Current Asthma Prevalence Using Methacholine Challenge Test in Korean Children from 2010 to 2014

Background@#Most epidemiological studies depend on the subjects' response to asthma symptom questionnaires. Questionnaire-based study for childhood asthma prevalence may overestimate the true prevalence. The aim of this study was to investigate the prevalence of “Current asthma” using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and methacholine challenge test in Korean children. @*Methods@#Our survey on allergic disease included 4,791 children (age 7–12 years) from 2010 to 2014 in Korean elementary schools. Bronchial hyperresponsiveness (BHR) was defined as provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20) ≤ 16 mg/mL. “Current asthma symptoms” was defined as positive response to “Wheezing, current,” “Treatment, current,” or “Exercise, current.” “Current asthma” was defined when the subjects with “Current asthma symptoms” showed BHR on the methacholine challenge test or had less than 70% of predicted FEV1 value. @*Results@#The prevalence of “Wheezing, ever,” “Wheezing, current,” “Diagnosis, ever,” “Treatment, current,” “Exercise, current,” and “Current asthma symptoms” was 19.6%, 6.9%, 10.0%, 3.3%, 3.5%, and 9.6%, respectively, in our cross-sectional study of Korean elementary school students. The prevalence of BHR in elementary school students was 14.5%. The prevalence of BHR in children with “Wheezing, ever,” “Wheezing, current,” “Diagnosis, ever,” “Treatment, current,” and “Exercise, current” was 22.3%, 30.5%, 22.4%, 28.8%, and 29.9%, respectively. BHR was 26.1% in those with “Current asthma symptoms.”The prevalence of “Current asthma” was 2.7%. @*Conclusions@#Our large-scale study provides 2.7% prevalence of current asthma in Korean elementary school children. Since approximately one third of the children who have “Current asthma symptoms” present BHR, both subjective and objective methods are required to accurately predict asthma in subjects with asthma symptoms.

Current Asthma Prevalence Using Methacholine Challenge Test in Korean Children from 2010 to 2014

Background@#Most epidemiological studies depend on the subjects' response to asthma symptom questionnaires. Questionnaire-based study for childhood asthma prevalence may overestimate the true prevalence. The aim of this study was to investigate the prevalence of “Current asthma” using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and methacholine challenge test in Korean children. @*Methods@#Our survey on allergic disease included 4,791 children (age 7–12 years) from 2010 to 2014 in Korean elementary schools. Bronchial hyperresponsiveness (BHR) was defined as provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20) ≤ 16 mg/mL. “Current asthma symptoms” was defined as positive response to “Wheezing, current,” “Treatment, current,” or “Exercise, current.” “Current asthma” was defined when the subjects with “Current asthma symptoms” showed BHR on the methacholine challenge test or had less than 70% of predicted FEV1 value. @*Results@#The prevalence of “Wheezing, ever,” “Wheezing, current,” “Diagnosis, ever,” “Treatment, current,” “Exercise, current,” and “Current asthma symptoms” was 19.6%, 6.9%, 10.0%, 3.3%, 3.5%, and 9.6%, respectively, in our cross-sectional study of Korean elementary school students. The prevalence of BHR in elementary school students was 14.5%. The prevalence of BHR in children with “Wheezing, ever,” “Wheezing, current,” “Diagnosis, ever,” “Treatment, current,” and “Exercise, current” was 22.3%, 30.5%, 22.4%, 28.8%, and 29.9%, respectively. BHR was 26.1% in those with “Current asthma symptoms.”The prevalence of “Current asthma” was 2.7%. @*Conclusions@#Our large-scale study provides 2.7% prevalence of current asthma in Korean elementary school children. Since approximately one third of the children who have “Current asthma symptoms” present BHR, both subjective and objective methods are required to accurately predict asthma in subjects with asthma symptoms.

