RESUMO
PURPOSE: Pediatric asthma is the most common chronic disease in children. It negatively affects the health-related quality of life (QoL) in children with this disease and of their caregivers. This study evaluated the relationship between clinical disease severity and the QoL of patients with asthma and their caregivers. METHODS: The study included 247 patients with asthma and their caregivers. The patients and caregivers completed the Korean Pediatric Asthma Quality of Life Questionnaire and the Korean Pediatric Asthma Caregivers Quality of Life Questionnaire, respectively, during clinic visits. The results were expressed as the mean score for each domain. All items were rated from 1 to 5: 1, low QoL; and 5, satisfactory QoL. RESULTS: The emotion and activity QoL scores of boys were significantly higher than those of girls (P=0.001). The QoL of both patients and their caregivers was correlated more with the patients' subjective symptom scores than with the clinical severity of asthma or with lung function. CONCLUSION: The QoL of patients with asthma and their caregivers decreased as asthmatic symptoms became worse. Controlling asthma symptoms is important for improving the QoL of both patients and their caregivers. Patients and their caregivers need to be evaluated and counseled during asthma treatment to improve their QoL.
Assuntos
Criança , Humanos , Assistência Ambulatorial , Asma , Cuidadores , Doença Crônica , Pulmão , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
PURPOSE: We investigated the influence of respiratory virus and atopic characteristics on the severity of bronchiolitis. METHODS: Four hundred and eighteen infants <2-years-old and hospitalized at Daegu Fatima Hospital with bronchiolitis from March 2007 to February 2010 were evaluated. They were detected for specific respiratory viruses in nasopharyngeal aspirates by multiplex reverse transcription-polymerase chain reaction. Clinical severity score, based on respiratory rate, wheezing, chest retraction, and oxygen saturation was assessed at admission. According to the scores, all patients were divided into a mild to moderate bronchiolitis group and a severe group. Clinical data related to host factors, including atopic characteristics and respiratory viruses, were compared among individual groups. Multivariate logistic regression analyses were performed to identify independent risk factors for severe bronchiolitis. RESULTS: A single virus was identified in 365 infants (87%) and multiple viruses in 53 (13%). Respiratory syncytial virus (RSV) was the most common virus detected (51%). RSV and rhinovirus were the viruses most frequently identified in mixed infections in infants hospitalized with bronchiolitis. Infants with coinfections were 3.28 times (95% confidence interval, 1.36 to 7.89) more at risk for severe bronchiolitis than those with a single infection. Host factors associated with more severe bronchiolitis included male gender, younger age, prematurity, and chronic cardiorespiratory illness. Type of viruses, personal and family history of atopy, and passive smoking were not significantly associated with bronchiolitis severity. CONCLUSION: Viral coinfections and host factors, including male gender, younger age, prematurity, and chronic cardiorespiratory illness are relevant risk factors for infants with severe bronchiolitis.
Assuntos
Humanos , Lactente , Masculino , Bronquiolite , Coinfecção , Modelos Logísticos , Oxigênio , Taxa Respiratória , Sons Respiratórios , Vírus Sinciciais Respiratórios , Rhinovirus , Fatores de Risco , Tórax , Poluição por Fumaça de Tabaco , VírusRESUMO
PURPOSE: Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection. METHODS: A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups. RESULTS: Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P<0.001), asthma (65% vs 35%, P=0.011), allergic rhinitis (71% vs 40%, P=0.009), and IgE level (P=0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P=0.007). CONCLUSION: Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.
