• Clinical and Experimental Pediatrics
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• v.58 no.9
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• pp.330-335
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• 2015

Purpose: The clinical interpretation of children sensitized to allergens is challenging, particularly in children with food allergies. We aimed to examine clinical differences between children with monosensitization and those with polysensitization to common food allergens and to determine risk factors for polysensitization in young children <10 years of age with immediate-type food allergies. Methods: The study included children <10 years of age with signs and symptoms indicative of immediate-type food allergies. Serum total IgE level was measured, and ImmunoCAP analysis for food allergens was performed. Results: The mean age of the study subjects was $1.6{\pm}1.6$ years (75 boys and 51 girls). Thirty-eight children (30.2%) were monosensitized and 88 children (69.8%) were polysensitized. Multivariate logistic regression analysis showed that the development of polysensitization to common food allergens was positively associated with a parental history of allergic rhinitis (adjusted odds ratio [aOR], 6.28; 95% confidence interval [CI], 1.78-22.13; P=0.004), season of birth (summer/fall) (aOR, 3.10; 95% CI, 1.10-8.79; P=0.033), and exclusive breastfeeding in the first 6 months of age (aOR, 3.51; 95% CI, 1.20-10.25; P=0.022). Conclusion: We found significant clinical differences between children with monosensitization and those with polysensitization to common food allergens and identified risk factors for the development of polysensitization in young children with immediate-type food allergies. Clinicians should consider these clinical risk factors when evaluating, counseling, treating, and monitoring young children with food allergies.

• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.73-81
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• 2002

Objective : in order to be convinced of improvement in quality of life in allergic rhinitis patients, I observed clinically remedical effect of Quingbixiaoyanwan-Derivatives(淸鼻消炎丸) on allergic rhinitis with a questionnaire. Methods : We treated forty five allergic patients at the Nam Chun Oriental Medical Hospital from October, 2001 to January, 2002. They were treated with Quingbixiaoyanwan-Derivatives(淸鼻消炎丸), nasal cleansing solution and dietary treatment, and the health-related quality of life with a questionnaire. Results : 1. The gender proportion was twenty five males(55.6%) and twenty females(44.4%); seven teenagers (15.6%); ten patients in their 20s(22.2%); twenty patients in their 30S(44.4%); six patients in their 40s(13.3%); two patients in over 50s (4.4%) 2. The duration of the disease: 0 case within six months; three cases for six months to one year (6.6%); fourteen cases for one year to five years(31.1%); twenty six cases for over five years(62.2%) 3. Major symptoms; forty three cases for watery rhinorrhea (95.5%); thirty one caess for nasal itching(68.8%); 91.1 cases for sneezing(41.0%);thirty nine cases for nasal obstruction (86.6%); sixteen cases for difficulty in smelling(35.5%);seventeen postnasal drip(37.7%);three bloody rhinorrhea (6.6%);fourteen cases for headaches(31.1%); nine cases for eyelid itching (60.0%). 4. Seasonal Distribution: perennial allergic rhinitis occurred as follows: 55.6% in winter; 13.3% in fall; 11.1 % in spring;2.2% in summer. 5. Other combined allergic symptoms; sixteen cases for allergic conjunctives (37.8%); eight cases for sinus(17.8%);four cases for atopic dermatitis (8.9%); three cases for bronchial asthma(6.7%); sixteen cases for none(35.6%) 6. After a specific prescription of Quingbixiaoyanwan-Derivatives(淸鼻消炎丸), nasal cleansing solution and dietary therapy, the quality of life in allergic rhinitis patients was improved to 20.27%, which was significantly.(P<0.001) 7. The specific treatment did not affect GOT/GPT and BUN/Creatinine. 8. The specific treatment did not influence the level of total IgE serum significantly. Conclusions : Based on the above results, I have concluded that the specific treatment of Quingbixiaoyanwan-Derivatives(淸鼻消炎丸), nasal cleansing solution and dietary therapy can improve the quality of life in allergic rhinitis patients.

• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.386-394
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• 2003

Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

• The Journal of Korean Medicine
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• v.21 no.3
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• pp.149-165
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• 2000

As recent developments of Immunology and Nuclear medicine, serum IgE and IgG values are helpful in the diagnosis and evaluation of the therapeutic effects of nasal allergies. But in Korea, air pollution and the increased use of food additives have become leading factors in nasal allergies, It seems to be induced by environmental change, especially industrialization and urbanization, so allergic rhinitis in our environment has changed in accordance with the changes made in the living environment. Therefore this study is attempted in order to observe a clinical analysis which places more importance on allergic rhinitis. We studied 200 patients who had visited Kyunghee Oriental Medical Center with allergic rhinitis from January 1, 1999 to December 31, 1999 The results were as follows: 1. The sex distribution was 114 males(57%) and 86 females(43%). In age distribution, the average age was 25. In males, ages ranged from 3 to 66 years old and the average was 23.81. In females, ages ranged from 4 to 67 years old and the average was 28.57. The peak age was 30～39 years old(24%); under 9 years old and 10～19 years old were each 18%; 20～29 years old was 22%; 40～49 years old was 11 %; over 50 years old 6.5%. The gulf between males and females showed a statistically significant difference(P<0.025). 2. In the age of onset, male' s maximum was 62.5, minimum was 0.25; female s maximum was 59.5, minimum was 0.2. Under 9 years old was the most with 34%(male 24%, female 10%), 10～19 years old was 18%, 20～29 years old was 22.5%, 30～39 years old was 13.50%, over 40 years old was 12%, The gulf between males and females were showed statistically significant difference.(p<0.014) 3. The average duration of the disease was 5.67 years. In male and female, the maximum was 30, the minimum was 0.05; under 5 years old was the most with 62%(male 34.50%, female 27.50%); 6～10 years old was 23%. So, under 10 years old was 85%. There was no statistically significant difference in the duration of disease. 4. Regarding type of residence, 47.50% of patients with allergic rhinitis lived in apartments, 52.50% lived in houses. In males, 29.50% lived in apartments, 27.50% lived in houses. In females, 18% lived in apartments, 25% lived in houses. There was no statistically significant difference in the residence by T-test and chi-test. 5. In the distribution of season, spring is the most with 29.5% of patients, winter 28%, fall 25.5%, and summer 17%. But there was no statistically significant difference. 6. After observing 200 patients with allergic rhinitis, classifying main symptoms into 5 types, sneezing was the main symptom in 177cases(88.50%), nasal obstruction in 176cases(88%), rhinorrhea in 169cases(84.5%), post nasal discharge in 87cases(43.50%), and itching in I04cases(52%). The Cumulus ration is 98.50% and symptoms overlapped with an average 3.57±0.1 times but in an analysis of variance of these symptoms, the gulf between males and females was not recognized as statistically significant by T-test and ANOVA. 7. Patients whose families have allergic diseases account for 90 cases(45%) : 49cases(24.50%) male and 41cases(20.50%) female. There were 4 cases (71.11 %) whose families have allergic rhinitis, 9cases(10%) of asthma, and 7.78% with allergic dermatitis. There were 61 (67.80%) cases of patients whose parents have allergic diseases; cases wherein the patient s child had allergic diseases numbered 13 (14.45%); and cases with a sibling with allergic diseases totalled 16cases (17.80%). There was no statistically significant difference in allergic disease regarding sex, parents, or siblings by chi-test. 8. Blood type: For males, type A is the most common, with 37cases(18.5%), followed by type B with 32cases(16%), type O 28cases(l4%) and type AB 13cases(6.5%). For females, type B is the most common, with 30cases(15%), followed by type O with 23cases(l1.5%), type A with 18cases(9%) and type AB with 13cases(6.5%). There was no statistically significant difference in blood type by chi-test. 9. In the selection of prefered food, most patients prefer cool food, with 98 such cases(49%), tepid food in 54cases(27%) and warm food in 48cases(24%). These showed a statistically significant difference in the selection of prefered food between males and females by chi-test(p<0.009). 10. The state of Past History was classified into II types. chronic hypertrophic rhinitis is the most common with 11cases (18.64%), tonsil and adenoid hypertrophy is 8cases(l3.56%), sinusitis is 6cases(10.17%), nasal septum deviation is 4cases, nasal polyp is 2cases, others are 10cases(l6.95%). No statistically significant difference in past history between males and females was shown, but a statistically significant difference was shown when males and females were compared with total cases by T-test(p<0.002, P<0.0008). 11. Regarding complications, 37 patients (28.91%) had sinusitis: 22cases(17.19%) in male, 15cases(11.72%) in female. Chronic hypertrophic rhinitis was found in 15cases(11.72%). Others are under 10%. There was no statistically significant difference in the type of complications between males and females, but a statistically significant difference was shown when males and females were compared with total cases by T-test(P<0.00l, P<0.007). 12. In the treatment, medication was used 1691 times, an average of 2.58 times. No.34 was used 370 times for 124 cases, an average of 2.98 times. No. 152 was used 318 times for 106 cases, an average of 3.00 times. No.151 was used 307 times for 97cases, an average of 3.16 times. No. 31 was used 117 times for 33 cases, an average of 3.55 times. No 25 was used 116 times for 33 cases, an average of 3.52 times. 13. In the duration of treatment, the most frequent is 1 week(69cases, 34.50%), the maximum is 20weeks, and the minimum is 1week. A treatment period of 2～3 weeks accounted for 32% of cases, a period of 4～5weeks accounted for 13.5%. The gulf between males and females showed a statistically significant difference in the duration of treatment.(p<0.01). There was a statistical significance when the males were compared with total cases by ANOVA(P<0.03). 14. A comparison between before-treatment and after-treatment showed a statistically significant difference in treatment by T-test (p<0.01) and F-test (p<0.0058).

