Pleural empyema is characterized by presence of pus or microorganism in the pleural fluid. Most cases of empyema in children are caused by bacterial pneumonia, and the most common pathogen is Staphylococcus areus or Streptococcus pneumoniae. But other uncommon causes of empyema include esophageal rupture, mediastinal disease, tumors, sepsis, thoracic trauma, and surgery can be produced by various pathogens. We experienced a case of Escherichia coli empyema followed by gastroenteritis in 9-year-old boy.
Child ; Empyema* ; Empyema, Pleural ; Escherichia coli ; Gastroenteritis* ; Humans ; Male ; Mediastinal Diseases ; Pneumonia, Bacterial ; Rupture ; Sepsis ; Staphylococcus ; Streptococcus pneumoniae ; Suppuration

Systemic lupus erythematosus (SLE) is a chronic and multisystemic disease. Pleuropulmonary disease in SLE has various clinical manifestations, such as immunologic pneumonia, infectious pneumonia, interstitial lung disease, pulmonary hypertension, pulmonary hemorrhage, pleuritis and pleural effusion. It can manifest as an initial clinical finding of SLE. We experienced two cases; one case of pulmonary hemorrhage and one case of atypical pneumonia as an initial clinical manifestation of SLE.
Hemorrhage ; Hypertension, Pulmonary ; Lung Diseases ; Lung Diseases, Interstitial ; Lupus Erythematosus, Systemic* ; Pleural Effusion ; Pleurisy ; Pneumonia

Congenital tuberculosis is a rare disease in which an unborn child inside the uterus or right after delivery is infected with tubercle bacillus, due to the mother suffering primary tuberculosis right before pregnancy or during pregnancy. As a newborn who was naturally delivered with a gestational age of 38 weeks, and 3.02 kg in birth weight, he entered an other hospital with a fever, which he contracted one month after birth, but the fever continued for 10 days, thus he was transferred to this hospital. Chest radiography, indicated infiltration of both lungs, thus he was treated with suspected pneumonia and sepsis. And then, his symptoms became favorable, and he left hospital. However, since chest radiography one month later, his condition had not improved, thus he was hospitalized again. In a computerized chest tomography scan, infiltration of the lungs and tuberculosis were suspected due to a mysterious region of shadow. A tubercle bacillus test was conducted, and the tuberculin test was negative. However, acid- fast bacilli smear, acid-fast bacilli culture test, and polymerase chain reaction test, which were carried out the gastric aspiration were positive. The patient was administered antitubercular agents under the diagnosis of congenital tuberculosis, and he is currently under observation as an outpatient, without complications. The authors experienced a case of congenital tuberculosis, which was discovered due to fever, generated 4 weeks after birth, and to abnormal views in chest radiography, which continued more than 2 months. We report this.
Antitubercular Agents ; Bacillus ; Birth Weight ; Child ; Diagnosis ; Fever ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Lung ; Mothers ; Outpatients ; Parturition ; Pneumonia ; Polymerase Chain Reaction ; Pregnancy ; Radiography ; Rare Diseases ; Sepsis ; Thorax ; Tuberculin Test ; Tuberculosis* ; Uterus

PURPOSE: we performed this study to determine whether early and low dose ribavirin therapy for respiratory syncytial virus (RSV) bronchiolitis in previously healthy infants may reduce the duration of hospital stay. METHODS: Thirty-four Previously healthy infants with RSV bronchiolitis were enrolled in this study. Early in the course of illness, less than 5 days, aerosol ribavirin was administered at a low, single-dose (3 g/150 mL/day) and then we assessed the duration of hospital stays for 16 infants treated with ribavirin (ribavirin group) and 18 infants who received conservative treatment (control group). RESULTS: The baseline characteristics of each group were not significantly different with respect to gestational age, birth weight, age, sex, weight, and height. On admission, there were no significant differences between the two groups in the respiratory rate and body temperature. Duration of hospitalization was significantly shorter in the ribavirin group (4.4+/-0.3 days) as compared to the control group (5.5+/-0.3 days) (P=0.02). CONCLUSION: Early and low-dose ribavirin therapy for RSV bronchiolitis in previously healthy infants may decrease duration of hospital stay.
Birth Weight ; Body Temperature ; Bronchiolitis* ; Gestational Age ; Hospitalization ; Humans ; Infant* ; Length of Stay ; Respiratory Rate ; Respiratory Syncytial Viruses* ; Ribavirin*

