1
|
Kim HS, Choi J, Lee E, Park JS, Jung S, Yoon J, Lee KH, Kim K, Yang HJ, Suh DI. Incidence, prevalence, and pattern of medical service utilization of children's rare lung diseases in South Korea. Pediatr Pulmonol 2024; 59:1305-1312. [PMID: 38372471 DOI: 10.1002/ppul.26906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/11/2024] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Children's rare lung diseases are a heterogeneous group of rare lung diseases with significant morbidity and mortality. There is very limited information on the incidence and prevalence of children's rare lung diseases in Asia. We investigated the nationwide incidence, prevalence, and pattern of medical service utilization of children's rare lung diseases in Korea. METHODS We studied patients who were diagnosed with rare lung diseases coded per International Statistical Classification of Diseases and Related Health Problems, 10th Edition and registered in the national rare diseases database of confirmed patients. Data was extracted from the Korean National Health Insurance Service Claims database over 2019-2021. RESULTS Average incidence rate was 12.9 new cases per million children per year, and average prevalence rate was 60.2 cases per million children during the study period of 2019-2021. We found that more than 65% of new cases were diagnosed before 2 years of age. ChILD, primary ciliary dyskinesia, and cystic fibrosis were usually diagnosed after 6 years of age. Congenital airway and lung anomalies were often diagnosed before 2 years of age. Busan and Gyeongsangnam-do residents tended to visit hospitals near their place of residence, while residents of other areas tended to visit hospitals in Seoul regardless of their area of residence. CONCLUSIONS We examined the epidemiology of rare lung diseases in children in South Korea. Our estimation of the incidence and prevalence could be used for sustainable health care and equitable distribution of health care resources.
Collapse
Affiliation(s)
- Hwan Soo Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jiin Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Sungsu Jung
- Department of Pediatrics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Kyeong Hun Lee
- Department of Pediatrics, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Kyunghoon Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
2
|
Lee E, Rhee EH, Yu J, Kim K, Kim HS, Im CH, Seo G, Kim WK, Song DJ, Park JS, Yoo Y, Suh DI, Jung S, Yoon J, Lim DH, Baek HS, Shin M, Kwon JW, Jang GC, Seo JH, Woo SI, Shin YH, Lee JS, Lee SW, Yang HJ. Incidence of healthcare utilization for allergic and respiratory infectious diseases in children with asthma before and during the COVID-19 pandemic. Allergy 2024; 79:1064-1067. [PMID: 38140807 DOI: 10.1111/all.15992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Hee Rhee
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyunghoon Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hwan Soo Kim
- Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chae Hyun Im
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Gitae Seo
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Dae Hyun Lim
- Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
| | - Hey Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Ji Won Kwon
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Ju Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Sung Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Youn Ho Shin
- Department of Pediatrics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| |
Collapse
|
3
|
Song IG, Kim YS, Kim MS, Lee JW, Cho YM, Lim Y, Kwon SK, Suh DI, Park JD. Healthcare service use and medical outcomes of tracheostomy-dependent children: a nationwide study. BMJ Paediatr Open 2024; 8:e002377. [PMID: 38508660 PMCID: PMC10952918 DOI: 10.1136/bmjpo-2023-002377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/10/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Despite the rising trend of tracheostomies in children, there is a lack of comprehensive resources for families to navigate the challenges of living with a tracheostomy, emphasising the need for evidence-based support in understanding postoperative care and long-term adjustments. This study aimed to examine the pattern of using healthcare services and nationwide medical outcomes in children who underwent a tracheotomy before the age of 2 years. METHODS This retrospective study used the National Health Insurance System database from 2008 to 2016 and included all children codified with tracheotomy procedure codes before their second birthday. Healthcare utilisation, such as medical costs, number of hospital visits, home healthcare nursing and medical diagnoses on readmission, in the first 2 years after tracheotomy was evaluated. Multivariable logistic regression analysis was used to determine the factors affecting mortality. RESULTS In total, 813 patients were included in this study. Their use of healthcare services and the accompanying expenses were higher than the national medians for similar age groups; however, both metrics decreased in the second year. The major causes of admission within 2 years of surgery were respiratory and neurological diseases. The mortality rate within 2 years was 37.8%. Higher risks of mortality were associated with having two or more complex chronic conditions. Use of home healthcare nursing services was associated with a lower mortality risk. CONCLUSION Paediatric patients with more complex chronic conditions tended to have higher mortality rates within 2 years after surgery. However, receiving home healthcare nursing was significantly associated with a reduced risk of death. Many causes of hospitalisation may be preventable with education and supportive care. Therefore, further research for establishing an integrated care system for these patients and their caregivers is required.
