• Clinical and Experimental Pediatrics
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• v.45 no.7
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• pp.875-883
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• 2002

Purpose : Airways eosinophilia and increased IgE, characteristic features of asthma, result from a predominant Th2 response. In this study, we investigated the effect of CpG oligodeoxynucleotides (ODNs) on the inhibition of airways eosinophilia in mice with established airway inflammation. We also investigated the immunological mechanisms involved. Methods : Groups of BALB/c mice were sensitized intradermally with ovalbumin(OVA). At week 10, airway inflammation was induced by intranasal challenge of the mice with OVA. At week 14, the mice were challenged intranasally again with OVA in the presence and without the presence of CpG ODNs. Mice with saline administration served as negative controls. Bronchoalveolar lavage fluids(BALF) were obtained and eosinophils were counted. Th1 and Th2 cytokines in the spleen cell cultures were measured by ELISA. Serum OVA-specific IgE and IgG2a antibodies were also measured by ELISA. Results : BALF eosinophils were significantly inhibited in the CpG ODNs-treated mice(P<0.01). IgE and IgG2a levels increased significantly in both CpG ODNs-treated and untreated groups as compared to the negative control group; there was, however, no significant difference between the two groups four days after intranasal administration of CpG ODNs. Cytokine analysis revealed decreased production of IL-4, IL-5, and IL-13 and increased production of IL-12 in the CpG ODNs-treated group as compared to the untreated group. Interestingly, $IFN-{\gamma}$ levels were not upregulated in the CpG ODNs-treated group. Conclusion : CpG ODNs vaccination is a potentially useful approach for reversing airways eosinophilia in mice with established airways inflammation.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.28-32
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• 2010

Purpose : Although eosinophilia is a common laboratory finding in many neonatal intensive care units (ICUs), its causative mechanisms remain obscure. We aimed to determine the causes of eosinophilia in the neonatal ICU environment. Methods : Serial eosinophil counts were determined weekly for 288 hospitalized, appropriately grown neonates. Infants were divided into four groups according to gestational age, and the incidence and etiologic factors of eosinophilia were retrospectively studied. Results : Absolute eosinophilia (>$700/mm^3$) was documented in 18% (52/288) of neonates. Twenty-two infants (42.3%) exhibited mild eosinophilia ($700-999cells/mm^3$), 27 (51.9%) exhibited moderate eosinophilia ($1,000-2,999cells/mm^3$), and 3 (5.8%) exhibited severe eosinophilia (>$3,000cells/mm^3$). Of the 288 infants studied, 54 suffered sepsis. Thirty of these 54 infants (55.6%) showed eosinophilia, and 22 out of the remaining 234 infants (9%) without sepsis showed eosinophilia, indicating that eosinophilia was more prevalent in the sepsis group (P <0.05). All 5 infants suffering from bronchopulmonary dysplasia showed eosinophilia, and 47 out of the remaining 283 infants (16.7%) without bronchopulmonary dysplasia showed eosinophilia. Thus, eosinophilia was more prevalent in the bronchopulmonary dysplasia group (P<0.05). Furthermore, increased prevalence of eosinophilia was associated with respiratory distress syndrome, ventilator use, blood transfusion, and total parenteral nutrition (P<0.05). Conclusion : Our results suggest that eosinophilia is influenced by sepsis and bronchopulmonary dysplasia, although it can also occur idiopathically at birth. Moreover, the potential role of eosinophils in conditions such as wound healing and fibrosis in sepsis or chronic lung disease may be a cause of eosinophilia.

• Tuberculosis and Respiratory Diseases
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• v.55 no.2
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• pp.206-210
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• 2003

Eosinophilic lung diseases are heterogenous disorder which are characterized by the presence of pulmonary symptoms or an abnormal chest radiograph accompanied by inflammatory cellular infiltrates in the airways and lung parenchyma which contain large numbers of eosinophils. The incidence of drug-induced pulmonary disorder is increasing, with at least 40 drug entities having been reported to cause this pulmonary disease. However, nonsteroidal anti-inflammatory drugs (NSAIDs) are rarely mentioned in the lists of drugs in published articles describing drug induced eosinophilic pneumonia. The following is a case of eosinophilic pneumonia that we believe was related to ibuprofen therapy.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.795-804
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• 1998

