PURPOSE: Mycoplasma pneumoniae pneumonia is one of the most common community- acquired pneumonias in childhood. Recently, it has tended to occur at a young age. We reviewed clinical manifestations of M. pneumoniae pneumonia in the young. METHODS: A total of 378 children who were admitted to the Bundang Jesaeng Hospital due to M. pneumoniae pneumonia from 2003 to 2006 were retrospectively analyzed. M. pneumoniae infection was confirmed by mycoplasma antibody titer >1:320 or four-fold increase of titer. The children were divided into an infant group (Group A, 0-4 years) and an older children group (Group B, 4-14 years). We analyzed the differences between the two groups according to incidence, clinical manifestations, laboratory and radiologic findings. RESULTS: The number of patients in Group A was 147 (38.9%) and in Group B, 231 (61.1%), respectively. Seasonal distribution showed the highest frequency in autumn and the lowest frequency in spring in both groups. The most common symptom was cough (98.6% and 96.5%, respectively) and fever (85.7% and 91.3%, respectively). The most common physical findings were crackle (72.8% and 73.3%, respectively). The common radiologic findings were lobar pneumonia in both groups (55% and 76.1%, respectively), followed by bronchopneumonia (29.2% and 11.6%, respectively). Group A had a lower incidence of high antimycoplasma antibody titer (>1:5,120) and severe pulmonary complication than Group B. CONCLUSION: Group A had the more incidence of sputum production, leukocytosis, bronchopneumonia and duration of fever less than 7days. Group B had the more incidence of weak breathing sound, lobar pneumonia and duration of fever more than 7days.
Bronchopneumonia ; Child ; Cough ; Fever ; Humans ; Incidence ; Infant ; Leukocytosis ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Retrospective Studies ; Seasons ; Sputum

No abstract available.
Anemia, Megaloblastic* ; Humans ; Megaloblasts* ; Methotrexate*

Cytomegalovirus (CMV) is the most common agent of congenital infections and opportunistic infections in an immunocompromised host. CMV in an immunocompetent host has inapparent infections, which are usually asymptomatic or cause mild mononucleosis-like symptoms. However, severe CMV diseases, such as pneumonia, hepatitis, gastrointestinal disease, often occur in a healthy infant. The association of CMV pneumonia with the development of pneumothorax has rarely been reported. We experienced a case of CMV pneumonia presenting as pneumothorax in a 4-month-old healthy infant, who was successfully treated with supportive care. CMV was confirmed by using CMV polymerase chain reaction of tracheal aspirates. This case suggested that CMV should be considered as a cause of viral pneumonia during the infant period.

PURPOSE: Recently, the incidence of refractory Mycoplasma pneumoniae (MP) pneumonia has increased in Korea. Given that its early diagnosis is helpful in selection of the treatment, this study aimed at investigating the value of the antimycoplasma antibody (IgM) for early diagnosis of MP pneumonia. METHODS: A total of 315 children admitted with MP pneumonia from September 2015 to May 2016 were investigated with the IgM and polymerase chain reaction (PCR) for the diagnosis of MP pneumonia. Specifically, patients were grouped into nonrefractory respiratory MP and refractory MP groups according to their response to macrolide therapy. RESULTS: In the 44 PCR-negative seroconversed children, seroconversed IgM was more frequent in the refractory MP group compared with the nonrefractory respiratory MP group with statistical significance (P<0.001). In the 264 IgM-positive children, the time of antibody reaction was more delayed in the refractory MP group compared to the nonrefractory respiratory MP group with statistical significance (P<0.001). CONCLUSION: This study showed that there was a higher incidence of seroconversed IgM and delayed antibody reaction in the refractory MP group. In children with suspect MP pneumonia, follow-up studies of antibody are necessary, even through initial antibody and PCR showed negative findings. In addition, this result may suggest that the diagnosis of refractory MP pneunomia will be helpful in establishing the strategy of the treatment.
Child ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Incidence ; Korea ; Mycoplasma pneumoniae ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction

