Serum Zinc Levels in Young Children with Recurrent Wheeze / 소아알레르기및호흡기학회지

PURPOSE: Zinc is a dietary antioxidant which is crucial for normal development and function of the immune system. Zinc supplementation is reported to reduce respiratory infections and prevent severe pneumonia in children. We examined serum zinc levels in young children who had recurrent wheezing and evaluated the clinical and laboratory findings in relation to serum zinc levels. METHODS: Seventy three patients admitted due to lower respiratory infections with wheezing were enrolled. All children had experienced more than 3 episodes of wheezing before admission. Serum zinc levels were measured by using inductively coupled plasma-optical emission spectrometry (ICP-OES), and serum zinc level of <64 microgram/dL was defined as zinc deficiency. Clinical and laboratory findings were evaluated and compared between the patients with zinc deficiency and those without it. Two age-matched control groups: normal controls (control 1) and patients with acute viral illnesses (control 2) were also studied. RESULTS: Zinc levels were significantly lower in the patient group than in the 2 control groups.(P<0.0001) Zinc deficiency was observed in 49.3% of the patient group, which was significantly higher than in controls.(P<0.0001) Peripheral blood CD4/CD8 was significantly lower in the patients with zinc deficiency than in the subjects with a normal value.(P=0.01) CONCLUSION: This study showed that the serum zinc level was significantly lower and that zinc deficiency was more frequently observed in the patients with recurrent early wheeze. Zinc deficiency was found to be associated with lower CD4/CD8. Our results suggest that zinc deficiency may be associated with frequent respiratory infections, a likely trigger for recurrent early wheeze.

Association Between Plasma Vascular Endothelial Growth Factor, Plasmin System Regulators and Recurrent Early Wheeze / 소아알레르기및호흡기학회지

PURPOSE:Vascular endothelial growth factor (VEGF) is known to play an important role in the process of angiogenesis and chronic inflammation. Plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (tPA) are main regulators of the plasmin system. The functions of these components are shown to be closely associated and recent studies have reported their potential roles in the asthmatic airways. We determined plasma levels of soluble VEGF (sVEGF), PAI-1, tPA and endothelin (ET)-1 in children with recurrent early wheeze. Our purpose was to examine whether there would be any difference in these biomarkers in relation to the relapse rate of wheezing. METHODS:Fifty-eight children aged 2-6 years who were admitted with acute wheezing were enrolled. They were divided into two groups: patients with more than three relapses of wheezing (group 1, n=34) and those with less than one relapse (group 2, n=24). Plasma levels of sVEGF, PAI-1, ET-1 and tPA on admission were measured using ELISA in the two patient groups and controls (n=16). RESULTS:PAI-1, sVEGF and tPA significantly increased during acute wheezing episode. The levels of these biomarkers were significantly higher in group 1 than in group 2 (P<0.01). ET-1 showed no significant difference between the patient groups and controls. CONCLUSION:Our study showed significantly elevated plasma levels of sVEGF and plasmin system regulators in children with recurrent early wheeze, which was even higher in the group with more frequent relapses. Our results suggest that these biomarkers may be associated with airway inflammation and may contribute to the later development of asthma in these children.

Association Between Plasma Vascular Endothelial Growth Factor, Plasmin System Regulators and Recurrent Early Wheeze / 소아알레르기및호흡기학회지

PURPOSE:Vascular endothelial growth factor (VEGF) is known to play an important role in the process of angiogenesis and chronic inflammation. Plasminogen activator inhibitor (PAI)-1 and tissue plasminogen activator (tPA) are main regulators of the plasmin system. The functions of these components are shown to be closely associated and recent studies have reported their potential roles in the asthmatic airways. We determined plasma levels of soluble VEGF (sVEGF), PAI-1, tPA and endothelin (ET)-1 in children with recurrent early wheeze. Our purpose was to examine whether there would be any difference in these biomarkers in relation to the relapse rate of wheezing. METHODS:Fifty-eight children aged 2-6 years who were admitted with acute wheezing were enrolled. They were divided into two groups: patients with more than three relapses of wheezing (group 1, n=34) and those with less than one relapse (group 2, n=24). Plasma levels of sVEGF, PAI-1, ET-1 and tPA on admission were measured using ELISA in the two patient groups and controls (n=16). RESULTS:PAI-1, sVEGF and tPA significantly increased during acute wheezing episode. The levels of these biomarkers were significantly higher in group 1 than in group 2 (P<0.01). ET-1 showed no significant difference between the patient groups and controls. CONCLUSION:Our study showed significantly elevated plasma levels of sVEGF and plasmin system regulators in children with recurrent early wheeze, which was even higher in the group with more frequent relapses. Our results suggest that these biomarkers may be associated with airway inflammation and may contribute to the later development of asthma in these children.

Language Development of Non-handicapped Low Birth Weight Infants

PURPOSE: The purpose of this study was to examine the developmental delay in non- handicapped low birth weight infants, with an emphasis on the delayed language development and the perinatal risk factors affected early language development. METHODS: The sample consisted of 31 preterm infants with birth weight less than or equal to 2,000 g who had no obvious neurological impairment at the age of 18-32 months. Each infant was assessed using three instruments; the Bayley Scales of Infant Development, the Capute Scales, and the Sequenced Language Scale for Infants (SELSI). RESULTS: On Bayley Scales of Infant Development, mental developmental index (MDI) was 81.0+/-17.1 and psychomotor developmental index (PDI) was 90.3+/-13.7. On the Capute scales, 38.7% of infants exhibited a significant language delay, below 70 at the age of 18- 32 months. On the SELSI, expressive language was delayed 5.7 months, receptive language, 5.4 months. On the Capute scales, expressive language was significantly related with gestational age and duration of oxygen therapy. Receptive language was associated with gestational age only. On the SELSI, language developmental quotient was influenced by gestational age, days on ventilation, and duration of oxygen therapy. CONCLUSION: 38.7% of non-handicapped low birth weight infants exhibited clinically significant delay in language development at the age of 18-32 months. Language delay was significantly related with gestational age, days on ventilation, and duration of oxygen therapy. The most single significant perinatal risk factor for language delay was gestational age.

A Case of Membranoproliferative Glomerulonephritis Associated with Complement Deficiency and Meningococcal Meningitis

Hypocomplementemia is found in all types of membranoproliferative glomerulonephritis (MPGN) but not in all patients. Hypocomplementemia can be ascribed to at least two circulating complement reactive modalities. The activation of the classical pathway produced by circulating immune complexes and the presence in the blood of anticomplement autoantibodies, called "nephritic factor"(NF). The activation of the classical pathway by circulating immune complexes is probably the major mechanism responsible for hypocomplementemia in idiopathic MPGN type I. Nephritic factors have been shown to be responsible for the hypocomplementemia in both MPGN type II and III. NFa is probably the major mechanism responsible for the hypocomplementemia of idiopathic MPGN type II. NFt appears to be solely responsible for the hypocomplementemia in MPGN type III. Judging from the complement profile, NFt also may be present in some patients with MPGN type I. Although infection by meningococcus has been associated with deficiency of any of the plasmatic proteins of complement, it more commonly involves deficiency of the terminal components of the complement pathway(C5-C9). We experienced a patient who had MPGN and meningococcal meningitis. We examined the complement level and significantly lower levels of C3, C5 were found persistently. C7 was low at first and it returned to normal range after 2 months. C9 was normal at first, and was low after 2 months. This is the first reported case in which MPGN with meningococcal meningitis occurred.