Journal Detail Information

1

Cite

Share

A Case Report of a Patient with Pleuropulmonary Blastoma Presenting as Congenital Cystic Adenomatoid Malformation.

Sung Il WOO ; Hyo Bin KIM ; Joon Sup SONG ; Hyun Lyoung KOO ; Ho Jun LIM ; Soo Jong HONG

Pediatric Allergy and Respiratory Disease.2006;16(2):177-182.

Congenital cystic adenomatoid malformation(CCAM) is one of the most common congenital lung lesions. Clinical manifestations that show are neonatal respiratory distress, recurrent respiratory infection, pneumothorax, and hemothorax. But, there are patients who are asymptomatic until mid-childhood. The treatment of asymptomatic CCAM is controversial. There is a possibility to resolve it spontaneously, but late complications such as recurrent pulmonary infection, pneumothorax, hemothorax, and cancer, which includes bronchoalveolar carcinoma and rhabdomyocarcinoma, pleuropulmonary blastoma still remain. Some investigators advocate routine surgery for all cases of CCAM that are apparent at birth. A previously healthy 16-months-old girl who had suffered from a cough for 2 weeks was transferred to Asan Medical Center with CCAM. Due to a chest CT and fever, we first thought that she had CCAM with infection. After we treated her with antibiotics for one week, we performed surgery to confirm the diagnosis and to prevent further complication. But by surgical wedge resection, a pleuropulmonary blastoma was found. There were no evidence of metastasis and adjacent involvement. She started her chemotherapy with vincristine, actinomycin D and cyclophosphamide, and is now continuing maintenance chemotherapy with etoposide, vincristine, and Ifosfamide. We report pleuropulmonary blastoma that presented as CCAM. So we recommend surgical resection in asymptomatic CCAM to confirm the diagnosis and to prevent its malignant transformation, even not accompanied by symptoms.
Anti-Bacterial Agents ; Child ; Chungcheongnam-do ; Cough ; Cyclophosphamide ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Dactinomycin ; Diagnosis ; Drug Therapy ; Etoposide ; Female ; Fever ; Hemothorax ; Humans ; Ifosfamide ; Lung ; Maintenance Chemotherapy ; Neoplasm Metastasis ; Parturition ; Pneumothorax ; Research Personnel ; Tomography, X-Ray Computed ; Vincristine

2

Cite

Share

A Case of Toxic Epidermal Necrolysis Treated with High Dose Intravenous Immunoglobulin in a 2 Years Old Boy.

Se Yun JEON ; Ji Hyung NAM ; Sang Myung HAN ; Kyung Hee RHUE ; Seong Yul LEE ; Joon Soo PARK

Pediatric Allergy and Respiratory Disease.2006;16(2):171-176.

Toxic epidermal necrolysis(TEN) is a severe drug induced life-threatening disease and an acute illness. This disease is characterized by rapid onset of widespread necrosis resulting in sloughing of epidermis. The incidence of TEN is very rare, with approximately 0.5 to 1.4 cases per million per year. but TEN has a high mortality rate of 25-40 percent. Therapy for TEN is primarily aimed at supportive care. Treatment with systemic corticosteroid, immunosuppresive agent such as cyclosporine, cyclophosphamide, pentoxifyllin or plasmapheresis have not been shown to improve outcome. Recently, administration of high dose intravenous immunoglobulin(IVIG) has been shown to result in rapid improvement in patients with TEN. There have been several reports of the benefit of IVIG in adult patients with TEN. However we could not find using IVIG in pediatric patient with TEN in Korea. We have experienced improvement in a 2 years old boy with TEN after using high dose IVIG.
Adult ; Child ; Child, Preschool* ; Cyclophosphamide ; Cyclosporine ; Epidermis ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Korea ; Male* ; Mortality ; Necrosis ; Plasmapheresis ; Stevens-Johnson Syndrome*

3

Cite

Share

The Effect of Skin-colonizing Staphylococcus aureus and Its Exotoxins on Childhood Atopic Dermatitis.

Young Ho KIM ; Eun Sook LEE ; Jae Seok KIM ; Me Jin KIM ; Ji Ah JUNG ; Seung YANG ; Il Tae HWANG ; Hae Ran LEE

Pediatric Allergy and Respiratory Disease.2006;16(2):162-170.

