Role of Fractional Exhaled Nitric Oxide in Predicting Development of Allergic Rhinits in Children with Bronchial Asthma / 소아알레르기및호흡기학회지

PURPOSE: Fractional exhaled nitric oxide (FeNO) has been widely reported as a marker for airway inflammationin, and FeNO have shown increased levels in the non-asthmatic patients with other atopy related diseases, such as rhinitis. Bronchial hyperresponsiveness is a characteristic feature of asthma, which is often associated with airway inflammationin allergic rhinitis. It has been suggested that asthma is associated with rhinitis, which is a link between the upper and the lower airways, beyond allergy associated inflammation in the respiratory tract. To evaluate the usefulness of FeNO measurement, as a risk factor of allergic and nonallergic rhinitis in children with asthma. METHODS: Fifty-three children included in this study were diagnosed as asthma from April through August 2005 in the Department of Pediatrics, Kyung Hee University School of Medicine. They conducted FeNO monitoring, total eosinophil count and serum immunoglobulin E at that time. We put a question to the participants' parents about the doctor diagnosed participants' manifestations (sneezing, nasal congestion, nasal itching, rhinorrhea), via a telephone interview survey or at the outpatient department in July 2011. Statistical analyses were performed using IBM SPSS ver. 18.0. RESULTS: The overall prevalence of rhinitis, among the 53 children, was 67.9%. The means of FeNO differed significantly between the two groups, being higher in children who have rhinitis symptoms and lower in asymptomatic children. (mean+/-SD, 29.4+/-24.6 to 13.6+/-11.8 parts per billion; P=0.003; T-test) CONCLUSION: To take the measurement of FeNO value in asthmatics may be a tool in the predictor of the causes of rhinitis.

Treatment of Infected Total Hip Arthroplasty

Deep infection after total hip arthroplasty is one of the most serious post operative complications. Treatment of infection of the hip joint can be made very difficult by poor response to antibiotic therapy. Infection rates of total hip arthroplasty have decreased due to prophylactic antibiotics, sterilization of surgical instruments, cleaner operation environments, Improvement of surgical methods and proper patient selection. Recently, post operative infection rates of primary or revision arthroplasties were reported to still be as high as 1% to 2%. Therefore, the aim of this article is to review the recent literature and to evaluate the cause, environment diagnosis and treatment of infection after total hip arthroplasty.

Relationship between exhaled nitric oxide and pulmonary function test in children with asthma / 소아과

PURPOSE: Asthma is characterized by reversible airway obstruction and bronchial hyperresponsiveness result from airway inflammation. Fraction of nitric oxide in expired air (FeNO) has recently been investigated as a noninvasive measure of airway inflammation. FeNO has been reported to correlate with induced sputum eosinophilia and methacholine challenge test that it is represent severity of asthma. The purpose of this study was to analyze the relationship of FeNO with pulmonary function tests in patients with intermittent asthma. METHODS: Eighty children included in this study were diagnosed as asthma from April through August, 2005 in Department of Pediatrics, College of Medicine, Kyunghee University. They aged from 4 to 15 years who were able to conduct spirometry and FeNO monitoring. They did not have upper respiratory tract infection and did not use an asthma controller which contain corticosteroids within 4 weeks. Pulmonary function test was done and FeNO was measured with online tidal breathing method using a chemiluminescence NO analyzer (CLD 88 sp, Eco Medics, Duernten, Switzerland). The correlations between pulmonary function test and FeNO were analyzed using Spearman correlation coefficient method. RESULTS: The mean of FeNO of subject was 16.88 parts per billion (ppb). The mean of forced expiratory volume in 1 second (FEV1) was 0.890+/-0.455 L and forced vital capacity (FVC) was 1.071+/-0.630 L. The mean of predicted FEV1% (FEV1%pred) was 98.39+/-34.27% and FEV1/FVC was 88.53+/-19.49. FeNO was significantly correlate with FEV1 (r=0.345, P<0.01) and FVC (r=0.244, P<0.05). FeNO did not correlate with FEV1%pred or FEV1/FVC. CONCLUSION: The measurement of FeNO could be a useful marker in the management of childhood asthma and it is evolving to provide a complementary role alongside existing pulmonary function test. We propose that measuring technique and establishment of normal reference range are important area for future research.

The Clinical Results of Autologous Osteochondral Grafts in Osteochondral Lesion of the Talus / 대한족부족관절학회지

PURPOSE: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. MATERIALS AND METHODS: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. RESULTS: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. CONCLUSION: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.

A Case of Multiple Cardiac Myxomas Complicating Recurrent Right Hemiparesis in a Child who had a Wrong Diagnosis of Acute Disseminated Encephalomyelitis

Multiple cardiac myxomas are rare in children. However, myxomas may be lethal because of their various manifestations such as blood flow obstruction, embolization and constitutional changes. Especially, the cerebral infarction due to tumor fragmentation are more likely to be misdiagnosed of acute disseminated encephalomyelitis. We report a case of multiple cardiac myxoma complicating recurrent right hemiparesis in a 12-year-old child who at first had a wrong diagnosis of acute disseminated encephalomyelitis (ADEM). Consequently, a child who show unrepresentative symptom of ADEM, should be examined rapidly by various tools to rule out the cerebral infarction from cardiogenic cause.

Risk Factors of Cardiovascular Disease in Korean Exceptional Longevity

BACKGROUND: It has been shown that subjects with exceptional longevity and their offsprings have a lower incidence and delayed onset of age-related diseases. Cardiovascular protective effect through over-presentation of Apo E2 with lower LDL cholesterol level, high HDL cholesterol, and larger size of HDL and LDL particle with cholesteryl ester transfer protein(CETP) genetic variation were suggested as a mechanism of less cardiovascular disease in exceptional longevity. Objective of this study is to examine what risk factors of cardiovascular diseases were related with exceptional longevity in Korea. METHODS: One hundred seventeen centenarians, 179 nonagenarians, 61 octogenarian regional controls were visited and joined after informed written consent was obtained. Age was first identified by National Residence Registry with help of regional government and verified by visiting researchers with birth year animal, age of first child and neighbor's connection memory. Detailed interview with questionnaires about health status and life style, physical examination, physical and cognitive function, and blood tests were performed. Data about risk factors of cardiovascular disease was analyzed and compared exceptional longevity group with regional control group and 455 octogenarian control data from 2001 National Health and Nutrition Examination. RESULTS: Hypertension and diabetes history, hypercholesterolemia and hypertriglyceridemia, obesity and abdominal obesity, and physical inactivity ratio of longevity groups were significantly less than control group. Level of homocysteine, and C-reactive protein and low serum HDL cholesterol ratio were not much different between longevity and control group. CONCLUSION: Fewer risk factors and delayed onset of cardiovascular disease were observed in Korean exceptional longevity group. Future research about genetic protective effect of cardiovascular disease in longevity is required.