Assuntos
Criança , Humanos , Asma , Eosinofilia , Imunoglobulina E , Influenza Humana , Pandemias , Pneumonia , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Rinite , Rinite Alérgica Perene , Fatores de Risco , DNA Polimerase Dirigida por RNARESUMO
PURPOSE: We studied to know the influence of respiratory virus and atopic characteristics on recurrence of virus-induced wheezing in children under 3 years of age. METHODS: Between March 2006 and February 2009, 340 children who were hospitalized with symptoms of sudden onset of dyspnea, cough and wheezing after symptoms of acute upper respiratory tract infection and detected specific respiratory viruses by multiplex RT-PCR were enrolled. The data were analyzed according to age (< or =6, 7-12, 13-24, and 25-36 months) as well as previous wheezing episodes (first or recurrent episode). Respiratory viruses and atopic characteristics were compared among individual groups. RESULTS: The 3 commonly identified viruses were RSV (62.4%), PIV (15.6%) and RV (11.8%). PIV and RV were significantly associated with recurrence, but RSV was not significantly associated with recurrence. Food sensitization, aeroallergen sensitization, elevation of total IgE, history of atopic dermatitis and history of parent asthma were significantly associated with the recurrent episode, but serum eosinophil and passive smoking were not significantly associated with the recurrent episode. CONCLUSION: These findings show that specific respiratory viruses can have different influence on recurrence and that atopy may be a risk factor for recurrence of wheezing, in children under 3 years of age with virus-induced wheezing.
Assuntos
Criança , Humanos , Asma , Tosse , Dermatite Atópica , Dispneia , Eosinófilos , Imunoglobulina E , Pais , Recidiva , Sons Respiratórios , Infecções Respiratórias , Fatores de Risco , Poluição por Fumaça de Tabaco , VírusRESUMO
BACKGROUND/AIMS: The clinical usefulness of nasogastric tube insertion in poisoning patients is controversial. This study compared the incidence of aspiration pneumonia between patients with or without nasogastric tubes. METHODS: We retrospectively reviewed the clinical reports of poisoning patients seen from January 2006 to December 2007. We classified the patients into groups with and without nasogastric tube insertion and evaluated the incidence and risk factors of aspiration pneumonia. RESULTS: Ultimately, 63 patients were included. The incidence of aspiration pneumonia was higher in patients with nasogastric tube insertion than in patients without nasogastric tube insertion (conscious patients: 58.8% vs. 11.8%, p=0.010; unconscious patients: 72.2% vs. 27.3%, p=0.027). Nasogastric tube insertion was a significant risk factor for developing aspiration pneumonia (odds ratio 3.54; 95% confidence interval 1.74~12.34). CONCLUSIONS: Nasogastric tube insertion did not prevent aspiration pneumonia, but was a risk factor. The results have implications in the development of a hypothesis about why a nasogastric tube increases the risk of aspiration pneumonia. This study has important limitations stemming mostly from other compounding factors and its retrospective design.
Assuntos
Humanos , Carvão Vegetal , Incidência , Pneumonia Aspirativa , Estudos Retrospectivos , Fatores de Risco , Inconsciente PsicológicoRESUMO
Protein C is an important physiological anticoagulant factor. Protein C deficiency has been linked to venous thrombosis at unusual sites, including the cerebral and mesenteric veins. Hereditary protein C deficiency is inherited primarily as an autosomal dominant trait with incomplete penetrance. Protein C and S deficiencies are known to increase the risk of venous thrombosis and pulmonary thromboembolism. Testing for protein C levels and function is necessary for the detection of both type I and type II protein C deficiency. In this article, we report a case of pulmonary embolism and mesentery ischemia due to type 1 protein C deficiency.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Colonoscopia , Isquemia/diagnóstico , Angiografia por Ressonância Magnética , Veias Mesentéricas , Deficiência de Proteína C/complicações , Embolia Pulmonar/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Pollinosis is one of the allergic diseases which caused by airborne pollens from allergic plants, such as allergic rhinitis, asthma, and allergic conjunctivitis. The distribution of pollens in the air is fully related to weather condition, especially temperature and humidity, etc. This study is focused on the evaluation of the relation between pollen count and the outbreak of allergic diseases (symptom index) from allergic patients in Korea and this data would be necessary to evaluate Korean own allergy index for pollen forecasting system. Airborne particles carrying allergens were collected daily from nationwide 8 stations (Seoul, Guri, Daejeon, Daegu, Kwangju, Busan, Kangneung, and Jeju) by using 7 days-Burkard sampler (Burkard Manufacturing Co Ltd, Hertfordshire, UK) for 10 year in South Korea (March 1, 2008-October 30, 2008). They were counted and recorded along with the weather factors. Symptom index was evaluated and recorded by calling to allergic patients daily. Airborne pollen has two peak seasons that is May and September in Korea. The peak season for mold was June. There was the tree pollen seasons from the middle of February to late July, then followed during the grasses and weed season from the middle of July to the end of October. Ragweed was one of the most common pollen of autumn in Korea. In skin prick test, Ragweed was the highest sensitization rate (5.9%), followed by Mugwort (5.8%), alder (4.9%), birch (4.8%), oak grasses among the pollen extracts in Korean school aged children. Ragweed pollen counts were gradually increased since 2000. In same period, sensitization rates for airborne pollen, especially weeds in Korean children were increased annually (1999: 4.4%, 2000: 7.1%, 2001: 7.4%, 2002: 8.5%, 2003: 7.7%). There are significantly related between symptom index from allergic patients and allergic pollen concentrations. Sensitization rates for pollens are increased in Korean children with age. There are significantly related between symptom index from allergic patients and allergic pollen concentrations. Risk Grade of pollen for allergy pollen forecast among each allergic plant was established and still remain to confirm it.
