• 제목/요약/키워드: Pediatric allergy

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Sensitization rates of airborne pollen and mold in children

  • Park, So-Hyun;Lim, Dae-Hyun;Son, Byong-Kwan;Kim, Jeong-Hee;Song, Young-Eun;Oh, In-Bo;Kim, Yang-Ho;Lee, Keun-Hwa;Kim, Su-Young;Hong, Sung-Chul
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.322-329
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    • 2012
  • Purpose: Aeroallergens are important causative factors of allergic diseases. Previous studies on aeroallergen sensitization rates investigated patients groups that had visited pediatric allergy clinics. In contrast, we investigated sensitization rates in a general population group of elementary school to teenage students in Incheon, Jeju, and Ulsan. Methods: After obtaining parental consent, skin-prick tests were performed on 5,094 students between March and June 2010. Elementary school students were tested for 18 common aeroallergens, whereas middle and high school students were tested for 25 allergens. The 25 allergens included Dermatophagoides pteronyssinus, Dermatophagoides farinae, pollen (birch, alder, oak, Japanese cedar, pine, willow, elm, maple, Bermuda grass, timothy grass, rye grass, orchard grass, meadow grass, vernal grass, mugwort, Japanese hop, fat hen, ragweed, and plantain), and mold (Penicillatum, Aspergillus, Cladosporium, and Alternaria). Results: The sensitization rates in descending order were 25.79% (D. pteronyssinus ), 18.66% (D. farinae ), 6.20% (mugwort), and 4.07% (willow) in Incheon; 33.35% (D. pteronyssinus ), 24.78% (D. farinae), 15.36% (Japanese cedar), and 7.33% (Alternaria) in Jeju; and 32.79% (D. pteronyssinus), 30.27% (D. farinae), 10.13% (alder), and 8.68% (birch) in Ulsan. The dust mite allergen showed the highest sensitization rate among the 3 regions. The sensitization rate of tree pollen was the highest in Ulsan, whereas that of Alternaria was the highest in Jeju. The ragweed sensitization rates were 0.99% in Incheon, 1.07% in Jeju, and 0.81% in Ulsan. Conclusion: The differences in sensitization rates were because of different regional environmental conditions and distinct surrounding biological species. Hence, subsequent nationwide studies are required.

Food Protein-induced Enterocolitis Syndrome: an Update on Clinical Approaches and Its Pathophysiology (식품 단백질 유발성 장염 증후군: 임상적 접근과 병태생리의 최신 지견)

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.117-128
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    • 2007
  • Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when $1^{st}$ follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.

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Research for Health Examinations for Infants and Children by Korean Medicine (한방 영유아 건강검진 도입 필요성 연구)

  • Yu, Seung Ju;Cheon, Jin Hong;Kim, Ki Bong
    • The Journal of Pediatrics of Korean Medicine
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    • v.30 no.2
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    • pp.10-22
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    • 2016
  • Objectives This study is to analyze current guidelines for health check-ups in infants and children, and to develop better guidelines based on oriental medicine. Methods We analyzed The Manual of 2015's Health Examination for Infants and Children which is a Korean Developmental Screening Test for Infants and Children (K-DST). The statistics from the test was collected from 2010 to 2014 to figure out the problems of Health Examinations for Infants and Children. 20 articles from 2000 to 2014 from RISS, NDSL were also analyzed. Results The current guidelines for health examinations in infants and children didn't include major pediatric diseases such as allergy and asthma. Also, the pediatrics health education materials were mainly focused on hypernutrition but not so much on nutrition deficiency. The number of the centers for Health Examinations for Infants and Children was 52.2% of the number of NIP-Participating medical institutions for infants and children. Conclusions Oriental medicine can be useful to prevent major pediatric diseases and to promote general health in pediatrics. By legislating 'Geon-a-beop', which is a law for infants and children, we can increase the number of medical centers for infants and children to get health check-ups. Currently, there are 9,769 Korean medical institutions, and the rate of traditional medical doctors of public health doctors was 25.5%. Weak Children Questionnaire is developed, considered to be more useful when it is developed with 5-point scale rather than 2.