Glutathione S-transferase gene polymorphism and the susceptibility to hepatocellular carcinoma

Aim: glutathione S-transferase play an important role in protecting cells against cytotoxic and carcinogenic agents. GST gene polymorphism was linked to a variety of solid tumors including hepatocellular carcinoma. The present study was undertaken to evaluate the association between GSTM1 and GSTT1 gene polymorphisms and hepatocellular carcinoma [HCC]

Methods: a total number of 59 subjects [32 patients with proved HCC, 15 patients with chronic HCV infection and 12 healthy control subjects] were enrolled in this study. Serum total aflatoxin level was measured using enzyme-linked immunosorbent assay [ELISA]. Plasma total GST activity was measured by ELISA. PCR technique was used to determine GSTM1 and GSTT1 gene polymorphism

Results: the frequencies of GSTM1 and GSTT1 null genotypes in the HCC were 75% and 53.1% repectively. There was no correlation between the GST with aflatoxin or the hepatitis marker status of the HCC patients

Conclusion: the GSTM1 and GSTT1 null genotypes are associated with an increased risk of HCC in Egyptian patients

Expression of human recombinase activating gene 1 and recombinase activating gene 2 [rag 1 and rag 2] in acute lymphoblastic leukemia

The process of V[D]J recombination is limited and controlled by the enzymatic activity of cytoplasmic proteins called recombinase which are the products of the activating two genes called Recombinase Activating Gene 1 and Recombinase Activating Gene 2 [RAG1 and RAG 2]. Both genes are expressed in immature B and T lymphocytes and activated V[D]J rearrangement in Ig and TCR genes which are directed in cis by recombination signals sequences [RSSs]. Also, they show variable expression in lymphoid malignancies of both B and T-cell types. This study aimed to focus on the role of the two cytoplasmic proteins [RAG1 and RAG2] in the developing of both B and T ALL, correlation to the stages of differentiation and also, their possible prognostic significance. This study included 40 newly diagnosed acute lymphoblastic leukemic patients [ALL] their age ranged from 1-10 years. Assessment of RAG1 and RAG2 expression by reverse transcriptase polymerase chain reaction [RT-PCR] was done using peripheral blood sample. RAG1 and RAG2 positive expression was higher in frequency in pediatric ALL cases compared to control group, the difference was statistically significant [P<0.01]. Among the RAG1 and RAG2 positive ALL cases 25% were pro-B-ALL and 25% CALL and 31.2% pre-B-ALL and 18.8% were early T-ALL. On the other hand RAG1 and RAG2 negative ALL cases showed higher frequency of CALL phenotype [83.3%] while pro-B ALL, pre-B ALL and early-T ALL were 4.2% and 8.3% and 4.2% respectively. The RAG1 and RAG2 initially positive ALL cases studied had poor prognosis, where 37.5% relapsed and 25%, while 37.5 were in continuous complete remission. However among the RAG1 and RAG2 negative ALL cases studied, 91.7% had good prognosis with complete remission, while only one patient [4.2%] relapsed and one died [4.2%]. A statistical significant association between RAG1 and RAG 2 positive expression and poor prognosis was noticed. RAG1 and RAG2 could be used as prognostic marker in lymphoid malignancies and its sub-classification

clinic pathological study among Egyptian children with primary nephrotic syndrome

The study included 63 nephrotic children who performed a renal biopsy in the nephrology clinics of Alexandria University Children's Hospital between 1992 and 2002. They were 30 males and 33 females. Their age at the time of onset of the disease ranged from 6 months to 74.5 years [mean 5.8324.02 years]. Eight biopsies [12.6%] were inadequate for histological examination. The most frequent pathological diagnosis in the remaining 55 biopsies was DMP [42.9%], followed by MPGN [23.8%], FSGS [72.7%], MCNS [6.3%], and lastly, one case of CNS of Finnish type [1.6%]. Most cases were steroid resistant [76.1%] and 14.3% were steroid dependent. The percentage of steroid resistance was highest among cases with MPGN [93.3%]' whereas, was lowest [50%] among MCNS. ESRF occurred in 20.6% of cases, all of them were steroid resistant. Also, death occurred in 79% of cases