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1012-1021
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• 1998

Background : It is known that airway inflammation is present in most patients with asthma, but the relationship between symptoms and the severity and nature of airway inflammation has not been established. Cough variant asthma is defined as an asthma in which the dominant symptom is cough, and the condition can be successfully treated with inhaled steroids. This study was performed to evaluate the time course of bronchial responsiveness according to an inhaled anti-inflammatory therapy and the factors which affect the resolution of bronchial responsiveness, and an efficacy of nedocromil to cough asthma. Method: A prospective study for the investigation of bronchial responsiveness according to an inhaled anti-inflammatory treatment in sixty-one cough asthmatics was performed. Twenty-three entered budesonide ($400{\mu}g{\times}2/day$), twenty-two entered nedocromil ($4mg{\times}2/day$) and sixteen patients entered combined group. The bronchial hyperresponsiveness (BHR) was estimated by methacholine challenge test using counted breath method. The symptom was estimated by 'symptom score'. Reevaluation of BHR and symptom was performed at 2 month after treatment, and if BHR was not resoluted at this time, regarded as a non-responder, and then follow-up of BHR and symptom was performed at 4- and/or 6 month after treatment. Results: The improvement of BHR and symptom was significant in 2 month (p<0.05), but there was no change of them during follow-up period of 4- and/or 6 month in non-responders. In comparison of allergic markers such as serum total IgE, peripheral eosinophil count and skin test reactivity between responders and non-responders, there was no difference in each other. However, in comparison of other factors such as cumulative pack-years, symptom duration, age, gender, and the initial degree of PC20, there was a significant difference in each other(p<0.05). The percent of patients with the resolution of BHR in 2 month was not different in each group(p=0.95). There was no significant difference in the degree of improvement of BHR and symptom in each group. Conclusion: Bronchial responsiveness and symptom was not significantly improved in non-responders during follow-up period of 4- and/or 6 month. The effect of inhaled nedocromil was equivalent to that of inhaled steroid in cough asthmatics, and the response to combined treatment is not superior to that achieved by either of these agents used alone.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.276-285
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• 2008

Purpose : Allergic proctocolitis is a major cause of bloody stool in early infancy. This study was aimed at ascertaining the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis. We also analyzed the relationship between peripheral eosinophilia, the age at symptom onset, and sigmoidoscopic and histologic findings. Methods : We reviewed 25 infants retrospectively who had sigmoidoscopy and biopsy performed with a clinical diagnosis of allergic proctocolitis from April 2003 to April 2007. Results : The mean age at symptom onset was $15.2{\pm}13.2$ weeks. Fourteen infants (56.0%) were breast fed, one (4.0%) was formula fed, six (24.0%) were on combined formula, and four (16.0%) were on a weaning diet. Peripheral eosinophilia (${\geq}250/mm^3$) was seen in eighteen infants (75.0%), but total serum IgE was increased only in six (24.0%). Sigmoidoscopic findings were variable from normal (8.0%), erythema or edema (20.0%), lymphoid hyperplasia (8.0%), erosion (12.0%), hemorrhage and ulcer (4.0%) to lymphoid hyperplasia with erosion, hemorrhage, or ulcer (48.0%). Histologic findings showed focal infiltration of eosinophils in lamina propria (96.0%) and crypt epithelium (96.0%). In twenty four infants (96.0%), the number of eosinophils in mucosa was increased by a more than 60/10 high power field. There was a negative correlation between peripheral eosinophilia and the age at symptom onset. Among the twelve breast fed infants, bloody stool disappeared in ten (83.0%) with a maternal elimination diet of major food groups, but two improved spontaneously. Conclusion : Allergic proctocolitis should be considered as one of the major causes of bloody stool in healthy appearing infants. To confirm the diagnosis it is necessary to perform sigmoidoscopy and biopsy but histologic findings are more informative than sigmoidoscopic findings. Peripheral eosinophilia was prominent in the infants with an early onset of symptoms. Most infants experienced benign courses and recovered with the elimination of causative foods but did not need exclusive food restrictions.