• 한국환경보건학회지
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• 제34권5호
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• pp.369-373
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• 2008

The indoor environment is an important source of exposure to various aeroallergens and pathogenic microorganism. It has been shown that exposure to aeroallergens enhances the risk of indoor inhabitants developing asthma. Since the skin prick test, a typical clinical method for identification of subjects positive to allergens, can rarely cause fatal or non-fatal reactions in susceptible persons, an in vitro assay such as ELISA using serum has been considered for testing positivity against various allergens. We evaluated the validity of a serum ELISA kit for screening positive subjects to major aeroallergens including Dermatophagoides farinae, Dermatophagoides pteronyssinus, cockroach, Alternaria, Cladosporium, Aspergillus, Penicillium, dog hair, cat fur, mugwort, and ragweed. The ELISA results were compared with the skin prick test results, and sensitivity, specificity, and overall accuracy were calculated to each allergen. Higher sensitivities were obtained from D. farinae, (77.8%) and D. pteronyssinus (69.2%), but sensitivities to Aspergillus, Penicillium, dog hair, cat fur, and ragweed were very low down to 0%. Specificity ranged from 88.7% (cat fur) to 100% (mugwort and ragweed). Overall the accuracy of the serum ELISA kit was relatively high, in that the lowest was 85.1% for cat fur and the highest was 98.6% for Alternaria, Cladosporium, and ragweed. Considering specificity and overall accuracy for the serum ELISA kit, it may be considered reliable. However, when the kit is used for screening purpose, positivity to aeroallergens should be carefully determined since sensitivity for the kit is low.

• Clinical and Experimental Pediatrics
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• 제55권9호
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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.

• Clinical and Experimental Pediatrics
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• 제58권3호
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• pp.89-95
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• 2015

Purpose: House dust mite (HDM) has been suggested to be the most important aeroallergen responsible for atopic asthma in Korea. We aimed to investigate that specific IgE antibodies to HDM and other common indoor aeroallergens contribute differently to total serum IgE and show different relationships with longitudinal fractional exhaled nitric oxide (FeNO) measurements in Korean atopic asthmatic patients. Methods: A total of 193 children aged 8 to 16 years with intermittent or mild persistent atopic asthma were recruited. Sera were assayed for total IgE and specific IgE antibodies to HDM and other common indoor allergens. FeNO was serially measured 10 times or more over 2 years when subjects were not receiving controller medications. Results: In 152 children who completed the study, IgE antibodies to specific HDM were more prevalent than those to other common indoor aeroallergens. In addition, IgE antibody titers to HDM were the strongest contributor to total IgE increases. Furthermore, only HDM-specific IgE antibody titer significantly correlated with maximum FeNO (r=0.21, P=0.029) and the rate of FeNO higher than 21 parts per billion (ppb) (r=0.30, P=0.002). Eight patients (5%) were found to have maximum FeNO of 21 ppb or less, suggesting the presence of a low FeNO phenotype among atopic asthmatic patients. Conclusion: The quantity of HDM-specific IgE antibody provides a possible explanation for increases of total IgE and significantly correlates with the amount and frequency of FeNO increases in Korean atopic asthmatic patients.

• Journal of Rhinology
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• 제25권2호
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• pp.91-98
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• 2018

Background and Objectives: The present study evaluated the results of skin prick test using 55 allergens at 20 centers in the Republic of Korea in 2006, 2010, and 2014-2015. The aim was to assess changes in the positive rate of allergens according to temporal, regional, and environmental factors. Materials and Method: In total, 20 hospitals were selected based on the population distribution in the Republic of Korea. A skin prick test panel comprising 55 aeroallergens was distributed to 18 hospitals for this prospective study. The 2006 and 2010 skin prick test results were collected and analyzed retrospectively from 20 hospitals, while the 2014/2015 skin prick test results (from June 2014 to May 2015) were collected prospectively from 18 hospitals. Results: A total of 14,897 SPT test results were analyzed: 4,319 in 2006, 7,431 in 2010, and 1,852 in 2014/2015. The overall rate of skin prick test positivity to more than two allergens was significantly higher in males than females. The positive rates of alder pollens and birch, oak and ragweed pollen positivity were increased in older patients. Several positive rates were increased according to the temperature in spring. The positive rates for beech pollen, birch pollen, hazel pollen, oak pollen, Tyrophagus putrescentiae, mugwort, cat, Acarus siro, Lepidoglyphus destructor and Tyrophagus putrescentiae were significantly increased, while those of Cult rye pollen and dandelion were significantly decreased over the three test periods. The overall positive rate for allergens in Jeju province varied significantly from Seoul and other cities. Conclusion: Change in the positive rate of multiple aeroallergens was evaluated in the Republic of Korea over time. Our findings can be used to recommend aeroallergens suitable for inclusion in skin prick test panels in the Republic of Korea and will facilitate further investigation of changes in the patterns of allergic diseases.

