• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.149-154
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• 2019

The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%-5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.

• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.589-593
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• 2004

Aspergillus fumigatus causes a variety clinical syndrome in lung including aspergilloma, chronic necrotizing aspergillosis, invasive pulmonary aspergillosis, and allergic bronchopulmonary aspergillosis. Aspergilloma develops by a colonization and growing of Aspergillus inside lung cavities with underlying lung disease. There is a few report of endobronchial aspergilloma without lung parenchymal lesion. We experienced a case of endobronchial aspergilloma did not fit any category of Aspergillus-induced lesion, who show minimal fibrostreaky denstities on chest PA and chest CT. Massive hemoptysis was improved by a removal of the aspergilloma in this patient. Here, we report a rare case of endobronchial aspergilloma showing massive hemoptysis with review of literatures.

• Tuberculosis and Respiratory Diseases
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• 제69권6호
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• pp.434-441
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.321-325
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• 2015

Background: The adverse effects of the phosphodiesterase-4 inhibitor roflumilast, appear to be more frequent in clinical practice than what was observed in chronic obstructive pulmonary disease (COPD) clinical trials. Thus, we designed this study to determine whether adverse effects could be reduced by starting roflumilast at half the dose, and then increasing a few weeks later to $500{\mu}g$ daily. Methods: We retrospectively investigated 85 patients with COPD who had taken either $500{\mu}g$ roflumilast, or a starting dose of $250{\mu}g$ and then increased to $500{\mu}g$. We analyzed all adverse events and assessed differences between patients who continued taking the drug after dose escalation and those who had stopped. Results: Adverse events were reported by 22 of the 85 patients (25.9%). The most common adverse event was diarrhea (10.6%). Of the 52 patients who had increased from a starting dose of $250{\mu}g$ roflumilast to $500{\mu}g$, 43 (82.7%) successfully maintained the $500{\mu}g$ roflumilast dose. No difference in factors likely to affect the risk of adverse effects, was detected between the dose-escalated and the discontinued groups. Of the 26 patients who started with the $500{\mu}g$ roflumilast regimen, seven (26.9%) discontinued because of adverse effects. There was no statistically significant difference in discontinuation rate between the dose-escalated and the control groups (p=0.22). Conclusion: Escalating the roflumilast dose may reduce treatment-related adverse effects and improve tolerance to the full dose. This study suggests that the dose-escalated regimen reduced the rate of discontinuation. However, longer-term and larger-scale studies are needed to support the full benefit of a dose escalation strategy.

• Journal of Chest Surgery
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• 제50권1호
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• pp.50-53
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• 2017

A mixed infection of Mycobacterium abscessus subsp. abscessus (Mab) and Mycobacterium tuberculosis (MTB) in the lung is an unusual clinical manifestation and has not yet been reported. A 61-year-old woman had been treated for Mab lung disease and concomitant pneumonia, and was diagnosed with pulmonary tuberculosis (PTB). Despite both anti-PTB and anti-Mab therapy, her entire left lung was destroyed and collapsed. She underwent left pneumonectomy and received medical therapy. We were able to successfully treat her mixed infection by pneumonectomy followed by inhaled amikacin therapy. To the best of our knowledge, thus far, this is the first description of a mixed Mab and MTB lung infection.

• 생명과학회지
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• 제14권5호
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• pp.847-854
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• 2004

알러지는 복합적인 유전적, 환경적 요인에 의해 발병하는 질환이다. 선진국에서 알러지 질환의 수가 증가함에 따라 알러지에 대한 관심이 증가하고 있으며 이에 대한 유전적인 원인에 대한 관심도 증가하고 있다. 알러지에는 천식, 아토피, 비염을 포함한 알러지에 관련된 유전자와 염색체 부위가 밝혀지고 있다. 하지만 이들에 대한 평가 및 확인이 제대로 진행되지 않는 상황이다. 본 연구팀은 알러지를 일으키는 유전적인 요인을 찾고자 하였다. 과학영재학교 138명을 대상으로 하였고 이들 중 약 30%가 천식, 아토피, 비염과 같은 알러지 질환을 앓고 있었다. 본 연구팀은 지금까지 보고된 연구 결과들을 토대로 알러지에 관련된 유전자를 찾았으며 그중 알러지를 일으키는데 관여하는 IL-4와 IL-4Ra를 후보 유전자로 선정하였다. 지금까지 발표된 보고들은 SNP의 발견과 그리고 하나 혹은 두개의 SNP에 초점을 맞추어 발표한 반면, 본 연구팀은 알러지와 관련하여 발표된 IL-4와 IL-4Ra의 SNP를 종합적으로 분석하고자 하였다 과학영재학교 학생들 96명을 머리카락 샘플을 확보하고 이 것으로 9개 의 SNP를 선정 하여 염기서열 분석 및 MALDI-TOF을 이용한 유전자 분석을 진행하였다. 각각의 SNP에 대해 알러지를 가지고 있는 그룹과 정상 그룹간의 약간의 차이들은 있었지만 이것이 알러지를 가지고 있는 사람과 정상인과의 구분을 시켜줄 수 있을 정도는 아니었다. 이러한 결과는 현재 한국에서 널리 행하여지고 있는 유전자 검사에 대한 재고가 필요함을 시사한다.