Joint mobility in insulin dependent diabetic children and its relation to microvascular complications

The aim of this study was to evaluate joint mobility in insulin dependent diabetic children and to determine any association between limitation of the range of motion and microvascular complications of this disease. The study was conducted on 60 children suffering of IDDM chosen randomly from regular attendants of the Diabetology Clinic of the Children's Hospital, Ain Shams University. They were subjected to medical history taking and clinical examination laying stress on fundal examination by direct ophthalmoscopy. Clinical assessment of joint mobility qualitatively and quantitatively was performed using a goniometer. Laboratory investigations included glycosylated hemoglobin and detection of microalbuminuria. A control group of twenty apparently healthy children was assessed clinically for joint mobility. The prevalence of limited joint mobility [LJM] in our insulin dependent diabetics was significantly higher than in the control group. Interestingly, this study suggested that ankle range was the most sensitive test for determination of LJM in diabetics. A positive correlation was found between the severity of LJM, negative glycemic control, retinopathy and microalbuminuria. Accordingly, detection of LJM may reflect the development of microvascular changes in IDDM

Study of different causes of respiratory distress in infants of diabetic mothers

This study was conducted on forty two infants of diabetic mothers [IDMs] and ten healthy neonates as control group. Our aim was to assess the different causes of respiratory distress and to see the impact of fetal hyperinsulinemia in relation to the degree of control of maternal diabetes [judged by history and glycosylated hemoglobin [HBA1C] on different causes of respiratory distress [RD], other morbidities and mortalities. All neonates were subjected to: thorough history and clinical examination, assessment of gestational age. Investigations done were: CBP, C reactive protein, serial blood glucose levels, serum insulin level, chest x- ray, blood gases analysis and in selected cases: echocardiography, brain sonar and postmortum study in cases of death. For diabetic mothers [HbA1C] was done. The results showed that respiratory distress [RD] still represents the commonest morbidity among IDMs with a higher incidence [100%] in group of infants of poorly controlled diabetic mothers [group II] compared to [32.1%] in group of infants with fair controlled diabetic mothers [group 1]. 23 infants out of the 42 [54.8%] had respiratory distress [RD]. The different causes were: Transient tachypnea of newborn [TTN] in [16.6%], Perinatal asphyxia [PA] in [14.2%], Hyaline membrane disease [HMD] in [7.1%], Congenital ventricular septal defect [2.2%], Congenital hypertrophic cardiography in [4.8%], Polycythemia in [4.8%], Symptomatic hypoglycemia in [4.8%] and meconium aspiration [2.2%]. A positive correlation was found between respiratory distress and incidence of cesarean section [CS]. Mortalities ocurred in 6 infants among the 42 IDMS. One infant died from PA., macrosmia and birth trauma in group I, five infants died in group II [infants of poorly controlled diabetic mothers], three died from perinatal asphyxia and the other two from congestive heart failure and pulmonary edema complicating hypertrophic cardiomyopathy. Serum insulin levels were markedly high in infants who had morbidities and mortalities. A negative correlation was found between serum insulin levels and APGAR scores at 1 minute and 5 minutes. A positive correlation was found between serum insulin and maternal HbA1C.Also maternal HbA1C showed a negative correlation with gestational age and APGAR scores at 1 minute and 5 minutes. In conclusion we could say that, IDMS are at increased risk of various causes of RD and the risk greatly increases with poor control of maternal diabetes through fetal hyperinsulinemia which plays a major role indifferent morbidities and mortalities, also through increased incidence of prematurity and cesarean sections which in turn increased risk for respiratory distress

Skin manifestations in insulin dependent diabetes mellitus [IDDM]

