A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

PURPOSE: Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. METHODS: We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. RESULTS: A total of 991 cases (mean age=5.89±5.24) were reported, with 63.9% involving patients younger than 6 years of age and 66% involving male children. Food was the most common anaphylaxis trigger (74.7%), followed by drugs and radiocontrast media (10.7%), idiopathic factors (9.2%), and exercise (3.6%). The most common food allergen was milk (28.4%), followed by egg white (13.6%), walnut (8.0%), wheat (7.2%), buckwheat (6.5%), and peanut (6.2%). Milk and seafood were the most common anaphylaxis triggers in young and older children, respectively. Drug-triggered anaphylaxis was observed more frequently with increasing age, with antibiotics (34.9%) and nonsteroidal anti-inflammatory drugs (17.9%) being the most common causes. CONCLUSIONS: The most common anaphylaxis trigger in Korean children was food. Data on these triggers show that their relative frequency may vary by age.

Multicenter Analysis of the Current Status of Unproved Complementary/Alternative Medicine Other than Herbal Medication in Allergy Patients / 대한내과학회지

BACKGROUND/AIMS: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. METHODS: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. RESULTS: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included "improved" in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but "worse" in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was 'hope to improve my constitution'. CONCLUSIONS: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed.

A Case of Pulmonary Paragonimiasis with Involvement of the Abdominal Muscle in a 9-Year-Old Girl

In Korea, many people enjoy eating raw or underkooked freshwater crayfish and crabs which unfortunately may cause paragonimiasis. Here, we describe a case of pulmonary and abdominal paragonimiasis in a 9-year-old girl, who presented with a 1-month history of abdominal pain, especially in the right flank and the right inguinal area, with anorexia. A chest radiograph revealed pleural effusion in both lungs, and her abdominal sonography indicated an inflammatory lesion in the right psoas muscle. Peripheral blood analysis of the patient showed hypereosinophilia (66.0%) and an elevated total serum IgE level (>2,500 IU/ml). The pleural effusion tested by ELISA were also positive for antibodies against paragonimiasis. Her dietary history stated that she had ingested raw freshwater crab, 4 months previously. The diagnosis was pulmonary paragonimiasis accompanied by abdominal muscle involvement. She was improved after 5 cycles of praziquantel treatment and 2 times of pleural effusion drainage. In conclusion, herein, we report a case of pulmonary and abdominal paragonimiasis in a girl who presented with abdominal pain and tenderness in the inguinal area.

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

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.

A Comparative Study on Spiritual Well-Being and Perceived Health Status between Above Average and Low Income for Elderly People / 기본간호학회지

PURPOSE: This study was to provide basic data for comprehensive nursing care for elderly people and to compare the spiritual well-being and perceived health status between elderly people who have above average income and those who have low income. METHODS: The data were collected from 80 elders with above average income and 81 with low income through face-to-face interviews. An elder was defined as a person over 60 years of age. The data were analyzed using t-test, ANOVA, ANCOVA, Pearson correlation coefficients and Scheffe test. RESULTS: The mean score for spiritual well being for elders with above average income was 2.90 of a total possible score of 4 and for elders with low income, 2.49 and the difference was significant. The mean score for perceived health status for elders with above average income was 8.93 of a total possible score of 14 and for elders with low income, 7.47 and the difference was also significant. There was a statistically positive correlation between existential well-being and perceived health status for the total sample of elderly people and for the elders with low income. CONCLUSION: Spiritual nursing care should be included in comprehensive health care programs for elderly people in Korea. Especially, it is important to develop nursing interventions for elders with low income that will increase their spiritual well-being and help them to develop positive thinking towards perceived health status.