Collapse
Affiliation(s)
- In Gyu Song
- Pediatrics, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
| | - You Sun Kim
- Department of Paediatrics, National Medical Center, Jung, Korea (the Republic of)
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Min Sun Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Seoul National University Children's Hospital Integrated Care Center, Seoul, Korea (the Republic of)
| | - Ji Weon Lee
- Seoul National University Children's Hospital Integrated Care Center, Seoul, Korea (the Republic of)
| | - Yoon-Min Cho
- National Health Insurance Service, Wonju, Korea (the Republic of)
| | - Youna Lim
- Seoul National University, Gwanak-gu, Korea (the Republic of)
| | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Dong In Suh
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - June Dong Park
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| |
Collapse
|
4
|
Jeong MS, Choi YY, Ahn YH, Lee K, Park JS, Suh DI. Etanercept treatment for pediatric toxic epidermal necrolysis induced by deflazacort: a case report and literature review. Front Immunol 2024; 15:1342898. [PMID: 38333208 PMCID: PMC10850310 DOI: 10.3389/fimmu.2024.1342898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Toxic epidermal necrolysis (TEN) is a life-threatening mucocutaneous disorder commonly caused by drugs. TEN is often treated with corticosteroids, intravenous immunoglobulin (IVIG), or cyclosporine; however, the efficacy of these treatments is controversial. Etanercept (a TNF-α antagonist) was proven to decrease skin-healing time in a randomized clinical trial. Herein, we report the case of a 44-month-old boy who developed TEN due to deflazacort as the probable culprit drug and was successfully treated with etanercept. The patient presented to the emergency department complaining of erythematous maculopapular rashes and vesicles all over the face and body, with vesicles on the hands, feet, and trunk. Symptoms started 4 days before presentation, with edema of the upper lip, which progressed to erythematous macules over the body. He was started on deflazacort for nephrotic syndrome 21 days before the visit. Approximately 20% of the body surface area (BSA) was covered by vesicular lesions. Under the diagnosis of Steven Johnson syndrome/TEN, deflazacort was discontinued, and intravenous dexamethasone (1.5 mg/kg/day), a 5-day course of IVIG (0.4 mg/kg/day), and cyclosporine (3 mg/kg/day) were administered. The lesions seemed to be stationary for 3 days, but on the 6th day of hospitalization, when IVIG was discontinued, the vesicular lesions progressed to approximately 60% of the BSA. Etanercept 0.8 mg/kg was administered subcutaneously. Lesions stopped progressing, and bullous lesions started epithelialization. However, on the 15th day, around 30% of the BSA was still involved; thus, a second dose of etanercept was administered. No acute or sub-acute complications were observed. In conclusion, the use of etanercept in children with TEN that is not controlled with conventional therapy is both effective and safe.
Collapse
Affiliation(s)
| | | | | | | | - Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | |
Collapse
|
5
|
Lee E, Kim K, Jeon YH, Sol IS, Kim JD, Min TK, Hwang YH, Cho HJ, Suh DI, Kim HS, Kim YH, Woo SI, Lee YJ, Jung S, Yang HJ, Jang GC. Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents. Clin Exp Pediatr 2024:cep.2023.00871. [PMID: 38271987 DOI: 10.3345/cep.2023.00871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/04/2023] [Indexed: 01/27/2024] Open
Abstract
Noncystic fibrosis bronchiectasis is a chronic respiratory disease that carries high socioeconomic and medical burdens and is caused by diverse respiratory illnesses. To improve clinical outcomes, early recognition, active treatment of exacerbations, and prevention of further exacerbations are essential. However, evidence for the treatment and prevention of acute exacerbation of noncystic fibrosis bronchiectasis, especially in children, is lacking. Therefore, the evidence- and consensus-based guidelines for medical and nonmedical treatment strategies for noncystic fibrosis bronchiectasis in children and adolescents were developed by the Korean Academy of Pediatric Allergy and Respiratory Disease using the methods recommended by the Grading of Recommendations Assessment, Development, and Evaluation working group with evidence published through July 2, 2020. This guideline encompasses evidence-based treatment recommendations as well as expert opinions, addressing crucial aspects of the treatment and management of noncystic fibrosis bronchiectasis in children. This includes considerations for antibiotics and airway clearance strategies, particularly in areas where evidence may be limited. Large, well-designed, and controlled studies are required to accumulate further evidence of management strategies for noncystic fibrosis bronchiectasis in children and adolescents.