• Tuberculosis and Respiratory Diseases
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• 제81권3호
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• pp.228-232
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• 2018

Background: Chronic bronchitis (CB) is an important phenotype in chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate different pattern of COPD assessment test (CAT) score between CB and non-CB patients. Methods: Patients were recruited from 45 centers in Korea, as part of the Korean COPD Subgroup Study cohort. CB was defined when sputum continued for at least 3 months. Results: Total 958 patients with COPD were eligible for analysis. Among enrolled patients, 328 (34.2%) were compatible with CB. The CAT score was significantly higher in patients with CB than non-CB, and each component of CAT score showed a similar result. CB was significantly associated with CAT score when adjusted with age, sex, modified Medical Research Council, and post-bronchodilator forced expiratory volume in 1 second. Each component of CAT score between patients with CB and non-CB showed different pattern according to Global Initiative for Chronic Obstructive Lung Disease grade. Conclusion: CAT score is significantly higher in patients with CB than non-CB. Each component of CAT score was significantly different between two groups.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.269-276
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• 2019

Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.

• Tuberculosis and Respiratory Diseases
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• 제73권5호
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• pp.266-272
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• 2012

Background: Limited data on the incidence and clinical characteristics of adult pertussis infections are available in Korea. Methods: Thirty-one hospitals and the Korean Centers for Disease Control and Prevention collaborated to investigate the incidence and clinical characteristics of pertussis infections among adults with a bothersome cough in non-outbreak, ordinary outpatient settings. Nasopharyngeal aspirates or nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and culture tests. Results: The study enrolled 934 patients between September 2009 and April 2011. Five patients were diagnosed as confirmed cases, satisfying both clinical and laboratory criteria (five positive PCR and one concurrent positive culture). Among 607 patients with cough duration of at least 2 weeks, 504 satisfied the clinical criteria of the US Centers for Disease Control and Prevention (i.e., probable case). The clinical pertussis cases (i.e., both probable and confirmed cases) had a wide age distribution ($45.7{\pm}15.5$ years) and cough duration (median, 30 days; interquartile range, 18.0~50.0 days). In addition, sputum, rhinorrhea, and myalgia were less common and dyspnea was more common in the clinical cases, compared to the others (p=0.037, p=0.006, p=0.005, and p=0.030, respectively). Conclusion: The positive rate of pertussis infection may be low in non-outbreak, ordinary clinical settings if a PCR-based method is used. However, further prospective, well-designed, multicenter studies are needed.

• 대한지역사회영양학회지
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• 제22권4호
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• pp.298-306
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• 2017

Objectives: The purpose of this study was to investigate the awareness and nutritional management of food allergy (FA) by preschooler's faculty members in child care centers. Methods: A questionnaire survey was conducted among faculty members of child care centers in Seoul. The questionnaire was designed to identify the prevalence of food allergies, requirements of food allergy support and differences in food management depending on the presence of allergic diseases. After excluding incomplete responses, the data of 171 faculties in 137 child care centers (95.0%) were used for statistical analysis. Results: According to the 137 collected questionnaires, 96 child care centers asked parents about their children's allergic disease and 151 children from 66 child care centers had food allergies. A reported 89 children from 43 child care centers had food restrictions. However, 9 child care centers (21.0%) were not aware of food restriction for children with food allergies. Only 6 child care centers (14.0%) supplied substitute foods with the same amount and type of nutrients. Forty eight faculties (28.1%) received training about food allergies. Although there were some differences according to institution type, most of the faculty members wanted food allergy-related support. Conclusions: This study identified a lack of food allergy training for faculty members in child care centers. For proper management, it is necessary for faculty members of child care centers to be educated on overall food allergies. Food allergy-related support such as menus without allergenic ingredients, guidelines on emergency care for food allergies and anaphylaxis should be provided for faculty members in child care centers.