This study included one hundred children with IDDM, 51 females and 49 males with mean age 9.15 years +/- 2.25. They were subjected to full history taking, thorough clinical examination and investigations including random urine sugar and acetone, random blood sugar, glycosylated hemoglobin level, and clinical examination of skin lesions. Bacteriological and mycological examinations were done when needed. No significant relation was detected between the occurrence of skin manifestations and either the blood glucose level or the presence of ketoacidosis. The pyogenic and fungal infections increased significantly in children with poor glycemic control as proved by measuring the glycosylated hemoglobin level [HBA1C] which raises the need for proper geycemic control in IDDM. In conclusion the diabetic children should be regularly followed up and examincd dermatologieally for early detection and treatment of any skin disorder associating IDDM

epidemiological study of insulin-dependent diabetes mellitus [IDDM] in east Cairo school age pupils and students

This study is a trial to determine the prevalence rate of IDDM and to understand some epidemiologic feature of this disease among school age students in Heliopolis district [5 primary, 2 preparatory and 4 secondary schools]. The subject of the study were 9166 students, of whom 4128 were males and 5038 were females. The age range was between 6-12 in 3024 students [1793 males and 1231 females], and 12-15 years in 2482 students [1297 males and 1185 females] and between 15-18 years in 3660 students [1038 males and 2622 females]. Their mean ages and standard deviation were 9.1 +/- 1.1, 13.4 +/- .94 and 16.3 +/- .93 respectively]. These students were survyed for the presence of IDDM by means of urine testing using glucotest followed by determination of blood glucose level. The prevalence rate of IDDM in the present study was 1.09/1000 with male predominance. In our study 70% of cases of IDDM occurred between 10-14 year. All cases were first diagnosed during autumn and winter. In formation from this study clarified that, in most cases there was a history of viral infection and positive family history of diabetes. [80% and 80% respectively]

Clinical, biochemical and electromyographic studies in muscle diseases in infancy and childhood

The study included 49 cases suspected of having muscle disease and the initial clinical was confirmed by investigations in 42 cases [84%]. In 7 cases [14%], electromyography and enzyme studies [CPK, aldolase, L.D.H., L.D.H. isoenzymes and choline-estrase] were essential for final diagnosis. Creatinep hosphokinase levels are more markedly increase in cases of muscular dystrophy and the levels have positive correlation with the duration of the disease. Lactic dehydrogrenase showed more definite rise than serum aldolase in cases of muscular dystrophy. Serum levels over 1500 I.U/L were encountered only in cases of muscular disease as well as permitting early diagnosis. Serum choline-estrase showed no significant change in all cases and this means that is still no positive evidence of presence of a relationship between the neurotransmitter and muscle disease

Islet cell antibodies in diabetic children and their family members

Indirect immunofluorescence [IF] technique was used to detect islet cell antibodies [ICA] in sera of 35 children with insulin dependent diabetes mellitus [IDDM]. They include 24 males and 11 females. Their ages ranged between 3.5-20 yr. [mean, 10.9 +/- 3.6 yr.]. The duration of the disease ranged from 4d. - 9yr. Thirty five healthy control children with comparable age group [4 - 16 yr., mean, 9.7 +/- 3.2 yr.] and sex [19 males and 16 females]; and 35 first degree relatives of the patients were also studied. ICA were detected in 54% of the diabetic children, while none of the relatives or the control children were positive [P < 0.001]. The prevalence of ICA was higher [83%] among newly diagnosed cases than those with more than 6 months duration of IDDM [48%] [P < 0.05]. No correlation was found between the presence of ICA and blood group isotypes. The results are thoroughly explained and the significance of ICA as a marker for the development of IDDM is discussed

Pharmacokinetics of cefazolin and chloramphenicol in protein-energy malnuirition

The antibacterial levels of cefazolin and chloramphenicol-Chloramphenicol were assayed in the serum by a microbiological method using Sarcina lutea as the test organism. Twenty infants and children suffering from protein-energy malutrition [PEM] compared to normal controls of the same age and sex were the subject of this study. All children were studied on two separate occasions with a seven to ten days interval between the two studies. The bioavailabitity of chloramphenicol for parenteral route was found to be significantly higher in malnourishd infants and children compared to normal controls, while with cefazolin no variation from normal was noticed. Concomitant higher levels of chioram were assayed in the serum by a microbiological method using Sarcina lutea as the test organism