Effects of ipratropium bromide oxygen nebulization on pulmonary function of young children with asthma / 重庆医科大学学报

Objective:To investigate the effects of ipratropium bromide(Atrovent)on pulmonary function of young children with asthma.Methods:Type2600 Pediatric Pulmonary Function machine(Sensor Medics,USA)was used to determine the pulmonary function of 30 asthmatic children before and after Atrovent nebulization.Results:After nebulizing with Atrovent,of all the seven indexes there were obvious increase in ?V50,?V25,%T-PF,%V-PF,ME/MI as compared with those before( P

Immunologic Responses in Infants with Asthma and Bronchiolitis / 소아알레르기및호흡기학회지

PURPOSE: Respiratory syncytial virus (RSV) is the most common etiologic agent of acute bronchiolitis in infancy, and has been regarded as a possible cause of hyperreactive airway disease later in childhood. This study was performed to compare the immunologic responses between infantile asthma and bronchiolitis and to evaluate whether these immunologic responses can be useful markers to predict the development of subsequent wheezing. METHODS: We analyzed the serum concentrations of interleukin-4 (IL-4) and soluble intercellular adhesion molecule-1 (sICAM-1) from 29 infantile asthmatics, 13 infants with bronchiolitis, and 19 non-atopic controls. RSV infection was confirmed with indirect immunofluorescent staining and viral culture. RESULTS: Serum concentrations of IL-4 and sICAM-1 were significantly higher in infants with asthma compared with infants with those of controls. Peripheral blood eosinophils were significantly decreased in RSV positive bronchiolitis, but there were no differences in the serum concentrations of IL-4 and sICAM-1 between the infants with and without RSV infection. Serum concentrations of IL-4 and sICAM-1 in the first wheezing episode were higher in infants with persistent wheezing than those without. CONCLUSION: There are significant differences in immunologic responses between infantile asthma and bronchiolitis, and the serum IL-4 and sICAM-1 levels in the first wheezing episode may be used as a marker to predict the development of subsequent wheezing.

Prevalence of gastroesophageal reflux in infants with recurrent wheezing / 천식및알레르기

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.

A Clinical Study on Infantile Asthma / 소아알레르기및호흡기학회지

PURPOSE: Early diagnosis and treatment of infantile asthma is very important because early treatment might influence the long term outcome. Tabachnik and Levison proposed in 1981 that "any infant with three or more episodes of wheezing should be considered as having asthma, regardless of the age of onset, evidence of atopy, apparent precipitating cause of wheeze." So we conducted clinical study in infants (less than 2 yr of age) with three or more episodes of wheezing. Method : 69 infants less than 2 yr of age with three or more episodes of wheezing admitted to the Department of Pediatrics, Keimyung University, Dongsan Medical Center from January, 1993 to December, 1994 were investigated for their chief complaint, allergic history, physical examination, serum IgE, MAST(multiple antigen simultaneous test), severity of asthma, response to bronchodilator and outcome after 3 yrs. RESULTS: The male to female ratio was 3.6:1. In age distribution, 60.8% of infants with asthma was less than 12 month. The Serum level of total eosinophil count and total IgE was mostly within normal limit, and only 5 of 30 cases performed MAST were positive. In chest radiologic finding, hyperinflation was most common(65.2%) and increased bronchovascular marking, pneumonia in orders. In the severity of asthmatic attack according to age on diagnosis, infants with asthma less than 12 month of age showed more severe than over than 13 month of age. In the responsiveness to bronchodilator therapy, infants with asthma less than 12 month of age showed poorer response than over than 13 month of age. In the outcome of 69 infantile asthma after 3 yrs, the patients of infantile asthma with atopy showed poorer prognosis than without atopy. CONCLUSIONS: In the diagnosis of infantile asthma, three or more episodes of wheezing and/or allergic history was more important than laboratory and allergic test. Because infants with asthma less than 12 month of age showed more severe asthmatic attack and poorer response to bronchodilator therapy than over than 13 month of age, it is very important to apply nebulized corticosteroid to them earlier. In the outcome of 69 infantile asthma after 3 yrs, the patients of infantile asthma with atopy showed poorer prognosis than without atopy.