PURPOSE: Peanut allergy is a major cause of fatal food-induced anaphylaxis. Cooking methods can affect the allergic properties of peanut proteins. The aim of this study was to determine the allergenicity of peanut according to cooking methods. METHODS: Eight kinds of peanut were included in the study: raw peanut, boiled peanut, roasted peanut (10 min, 20 min and 30 min), peanut butter, fried peanut and vinegarish peanut. The proteins were extracted with PBS and analyzed using the SDS-PAGE IgE immunoblot assay with pooled sera from 8 patients with atopic dermatitis. These patients had peanut- specific IgE levels greater than 15 kU/L, which were measured by the CAP-FEIA. RESULTS: The SDS-PAGE IgE immunoblot assay revealed more intense protein bands of Ara h 2 in roasted peanut and peanut butter than in raw, boiled, fried and vinegarish peanut. The protein band of Ara h 1 was not undetected in fried and vinegarish peanut. Ara h 3 had a stable band pattern in all samples, but there was the most prominent band at 37-40 kDa in vinegarish peanut. The IgE immunoblot assay revealed that 10 min roasted peanut had more IgE binding to Ara h 2, and there was no IgE binding to Ara h 1 in fried and vinegarish peanut. In vinegarish peanut, there was almost no IgE binding to it. CONCLUSION: The results of this study suggest that the roasted peanut may increase the allergenicity of Ara h 2 as compared to Ara h 1. Fried and vinegarish peanut may reduce the allergenicity of peanut.
Anaphylaxis ; Butter ; Cooking ; Dermatitis, Atopic ; Electrophoresis, Polyacrylamide Gel ; Humans ; Immunoglobulin E ; Peanut Hypersensitivity ; Proteins

PURPOSE: The superiority of breast-feeding to artificial feeding of infants aged 6 months or less has been well established. Due to the low rate of breast-feeding in our 1994 hospital survey we recommended and educated about breast-feeding to mothers who delivered in our hospital since January 1995. The purpose of this survey is to assess if the rate of breast-feeding increased in our hospital thereafter. METHODS: One hundred twenty-five infant born at National Medical Center (NMC) after January 1. 1995 were surveyed through questionnaire about breast feeding at the well-baby clinic of pediatric department of NMC from May, 1996 to September, 1996. RESULTS: The rate of breast-feeding was 26.4% in the nursery after birth, 40.8% at 1 month of age. Breast-feeding at 1 month of age was more common among children fed breast milk in the nursery after birth (P<0.05), who initiated breast-feeding within 3 days of age (P<0.05), born by vaginal delivery (P<0.05) and positive maternal response to the guideline of breast-feeding (P<0.05). The decision of breast-feeding was made mainly by the mother and 12.0% were by doctor or nurse's suggestion. The main reason for giving up or failure of breast-feeding was "insufficient breast milk". CONCLUSION: Compared with baseline data surveyed in our hospital in 1994, breast-feeding at the nursery increased from 1.3% to 26.4% and at 1 month of age, increased from 35.1% to 40.8%. So recommendation for breast-feeding at hospitals is very important and may play a role to increase the rate of breast-feeding.
Breast ; Breast Feeding ; Child ; Humans ; Infant ; Milk, Human ; Mothers ; Nurseries ; Nutritional Support ; Parturition ; Surveys and Questionnaires

PURPOSE: Histologic classification plays a key role in the classification of idiopathic interstitial pneumonia (IIP) into clinically meaningful categories in terms of natural history, prognosis and treatment. The implications of histological diagnosis, clinical features and prognosis in children has not been described. This study aimed to analyze the clinical features of IIP in children. METHODS: A total of 15 patients with IIP were recruited, who had a surgical lung biopsy. The age, sex, symptoms, initial oxygen saturation, radiologic findings and clinical courses were retrospectively investigated. RESULTS: The median age at diagnosis was 3 years. Cough (93.3%), tachypnea (86.7%) and dyspnea (80%) were the most common symptoms, and laboratory findings were nonspecific. Acute interstitial pneumonia (n=6), chronic pneumonitis of infancy (n=4) nonspecific interstitial pneumonia (n=3) were relatively common. All patients received corticosteroid therapy and the mortality rate was 26.7% (n=4). CONCLUSION: IIP has diverse clinical features according to subtypes. Knowledge of the underlying histopathology will allow the prediction of more accurate prognosis, the decision of appropricate therapy, and the clinical investigation of novel therapeutic agents in patients with IIP.
Biopsy ; Child ; Classification ; Cough ; Diagnosis ; Dyspnea ; Humans ; Idiopathic Interstitial Pneumonias* ; Lung ; Lung Diseases, Interstitial ; Mortality ; Natural History ; Oxygen ; Pneumonia ; Prognosis ; Retrospective Studies ; Tachypnea

