A nationwide study of children and adolescents with pneumonia who visited Emergency Department in South Korea in 2012 / 소아과

PURPOSE: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. METHODS: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ≤18 years who were diagnosed with pneumonia between January and December 2012. RESULTS: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). CONCLUSION: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.

A nationwide study of children and adolescents with pneumonia who visited Emergency Department in South Korea in 2012 / 소아과

PURPOSE: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. METHODS: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ≤18 years who were diagnosed with pneumonia between January and December 2012. RESULTS: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). CONCLUSION: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.

Seasonal Patterns of Asthma in Children and Adolescents Presenting at Emergency Departments in Korea

PURPOSE: Seasonal variations in asthma-related hospitalizations and emergency department visits have long been recognized. This study aimed to investigate the seasonal patterns of asthma in children and adolescents who presented at emergency departments in Korea. METHODS: We analyzed the National Emergency Department Information System records from 117 emergency departments in Korea that comprised all of the patients with asthma who were aged 3-18 years and who presented at the emergency departments from 2007 to 2012. The children and adolescents were divided into 3 groups based on their ages, namely, 3-6 years, 7-12 years, and 13-18 years. The data were tabulated, and graphs were created to show the seasonal trends in the monthly numbers of emergency department visits as a consequence of asthma. RESULTS: A total of 41,128 subjects were identified, and the male-to-female ratio was 1:0.5. General ward admissions comprised 42.6% (n=17,524 patients) of the emergency department visits, and intensive care unit admissions comprised 0.8% (n=335 patients) of the emergency department visits. The monthly numbers of emergency department visits for asthma varied according to the season, with high peaks during fall, which was from September to November, and low levels in summer, which was from June to August. CONCLUSIONS: Important differences in the seasonal patterns of emergency department visits for asthma were evident in children and adolescents. Identifying seasonal trends in asthma-related emergency department visits may help determine the causes and reduce the likelihood of asthma exacerbation.

Clinical characteristics of children and adolescents with croup and epiglottitis who visited 146 Emergency Departments in Korea / 소아과

PURPOSE: Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients. METHODS: The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged < or =18 years presenting with croup or epiglottitis. RESULTS: We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were 2.2+/-2.0 and 5.6+/-5.8 years, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05). CONCLUSION: Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

Clinical characteristics of patients with acute bronchiolitis who visited 146 Emergency Department in Korea in 2012

PURPOSE: This study was aimed to investigate the clinical and epidemiological characteristics of the patients with acute bronchiolitis who visited in 146 Emergency Departments (EDs) in Korea in 2012. METHODS: We used the NEDIS (National Emergency Department Information System) database to obtain all children with acute bronchiolitis who visited ED under the age of 3 between January 1, 2012 and December 31, 2012. RESULTS: Totally 18,313 children with acute bronchiolitis were enrolled at this study. The male to female ratio was 1.55:1 and mean age was 10 months. The peak proportion was 17.3% in November during the whole year. The most common chief complaints were fever (38.5%), cough (37.4%), dyspnea (9.5%), gastrointestinal symptom (6.7%), and wheezing (2.5%). The most common accompanying disease was pneumonia (13.3%). The rate of hospital admission and intensive care unit admission were 34.5% and 0.3%, respectively. A predictor for admission via ED was respiratory difficulty. CONCLUSION: These data expand our understanding of clinical characteristics of patients with acute bronchiolitis who visited all ED in Korea in 2012.

Clinical Features of Patients with Anaphylaxis at a Single Hospital / 소아알레르기및호흡기학회지