Collapse
Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kyunghoon Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - You Hoon Jeon
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - In Suk Sol
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Deok Kim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Taek Ki Min
- Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon Ha Hwang
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, International St. Mary's hospital, Catholic Kwandong University, Incheon, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hwan Soo Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Il Woo
- Department of Pediatrics, Chungbuk National University Hospital & College of Medicine, Cheongju, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyeon-Jong Yang
- Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service, Ilsan Hospital, Ilsan, Korea
| |
Collapse
|
6
|
Shin YH, Kim JH, Lee SH, Lee SY, Park YM, Choi EJ, Paek EY, Song KB, Park MJ, Jung S, Yoon J, Suh DI, Kim KW, Ahn K, Hong SJ. Allergic rhinitis phenotypes with distinct transcriptome profiles in children: A birth cohort. J Allergy Clin Immunol 2024:S0091-6749(24)00032-0. [PMID: 38242217 DOI: 10.1016/j.jaci.2023.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Allergic rhinitis (AR) phenotypes in childhood are unclear. OBJECTIVES This study sought to determine AR phenotypes and investigate their natural course and clinical and transcriptomic characteristics. METHODS Latent class trajectory analysis was used for phenotyping AR in 1050 children from birth through 12 years using a birth cohort study. Blood transcriptome analyses were performed to define the underlying mechanisms of each phenotype. RESULTS Five AR phenotypes were identified: early onset (n = 88, 8.4%), intermediate transient (n = 110, 10.5%), late onset (n = 209, 19.9%), very late onset (n=187, 17.8%), and never/infrequent (n = 456, 43.4%). Children with early-onset AR were associated with higher AR severity and sensitizations to foods at age 1 year and inhalants at age 3 years and asthma symptoms, but not with bronchial hyperresponsiveness (BHR). Children with late-onset AR phenotype associated with sensitizations to various foods at age 1 year but not from age 3 years, and to inhalants from age 7 years and with asthma with BHR. Children with very late-onset AR phenotype associated with sensitizations to foods throughout preschool age and to inhalants at ages 7 and 9 years and with asthma with BHR. Transcriptome analysis showed that early-onset AR was associated with viral/bacterial infection-related defense response, whereas late-onset AR was associated with T cell-related immune response. CONCLUSIONS Early-onset AR phenotype was associated with sensitization to foods and inhalants at an early age and asthma symptoms, but not with BHR, whereas very late- and late-onset AR phenotypes were positively associated with sensitization to inhalants and asthma with BHR. Transcriptomic analyses indicated that early- and late-onset AR phenotypes had distinct underlying mechanisms related to AR as well.
Collapse
Affiliation(s)
- Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St Mary's Hospital, Seoul, Korea
| | - Jeong-Hyun Kim
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Si-Hyeon Lee
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Yoon Mee Park
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Eum Ji Choi
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Young Paek
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Kun-Baek Song
- Department of Pediatrics, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Min Ji Park
- Department of Pediatrics, Hallym Sacred Heart Hospital, Anyang, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
| |
Collapse
|
7
|
Kim HS, Kim K, Rhee EH, Kim WK, Song DJ, Park JS, Suh DI, Yoon J, Lee E, Lee SW, Kim JT, Lim DH, Baek HS, Shin M, Kwon JW, Jang GC, Seo JH, Woo SI, Kim HY, Lee JS, Yoo YY. Atmospheric environment and persistence of pediatric asthma: A population-based cohort study. Asian Pac J Allergy Immunol 2024. [PMID: 38183649 DOI: 10.12932/ap-170623-1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2024]
Abstract
BACKGROUND Asthma is a heterogeneous disease with different outcomes. For children with asthma at the age of 7 years, 67-75% are symptom-free as adults. Data on the important link between childhood and adult asthma are sparse. OBJECTIVE We aimed to investigate factors associated with persistence of childhood asthma over three years of follow-up by linking data between Korea childhood Asthma Study (KAS) and their matched claims data from Health Insurance Review and Assessment Service (HIRA). METHODS We analyzed data from 450 preadolescent children aged 7 to 10 years and classified them into remission or persistence groups. Baseline clinical characteristics and exposure to air pollution materials including PM2.5 and PM10 during three years of follow-up were compared. The main outcome was asthma persistence which was defined as the presence of asthma episodes with healthcare utilization and prescription of asthma medications within three years after KAS enrollment. RESULTS At the third year of follow-up, after stepwise regression analysis, lower age at enrollment (adjusted odds ratio (aOR): 0.79; 95% confidence interval (CI): 0.64-0.96), male sex (aOR: 1.66; 95%CI: 1.05-2.63), proximity from an air-polluting facility (aOR: 2.4; 95%CI: 1.34-4.29), higher level outdoor PM2.5 (aOR: 1.1; 95%CI: 1.02-1.20), and higher rate of doctor-diagnosed food allergy (FA) (aOR: 2.33; 95%CI: 1.06-5.12) were significantly associated with persistence. CONCLUSION We discovered various independent risk factors for the persistence of childhood asthma. By linking HIRA claims data, we could clarify risk factors for persistence in a well-defined study population.
Collapse
Affiliation(s)
- Hwan Soo Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyunghoon Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Hee Rhee
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University School of Medicine, Korea
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dae Hyun Lim
- Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
| | - Hey Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University School of Medicine, Korea
| | - Ji Won Kwon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Ju Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Sung Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Young Yoo Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
8
|
Lee E, Lee SY, Kim HB, Yang SI, Yoon J, Suh DI, Oh HY, Ahn K, Kim KW, Shin YH, Hong SJ. Insights from the COCOA birth cohort: The origins of childhood allergic diseases and future perspectives. Allergol Int 2024; 73:3-12. [PMID: 37752021 DOI: 10.1016/j.alit.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
The ongoing COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study is a prospective birth cohort investigating the origin and natural courses of childhood allergic diseases, including atopic dermatitis, food allergy, allergic rhinitis and asthma, with long-term prognosis. Initiated under the premise that allergic diseases result from a complex interplay of immune development alterations, environmental exposures, and host susceptibility, the COCOA study explores these dynamic interactions during prenatal and postnatal periods, framed within the hygiene and microbial hypotheses alongside the developmental origins of health and disease (DOHaD) hypothesis. The scope of the COCOA study extends to genetic predispositions, indoor and outdoor environmental variables affecting mothers and their offsprings such as outdoor and indoor air pollution, psychological factors, diets, and the microbiomes of skin, gut, and airway. We have embarked on in-depth investigations of diverse risk factors and the pathophysiological underpinnings of allergic diseases. By employing multi-omics approaches-proteomics, transcriptomics, and metabolomics-we gain deeper insights into the distinct pathophysiological processes across various endotypes of childhood allergic diseases, incorporating the exposome using extensive resources within the COCOA study. Integration with large-scale datasets, such as national health insurance records, enhances robustness and mitigates potential limitations inherent to birth cohort studies. As part of global networks focused on childhood allergic diseases, the COCOA study fosters collaborative research across multiple cohorts. The findings from the COCOA study are instrumental in informing precision medicine strategies for childhood allergic diseases, underpinning the establishment of disease trajectories.