Assuntos
Idoso , Criança , Humanos , Alérgenos , Alnus , Ambrosia , Antígenos de Plantas , Artemisia , Asma , Betula , Conjuntivite Alérgica , Previsões , Fungos , Umidade , Hipersensibilidade , Coreia (Geográfico) , Remoção , Extratos Vegetais , Plantas , Poaceae , Pólen , República da Coreia , Rinite , Rinite Alérgica Perene , Rinite Alérgica Sazonal , Estações do Ano , Pele , Tempo (Meteorologia)RESUMO
PURPOSE: This study aimed to evaluate the relationship between the serum IgE level and allergic sensitization/bronchial hyperresponsiveness (BHR) in preschool children with asthma. METHODS: One hundred nine asthmatic children age 4-6 years were enrolled. Total serum IgE levels, and specific IgE level to food and inhalant allergens were tested using Pharmacia Auto CAP system RAST(R)FEIA, methacholine bronchial challenge test (PCw=Provocative concentration at wheezing. PCsat=Provocative concentration at 5% fall of oxygen saturation) were performed in all subjects. They were divided into 3 groups according to the serum IgE level:less than 120 IU/mL (group A, n=38), 120 to 1,000 IU/mL (group B, n=45), and greater than 1,000 IU/mL (group C, n=26). The relationships with allergic sensitization and BHR were evaluatied among the 3 groups. RESULTS: Sensitization to foods and inhalant allergens were related to a higher total serum IgE levels. However, BHR and severity of asthma were not related to higher total serum IgE levels, except in group B. Presence of atopic dermatitis, high serum eosinophil (>450/mm3), allergic sensitization to foods and inhalants were related to high serum IgE greater than 1,000 IU/mL. (odds ratio ; 95% confidence interval=4.4;1.7-11.2, 3.2;1.2-9.2, 4.8;1.7-13.2, 5.5;1.2-24.9) CONCLUSION: Moderately elevated total serum IgE was related to allergic sensitization, severity of asthma and BHR. However highly elevated total serum IgE was related to only allergic sensitization. This may be attributed to other factors in preschool children with asthma.
