• 생명과학회지
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• 제20권5호
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• pp.794-798
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• 2010

알러지성 피부염은 현재 영유아 4인 중 1명이 발병할 정도로 심각한 질환으로 보고되어 있다. 본 연구는 청도감물염색을 한 직물 2종(인견과 면)의 물 추출물이 알러지성 피부염 유도 동물모델에서 피부의 표피에 면역관련의 세포의 수를 감소시킴을 H&E 염색으로 확인하였으며, 알러지성 피부염에 직접 관련이 있는 분자표적인 $CD4^+$ cell의 분포를 비교하여 본 결과, 유의성 있게 항알러지성 피부염 활성을 보유하고 있는 것을 확인하였다. MMP-2와 MMP-9의 면역조직화학적 분석을 수행한 결과, 이들의 발현도 감소함으로 감물염색에 사용된 감의 유용성분 예를 들면 폴리페놀 성분 등이 알러지성 피부염의 억제활성에 관련이 있을 것으로 추정된다.

• 한국환경보건학회지
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• 제38권6호
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• pp.472-481
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• 2012

Objectives: This study aims to investigate the AD (allergic diseases: asthma, allergic rhinitis and atopic dermatitis) prevalence among elementary schoolchildren in an industrial city, Ulsan, and identify major environmental risk factors associated with AD prevalence. Methods: Data on the physician-diagnosed prevalence over the past 12 months and potential risk factors of AD were collected through a questionnaire from a 2009-2010 survey of 4,067 schoolchildren living in different urban environments. The logistic regression analysis was performed to assess differences in AD prevalence among the areas and to determine which environmental factors impacted AD. Results: Our survey results showed that the AD prevalence rate ranged between 26.2% and 35.9%. Children living in polluted areas (near industrial and central urban areas) had about a 10% higher prevalence of AD than did those living in coastal or suburban residences. The Chi-Square test demonstrated that this local difference was statistically significant before and after adjustment of major confounders such as parental AD history and parental education. The results of the logistic regression analysis showed a statistically significant association between several environmental factors (ventilation in winter, odor conditions and exposure to traffic smoke, and outdoor $PM_{10}/O_3$ pollution) and the prevalence of AD found by multivariate model after adjusting confounders. Conclusion: These results suggest that local differences in AD prevalence are significantly associated with outdoor environmental factors. Although there are likely to be other risk factors for AD, living in a polluted area and exposure to high levels of air pollutants can contribute to an increased risk of childhood AD.

• Clinical and Experimental Pediatrics
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• 제52권10호
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• pp.1103-1108
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• 2009

목 적:만성질환자가 아닌 일반 학동기 아동을 대상으로 보완대체요법 이용실태를 파악하며 소아청소년과 의사로서 대처 방향을 모색하고자 연구를 실시하였다. 방 법:3개 초등학교 1학년부터 6학년 1,688명의 학부모를 대상으로 설문조사를 시행하였다. 그중 설문지가 회수된 794명(47%)을 분석하였다. 결 과:일반적인 학동기 아동에서 보완대체요법의 이용률은 278명(35%)이었고, 보완대체요법의 종류는 한약제 62.6%, 보조식품 31.3%, 비타민 30.2%, 선식 11.2%, 침술 11.2%, 체 냄, 수지침 순이었다. 보완대체요법의 이용률은 어머니의 학력이 대학 이상 일 때, 종교가 있을 때, 가정 월 총수입이 100만 원 이상일 때 의미 있게 높았으며 이용하게 된 동기는 질병예방목적이 가장 많았고, 주로 주변 사람이나 매체를 통해 이용하였다. 보완대체요법에 대한 만족하지 못하는 경우는 16%였고, 재사용 의향이 없는 경우는 20.5%였고, 환아가 건강할 때 주로 사용하는 경향을 보였다. 환아가 영양결핍, 아토피 피부염, 관절통증, 알레르기비염, 비만, 천식 때 주로 이용하는 경향을 보였다. 결 론:보완대체 의학의 사용이 아이의 건강상태와는 밀접하지 않으며 사용 경로 또한 주변 사람의 권유나 방송 매체 등을 통해 이루어지고, 병원치료와 병행 시 좋을 것이라는 막연한 기대감으로 사용되고 있는 경우가 많아 보완대체요법에 대한 부작용, 효과, 안전성에 대한 연구가 필요하며 만성질환 및 알레르기 질환의 경우 소아청소년과 의사로서 현대의학의 적극적인 치료 및 교육이 필요할 것으로 사료된다.