BACKGROUND: About 70-80% of children with cow's milk allergy (CMA) become outgrown clinically by the age of 3 years. Casein, one of the three major cow's milk proteins (casein, beta-lactoglobulin (BLG), alpha-lactoalbumin (ALA) ) has been reported to play an important role in the persistence of CMA. The aim of this study was to determine different effects of causative milk proteins on the persistence of CMA between two age groups. METHODS: A total of 65 patients with CMA were enrolled in this study. Their cow's milk-specific IgEs were positive ( 0.7 U/ml by Pharmacia CAP). After dividing 65 patients into two age groups, under the age of 3 years and over 3 years (persistent CMA), we compared the levels of casein-, BLG- and ALA-specific IgE antibodies between the two groups. RESULTS: There were 44 patients in the group of less than 3 years of age and 21 patients in the group of more than 3 years of age. The concentrations of the specific IgE antibodies to casein, BLG and ALA were not significantly different between the two groups. However, although statistically insignificant, those more than 3 years of age had higher mean values of casein-specific IgE antibodies and lower mean values of whey protein (BLG and ALA) - specific IgE antibodies compared with those less than 3 years of age. A single dominant allergenic milk protein was not identified within either of the two age groups, but the con centrations of the casein-specific IgE antibodies in children with more than 3 years of age tended to be higher than those of whey protein-specific IgE antibodies. CONCLUSION: Although statistically insignificant, the concentrations of the casein-specific IgE antibodies were higher in the group of more than 3 years of age than in the younger group. Moreover, the concentrations of the casein-specific IgE antibodies in children more than 3 years of age tended to be higher than those of whey proteins. These findings implicate that casein plays a certain role in the persistence of CMA.
Antibodies ; Caseins ; Child* ; Humans ; Immunoglobulin E* ; Lactoglobulins ; Milk Hypersensitivity* ; Milk Proteins ; Milk* ; Whey Proteins

PURPOSE: Interleukin-9(IL-9), one of Th2-type cytokines, might be important in the pathophysiology of allergic diseases. We investigated the effect of IL-9 on human mast cells by assessing cell proliferation and histamine release. METHODS: Human umbilical cord blood cells were cultured in the presence of stem cell factor(SCF, 100 ng/mL) and IL-6(50 ng/mL) in liquid medium for 8 weeks. Then these cells were divided into 3 aliquots. Each aliquot was cultured for 4 more weeks in different conditions : SCF alone(100 ng/mL), IL-9 alone(50 ng/mL) and SCF+IL-9. Cell numbers were counted using hemocytometer. For evaluation of apoptosis, DNA fragmentation was determined by propidium iodide(PI) staining and flow cytometric analysis. Histamine concentration was measured by ELISA after stimulation with human IgE and anti-human IgE. RESULTS: Cell numbers increased significantly when they were cultured in the presence of SCF and IL-9 compared with SCF alone(P<0.05). Proliferation of mast cells was mediated by decreased apoptosis. Histamine release in activated mast cells was not different regardless of incubation with IL-9. CONCLUSION: IL-9 might be involved in allergic inflammation via proliferation of mast cells in target tissue.
Apoptosis ; Cell Count ; Cell Proliferation* ; Cytokines ; DNA Fragmentation ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood ; Histamine Release* ; Histamine* ; Humans* ; Immunoglobulin E ; Inflammation ; Interleukin-9* ; Mast Cells* ; Propidium ; Stem Cells

PURPOSE: We investigated the clinical difference between single infection and coinfection with respiratory virus in hospitalized children with acute respiratory tract infections. METHODS: We reviewed 727 patients who were admitted with the diagnosis of acute respiratory infection at the Department of Pediatrics, Bundang Jesaeng Hospital between January and December of 2014. Diagnoses were made using the multiplex reverse transcriptase polymerase chain reaction (RT-PCR) assay targeting 16 viruses in nasopharyngeal swabs. Subjects were classified as the single virus infection and coinfection groups. RESULTS: A total of 439 patients were enrolled; 359 (77.2%) under 24 months. Single virus was detected in 279 (63.6%). Coinfection with multiple virus was detected in 160 (36.4%): 126 (28.7%) with 2 viruses, 30 (6.8%), and 4 (0.9%) with 3 to 4 viruses. Viral coinfection was detected in 28 samples (17.5%), with respiratory syncytial virus (RSV) A and rhinovirus being the most dominating combination. There were no clinical differences between the single infection and coinfection groups, except sputum and the frequency of high RSV load. Sputum was significantly more frequent in the coinfection group (P=0.043), and the frequency of high RSV load was significantly higher in the single infection group (P=0.029). Disease severity (high fever, the duration of fever [≥5 days], and the length of hospital stay [≥5 days], O₂ therapy) did not differ significantly between both groups. RSV was a frequent virus of single infection during winter. Coinfection was most common in winter. CONCLUSION: There were no clinical differences between single infection and coinfection, except sputum and the frequency of high RSV load.
Child ; Child, Hospitalized ; Coinfection* ; Diagnosis ; Fever ; Humans ; Length of Stay ; Multiplex Polymerase Chain Reaction ; Pediatrics ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Sputum