PURPOSE: Nasal stuffness is one of most common symptom in children who suffer from rhinitis although there is still debates at to the best measurable device. The aim of the study was to evaluate the sniff nasal inspiratory pressure (SNIP) with respiratory pressure meter and compare this with the clinical status of patients. METHODS: We enrolled 57 rhinitis patients who visited our hospital during June 2005 to July 2006. They were treated with intranasal steroid spray (mometasone furoate) for first 2 weeks. To evaluate the outcome of treatment, we used symptom score (SS) and measured the SNIP with respiratory pressure meter (Micro RPM, Micro Medical, Rochester, UK) and also measured peak nasal inspiratory flow (PNIF) with peak nasal inspiratory flow meter (Youlten peak flow meter, Clement Clarke Int., London, UK) before and after the therapy. Skin prick test was performed to all patient to classify the atopic (AR) and non-atopic rhinitis (NAR). RESULTS: Among 57 identified patients (median age, 7 years 9 months), 40 AR and 17 NAR were studied. Most patient showed clinically improvement with 2 weeks intranasal steroid therapy (0 wk SS=4.9, 2 wk SS=1.7 in AR; 0 wk SS=4.5, 2 wk SS=1.5 in NAR, P< 0.01). The SNIP of AR group was increased after intranasal therapy (0 wk SNIP=58.5 cm H2O, 2 wk SNIP=76.2 cmH2O; P<0.01). There was also significant improvement in terms of SNIP in NAR group (0 wk SNIP=51.7 cmH2O, 2 wk SNIP=62.9 cmH2O, P<0.01). However, we could not find any correlation between SS and SNIP. Although there was the improvement of symptoms scores, there was no significant difference of peak flow between before and after treatment (71.9-->77.6 L/min, P>0.05). And there was no correlation between SNIP and PNIF measurement. CONCLUSION: The respiratory pressure meter is a useful device to evaluate the therapeutic effectiveness and clinical improvement in pediatric rhinitis patients.
Child ; Humans ; Nasal Obstruction ; Rhinitis* ; Skin

PURPOSE: The aim of this study was to evaluate the etiology and outcome of chronic urticaria (CU) in childhood. METHODS: We reviewed retrospectively the clinical manifestations and laboratory findings of the thirty-nine patients with urticaria and/or angioedema for more than 6 weeks. We also invested the clinical parameters affecting the remission. Positive autologous serum skin test (ASST) results were compared with CU remission. RESULTS: Male occupied about 56.4% of patients (n=22). Age at first outpatient clinic visit was from 12 month to 13 years 9 month. Duration of symptoms before visit were from 6 weeks to 6 months. Among the etiologic causes, 35.9% (n=14) of patients had physical urticaria, concretely, 17.9% (n=7) of patients had cold urticaria, 12.8% (n=5) of patients had symptomatic dermographism, 5.1% (n=2) of patients had cholinergic urticaria. Sinusitis was associated with CU in 5.1% (n=2) of patients. Unknown causes were 59.9% (n=23) of patients, and among them, 34.8% (n=8) of patients had positive ASST. Disease remission was observed in 56.4% (n=22), but non-remission was observed in 43.6% (n=17). Remission of CU was not associated with age, gender, etiology, and ASST. The remission rate of ASST negative group was higher than the ASST positive group, but it was not significant statistically. CONCLUSION: Etiologies of CU were variable and physical urticaria should be evaluated first. Unknown etiology were 59.9% and of them, correlation positive ASST with disease remission rate should be evaluated later with further study.
Ambulatory Care Facilities ; Angioedema ; Humans ; Male ; Retrospective Studies ; Sinusitis ; Skin Tests ; Urticaria*