PURPOSE: Staphylococcus aureus and its exotoxins have been regarded as having an influence on atopic dermatitis(AD). We aimed to examine the prevalence of S. aureus in the AD lesion, the types of the exotoxins, and the relationship between S. aureus and AD. METHODS: AD patients(n=32) and a normal control group(n=20) were enrolled. The severity of AD was measured by SCORAD index. Through skin culture and PCR, we tried to identify S. aureus and its exotoxins. RESULTS: S. aureus was isolated from 18(56 percent) out of 32 AD patients and its exotoxins were identified from 10(31 percent) out of them. The exotoxin types were as follows; sea in 4, eta in 3, sea+tst-1 in 1, sea+see in 2 patients. On the contrary, S. aureus was isolated from only 1(5 percent) out of 20 subjects of the normal control group, and its exotoxin type was sea. The SCORAD index in the S. aureus(+) group was higher than in the S. aureus(-) group, however it was not significant.(44+/-14.2 vs 38+/-17.1, P= 0.304) The SCORAD index was higher in the exotoxin(+) group than in the exotoxin(-) group(49+/-11.2 vs 38+/-16.2, P<0.05). The prevalence of S. aureus and its exotoxins in the AD group was higher than in the normal control group(P<0.001, P<0.05, respectively). The difference of SCORAD index was significant between the exotoxin(+) group and the exotoxin(-) group, but not between the S. aureus(+) group and S. aureus(-) group.(P<0.05, P= 0.304, respectively) CONCLUSION: The exotoxins of S. aureus were found to influence the severity of AD.
Dermatitis, Atopic* ; Exotoxins* ; Humans ; Polymerase Chain Reaction ; Prevalence ; Skin ; Staphylococcus aureus* ; Staphylococcus*

4

Cite

Share

Current Management of Acute Bronchiolitis in Incheon.

Jung Sun KIM ; Doo Kyo IN ; Yong Han SUN ; Hee Joo HONG ; Kang Ho CHO ; Dong Woo SON ; In Sang JEON ; Hann TCHAH

Pediatric Allergy and Respiratory Disease.2006;16(2):150-161.

PURPOSE: Although acute bronchiolitis is the most common lower respiratory tract infection in the first year of life, the use of pharmaceutical agents has been debated. The purpose of this study was to examine the current management practice of acute bronchiolitis by pediatricians in Incheon and to compare this with management internationally. METHODS: We sent postal questionnaires to all pediatricians in Incheon to assess their current practice for treating acute bronchiolitis. We analyzed the frequency of bronchodilators, steroids, xanthines use. These results were compared with international management. RESULTS: Of a total 131 questionnaires, 80(61 percent) were returned. Ninety percent of pediatricians used bronchodilator inhalation, either routinely(41 percent) or occasionally(43 percent). Steroid were used by 93 percent of the respondents, always(23 percent) or sometimes (65 percent). Pediatricians in Incheon tended to use pharmaceutical agents more frequently than Australian pediatricians who have consensus guidelines for the management of acute bronchiolitis, and as frequently as Swiss pediatricians who do not. CONCLUSION: Pharmaceutical agents are frequently used in the management of acute bronchiolitis by pediatricians in Incheon. Better therapeutic approaches are needed for bronchiolitis care.
Bronchiolitis* ; Bronchodilator Agents ; Consensus ; Incheon* ; Inhalation ; Surveys and Questionnaires ; Respiratory Tract Infections ; Steroids ; Xanthines

5

Cite

Share

Dexamethasone Attenuates PDGF- and TGF-beta-enhanced Vascular Endothelial Growth Factor Production in Cultured Human Bronchial Smooth Muscle Cells.

Myung Hwan YOO ; Jung Yeon SHIM ; Bo Gil SEO ; Deok Soo KIM ; Jae Won SHIM ; Hye Lim JUNG ; Moon Soo PARK

Pediatric Allergy and Respiratory Disease.2006;16(2):142-149.

