Isolated pulmonary cryptococcosis in an immunocompetent boy

Bauer, Siegfried,Kim, Ji-Eun,La, Kyong-Suk,Yoo, Young,Lee, Kee-Hyoung,Park, Sang-Hee,Choung, Ji-Tae,Kim, Chul-Whan The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.11

Pulmonary cryptococcosis is rare in immunocompetent subjects. Here, we present the case of a 16-year-old boy who was referred to our pediatric department for the management of multiple consolidations detected on chest radiography, which was routinely performed when the patient was being evaluated for an ankle fracture. Fine needle aspiration biopsy was performed, and the definitive diagnosis was established as cryptococcal pneumonia. After 8 weeks of antifungal treatment, the pulmonary nodules on the chest radiographs disappeared.

Assessment of Bronchodilator Responsiveness Following Methacholine-Induced Bronchoconstriction in Children With Asthma

Siegfried Bauer,박하늘,서현석,김지은,송대진,박상희,정지태,유영,김형진 대한천식알레르기학회 2011 Allergy, Asthma & Immunology Research Vol.3 No.4

Purpose: The aim of this study was to investigate bronchodilator responsiveness (BDR) following methacholine-induced bronchoconstriction and to determine differences in BDR according to clinical parameters in children with asthma. Methods: The methacholine challenge test was performed in 145 children with mild to moderate asthma, and the provocative concentration causing a 20% decline in FEV1 (PC20) was determined. Immediately after the challenge test, patients were asked to inhale short-acting β2-agonists (SABAs) to achieve BDR, which was assessed as the change in FEV1% predicted×100/post-methacholine FEV1% predicted. For each subject, the asthma medication, blood eosinophil count, serum total IgE, serum eosinophil cationic protein level, and skin prick test result were assessed. Results: The FEV1 (mean±SD) values of the 145 patients were 90.5±10.9% predicted, 64.2±11.5% predicted, and 86.2±11.2% predicted before and after methacholine inhalation, and following the administration of a SABA, respectively. The BDR did not differ significantly according to asthma medication, age, or gender. However, BDR in the atopy group (37.4±17.7%) was significantly higher than that in the non-atopy group (30.5±10.7%; P=0.037). Patients with blood eosinophilia (38.6±18.1%) displayed increased BDR compared with patients without eosinophilia (32.0±13.8%; P=0.037). Conclusions: In children with mild to moderate asthma, the responsiveness to short-acting bronchodilators after methacholine-induced bronchoconstriction was not related to asthma medication, but was higher in children with atopy and/or peripheral blood eosinophilia.

Isolated pulmonary cryptococcosis in an immunocompetent boy

Siegfried Bauer,김지은,라경숙,이기형,박상희,정지태,김철환,유영 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.11

Pulmonary cryptococcosis is rare in immunocompetent subjects. Here,we present the case of a 16-year-old boy who was referred to our pediatric department for the management of multiple consolidations detected on chest radiography, which was routinely performed when the patient was being evaluated for an ankle fracture. Fine needle aspiration biopsy was performed, and the definitive diagnosis was established as cryptococcal pneumonia. After 8 weeks of antifungal treatment, the pulmonary nodules on the chest radiographs disappeared.

CD4+/CD8+ T lymphocytes imbalance in children with severe 2009 pandemic influenza A (H1N1) pneumonia

김지은,Siegfried Bauer,라경숙,이기형,정지태,노경호,이창규,유영 대한소아청소년과학회 2011 Clinical and Experimental Pediatrics (CEP) Vol.54 No.5

