소아 마이코플라스마 폐렴: 나이에 따른 임상적 특징과 불응성폐렴의 위험 요인

김형영 ( Hyung Young Kim ),박희주 ( Hee Ju Park ) 대한천식알레르기학회 2018 Allergy Asthma & Respiratory Disease Vol.6 No.6

Purpose: It is thought that Mycoplasma pneumoniae infection is more prevalent and causes more severe pneumonia in school-age children and young adults than in preschool children; however, recent studies suggest that the infection may be underdiagnosed and more severe in preschool children. This study investigated the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) and the risk factors of refractory MPP (RMPP) by age. Methods: We retrospectively reviewed the medical records of 353 children admitted due to MPP from January 2015 to December 2016. Demographics, clinical information, laboratory data and radiological findings were collected from all patients in this study. The patients were divided into 2 groups by the age of 6 years. Also, both preschool (< 6 years old) and school-age (≥6 years old) children were divided into RMPP and non-RMPP patients. Results: Total febrile days, febrile days before admission and the duration of macrolide antibiotic therapy were significantly longer in school-age children than in preschool children. School-age children had significantly greater risk of lobar consolidation (P=0.036), pleural effusion (P=0.001) and extrapulmonary complications (P=0.019). Necrotizing pneumonia and bronchiolitis obliterans tended to occur more frequently in preschool children than in school-age children. In both preschool and school-age children, lactate dehydrogenase (LDH) levels were significantly higher in RMPP patients than in non-RMPP patients. In preschool children, LDH >722 IU/L (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44-6.50) and ferritin >177 ng/mL (OR, 5.38; 95% CI, 1.61-19.49) were significant risk factors for RMPP, while LDH >645 IU/L (OR, 4.12; 95% CI, 1.64-10.97) and ferritin >166 ng/mL (OR, 5.51; 95% CI, 1.59-22.32) were so in school-age children. Conclusion: Clinical features of MPP were significantly different between preschool and school-age children. LDH and ferritin may be significant factors of RMPP in preschool and school-age children. (Allergy Asthma Respir Dis 2018;6:295-302)

한중일 강구조 기술 SYMPOSIUM

김형영(Hyung Young Kim) 한국강구조학회 2002 韓國鋼構造學會誌 Vol.14 No.4

청소년에서 진단된 미만성 범세기관지염 1예

김형영 ( Hyung Young Kim ),손승국 ( Seung Kook Son ),박희주 ( Hee Ju Park ) 대한천식알레르기학회 2016 Allergy Asthma & Respiratory Disease Vol.4 No.1

Diffuse panbronchiolitis (DPB) is a progressive inflammatory respiratory disease of unknown cause mainly occurring in East Asian people. Studies on causes of the disease point to a genetic predisposition unique to Asians, but the cause remains unknown. If untreated, DPB progresses to bronchiectasis, respiratory failure, and death. The age of patients at onset of the disease varies from young to elderly people with a peak at 40?60 years. A few cases of DPB have been reported in Korean adults since 1992; however, the case of DPB in children is uncommon. Herein, we describe a 16-year-old girl with DPB who presented with chronic cough and sputum. (Allergy Asthma Respir Dis 2016;4:65-69)

인천과 아산지역 소아청소년의 흡입 알레르겐 감작률 및 다항원 감작과 알레르기질환 발병과의 관계

김형영 ( Hyung Young Kim ),서주희 ( Ju Hee Seo ),정영호 ( Young Ho Jung ),이은 ( Eun Lee ),양송이 ( Song I Yang ),하미나 ( Min A Ha ),권호장 ( Ho Jang Kwon ),임종한 ( Jong Han Lim ),김환철 ( Hwan Chul Kim ),이기재 ( Kee Jae Lee ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.1

Purpose: Sensitization to allergens is considered as major mechanism of allergy and related to the development of allergic diseases. The objective of this study was to evaluate overall sensitization rates of inhalant allergens and the relationship between polysensitization and prevalence of allergic diseases in children and adolescents. Methods: A cross-sectional pilot study of 122 elementary school students, 114 middle school students, and 115 high school students from Incheon and Asan was conducted by using the International Study of Asthma and Allergies in Childhood (ISSAC) questionnaire. The skin prick tests were performed with 14 common inhalant allergens on 339 students. Results: The inhalant allergen that has a significantly different sensitization rate according to age was Dermatophagoides farinae. And the inhalant allergen that has significantly different sensitization rate according to region was Japanese hop. In addition, girls have higher sensitization rate to any mold allergens than boys. In case of having sensitization more than two allergens, the risks of diagnosis of asthma and allergic rhinitis on questionnaire were increased. Asthma is related to sensitization of dog or cat and allergic rhinitis is related to sensitization of house dust mites. However, atopic dermatitis is not related to sensitization of any inhalant allergens. Conclusion: The sensitization rates of inhalant allergens may differ among age, gender, and region in children and adolescents of Incheon and Asan area. The polysensitized children and adolescents with inhalant allergens showed higher prevalences of allergic diseases such as asthma and allergic rhinitis on questionnaire than monosensitized group. (Allergy Asthma Respir Dis 1?1):41-49, 2013)Allergy Asthma Respir Dis 1(1):41-49, 2013)