PURPOSE: The studies concerning the clinical features of patients with anaphylaxis, who meet the newly established diagnostic criteria, are reported in Korea, but comparative studies regarding the clinical features of children and adult patients with anaphylaxis are lacking. The purpose of this study is to compare the clinical features of the children and adults with anaphylaxis, who meet the new diagnostic criteria at a single hospital. METHODS: We reviewed the medical records of patients who were diagnosed with anaphylaxis, anaphylactic shock, urticaria, and angioedema, including inpatients, outpatients and emergency room visited patients, at the National Medical Center from July, 2005 to August, 2011. The clinical characteristics of children and adults, who met the new diagnostic criteria for anaphylaxis, were analyzed. RESULTS: We identified 91 patients with anaphylaxis. Sixteen were children and 75 were adults. The sex ratio (male:female) and the mean age were 1:1.7 and 9.6 years among children, respectively, and 1:2.3 and 42.3 years, respectively, among adults. The most common cause of anaphylaxis based on clinical history was foods in 15 children (93.7%) and 35 adults (46.7%). Twelve children (75%) and 36 adults (48%) were rediagnosed with anaphylaxis. Patients with cardiovascular symptoms and severe severity were 1 (6.3%) and 1 (6.3%), respectively, among children, and 28 (37.3%) and 23 (30.3%), respectively, among adults. CONCLUSION: We rediagnosed some cases of anaphylaxis, using the new diagnostic criteria and most of the cases were diagnosed initially as urticaria or angioedema. The adults had more severe and more cardiovascular symptoms than children. In the future, a nationwide, multiinstitutional research will be necessary for the prevalence and the clinical features of anaphylaxis by the new diagnostic criteria in Korea.

A Case of Hypersensitivity to Mosquito Bite Associated with Epstein-Barr Viral Infection and Natural Killer Cell Lymphocytosis

Hypersensitivity to mosquito bites (HMB) is a disorder characterized by a necrotic skin reaction and generalized symptoms subsequent to mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer cell leukemia/lymphoma. We describe here a Korean child who had HMB associated with chronic EBV infection and natural killer cell lymphocytosis. A 5-yr-old boy was suffered from necrotic skin lesions on the right ear lobe. Type A EB virus was detected from hlood cells and bone marrow biospy recognized hemophagocyrosis.

Clinical significance of codetection of the causative agents for acute respiratory tract infection in hospitalized children / 소아과

PURPOSE: To determine the prevalence and clinical features of codetected respiratory etiological agents for acute respiratory infection in hospitalized children. METHODS: Nasopharyngeal aspirates were obtained from hospitalized children with acute respiratory infection at Dankook University Hospital from September 2003 through June 2005. Immunofluorescent staining and culture were used for the detection of respiratory viruses (influenza virus [IFV] types A, B; parainfluenza virus [PIV] types 1, 2, 3; respiratory syncytial virus [RSV]; adenovirus [AdV]). Polymerase chain reaction (PCR) assays were used for Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT) detection, and PCR and culture were performed for enterovirus detection. Acid-fast staining and culture were performed for tuberculosis detection. The demographic and clinical characteristics were reviewed retrospectively from the patients medical records. RESULTS: Evidence of two or more microbes was found in 28 children: RSV was detected in 14, PIV 3 in 10, AdV in 10, MP in 8, PIV 2 in 8, CT in 4, and PIV 1 in 3. Codetected agents were found as follows: RSV+PIV 2, 6 patients; AdV+MP, 4 patients; AdV+PIV, 3 patients; RSV+MP, 3 patients; PIV 1+PIV 3, 3 patients. Distinct peaks of codetected agents were found in epidemics of MP and each respiratory virus. CONCLUSION: The codetected infectious agents were RSV, PIV, AdV, and MP, with distinct peaks found in epidemics of MP and each respiratory virus. Although advances in diagnostic methods have increased the prevalence of codetection, its clinical significance should be interpreted cautiously.

Quantitative Analysis of Egg Protein by ELISA in Distributed Influenza Vaccine in Korea / 소아알레르기및호흡기학회지

PURPOSE: Influenza infection is a major public health concern, especially in young children and in high risk groups such as asthma patients. Traditionally, influenza vaccines are produced from infertilized eggs. Therefore, patients with severe egg allergy can show adverse reactions after vaccination and be dalayed in active immunization. The aim of this study was to determine the ovalbumin concentration of a commercially available influenza vaccines in Korea. METHODS: The ovalbumin content in each vaccine was determined by enzyme linked immunosorbent assay. The ovalbumin content was compared among the different manufactures, the different lot numbers and the same lot numbers of vaccines. The microtiter plates coated with goat anti-chicken egg albumin antibody were inoculated with serial diluted vaccines and ovalbumin. After incubation with horse radish peroxidase-conjugate rabbit anti-ovalbumin, absorbance was read at 450 nm and fitted to the standard curve. RESULTS: The highest ovalbumin content was 101.24 ng/mL, and the lowest ovalbumin content was 21.23 ng/mL. The amount of ovalbumin differed not only among the different vaccines, but also different lot numbers of individual vaccines and even the same lot numbers of vaccines. CONCLUSION: In none of the vaccines tested in our study, ovalbumin content reached the maximum values for ovalbumin (1.2 microgram/mL). Therefore, in severe egg allergic patients, our results provide the useful information on influenza vaccination.

