Lung Function Reference Values in Healthy Korean Children / 소아알레르기및호흡기학회지

PURPOSE: Appropriate reference values are needed for assessment of pulmonary function during childhood. We performed pulmonary function test with simple computerized spirometry to establish reference values of air flow rates in healthy Korean children. METHODS: We examined 1,317 children aged 6 to 15 years at their schools by standardized method during May, 2001. The children with poor cooperation, respiratory symptom, and chronic disease were excluded. Regression analysis was applied for FVC, FEV1, PEF, FEF25-75% predicted from sex, age, standing height, weight, and body surface area. RESULTS: In 1,317 children(Male : 716, Female : 601), the distribution of height was from 106.7 cm to 173.5 cm, weight was from 16.5 kg to 75.5 kg. We could get regression equations and determinant coefficients between anthropometric parameters and air flow rates. In both sexes, height showed very close correlation with lung function variables, and FEV1 showed very close correlation with all anthropometric parameters. Reference values of pulmonary function test were generally higher in boys than in girls. CONCLUSION: After performing the pulmonary function test in healthy Korean children, we report their normal values of air flow rates and regression equations for the predicted values. Among anthropometric parameters, height showed most close correlation with lung function variables in both sexes.

A Model of Game Program for Childhood Asthma / 소아알레르기및호흡기학회지

PURPOSE: The increased prevalence of childhood asthma in Korea from 3.4% in 1964 to 15% in 1995 might be very important for morbidity and mortality in children. Recognition of this led to consider the necessity of new management strategies emphasizing patient education. We developed the educational program including asthma-specific play game called 'Malgunsum asthma game' to improve the child's interest and evaluated its educational effect. METHOD: Twenty asthmatic children between the age seven to fifteen were attended Malgunsum Asthma Camp. The Children were randomly assigned to 5 groups, and each player had to move the horse by answering the questions on the card. The first one who reaches the goal wins the game. RESULTS: All the children well followed the play rule and were interested to the game. CONCLUSION: This educational game model will achieve better control of asthma by leading the patients to understand the nature of asthma, how to identify and control the aggravating factors, how to recognize symptoms and appropriate steps for asthma, and the importance of daily maintenance therapy with anti-inflammatory medications.

A Case of Nedocromil Sodium Withdrawal Due to Headache and Dizziness / 소아알레르기및호흡기학회지

Nedocromil sodium is an anti-inflammatory medication for the treatment of mild to moderate asthma. The most common side effect of the nedocromil sodium is an unpleasant and bitter taste. However it is rare, less than 3%, to stop the treatment because of this side effect. Other side effects includes cough, headache, throat irritation and nausea which are reported as mild and transient. A 7-year-old female had a severe headache and dizziness during the treatment of asthma with nedocromil sodium. The symptoms subsided after nedocromil sodium was replaced by budesonide. We experienced a case of a severe headache and dizziness due to nedocomil sodium that lead to withdraw of the nedocromil sodium.

Transplacental transfer and age-related levels of serum IgG antibodies to the capsular polysaccharides of Streptococcus pneumoniae types 14 and 19 in Korea

Little is known about the prevalence of naturally acquired IgG antibodies to the capsular polysaccharides of Streptococcus pneumoniae (pneumococcal IgG) in Korea. In the present study, we investigated transplacental transfer and age-related levels of pneumococcal IgG to provide background seroepidemiologic data for S. pneumoniae in Korea. One hundred thirty eight sera were assayed by ELISA for IgG to pneumococcal polysaccharide capsular serotypes 14 and 19, the predominant serotypes for under 15 yr of age in Korea. The subjects were divided into 7 subgroups according to age. The cord/maternal geometric mean titer of pneumococcal were 4.47+/-5.88/5.21 +/- 5.88 for serotype 14, and 4.68 +/- 5.55/6.55 +/- 6.92 for serotype 1 9 (mean +/- standard deviation, microg/mL). After birth, the geometric mean titers of pneumococcal IgG for serotypes 14 and 19 expressed in microg/mL were 1.18+/-2.12 and 1.41+/-2.17 in the 0-6 months group, 0.27+/-0.19 and 0.69+/-0.93 in 7-12 months, 0.21+/-0.22 and 0.64+/-1.32 in 1-2 yr, 0.69+/-0.78 and 2.65+/-2.46 in 3-6 yr, 2.52+/-2.72 and 8.29+/-4.24 in 7-10 yr, respectively. In conclusion, reduced transplacental transfer and very low serum concentrations of pneumococcal IgG may contribute to the susceptibility of neonates, infants, and young children to S. pneumoniae infection.

The Role of Patient and Parents Education in the Management of Pediatric Asthma / 소아알레르기및호흡기학회지

PURPOSE: Patient education is an important part of asthma management. This study was designed to evaluate the role of education program for asthmatic children and their parents. In the western countries, the effectiveness of patient education on improving self-management of asthma has been well documented. However, data from Korean population is lacking. METHODS: We performed the study to evaluate the efficacy of a hospital based education program aimed at improving self-management skills and reducing morbidity. Twenty patient and their parents attending Korea University Ansan Hospital allergy clinic were enrolled in the study. They were instructed 4 times of 10-15 minutes session with every 3 month interval on the pathophysiology of asthma, treatment and the appropriate use of medication including proper inhaler technique and the self-management of their diseases. The instructions were reinforced by three more education session at subsequent outpatient clinic attendance. RESULT: After twelve months, morbidity was assessed by the numbers of hospitalization, emergency department attendance and outpatient clinic attendance, use of oral steroids and steroid inhalation and impairment of quality of life. The efficacy of the education was demonstrated by significant reduction in the number of hospitalization(P<0.005), emergency department visit(P<0.005), outpatient clinic visit(P<0.05) and reduction of oral steroid use(P<0.001). There were also reduction of outpatient department attendance and improvement in steroid inhalation and quality of life. CONCLUSION: The result of this study suggest that a proper patient education is essential in reduction of asthma morbidity and improving in quality of life.

Postnatal Changes in Left Ventricular Performance in Early Neonatal Life

PURPOSE: This study was undertaken to investigate changes in cardiac performance in early neo-natal life by observing the changes of left ventricular(LV) function and volume according to the size of ductus arteriosus. METHODS: The study group consisted of 21 full-term Cesarean section neonates who were admitted to the nursery of Korea University Hospital. We serially investigated the patency and size of the ductus at 2, 24, 120 hours after birth by two-dimensional echocardiography. The standard two-dimensional tracings of LV volume were obtained under the guidance of apical two- and four-chamber views. LV end-diastolic and end-systolic volumes were calculated using a biplanar Simpson's method. RESULTS: LV end-diastolic volume was highest(3.44>0.4mm) at 2 hours of age(P<0.01), being constant from 24 to 120 hours. LV contractility, indicated by the mean normalized systolic ejection rate, remained constant during the whole period of investigation. The size of the ductus arteriosus was maximal at 2 hours after birth, and decreased significantly at 24 hours of age (P<0.01). The size of ductus arteriosus demonstrated a close linear correlation with the left ventricular end-diastolic volume(y=0.17x+2.92, r=0.59: P<0.01). CONCLUSION: Changes in LV end-diastolic volume soon after birth depend on changes in ductus arteriosus flow, which in turn is affected by ductal diameter. Upon patency of the ductus arteriosus, the newborn left ventricle operates at maximal performance with only a limited capacity to increase contractility.

A Case Report of Idiopathic Myelofibrosis with Down Syndrome / 대한소아혈액종양학회지

No abstract available.