Purpose: This study was conducted to investigate the immune responses of children with moderate and severe novel influenza A virus (H1N1) pneumonia, and to compare their clinical and immunological findings with those of control subjects. Methods: Thirty-two admitted patients with H1N1 pneumonia were enrolled in the study. The clinical profiles, humoral and cell-mediated immune responses of the 16 H1N1 pneumonia patients who were admitted to the pediatric intensive care unit (severe pneumonia group),16 H1N1 pneumonia patients admitted to the pediatric general ward (moderate pneumonia group) and 13 control subjects (control group)were measured. Results: Total lymphocyte counts were significantly lower in patients with H1N1 pneumonia than in the control group (P=0.02). The number of CD4+ T lymphocytes was significantly lower in the severe pneumonia group (411.5±253.5/μL) than in the moderate pneumonia (644.9±291.1/μL, P=0.04) and control (902.5±461.2/μL, P=0.01) groups. However, the number of CD8+ T lymphocytes was significantly higher in the severe pneumonia group (684.2±420.8/μL) than in the moderate pneumonia (319.7±176.6/μL, P=0.02) and control (407.2±309.3/μL,P=0.03) groups. The CD4+/CD8+ T lymphocytes ratio was significantly lower in the severe pneumonia group (0.86±0.24) than in the moderate pneumonia (1.57±0.41, P=0.01) and control (1.61±0.49, P=0.01) groups. The serum levels of immunoglobulin G, immunoglobulin M and immunoglobulin E were significantly higher in the severe pneumonia group than in the 2 other groups. Conclusion: The results of this study suggest that increased humoral immune responses and the differences in the CD4+ and CD8+ T lymphocyte profiles, and imbalance of their ratios may be related to the severity of H1N1 pneumonia in children.

청소년 임신에 따른 임산부와 신생아의 주산기 문제점

신정희,Siegfried Bauer,윤영선,정현철,이영준,우찬욱,최병민,김해중,박상희,송지원,이장훈 대한신생아학회 2010 Neonatal medicine Vol.17 No.1

Purpose:In recent years, Korea has showed a steady increase in the frequency of teenage birth, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. Methods:We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. Results:Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. Conclusion:Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers. 목적:현재 국내 출산율은 계속 감소하고 있고 또 출산 연령이 계속 높아지고 있는 추세임에도 불구하고 10대 청소년들의 분만은 줄어 들지 않고 있다. 이러한 청소년 임신은 어린 신부와 그들에게서 태어난 신생아들에게도 의학적인 문제점뿐 아니라 사회적인 부담으로 작용하게 되므로 본 연구자들은 이러한 문제점들을 알아 보고자 하였다. 방법:2004년 1월부터 2009년 7월까지 고려대학교 안산병원에 입원한 산부가 19세 이하로 청소년이었던 산부와 그들에게서 태어난 신생아를 대상으로 하였다. 대상 산부는 27명이었으며 대상 신생아는 28명이었고 이들의 의무기록을 후향적으로 분석하여 산부와 신생아의 특성, 주산기 합병증 및 지원했던 사회적 지원에 대해 조사하였다. 결과:27명의 모든 산부는 미혼이었으며 이 중 11명은 결손 가정의 자녀였다. 임신으로 적절한 산전검사를 받은 산부는 3명뿐이었으며 특히 11명(40.7%)의 산부는 산전검사를 전혀 받지 않았다. 산부의 주산기 합병증으로 조산, 빈혈, 조기 양막 파수, 융모양막염 등이 있었다. 대상 신생아 28명 중 미숙아는 17명(60.7%)이었으며 극소 저체중 출생아는 10명(35.7%)이었다. 신생아의 합병증은 모두 미숙아에서 나타났으며 호흡곤란증후군 8명, 패혈증 3명, 치료가 필요했던 동맥관 개존증, 괴사성 장염, 뇌실 내 출혈 등이었다. 입원 중 사망한 환아는 1명으로 사인은 폐출혈이었다. 퇴원한 신생아 27명 중 14명(51.9%)이 입양되었거나 아동 보호 시설에 위탁되었고 친부모에게 양육된 경우는 12명(44.4%)이었다. 결론:청소년 임신은 조산으로 출산하는 경우가 많고 산전 검사를 제대로 받지 못해 적절한 출산 준비 없이 신생아를 출산하게 되어 미숙아의 빈도가 높고 이로 이한 주산기 합병증이 많다. 또한 신생아가 미혼모에게서 출생하게 되므로 친부모에게 양육되지 못하고 입양되거나 아동 보호 시설에 위탁되는 경우가 많아 사회적 부담이 증가하게 된다. 따라서 이런 문제를 예방하기 위해 청소년에 대한 피임 교육과 함께 임신에 대한 적절한 정보를 제공하여 임신이 된 경우 적절한 관리를 받을 수 있도록 적극적인 사회 지지가 필요하겠다.