Assuntos
Criança , Pré-Escolar , Humanos , Alérgenos , Asma , Hiper-Reatividade Brônquica , Testes de Provocação Brônquica , Dermatite Atópica , Eosinófilos , Imunoglobulina E , Cloreto de Metacolina , Oxigênio , Sons RespiratóriosRESUMO
BACKGROUND: There were debates on the relationship between peak expiratory flow (PEF) and oil spill cleanup activity. The aim of this study was to compare the distinction of PEF among pre-works and post-works in Hebei Spirit oil. METHODS: The study subjects were participators of cleanup works. The questionaire on symptoms was done. And PEF was measured. The subjects were sampled on random basis. We then used a logistic regression analysis to evaluate the effects of cleanup works on PEF. RESULTS: Only 66 (35.3%) participants versus 121 showed with low values in PEF before cleanup works. But, 78 (80.1%) participants versus 20 significantly showed with low values in PEF after cleanup works (P = 0.002). On our analysis, measuring their own PEF after cleanup works (Odds ratio [OR], 2.328; 95% confidence interval [CI], 1.218 to 6.624), female gender (OR, 5.841; 95% CI, 3.571 to 9.557), the number of working days on cleanup activities (OR, 2.760; 95% CI, 1.364 to 7.900), and residents (OR, 4.610; 95% CI, 2.488 to 8.544) were shown to be significant risk factors for low value of peak expiratory flow. CONCLUSION: Our results suggest that exposure to petroleum in cleanup works are associated with a significant low value in PEF. But, the heterogeneity of pre-works and post-works groups is a limitation of the study.
Assuntos
Feminino , Humanos , Modelos Logísticos , Pico do Fluxo Expiratório , Petróleo , Poluição por Petróleo , Características da População , Fatores de RiscoRESUMO
We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.
Assuntos
Adulto , Humanos , Abdome , Dor Abdominal , Apendicite , Apêndice , Contagem de Células Sanguíneas , Dengue , Vírus da Dengue , Enterite , Ensaio de Imunoadsorção Enzimática , Febre , Seguimentos , Imunoglobulina M , Coreia (Geográfico) , Pelve , Filipinas , Contagem de Plaquetas , TrombocitopeniaRESUMO
We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.
Assuntos
Adulto , Humanos , Abdome , Dor Abdominal , Apendicite , Apêndice , Contagem de Células Sanguíneas , Dengue , Vírus da Dengue , Enterite , Ensaio de Imunoadsorção Enzimática , Febre , Seguimentos , Imunoglobulina M , Coreia (Geográfico) , Pelve , Filipinas , Contagem de Plaquetas , TrombocitopeniaRESUMO
PURPOSE: We performed this study to evaluate the effect of pulmonary function and bronchial hyperresponsiveness (BHR) on the persistence of asthma symptoms from late childhood to early adult life. METHODS: One-hundred thirty-one children with asthma treated at our hospital during the past 10 years were divided into 2 groups according to the persistence of symptoms in early adult life: the persistent and remission groups. Information about symptoms, body mass index, serum ECP, serum IgE and skin test reactivity in late childhood were obtained and prebronchodilator FEV1, FEV1/FVC (expressed as % of predicted) and BHR to methacholine were measured in late childhood and early adult life, and compared the 2 groups. Results: The persistent group was accounted for 45.8% of the subjects and FEV1, FEV1/ FVC and BHR to methacholine in late childhood were associated with the persistence of symptoms. We found a positive correlation between FEV1 in late childhood and early adult.(r=0.250, P=0.013) Also we found a positive correlation between FEV1/FVC in late childhood and early adult.(r=0.285, P=0.018) BHR and FEV1% of 60% to 79% of late childhood were associated with BHR in early adult.(Odds ratio; 95% confidence interval=3.8; 1.7-8.7, 4.6; 1.0-20.2) Conclusion: Low pulmonary function and increased BHR in childhood asthma were associated with persistence of symptom, degree of pulmonary function and BHR in early adult life.
