BACKGROUND: Though immunotherapy(IT) has become an effective rnethod in extrinsic allergic patients who didn't respond to pharmacologic therapy or couldn't avoid allergen, the mechanism, termination index and prognostic index of IT have not been clarified yet. METHOD: We selected 81 asthmatic children on immunotherapy with house dust mite (Dermatophagoides pteronyssinus and Dermatophagoides farinae). We measured the hematologic findings, the levels of serum IgG and IgE, allergen(house dust, Dermatophagoides pteronyssinus and Dermatophagoides farinae)-specific IgE concentrations, lymphocyte subsets and methacholine challenge test yearly during IT, and checked the radiographs of chest and paranasal sinus. RESULTS: Peripheral white blood cell count, the percentage of eosinophil and total eosinophil count decreased significantly after 2 years of IT. Serum IgG level increased significantly after 3 years of IT. Serum total and specific IgE levels decreased significantly after 3 years of IT, but they were still higher than the normal values. CD4+, CD8+, and B lymphocytes did not change with the IT, but CD3+ lymphocytes increased significantly after 2 years of IT. PC20-methacholine increased significantly after 1 year of IT, but no correlation was found between the duration of IT and bronchial hyperreactivity. Twenty-eight patients(34.6%) had abnormal findings on chest radiographs: 15 patients(53.6%) as bronchitis, 10 patients(35.7%) as bronchopneumonia, 2 patients(7.1%) as hyperinflation and 1 patient(3.6%) as atelectasis. Sixty-three patients(77.8%) had abnormal findings on paranasal sinus radiographs. In the follow-up radiographs of 49 patients, 28 patients(57.1%) showed improvement of paranasal sinusitis after 1 year of IT. CONCLUSION: This study showed some changes of the immunologic findings such as eosinophil count, IgG, IgE, allergen-specific IgE and CD3+ lymphocytes, and improvement of bronchial hyperreactivity and paranasal sinusitis' in asthmatic children during IT. These findings were closely related to clinical improvement.
B-Lymphocytes ; Bronchial Hyperreactivity* ; Bronchitis ; Bronchopneumonia ; Child* ; Dermatophagoides pteronyssinus ; Dust ; Eosinophils ; Follow-Up Studies ; Humans ; Immunoglobulin E* ; Immunoglobulin G ; Immunotherapy* ; Leukocyte Count ; Lymphocyte Subsets ; Lymphocytes ; Methacholine Chloride ; Pulmonary Atelectasis ; Pyroglyphidae ; Radiography, Thoracic ; Reference Values ; Sinusitis* ; Thorax

No abstract available.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant, Newborn*

In order to examine the actual condition of smoking, the change of knowledge and the attitude on smoking of the students attending junior and senior high schools in Korea, the survey was performed six times ranging from 1988 to 1997. The first two years, the survey was performed only for male students. Since 1991, both male and female students were surveyed. The students in junior and senior high school were selected by a random sampling method and surveyed by mail. In this survey, the number of classes of Junior and senior high schools in Korea was a sampling unit, and the classes were selected in proportion to the number of classes of each city and each county. The total number of respondents was 3,437 in 1988, 3,055 in 1989, 6,087 in 1991(2,923 of male, 3,164 of female), 7,067 in 1993(3,162 of male, 3,905 of female), 5,412 in 1995(2,598 of male, 2,814 of female), 4,754 in 1997(2,281 of male, 2,473 of female). The results obtained from the data analysis are as follows; 1.The ratio of smokers among male junior high school students has increased from 1.8% in 1988 to 3.9% in 1997. The ratio of smokers among female junior high school students has increased from 1.2% in 1991 to 3.9% in 1997. The ratio of smokers among male senior high school students has increased from 23.9% in 1988 to 35.3% in 1997. The ratio of smokers among male senior high school students has increased from 23.9% in 1988 to 35.3% 1997. And the ratio of smokers among female senior high school students has increased from 3.0% in 1991 to 8.7% in 1997. Especially the ratio of smokers among female junior high school students is same as that of male in 1997. 2. With respect to areas, the number of current smokers and the experienced ones was higher in the county than in the city in 1988. But in 1997, the number of current smokers and the experienced one is higher in the city than in the county. 3. In respect of whether or not there is a smoker among the member of a family, the odds ratio of smoking among the male senior high school students was 1.70 in 1988 and 1.94 in 1997. the odds ratio of smoking among female senior high school students was 1.43 in 1991 and 1.98 in 1997. This result showed that the effect of family smoking on adolescent smoking has not decreased.
Adolescent ; Surveys and Questionnaires ; Female ; Humans ; Korea* ; Male ; Odds Ratio ; Postal Service ; Smoke ; Smoking* ; Statistics as Topic ; Tobacco Products*