Collapse
Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Hea Young Oh
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| |
Collapse
|
9
|
Kim M, Lee MH, Hong SJ, Yu J, Cho J, Suh DI, Kim HY, Kim HY, Jung S, Lee E, Lee S, Jeong K, Shim JY, Kim JH, Chung HL, Jang YY, Kwon JW, Seo JH, Kim JH, Ahn JY, Song KB, Song KS, Kim SY, Kim SY, Kil HR, Chung EH. Clinical Manifestations and Genotype of Primary Ciliary Dyskinesia Diagnosed in Korea: Multicenter Study. Allergy Asthma Immunol Res 2023; 15:757-766. [PMID: 37957793 PMCID: PMC10643857 DOI: 10.4168/aair.2023.15.6.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/10/2023] [Accepted: 06/13/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disorder that leads to secondary ciliary dysfunction. PCD is a rare disease, and data on it are limited in Korea. This study systematically evaluated the clinical symptoms, diagnostic characteristics, and treatment modalities of pediatric PCD in Korea. METHODS This Korean nationwide, multicenter study, conducted between January 2000 and August 2022, reviewed the medical records of pediatric patients diagnosed with PCD. Prospective studies have been added to determine whether additional genetic testing is warranted in some patients. RESULTS Overall, 41 patients were diagnosed with PCD in 15 medical institutions. The mean age at diagnosis was 11.8 ± 5.4 years (range: 0.5 months-18.9 years). Most patients (40/41) were born full term, 15 (36.6%) had neonatal respiratory symptoms, and 12 (29.3%) had a history of admission to the neonatal intensive care unit. The most common complaint (58.5%) was chronic nasal symptoms. Thirty-three patients were diagnosed with transmission electron microscopy (TEM) and 12 patients by genetic studies. TEM mostly identified outer dynein arm defects (alone or combined with inner dynein arm defects, n = 17). The genes with the highest mutation rates were DNAH5 (3 cases) and DNAAF1 (3 cases). Rare genotypes (RPGR, HYDIN, NME5) were found as well. Chest computed tomography revealed bronchiectasis in 33 out of 41 patients. Among them, 15 patients had a PrImary CiliAry DyskinesiA Rule score of over 5 points. CONCLUSIONS To our knowledge, this is the first multicenter study to report the clinical characteristics, diagnostic methods, and genotypes of PCD in Korea. These results can be used as basic data for further PCD research.
Collapse
Affiliation(s)
- Minji Kim
- Department of Pediatrics, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
| | - Mi-Hee Lee
- Department of Pediatrics, Incheon Medical Center, Incheon, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
| | - Joongbum Cho
- Department of Pediatrics, Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Dongnam Institute of Radiology and Medical Sciences, Busan, Korea
| | - Hye-Young Kim
- Integrated & Respite Care Center for Children, Seoul National University Hospital, Seoul, Korea
| | - Sungsu Jung
- Department of Pediatrics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Kyunguk Jeong
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Hee Kim
- Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
| | - Hai Lee Chung
- Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Korea
| | - Yoon Young Jang
- Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Medical School, Cheonan, Korea
| | - Ju Hee Kim
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Kun-Baek Song
- Department of Pediatrics, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Kyu-Sang Song
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
| | - Hong Ryang Kil
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
| |
Collapse
|
10
|
Lee E, Rhee EH, Kim K, Kim HS, Kim WK, Song DJ, Park JS, Yoo Y, Suh DI, Jung S, Yoon JS, Lee SW, Kim JT, Lim DH, Baek HS, Shin M, Kwon JW, Jang GC, Seo JH, Woo SI, Kim HY, Shin YH, Lee JS, Yang HJ, Yu J. Frequency of exacerbation and degree of required asthma medication can characterize childhood longitudinal asthma trajectories. Ann Allergy Asthma Immunol 2023; 131:444-450. [PMID: 37302526 DOI: 10.1016/j.anai.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND To the best of our knowledge, there have been no investigations of longitudinal asthma trajectories based on asthma exacerbation frequency and medications required for asthma control in children. OBJECTIVE To investigate longitudinal asthma trajectories based on the exacerbation frequency throughout childhood and asthma medication ranks. METHODS A total of 531 children aged 7 to 10 years were enrolled from the Korean childhood Asthma Study. Required asthma medications for control of asthma from 6 to 12 years of age and asthma exacerbation frequency from birth to 12 years of age were obtained from the Korean National Health Insurance System database. Longitudinal asthma trajectories were identified on the basis of asthma exacerbation frequency and asthma medication ranks. RESULTS Four asthma clusters were identified: lesser exacerbation with low-step treatment (8.1%), lesser exacerbations with middle-step treatment (30.7%), highly frequent exacerbations in early childhood with small-airway dysfunction (5.7%), and frequent exacerbations with high-step treatment (55.6%). The frequent exacerbations with high-step treatment cluster were characterized by a high prevalence of male sex, increased blood eosinophil (counts) with fractional exhaled nitric oxide, and high prevalence of comorbidities. The highly frequent exacerbation in early childhood with small-airway dysfunction cluster was characterized by recurrent wheeze in preschool age, with high prevalence of acute bronchiolitis in infancy and a greater number of family members with small-airway dysfunction at school age. CONCLUSION The present study identified 4 longitudinal asthma trajectories on the basis of the frequency of asthma exacerbation and asthma medication ranks. These results would help clarify the heterogeneities and pathophysiologies of childhood asthma.
