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강정완,박여훈,김경원,지혜미,손명현,김대준,김명준,조상호,김규언 대한 소아알레르기 호흡기학회 2007 Allergy Asthma & Respiratory Disease Vol.17 No.4
Interstitial lung disease, mostly chronic lung disorder, is usually characterized by diffuse infiltrates and disordered gas exchange, is a very rare disease in children. Chronic pneumonitis of infancy (CPI) is a recently described entity representing a distinct form of interstitial lung disease affecting infants and young children. The histologic findings suggest marked alveolar septal thickening, striking alveolar pneumocyte hyperplasia, and alveolar exudates containing numerous macrophages and foci of eosinophilic debris. A 3-year-old boy visited a local clinic with cough and tachypnea for a duration of 3 weeks. His clinical symptoms were aggravated and he was referred to our hospital. He was diagnosed with chronic pneumonitis of infancy after undergoing open lung biopsy. We herein present the case with review of literature. 소아기에 발생하는 간질성 폐렴은 발생 빈도가 매우 낮기는 하지만 일단 발생하면 사망률이 높은 치명적인 질환중의 하나이다. 만성 영아 폐렴은 이러한 간질성 폐렴중에서도 매우 드문 형태로 아직까지도 병에대한 이해와 치료에 관한 지식이 부족한 상황이다. 저자들은 3세에 내원 3주전부터 시작된 기침과 열 증상으로 내원하여 간질성 폐렴으로 진단받고 외과적으로 폐 생검을 시행하고 조직학적으로 만성 영아 폐렴으로 확진한 1례를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.
Utility of a forced expiratory flow of 25 to 75 percentas a predictor in children with asthma
강정완,김경원,김은수,박준영,손명현,김규언 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.3
Purpose:Asthma is defined as chronic inflammation of the lower small airways, and bronchial hyperreactivity (BHR) is a pathophysiologic feature of asthma. It has been proposed that although there is no direct variable capable of assessing the small airways, a forced expiratory flow of between 25 and 75 percent (FEF25-75) might be considered a more sensitive early marker of small airway obstruction than the forced expiratory volume in 1 second (FEV1). Thus, we proposed that the presence and degree of positive responses to bronchial methacholine testing were related to the difference (DFF) and ratio (RFF) between FEV1 and FEF25-75 in asthmatic children. Methods:The subjects were 583 symptomatic children, including 324 children with BHR and 259 controls. Pulmonary function tests, methacholine challenge tests, and skin prick tests were performed, and the total eosinophil count, total serum IgE, and serum eosinophil cationic protein level were measured in all subjects. From a concentration-response curve, the methacholine concentration required to produce a decrease of 20% from post-saline FEV1 was calculated (PC20). Results:The median DFF and RFF values decreased in controls compared to subjects with bronchial hyperresponsiveness, and this trend was found in groups ranked by its severity. PC20 had a negative correlation with DFF and RFF. Cutoff values of 0.5 for DFF and 1.042 for RFF were identified, and sensitivity and specificity were calculated. Conclusion:This study revealed that DFF and RFF might be predictive of bronchial hyperresponsiveness in the context of normal FEV1 in children. (Korean J Pediatr 2008;51:323-328) Purpose:Asthma is defined as chronic inflammation of the lower small airways, and bronchial hyperreactivity (BHR) is a pathophysiologic feature of asthma. It has been proposed that although there is no direct variable capable of assessing the small airways, a forced expiratory flow of between 25 and 75 percent (FEF25-75) might be considered a more sensitive early marker of small airway obstruction than the forced expiratory volume in 1 second (FEV1). Thus, we proposed that the presence and degree of positive responses to bronchial methacholine testing were related to the difference (DFF) and ratio (RFF) between FEV1 and FEF25-75 in asthmatic children. Methods:The subjects were 583 symptomatic children, including 324 children with BHR and 259 controls. Pulmonary function tests, methacholine challenge tests, and skin prick tests were performed, and the total eosinophil count, total serum IgE, and serum eosinophil cationic protein level were measured in all subjects. From a concentration-response curve, the methacholine concentration required to produce a decrease of 20% from post-saline FEV1 was calculated (PC20). Results:The median DFF and RFF values decreased in controls compared to subjects with bronchial hyperresponsiveness, and this trend was found in groups ranked by its severity. PC20 had a negative correlation with DFF and RFF. Cutoff values of 0.5 for DFF and 1.042 for RFF were identified, and sensitivity and specificity were calculated. Conclusion:This study revealed that DFF and RFF might be predictive of bronchial hyperresponsiveness in the context of normal FEV1 in children. (Korean J Pediatr 2008;51:323-328)