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신윤호 ( Youn Ho Sheen ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.6
Asthma is considered a chronic inflammatory airway disease. Mounting evidence reports that patients with asthma are at significantly higher risk of developing communicable diseases such as invasive pneumococcal disease, Haemophilus influenza, varicella, measles, pertussis and tetanus. While impaired innate immunity may play a role in increased risk of developing these infections, suboptimal adaptive immune responses have also been reported to play a role in asthmatic subjects with regard to increased risk of infections. This review discusses the currently underrecognized immunological effect of asthma on antibody to vaccines and recommends that clinicians be aware of less optimal antibody production in response to vaccines in subjects with asthma. (Allergy Asthma Respir Dis 2018;6:279-283)
호흡기 바이러스의 연령별, 성별, 계절별에 따른 유병률 변화: 단일기관에서 10년 동안 호흡기 질환으로 입원한 소아 환자를 중심으로
이승진 ( Seung Jin Lee ),이신혜 ( Shin Hae Lee ),하은교 ( Eun Kyo Ha ),신윤호 ( Youn Ho Sheen ),성명순 ( Myong Soon Sung ),정영호 ( Young-ho Jung ),이경석 ( Kyung Suk Lee ),지혜미 ( Hye Mi Jee ),한만용 ( Man Yong Han ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.6
Purpose: It is well known that respiratory viral infection has epidemiological characteristics, including season. This study aimed to investigate the patterns of the prevalence of common respiratory viruses during a period of 10 years with regard to age, sex, and season in Korean children. Methods: From June 2006 to November 2016, we obtained 11,798 specimens from patients aged less than 18 years who were admitted with lower respiratory infections. Ten respiratory viruses were detected using multiplex reverse transcription-polymerase chain reaction. Results: Of 11,798 specimens, at least 1 virus was detected in 4,845 (41.1%). Respiratory syncytial virus (RSV, 18.9%) was the most common virus detected, followed by human rhinovirus (HRV, 14.8%), adenovirus (9.5%), and human bocavirus (HBoV, 7.4%). The detection rate of HRV was higher in male subjects (male 60.0% vs. female 40.0%, P=0.004), but the other viruses had no significant differences with regard to sex. The subjects who were positive for RSV test were youngest (median, 10.5 months; interquartile range, 3.0-25.0 months), followed by human coronavirus (median, 13.0 months), HRV (median, 14 months), and parainfluenza (median, 14 months). HBoV was most commonly detected in spring (29.3%), enterovirus in summer (25.8%), HRV in fall (22.6%), and RSV in October and winter (22.6%). Conclusion: We found that the prevalence of respiratory viruses in Korean children during a period of 10 years was associated with age, sex, and season when the infection occurred. Further nationwide data is warranted to infer clinical implication of our results. (Allergy Asthma Respir Dis 2017;5:320-325)
영아 아토피피부염에서 알레르기 감작과 IgE 매개 여부에 따른 임상 양상
나민선 ( Min Sun Na ),김가람 ( Ga Ram Kim ),하은교 ( Eun Kyo Ha ),이승진 ( Seung Jin Lee ),신윤호 ( Youn Ho Sheen ),최선희 ( Sun Hee Choi ),정영호 ( Yong Ho Jung ),이경석 ( Kyung Suk Lee ),지혜미 ( Hye Mi Jee ),한만용 ( Man Yong H 대한소아알레르기호흡기학회 2017 Allergy Asthma & Respiratory Disease Vol.5 No.3
Purpose: Few studies have demonstrated the effects of aeroallergen sensitization on the development of atopic dermatitis (AD) in young children. This study aimed to investigate the sensitization rate of food and aeroallergens in AD patients under 2 years of age and to compare clinical characteristics between IgE- and non-IgE-mediated AD patients. Methods: Children aged less than 2 years who had visited CHA Bundang Medical Center from 2013 through 2016 were enrolled. Allergen sensitization was measured by specific IgE levels for common allergens. Detailed information was obtained using an atopy questionnaire. Results: A total of 173 patients were examined, 118 (68.2%) were male patients. The prevalence of aeroallergen sensitization under 1 year of age was 4.8% and increased to 19.5% for children aged 2 years (P=0.005). The mean age (13.6±6.3 months vs. 9.0±5.1 months, P=0.003) and the proportion of children born prematurel (15.4% vs. 2.3%, P=0.013) were higher in the aeroallergen-sensitized group than in nonsensitized group. Sensitization to food allergens between children aged less than 1 year and 2 years appeared to be similar (61.1% vs. 57.1%, P=0.651). There were no significant differences in clinical characteristics between food allergen IgE-mediated and non-IgE-mediated AD children. Conclusion: Aeroallergen sensitization increased markedly in AD patients aged 2 years which is about 4 times that of the general population. However, there were no significant differences in clinical manifestations between allergen IgE-mediated and non-IgE-mediated AD children in both food and aeroallergens. (Allergy Asthma Respir Dis 2017:5:128-134)
2016-2017년 겨울철 급성모세기관지염으로 입원한 영아의 임상 양상과 호흡기 세포융합 바이러스 유전적 변이
연동건 ( Dong Keon Yon ),민채연 ( Chae-yeon Min ),하은교 ( Eun Kyo Ha ),지혜미 ( Hye Mi Jee ),정영호 ( Young-ho Jung ),이경석 ( Kyung Suk Lee ),신윤호 ( Youn Ho Sheen ),한만용 ( Man Yong Han ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.2