PURPOSE: Human bronchial smooth muscle cell(HBSMC) plays an important role in the remodeling of the airways in asthma. Vascular endothelial growth factor(VEGF) is a multifunctional cytokine, which induces edema, angiogenesis, vascular remodeling, mucus metaplasia, subepithelial fibrosis, and antigen-induced Th2 inflammation. Transforming growth factor-beta(TGF-beta) is a growth modulator of HBSMC and an important cytokine in airway remodeling. We investigated the effect of dexamethasone on the release of VEGF from HBSMC stimulated with platelet-derived growth factor(PDGF) and TGF-beta. METHODS: HBSMC cultured in 10 percent FCS-DMEM media was growth-arrested in serum-deprived medium for 48 hours. Dexamethasone and TGF-beta were added and incubated for 16 hours before stimulation with PDGF. After 24 hours of stimulation, culture medium was harvested and stored at -80 degrees C until ELISA for VEGF was performed. RESULTS: The release of VEGF was significantly increased after stimulation with PDGF (P<0.01). The production of VEGF pretreated with TGF-beta before stimulation with PDGF was higher than those without TGF-beta pretreatment(P<0.01). Dexamethasone suppressed the release of VEGF in HBSMC stimulated with PDGF(P<0.01), TGF-beta and PDGF(P<0.01). CONCLUSION: PDGF and TGF-beta may be one of the key mediators in inducing airway remodeling and glucocorticoid, and can be used as useful therapies to prevent airway vascular remodeling by modulating the VEGF on airway smooth muscle cells.
Airway Remodeling ; Asthma ; Dexamethasone* ; Edema ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Humans* ; Inflammation ; Metaplasia ; Mucus ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Transforming Growth Factor beta ; Vascular Endothelial Growth Factor A*

6

Cite

Share

Evaluation of Anti-allergic Effect of Bifidobacteria in Murine Model of Peanut Allergy.

Soo Young LEE ; Se Ko OH ; Seok Won PARK ; Gey Ree JEON ; Ji Yun KIM ; So Yoon YOON ; Geun Ek JI

Pediatric Allergy and Respiratory Disease.2006;16(2):131-141.

PURPOSE: We underwent this study to evaluate the immunomodulating effects of intragastric administration of bifidobacterium(BGN4) using murine model of peanut allergy. METHODS: C3H/HeJ mice were sensitized with 1 mg/dose of crude peanut(PN) extract with cholera toxin, intragastricly. Group I mice were pretreated with BGN4 for 14 days before PN snesitization, Group II were treated 14-days each before and during sensitization, Group III were sham treated PN sensitized mice, and Group IV were naive. PN-specific serum IgE levels and PN stimulated cytokine productions from splenocyte were measured in study groups. RESULTS: PN-specific IgE levels were significantly lowered in Group II mice compare to Group I or Group III. PN-stimulated IL-4 productions were also remarkably depressed in Group II mice. The ratio of IFN-gamma/IL-4 in Group II was the highest among experimental Groups, furthermore, PN-stimulated IL-12 production was only measured in Group II mice. The decreased levels of PN-specific IgE in Group II consist with decreased production of IL-4 and increased ratio of IFN-gamma/IL-4 in this experiment. CONCLUSION: BGN4 treatment, especially pre-and-during PN sensitization, seemed to have anti-allergic effect by suppressing PN-specific IgE production. And lowered production of IL-4, increased production of IL-12, and the increased ratio of IFN-gamma/IL-4 could be suggested as a part of immunomodulating mechanism of BGN4 treatment in this experiment.
Animals ; Cholera Toxin ; Immunoglobulin E ; Interleukin-12 ; Interleukin-4 ; Mice ; Peanut Hypersensitivity*

7

Cite

Share

Bacterial Contaminations of Home Nebulizers in Asthmatic Children.

Young YOO ; Kang Jin SEO ; Tae Yeun KIM ; Yoon LEE ; Ji Tae CHOUNG ; Kyong Ho ROH

Pediatric Allergy and Respiratory Disease.2006;16(2):122-130.