A Clinical Study on Herbal Medicine Threapy Treating Nasal Polyps (비용종(鼻茸腫)(Nasal polyp) 한방(韓方) 치험예(治驗例)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Lee Hai-Ja;Park Eun-Jung
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.1
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    • pp.191-204
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    • 1999
  • Background: Nasal polyps are benign mass of nasal mucose, chronic sinusitis are swelling of nasal mucose, so nasal polyps and chronic sinusitis take a place at the same time. Nasal polyps are located lateral wall of nose, middle meatus, between middle nasal concha and inferior nasal concha. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis and nasal polyps before and after treatment using computed tomography (CT). To compared before and after treatment of otitis media using earscope. Materials and methods: Five patients (4 mail and 1 femail) treated in our hospital between August 1998 and July 1999 were studied. Ages ranged from 9 to 23 years (mean age:13 years). All patients had a underlying family history, and past history(allergy or sinusitis of parents or brothers). Illness period was from 1 to 36 months (mean period:10.5 month). To ascertain the efficacy of treatment, CT were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. We classified treatment period into the type of allergic disease. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms. Results: Treatment period was from 126 to 157 days (mean period:140.7 days). To 3 patients with chronic sinusitis and nasal polyp, treatment period was 140.7 days, to 2 patients with otitis media and chronic sinusitis and nasal polyp, treatment period was 141.5 days. So they had no significance. Not nasal polyp from middle meatus, but also polypoid mucosal change of maxillary sinus is polyps Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis and otitis media using earscope and CT. Herbal medicine therapy was effective in increasing immunity, inhibiting allergic reaction and inflammation of respiratory system. we practice ECP(eosinophil cataionic protein) and MAST examination, objectify herbal medicine therapy.

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Immunological mechanism of postherpetic neuralgia and effect of pregabalin treatment on the mechanism: a prospective single-arm observational study

  • Mercan, Aysel;Uzun, Sema Tuncer;Keles, Sevgi;Hacibeyoglu, Gulcin;Yilmaz, Resul;Reisli, Ruhiye
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.463-470
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    • 2021
  • Background: Although neuropathic pain is a severe and common pain, its pathophysiology has not been elucidated yet. Studies in recent years have focused on the immune system's role in the pathogenesis of neuropathic pain. The aim of this study was to investigate the role of immunological mechanisms in neuropathic pain and the effect of pregabalin by measuring immunological marker levels in peripheral blood before and after pregabalin treatment in postherpetic neuralgia (PHN) patients with neuropathic pain. Methods: Forty patients diagnosed with PHN were included in the study. CD4, T follicular cells (Tfh: CD4+CXCR5+PD1+), Th17 (CD4+CCR6+ and CD4+IL17A+), regulatory T cells (Treg: CD4+ CD25+foxp3+), Th1 (CD4+ CXCR3+ and CD4+ IFN-γ+) and Th2 (CD4+ IL-4+) cell ratios were measured in peripheral blood samples before treatment and after 3 months of treatment. Results: When immunological marker and inflammation parameter levels were compared before and after treatment, the helper T cell ratio (CD3+, CD4+) was 30.28 ± 12.27% before treatment and 34.93 ± 11.70% after treatment, so there was a statistically significant increase (P = 0.028). Th17 was 4.75 ± 5.02% before treatment and 5.80 ± 3.13% after treatment, and there was a statistically significant increase (P = 0.036). Conclusions: Immunological mechanisms play an essential role in the pathogenesis of neuropathic pain, immunologically based treatment approach will be the critical point of treatment.

Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSSTM) Values in Symptomatic Infants

  • Kozlowska-Jalowska, Anna;Horvath, Andrea;Vandenplas, Yvan;Szajewska, Hania
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.4
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    • pp.384-391
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    • 2021
  • Purpose: The Cow's Milk-related Symptom Score (CoMiSSTM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSSTM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSSTM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSSTM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSSTM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSSTM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSSTM values were retrospectively and prospectively determined. Lower CoMiSSTM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSSTM in clinical practice.

Detection of Enteropathogens in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children with Acute Diarrhea in an Indonesian Tertiary Hospital Using Multiplex Real-Time Polymerase Chain Reaction

  • Dewi Wulandari;Rivaldi Febrian;Pramita Gayatri Dwipoerwantoro;Nia Kurniati
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.2
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    • pp.95-103
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    • 2024
  • Purpose: Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital. Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020. Results: The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacter spp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens. Conclusion: The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.