Collapse
Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Eun Hee Rhee
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Kyunghoon Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hwan Soo Kim
- Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Republic of Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Yoo
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Ji-Sun Yoon
- Department of Pediatrics, Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Jin Tack Kim
- Department of Pediatrics, School of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seoul, Republic of Korea
| | - Dae Hyun Lim
- Department of Pediatrics, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Hey Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea
| | - Ji Won Kwon
- Department of Pediatrics, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
| | - Ju Hee Seo
- Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Sung Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
11
|
Lee JS, Shin JI, Kim S, Choi YS, Shin YH, Hwang J, Shin JU, Koyanagi A, Jacob L, Smith L, Jeong HE, Noh Y, Oh IS, Rhee SY, Min C, Cho SH, Turner S, Fond G, Boyer L, Suh DI, Acharya KP, Shin JY, Lee SW, Yon DK. Breastfeeding and impact on childhood hospital admissions: a nationwide birth cohort in South Korea. Nat Commun 2023; 14:5819. [PMID: 37730734 PMCID: PMC10511528 DOI: 10.1038/s41467-023-41516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Benefits of breastfeeding for both the mother and the child are well established, but a comprehensive and robust study to investigate the protective effect of breastfeeding and attenuated time effect stratified by cause of morbidity are lacking. This study is based on the nationwide birth cohort in Korea that includes data on all infants born from 2009 to 2015. Of 1,608,540 children, the median follow-up period was 8.41 years (interquartile range, 6.76-10.06). When compared to children with fully formula feeding, the hospital admission rate was 12% lower in those with partially breastfeeding and 15% lower in those with exclusive breastfeeding. The apparent protective effect of breastfeeding was reduced with increasing age. Our study provides potential evidence of the beneficial association of breastfeeding on subsequent hospital admissions. The protective effect declined over time as the children grew older. Encouraging any breastfeeding for at least the first 6 months among infants is an important public health strategy to improve overall child health.
Collapse
Affiliation(s)
- Jeong-Seon Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sunyeup Kim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Yong-Sung Choi
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Republic of Korea
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
- Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, Université Paris Cité, Paris, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Deparments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Deparments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Steve Turner
- Maternity and Child Health Division, NHS Grampian, Aberdeen, UK
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
12
|
Kim HS, Lee SW, Kim JT, Kim JH, Lim DH, Kim WK, Song DJ, Yoo Y, Suh DI, Baek HS, Shin M, Kwon JW, Jang GC, Yang HJ, Lee E, Seo JH, Woo SI, Kim HY, Shin YH, Lee JS, Jung S, Lee NK, Yu J. Fetal growth rather than prematurity determines lung function in children with asthma. Respirology 2023; 28:841-850. [PMID: 37308162 DOI: 10.1111/resp.14528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/15/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Preterm birth or fetal growth has been associated with reduced lung function and asthma during childhood in the general population. We aimed to elucidate whether prematurity or fetal growth has a significant influence on lung function or symptoms in children with stable asthma. METHODS We included children with stable asthma who participated in the Korean childhood Asthma Study cohort. Asthma symptoms were determined by asthma control test (ACT). Percent predicted values of pre- and post-bronchodilator (BD) lung function including forced expiratory volume in 1 second (FEV1 ), forced vital capacity (FVC), and forced expiratory flow at 25%-75% of FVC (FEF25%-75% ) were measured. Lung function and symptoms were compared according to the history of preterm birth and birth weight (BW) for gestational age (GA). RESULTS The study population consisted of 566 children (age range: 5-18 years). There were no significant differences in lung function and ACT between preterm and term subjects. We observed no significant difference in ACT but significant differences were observed in pre- and post-BD FEV1 , pre- and post-BD FVC, and post-BD FEF25%-75% according to BW for GA in total subjects. Two-way ANOVA revealed that BW for GA rather than prematurity was a significant determining factor for pre- and post-BD lung function. After regression analysis, BW for GA was still a significant determining factor of pre- and post-BD FEV1 and pre- and post-BD FEF25%-75% . CONCLUSION Fetal growth rather than prematurity appears to have a significant effect on lung function in children with stable asthma.
