한국 3개 지역 고등학생에서 알레르기질환의 유병률에 대한 조사

김봉성 ( Bong Seong Kim ),김효빈 ( Hyo Bin Kim ),이소연 ( So Yeon Lee ),김자형 ( Ja Hyeung Kim ),진현승 ( Hyun Seung Jin ),김병주 ( Byung Ju Kim ),유진호 ( Jin Ho Yu ),유선미 ( Sun Mi Yoo ),홍수종 ( Soo Jong Hong ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.3

Background: Whereas allergic disease has a high morbidity among adolescents, there have been few reports concerning asthma prevalence using objective parameters such as methacholine bronchial provocation tests in this age group. Objective: Thus we investigate the prevalence of asthma and other allergic diseases using questionnaires and measuring bronchial hyperresponsiveness (BHR) in high school students in Korea. Method: A questionnaire survey was conducted among 1499 high school students, from 3 regions in Korea between April and May, 2006. They responded to a modified International Study of Asthma and Allergies in Childhood (ISAAC) written (WQ) and video (AVQ) questionnaires. 709 subjects of them underwent methacholine bronchial challenge test. Result: The WQ showed that the lifetime and 12-month prevalences of wheeze were 16.0% and 8.9%. The lifetime prevalence of asthma diagnosis was 7.0% and 12-month prevalence of asthma treatment was 1.5%. By video questionnaire, the lifetime prevalence and 12-month prevalence of wheeze were 7.9% and 5.5%. The prevalence of current asthma based on the questionnaire and bronchial challenge tests was 3.2%. The prevalence of current asthma and BHR were higher in female than in male subjects. For 12-month prevalence of allergic rhinitis and atopic dermatitis were 37.7% and 11.4%, respectively. Conclusion: The prevalence of current asthma in high school students were 3.2%. Despite the fact that 12-month prevalence of wheeze and lifetime prevalence of asthma diagnosis were 8.9% was 7.0%, only 1.5% of answered subjects received asthma treatment. Its prevalence was still low compared to asthma prevalence. (Korean J Asthma Allergy Clin Immunol 2007;27:168-175)

IL-13 +2044G/A Polymorphism 과 소아천식의 관련성 및 그 기능 연구

김효빈 ( Hyo Bin Kim ),이소연 ( So Yeon Lee ),진현승 ( Hyun Seung Jin ),김자형 ( Ja Hyeong Kim ),김봉성 ( Bong Seong Kim ),강미진 ( Mi Jin Kang ),장성옥 ( Seong Ok Jang ),홍수종 ( Soo Jong Hong ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.4

Background: The IL-13 +2044G/A is known to be associated with increased serum total IgE levels and asthma development. Variant type of IL-13 was significantly more active than wild type in inducing CD23 expression in monocytes. Objective: We investigated the association of asthma susceptibility and asthma-related phenotypes with +2044G/A and the functional difference between wild (+2044G, R110) and variant types (+2044A, Q110). Method: We enrolled 358 atopic asthmatic, 81 non-atopic asthmatic, and 146 control children and evaluated total IgE and bronchial hyperresponsiveness. Genotypes were analyzed by PCR-RFLP method. We applied wild and variant types of IL-13 to B cells and evaluated CD23 expression by flow cytometry. Result: The group with more than one variant alleles of +2044G/A was associated with asthma development, but not with increased total IgE levels than those with wild homozygote in children with asthma. When Q110 was applied to peripheral blood B cells of normal subjects and EBV-transformed B cells from children with atopic asthma, CD23 expressions was higher than those when R110 applied. Conclusion: IL-13 +2044G/A was associated with asthma development in Korean children with asthma, but not with total IgE. In addition, Q110 enhanced CD23 expression on B cells. These findings suggest that IL-13 +2044A (Q110) polymorphism may play a role in asthma development or IgE production. (Korean J Asthma Allergy Clin Immunol 2006;26:271-276)