Quantitative Analysis of Egg Protein by ELISA in Distributed Influenza Vaccine in Korea / 소아알레르기및호흡기학회지

PURPOSE: Influenza infection is a major public health concern, especially in young children and in high risk groups such as asthma patients. Traditionally, influenza vaccines are produced from infertilized eggs. Therefore, patients with severe egg allergy can show adverse reactions after vaccination and be dalayed in active immunization. The aim of this study was to determine the ovalbumin concentration of a commercially available influenza vaccines in Korea. METHODS: The ovalbumin content in each vaccine was determined by enzyme linked immunosorbent assay. The ovalbumin content was compared among the different manufactures, the different lot numbers and the same lot numbers of vaccines. The microtiter plates coated with goat anti-chicken egg albumin antibody were inoculated with serial diluted vaccines and ovalbumin. After incubation with horse radish peroxidase-conjugate rabbit anti-ovalbumin, absorbance was read at 450 nm and fitted to the standard curve. RESULTS: The highest ovalbumin content was 101.24 ng/mL, and the lowest ovalbumin content was 21.23 ng/mL. The amount of ovalbumin differed not only among the different vaccines, but also different lot numbers of individual vaccines and even the same lot numbers of vaccines. CONCLUSION: In none of the vaccines tested in our study, ovalbumin content reached the maximum values for ovalbumin (1.2 microgram/mL). Therefore, in severe egg allergic patients, our results provide the useful information on influenza vaccination.

Molecular identification and clinical features of enteroviral infection in children of central Korea: An overview of enteroviral epidemiology between spring 2005 and autumn 2006 / 소아과

PURPOSE: Enteroviruses (EVs) are commonly known to cause infection, especially in infants and children. This report presents an overview of enterovirus epidemiology in central Korea. METHODS: From the spring of 2005 to the autumn of 2006, we collected the cerebrospinal fluid (CSF) and stool samples from the pediatric patients with a febrile illness or suspected meningitis who were admitted to hospitals in central Korea. In order to test for EVs, cell lines were derived from pretreated susceptible specimen, and the cytopathic effects were observed. Seminested real time-polymerase chain reaction (RT-PCR) and direct sequencing were performed for genotypic and phylogenetic analyses. RESULTS: Of the 305 patients examined, 51 (16.7%) tested positive for EV. Of these 51 patients, 44 showed the following serotypes: Echovirus (ECV) 18 (18 cases, 35.2%), Coxsackievirus B (CVB) 5 (13 cases, 25.4%), ECV25 (5 cases, 9.8%), ECV9 (4 cases, 7.8%), ECV5 (3 cases, 5.8%), and EV74 (1 case, 1.9%). In 2005, between June and August, ECV18 and CVB5 were mostly responsible for the enteroviral infections among the patients in central Korea. In 2006, between July and August, ECV25 was mostly the cause of enteroviral infection. Conclusions: There is a need for continuous surveillance of enteroviral infection and its clinical manifestations, particularly for EV74, which was first identified in Korea.

Molecular identification and clinical features of enteroviral infection in children of central Korea: An overview of enteroviral epidemiology between spring 2005 and autumn 2006 / 소아과

PURPOSE: Enteroviruses (EVs) are commonly known to cause infection, especially in infants and children. This report presents an overview of enterovirus epidemiology in central Korea. METHODS: From the spring of 2005 to the autumn of 2006, we collected the cerebrospinal fluid (CSF) and stool samples from the pediatric patients with a febrile illness or suspected meningitis who were admitted to hospitals in central Korea. In order to test for EVs, cell lines were derived from pretreated susceptible specimen, and the cytopathic effects were observed. Seminested real time-polymerase chain reaction (RT-PCR) and direct sequencing were performed for genotypic and phylogenetic analyses. RESULTS: Of the 305 patients examined, 51 (16.7%) tested positive for EV. Of these 51 patients, 44 showed the following serotypes: Echovirus (ECV) 18 (18 cases, 35.2%), Coxsackievirus B (CVB) 5 (13 cases, 25.4%), ECV25 (5 cases, 9.8%), ECV9 (4 cases, 7.8%), ECV5 (3 cases, 5.8%), and EV74 (1 case, 1.9%). In 2005, between June and August, ECV18 and CVB5 were mostly responsible for the enteroviral infections among the patients in central Korea. In 2006, between July and August, ECV25 was mostly the cause of enteroviral infection. Conclusions: There is a need for continuous surveillance of enteroviral infection and its clinical manifestations, particularly for EV74, which was first identified in Korea.