급성 Respiratory syncytial virus 세기관지염 환아의 비인두흡인액에서 혈관내피세포 성장인자의 증가

라경숙,남효경,Siegfried Bauer,김지은,최익선,이윤,박상희,정지태,유영 대한 소아알레르기 호흡기학회 2010 Allergy Asthma & Respiratory Disease Vol.20 No.3

목 적:급성 respiratory syncytial virus (RSV) 세기관지염으로 입원한 2세 이하 환아에서 천명의 지속 기간과 혈청 또는 비인두흡인액 VEGF 농도와의 관계를 알아보고자 하였다. 방 법:2008년 11월부터 2009년 4월까지 고려대학교 안암병원 소아청소년과에 급성 바이러스성 세기관지염으로 입원한 2세 이하 환아 94명을 대상으로 혈액의 알레르기 염증 지표를 검사하고 의무기록지를 토대로 발열, 천명, 입원 기간 등의 임상 소견을 분석하고, 비인두흡인액과 혈청 VEGF 농도를 측정하였다. 결 과:대상 환아 94명 중 비인두흡인액 바이러스 배양에서 RSV가 검출된 RSV 양성군 51명과 RSV 음성군 43명에서 입원 기간은 각각 6.9±2.1일과 5.5±1.8일로 차이가 없었으나, 천명의 지속기간은 RSV 양성군이 3.8±2.7일로 RSV 음성군의 2.4±1.8일에 비해 유의하게 길었다. 혈청 VEGF 농도의 평균값은 RSV 양성군이 240.3±113.2 pg/mL로 RSV 음성군의 194.4±119.3 pg/mL 보다 약간 높았으나 통계적인 유의성은 없었고 (P=0.134), 비인두흡인액 VEGF 농도는 RSV 양성군이 331.8±197.8 pg/mL로 RSV 음성군의 204.5±97.0 pg/mL 보다 유의하게 높았다(P=0.002). 결 론:RSV 양성 세기관지염 환아군에서 RSV 음성 환아군에 비해 비인두흡인액 VEGF 농도가 높았고, 천명의 지속 기간도 길게 나타났다. 이는 RSV 세기관지염에서 증가된 VEGF가 기관지벽의 투과도 증가와 부종을 유발하고 기류제한을 초래하여 천명이 오래 지속되는 것에 일부 관계 있을 것으로 생각해 볼 수 있다. Purpose:Viral infection is known as one of the dominant risk factors for wheezing in children hospitalized before 2 years of age. Although the major viral pathogen associated with wheezing is respiratory syncytial virus (RSV), the mechanisms of wheezing remain unclear. Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and vascular permeability. The aim of this study was to evaluate the relationship between VEGF concentration and wheezing in children with acute RSV bronchiolitis. Methods:Ninety-four children with acute bronchiolitis who were admitted to Korea University Anam Hospital were enrolled in this study. Based on the proven viral agents, children with bronchiolitis were divided into 2 groups: those who were infected with RSV (RSV (+) group, n=51) and those who were not (RSV (–) group, n=43). A complete history taking, physical examination and routine laboratory tests were performed on all children. VEGF levels in serum and nasopharyngeal aspirates (NPA) were determined by ELISA. Results:NPA VEGF levels were significantly higher in the RSV (+) group than in the RSV (-) group (331.8±197.8 vs. 204.5±97.0 pg/mL, P=0.002). The duration of wheezing is significantly longer in the RSV (+) group than in the RSV (-) group (3.8±2.7 days vs. 2.4±1.8 days, P=0.037). Conclusion:The results of this study suggest that children with RSV bronchiolitis may have significantly higher NPA VEGF levels than those without, which may be associated with a longer duration of wheezing in those with RSV bronchiolitis.