PURPOSE: Nebulizers are commonly used to treat children with asthma. Some pulmonary infections associated with contaminated nebulizer units have been reported. The aims of this study were to determine whether home nebulizers are repositories of bacteria and to ascertain how asthmatic patients use and maintain their nebulizers at home. METHODS: Fifty-five children with asthma aged 2 to 6 years were enrolled in this study. The parents were asked to bring their child's nebulizer units to regular follow-up visits. Bacterial samples which were obtained from the masks(or mouthpieces), nebulizer chambers and throat swabs were inoculated to blood agar, chocolate agar, and McConkey agar. Cultures were incubated at 5 percent CO2 incubator and observed after 24 hours. Parents completed a questionnaire regarding nebulizer usage and care in their child. RESULTS: Bacterial contamination was found in samples from 27(49.1%) of the 55 masks(or mouthpieces) and 24(43.6%) of the 55 chambers. The predominant microorganisms isolated were Acinetobacter baumannii, Bacillus subtilis, Klebsiella pneumoniae, Staphylococcus aureus, and Candida albicans. The questionnaire revealed that 40 parents cleaned the nebulizer units with tap water(and soap) and dried then, as they had received cleaning and drying instructions from a medical staff member. Seven organisms from nebulizer units were indistinguishable from the patient's throat isolates. CONCLUSION: We have demonstrated that home nebulizers in these asthmatic children were frequently contaminated with aerobic bacteria. Aerosolization might transmit these bacteria to their upper respiratory tracts. The education and training of home caregivers should include the principles of cleaning and maintenance of their child's nebulizer units.
Acinetobacter baumannii ; Agar ; Asthma ; Bacillus subtilis ; Bacteria ; Bacteria, Aerobic ; Cacao ; Candida albicans ; Caregivers ; Child* ; Education ; Follow-Up Studies ; Humans ; Incubators ; Inhalation ; Klebsiella pneumoniae ; Medical Staff ; Nebulizers and Vaporizers* ; Parents ; Pharynx ; Surveys and Questionnaires ; Respiratory System ; Staphylococcus aureus

8

Cite

Share

The Correlation between Increased Sensitization Rate to Weeds in Children and the Annual Increase in Weed Pollen in Korea.

Jae Won OH ; Im Ju KANG ; Sung Won KIM ; Myung Hee KOOK ; Bong Seong KIM ; Kyung Soo SHIN ; Youn Soo HAHN ; Ha Baik LEE ; Myung Hyun SHON ; Jee Tae CHEONG ; Hae Ran LEE ; Kyu Earn KIM

Pediatric Allergy and Respiratory Disease.2006;16(2):114-121.

PURPOSE: Recently allergic diseases have gradually increased in schools and among preschool aged childhood. Pollen amount of weeds also, especially ragweed, were increased. We evaluated the increased pollen count of weed was associated with the sensitization rate to weed in childhood. METHODS: Airborne particles carrying allergens were collected daily from eight stations nationwide(Seoul, Guri, Cheongju, Daegu, Kwangju, Busan, Kangneung, and Jeju) by using 7 days-Burkard sampler(Burkard Manufacturing Co Ltd, Hertfordshire, UK), for 7 years in South Korea(July 1, 1997-June 30, 2004). They were counted and recorded along with the weather. Data was collected through pediatric patients with allergic symptoms, who visit the pediatrics allergy clinics and capable of allerfy skin test among hospitals that have pollen collecting centers. RESULTS: Airborne pollen has two peak seasons:May and September in Korea. There were the tree pollen seasons from the middle of February to late July, then followed the grasses and weed season from the middle of July to the end of October. Ragweed was one of the most common pollens of autumn in Korea. In skin prick tests, Mugwort was the highest sensitization rate(7.6 percent), followed by ragweed(7.1 percent), birch(6.1 percent), alder, grasses mix among the pollen extracts in Korean school aged children. Ragweed pollen counts have gradually increased since 2000. In the same period, sensitization rates for airborne pollen, especially weeds, in Korean children have increased annually(1999:4.4 percent, 2000:7.1 percent, 2001:7.4 percent, 2002:8.5 percent, 2003:7.7 percent). CONCLUSION: Sensitization rates for outdoor airborne pollens have increased in Korean children. These findings might result from the changes of life styles and living environments in Korea.
Allergens ; Alnus ; Ambrosia ; Artemisia ; Busan ; Child* ; Chungcheongbuk-do ; Daegu ; Gangwon-do ; Gwangju ; Humans ; Hypersensitivity ; Korea* ; Life Style ; Pediatrics ; Poaceae ; Pollen* ; Seasons ; Skin ; Skin Tests ; Weather

9

Cite

Share

Pediatric Obstructive Sleep Apnea Syndrome.

