play a key role in elicitation of the early-phase and late-phase IgE-mediated allergic inflammatory reactions. Mast cells are derived from pluripotent stem cells from the bone marrow. These cells migrate through circulation into connective tissues and mucosal surfaces where they mature. On the cell surfaces, mast cells have high affinity IgE receptor(FcepsilonRI), which react with specific IgE to secrete preformed and newly synthesized mediators within minutes or over a period of hours. For human mast cells, two subtypes have been recognized by the distribution of granular neutral proteases. TC-type mast cells(MCTC) contain tryptase together with chymase, cathepsin-G, and carboxypeptidase, while T-type mast cells(MCT) contain tryptase only. They also produce Th2- type cytokines to persist chronic allergic inflammation in local tissues. Mast cells have been widely studied in the context of allergic reactions and parasite infections, but there is growing evidence that they participate in innate immunity, wound healing, fibrosis, remodelling and autoimmune disease. Much research works are expected to be underwent by the development of in vitro culture system of human mast cells in addition to mast cells obtained from animals, human biopsy or cell lines. In conclusion, it is clear that mast cells are pleiotropic, multipotential and complex. More detailed research remains to be needed for further understanding of biology of mast cells and it will be helpful to develop novel treatment modality in allergic inflammation.
Animals ; Autoimmune Diseases ; Biology ; Biopsy ; Bone Marrow ; Cell Line ; Chymases ; Connective Tissue ; Cytokines ; Fibrosis ; Humans ; Hypersensitivity ; Immunity, Innate* ; Immunoglobulin E ; Inflammation* ; Mast Cells* ; Parasites ; Peptide Hydrolases ; Pluripotent Stem Cells ; Tryptases ; Wound Healing

No abstract available.
Bronchoconstriction ; Nitric Oxide

No abstract available.
Child* ; Dermatitis, Atopic* ; Humans ; Prevalence*

Food allergy is an immune-mediated adverse reaction that occurs mainly by consumption of food. Some of the children with food allergies have mild symptoms like urticaria and pruritus, while others manifest fatal symptoms like anaphylaxis. Many cases develop in infants and children, and disappear spontaneously over time. The prevalence of food allergy is known to be up to 6% of children and 3%–4% of adults. Growing concern is that prevalence of food allergy seems to be increasing. The prevalence, common allergens and natural course of food allergy vary according to the race, age, eating habits, and unknown factors. In Korea, many researchers have reported regional data on food allergy for comparison with those of foreign countries. Awareness is increasing and food labelling is being established to help people avoid allergenic foods. In the future, monitoring of prevalence and common food allergens at regular intervals is needed to make appropriate policies for children with food allergy. There are still lack of data on pathogenesis, natural course and clinical trials of immunotherapy in Korean children. In addition, it is necessary to form a consensus on primary prevention of food allergy by early exposure to allergenic foods. Further regional studies should be performed to expand our understanding of food allergy and to lead to proper management for Korean children with food allergy.
Adult ; Allergens ; Anaphylaxis ; Child* ; Consensus ; Continental Population Groups ; Eating ; Food Hypersensitivity* ; Food Labeling ; Humans ; Immunotherapy ; Infant ; Korea ; Prevalence ; Primary Prevention ; Pruritus ; Urticaria

Food allergy is an important public health problem affecting 5% of infants and children in Korea. Food allergy is defined as an immune response triggered by food proteins. Food allergy is highly associated with atopic dermatitis and is one of the most common triggers of potentially fatal anaphylaxis in the community. Sensitization to food allergens can occur in the gastrointestinal tract (class 1 food allergy) or as a consequence of cross reactivity to structurally homologous inhalant allergens (class 2 food allergy). Allergenicity of food is largely determined by structural aspects, including cross-reactivity and reduced or enhanced allergenicity with cooking that convey allergenic characteristics to food. Management of food allergy currently focuses on dietary avoidance of the offending foods, prompt recognition and treatment of allergic reactions, and nutritional support. This review includes definitions and examines the prevalence and management of food allergies and the characteristics of food allergens.
Allergens ; Anaphylaxis ; Child ; Cooking ; Cross Reactions ; Dermatitis, Atopic ; Disease Management ; Food Hypersensitivity ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Infant ; Korea ; Nutritional Support ; Prevalence ; Proteins ; Public Health

PURPOSE: The present study was performed to determine the factor, either duration or the temperature of heat treatment, exerting maximal and significant influence on the composition and allergenicity of egg white (EW) proteins. METHODS: Raw EW and 4 kinds of heated EW (fried EW, boiled EW for 10 minutes, boiled EW for 30 minutes, and baked EW for 20 minutes at 170degrees C) were prepared, and subsequently protein extraction was carried out. The proteins were separated by SDS-PAGE, and then immunoglobulin E (IgE) immunoblots were performed with the sera of 7 egg-allergic patients. Furthermore, the antigenic activities of ovalbumin (OVA), ovomucoid (OM), and ovotransferrin (OT) in different EW samples were measured by inhibition enzyme-linked Immuno-sorbent assay (ELISA). RESULTS: In SDS-PAGE analysis, the intensity of the protein band at 45 kD (corresponding to OVA) decreased significantly in boiled EW (30 minutes) and baked EW, but no change was observed in the case of boiled EW for 10 minutes. In IgE immunoblots, the IgE response to 34-50 kD (OM and OVA) in boiled EW for 30 minutes decreased significantly, when compared with raw EW and other heated EWs. In inhibition ELISA, a significant decrease in the OVA antigenic activity was observed in boiled EW for 30 minutes amongst other heated EW samples. However, OM antigenic activity in all kinds of heated EW including boiled EW for 30 minutes did not reduce after heat treatment. The OT antigenic activity nearly disappeared in heated EWs except in the case of boiled EW for 10 minutes. CONCLUSIONS: Amongst 4 kinds of heated EWs, the boiled EW for 30 minutes showed the most significant changes both in composition and reduction in allergenicity. Our results revealed that the duration of heat treatment had more influence on the composition and allergenicity of EW proteins than the temperature.
Conalbumin ; Egg Hypersensitivity ; Egg Proteins ; Egg White ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Hot Temperature ; Humans ; Immunoglobulin E ; Immunoglobulins ; Ovalbumin ; Ovomucin ; Ovum ; Proteins