PURPOSE: Recent studies suggest that oral probiotic administration might be useful in the management of atopic dermatitis. Probiotics are known to promote the maturation of gut- associated lymphoid tissue (GALT) and control inflammatory responses. The purpose of this study was to evaluate clinical and anti-inflammatory effects on children's atopic dermatitis with Lactobacillus casei (L. casei), a kind of probiotic, supplementations. METHODS: Forty four patients with atopic dermatitis who visited the Pediatric Allergy Clinic in Soonchunhyang University Hospital from December 2004 to April 2005 were enrolled. We evaluated the SCORAD scores. Then, fresh stools were collected and cultured to count colony numbers of L. casei, and blood were samples were taken to measure IFN-gamma, total IgE, specific IgE (house dust mites, milk, egg white, dog hair, soy bean), peripheral blood eosinophil percent, and ECP. We divided patients by two groups randomly. L. casei containing yoghurt was ingested by one group but not by the other group for 16 weeks. After that period, SCORAD scores, stool cultures and blood samples were reevaluated. RESULTS: Most patients who received L. casei experienced improvement of atopic dermatitis, but changes in SCORAD scores were not so significant compared with the other group. Just forty patients had their blood tested again (L. casei group was 21), and there were no statistical significances. There were also no significant changes of specific IgE, eosinophil percent, ECP, total IgE, and IFN-gamma levels, before and after. The colony counts of L. casei in stool which were cultured after investigation, were relatively high in the group with L. casei supplements. (P=0.03) Conclusion: The administration of L. casei in children with atopic dermatitis might be helpful to improve the colony counts of L. casei in intestines, and these increased L. casei are expected to act as a down-regulator of allergic inflammation, but more investigations should be conducted to reveal the precise mechanisms and possible complications.
Animals ; Child* ; Dermatitis, Atopic* ; Dogs ; Dust ; Egg White ; Eosinophils ; Hair ; Hematologic Tests ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Intestines ; Lactobacillus casei* ; Lactobacillus* ; Lymphoid Tissue ; Milk ; Mites ; Probiotics ; Yogurt

PURPOSE: The purpose of our study was to investigate the risk factors in developing persistent wheezing in infants with recurrent wheezing. METHODS: Two hundred thirty two infants with recurrent wheezing under two years old visited to Pediatric Allergy and Respiratory Center in Soonchunhyang University Hospital from August 1998 to May 2002 were enrolled and investigated until May 2006, retrospectively. The patients were divided into two groups; persistent wheezer group (PW) who had recurrent wheezing until six years old and transient wheezer group (TW) who didn't have wheezing after three years old. The patients' demographics and laboratory data such as serum total IgE, specific IgE (Dp, Df, dog hair, egg white, milk, soy) and peripheral blood eosinophil count at the first visit were analysed to investigate the risk factors for developing persistent wheezing. RESULTS: PW was 115 (49.5%) and TW was 117 (50.5%) out of 232 infants with recurrent wheezing. In comparison analysis between PW and TW, there were no significant differences in age (months), serum total IgE, peripheral blood eosinophil (P=0.319), birth weight, and gestational age. However, increased serum total IgE (OR 1.72; 95% CI 1.01-2.90), sensitization to Dp (3.6, 1.14-11.39) and egg white (2.96, 1.49-5.89), family history of allergic diseases (2.35, 1.33-4.13), personal history of atopic dermatitis (2.08, 1.11-3.89), and not having older siblings (2.93, 1.64-5.24) had statistic significance. Among these results, not having older sibling (adjusted OR 2.74, 1.46-5.13) and having family history of allergic diseases (adjusted OR 2.69, 1.39-5.18) had strong significance by regnession a nalysis. CONCLUSION: Early intervention of infants with high risk factors for developing persistent wheezing may improve their outcome. Therefore early intervention of infants with high risk factors will be necessary for preventing develop childhood asthma.
Animals ; Asthma ; Birth Weight ; Demography ; Dermatitis, Atopic ; Dogs ; Early Intervention (Education) ; Egg White ; Eosinophils ; Gestational Age ; Hair ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant* ; Milk ; Respiratory Center ; Respiratory Sounds* ; Retrospective Studies ; Risk Factors* ; Siblings