Assuntos
Adulto , Criança , Humanos , Asma , Índice de Massa Corporal , Hiper-Reatividade Brônquica , Imunoglobulina E , Cloreto de Metacolina , Fatores de Risco , Testes CutâneosRESUMO
PURPOSE: For the past two decades, there has been a significant increase in the prevalence of both asthma and obesity. Obesity may be associated with increasing childhood asthma and atopy. So, we performed this study to know the effects of body mass on bronchial hyperresponsiveness (BHR) and atopy in childhood asthma. METHODS: The subjects were, 340 children aged 6-15 years with asthma, visited the Pediatric Outpatient Clinic. There, their heights and, weights were measured and they underwent, pulmonary function tests (PFT), BHR to methacholine and skin prick tests. After determining body mass index (BMI), they were divided into four groups by BMI percentile curve based on gender and age (underweight or =95.1th percentile). Atopy, allergen sensitization, BHR, respiratory symptoms, PFT were compared between each group. RESULTS: In all subjects, there were 70 (20.6%) and 73 (21.5%) cases in the overweight and obese groups, respectively. Increasing BMI was significantly associated with a higher prevalence of snoring,(P=0.004) wheezing in the perceding three months (P=0.002) and BHR- positive,(P=0.003) but not atopy.(P=0.075) Among the groups classified by BMI percentile, there were significant differences in FEV1 and FEV1/FVC.(P=0.027, P=0.033) Being overweight and/or, obese were significant risk factor for BHR, though only among females (OR 5.1; 95% CI 1.6-16.5, 4.9; 1.8-13.4) not male (OR 1.1; 95% CI 0.5-2.1, OR 1.7; 95% CI 0.7-2.0). CONCLUSION: Among girls, a higher BMI might be a risk factor for BHR. Higher BMI is not associated with atopy on either boys or girls.
Assuntos
Criança , Feminino , Humanos , Masculino , Instituições de Assistência Ambulatorial , Asma , Índice de Massa Corporal , Hiper-Reatividade Brônquica , Hipersensibilidade , Cloreto de Metacolina , Obesidade , Sobrepeso , Prevalência , Testes de Função Respiratória , Sons Respiratórios , Fatores de Risco , Pele , Pesos e MedidasRESUMO
BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Assuntos
Adulto , Feminino , Humanos , Masculino , Talassemia alfa , Anemia Hemolítica Congênita , Talassemia beta , Bilirrubina , Membrana Celular , Diagnóstico , Eliptocitose Hereditária , Índices de Eritrócitos , Hemoglobinopatias , Medicina Interna , Icterícia , Coreia (Geográfico) , L-Lactato Desidrogenase , Oxirredutases , Palidez , Patologia Molecular , Pediatria , Fosfopiruvato Hidratase , Prevalência , Piruvato Quinase , Contagem de Reticulócitos , Estudos Retrospectivos , Razão de Masculinidade , Inquéritos e QuestionáriosRESUMO
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.
Assuntos
Criança , Humanos , Alérgenos , Alnus , Ambrosia , Artemisia , Hipersensibilidade , Coreia (Geográfico) , Estilo de Vida , Pediatria , Poaceae , Pólen , Estações do Ano , Pele , Testes Cutâneos , Tempo (Meteorologia)RESUMO
PURPOSE: Atopic dermatitis is affected by genetic and environmental factors. Bronchial asthma often develops in atopic dermatitis children. Allergen sensitization may affect the frequency of asthma in preschool atopic dermatitis children. So, we performed this study to know the relationship between allergen sensitization and the frequency of asthma in preschool atopic dermatitis children. METHODS: Three-hundred twelve of the children with atopic dermatitis in preschool aged children were divided into 3 groups; Assuntos
Criança
, Pré-Escolar
, Humanos
, Alérgenos
, Asma
, Dermatite Atópica
, Imunoglobulina E
, Pyroglyphidae
RESUMO
No abstract available.
Assuntos
Criança , Humanos , Lactente , Neoplasias Encefálicas , EncéfaloRESUMO
PURPOSE: Bronchial asthma is an inflammatory respiratory disease characterized by the activation of inflammatory cells and its infiltration. It has been recently reported that MMP- 9 dose an importance role in the movement of inflammatory cells through basal membrane, that the function may be suppressed by TIMP-1. We studied to know the change of MMP-9 and TIMP-1 in sputum before and after corticosteroid (CS) therapy, and the relation with MMP-9/TIMP-1 ratio and improvement of FEV1. METHODS: Seventeen acute moderate to severe asthmatics were selected as was a control group of 17 healthy children. MMP-9 and TIMP-1 in sputum were measured on the 0 day, 7 days and 3 months later and observed as to the flow of time. FEV1 was measured before the CS therapy and 3 months later, and the change of FEV1 & FEV1 at 3 months were compared with the relation of MMP-9/TIMP-1 ratio. RESULTS: Sputum MMP-9 was lowered more at 7 days and 3 months compared with 0 day (P< 0.05). Sputum TIMP-1 was significantly high on 7 days (P< 0.05) and then had a tendency to decrease until 3 months (P< 0.05). MMP-9/TIMP-1 ratio decreased according to the flow of time (P< 0.05). MMP-9/TIMP-1 ratio at 3 months closely correlated with the change of FEV1 (r=0.65, P< 0.05). CONCLUSION: These data suggest that the overproduction of MMP-9 after asthma exacerbation correlates with airway inflammation and TIMP-1 production might contribute to airway fibrosis. MMP-9/TIMP-1 ratio at 3 months correlates with improvement of pulmonary function after CS therapy.