Relationships Between Exhaled Nitric Oxide and Atopy Profiles in Children With Asthma

장원녕,박인수,최창희,Siegfried Bauer,Samuel Harmin,서성철,최익선,정지태,유영 대한천식알레르기학회 2013 Allergy, Asthma & Immunology Research Vol.5 No.3

Purpose: We examined whether fractional exhaled nitric oxide (FeNO) levels are associated with atopy profiles in terms of mono-sensitization andpoly-sensitization in asthmatic children. Methods: A total of 119 children underwent an assessment that included FeNO measurements, spirometry,methacholine challenge, and measurement of blood eosinophil count, serum total IgE, and serum eosinophil cationic protein (ECP). We also examinedsensitization to five classes of aeroallergens (house dust mites, animal danders, pollens, molds, and cockroach) using skin prick testing. Thechildren were divided into three groups according to their sensitization profiles to these aeroallergens (non-sensitized, mono-sensitized, and polysensitized). Results: The geometric means (range of 1 SD) of FeNO were significantly different between the three groups (non-sensitized, 18.6 ppb[10.0-34.7 ppb]; mono-sensitized, 28.8 ppb [16.6-50.1 ppb]; and poly-sensitized, 44.7 ppb [24.5-81.3 ppb], P=0.001). FeNO levels were correlatedwith serum total IgE concentrations, peripheral blood eosinophilia, and serum ECP levels to different degrees. Conclusions: FeNO levels vary accordingto the profile of atopy, as determined by positive skin prick test results to various classes of aeroallergens. FeNO is also moderately correlatedwith serum total IgE, blood eosinophilia, and serum ECP. These results suggest that poly-sensitized asthmatic children may have the highest riskof airway inflammation.

천식 소아에서 호기산화질소 농도와 기도 과민성, 혈액 호산구 수, 혈청 호산구 양이온 단백 농도와의 상관관계

서현석,정보현,박하늘,서성철,Bauer Siegfried,송대진,정지태,유영 대한 소아알레르기 호흡기학회 2012 Allergy Asthma & Respiratory Disease Vol.22 No.3

Purpose:The measurement of fraction of nitric oxide (FeNO) is a noticeable tool that reflects airway inflammation in asthmatic patients. We wanted to find out the relationship between pulmonary function, bronchial hyperresponsiveness (AHR), blood eosinophilic inflammatory markers and FeNO level before and after methacholine bronchoprovocation test in asthmatic patients. Methods:Fifty-five children, who visited the Allergy Clinic of Korea University Anam Hospital from March 2011 to February 2012, due to asthmatic symptoms, such as history of episodic wheezing or dyspnea during the previous year and resolved after using bronchodilators, were enrolled. We performed the baseline pulmonary function and methacholine bronchoprovocation test in the enrolled patients. Blood eosinophil counts and blood eosinophil cationic protein (ECP) were measured. FeNO levels were measured before and after the methacholine bronchoprovocation test. Results:The mean FeNO levels (36.3 ppb) fell after methacholine bronchoprovocation test (25.7 ppb). Forced expiratory volume in one second (FEV1) %pred inversely correlated both with FeNO level before (R2=0.07, P=0.029) and after (R2=0.059, P=0.01) methacholine bronchoprovocation test. The provocative concentration, causing a 20% decrease in FEV1 to methacholine (methacholine PC20) inversely correlated both with FeNO levels before (R2=0.086, P=0.001) and after (R2=0.141, P=0.001) the challenge. FeNO level measured at bronchoconstriction state significantly correlated with blood eosinophil counts (R2=0.112, P=0.028). Serum ECP levels correlated FeNO level, neither before nor after bronchoprovocation. Conclusion:The baseline FeNO levels were higher in asthmatic children. However, FeNO levels rather decreased after methacholine induced bronchoconstriction. Repeated spirometry maneuver was considered to have an effect on reducing FeNO levels. FeNO correlated with pulmonary function, airway AHR and blood eosinophil counts. 목 적:호기산화질소 농도의 측정은 천식 환자에서 시행이 간편하며, 빠르고 비침습적인 하기도 염증의 임상적 지표로서 최근 각광받고 있다. 본 연구는 천식 소아에서 폐 기능, 메타콜린 기도 과민성, 혈액 호산구 염증지표와 메타콜린 유발시험 전, 후에 측정한 호기산화질소 농도 사이의 연관성을 알아보고자 하였다. 방 법:기침, 천명, 호흡 곤란 등 천식 증상으로 고려대학교 안암병원 소아알레르기 호흡기 클리닉을 방문한 환아 55명에서 폐 기능 검사, 메타콜린 유발 검사, 혈액 호산구 수와 혈청 호산구 양이온 단백 농도를 측정하고, 메타콜린 유발 검사 전 기저 폐 기능 상태와 유발 시험 후 기도 수축 상태에서 호기산화질소 농도를 측정하였다. 결 과:메타콜린 유발시험 후 호기산화질소 농도는 평균 25.7 ppb (13.8–47.9)으로 유발시험 전 36.3 ppb (20.9–63.1)에 비해 유의하게 낮았다.(P=0.001) 기저 폐 기능과 호기산화질소 농도는 유발시험 전(R2=0.07, P=0.029)과 후(R2=0.059, P=0.01) 모두에서 유의한 음의 상관관계를 보였다. 호기산화질소 농도와 메타콜린 PC20의 상관관계는 유발 시험 전(R2=0.086, P=0.001)과 후(R2=0.141, P=0.001) 모두에서 유의한 음의 상관관계를 보였다. 호기산화질소 농도와 혈액 호산구 수는 유발시험 전 R2= 0.082, P=0.211 이었으나 후에는 R2=0.112, P=0.028로 기도 수축 상태에서만 유의한 양의 상관관계를 보였다. 호기산화질소 농도는 혈청 호산구 양이온 단백 농도와 유의한 상관관계를 보이지 않았다. 결 론:호기산화질소 농도와 기저 폐 기능, 메타콜린 PC20은 유의한 음의 상관관계를 보이며, 기도 수축 상태에서 측정한 호기산화질소 농도와 혈액 호산구 수는 유의한 양의 상관관계를 보였다. 기도 염증의 간접 지표의 하나인 호기산화질소 농도는 반복적인 폐 기능 검사 자체로 인해 감소될 수 있다.

