Congenital bronchial stenosis is a rare condition with variable symptoms of presentation. Affected patients are usually asymptomatic, but because of the reduced airway, cough, cyanosis and respiratory distress may be presented. We report a 19 month-old girl with a recurrent history of severe wheezing, dyspnea and cyanosis accompanied by lower respiratory tract infections. Young children with severe respiratory symptoms and no immunological abnormalities must be suspected of airway structural abnormalities.
Child ; Constriction, Pathologic ; Cough ; Cyanosis ; Dyspnea ; Humans ; Organic Chemicals ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Infections

PURPOSE: Viral infection is known as one of the dominant risk factors for wheezing in children hospitalized before 2 years of age. Although the major viral pathogen associated with wheezing is respiratory syncytial virus (RSV), the mechanisms of wheezing remain unclear. Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and vascular permeability. The aim of this study was to evaluate the relationship between VEGF concentration and wheezing in children with acute RSV bronchiolitis. METHODS: Ninety-four children with acute bronchiolitis who were admitted to Korea University Anam Hospital were enrolled in this study. Based on the proven viral agents, children with bronchiolitis were divided into 2 groups: those who were infected with RSV (RSV (+) group, n=51) and those who were not (RSV (-) group, n=43). A complete history taking, physical examination and routine laboratory tests were performed on all children. VEGF levels in serum and nasopharyngeal aspirates (NPA) were determined by ELISA. RESULTS: NPA VEGF levels were significantly higher in the RSV (+) group than in the RSV (-) group (331.8+/-197.8 vs. 204.5+/-97.0 pg/mL, P=0.002). The duration of wheezing is significantly longer in the RSV (+) group than in the RSV (-) group (3.8+/-2.7 days vs. 2.4+/-1.8 days, P=0.037). CONCLUSION: The results of this study suggest that children with RSV bronchiolitis may have significantly higher NPA VEGF levels than those without, which may be associated with a longer duration of wheezing in those with RSV bronchiolitis.
Bronchiolitis ; Capillary Permeability ; Child ; Enzyme-Linked Immunosorbent Assay ; Humans ; Korea ; Physical Examination ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Risk Factors ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

OBJECTIVES: The Allergic rhinitis and its impact on asthma (ARIA) guidelines were suggested for use to classify allergic rhinitis (AR). However, few studies have been performed in Asians. The objective of this study is to identify the clinical characteristics of AR in Korean patients according to the ARIA guidelines. METHODS: For the study, 610 patients who had been diagnosed with allergic rhinitis at Seoul National University Bundang Hospital and 545 patients who had been diagnosed with allergic rhinitis at 3 local clinics were included. All the patients were categorized into 4 groups, such as the mild intermittent, mild persistent, moderate-severe intermittent and moderate-severe persistent groups. The patients were given a questionnaire on allergic rhinitis-related symptoms and they underwent blood tests, including the blood eosinophil count and the serum total IgE level. RESULTS: The most prevalent type was the moderate-severe persistent group (34.7%), and the moderate-severe intermittent group (17.1%) was the rarest. There were significant differences among the 4 groups for olfaction (P<0.001), self-awareness of rhinitis (P=0.013), a previous history of AR (P<0.001), self-awareness of asthma (P=0.001) and allergic conjunctivitis (P<0.001). On the allergy laboratory tests, there was a significant difference between the groups for the eosinophi count (P=0.004). The number of blood eosinophil was more in the persistent groups than in the intermittent groups. CONCLUSION: According to the ARIA guidelines, the moderate-severe persistent group was the most prevalent for Korean patients. Blood eosinophilia and olfactory dysfunction were the most severe in the moderate-severe persistent group.
Asian Continental Ancestry Group ; Asthma ; Conjunctivitis, Allergic ; Eosinophilia ; Eosinophils ; Hematologic Tests ; Humans ; Hypersensitivity ; Immunoglobulin E ; Rhinitis ; Rhinitis, Allergic, Perennial ; Smell ; Surveys and Questionnaires

