Multicenter Study on Factors Influencing the Quality of Life of Asthmatic Children and Their Caregivers / 소아알레르기및호흡기학회지

PURPOSE: Pediatric asthma is the most common chronic disease in children. It negatively affects the health-related quality of life (QoL) in children with this disease and of their caregivers. This study evaluated the relationship between clinical disease severity and the QoL of patients with asthma and their caregivers. METHODS: The study included 247 patients with asthma and their caregivers. The patients and caregivers completed the Korean Pediatric Asthma Quality of Life Questionnaire and the Korean Pediatric Asthma Caregivers Quality of Life Questionnaire, respectively, during clinic visits. The results were expressed as the mean score for each domain. All items were rated from 1 to 5: 1, low QoL; and 5, satisfactory QoL. RESULTS: The emotion and activity QoL scores of boys were significantly higher than those of girls (P=0.001). The QoL of both patients and their caregivers was correlated more with the patients' subjective symptom scores than with the clinical severity of asthma or with lung function. CONCLUSION: The QoL of patients with asthma and their caregivers decreased as asthmatic symptoms became worse. Controlling asthma symptoms is important for improving the QoL of both patients and their caregivers. Patients and their caregivers need to be evaluated and counseled during asthma treatment to improve their QoL.

Comparison of Interferon-gamma Assays with the Tuberculin Skin Test in Children / 소아알레르기및호흡기학회지

PURPOSE: In vitro interferon-gamma assays have emerged as alternatives to the tuberculin skin test for the diagnosis of latent tuberculosis infection. These assays have been performed on adults, especially in foreign countries. The aim of this study was to investigate the usefulness of interferon-gamma assays in children. METHODS: Between July 2007 and May 2009, we recruited 82 children with suspected latent tuberculosis infections. We performed chest radiography, the tuberculin skin test (2 TU) and the QuantiFERON-TB Gold assay. The volunteers who were positive for the QuantiFERON-TB Gold assay treated for 6 months with isoniazid. After treatment, the QuantiFERON-TB Gold assay was repeatedly performed. RESULTS: Of the 82 participants, 27 had positive QuantiFERON-TB Gold assay results. For the tuberculin skin test, 26 participants were positive at a 10-mm cutoff. With a cutoff point of 15 mm, 14 participants had positive tuberculin skin test results. Data on agreement between the tuberculin skin test and the QuantiFERON-TB Gold assay were available for all children. With a cutoff point of 10 mm, agreement was 86.8%, whereas with a cutoff point of 15 mm, it was 74.4%. The QuantiFERON-TB Gold assay was repeatedly performed on 7 participants, 3 of whom had persistently positive QuantiFERON-TB Gold assay results. CONCLUSION: In our study, it is suggested that the QuantiFERON-TB Gold assay may have good agreement with the tuberculin skin test. Further studies with a larger sample size are needed to evaluate a definitive relationship between the QuantiFERON-TB Gold assay and the tuberculin skin test in children

Association of Vitamin D Status with Acute Lower Respiratory Infection in Children / 소아알레르기및호흡기학회지

PURPOSE: Acute lower respiratory tract infection (ALRI) is a common disease in children. Micronutrient deficiencies may increase the risk of ALRI. The aim of this study is to determine the association of vitamin D status with susceptibility to ALRI by comparing serum 25 hydroxy-vitamin D [25(OH)D] levels between a group of young children under 5 years of age with ALRI and healthy children. METHODS: Serum 25(OH)D concentrations were measured in patients under 5 years of age admitted to hospital with a diagnosis of pneumonia (n=40) or bronchiolitis (n=34) from October 2009 to December 2009 as well as in healthy patients of similar age without respiratory symptoms (n=54). Serum 25(OH)D concentrations were measured by electrochemileuminescence immunoassay. RESULTS: The mean serum 25(OH)D level were similar between the ALRI and control groups (28.4+/-9.0 versus 29.1+/-7.1 ng/mL). There was no significant difference in the prevalence of 25(OH)D insufficiency between the 2 groups at 2 thresholds (for <15 ng/mL, 8.1 vs. 5.6%; P=0.19, and for <30 ng/mL, 59.5 vs. 64.8%; P=0.75). CONCLUSION: In our study, no difference was observed in vitamin D levels between the ALRI and control groups. Therefore, Vitamin D status may not be associated with the risk of hospitalization for ALRI in children.