• Parasites, Hosts and Diseases
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• 제44권1호
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• pp.73-79
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• 2006

We evaluated the efficacy of health education in reducing indoor arthropod allergens in Seoul. The mite control measures comprised the use of mite-proof mattress and pillow coverings, regular washing of potentially infested materials, maintenance of a low humidity, removal of carpets, and frequent vacuum cleaning. Cockroach control measures included trapping, application of insecticides, and protecting food. Of 201 homes enrolled in October 1999, 63 volunteers were included in a 2-year follow-up survey between April 2000 and January 2002. Before intervention, the density of mites/g of dust varied greatly; 27.1/g in children's bedding, 20/g in adult bedding, 7.2/g on the floors of children's bedrooms, 6.8/g in sofas, 5.9/g on the floors of adult's bedrooms, 3.9/g on living room floors, 3.7/g in carpets, and 1.9 mites/g on kitchen floors. The predominant mite species and house percentages infested were; Dermatophagoides farinae $93\%$, D. pteronyssinus $9\%$, and Tyrophagus putrescentiae $8\%$. Comparing 1999 and 2001 infestations, before and after 25 mo of education, mite abundance was reduced by $98\%$, from 23.7 to 0.57 mites/g of dust. In 1999, cockroaches were detected in $62\%$ homes: $36\%$ Blattella germanica and $35\%$ Periplaneta spp., including $9\%$ double infestations of B. germanica and P. americana. Following intervention, cockroach infestation rates decreased to $22\%$ of houses in 2000 and $23\%$ in 2001. We conclude that continuous and repetitive health education resulted in the effective control of domestic arthropods.

• Clinical and Experimental Pediatrics
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• 제46권4호
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• pp.370-375
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• 2003

목 적 : 출생 후 영아기에 알레르겐에 대한 노출 여부가 추후 감작과 알레르기질환의 발생에 중요한 것으로 알려져 왔다. 우리나라에서는 집먼지진드기가 알레르기질환의 주요 흡입 알레르겐으로, 집먼지진드기 항원량은 계절적으로 가을에 가장 높은 것으로 보고되었다. 이에 저자들은 소아 호흡기 알레르기 환자에서 집먼지진드기에 대한 감작 여부에 따라서 출생 월 분포의 차이가 있는지 알아보기 위해 본 연구를 시행하였다. 방 법 : 1995년 1월부터 2002년 5월까지 만성 호흡기 증상으로 서울대학교병원 어린이병원을 방문하여 알레르기 피부단자시험과 메타콜린 유발시험을 시행 받은 환아 1,327명을 대상으로 집먼지진드기에 대한 감작 여부와 출생 월을 조사하여, 집먼지진드기 감작 유무에 따라 출생 월 분포를 비교하였다. 결 과 : 한 가지 이상의 알레르겐에 피부시험 양성을 보인 아토피군은 864명(65.1%)이고 비아토피군은 463명(34.9%)이었다. 아토피군에서 집먼지진드기에 양성을 보인 환아의 수는 787명(91.1%)이고 집먼지진드기를 제외한 나머지 피부시약에 양성반응을 보인 수는 77명(8.9%)이었다. 집먼지진드기 아토피군과 비아토피군의 출생 월별 분포를 기대 환자수와 비교했을 때 집먼지진드기 알레르기를 가진 환아들은 계절적으로 8월에서 11월까지 기대 환자수 보다 유의하게 많이 출생하였고(P=0.03) 비아토피군에서는 상기와 같은 출생 월 분포를 보이지 않았다. 천식으로 진단된 환아는 총 543명(40.9%)이었고 이중 아토피성 천식 환아는 421명(77.5%)이었고 비아토피성 천식 환아가 122명(22.5 %)이었다. 아토피성 천식 환아 중 집먼지진드기 아토피성인 환아는 387명(91.9%)이었다. 집먼지진드기 아토피성 천식과 비아토피성 천식 환아에서 출생 월의 계절별 비교에서 8월에서 11월까지 집먼지진드기 아토피성 천식 환아가 비아토피성 천식 환아보다 유의하게 많이 출생하였다(P=0.002). 결 론 : 출생 월은 알레르겐에 대한 감작 여부에 연관이 있는 것으로 보이며, 우리나라에서는 8월에서 11월까지의 출생이 집먼지진드기에 대한 감작의 위험이 큰 시기로 보인다.