익수 환아의 임상양상과 예후를 예측할 수 있는 인자

김경수(Kyoung Soo Kim),정재일(Jae Il Joung),한명기(Myung Ki Han),김봉성(Bong Seung Kim),박기영(Kie Young Park),이정주(Jung Joo Lee),김정호 (Jeong Ho Kim) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.2

목 적 : 익수 환아의 임상경과와 예후에 영향을 미치는 인자들을 알아보고자 본 연구를 시행하였다. 방 법 : 1996년 3월부터 2002년 3월까지 강릉아산병원에 익수되어 내원한 환아 28례를 대상으로 병록지 고찰을 통해 익수 환아의 임사양상을 후향적으로 조사하였다. 또한, 신경학적 후유증 없이 완전히 회복된 좋은 예후군과 사망하거나 심한 신경학적 후유증이 남은 나쁜 예후군으로 구분하여 두 군 사이의 차이를 조사하였다. 결 과 : 28례 중 남아가 18례(64.3%), 여아가 10례(35.7%)로 남아가 많았다. 연령별로는 4세 이하가 10례(35.7%), 5-8세가 7례(25.0%, 9-12세가 8례(33.3%), 13-16세가 3례(10.7%)였다. 계절별로는 여름이 18례(64.3%), 봄이 6례(21.4%), 가을이 3례(10.7%), 겨울이 1례(4.2%)였다. 침수시간에 따란 5분 미만이 15례(53.6%), 5분 이상 10분 미만이 6례(21.4%)였다. 신경학적 후유증 없이 완전히 회복된 좋은 예후군은 28례 중 23례(82.1%), 신경학적 후유증이 있거나 사망한 나쁜 예후군은 식물인간상태 1례, 사망례 4례를 포함하여 5례(17.9%)였다. 좋은 예후군과 나쁜 예후군 사이에 성별, 나이, 계절, 침수장소, 이송시간, 응급심폐소생술 시행 여부에 따른 분류에서 두 군간 통계학적으로 유의한 차이가 없었으나, 침수시간, 기계환기요법의 적용 여부, 초기 혈당치, 초기 동맥혈 pH가 좋은 예후군과 나쁜 예후군 사이에 차이를 나타냈다. 결 론 : 익수 환아에서 침수시간이 10분 이상인 경우, 기계환기요법을 받은 경우, 초기 혈당치가 높은 경우, 초기 동맥혈 pH가 낮은 경우 신경학적 예후가 나쁠 것으로 예상된다. Purpose : We intended to find out clinical aspects and prognostic factors of near drowning children in this study. Methods : We conducted a retrospective study on twenty eight near-drowning children, who were admitted to Gangneung Asan Hospital from March, 1996 to March, 2002. We investigated their clinical aspects and the differences between two groups, namely a good prognosis group and a poor prognosis group. Those in the good prognosis group had no neurologic impairments and were fully recovered while those in the poor prognosis group died or fell into vegetative states. Results : Out of 28 patients, there were 18 males(64.3%) and 10 females(35.7%). Age distribution was ≤4 years in 10 cases, 5 to 8 years in 7 cases, 9 to 12 years in 8 cases, and 13 to 16 years in 3 cases. Seasonal distribution was summer in 18 cases, spring in 6 cases, autumn in 3 cases, and winter in 1 case. Submersion time was ≤5 minutes in 15 cases, 5 to 10 minutes in 7 cases, and unknown in 7 cases. Initial blood glucose level was 175.2±88.0 mg/dL and initial arterial blood pH was 7.24±0.21. Good prognosis group had 23 out of 28 cases(82.1%) while poor prognosis group had 5 out of 28 cases(17.9%) which included 4 deaths and 1 vegetative case. Between the two groups there were no significant differences in the distributions of sex, age, season, submersion place, transfer time to hospital and resuscitation time. However, submersion time, mechanical ventilation need, initial blood glucose level and initial arterial pH were significantly different between the two groups. Conclusion : We found out that poor prognosis is expected for near-drowning children of submersion time over 10 minutes, applied mechanical ventilation, high initial blood glucose level, and low initial arterial blood pH.