Assuntos
Criança , Humanos , Asma , Fibrose , Gelatinases , Inflamação , Metaloproteinase 1 da Matriz , Metaloproteinase 9 da Matriz , Membranas , Prednisolona , Escarro , Inibidor Tecidual de Metaloproteinase-1RESUMO
Cystic fibrosis (CF) is inherited as an autosomal recessive trait, and the mutations in cystic fibrosis transmembrane conductance regulator (CFTR) gene contributes to the CF syndrome. Although CF is common in Caucasians, it is known to be rare in Asians. Recently, we experienced two cases of CF in Korean children. The patients were girls with chronic productive cough since early infancy. Chest computed tomography showed the diffuse bronchiectasis in both lungs, and their diagnosis was confirmed by the repeated analysis of a quantitative pilocarpine iontophoresis test (QPIT). The sweat chloride concentrations of the first patient were 108.1 mM/L and 96.7 mM/L. The genetic analysis revealed that she was the compound heterozygote of Q1291X and IVS8 T5 -M470V. In the second case, the sweat chloride concentrations were 95.0 mM/L and 77.5 mM/L. Although we performed a comprehensive search for the coding regions and exonintron splicing junctions of CFTR gene, no obvious disease-related mutations were detected in the second case. To our knowledge, this is the first report of CF in Korean children identified by a QPIT and genetic analysis. The possibility of CF should be suspected in those patients with chronic respiratory symptoms even in Korea.
Assuntos
Criança , Feminino , Humanos , Pressão Sanguínea , Bronquiectasia/diagnóstico , Tosse , Fibrose Cística/diagnóstico , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Análise Mutacional de DNA , Éxons , Heterozigoto , Íntrons , Iontoforese/métodos , Coreia (Geográfico) , Pulmão/patologia , Agonistas Muscarínicos/farmacologia , Mutação , Pâncreas/patologia , Linhagem , Fenótipo , Pilocarpina/farmacologia , Polimorfismo Genético , Sinusite/diagnóstico , Suor , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Epidemiologic studies have demonstrated that rhinitis and asthma commonly coexist in the same patients and that a temporary relationship exists between the onset of rhinitis and asthma, with rhinitis frequently preceeding the development of asthma. Despite the compelling evidence that rhinitis has a remarkable impact on asthma, it has been controversial how the presence of rhinitis causes asthma to be worsen. We studied to know the effect of coexistence of allergic rhinitis on lower airway eosinophilic inflammation in mild persistent bronchial asthma. METHODS: A total of 129 mild persistent asthmatics were enrolled and divided into three different groups as follows: 37 cases with asthma only; 40 cases with mild allergic rhinitis; and 52 cases with moderate to severe allergic rhinitis. Methacholine challage test and sputum induction were performed and sputum ECP, sputum eosinophils and bronchial hyperresponsiveness (BHR) were compared in each group. RESULTS: In mild asthmatics with moderate to severe allergic rhinitis, the BHR to methacholine increased compared to those with mild or no allergic rhinitis. Eosinophils and ECP in induced sputum were significantly higher in more severe allergic rhinitis groups. We also found a significant correlation between BR index and sputum eosinophils. (gamma=0.578, P< 0.05) CONCLUSION: Our results demonstrated that the severity of allergic rhinitis was related to lower airway eosinophilic inflammation and bronchial hyperresponsiveness in mild persistent asthmatics with allergic rhinitis.