The Effects of Particulate Matter on Respiratory Function of Schoolchildren in Jeju: A Panel Study / 대한산업의학회지

OBJECTIVE: To evaluate the changes in respiratory function associated with daily changes in particulate pollution. METHODS: A total of 105 healthy schoolchildren of fourth and fifth grade elementary school age performed peak expiratory flow rates (PEFR) during 2 periods (May 14~June 15, Oct 22~Nov 23). We monitored concomitant ambient particulate matter (PM) levels during the periods. RESULTS: An elevation PM(10) level of 1 microgram/m) led to decreases in PEFR of 0.20 L/min. A 1 microgram/m3 elevation of PM(2.5) led to a decrease of 0.36 L/min in PEFR. In addition, 1 day lag was associated with PM(10) levels and PEFR changes, and PM(2.5) showed the same result. The metal levels determined at PM(10) and PM(2.5) were found to be associated with decreased respiratory function. CONCLUSIONS: An association between respiratory function and particulate pollution was observed when particulate pollutant levels were lower than the yearly average National Ambient Air Quality Standard in the Korea(50 microgram/m3).

The Prognosis of Focal Segmental Glomerulosclerosis Patients with Methylprednisolone Pulse Therapy Alone

PURPOSE: Since the first report by Mendoza in 1990, there have been several studies reporting that long-term intravenous methylprednisolone(MP) pulse therapy combined with cyclosporin A(CsA) or cyclophosphamide might be beneficial for the treatment of steroid resistant focal segmental glomerulosclerosis(FSGS). We investigated the therapeutic effect of long-term MP pulse therapy without CsA or cyclophosphamide on steroid resistant FSGS. METHODS: The medical records of the 10 steroid resistant FSGS patients who were treated with MP pulse therapy by the Mendoza protocol without CsA or cyclophosphamide in our hospital were retrospectively reviewed. RESULTS: The median age at onset was 2.6 years(range 1.1-10.6 years) and the median age at the initiation of therapy was 5.7 years(range 1.8-20 years). The median duration of follow-up was 35 months(range 4-132 months). At the end of therapy, 5 patients achieved complete remission(50%) and 2 partial remission(20%), one of whom relapsed after the therapy. Three patients did not respond to the therapy, two of whom progressed to end-stage renal failure during the therapy eventually requiring kidney transplantation. CONCLUSION: Intravenous long-term MP pulse therapy without CsA or cyclophosphamide by the Mendoza protocol may be effective in a subset of patients with steroid-resistant FSGS.

Outcome and Prognosis in Critically Ill Children Receiving Continuous Renal Replacement Therapy

PURPOSE: Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. METHODS: We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days- 16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). RESULTS: Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT. Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation(9.8+/-5.3 vs. 26.7+/-7.6, P<0.0001), (2) maximum pressor number (2.1+/-1.2 vs. 3.0+/-1.0, P=0.038), and (3) the degree of fluid overload(5.2+/-6.0 vs. 15.0+/-8.9, P=0.002) were significantly lower in survivors than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. CONCLUSION: CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure.

Prevalence of Allergic Diseases among Primary School Children in Ilsan, Gyeonggi and Changes of Symptoms After Environmental Control in 2005 / 소아알레르기및호흡기학회지

PURPOSE:The purpose of this study was to determine the prevalence of asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis among primary school pupils in Ilsan, Gyeonggi province. We also investigated change of symptoms after environmental control. METHODS:In April 2005, a cross-sectional study was performed among 2,745 1st to 6th graders of 3 primary schools in Ilsan, Gyeonggi province. International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaires and additional questionnaires about environmental changes were distributed to their parents. RESULTS:Data were collected from 2,535 children (1,279 boys and 1,256 girls). The most common allergic symptom was rhinorrhea (43.0%), and atopic skin lesions, ocular lesions and wheezing were 24.5%, 19.7% and 18.2%, respectively. There was no significant relationship between allergic diseases and environmental status. One thousand four hundred nineteen children moved to a new place or had new interior decorations within the last 2 years. Of these children, 352 (24.8%) had allergic symptoms (OR=2.76, CI= 1.96-3.41, P=0.001). Interestingly, we found that children who had moved into apartments experienced more symptom changes than those who had not (P=0.022). CONCLUSION:The results of this study demonstrated that the prevalence of allergic conditions in primary school children in Ilsan, Gyeonggi province in 2005 was higher than those of nation-wide studies in 2000. We found the results of our study is similar to those of Seoul in 2005. We found a significant relationship between environmental status and changes of symptoms in primary school children in Ilsan, Gyeonggi province.

Prevalence of Allergic Diseases among Primary School Children in Ilsan, Gyeonggi and Changes of Symptoms After Environmental Control in 2005 / 소아알레르기및호흡기학회지

PURPOSE:The purpose of this study was to determine the prevalence of asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis among primary school pupils in Ilsan, Gyeonggi province. We also investigated change of symptoms after environmental control. METHODS:In April 2005, a cross-sectional study was performed among 2,745 1st to 6th graders of 3 primary schools in Ilsan, Gyeonggi province. International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaires and additional questionnaires about environmental changes were distributed to their parents. RESULTS:Data were collected from 2,535 children (1,279 boys and 1,256 girls). The most common allergic symptom was rhinorrhea (43.0%), and atopic skin lesions, ocular lesions and wheezing were 24.5%, 19.7% and 18.2%, respectively. There was no significant relationship between allergic diseases and environmental status. One thousand four hundred nineteen children moved to a new place or had new interior decorations within the last 2 years. Of these children, 352 (24.8%) had allergic symptoms (OR=2.76, CI= 1.96-3.41, P=0.001). Interestingly, we found that children who had moved into apartments experienced more symptom changes than those who had not (P=0.022). CONCLUSION:The results of this study demonstrated that the prevalence of allergic conditions in primary school children in Ilsan, Gyeonggi province in 2005 was higher than those of nation-wide studies in 2000. We found the results of our study is similar to those of Seoul in 2005. We found a significant relationship between environmental status and changes of symptoms in primary school children in Ilsan, Gyeonggi province.