BACKGROUND: Hemophiliacs are known to have higher risk of exposure of hepatitis virus and immunosuppression. The aim of this study is to investigate the positive rate of viral markers for hepatitis and anti-HIV and the changes of lymphocyte subpopulations in Hemophiliacs in Chonnam GwangJu area. METHODS: One hundred four patients who had visited to the Hemophilic Clinic, Chonnam University Hospital from 1999 to 2001 were enrolled. They were checked for type A, B, C hepatitis viral markers, anti-HIV and lymphocyte subpopulations. The prevalence of hepatitis and lymphocyte subpopulation were compared according to severity and age of hemophiliacs. RESULTS: Anti-HAV IgM, anti-HAV IgG, HBsAg, anti-HBs, anti-HCV were positive in 40%(22/55), 65.5%(66/101), 42.3%(42/97) of cases tested. Positivity of anti-HCV showed trends of increase according to the severity of hemophiliacs (P<0.01) and age(P<0.001). Previous infection of hepatitis B were increased according to age (P=0.01) but not to the severity (P=0.194). Positive rate of anti-HCV and previous infection of hepatitis B were significantly lower in young age group (10 years old) than in older age group (>11 years old) (P=0.003, P<0.001, respectively). Although all enrolled patients were negative for anti-HIV, absolute T and B cells counts were decreased in 71.6% and 14.9% of patients, respectively and inversion of CD4/CD8 ratio were found in 65.7%. But there were no statistical difference in not only decrease of T and B cells but also inversions of CD4/CD8 ratio according to age and severity. CONCLUSION: The number of hemophiliacs with previous history of hepatitis B virus infection and seropositivity of anti-HCV were increased according to the age and severity of hemophilia. Active vaccinations of hepatitis B may be required in hemophiliacs. The greater part of hemophiliacs showed decrease in T cell count and inverted CD4/CD8 ratio. The hemophiliacs need a cautiion for infection and follow up tests for immunologic function.
B-Lymphocytes ; Biomarkers ; Cell Count ; Follow-Up Studies ; Gwangju* ; Hemophilia A ; Hepatitis A Antibodies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis Viruses ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunosuppression ; Jeollanam-do* ; Lymphocyte Subsets* ; Lymphocytes* ; Prevalence ; Vaccination

No abstract available.
Rhinitis* ; Sinusitis*

Allergic fungal sinusitis is characterized by eosinophilic allergic mucin with fungal hyphae in histopathologic aspect. "Allergic mucin sinusitis without fungus" or "Allergic fungal sinusitis-like syndrome" is a new term used to describe patients who have clinical and histopathologic features of allergic fungal sinusitis but fail to demonstrate fungi in histopathologic sections or cultures of sinus tissue. In this study, we report on a case of allergic mucin sinusitis which involved only sphenoid sinus of the left side in a 31 year old female.
Adult ; Eosinophils ; Female ; Fungi* ; Humans ; Hyphae ; Mucins* ; Sinusitis ; Sphenoid Sinus

BACKGROUND AND OBJECTIVES: In order to measure the level of nasal trigeminal pungency threshold and to evaluate the interaction between olfactory and trigeminal nerves, we measured olfactory thresholds and trigeminal pungency thresholds using 1-butanol in 40 normal people and in 46 patients with decreased sense of smell by non-sinonasal origin. MATERIALS AND METHODS: Two-alternative forced-choice modified ascending method of limit (CCCRC test) was used for the measurement of olfactory and pungency thresholds, using 1-butanol plastic squeezable bottles successively threefold diluted by distilled water as stimulus, while distilled water as blank. RESULTS: There was a statistically significant difference in pungency threshold between normals (2.18+/-1.5 dilution step) and patients (1.11+/-1.0 dilution step)(p<0.001). CONCLUSION: The pungency thresholds of hyposmics and anosmics are higher than those of normals, which suggests that a loss or decrease of olfactory sensation is accompanied by a simultaneous decrease of trigeminal chemosensitivity.
1-Butanol ; Humans ; Olfaction Disorders ; Plastics ; Sensation ; Smell* ; Trigeminal Nerve ; Water