Eosinophil-derived neurotoxin: a novel biomarker for diagnosis and monitoring of asthma

  • Kim, Chang-Keun
    • Clinical and Experimental Pediatrics
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    • v.56 no.1
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    • pp.8-12
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    • 2013
  • Asthma is associated with increased levels of eosinophils in tissues, body fluids, and bone marrow. Elevated levels of eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) have been noted in asthma patients. Higher levels of EDN and ECP are also associated with exacerbated asthmatic conditions. Thus, EDN, along with ECP, may aid the diagnosis and monitoring of asthma. Several groups have suggested that EDN is more useful than ECP in evaluating disease severity. This may partially be because of the recoverability of EDN (not sticky, 100% recovery rate), as ECP is a sticky and more highly charged protein. In terms of clinical utility, EDN level is a more accurate biomarker than ECP when analyzing the underlying pathophysiology of asthma. As a monitoring tool, EDN has shown good results in children with asthma as well as other allergic diseases. In children too young to fully participate in lung function tests, EDN levels may be useful as an alter native measurement of eosinophilic inflammation. EDN can also be used in adult patients and in multiple specimen types (e.g., serum, sputum, bronchoalveolar lavage fluid, and nasal lavage fluid). These results are repeatable and reproducible. In conclusion, EDN may be a novel biomarker for the diagnosis, treatment, and monitoring of asthma/allergic disease.

Effects of the Mother-Medical Staff Partnership on Mothers' Condition Management Ability for Children with Chronic Allergic Diseases (만성 알레르기 질환 아동의 어머니-의료진 간 파트너십이 어머니의 아동 상태 관리능력에 미치는 영향)

  • Son, Hae Kyoung;Song, Hyo Bin;Kim, Dong Hee
    • Child Health Nursing Research
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    • v.24 no.1
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    • pp.101-108
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    • 2018
  • Purpose: This study aimed to identify the effects of the mother-medical staff partnership on mothers' condition management ability for children with chronic allergic diseases. Methods: A total of 109 Korean mothers caring for a child with a chronic allergic diseases, identified according to the allergic march, such as food allergy, atopic dermatitis, allergic rhinitis, and allergic asthma, were recruited from the pediatric department of a general hospital in Seoul through convenience sampling. Data were collected using structured self-reported questionnaires from August 1, 2017 to October 31, 2017. and analyzed by descriptive statistics and multiple regression using SPSS version 22.0. Results: The Mother-medical staff partnership had a statistically significant effect on mothers' condition management ability for children with chronic allergic diseases (p<.05). Among the general characteristics, satisfaction with nursing services had a statistically significant effect on mothers' condition management ability (p<.05). Conclusion: In conclusion, strategies to support children with chronic allergic diseases, as well as their caregivers, should consider the mother-medical staff partnership as part of a family-centered approach.

Phenethyl Isothiocyanate Inhibits Ovalbumin-induced Inducible Nitric Oxide Synthase Expression (Ovalbumin에 의해서 유도된 inducible nitric oxide synthase 발현에 대한 phenethyl isothiocyanate의 억제효과)

  • Shin, Hwa-Jeong;Youn, Hyung-Sun
    • Korean Journal of Food Science and Technology
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    • v.44 no.6
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    • pp.759-762
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    • 2012
  • Egg allergies have been reported as one of the most prevalent food hypersensitivities in the pediatric population. One of the major egg allergens is ovalbumin (OVA), which is the major protein in the egg whites. Phenethyl isothiocyanate (PEIC) from cruciferous vegetables has an effect on anti-inflammatory therapy. In the present report, we show that PEIC inhibits the nuclear factor-${\kappa}B$ (NF-${\kappa}B$) activation induced by OVA. PEIC also inhibits the OVA-induced inducible nitric oxide synthase (iNOS) expression and nitrite production. However, PEIC did not suppress the cyclooxygenase-2 (COX-2) expression induced by OVA. These results suggest that PEIC has the specific mechanism for anti-inflammatory responses and efficient anti-allergic activities.