CD4+/CD8+ T lymphocytes imbalance in children with severe 2009 pandemic influenza A (H1N1) pneumonia

Kim, Ji-Eun,Bauer, Siegfried,La, Kyong-Suk,Lee, Kee-Hyoung,Choung, Ji-Tae,Roh, Kyoung-Ho,Lee, Chang-Kyu,Yoo, Young The Korean Pediatric Society 2011 Clinical and Experimental Pediatrics (CEP) Vol.54 No.5

Purpose: This study was conducted to investigate the immune responses of children with moderate and severe novel influenza A virus (H1N1) pneumonia, and to compare their clinical and immunological findings with those of control subjects. Methods: Thirty-two admitted patients with H1N1 pneumonia were enrolled in the study. The clinical profiles, humoral and cell-mediated immune responses of the 16 H1N1 pneumonia patients who were admitted to the pediatric intensive care unit (severe pneumonia group), 16 H1N1 pneumonia patients admitted to the pediatric general ward (moderate pneumonia group) and 13 control subjects (control group) were measured. Results: Total lymphocyte counts were significantly lower in patients with H1N1 pneumonia than in the control group (P=0.02). The number of CD4+ T lymphocytes was significantly lower in the severe pneumonia group ($411.5{\pm}253.5/{\mu}L$) than in the moderate pneumonia ($644.9{\pm}291.1/{\mu}L$, P=0.04) and control ($902.5{\pm}461.2/{\mu}L$, P=0.01) groups. However, the number of CD8+ T lymphocytes was significantly higher in the severe pneumonia group ($684.2{\pm}420.8/{\mu}L$) than in the moderate pneumonia ($319.7{\pm}176.6/{\mu}L$, P=0.02) and control ($407.2{\pm}309.3/{\mu}L$, P=0.03) groups. The CD4+/CD8+ T lymphocytes ratio was significantly lower in the severe pneumonia group ($0.86{\pm}0.24$) than in the moderate pneumonia ($1.57{\pm}0.41$, P=0.01) and control ($1.61{\pm}0.49$, P=0.01) groups. The serum levels of immunoglobulin G, immunoglobulin M and immunoglobulin E were significantly higher in the severe pneumonia group than in the 2 other groups. Conclusion: The results of this study suggest that increased humoral immune responses and the differences in the CD4+ and CD8+ T lymphocyte profiles, and imbalance of their ratios may be related to the severity of H1N1 pneumonia in children.