• Clinical and Experimental Pediatrics
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• 제49권3호
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• pp.298-304
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• 2006

목 적 : 소아 천식이 급격히 증가하고 있다. 영유아 시기의 천명을 보이는 환아들에서 천식 발생을 예측할 수 있는 고위험군을 선별하는 지표들이 알려져 있다. 저자들은 Tucson Children's Respiratory Study Group에서 제시한 천식 예측 지표 API와 변형한 천식 예측 지표 mAPI를 한국 영유아 천명 환아들에게 적용하여 의미있는 예측 지표를 규명하고자 하였다. 방 법 : 반복성 천명을 주소로 서울아산병원 소아과를 방문한 262명의 환아들을 대상으로 API와 mAPI를 적용하여 고위험군과 저위험군으로 나누었다. 각 군에서 알레르기 지표 뿐만 아니라 환아와 가족들의 알레르기 질환의 병력을 조사하였다. 결 과 : API 고위험군 환아(n=131)는 저위험군 환아(n=131) 보다 성별은 차이가 없었고 연령, 총호산구수, 호산구 비율, 혈중 ECP, 총 IgE가 높았으며, 흔한 항원에 대한 감작 여부가 포함되지 않았지만 흡입항원과 식품항원에 대한 감작률이 더 높게 나타났다. mAPI 고위험군 환아(n=141)는 저위험군 환아(n=121) 보다 총호산구수, 호산구 비율, 혈중 ECP, 총 IgE, egg, milk, D.p-, D.f-특이 IgE 농도가 높았으며 성별과 연령의 차이는 없었다. 위험군별 다변량 분석에서는 API군에서는 흡입항원에 대한 감작 여부가 고위험군을 결정하는 유의한 지표로 나타났으며 mAPI군에서는 혈중 ECP 농도가 유의한 지표로 나타났다. 대상군 중 6세 이상 추적 관찰된 환아는 모두 29명이었으며 최근 1년간 천명의 병력이 확인되고 임상적으로 천식으로 진단된 환아는 15명이었다. API의 민감도, 특이도, 양성예측률, 음성예측률은 66.7%, 50.0%, 58.8%, 58.3%이었으며, mAPI는 93.3%, 57.1%, 70.0%, 88.9%로서 mAPI가 더 높았다. 결 론 : API와 mAPI를 적용한 고위험군 환아에서 흔한 흡입 항원과 식품항원에 대한 감작률이 높아서, 영유아 천명 환아에서 주관적인 증상에 의한 진단보다는 객관적인 흡입항원과 식품항원에 대한 감작 여부를 지표로 사용하는 것이 더 의미 있을 것으로 생각한다. 또한 한국 영유아 천명 환아에서는 mAPI가 소아 천식의 발생을 예측하는데 더 도움이 될 것으로 생각한다. 그러나 본 연구는 29명의 소수의 환아들만 추적 관찰된 결과이므로 이후로 보다 더 많은 환아들을 추적 관찰하는 것이 필요할 것이다.