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6세 미만 소아에서 혈청 난백과 성분 항원 특이 IgE와 구운 계란 경구유발시험
송근백,양송이,정성수,황금희,김민주,윤지선,유진호 대한 소아알레르기 호흡기학회 2022 Allergy Asthma & Respiratory Disease Vol.10 No.3
Purpose: Sixty to eighty percent of children with egg allergy are able to tolerate eggs in baked form. The purpose of this study was to evaluate the clinical usefulness and diagnostic value of measurements of IgE specific to egg white, ovalbumin, and ovomucoid for reactivity to baked egg in children with sensitivity to egg. Methods: Two hundred seventeen children with suspected egg allergy underwent open food challenges with baked egg (in the form of muffins). The outcomes of the challenges were compared to the serum concentrations of IgE specific to egg white, ovalbumin, and ovomucoid by using ImmunoCAP. Results: There were no statistically significant differences in levels of IgE specific to egg white, ovalbumin, and ovomucoid between the baked egg challenge positive and negative groups younger than 2 years (n=163). However, significant differences were observed between the challenge positive and negative groups in 54 subjects aged 2 to 5 years (all P<0.05). The optimal cutoff points of egg white, ovalbumin, and ovomucoid specific IgE levels among children aged 2 to 5 years were 12.40 kUA/L (sensitivity 79%, specificity 66%), 4.07 kUA/L (sensitivity 88%, specificity 58%), and 3.65 kUA/L (sensitivity 77%, specificity 62%), respectively. Conclusion: The level of IgE specific to egg white and its components can predict the reactivity to baked egg in children aged 2 to 5 years.
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일반병동에 입원한 호흡부전 소아에서 고습도 고유량 비캐뉼라의 유용성
송근백,길홍량,조은영,이미희,정은희 대한 소아알레르기 호흡기학회 2020 Allergy Asthma & Respiratory Disease Vol.8 No.2
Purpose: This study evaluated the clinical effects of heated humidified high flow nasal cannula (HHHFNC) treatment in pediatric patients with respiratory disease and respiratory insufficiency. Methods: We reviewed the medical records for clinical features and tests performed in patients admitted to Chungnam University Hospital pediatric ward and treated with HHHFNC between July 2014 and December 2018. We evaluated the effects of HHHFNC treatment in patients with bronchiolitis treated with oxygen using a nasal prong. Results: The 136 children were treated with HHHFNC during the study period, and their median age was 8 months. Among the 136 patients, 39 (28.7%) were diagnosed with bronchiolitis and pneumonia, 42 (30.9%) with pneumonia, 28 (20.6%) with bronchiolitis, and 3 (2.2%) with epilepsy. Thirty-five patients (25.7%) had underlying neurological disorders. Fifty-one (37.5%) received invasive ventilator treatment. After HHHFNC treatment, venous blood gas analysis showed a pH increase from 7.32 to 7.37 (P<0.05) and a decrease in partial pressure of carbon dioxide (pCO2) from 53.1 to 46.2 mmHg (P<0.05). The respiratory rate had decreased from 46.3 to 43.3/min (P<0.05). There were no statistically significant differences in hospital stay duration or intensive care unit admission rates between bronchiolitis patients receiving HHHFNC treatment and those not receiving. Conclusion: In this study, in various diseases leading to pediatric respiratory insufficiency, HHHFNC treatment may improve physiologic parameters at the pediatric ward. HHHFNC may also be effective in patients with underlying neurological disorders and those with respiratory insufficiency from nonrespiratory infectious disease.
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난백에 감작이 있는 2세 미만의 소아에서 난백 특이 IgE 변화 결정 인자
최엄지,백은영,송근백,윤지선,유진호 대한 소아알레르기 호흡기학회 2023 Allergy Asthma & Respiratory Disease Vol.11 No.2
Purpose: Food sensitization to egg white (EW) peaks during early childhood, after which some children with sensitization to EW outgrow food sensitization, while others develop an increased degree of sensitization to EW. We investigated factors determining changes in EW-specific IgE in children under 2 years of age. Methods: Among children under 2 years of age with atopic dermatitis or food allergy who visited Asan Medical Center from March 2018 to September 2021, a total of 172 sensitized to EW were enrolled. Serum specific IgE to EW, ovalbumin and ovomucoid, and specific IgG4 to EW and ovomucoid were measured at 0, 6, and 12 months. An increase in EW-specific IgE was defined as an increased level of EW-specific IgE after 12 months from baseline. Multiple logistic regression analysis was performed to identify factors determining an increase in EW-specific IgE. Results: Of the 172 children, 85 had complete data on serum specific IgE and specific IgG4 during a period of 12 months. The levels of EW-specific IgE were decreased in 51 subjects (60.0%), while they were increased in 34 subjects (40.0%). Introduction of baked eggs had a protective effect against an increase in EW-specific IgE levels during a period of 12 months (adjusted odds ratio, 0.148; 95% confidence interval, 0.022–0.983). Conclusion: Introduction of the baked egg can prevent an increase in EW-specific IgE during early childhood. Further studies are needed for the long-term effect of baked egg on the natural course of EW sensitization. .
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김지윤,박민지,송근백,최엄지,백은영,이다경,홍수종 대한 소아알레르기 호흡기학회 2023 Allergy Asthma & Respiratory Disease Vol.11 No.4
Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by hypoxemic respiratory failure due to the accumulation of lipoproteinaceous material in alveolar macrophages and alveoli. It has been reported that granulocyte macrophage colony-stimulating factor (GM-CSF) inhalation or whole lung lavage significantly improves the disease state. We present a case of 17-year-old female diagnosed with PAP and treated with both GM-CSF inhalation and whole lung lavage. Her symptoms, imaging findings, and pulmonary function tests improved after these treatments. Therefore, combined treatments of whole lung lavage and subsequent GM-CSF inhalation should be considered a treatment option for children and adolescents.
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Vaccine-related Anaphylaxis Cases Confirmed by KCDC from 2001–2016
Eui jeong Roh,이미희,송근백,Yeon Kyeong Lee,Min-Kyung Kim,Tae Eun Kim,정은희 대한의학회 2020 Journal of Korean medical science Vol.35 No.38
Background: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion: Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.
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