Curry powder is widely used in various dishes. It is a mixture of 20-50 kinds of natural spices made from the leaves and seeds of plants. Although there have been some reports of allergy caused by inhalation of spices in western countries, while there are no reports of occupational allergy caused by spices in our country. We report a patient with rhinitis and asthma induced by exposure to spice dusts in a curry industry. A 32-year-old man developed rhinorrhea, sneezing and coughing three years prior to visiting our hospital. Since 10 years ago, he has been involved in grinding and mixing spices in a curry industry. Total peripheral eosinophil count was 400/mm3 and serum total IgE level was 163 IU/ml. Allergy skin-prick test showed positive responses to mugwort (3+), D. farinae (3+) and celery (3+), while serum specific IgE detected by RIA (DPC, LA, CA) showed all negative results. Skin-prick test to four kinds of spice extractscelery seed, fennel, cumin and coriander-showed strong positive responses. Bronchoprovocation test with celery seed extract (1:10 v/v) showed an early asthmatic response. Specific IgE and IgG4 antibodies to celery seed and the other three spices were detectable by ELISA. IgE-ELISA inhibition test using each spice antigen showed significant inhibitions. In conclusion, IgE-mediated mechanism may be involved in the pathogenesis of curry powder-induced bronchoconstriction in an exposed worker. Further studies will be needed to investigate the role of specific IgG4 in pathogenesis of bronchoconstriction in curry powder-induced asthma.
Adult ; Antibodies ; Apium graveolens ; Artemisia ; Asthma ; Asthma, Occupational* ; Bronchoconstriction ; Cough ; Cuminum ; Dust ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Foeniculum ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Inhalation ; Rhinitis* ; Sneezing ; Spices

BACKGROUND AND OBJECTIVES: Tonsillar and adenoid hypertrophy is one of the common causes of nasal obstruction, mouth breathing, snoring and sleep apnea in children. Tonsillectomy and adenoidectomy (T & A) could relieve these symptoms but may also cause voice changes after the operation. The aim of this study was to evaluate the voice changes objectively by nasometric and acoustic rhinometric analyses. MATERIALS AND METHODS: Thirty-eight patients who underwent T & A and twenty-two control children who had no sinonasal or tonsillar hypertrophy problems were selected. A visual analogue scale was used for determining the subjective nasality changes and nasometric analyses were used to determine the objective nasalance differences. Acoustic rhinometry was used to measure the nasopharyngeal volume changes and the removed adenoid tissue were directly measured. Data were collected prior to the operation, and on the second, 7th and 14th days after the operation. Data were compared and analyzed statistically. RESULTS: The volume of removed adenoid tissue was not statistically related with the subjective nasality changes which increased significantly after T R. A. Nasalance in the patient group increased significantly after the operation compared to that in the control group. The voiume of nasopharynx increased significantly after adenoidectomy, but it had a minimal statistical correlation with the volume of the removed adenoid tissue. CONCLUSION: Nasometric and acoustic rhinometric tests can serve as objective tools for evaluating the subjective nasality changes after T 5z A.
Acoustics ; Adenoidectomy* ; Adenoids ; Child* ; Humans ; Hypertrophy ; Mouth Breathing ; Nasal Obstruction ; Nasopharynx ; Rhinometry, Acoustic ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy* ; Voice

BACKGROUND AND OBJECTIVES: To study the incidence of nasal septal deformities (NSD) in neonates and to identify pregnancy conditions related with NSD occurrence. MATERIALS AND METHODS: Prospective study of 131 women and their newborns. Incidences of neonatal NSD were looked for with a cotton wool test and through direct visual examination of the neonatal nasal cavity with an otoscope. Under study were arbitrary but possibly related factors of neonatal NSD : the mother's age, parity, medical history, the duration of total labor, the duration of second-stage labor, the delivery type, neonatal birth weight and gestational age. The contributions of these factors were analyzed statistically. RESULTS: The incidence of neonatal NSD as identified through otoscopic examination was 11.5%. All studied factors indicated no statistically significant relationship with neonatal NSD. CONCLUSION: Probable nasal trauma during pregnancy and delivery is likely not a factor in the occurrence of NSD in neonates.
Birth Weight ; Congenital Abnormalities* ; Female ; Gestational Age ; Humans ; Incidence* ; Infant, Newborn* ; Nasal Cavity ; Otoscopes ; Parity ; Pregnancy* ; Prospective Studies ; Wool