Two Cases of Pneumonia Alba in Congenital Syphilis / 소아알레르기및호흡기학회지

Congenital syphilis is a completely preventable disease, but it still occurs. It usually involves multiple organs, which may cause neurological or skeletal disabilities or death in the fetus or newborn. Although lung involvement is rare in congenital syphilis, we should consider pneumonia alba when respiratory symptoms or radiologic findings are abnormal. We first report herein two cases of pneumonia alba with high resolution computerized tomography (HRCT) findings.

Prevalence and Clinical Characteristics of Pertussis in Children, Cheonan, Korea / 소아감염

PURPOSE: A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. METHODS: We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. RESULTS: Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9+/-5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/mm3). There was a statistically significant relation between vaccine being received and development of complications (P=0.033). CONCLUSION: We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.

Chlamydia trachomatis respiratory infection in Korean young infants / 소아과

PURPOSE: Chlamydia trachomatis is one of the most common sexually transmitted diseases and is also a cause of pneumonia in infants. Respiratory infections by respiratory viruses are also common for infants. The objectives of this study were to identify the clinical manifestations and to determine the prevalence of C. trachomatis respiratory infections and coinfections by respiratory viruses in infants younger than 6 months of age. METHODS: For this study, we enrolled 6 months or younger infants who were admitted to the Dankook University Hospital between January 2002 and July 2007, with respiratory symptoms. Nasopharyngeal aspirates or throat swabs were collected within s d of hospitalization and C. trachomatis was detected using polymerase chain reaction (PCR). Patients who tested positive underwent multiplex PCR for respiratory viruses. RESULTS: A total of 690 patients underwent chlamydial PCR testing and 36 (5.2%) had positive results. Of the 36, 28 (78%) were male; 30 were vaginally delivered. From the 36 patients positive for C. trachomatis, 26 underwent multiplex respiratory viral PCR; 12 were coinfected with viruses. Respiratory syncytial virus (RSV) was the most frequent pathogen that was detected in 6 patients. Increased C-reactive protein and fever were significant in patients coinfected with respiratory viruses. CONCLUSION: C. trachomatis can infected in infants delivered by cesarean section as well as in 6 months old or younger infants. Infant with C. trachomatis respiratory infections can also be coinfected with respiratory infection also coinfected with respiratory viruses. Further studies are needed to better understand the prevalence rates of the this infection and its coinfection rate with respiratory viruses.

Clinical Features of Anaphylaxis in the Middle Area of South Korea / 소아알레르기및호흡기학회지

PURPOSE: Anaphylaxis is a medical emergency requiring immediate recognition and treatment. Despite the serious nature of these reactions, there is no universal agreement on the definition and there have been few epidemiologic studies of anaphylaxis in children. The purpose of the study is to investigate the causative agents, presenting signs and symptoms and course of disease in children suitable for established diagnostic criteria for anaphylaxis in the middle area of South Korea. METHODS: We identified potential episodes of anaphylaxis occuring between March 1994 and October 2007 from the university hospitals in the middle area of South Korea. We reviewed all patients' medical records diagnosed with anaphylaxis and other related diagnoses. From chart review, we retrospectively collected demographic and epidemiologic data. RESULTS: We identified 40 patients with anaphylaxis. Patients' ages ranged from 2 months to 17 years, with a mean age of 6.6 years. A causative agent was recognized in 84.5%. The inciting agent included foods in 26 cases (65%), medication in 7 cases (17.5%) and bee sting in 1 case (2.5%). Mucocutaneous manifestations were the most common, respiratory symptoms were in 35 patients, cardiovascular symptoms were in 8 patients, and gastrointestinal symptoms were in 5 patients. CONCLUSION: We found some cases of anaphylaxis which had misdiagnosed as urticaria or angioedema using the established diagnostic criteria. Therefore, clinicians must accurately know the criteria of anaphylaxis and make an effort to identify cases of anaphylaxis with a high suspicion. Also, we found the epidemiology, causative agents, and symptoms and treatments of anaphylaxis in the middle area of South Korea. Our data will be the basis for anaphylactic studies in South Korea.