Objective: This study aimed to evaluate the change in length of stay (LOS) in the emergency department (ED) and outcomes during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This is a single-center, retrospective observational study. We compared ED LOS and outcomes in patients aged ≥19 years who presented to the ED of Soonchunhyang University Bucheon Hospital, a single tertiary university hospital, between January and December in 2018, 2019, and 2020. We included patients who were diagnosed with fever, pneumonia, and sepsis in the ED, based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision. We also compared the LOS and outcomes of overall ED patients in 2019 (before COVID-19) and in 2020 (after COVID-19). Results: A total of 5,061 patients with fever, pneumonia, and sepsis were analyzed. The LOS in the ED in 2020 significantly increased compared with 2018 and 2019 (177.0±115.0 minutes in 2018, 154.0±85.0 minutes in 2019, and 208.0±239.0 minutes in 2020). The proportion of patients who were transferred to other hospitals in 2020 (2.1%) increased compared with 2018 (0.8%) and 2019 (0.7%). Intensive care unit admission significantly increased in 2020 (13.7%) compared with 2019 (10.3%). Among all ED patients, ED LOS in 2020 was longer than in 2019, particularly in patients who were admitted and then transferred to another hospital. Intensive care unit admission (4.4% vs. 5.0%), transfer rate (0.7% vs. 0.9%), and ED mortality (0.6% vs. 0.7%) also significantly increased. Conclusion The ED LOS, time to intensive care unit admissions, time to transfer to other hospitals, and ED mortality significantly increased during the COVID-19 pandemic.

No abstract available.
Humans ; Infant, Newborn* ; Neurologic Examination*

Thirty eight cases of moyamoa disease, 21 children, 17 adults were encountered during a 16-year period at Yonsei University Medical Center. Clinical manifestations, together with computed tomography (CT) and angiographic findings were analyzed with a review of the literature. The mean age was 6.3 +/- 3.5 years in children and 36.8 +/- 9.9 years in adults. The majority of attacks occurred in spring in both adults and children. The most common chief complaint on admission was hemiparesis followed by convulsion in children, while in adults, loss of consciousness was most common followed by headache. Of transient neurologic deficits, hemiplegia was most common in children, while cranial nerve involvement was common in adults. Hemiplegia, also was the most common permanent neurologic manifestation in children, while hemiparesis and intellectual deterioration were the most common in adults. Of the children, 90.6% showed infarction on CT, while 88.2% of adults had hemorrhage. Bilateral occlusion of the carotid arteries was the most common site of lesions in both adults and children on cerebral angiogaphy.
Adolescent ; Adult ; Age Factors ; Central Nervous System Diseases/physiopathology ; Child ; Child, Preschool ; Cranial Nerves/pathology ; Female ; Human ; Korea/epidemiology ; Male ; Middle Age ; Moyamoya Disease/*epidemiology/physiopathology/radiography ; Retrospective Studies ; Seasons ; Tomography, X-Ray Computed