Background: Chronic eosinophilic pneumonia(CEP) is interstitial lung disease characterized by multiple infiltration on radiographic study, accumulation of eosinophils in the alveolar space and interstitium of the lung, chronic persistent symptoms and possible relapse. Acute eosinophilic pneumonia(AEP) is a recently described illness, characterized by rapid clinical course, acute respiratory insufficiency and no relapse. Method : To better characterize acute and chronic eosinophilic pneumonia, we studied the clinical and laboratory features of 16 patients(AEP : 7 patients, CEP : 9 patients), which were clinico-pathohistologically diagnosed and not to be associated with organic disorders producing peripheral blood eosinophilia. Results: The mean age was higher for patients with CEP than for patients with AEP ($55.4{\pm}15.1$ vs. $24.6{\pm}7.9$ years, p<0.05). High fever(above $38^{\circ}C$) was presented in all patients of AEP and in one patient(11%) of CEP. All patients of AEP and eight patients (89%) of CEP showed bilateral pulmonary infiltrates, and 6 patients(86%) of AEP and 2 patients(22%) of CEP showed pleural effusion in chest radiograph. The mean white blood cell count of AEP and CEP were $17,186/mm^3$ and $12,867/mm^3$, respectively. The mean peripheral blood eosinophil count of AEP and CEP were $939/mm^3$ and $2,104/mm^3$, respectively. The mean eosinophil fraction of BAL fluid of AEP and CEP were 32.4% (range: 18~47%) and 35.8% (range: 15.3~88.2%), respectively. The mean $PaO_2$ was lower for patients with AEP than for patients with CEP ($44.1{\pm}15.5$ vs. $62.7{\pm}6.9$mmHg, p<0.05). All patients of AEP and CEP were initially treated with antibiotics. All patients of CEP and one patients of AEP were finally required systemic steroid therapy. 6 patients of AEP were improved without steroid therapy. Relapse was observed in 3 patients(33%) of CEP. Conclusion : Compair with of chronic eosinophilic pneumonia, acute eosinophilic pneumonia was characterized by relatively young age, acute onset, high fever, severe hypoxemia, diffuse pulmonary infiltrates with pleural effusion, steroid therapy is effective but spontaneous improvement with conservative therapy was frequent.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.298-303
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• 2023

Electronic cigarette or vaping-associated lung injury (EVALI) is a disease defined by lung injuries caused by e-cigarette use. It predominantly manifests in forms of organized pneumonia or diffuse alveolar damage but rarely as acute eosinophilic pneumonia (AEP). This report describes a 34-year-old male with acute respiratory symptoms and a vaping history of only nicotine. Chest CT revealed peripheral distributing multiple patchy consolidations and ground-glass opacities dominant in both lower lobes, bilateral diffuse interlobular septal thickening, and bilateral pleural effusion without cardiomegaly. Bronchoalveolar lavage fluids showed increased eosinophilia levels, while infectious laboratory results were all negative, enabling the diagnosis of both AEP and EVALI. Herein, we report a rare case of only-nicotine vaping EVALI manifested as AEP.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1237-1244
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• 2021

Objectives: Drug fever and procedure-related fever are the causes of nosocomial fever. Oriental medicine has been practiced in Asia and is now being practiced as an alternative medicine in western countries. No data are available on the incidence of drug fever and procedure-related fever in oriental medical hospitals (OMHs). The aim of this study was to identify the incidence of drug fever related to oriental herbal medicine and oriental medical procedure-related fever. Methods: This was a retrospective study at one OMH of a university medical institute in Seoul, Korea, conducted from June 2006 to June 2013. Results: Overall, 95 episodes of drug fever occurred among 10880 patients treated with herbal medicine (0.89%). Peak body temperature was 38.37±0.58 ℃, and the fever lasted for 1.0 day (range 1.0-17.0 days). Eosinophilia was found in 15 patients (15.79%) and 8 patients developed toxic hepatitis (8.42%). Five patients had a drug-related skin rash (5.26%). The most common ingredients of the herbal medicines associated with drug fever were licorice, Angelica gigas root, and white Atractylodes rhizome. In total, 16 episodes of procedure-related fever (0.20%) occurred in 8125 patients treated with oriental medical procedures. The peak body temperature was 38.26±0.51 ℃, and the fever lasted for 1.0 day (range 1.0-3.0 days). Among various oriental medical procedures, moxibustion was the most common procedure related to fever, followed by acupuncture. Conclusions: The incidence of drug fever and procedure-related fever in oriental medicine is not high compared with the incidence in western medicine.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.207-212
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• 2001