A Case of Fixed Drug Eruption Caused by Acetaminophen in a Child / 소아알레르기및호흡기학회지

Fixed drug eruption (FDE) is an eruption, which recurs at the same site or sites on each administration of the causative drug, and heals with residual hyperpigmentation. FDE is caused by many drugs, barbiturates, tetracyclines, sulfonamide, and phenolphthalein. Salicylate and nonsteroidal anti-inflammatory drugs (NSAIDs) also cause FDE, but acetaminophen does so only rarely. A 9-year-old girl presented with a 3-year-history of symptomatic pigmented macules on her face, abdomen, and extremities. The eruption was first appeared three years ago, which was when she took medicine after she was discharged following suspicions of Kawasaki disease. Thereafter, she had the same eruption on the same sites when she took medicine for common colds including acetaminophen and ibuprofen. The oral challenge provocation test for ibuprofen was negative, whereas for acetaminophen it was positive. We report a rare case of FDE due to acetaminophen with clinical findings and results of oral challenge test.

A Useful Predictor of Early Atherosclerosis in Obese Children: Serum High-sensitivity C-reactive Protein

Childhood obesity seems to contribute to the development of vascular inflammation and the progression of arterial wall changes. High-sensitivity C-reactive protein (hs-CRP) has recently emerged as a useful biomarker for vascular inflammation associated with atherosclerosis. The objectives of this study were to evaluate the association of the serum hs-CRP level with ultrasonic findings of early atherosclerosis, carotid intima-media wall thickness (IMT) and brachial flow-mediated dilation (FMD), in obese children. Thirty eight obese children and 45 sex/age-matched healthy control children were recruited. Serum CRP levels were measured by the high-sensitive latex turbidimetric immunoassay, and we measured carotid IMT and brachial FMD using high-resolution B-mode ultrasonography. Obese children had significantly higher hs-CRP levels (1.40+/-0.74 mg/L vs. 0.55+/-0.49 mg/L, p<0.01), as well as increased IMT (0.52+/-0.09 mm vs. 0.41+/-0.07 mm, p<0.01) and impaired FMD (7.35+/-7.78% vs. 20.34+/-16.81%, p<0.01) compared to healthy controls. Serum hs-CRP correlated positively with IMT (r=0.413, p<0.05) and inversely with FMD (r=-0.350, p<0.05) in the obesity group. Measurement of the serum hs-CRP level is a simple, cheap, and highly reproducible assay and correlates with IMT and FMD in obese children. Thus, it would be a useful marker for evaluating and estimating the degree of atherosclerosis in children.

Change of early atherosclerotic markers in obese children / 소아과

PURPOSE: The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. METHODS: Thirty-eight obese children(14-16 years old of age, male, body mass index 29.40+/-3.18 kg/m2) and forty-five age and sex-matched healthy control children(body mass index 18.43+/-1.01 kg/ m2) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flow-mediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. RESULTS: The obese children had significantly increased IMT(0.52+/-0.09 mm vs 0.40+/-0.07 mm, P< 0.001) and markedly impaired FMD(7.35+/-7.78 percent vs 20.34+/-16.81 percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P< 0.001) and reduced FMD(r=-0.414, P<0.001). CONCLUSION: We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

Correlation of inhalant MAST on chronically coughing children / 소아과

PURPOSE: Recently, incidences of chronic cough with allergic disease have been increased. The identification of specific allergens for chronically coughing children is significant for diagnosis, proper treatment and prevention. The aim of this study was to identify significant contributors for sensitization in chronically coughing children. METHODS: A total of 106 children, aged 1-6 years, visiting for chronic cough(>3 weeks), were tested for inhalant multiple allergosorbent assay(MAST), eosinophil count and total IgE. Parents completed a questionnaire on past history of atopy(infantile eczema) and bronchiolitis, family history of allergy, breastfeeding, smoking, pets and floor coverings at home. RESULTS: Significant contributors for sensitization were:age(4-6 years), infantile eczema, positive family history of allergy and smoking by family. CONCLUSION: We were able to identify significant contributors for sensitization in chronically coughing children.