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단일기관에서 전산을 통해 수집된 자발적 소아 약물유해반응 보고사례의 분석
박근미 ( Geun-mi Park ),박주현 ( Joo Hyun Park ),정주원 ( Joo Won Jung ),한혜원 ( Hye Won Han ),김재연 ( Jae Youn Kim ),이은 ( Eun Lee ),조현주 ( Hyun-ju Cho ),김영호 ( Yeongho Kim ),윤지선 ( Jisun Yoon ),유진호 ( Jinho Yu ),김태범 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.5
Purpose: The incidence of adverse drug reactions (ADRs) is increasing. However, studies on the prevalence of ADRs in children are rare. The aim of this study was to investigate the causative drugs and clinical features of ADRs for children in a tertiary university hospital of Korea. Methods: We retrospectively collected ADRs by a computerized self-reporting system in Asan Medical Center. ADRs of children under the age 18 were collected from January 2005 to August 2015, and we analyzed only ADRs containing current symptoms among total ADR data. Results: A total of 1,408 ADR cases were reported, There were 764 male (54.3%) and 644 female patients (45.7%), and the mean age was 11.5±5.8 years (range, 0.18 years). Antibiotics (n=479, 34.0%) were the most common causative drugs, followed by tramadol (n=173, 12.3%), nonsteroidal anti-inflammatory agents (NSAIDs) and acetylsalicylic acid (n=103, 7.3%), narcotics (n=91, 6.5%), antineoplastics (n=87, 6.2%), and sedatives (n=82, 5.8%). The most common clinical features were skin manifestations (n=500, 34.4%). Gastrointestinal symptoms (n=435, 29.9%) were the second most common clinical features, followed by neuropsychiatric symptoms (n=155, 10.7%) and respiratory symptoms (n=123, 8.5%). Among antibiotics, glycopeptides (n=110, 23.0%), third-generation cephalosporins (n=83, 17.3%), and penicillin/ß-lactamase inhibitors (n=60, 12.7%) were the most frequently reported causative drugs. Conclusion: Antibiotics were the most reported common causative drugs of ADRs in children, followed by tramadol, NSAID, and narcortics. Compared with adults, the prevalence of contrast medium-induced ADR was lower in children with a higher prevalence of sedative-associated ADR. Greater attention to possible ADRs in children is needed among medical personnel. (Allergy Asthma Respir Dis 2016:4:354-359)
박근미 ( Geun Mi Park ),서주희 ( Ju Hee Seo ),김형영 ( Hyung Young Kim ),유진호 ( Jin Ho Yu ),홍수종 ( Soo Jong Hong ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.4
Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), which reduce the production of prostaglandin by inhibiting cyclooxygenase (COX), are widely used in children as antipyretic, analgesic, or anti-inflammatory drugs. They are known to be a major cause of pediatric drug allergies, which are diagnosed by a drug provocation test. The mechanism comprises an immunoglobulin E- or T cell-mediated immune reaction or pseudoallergy caused by the inhibition of COX-1. The diagnosis of NSAIDs drug allergy requires a differential, because there is a high cross-reactivity between NSAIDs. In this study, oral provocation tests with ibuprofen, acetaminophen, diclofenac and celecoxib were carried out, and various types of NSAIDs and acetaminophen allergies were observed. Safe drugs were recommended for each patient according to the test results. We report four cases of NSAIDs and acetaminophen allergy and include the results of oral provocation tests. (Pediatr Allergy Respir Dis(Korea) 2011;21:344-349)
박근미 ( Geun Mi Park ),한혜원 ( Hae Won Han ),김재연 ( Jae Yeon Kim ),황금희 ( Keum Hee Hwang ),이은 ( Eun Lee ),양송이 ( Song I Yang ),정영호 ( Young Ho Jung ),홍수종 ( Soo Jong Hong ),서주희 ( Ju Hee Seo ),유진호 ( Jin Ho Yu ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.4
Lidocaine is a commonly used local anesthetic for dental treatment. Urticaria caused by lidocaine has seldom been reported. Generally, urticaria immediately develops after exposure to a causative agent and is considered a manifestation of IgE-mediated hypersensitivity. However, delayed urticaria caused by local anesthetics was reported to be related to cell mediated hypersenstivity. A 3-year old girl visited our allergy clinic due to delayed urticaria after local administration of lidocaine. Both skin prick and intradermal tests with lidocaine revealed negative reactions. However, the provocation test with subcutaneous injection of lidocaine showed urticaria 7 hours after test. In order to identify alternative local anesthetic for the subsequent dental procedure, we performed skin prick, intradermal and provocation tests with procaine, a local anesthetic of the other class, all of which showed negative results. Therefore, we recommended procaine as an alternative local anesthetic, and the patient was successfully treated with procaine. To the best of our knowledge, this is the first case of delayed urticaria caused by lidocaine in Korea.
서울지역 단일 3차병원 천식 및 알레르기비염 소아의 흡입항원 감작률에 대한 10년간의 변화
정영호 ( Young Ho Jung ),황금희 ( Keum Hee Hwang ),양송이 ( Song I Yang ),이은 ( En Lee ),김경희 ( Kyung Hee Kim ),김민주 ( Min Ju Kim ),박근미 ( Geun Mi Park ),서주희 ( Ju Hee Seo ),김형영 ( Hyung Young Kim ),유진호 ( Jin Ho Yu 대한소아알레르기호흡기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.2
Purpose: Allergic diseases have been increased in Korea. The aim of this study was to investigate the changes of sensitization rate to inhalant allergens over 10 years in children with allergic diseases from a tertiary referral hospital. Methods: Skin prick tests were done in total 2,225 children in 2000, 2005, and 2010. Changes of skin reactivity to 12 major inhalant allergens, including Tree pollen mixture I (Alder, Elm, Hazel, Poplar, Willow), Tree pollen mixture II (Beech, Birch, Oak, Plane tree), Dermatophagoides pteronyssinus, Dermatophagoides farina, Alternaria, cat dander, and dog dander were investigated. Results: The sensitization rates to Tree pollen mixture I and II were increased as 5.0%, 6.8% in 2000, 8.5%, 9.8% in 2005, and 14.8%, 17.3% in 2010, respectively (trend P<0.001, P<0.001, respectively). And the sensitization rates to D. pteronyssinus cat dander and dog dander were changed as 55%, 4.8%, 4.8% in 2000, 62.2%, 11.9%, 28% in 2005, and 63.1%, 12.7%, 16.7% in 2010, respectively. The distribution of sensitized pollens was oak (12.8%), beech (12.4%), pine (10.3%), birch (10%), hazel (9.6%), alder (8%), elder (6.9%), elm (5.4%) in the study of 2010. When allergen/histamine ratio was compared, rates of strong sensitization over 4+ to tree pollen were increased. Conclusion: The sensitization rates to inhalant allergens were increased in children with asthma or allergic rhinitis from a tertiary referral hospital in Seoul over last 10 years. Especially, an increase in the degree of skin reactivity was observed in cat dander, dog dander, and tree pollens. The studies to investigate the etiology of this increase and prevention will be needed. (Allergy Asthma Respir Dis 2014;2:97-102)