Collapse
Affiliation(s)
- Hwan Soo Kim
- Department of Pediatrics, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seoul, Korea
| | - Jung Hoon Kim
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Hyun Lim
- Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hey Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Ji Won Kwon
- Department of Pediatrics, Seoul National University College of Medicine, Seongnam, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ju Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Sung Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Korea
| | - Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Korea
| | - Nang Kyeong Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
13
|
Choi CW, Yang BR, Suh DI, Kim MS, Ohn J, Hong JS, Lee J, Kim KH. Infections and Exposure to Antibiotics May Affect the Development of Late-onset Rather than Early-onset Atopic Dermatitis. Ann Dermatol 2023; 35:325-328. [PMID: 37550235 PMCID: PMC10407339 DOI: 10.5021/ad.21.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/11/2022] [Accepted: 04/24/2022] [Indexed: 08/09/2023] Open
Affiliation(s)
- Chong Won Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Bo Ram Yang
- College of Pharmacy, Chungnam National University, Daejeon, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Mi-Sook Kim
- Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, Korea
| | - Jungyoon Ohn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
- Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea
| | - Jong Soo Hong
- Department of Dermatology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Han Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
- Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea.
| |
Collapse
|
14
|
Choi EA, Nah G, Chang WS, Lee SY, Suh DI, Kim KW, Shin YH, Ahn K, Hong SJ, Kim YY, Lee HJ. Blood eosinophil related to maternal allergic rhinitis is associated with the incidence of allergic rhinitis in offspring: COCOA study. BMC Pediatr 2023; 23:343. [PMID: 37415120 PMCID: PMC10324231 DOI: 10.1186/s12887-023-04156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/24/2023] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVE The identification of allergic rhinitis (AR) in early life is important for the target of intervention. AR is caused by various environmental factors, including house dust mites. We investigated the relationship between the Dermatophagoides farinae (Der f)-IgE and eosinophil in mothers with AR at delivery and the eosinophil levels and AR incidence in children. METHODS The study participants were 983 mother-child pairs from the COhort for Childhood Origin of Asthma and Allergic Diseases. AR was diagnosed by a doctor at delivery in mother and at 3 years of age in offspring. The association between eosinophil level and AR was assessed using logistic regression analysis. RESULTS The Der f-IgE level in mother having AR at delivery was associated with the mother's eosinophil level, and the mother's eosinophil level was associated with the child's eosinophil level both at age 1 and 3. The risk of AR at age 3 in children was increased according to increased eosinophil levels in mothers at delivery and in children both aged 1 and 3 years (adjusted odds ratio [aOR] and 95% confidence interval [CI]: 2.57 [1.14-5.78], 2.28 [1.02-5.13], respectively). The risk of childhood AR at the age of 3 is increased when both mothers and children have high eosiniophils (aOR and 95% CI: 2.62 [1.01-6.79], 1.37 [0.98-1.91]). CONCLUSIONS Der f-IgE in mothers at delivery was related to eosinophil levels in mothers with AR and higher level of eosinophils in both mother and children was associated with the increased risk of AR incidence at the first 3 years of life of children.
Collapse
Affiliation(s)
- Eun-A Choi
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Geumkyung Nah
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Woo-Sung Chang
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Environmental Health Center for Atopic Disease, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Youl Kim
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hye-Ja Lee
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea.
| |
Collapse
|
15
|
Lee Y, Lee S, Hur S, Jeong YS, Suh DI, Moon J, Kim MJ, Choi YH, Cheon JE. The spectrum of imaging manifestations of Gorham-Stout disease: a novel dynamic contrast-enhanced MR lymphangiography. Orphanet J Rare Dis 2023; 18:96. [PMID: 37101303 PMCID: PMC10131433 DOI: 10.1186/s13023-023-02704-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/20/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND To describe the radiological features of Gorham-Stout disease (GSD) as evaluated using plain radiography and dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) imaging techniques. METHODS Clinical and conventional imaging data were retrospectively reviewed for 15 patients with GSD between January 2001 and December 2020. After December 2018, DCMRL examinations were performed for lymphatic vessel evaluation in patients with GSD and reviewed in four patients. RESULTS The median age at diagnosis was 9 years (range: 2 months-53 years). The clinical manifestations were dyspnea in seven patients (46.7%), sepsis in 12 (80.0%), orthopedic problems in seven (46.7%), and bloody chylothorax in seven (46.7%). The common sites of osseous involvement were the spine (73.3%) and pelvic bone (60.0%). Among the non-osseous involvements, peri-osseous infiltrative soft-tissue abnormalities adjacent to the area of bone involvement were the most common (86.7%), followed by splenic cysts (26.7%) and interstitial thickening (26.7%). DCMRL demonstrated weak central conducting lymphatic flow in two patients with abnormal giant tortuous thoracic ducts and no flow in one patient. All patients who underwent DCMRL in this study presented with altered anatomical lymphatics and functional flow with collateralization. CONCLUSION DCMRL imaging and plain radiography are very useful for determining the extent of GSD. DCMRL is a novel imaging tool for the visualization of abnormal lymphatics in patients with GSD, which helps in further treatment. Therefore, in patients with GSD, it might be necessary to obtain not only plain radiographs but also MR and DCMRL images.