Purpose: Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has not been studied yet until now in Korea. Methods: We performed the prospective study of 19 cases that had AST and ALT>50 IU/L respectively without evidence of hepatitis A, B, C, cytomegalovirus, and Ebstein-Barr virus infections amongst 143 patients with M. pneumoniae pneumonia who were admitted to the Department of Pediatrics, Seoul Red Cross Hospital from Jan. 1999 to Dec. 2000. Results: 1) Hepatitis occurred in 13.3% of Mycoplasma pneumoniae infection, especially in fall and winter times. The average age was 4.86 years and male to female ratio was 2.2:1. 2) Vomiting was developed in 21.1%, diarrhea in 36.8%, and hepatomegaly in 21.1%, respectively. And leukocytosis was noted in 21.1%, eosinophilia in 15.4%, anemia in 10.5%, and thrombocytosis in 5.3%, respectively. The average level of C-reactive protein was $6.34{\pm}4.82$ mg/dl. 3) There was no hyperbilirubinemia, but hypoalbuminemia was detected in 42.1%. The average serum levels of AST and ALT were $214.05{\pm}183.22$ IU/L and $284.16{\pm}286.84$ IU/L, respectively. 4) Chest radiology showed lobar or lobular consolidation in 73.7%, bronchial infiltration in 26.3%, and pleural effusion in 31.6%. 5) The average length of hospitalization was 7.9 days, and the average length of normalization of serum transaminases was 8.8 days. All patients recovered within 2 weeks completely. Conclusion: The prognosis of M. pneumoniae hepatitis is good. However, its incidence is not so low that liver function should be considerately checked in case of M. pneumoniae infection.

• Neonatal Medicine
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• v.18 no.2
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• pp.204-210
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• 2011

Purpose: Feeding intolerance is common in very low birth weight infants(VLBWI); however, research on the etiology is limited. We investigated the incidence of allergic enterocolitis (AEC) as a cause of feeding intolerance and present the clinical characteristics of VLBWIs. Methods: The medical records of VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center between January 2009 and July 2010 were retrospectively analyzed. AEC was defined as patients who had feeding intolerance with eosinophila and who responded to hypoallergenic feeding intervention. Feeding intolerance symptoms included blood tinged stools, abdominal distension, residual feeding and regurgitation. Eosinophilia was defined as an eosinophil count ${\geq}$700 cells/$mm^3$. Patients with feeding intolerance were divided into the AEC or non-AEC group. Results: Of the 181 patients, 161 (88.9%) had a feeding intolerance, and 119 (65.7%) had eosinophilia. Seventeen infants were diagnosed with AEC. No difference in mean gestational age, birth weight, antibiotics duration, TPN duration, hospitalization, or symptom onset day was observed between patients with AEC and non-AEC patients. The percentage of eosinophilia was significantly higher in patients with AEC than in non-AEC patients. Two patients (12%) improved with restricted breast milk, 10 patients (59%) with extensively hydrolyzed formula and five patients (29%) with free amino acid-based formula. Conclusion: Our results suggest that AEC should be considered in VLBWIs who have clinical features of feeding intolerance and eosinophilia. An aggressive increase in feeding would be possible through feeding intervention in VLBWIs with feeding intolerance.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.889-894
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• 2006

Purpose : Asthma is characterized by the presence of airway hyperresponsiveness(AHR) and inflammation. The extensive eosinophil infiltration into the lung is the hallmark of asthma and contributes to the damage of respiratory epithelium during late phase airway responses. Eotaxin is the major eosinophil chemoattractant found in bronchoalveolar lavage(BAL) fluid of allergic inflammation. IL-13 has been known to induce the expression of exotaxin and eosinophilia. IL-13 also induces airway inflammation, mucus production and leads to marked fibrosis, airway remodeling and AHR. We investigated whether serum IL-13 levels can reflect the presence of airway hyperresponsiveness in children with asthma, and the relationship between serum IL-13 and eotaxin levels. Methods : Using sandwich enzyme-linked immunosorbent assay, the serum IL-13 and eotaxin levels were measured in 13 atopic asthmatics, 5 atopic non-asthmatics and 12 control subjects. Metacholine challenge tests were performed in all subjects. Airway hyperresponsiveness to metacholine was expressed as provocative concentration of metacholine causing a 20% fall in FEV1[$PC_{20}mg/mL$]. $PC_{20}$ value of 25 mg/mL was used as a cut-off for defining a AHR. Results : Serum IL-13 levels showed positive correlation with eotaxin levels. Serum IL-13 and eotaxin levels showed no differences among atopic asthmatics, atopic non-asthmatics and control subjects. And there were no differences serum IL-13 and eotaxin levels in children with and without AHR and atopy. Serum IL-13 and eotaxin levels did not correlate with $logPC_{20}$ levels. Conclusion : IL-13 is closely related to the eotaxin release. But serum IL-13 and eotaxin per se can't predict the severity of airway hyperresponsiveness. IL-13 and eotaxin may have local effect on respiratory epithelium or there can be some factors to induce airway hyperresponsiveness other than serum IL-13 in asthmatic airways.