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 대한천식알레르기학회 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)

수도권 학령전기 소아에서 식품알레르기의 유병률 및 위험인자

정영호 ( Young Ho Jung ),고훈 ( Hoon Ko ),김형영 ( Hyung Young Kim ),서주희 ( Ju Hee Seo ),권지원 ( Ji Won Kwon ),김병주 ( Byoung Ju Kim ),김효빈 ( Hyo Bin Kim ),이소연 ( So Yeon Lee ),장광천 ( Gwang Cheon Jang ),송대진 ( Dae Jin 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.3

Background: The aim of this study was to investigate the prevalence of food allergy (FA) and determine its risk factors in the preschool urban children in Seoul, Korea. Methods: A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to survey 933 pre-school children from nine urban areas of Seoul in Korea. The risk factor analysis was done by logistic regression analysis. Results: In preschool children, the lifetime and recent 12-month prevalence of FA symptoms were 21.0% and 10.6%, respectively. The lifetime prevalence of FA diagnosis was 6.1%, the prevalence of current FA (12-month symptoms and diagnosis) was 3.3%, and the recent 12-month prevalence of FA treatment was 3.6%. Blood eosinophils [0] in FA group and Non-FA group were 5.00±3.93% and 3.93±2.91%, respectively (P=0.002). The median total Immunoglobulin E (IgE) of FA group was 102 (interquatile [IQ] range 44.8∼257) IU/mL, the median total IgE of Non-FA group was 70.9 (IQ range 70.9∼161) IU/mL (P=0.001). Parental FA(adjusted odds ratio [aOR], 2.17; 95% confidence interval [CI], 1.22∼3.85), past history of AD diagnosis (aOR, 3.69; 95% CI, 2.33∼5.85), eczema on doctor`s physical examination (aOR, 3.74; 95% CI, 2.16∼6.47), use of antibiotics during infancy more than 3 days (aOR, 1.72; 95% CI, 1.08∼2.73) were the independent risk factors for FA symptoms within 12 months. Conclusion: In preschool urban children in Seoul, the lifetime prevalence of FA diagnosis was 6.1%, the recent 12 month prevalence of FA treatment was 3.6%. The prevalences of AD and doctor examined AD in FA group were significantly higher compared to Non-FA group. Family history, and the use of antibiotics during infancy could be the independent risk factors for the development of FA. (Korean J Asthma Allergy Clin Immunol 2011;31: 177-183)

NC/Nga 마우스에서 Dermatophagoides farinae의 피부 적용과 기도 유발에 의해 발생한 기도 염증에 대한 CpG Oligodeoxynucleotide의 효과

김영준 ( Young Joon Kim ),장성옥 ( Seong Ok Jang ),최원아 ( Won Ah Choi ),강미진 ( Mi Jin Kang ),정현돈 ( Hyun Don Jung ),김하정 ( Ha Jung Kim ),김형영 ( Hyung Young Kim ),서주희 ( Ju Hee Seo ),유진호 ( Jin Ho Yu ),홍수종 ( Soo Jo 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.2

Background: Atopic dermatitis (AD) is the initial step of allergic march that progresses to airway allergic disease. There has been much interest in the interruption of the allergic march, but the results are not promising. CpG oligodeoxynucleotide (ODN) has been reported to have both preventive and therapeutic effects on the development of asthma in mouse models. Objective: To identify the development of airway inflammation after having atopic dermatitis-like skin lesions induced by topical application of Dermatophagoides farinae (Df), and to evaluate the preventive effect of CpG ODN on the development of airway inflammation. Method: We injected 5 μg of Df intradermally 8 times for 2 weeks into 8-week-old NC/Nga mice and then challenged them with 3 times of Df intranasally. CpG ODN with or without Df was injected subcutaneously before airway challenge. Airway hyperreactivity was determined by the change inenhanced pause (Penh) during methacholine provocation. Lung tissue and bronchoalveolar lavage specimens were evaluated. Result: Topical Df application induced AD-like skin lesion microscopically, but not macroscopically. NC/Nga mice with topical Df application developed more severe airway inflammation upon intranasal Df challenge than those with topical PBS application. However, the mice with CpG ODN injection before airway challenge showed reduced airway inflammation. The levels of Df-specific IgG1 were increased in the mice with both topical Df application and intranasal Df challenge but were decreased in the mice with CpG ODN injection. Conclusion: These results suggest that CpG may inhibit the development of airway inflammation from those with previous AD-like skin lesions induced by Df. (Korean J Asthma Allergy Clin Immunol 2011;31:131-139)

보험과 관련된 가정용 기계환기기의 적용에 관한 연구

문상욱 ( Sang Wook Mun ),김형영 ( Hyung Young Kim ),김혜영 ( Hye-young Kim ),박희주 ( Hee Ju Park ),김수연 ( Soo Yeon Kim ),신용범 ( Young Beom Shin ),손승국 ( Seung Kook Son ) 대한천식알레르기학회 2016 Allergy Asthma & Respiratory Disease Vol.4 No.3