Collapse
Affiliation(s)
- Yuna Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Seunghyun Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Saebeom Hur
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yun Soo Jeong
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jangsup Moon
- Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Man Jin Kim
- Department of Laboratory Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young Hun Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Eun Cheon
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| |
Collapse
|
16
|
Kwon R, Shin YH, Shin JI, Kang SM, Hwang J, Shin JU, Noh H, Heo CY, Koyanagi A, Jacob L, Smith L, Ludvigsson JF, Turner S, Shin JY, Jeong HE, Kim JH, Rhee SY, Min C, Suh DI, Koo MJ, Abuabara K, Kim S, Lee SW, Yon DK, Cho SH. Association of fracture incidence in children with the development of food allergy: A Korean nationwide birth cohort study. Allergy 2023; 78:858-862. [PMID: 36602289 DOI: 10.1111/all.15639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/01/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Rosie Kwon
- Department of Biomedical Engineering, University of Michigan, Michigan, Ann Arbor, USA.,Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Jae Il Shin
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - So Min Kang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Maryland, Baltimore, USA
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyungrye Noh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Chan Yeong Heo
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.,Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA.,Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
| | - Stephen Turner
- Maternity and Child Health Division, NHS Grampian Aberdeen, Aberdeen, UK
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.,Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Jung-Hyun Kim
- Department of Allergy and Clinical Immunology, Korean Armed Forces Capital Hospital, Seongnam, South Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.,Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Min Ji Koo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.,Department of Human Biology, University of Toronto, Ontario, Toronto, Canada
| | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, California, San Francisco, USA
| | - Sunyeup Kim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.,Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Florida, Tampa, USA
| |
Collapse
|
17
|
Lee E, Park YM, Lee SY, Lee SH, Park MJ, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ. Associations of prenatal antibiotic exposure and delivery mode on childhood asthma inception. Ann Allergy Asthma Immunol 2023:S1081-1206(23)00208-9. [PMID: 36990205 DOI: 10.1016/j.anai.2023.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/05/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Prenatal antibiotic exposure and delivery mode may affect the gut microbiome in early life and influence the development of childhood asthma, but the combined effect of these two factors is unknown. OBJECTIVE To identify the individual and combined effects of prenatal antibiotic exposure and delivery mode on the development of asthma in children and the potential mechanisms underlying these associations. METHODS A total of 789 children were enrolled from the Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) birth cohort study. Asthma was defined as physician-confirmed diagnosis with asthma symptoms in the previous 12 months at age 7. Information on the prenatal antibiotic exposure was obtained by mothers using questionnaire. Logistic regression analysis was used. Gut microbiota analysis using 16S rRNA gene sequencing of fecal specimens obtained at 6 months was undertaken for 207 infants. RESULTS Prenatal antibiotic exposure and cesarean section delivery (adjusted odds ratio [aOR], 95% confidence interval [CI], 5.70 [1.25-22.81] and 1.57 [1.36-6.14], respectively) were associated with childhood asthma, especially synergistically when compared to the vaginal delivery-prenatal antibiotic exposure reference group (aOR, 7.35; 95% CI, 3.46-39.61; Interaction P=.033). Prenatal antibiotic exposure was associated with childhood asthma with aORs 21.79 and 27.03 for one and two or more exposures, respectively. Significant small-airway dysfunction (R5-R20 in impulse oscillometry) was observed with prenatal antibiotic exposure and cesarean-section delivery, compared to those with spontaneous delivery without prenatal antibiotic exposure. There was no significant difference in the diversity of gut microbiota among the four groups. However, the relative abundance of Clostridium was significantly increased in infants with prenatal antibiotic exposure and delivered via cesarean section. CONCLUSION Prenatal antibiotic exposure and delivery mode might modulate asthma development in children and small-airway dysfunction, potentially through early-life gut microbiota alterations.