No abstract available.
Child* ; Humans ; Measles*

OBJECTIVES: Clinical studies have shown cognitive dysfunctions and soft neurological signs in schizophrenic patients and these findings have been suggested as evidence of organic bases in the pathophysiology of schizophrenia. This study was intended to investigate the characteristics of cognitive deficits and soft neurological signs in schizophrenia and, to determine whether any abnormality in these functions can be regarded as a trait marker of the illness which is independent of antipsychotic treatment and clinical improvement. We also investigated the correlation between cognitive deficits and soft neurological signs reflecting cognitive dysmetria, respectively. METHODS: Twenty schizophrenic patients were assessed for the soft neurological signs and cognitive functions before and after neuroleptic treatment. The patients had been medicated for at least 3 weeks with one of the atypical neuroleptics. Cognitive functions were evaluated by Trail making A, B, Stroop test and Word fluency test. Soft neurological signs were assessed by Cambridge Neurological Inventory(Part 2). Positive and Negative Syndrome Scale(PANSS) and Clinical Global Impression(CGI) were used to assess the clinical severity and Extrapyramidal Symtoms Rating Scale was used to estimate the extrapyramidal symptoms. Cognitive functions and soft neurological signs of twenty normal controls were assessed with the same scale. RESULTS: Before treatment, schizophrenic patients showed significant impairments on cognitive function tests(Trail Making A, B, Stroop Test) and soft neurological sign tests(8 items:Grasp reflex, Go/no-go, Finger thumb opposition, Rhythm tapping, Finger agnosia, Fist-edge-palm, Left-right orientation, Extinction). Although significant clinical improvements were observed after the treatment, there were no significant changes in cognitive functions and soft neurological signs(except for Go/no-go test and Finger agnosia). Among the soft neurological signs of the patients, abnormality in Rhythm tapping was significantly correlated with cognitive deficits. CONCLUSION: Schizophrenic patients showed characteristic cognitive deficits and soft neurological signs which were independent of medication and clinical symptoms. And these two characteristics were partly correlated with each other.
Agnosia ; Antipsychotic Agents ; Cerebellar Ataxia ; Fingers ; Humans ; Reflex ; Schizophrenia ; Stroop Test ; Thumb

PURPOSE: In most cases, myelodysplastic syndrome(MDS) transforms into a more aggressive state or acute myelogenous leukemia; it's prognosis is very poor. It is believed that hematopoietic stem cell transplantation(HSCT) is the only curative treatment of MDS, but available data in children are very sparse. In this report, the short term outcome of HSCT in childhood MDS was analyzed. METHODS: Ten children with MDS(CMMoL 5, RAEB 3, RAEBt 2) underwent HSCT(HLA- matched sibling transplantation 4, HLA-matched unrelated transplantation 4, cord blood transplantation 1, HLA-mismatched familial transplantation 1) between November 1995 and January 2001 at St. Mary's Hospital. Median follow-up duration was 11 months. RESULTS: Engraftment was successful in all cases and 8 patients are alive without disease. Three cases of VOD were observed and improved without complication. Four cases of grade II and 1 case of grade III acute GVHD were observed and well controlled with treatment. Three patients relapsed after transplantation. One patient is alive without disease after cytoreduction with allogenic stem cell rescue and 2 patients died of relapse. CONCLUSION: HSCT is a curative strategy of MDS and the survival rate is relatively higher than that of adults. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.
Adult ; Anemia, Refractory, with Excess of Blasts ; Child ; Fetal Blood ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes* ; Prognosis ; Recurrence ; Siblings ; Stem Cells ; Survival Rate

PURPOSE: Antineutrophil cytoplasmic antibody (ANCA) has been identified in various disorders including Wegener's granulomatosis, microscopic polyarteritis and Kawasaki disease. Measuring this antibody has a diagnostic role. It facilitates monitoring disease activity and may also help understand the pathogenesis of the diseases in which it is found. We investigated the correlation between the hematologic findings and ANCA in acute Kawasaki disease and the diagnostic potential of ANCA to predict coronary artery involvement. METHODS: Thirty-eight patients who met the diagnostic criteria for Kawasaki disease were enrolled in this study. We sampled and investigated the hematologic findings and the assay of ANCA before intravenous immunoglobulin treatment and weekly echocardiographs weekly. RESULTS: There was no sexual difference between ANCA positive and negative group. The age in ANCA positive group was significantly lower than in ANCA negative group. Duration of fever before treatment in ANCA positive group were not significantly different from those in ANCA negative group. In ANCA positive group, the mean WBC count and the mean ESRs were higher than in ANCA negative group. There was no relation between ANCA and coronary artery involvement. CONCLUSION: The assays of ANCA in acute Kawasaki disease does not help to predict disease activity and coronary artery involvement.
Antibodies, Antineutrophil Cytoplasmic* ; Coronary Vessels ; Fever ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome* ; Wegener Granulomatosis