한국 초등학생에서 12개월 천식증상 유별율의 위험인자로서 최근 식이형태의 연관성

이수영 ( Soo Young Lee ),홍수종 ( Soo Jong Hong ),김봉성 ( Bong Seung Kim ),김창근 ( Chang Keun Kim ),이동진 ( Dong Jean Lee ),이동근 ( Dong Keun Lee ),고영률 ( Young Yul Koh ),이준성 ( Joon Sung Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2006 소아알레르기 및 호흡기학회지 Vol.16 No.4

목적: 식이 양상(dietary pattern)이 천식 발생의 위험인자로 작용하는지를 알아보기 위하여 ISSAC 설문지를 이용하여 전국적인 설문조사를 시행하였다. 방법: 총 24,260면의 초등학생을 대상으로 알아보기 위하여 ISSAC 설문지와 우리나라에서 개발한 식이 관련 설문지를 이용하여 최근 12개월 동안 섭취한 16종의 식이군 빈도가 지난 12개월 동안의 천식 증상 발생에 미치는 영향을 조사 분석하였다. 결과: 천식 증상의 발생은 신선한 해산물 (OR:0.88, P=0.0126, 95% CI:0.795-0.973), 과일(OR:0.785, P<0.0001, 95% CI:0.715-0.861), 야채(OR:0.825, P<0.0001, 95% CI:0.764-0.891), 우유(OR:0.9, P=0.0451, 95% CI:0.811-0.998)의 섭취가 증가할수록 의미 있게 감소하였다. 또한 신선한 해산물을 거의 섭취하지 않는 소아에 비하여 주 1-2회 섭취하는 경우(OR:0.863, P=0.028, 95% CI:0.761-0.978)와 거의 매일 섭취하는 경우(OR:0.802, P=0.0755, 95% CI:0.630-1.023)에 천식 증상의 발생이 의미 있게 감소함을 알 수 있었다. 야채의 경우도 일주일 동안 거의 섭취하지 않은 경우에 비하여 주 1-2회 섭취하는 경우(OR:0.753, P=0.0416, 95% CI:0.595-0.950)와 거의 매일 섭취하는 경우(OR:0.674, P=0.0179, 95% CI:0.408-0.752)에 천식 증상의 발생이 가소함을 알 수 있었고, 과일의 경우는 야채의 경우와 동일한 양상을 보였다. 결론: 결론적으로 우리나라 소아에서 천식 증상의 발생은 신선한 해산물, 과일, 야채의 섭취가 증가함에 따라 의미 있게 감소함을 알 수 있었다. Purpose: To investigate the impact of dietary pattern on the risk of asthma development, we undertook a nation-wide study with ISSAC written questionnaire. Methods: We analyzed the relations between the previous 12-month dietary patterns (16 food groups) and asthma symptom prevalence, using the ISSAC written questionnaire and a domestically developed dietary questionnaire in 24,260 elementary school children. Results: Odds ratios (OR) were significantly decreased by increased food intake of natural seafood (OR:0.88, P=0.0126, 95% CI:0.795-0.973), fruit (OR:0.785, P<0.0001, 95% CI:0.715-0.861), vegetables (OR:0.825, P<0.0001, 95% CI:0.764-0.891), and cow`s milk (OR:0.9, P=0.0451, 95% CI:0.811-0.998). Compared to children that seldom consumed natural seafood, ORs of symptom development were lower in children that ate natural seafood 1-2 times per week (OR:0.863, P=0.028, 95% CI:0.761-0.978) and almost everyday (OR:0.802, P=0.0755, 95% CI:0.630-1.023), respectively. For green vegetables, ORs were significantly lower than in children who also ate gree vegetables 1-2 times per week (OR:0.753, P=0.0416, 95% CI:0.595-0.950) and almost everyday (OR:0.674, P=0.0179, 95% CI:0.408-0.752), respectively. Fruits showed the same pattern as green vegetables. Conclusion: Taken together, our study shows that the increased intake of natural seafood, fruit, and vegetables is significantly related to reduced asthma symptom prevalence in Korean children. [Pediatr Allergy Respir Dis(Korea) 2006;16:296-305]