Purpose: Use of a home mechanical ventilator can shorten the hospitalization duration of children with chronic respiratory failure requiring long-term use of a mechanical ventilator. In this study, the researchers analyzed patients who had used a home mechanical ventilator. Methods: From January 2009 to July 2014, we retrospectively investigated 15 patients under 18 years of age, from 2 hospitals, and their use of home mechanical ventilators. Results: The median age of the patients was 55 months. Ten children were male, and 5 were female. As for the type of mechanical ventilators, 10 used a pressure type, 3 used a volume type, and 2 used a volume-mask type. Analysis of underlying diseases revealed that 10 children had neuromuscular disease, 3 had pulmonary disease, and 2 suffered from hypoxic ischemic encephalopathy. The number of patients who were discharged from the hospital with a home mechanical ventilator was 13. One child died of sepsis irrespective of the mechanical ventilator. Six patients had health insurance. But 9 did not. The group with insurance had the possibility of being discharged earlier than the group without. On readmission, the length of hospitalization was also reduced in patients who had used a home mechanical ventilator. Conclusion: Use of a mechanical ventilator at home is helpful in patients who need long-term use of a mechanical ventilator due to neuromuscular disease, chronic pulmonary diseases, and accidents because complications are rare and insurance coverage is feasible. (Allergy Asthma Respir Dis 2016;4:195-198)

알레르기비염과 형제자매와의 연관성

서주희 ( Ju Hee Seo ),김형영 ( Hyung Young Kim ),정영호 ( Young Ho Jung ),권지원 ( Ji Won Kwon ),김병주 ( Byoung Ju Kim ),김효빈 ( Hyo Bin Kim ),김우경 ( Woo Kyung Kim ),이소연 ( So Yeon Lee ),장광천 ( Gwang Cheon Jang ),송대진 ( 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.1

Purpose: We investigated the effect of siblings on the development of allergic rhinitis (AR) in Korean adolescents. Methods: A cross-sectional study of adolescents (n=3,271) aged 12 to 15 years was conducted at three middle schools in Seoul. Demographic and disease-related information was obtained through a questionnaire. Results: The mean age of the subjects was 13.9±0.8 years comprising 48.7% males and 51.3% females. The percentage of the subjects who had ever been diagnosed with AR by physician was 30.7%. Subjects who had older sibling and who had younger sibling were 45.3% and 44.2% respectively. Subjects with older sibling were less likely to diagnose AR than subjects without older sibling (adjusted odds ratio [aOR], 0.69; 95% confidence interval [CI], 0.57 to 0.84). Subjects with older sibling, even though with family history of allergic disease had protective effect compared to subjects without older sibling (aOR, 0.62; 95% CI, 0.45 to 0.84). Subjects with younger sibling were more likely to diagnose AR than subjects without younger sibling (aOR, 1.23; 95% CI, 1.02 to 1.49). Conclusion: These findings suggest that having older sibling is one of the important protective factor for the development of allergic rhinitis and having younger sibling is risk factor for allergic rhinitis in adolescents. (Allergy Asthma Respir Dis 1?1):67-72, 2013)Allergy Asthma Respir Dis 1(1):67-72, 2013)

소아 객혈의 원인: 나이와 객혈의 양과의 연관성

곽혜원 ( Hae Won Kwak ),김형영 ( Hyung Young Kim ),손승국 ( Seung Kook Son ),김혜영 ( Hye Young Kim ),박희주 ( Hee Ju Park ) 대한천식알레르기학회 2016 Allergy Asthma & Respiratory Disease Vol.4 No.2

Purpose: Studies on hemoptysis is rare because hemoptysis is an uncommon symptom in children. The aim of this study was to identify the causes of hemoptysis in children. Methods: Medical chart review of patients with hemoptysis was retrospectively conducted at 2 tertiary hospitals from November 2008 to December 2014. Patients were divided into 3 groups according to age. The amount of hemoptysis was categorized as mild (<20 mL/day), moderate (20-99 mL/day), and massive (≥100 mL/day). Results: A total of 59 patients were identified, and their mean age was 11.0±5.6 years. Among the causes of hemoptysis, respiratory tract infection was most common. Other causes included vasculitis syndrome, neoplasm in the airway, idiopathic pulmonary hemosiderosis, cardiac disease, and bronchiectasis. According to age, a significant difference was identified between the age groups in children with pneumonia (<6 years vs. 12-18 years, P=0.001). Differences were verified between the age groups in children with tuberculosis (<6 years vs. 12-18 years and 6-11 years vs. 12-18 years, P=0.023). According to amounts of hemoptysis, no significant difference was identified regardless of the causes. Conclusion: This study showed that the causes of hemoptysis in children were heterogeneous and the respiratory tract infection was most common. In children with hemoptysis, the age of onset and the amount of hemoptysis are needed to be considered for more precise diagnosis and more proper management of the underlying cause of hemoptysis. (Allergy Asthma Respir Dis 2016;4:114-118)