A Survey on the Use of Alternative Medicine in Allergy Patients / 소아알레르기및호흡기학회지

PURPOSE: Alternative medicine(AM) is defined as the approaches and techniques that are not included in the curricula of medical schools or residency training at present. This study aimed to evaluate the present status of the use of AM in allergic diseases and to propose an appropriate guide. METHODS: Mailed questionnaires on the patterns of the use of AM were collected during the month of May in 2001. The data was analyzed using SPSS WINDOW 8.0. RESULTS: 1) One hundred and five patients responded. Their mean age was 46.5 years old and the mean duration of the diseases was 67 months. 2) Ninety six(91.4%) out of 105 responders who have allergic diseases experienced AM. Herb medicine(57.3%) was most popular and hot spring(22.9%), immune stimulants(22.9%), nutritional supplements(13.5%), acupuncture(12.5%), breathing exercise, aroma-therapy and foods such as aloe, honey and ginkgo nuts were also tried. 3) The annual mean expenditure for the AM was about 690,000 Won. Severely diseased patients spent more money out of their pocket for AM. 4) Doctors(43.5%), oriental doctors(19.8%), neighbours(27.1%) and mass media played some roles for the distribution of the information about AM. 5) The patients purchased the products for AM from drug store, hospital, market, health care shop and by mail or internet orders. 6) Thirty two patients(33.3%) were satisfied with the AM and 35(36.5%) patients answered that they would recommend the AM to the others. CONCLUSION: Many allergy patients used various kinds of AM without any guidelines. Therefore, doctors' active participation in AM is necessary to confirm the scientific basis, to strengthen patient's education and to filter the informations about AM spreaded by the mass media.

Aerobiological Study of Pollen and Mold in the 10 States of Korea / 소아알레르기및호흡기학회지

PURPOSE: As outdoor allergen, pollen and mold are increasely drawing attention all over the country in Korea. The peninsula is located in a temperate zone and has four distinct seasons. In this study, we described the seasonal variation of the pollen and mold distributions in Korea, which may be used to evaluate the pollenosis prevalence for the first time. METHODS: Rotorod samplers were installed on the 10 stations at each state in Korea. Outdoor allergens were collected daily in each station from July 1, 1997 to June 30, 1999. After staining they were identified, counted and recorded with the weather in each state. RESULTS: The pollens were found in the beginning of February through the middle of December. The earliest pollen was found from Pusan which is a south region, and followed by Chonju, Daegu which are midsouth. The peak season for pollen was from the end of April to the middle of May(major pollen: Tree, Grasses), the second peak was depicted from the end of August to the middle of September (major pollen : sagebrush, ragweed) the outdoor molds were largely collected from the July to the middle of October. Cladosporium and Alternaria were prevalent all year round and Ascospores of Leptospheria was peak in monsoon season. CONCLUSION: The pollens were found during the whole year except from middle of the December through the middle of the January. Molds were found all year round.

Reference Values of Hematologic and Biochemical Parameters of Nutrition around Weaning Period

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.

Reference Values of Hematologic and Biochemical Parameters of Nutrition around Weaning Period

PURPOSE: To determine the reference values of hematologic and biochemical parameters of nutrition around the weaning period. METHODS: From February 1996 to March 1997, several nutritional laboratory values were evaluated in 130 healthy babies and 120 inpatients in the recovery stage of acute illness at six general hospitals. RESULTS: Reference values in 9-month-old healthy babies(range : 6-12 months) were hemoglobin 11.8+/-0.9g/dL, hematocrit 30.9+/-0.7%, serum ferritin 25.7+/-15.4ng/mL, total protein(TP) 6.5+/-0.5g/ dL, albumin 4.6+/-0.5g/dL, prealbumin 15.6+/-3.9mg/L, cholesterol 154.7+/-22.4mg/dL, calcium 10.1+/-0.5mg/dL, phosphorus 6.1+/-0.9mg/dL, alkaline phosphatase(ALP) 235.1+/-66.4U/L. Reference values in 15-month-old healthy babies(range : 13-18 months) were hemoglobin 12.3+/-1.0g/dL, hematocrit 30.9+/-0.4%, serum ferritin 20.4+/-11.2ng/mL, TP 6.8+/-0.6g/dL, albumin 4.7+/-0.5g/dL, prealbumin 18.1+/-4.6mg/L, cholesterol 163.1+/-24.2mg/dL, calcium 9.3+/-1.0mg/dL, phosphorus 6.0+/-0.8mg/dL and ALP 254.5+/-64.0U/L. Most reference values were significantly lower in inpatients than the healthy babies, except for serum ferritin level which was the opposite. There were no significant differences in reference values according to feeding and weaning practices. Incidence of anemia(hemoglobin200mg/dL) was 8.6% in 15-month-old healthy babies. CONCLUSION: This study presented the reference values of hemoglobin, hematocrit, serum ferritin, total protein, albumin, prealbumin, cholesterol, calcium, phosphorus and alkaline phosphatase around the weaining period. The current nutritional status of Korean babies around the weaning period was appropriate except for borderline iron deficiency.