호흡기 증상을 호소하는 소아에서 기침과 천명음의 객관적 평가를 위한 기침-홀터 모니터링의 유용성

박하늘,장원녕,남효경,강인순,서성철,Siegfried Bauer,최익선,정지태,유영 대한 소아알레르기 호흡기학회 2012 Allergy Asthma & Respiratory Disease Vol.22 No.4

Purpose:Cough and wheezing are the most common respiratory symptoms in children. Recently, the cough-holter monitoring has been used to estimate the frequency and intensity of cough and wheezing, objectively. In this study, we aimed to evaluate the validity of cough-holter monitoring for the objective assessment of cough and wheezing in the hospitalized children with respiratory symptoms. Methods:Cough-holter monitoring was performed in 59 children who suffered from cough and/or wheezing. We obtained the information on the frequency and intensity of cough and wheezing from the parents, a pediatrician, and cough-holter monitoring. Visual Analogue Scale (VAS) scores were taken by parents, and the pediatrician estimated the wheezing score by using a stethoscope. We assessed a relationship between the VAS scores, wheezing score, and cough-holter monitoring data. Results:The frequencies and intensities of cough correlated positively with the VAS scores (r=0.301, P=0.032; and r=0.540, P=0.001, respectively) and the frequencies and intensities of wheezing also correlated positively with the Wheezing scores. (r=0.335, P=0.011; and r=0.457, P=0.001, respectively) The wheezing intensity did not correlate with the Wheezing score in wheezing children. (r=0.321, P=0.089)Conclusion:Cough-holter monitoring correlated positively with the VAS scores and the wheezing scores. Cough-holter monitoring appears to be a useful objective assessment tool for the children who have suffered from cough and/or wheezing. 목적:임상에서 기침, 천명에 대한 평가는 환자나 보호자가 호소하는 주관적인 증상과 의사의 신체 진찰을 통해 주로 이루어지고 있다. 하지만 이러한 방법들은 일회성이며 주관적인 측면이 있어 기침이나 천명음의 양적인 평가나 지속적인 모니터링에 제한점이 많다. 이에 본 연구에서는 기침-홀터 모니터에서 측정된 기침, 천명음의 빈도 및 강도와 호소하는 증상 및 청진 결과의 일치도를 평가하여 이에 따른 임상적 이용 가치를 알아보고자 하였다. 방법:기침이나 천명음을 주소로 2011년 2월 1일부터 2011년 10월 31일까지 고려대학교 안암병원 소아청소년과 호흡기 알레르기 클리닉을 방문하여 입원한 59명을 대상으로 시행하였다. 대상 환아들은 야간에 약 12시간 동안 기침-홀터 모니터를 사용하여 기침과 천명음의 빈도 및 강도를 분석하였으며, 측정된 결과와 보호자에 의해 설문 작성된 VAS score, 소아청소년과 의사의 청진 상 wheezing score 사이의 연관성을 분석하였다. 결과:전체 대상군에서 기침-홀터는 VAS score와 기침의 빈도, 강도에서 유의한 양의 상관 관계를 보였고, wheezing score도 천명음의 빈도와 강도에서 유의한 양의 상관 관계를 보였다. 천명군과 비천명군 모두에서 기침-홀터는 기침 강도와 유의한 양의 상관 관계를 보였으나, 천명군에서 wheezing score와 천명음의 빈도 및 강도는 모두 유의한 상관 관계가 없었다. 결론:본 연구에서 기침-홀터로 측정한 기침, 천명음은 환자 또는 보호자가 호소하는 기침 증상 및 소아청소년과 의사의 청진을 통한 주관적 평가 결과와 유의하게 일치하는 경향을 보였다. 기침-홀터는 임상에서 급, 만성 호흡기 증상을 호소하는 소아를 평가하는 객관적 평가 도구의 하나로서 유용하게 사용할 수 있을 것으로 판단된다.