A comparison between impulse oscillometry system and spirometry for spirometry for detecting airway obstruction in children / 소아과

PURPOSE: Measurement of forced expiratory volume in 1 second (FEV1) is usually difficult to obtain in children under six years of age because it requires active cooperation. This study evaluates the sensitivity of impulse oscillometry system (IOS) parameters for detecting airway obstruction in comparison with FEV1. METHODS: We studied 174 children who performed the lung function and methacholine challenge tests to diagnose asthma by IOS and spirometry. Children were divided into two subgroups according to their PC20, which is a parameter for bronchial sensitivity. We compared IOS parameters with FEV1 at the baseline, post-methacholine challenge, and evaluated their correlation. RESULTS: At the baseline, reactance at 5 Hz (X5) and resistance at 5 Hz (R5) significantly differed between the PC20 positive (PC2016 mg/mL) group; however, FEV1, FEV1% predicted, FEV1_Zs (Z score) did not differ. FEV1 is correlated with X5 (r=0.45, P<0.01) and R5 (r=-0.69, P<0.01). FEV1_Zs is also correlated with X5_Zs (r=-0.26, P<0.01) and R5_Zs (r=-0.31, P<0.01). After the methacholine challenge test, dose-response slopes in FEV1 and X5 significantly differed between the two subgroups (P<0.05). CONCLUSION: IOS parameters were more discriminative than FEV1 for detecting decreased baseline lung function between two subgroups and have a good correlation with FEV1.

A case of Spontaneous Transsphenoidal Encephalocele with Recurrent Bacterial Meningitis / 대한소아신경학회지

Encephaloceles are congenital defects in the skull through which menings and brain tissues herniated. Basal encephaloceles are found in 1 in 40,000 live births. Transsphenoidal basal encephaloceles are very rare, accounting for only 5% of all basal encephaloceles. Currently, most encephaloceles are diagnosed antenatally and present at birth. Postnatally, infants may present with CSF rhinorrhea, recurrent meningitis, headache, hypothalamic- pituitary dysfunction. Some, particularly trasnssphenoidal encephaloceles are often clinically occult and diagnosis of the disease may be postponed up to adulthood. Surgical indications and approaches for transsphenoidal encephaloceles have been remained controversial. We report a case of CSF rhinorrhea and recurrent meningitis caused by transsphenoidal encephalocele.