A Long Term Follow-up Study of Prognostic Factors in Infantile Asthma (Report I) / 소아알레르기및호흡기학회지

PURPOSE: Asthma has been known as a chronic inflammatory disease to cause airway obstruction by allergens, viral infections and other factors. Nowdays infantile asthma is increasing markedly. However, to date the enough study for predicting its long term prognosis was not performed. This study aimed to estimate the long term prognosis of infantile asthma. METHODS: In pediatric allergy clinic of Hanyang University Hospital, 84 asmatics younger than 24 months of age were included from January 1986 to December 1992, who had no abnormality in the airway. Infantile asthma was diagnosed on the basis of chronic cough, episodic wheezing more than three times and reversibility of clinical symptoms by using inhaled bronchodilators. Forty four asthmatics could have been followed and divided into two groups, symptomatic and resolved by analyzinng their medical records and performing follow- up examination with blood and skin prick tests to common allergens. RESULTS: 1) The two study groups included resolved 28 children (63.6%) and symptomatic 16 children (36.4%) with the ratio of male 3.9 to female 1. 2) There were no significant differences the age of first wheezing episode (9.6+/-5.6 mo. vs. 9.9+/-3.5 mo.) as well as diagnosis (14.3+/-5.7 mo. vs. 16.2+/-5.1 mo.) between two study groups, respectively (P>0.05). 3) For history of atopic dermatitis, there was significant difference between the resolved group 6 of 28 children and the symptomatic group 12 of 16 (P<0.05). 4) For laboratory examination, no significant difference was observed, between the levels of PB eosinophil count (310.4+/-282.2/mm3 vs. 368.1+/-465.9/mm3 at diagnosis; 294.3+/-205.3/mm3 vs. 457.7+/-511.2/mm3 at follow-up) and serum IgE (107.2+/-126.5 IU/ml vs. 157.6+/-246.3IU/ml at diagnosis; 267.3+/-700.5IU/ml vs. 442.6+/-546.0IU/ml at follow-up). 5) The frequency of asthmatic attack per year was 3.3+/-1.6 vs. 3.7+/-1.7; the duration of clinical symptom was 2.6+/-1.4 vs. 5.7+/-2.0 years, respectively. 6) The results of skin prick test showed that more frequent positivity to common inhalants in symptomatic group than in resolved was observed. CONCLUSIONS: In the long term follow-up for infantile asthma, the resolved 28 of 44 asthmatics were observed. The positive history of atopic dermatitis might be one of the important predictors for their persistent clinical symptoms.

A clinical study of chronic cough in infancy

Clinical studies were made on 50 cases of chronic cough infants who were admitted to the department of Pediatrics of Kangnam St. Mary' s hospital from January, 1990 to July, 1991. The results were as follows; 1) The age distribution was from 3 months to 24 months old, and the most prevalent age group was 13~18months old. The male to female was 2.1:1. 2) The etiologic classification of the 50 cases were infantile asthma in 23 cases(46%), viral lower respiratory infection in 13 cases(26%), and infantile asthma associated with sinusitis in 5 cases(10%). 3) Cough was the most common clinical manifestation in all cases and followed by rhinorrhea, dyspnea, fever, and nasal stuffiness. Among physical findings, wheezing rales, and chest retraction were noted. 4) The duration of cough was 5 to 8 weeks in 26 cases(52%), 2 to weeks in 19 cases(38%), and above 9 weeks in 5 cases(10%). 5) 13 of 50 cases had a past allergic history and 8 of 50 cases had a family history of allergy. 6) In 50 cases, formula feeding was done in 28 cases(56%), breast feeing in 13 cases(26%), and mixed feeding in 9 cases(18%). 7) Eosinophilia was noted in 39.3% of infantile asthma and total IgE level above 100IUm/ml was noted in 60.7% of infantile asthma and in 18.2% of other diseases. 8) RAST results of infantile asthma showed that the positivity was 21.4% in house dust, 32.1% in Dermatophagoides pteronyssinus, 28.6% in Dermatophagoides farinae, 28.6% in egg white, 35.7% in milk. The ratio of positive RAST results were higher in infantile asthma than in other diseases. 9) Abnormal findings, including overinflation, infiltration, increased bronchovascular marking, and atelectasis, were noted in 42 cases(84%) on chest X-ray. In 7 cases, total opacification was noted on Waters' and Caldwell's view. In conclusion, chronic cough in infancy is best managed by determining the precise cause of the cough, then specificially treating the underlying disorder.

Infantile asthma anf egg allergy

No abstract available.

A clinical study of the effect of early (<12 months) versus late (12-24 months) onset in infantile asthma

No abstract available.