• Pediatric Infection and Vaccine
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• 제15권2호
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• pp.152-161
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• 2008

목 적 : 과거 비교적 드물었던 포도알균 피부 증후군(이하 4S)은 최근 발생 보고가 증가하고 있다. 이에 4S 발생 추이와 관련 인자를 조사하고자 한다. 방 법 : 1998년 1월부터 2007년 12월까지 특징적인 임상양상을 보여 4S으로 진단된 신생아 27명과 소아 36명, 총 63명을 대상으로 의무기록과 균배양 결과를 후향적으로 검토하였다. 결 과 : 본원에서는 2003년 이후 지속적인 4S 발생을 경험하였다. 평균 연령은 16.3개월이었으며, 남녀비는 1:1로 비슷하였다. 임상 유형은 부전형이 38례(60%)로 가장 많았고 중간형 19례(30%), 전신형 6례(10%) 순이었다. 균배양 결과 Methicillin-resistant Staphylococcus aureus (MRSA) 36례, Methicillin-sensitive Staphylococcus aureus (MSSA) 4례, 배양 음성인 경우가 17례를 보였다. 치료는 반합성 페니실린을 투여하였고, MRSA가 배양된 환아중 호전이 없던 9례는 vancomycin으로 교체하였다. 전 례에서 예후는 양호하여 합병증은 보이지 않았다. 2005년 신생아에서 발생한 4S 급증은 주로 MRSA에 의한 신생아실 감염(18례)으로 추정된다. 발생과 관련된 요인으로 신생아에서는 2005년 발생한 신생아실 감염 18례를 포함한 27명 전원이 입원력이 있었고, 농가진성 피부염이 1명이었다. 소아에서는 아토피 피부염 9명과 입원력 3명을 제외한 24명에서는 특별한 위험인자가 없어 지역사회 획득감염을 시사하였다. 결 론 : 2003년 이후 지속적인 4S의 발생을 경험하였다. 발생과 관련 요인으로는 신생아실 감염 및 입원력, 아토피 피부염의 증가 그리고 원인 미상인 경우 지역사회 획득 감염이 관련있을 것으로 보인다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.253-260
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• 2015

Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

• Clinical and Experimental Pediatrics
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• 제48권9호
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• pp.929-934
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• 2005

목 적 : 본 연구는 소아, 청소년에게 행해지는 보완대체요법 사용실태에 대한 구체적이고, 다각적인 연구의 필요성이 있었기에 보완대체요법을 접할 기회가 많은 만성질환을 가진 소아, 청소년에서 보완대체요법이 어느 정도 사용되고 있는지, 보완대체요법의 종류에 따른 사용실태를 알아보고, 보완대체요법 사용에 영향을 미치는 인자가 있는지 알아보고자 하였다. 방 법 : 2004년 3월부터 8월까지 관동의대 부속병원 소아과에서 지속적 추적관찰을 해오던 입원 경험이 있는 환아들 중에 만성질환(기관지 천식, 아토피, 간질, 뇌성마비 등)을 앓고 있는 환아(160명)를 대상으로 하였고, 환아와 동행한 보호자에게 설문양식에 따라 면담설문을 실시하였다. 결 과 : 설문 조사에 응답한 만성질환을 앓고 있는 환아는 252명이었고, 그 중 보완대체요법을 시행한 160명(63.5%)을 대상으로 삼았다. 각 질환별 보완대체요법 이용률은 선천성 근병증(100%), 아토피성 피부염(91.1%), 만성 반복성 복통(73.5%), 기관지 천식(72.5%), 만성 설사(50.0%), 뇌성 마비(42.1%), 만성 기관지염(37.5%), 간질(17.1%) 순으로 이용률의 차이를 보였다. 시행한 종류는 식이요법(31.1%), 생약요법(23.4%), 수치요법(16.3%), 마사지(14.2%), 방향요법(8.9%), 침술요법(4.6%), 동종요법(1.3%) 순이었다. 64명(40.0%)이 2가지 이상의 보완대체요법을 동시에 시행하였고, 보완대체요법을 권유받은 경로는 비의사처방에 의한 경우가 133명(83.1%)이었으며, 99명(61.9%)이 보완대체요법의 효과에 대해 긍정적으로 답변했다. 보완대체요법 시행군에 있어서 보완대체요법 사용에 영향을 미치는 인자들 중 부모 연령, 자녀 연령이 통계학적 의의가 있었으며, 부모의 연령이 높을수록 시행경험이 많았고(P=0.001), 자녀의 나이가 어릴수록 보완대체요법을 시행하지 않는 경향을(P=0.002) 보였다. 결 론 : 만성질환을 앓는 환아들은 치료에 있어서 현대의학에 의존하는 반면, 상당수가 보완대체요법을 이용하고 있었으며, 2가지 이상을 동시에 사용하는 경우가 많았고, 그 효과에 대해 긍정적으로 평가하고 있었다. 이와 같은 결과는 국내에서 보완대체요법의 접근성이 용이하고, 긍정적인 측면이 강조되고 있기 때문이므로 무분별한 보완대체요법의 사용을 피하기 위해서는 보완대체요법의 효과와 부작용에 대한 현대의학적인 연구가 더 필요할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제58권5호
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• pp.190-193
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• 2015

