A Survey of Awareness and Application of the Guideline for Diagnosis and Management of Childhood Asthma / 소아알레르기및호흡기학회지

PURPOSE: This survey was intended to investigate the awareness and application of the asthma guideline among pediatricians. Insight into the feasibility in the guidelines can guide implementation strategies in the future and, if necessary, support the revision of the previous guideline. METHODS: This self-administered survey study was conducted with the data on 10 items of questionnaire about knowledge and implementation of Korean childhood asthma guideline. The data was analyzed using SPSS WINDOW 8.0. RESULTS: A total of 141 doctors out of 500 participants in the pediatric refresh course responded the questionnaire. Ninety-five percent of the responders were aware of guideline, but differences were found between the asthma management policies in the guideline and their habitual practice patterns. As far as the prescription of inhaled corticosteroid, approximately half of the responders followed the guideline. For peak flowmeter use, 57% of the responders never prescribed peak flowmeter and only 5% of the responders used peak flowmeter frequently. The barriers pediatricians face when applying the guideline in the practice were habitual management pattern, time limitation, low compliance, lack of knowledge and economic burden. CONCLUSION: The guideline for diagnosis and management of childhood asthma seemed to be recognized widely, however, the role of the guideline to change pediatricians habitual practice was limited. These data clearly indicate a need for further educational programs directed to both physicians and patients. Finally the development of more practical evidence- based guideline is needed

Epidemiologic and Clinical Features of Pertussis in Children (2000.3-2001.3)

PURPOSE: Pertussis is a highly communicable infectious disease in children with high mortality, especially in young infants. The incidence of pertussis in South Korea has decreased to about 10 cases a year in late '90s. Doubting previously reported incidences of pertussis, we designed this study to establish exact epidemiology and a diagnostic basis of pertussis. METHODS: From Mar. 2000 to Mar. 2001, polymerase chain reaction(PCR) and cultures of nasopharyngeal aspirates were taken from 49 patients who were clinically suspected of pertussis in Kangdong Sacred Heart Hospital. RESULTS:Among 49 patients suspected of pertussis, 10 cases showed positive results by PCR method. Four out of those 10 cases were positive in culture. The peak outbreak was noticed in the spring(Mar.-May) and the autumn(Sep.-Nov.). The mean age of the patients was 3.6 months. Eight of the 10 cases which were PCR positive results proved not to be immunized against pertussis. CONCLUSION: Most of the pertussis patients in our study were diagnosed as bronchiolitis, pneumonia or bronchitis at the beginning of the disease and only a few patients showed typical clinical manifestations of pertussis, including whooping. When the above results are taken together, we suggest the possibility that the actual prevalence of pertussis in South Korea might be higher than that of previous reports. The importance of pertussis screen tests should be emphasized in children with severe coughs.

A Case of Persistent Kawasaki Disease Improved with Pulsed Doses of Methylprednisolone / 소아알레르기및호흡기학회지

Kawasaki disease is an acute vasculitis of unknown causes that occurs predominantly in infants and young children and produces coronary artery aneurysm. We have recently experienced a case of persistent Kawasaki disease in a 24 month-old-girl improved with pulsed doses of methylprednisolone. Even with an administration of intravenous gamma globulin(IVIG), she repeated the course of recovery and aggravation. After four times repeated doses of IVIG, additional intravenous methylprednisolone pulse therapy was tried and resulted in remarkable improvement. We reported the case with a brief review of the related literature.

peripheral Blood T Lymphocytes in parients with psoriasis / 대한피부과학회지

Recent immunological investigations have demonstrated that the patients with psoriasis have various humoral and cellular immune abnormalities, such as increased serum IgG, IgE and secretory IgA, anti-IgC factor in psoriatic lesions, in peripheral blood lymphocytes and in serum, rhumatoid-like factors in IgA and IgG classes of immunoglobulins, antinuclear antibodies (ANA; reacting with the basal cell nuclei of uninvolved skin., anti-stratum corneum antibody and complements in psoriatic scales, immuoglobulin and complement bearing polymorphonuclear leucocytes in the Muro microabscess. These abnormal findings are enough to suggest an autoimmune mechanism in the pathogenesis of psoriasis. Several investigators have also reported the results of T cell enumeration in the peripheral blood in psoriatic patients. However, the results are not in general agreement,. Thee present study was undertaken to clarify any abnormality in the proportion of T cells in the peripheral blood in psoriatic patients. Forty-one patients with active psoriasis registered at the Department of Dermatology, Seoul National University Hospital entered this study from May, 1979 through April, 1980. Twelve healthy medical and paramedical personel the comprised the control group. Active and total T cells were enumerated by the method of E-rosetting technique, and the results were as follows. 1, in normal controls, the active and total T celIs identified as E rosetteforming cells accounted for 61.6+7.4% and 68.1+8.9% of the total lymphocyte population, respectively. 2. In patients with psoriasis, significant decrease of active T cells (54. 2,+11.0%,p<0.005) and total T cells (62.2+11.2%, p<0.05) was observed. More profound reduction of T cells was noted in patients with wide spread psoriasis than those with limited extent.