Short-term Effect of Partially Hydrolyzed Formula on the Prevention of Development of Atopic Dermatitis in Infants at High Risk

This short-term, prospective study was aimed to assess the effects of partially hydrolyzed formula (PHF) on the prevention of the development of atopic dermatitis in infants at high risk. The infants of parents with allergy symptoms and serum total IgE over 200 kU/L were divided into 3 groups by their feeding patterns: PHF group (n=15), standard formula (SF) group (n=32), and breast milk (BM) group (n=22). No allergenic food was given during the study period of 6 months, and breastfeeding mothers avoided egg ingestion. Their atopic symptoms were monitored every 2 months. The cumulative incidence and prevalence of atopic dermatitis at the age of 6 months were significantly less in the PHF group than in the SF group (47% vs.78%, p<0.05; 20% vs. 59%, p<0.05). Those rates of the PHF group were also less than those of the BM group, but they were not statistically significant. There was no difference in the onset age and disease severity. These results suggest that early feeding of PHF to infants at high risk has a short-term preventive effect on the development of atopic dermatitis during the first 6 months of life. Long-term preventive effects should be evaluated.

Gene Expression Profiling of Human Salivary Gland Carcinogenesis with cDNA Microarray

No abstract available.

A Case of Behcet's Colitis in Children / 대한소화기내시경학회지

Behcet's disease consists of a triad of relapsing inflammatory disease of the eye (iridocyclitis) with painful and recurrent oral and genital ulcerations. Arthritis, thrombophlebitis, neurologic abnormalities, fever, and colitis are associated clinical manifestations. The disease affects predominantly young adults and is very rare in children, especially those under 10 years of age. The proportion of Behcet's colitis in Behcet's disease is about 12%. Ulcerations are localized or diffuse, with the majority occuring in the ileocecal region. Extension to the serosal surface may result in perforation. The frequent complaints are abdominal pain, nausea, vomiting, diarrhea, hematochezia, loss of appetite, loss of weight gain, distention and palpable abdominal mass. The disease is complicated by intestinal obstruction, perforation, fistula formation, abscess formation and hemorrhage. We experienced a case of Behcet's colitis in a 9-year-old boy showing symptoms of abdominal pain, tenderness, and diarrhea. Thus, we report a case of Behcet's colitis with brief review of related literatures.

A Case of Septic Pulmonary Embolism in Neonate

Septic pulmonary embolization is an uncommon condition in which the clot or fibrin matrix, contaminated with micro-organisms, lodge in the pulmonary arterial tree, leading to infarction, suppuration and other complications. The septic emboli reach the lung from a variety of sources, including acute suppurative pelvic thrombophlebitis, infective endocarditis involving tricuspid and pulmonary valve, osteomyelitis, suppurative lesions of the neck, infected venous catheters or pacemaker wires and sepsis. Early clinical detection, along with prompt administration of broad- spectrum antibiotics, is an important factor in the prognosis of patients, but the initial clinical diagnosis is often difficult because of nonspecific findings in clinical and laboratory data. Recently, the characteristic appearance of septic emboli by chest computed tomography (CT) has been described, and chest CT is an important modality for confirming the presence of septic pulmonary emboli. We experienced a case of septic pulmonary embolism in a 14-day-old neonate with cough, fever dyspnea. Initial conventional chest radiogaphs revealed bilateral infilterate, but chest CT revealed the presence of multiple peripheral nodules, cavitation of nodules and a distinct vessel leading to a pulmonary nodule which is referred to as a feeding vessel sign, which diagnosis suggests. Coagulase negative staphylococcus was cultured in the blood stream and clinical and radiologic improvement was achieved after adminstration of antibiotics.

Two Cases of Leigh Disease

Leigh Disease, or subacute necrotizing encephalopathy (SNE), is a degenerative disorder characterized by lesions of the gray and white matter in the bran and spinal cord. The pathogenesis was known as mitochondrial enzyme defect of the respiratory chain system. We experienced 2 cases of Leigh disease. The first case, a seven-month old girl who was presented with weak respiration and failure to thrive, showed lactic acidemia and increased lactic acid in CSF fluid, high signal intensity in the bilateral putamen and head of caudate of nucleus at T2 weighted MR imaging. The second case, a 3-year-old girl with ataxic gait and bilateral ptosis also showed lactic acidemia, increased lactic acid in CSF fluid and high signal intensity in the bilateral basal ganglia. Respiratory difficuly developed in both cases and died within 1 month after visiting our hospital. The diagnosis was made by lactic acidosis and specific MRI finding. We report these cases with a brief review of its related literature.

A Case of Intracranial Granulocytic Sarcoma Associated with Myelodysplastic Syndrome / 대한소아혈액종양학회지

Granulocytic sarcoma is an uncommon extramedullary localized tumor composed of granulocytic precursor cells. The majority of cases have been reported in association with acute myeloid leukemia(AML) especially in children, but infrequently may occur in patients with myeloproliferative disorders or myelodysplastic syndromes. Most common sites of involvement were bone, soft tissue, lymph nodes and skin, but gastrointestinal tract, testis, central nervous system are also involved rarely. We present an unusual case of granulocytic sarcoma of the intracranium and the retro-orbital soft tissue occurring in a patient with concurrent myelodysplastic syndrome, diagnosed by brain magnetic resonance images and ultrasound guided needle biopsy.