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to bronchial colonization of Aspergillus fumigatus that occurs in susceptible patients with asthma or cystic fibrosis. A 10-year-old girl was referred to the Department of Pediatric Pulmonology for persistent consolidations on chest radiography. Pulmonary consolidations were observed in the right upper and left lower lobes and were not resolved with a 4-week prescription of broad-spectrum antibiotics. The patient had a history of atopic dermatitis and allergic rhinitis but no history of asthma. She had no fever but produced thick and greenish sputum. Her breathing sounds were clear. On laboratory testing, her total blood eosinophil count was $1,412/mm^3$ and total serum IgE level was 2,200 kU/L. Aspergillus was isolated in the sputum culture. The A. fumigatus-specific IgE level was 15.4 kU/L, and the Aspergillus antibody test was also positive. A chest computed tomography scan demonstrated bronchial wall thickening and consolidation without bronchiectasis. An antifungal agent was added but resulted in no improvement of pulmonary consolidations after 3 weeks. Pulmonary function test was normal. Methacholine provocation test was performed, revealing bronchial hyperreactivity ($PC_{20}=5.31mg/mL$). Although the patient had no history of asthma or bronchiectasis, ABPA-seropositivity was suspected. Oral prednisolone (1 mg/kg/day) combined with antifungal therapy was started. Pulmonary consolidations began decreasing after 1 week of treatment and completely resolved after 1 month. This is the first observed and treated case of seropositive ABPA in Korean children without previously documented asthma.

• 한국축산식품학회지
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• 제35권3호
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• pp.398-405
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• 2015

Egg allergy has been shown to be the most common food allergy in children with atopic dermatitis. Allergic reactions to proteins derived from egg white (EW) are more common than those derived from egg yolk. Ovomucoid, ovalbumin, ovotransferrin, and lysozyme have been identified as major allergens in EW. This study was conducted to evaluate the effect of EW on immune modulation in an induced allergy mouse model. A total of 50 five-week-old BALB/c male mice were treated with trimellitic anhydride (TMA) for three weeks to induce allergy-like symptoms. The TMA-treated mice were rested for one week and then divided into five groups and fed 0, 10, 50, and 100 mg/d EW for four weeks. All EW consumption groups showed no significant increase or decrease in the populations of white blood cells; however, a significant increase in B-lymphocyte activity was observed in the fourth week. Furthermore, EW consumption did not influence serum immunoglobulin G and immunoglobulin E levels. Taken together, these data demonstrate that the consumption of EW by TMA-treated mice did not increase allergic parameters such as serum IgE level, but enhanced the lymphocyte activities against pathogens. Therefore, this study suggests that the consumption of EW promotes Th2 immune modulation, and EW could be an excellent candidate for maintaining health.