PURPOSE: Mycoplasma pneumoniae is a common cause of lower respiratory disease, especially in children and young adults. Several studies have suggested that respiratory infection by M. pneumoniae is associated with reactive airway disease and asthma. Though eosinophilia in peripheral blood are revealed in patients with mycoplasmal pneumonia, what is not known is the functional capacity of M. pneumoniae to activate human eosinophils. We investigated whether M. pneumoniae lysate (MPL) can activate human eosinophils to release inflammatory mediators. METHODS: Human eosinophilic leukemic cell lines, EoL-1 cells were incubated with MPL. Activation of EoL-1 cells was monitored by IL-8 production, superoxide production and surface expression of CD69, ICAM-1, CD11b, and CD49d. In addition, we examined the effect of MPL and the role of mitogen-activated protein kinases (MAPKs) on IL-8 expression in EoL- 1 cells. RESULTS: MPL induced IL-8 release in a time- and dose- dependent manner. However MPL did not induce superoxide anion production and CD69, ICAM-1, CD11b, and CD49d surface expression in EoL-1 cells. Pretreatment with mitogen-activated protein/extracellular signal- regulated kinase (ERK) [MEK] inhibitor PD98059, c-Jun N-terminal kinase (JNK) inhibitor II SP600125, and selective p38 MAPK inhibitor SB202190 inhibited MPL-induced IL-8 production, but the MPL stimulation had no effect on the activities of nuclear factor (NF)-kappaB. CONCLUSION: These observations suggest that MPL causes activation of EoL-1 cells, and activation of MAPKs by MPL may be one of the mechanisms that result in an increase of the production of IL-8.
Asthma ; Cell Line ; Child ; Eosinophilia ; Eosinophils* ; Humans* ; Intercellular Adhesion Molecule-1 ; Interleukin-8 ; JNK Mitogen-Activated Protein Kinases ; Mitogen-Activated Protein Kinases ; Mycoplasma pneumoniae* ; Mycoplasma* ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Pneumonia ; Pneumonia, Mycoplasma* ; Superoxides ; Young Adult

Food allergy is an adverse food reaction as a result of immune mechanisms. In a sensitized individual, food allergens activate mast cells and basophils by binding with IgE present on the cell surface, resulting in the release of chemical mediators and various cytokines to cause various clinical symptoms of food allergy. 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). The class 1 food allergens are water-soluble glycoproteins with 10-70 kD size that are resistant to heat, acid and enzymes. On the other hand, the class 2 food allergens are highly unstable and degraded by heat or enzymatic digestion. Much progress has been made in identifying and isolating food allergen. Recently cDNAs for many proteins have been isolated and recombinant proteins have been generated. These techniques make it easier to characterize each responsible food allergens. Plant food allergens are classified into families and superfamilies by their structural and functional properties. The most of plant food allergens are the cupin and prolamin superfamilies and the protein families of the plant defense system. The cupin superfamily includes allergenic seed storage proteins of 7s globulin (vicilin) and 11s globulin (legumin). 2s albumin seed storage proteins, the nonspecific lipid transfer proteins, and the cereal alpha-amylase and protease inhibitors belong to the prolamin superfamily. Profilins, heveins, and nonspecific lipid transfer proteins are present in a variety of pollens, nuts, seeds, fruits, and vegetables. These are considered as panallergens, causing a significant degree of IgE-mediated cross-reactivity. Detailed informations about the character of food allergens can be used to develop more sophisticated diagnostic methods and treatment modalities in the near future. Further knowledge of food allergens is also useful to assess the allergenicity of novel protein of genetically mo.
Allergens* ; alpha-Amylases ; Basophils ; Edible Grain ; Classification* ; Cytokines ; Digestion ; DNA, Complementary ; Food Hypersensitivity ; Fruit ; Gastrointestinal Tract ; Glycoproteins ; Hand ; Hot Temperature ; Humans ; Immunoglobulin E ; Mast Cells ; Nuts ; Plants* ; Pollen ; Profilins ; Protease Inhibitors ; Recombinant Proteins ; Seed Storage Proteins ; Vegetables