Sung Wan KIM ; Min Jung KIM

Pediatric Allergy and Respiratory Disease.2006;16(2):102-113.

Obstructive sleep apnea syndrome(OSAS) is a frequent, but underdiagnosed problem in children. If it is left untreated, OSAS may lead to substantial morbidities affecting multiple target organs and systems. The immediate consequences of OSAS in children include behavioral disturbance and learning deficits, pulmonary hypertension, as well as compromised somatic growth. If it is not treated promptly and early in the course of the disease, OSAS may also impose long term adverse effect on neurocognitive and cardiovascular function. Therefore, all children is recommended to be screened for snoring and/or sleep apnea. Diagnostic evaluation, such as polysomnography, is useful and gold standard in discriminating between primary snoring and OSAS. Adenotosillectomy is the fist line of treatment for most children, otherwise continuous positive airway pressure(CPAP) is the first line of treatment in adults. CPAP is an option for those who are not candidates for surgery or do not respond to surgery. High risk patients should be monitored postoperatively. And patients with OSAS should be reevaluated postoperatively to determine whether additional treatment is required.
Adult ; Child ; Humans ; Hypertension, Pulmonary ; Learning ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring

10

Cite

Share

Eosionophils in Induced Sputum and Peak Experatory Flow Rate Variability in Children with Allergic Rhinitis.

Kyoung Ae PARK ; Sung Eun KIM ; Sung Suk DO ; Seung Hee JUNG ; Do Young SONG ; Im Ju KANG

Pediatric Allergy and Respiratory Disease.2000;10(2):131-140.

PURPOSE: A large number of studies have demonstrated that rhinitis and asthma commonly occur together, and that a temporary relationship between the onset of rhinitis and asthma with rhinitis frequently preceding the development of asthma. We studied to know whether there were asthmatic airway inflammations in subjects with allergic rhinitis with bronchial hyperresponsiveness to methacholine who had no asthma symptoms. METHODS: Thirty seven children with an allergic rhinitis who visited the pediatric allergy clinic from January 1998 through June 1999 were enrolled. They were grouped into two groups according to the degree of airway responsiveness to methacholine, and 19 bronchial asthma patients with had no asthma attacks for 2 months were compared as control group.; AR-Mch (+) group (n=19) had a PC20-Methacholine lower than 10 mg/mL: AR-Mch (-) group (n=18) had a PC20-Metacholine greater than 10 mg/mL. The relationship of PEFR variability, sputum eosinophils, and nasal eosinophils with bronchial hyperresponsiveness to methacholine in each groups was compared. RESULTS: 1) The PC20-Methacholine was 5.7+/-3.5 mg/mL in the AR-Mch (+) Group, 1.9+/-2.7 mg/mL in the BA Group. 2) Sputum eosinophil was 14+/-6.9% in the AR-Mch (+) Group, 8.1+/-5.2% in the AR-Mch (-) Group, 29.6+/-16.9% in the BA Group, and sputum eosinophils of the AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 3) PEFR dinural variation was 7.0+/-2.6% in the AR-Mch (+) Group, 5.0+/-2.9% in the AR-Mch (-) Group, 14.0+/-6.0% in the BA Group, and PEFR dinural variation in AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 4) The PC20-Methacholine was not correlated with PEFR dinural variation in both the AR-Mch (+) Group and the BA Group. 5) The PC20-Methacholine was correlated with sputum eosinophils only in the BA Group. 6) Nasal eosinophils were not correlated with sputum eosinophils in the AR-Mch (+) and the BA Group. CONCLUSIONS: This study demonstrated that patients with allergic rhinitis who had bronchial hyperresponsiveness to methacholine might have eosinophilic inflammation in the lower airway and increased dinural PEFR. Further studies are necessary to evaluate whether asthma symptoms will be developed in these allergic rhinitis children.
Asthma ; Child* ; Eosinophils ; Humans ; Hypersensitivity ; Inflammation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Rhinitis* ; Sputum*

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share