Purpose: Circulating patterns of predominant respiratory syncytial virus (RSV) genotypes in the community may be helpful in understanding molecular epidemiology and predicting future outbreaks of the RSV genotype. We investigated the association of genetic variations in RSV with acute severe bronchiolitis in infants. Methods: We reviewed medical records of infants younger than 1 year of age hospitalized due to acute bronchiolitis between November 2016 and February 2017. Subjects were classified as severe or mild based on the use of mechanical or noninvasive ventilation. The associations between severity of the disease, sex, age at admission, oxygen saturation at admission and laboratory test results were analyzed. RSV sequence analysis was performed in the severe group. Results: Among 114 infants, 80 underwent respiratory viral polymerase chain reaction using nasopharyngeal swab; of these, 53 (66.3%) showed positive for RSV. Of the 53 RSV-positive samples, 9 were categorized as the severe group and 44 were categorized as the mild group. Male sex, young age, longer duration of admission, minimum SaO<sub>2</sub> at admission and bronchiolitis severity score were significantly correlated with disease severity in the severe group than in the mild group (all variables, P<0.001). Phylogenetic and sequence analysis in the severe group revealed 8 RSV-A, ON1 genotype and 1 RSV-B, BA4 genotype. Conclusion: Phylogenetic types of RSV in subjects of the severe group were RSV-A, ON1 genotype or RSV-B, BA4 genotype which were prevalent in the Korean community at the same time. Our study showed that disease severity was not significantly associated with RSV genotypic evolution or antigenic drift in Korea during winter season 2016-17. (Allergy Asthma Respir Dis 2018;6:110-115)
소아에서 마이코플라스마 폐렴과 바이러스 폐렴의 임상적 특징 비교: 다기관 단면연구
안세환 ( Se Hwan An ),조홍제 ( Hong Je Cho ),백혜성 ( Hey-sung Baek ),성명순 ( Myong Soon Sung ),윤정원 ( Jung Won Yoon ),최선희 ( Sun Hee Choi ),신윤호 ( Youn Ho Sheen ),한만용 ( Man Yong Han ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.3
Purpose: This study was conducted to compare clinical features between Mycoplasma pneumonia and viral pneumonia. Methods: We retrospectively analyzed the medical records of 428 patients requiring hospitalization among children younger than 18 years of age in 5 hospitals in Seoul and Gyeonggi-do. There were 131 patients with M. pneumonia and virus coinfection, 167 patients with M. pneumonia without virus coinfection, and 130 patients with viral pneumonia. All subjects had radiographic evidence of pneumonia with specimens available for both M. pneumonia and viral testing. Virus was identified using the polymerase chain reaction assay in a nasopharyngeal or oropharyngeal swab. M. pneumoniae pneumonia was diagnosed serologically. Results: Human rhinovirus was detected in 60.3% (79 of 131) of children with M. pneumonia accompanied by virus coinfection. Respiratory syncytial virus (RSV) was detected in 38.2% (50 of 130) of children with viral pneumonia. The mean age was significantly lower in the viral pneumonia group than in the M. pneumonia group with and without virus coinfection. The sex distribution did not differ significantly among the 3 study groups. The procalcitonin level was higher in viral pneumonia and erythrocyte sedimentation rate level was higher in the M. pneumonia group although no significant difference was found in C-reactive protein level between the M. pneumonia and viral pneumonia groups. Conclusion: Clinical features and inflammatory markers between M. pneumonia and viral pneumonia may be useful for the treatment of community-acquired pneumonia. (Allergy Asthma Respir Dis 2018;6:155-160)
기관지확장제 반응 검사에서 속효성 기관지확장제 투여 용량의 차이가 소기도 반응도에 영향을 줄까?
백지현 ( Ji Hyeon Baek ),장호민 ( Homin Jang ),전유훈 ( You Hoon Jeon ),서보선 ( Bo Seon Seo ),이승진 ( Seung Jin Lee ),지혜미 ( Hye Mi Jee ),이경석 ( Kyung Suk Lee ),정영호 ( Young-ho Jung ),신윤호 ( Youn Ho Sheen ),한만용 ( Man 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.4
Purpose: It is recommended to use 200 (2 puffs) or 400 (4 puffs) μg of salbutamol in the bronchodilator response (BDR) test. We aimed to compare the difference between these 2 doses with regard to small airway dysfunction.Methods: One hundred sixteen subjects who visited the hospital for diagnosis or follow-up of asthma were consecutively enrolled between June 1 and November 31, 2013. The subjects were randomly assigned to the BDR test at the 2 doses (200 or 400 μg of salbutamol), with physicians blinded to the group each subject was assigned to and undertook the BDR test using the spirometry and impulse oscillometry system (IOS).Results: A total of 116 subjects participated in this study; the mean age was 7.8±3.6 years. The number of participants who were assigned to 2 and 4 puffs groups was 59 and 57, respectively. The mean age was older in the 4 puffs group than in the 2 puffs group (P=0.008). There were no significant difference in spirometric and oscillometric parameters between the 2 and 4 puffs groups. However, in subgroup analysis of asthmatic patients on maintenance therapy (n=21), there was a significant difference in relative changes in Rrs5 between the 2 and 4 puffs groups (16.4%±9.6% vs. 28.7%±8.8%, P=0.035). The forced expiratory volume of 1 second showed a significant correlation with resistance in the 2 puffs group and with reactance in the 4 puffs group.Conclusion: There was a significant relationship between the amounts of bronchodilators administered and the small airway dysfunction in children with asthma on maintenance therapy. Further research is warranted to delineate changes in spirometric and IOS measures in accordance with the different amounts of bronchodilators administered. (Allergy Asthma Respir Dis 2016:4:284-289)