• 한국환경보건학회지
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• 제34권1호
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• pp.20-26
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• 2008

The objective of the study which utilised population based data was to determine the respiratory condition of elementary school children in Gangneung. From October 9th to December 14th, 2006, Pulmonary Function Tests (PFT) including Forced Vital Capacity (FVC) and Forced Expiratoy Volume in I Second $(FEV_1)$ were conducted on the target group of children using a spirometer. The prevalence of asthmatic symptoms was 29.8% among boys and 39.6% among girls. By using logistic regression, we found that family history of allergic rhinitis (OR=3.90, CI=1.05-14.51), experience of allergic conjunctivitis (OR=4.67, CI=1.54-14.16) and atopic dermatitis (OR=2.86, CI=1.17-7.05) significantly increased the asthmatic symptoms. Also, a family history of asthma and food allergy were associated with asthmatic symptoms. In relation to housing and environmental risk factors, residences under the ground (OR=3.59, CI=1.35-9.51) and big-size dolls (OR=2.71, CI=0.86-8.53) significantly increased the prevalence of asthmatic symptoms. For PFT, above four families, exposure of passive smoking and pets significantly reduced FVC in both groups (p<0.05). In girls, a big-size doll was significantly associated with decreased lung function (FVC and $FEV_1$). In boys, using bed significantly reduced $FEV_1$. Also, the risk of asthmatic symptoms was found to increase when the house has been built for 5 years or more, the house is close to a road $({\leq}100m)$, a gas/Kerosene heater or carpet is utilized within the house. However, their differences were not significant. It is concluded that genetic factor such as a family history of respiratory disease, allergic symptoms and housing risk factor are related to asthmatic symptoms. These results were worth noting because the findings will help address risk factors related respiratory symptoms especially in relation to housing and environment.

• 대한한방소아과학회지
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• 제12권1호
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• pp.111-131
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• 1998

1. In oriental medicine, the case of sinusitis can be explained, not only external invasion such as PUNG HAN(wind-cold), PUNG YUL(wind-hot), SHUP YUL(damp-heat), but also functional disorder of internal organ such as spleen(脾), lung(肺), kidney(腎) The western medicine classified the cause of sinusitis as two factors. That is bacterial infection factor-Haemophilus influenza, streptococcus pyogeues, streptococcus pneumonia- and viral infection factor-Rhinovirus, parainfluenza, Echo28, Coxsacki21, Sinusitis is complicated to allergic rhinitis, chronic otitis media purulent, chronic tonsilitis, sinubronchitis. On the condition of nasal septum deformity, turbinates deformity, nasal septum deviation, sinusitis can be developed. the predisposing factors of sinusitis is swimming, air pollution, malnutrition, shortage of immunity.2. According to survey, sinusitis occurred that children from 4 to 12 years old and from 5 to 7 years old occupied 70% 3. From the past history data, they experienced chronic tonsillar hypertropy(20%), otitis media, atopic dermatitis, allergic rhinitis, bronchial asthma, pneumonia, bronchiolitis, chronic sore throat, urticaria, milk allergy in sequence. 4. the symptoms of sinusitis is nasal obstruction, postnasal dripping, purulunt(yellow)or white discharge, cough, nose bleeding in sequence. nasal obstruction take the portion of 95%, postnasal dripping 65%, night time or early morning cough 60%. 5. The suffering period of sinusitis is 6 month minimum, 4 years maximum, most cases are included in a year. The suffering period of children was shorter than adult. 6. Diagnosis depend on inspection of nasal cavity, postnasal dripping, X-ray finding. 75% of patient(15case) showed both maxillary sinusitis, 25%(5cases) showed left or right maxillary sinusitis. 7. Treatment of oriental medicine, consist of Herb-medicine, acupuncture and exposing of Lazer beam. Kamihyunggyeyungyotang(加味荊芥蓮翹湯) is administered mainly as the medical therapy, Kamigwaghyangjeungkisan(加味藿香正氣散) Kimizwakwieum(加味左歸飮), Kamihyangsosan(加味香蘇散) is administered for a additional symptoms which occurred by influenza recurrence. Kamijeonxibackchulsan(加味錢氏白朮散) is administered to treat gastro-intestine trouble patients who have sinusitis. 8. The period of treatment is varied with patient conditions and X-ray finding. The minimal period is 35days, maximal period is 202days. So it took about 86days in average and about 50% of patient(10cases) is recovered in one or two month.