Collapse
|
18
|
Lee SW, Shin YH, Shin JI, Kang SM, Abuabara K, Hwang J, Shin JU, Noh H, Kim S, Heo CY, Koyanagi A, Jacob L, Smith L, Ludvigsson JF, Turner S, Shin JY, Jeong HE, Kim JH, Rhee SY, Suh DI, Yon DK, Cho SH. Fracture incidence in children after developing atopic dermatitis: A Korean nationwide birth cohort study. Allergy 2023; 78:871-875. [PMID: 36353744 DOI: 10.1111/all.15577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - So Min Kang
- Research Administration Team, Seoul National University Bundang Hospital, Seongnam, South Korea.,H&Bio Co., Ltd, Seongnam, South Korea
| | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, California, San Francisco, USA
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Maryland, Baltimore, USA
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Hyungrye Noh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - Sunyeup Kim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Chan Yeong Heo
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.,Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA.,Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
| | - Stephen Turner
- Maternity and Child Health Division, NHS Grampian Aberdeen, Aberdeen, UK
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.,Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Jung-Hyun Kim
- Department of Allergy and Clinical Immunology, Korean Armed Forces Capital Hospital, Seongnam, South Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.,Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.,Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Florida, Tampa, USA
| |
Collapse
|
19
|
Park JS, Kim K, Kim JH, Choi YJ, Kim K, Suh DI. A machine learning approach to the development and prospective evaluation of a pediatric lung sound classification model. Sci Rep 2023; 13:1289. [PMID: 36690658 PMCID: PMC9871007 DOI: 10.1038/s41598-023-27399-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023] Open
Abstract
Auscultation, a cost-effective and non-invasive part of physical examination, is essential to diagnose pediatric respiratory disorders. Electronic stethoscopes allow transmission, storage, and analysis of lung sounds. We aimed to develop a machine learning model to classify pediatric respiratory sounds. Lung sounds were digitally recorded during routine physical examinations at a pediatric pulmonology outpatient clinic from July to November 2019 and labeled as normal, crackles, or wheezing. Ensemble support vector machine models were trained and evaluated for four classification tasks (normal vs. abnormal, crackles vs. wheezing, normal vs. crackles, and normal vs. wheezing) using K-fold cross-validation (K = 10). Model performance on a prospective validation set (June to July 2021) was compared with those of pediatricians and non-pediatricians. Total 680 clips were used for training and internal validation. The model accuracies during internal validation for normal vs. abnormal, crackles vs. wheezing, normal vs. crackles, and normal vs. wheezing were 83.68%, 83.67%, 80.94%, and 90.42%, respectively. The prospective validation (n = 90) accuracies were 82.22%, 67.74%, 67.80%, and 81.36%, respectively, which were comparable to pediatrician and non-pediatrician performance. An automated classification model of pediatric lung sounds is feasible and maybe utilized as a screening tool for respiratory disorders in this pandemic era.
Collapse
Affiliation(s)
- Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyungdo Kim
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Ji Hye Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
| |
Collapse
|
20
|
Suh DI. Community-acquired pneumonia in Korean children: time to read between the lines. Clin Exp Pediatr 2023; 66:22-23. [PMID: 36397258 PMCID: PMC9815943 DOI: 10.3345/cep.2022.00941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/14/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
21
|
Lee BR, Kim MJ, Kim JH, Choi YJ, Park JS, Suh DI. High-flow nasal cannula therapy for children with complex chronic disease in the general ward: A single, tertiary center experience. Allergy Asthma Respir Dis 2023. [DOI: 10.4168/aard.2023.11.1.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Bo Ra Lee
- Department of Pediatrics, Eulji University Uijeongbu Hospital, Uijeongbu, Korea
| | - Min Jung Kim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hye Kim
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
22
|
Lee JS, Lee YA, Shin CH, Suh DI, Lee YJ, Yon DK. Long-term health outcomes of early menarche in women: an umbrella review. QJM 2022; 115:837-847. [PMID: 35929081 DOI: 10.1093/qjmed/hcac187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/05/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is limited comprehensive evidence on the potential association between early menarche and subsequent health outcomes. AIM To evaluate the existing evidence for the association of early menarche with later health outcomes and assesse the strength and validity of the evidence for these associations. DESIGN Umbrella review. METHODS We searched PubMed, Web of Science, Embase, CINAHL, Cochrane Database of Systematic Reviews and Google Scholar, and manually screened retrieved references to find systematic reviews and meta-analyses from inception to July 2021. Early menarche was defined by taking into account ethnicity and birth year, and the outcomes were long-term consequences in adulthood. RESULTS Thirteen reviews encompassing 283 original articles and over 6.8 million participants from 39 countries across 5 continents were included. In categorical outcomes, early menarche was associated with metabolic syndrome (n = 37 543 pooled adjusted relative risk [aRR] 1.56, 95% confidence interval (CI) 1.33, 1.83; high certainty [Hi]), endometrial cancer (n = 874 188, aRR 1.40, 95% CI 1.17, 1.68; Hi), type 2 diabetes mellitus/impaired glucose tolerance (n = 1 185 444, aRR 1.30, 95% CI 1.19, 1.42; Hi), breast cancer (n = 103 574, aRR 1.19, 95% CI 1.06, 1.33; Hi), death from all causes (n = 152 747, aRR 1.11, 95% CI 1.03, 1.19; Hi), obesity (n = 54 006, aRR 1.68, 95% CI 1.53, 1.84; moderate certainty [Mod]), gestational diabetes mellitus (n = 48 535, aRR 1.32, 95% CI 1.09, 1.58; Mod), hypertension (n = 1 682 689, aRR 1.24, 95% CI 1.20, 1.29; Mod), endometriosis (n = 885 390, aRR 1.22, 95% CI 1.09, 1.37; Mod), ovarian cancer (n = 1 022 451, aRR 1.17, 95% CI 1.04, 1.31; Mod) and asthma (n = 22 859, aRR 1.31, 95% CI 1.09, 1.57; low certainty [Lo]). For continuous outcomes, early menarche was associated with increased body mass index (BMI) in adults ≥40 years of age (n = 121 943, adjusted pooled standardized mean difference [aSMD] 0.30, 95% CI 0.28, 0.32; Mod), BMI in adults <40 years of age (n = 124 728, aSMD 0.39, 95% CI 0.36, 0.43; Mod), serum fasting insulin level (n = 17 020, aSMD 0.52, 95% CI 0.48, 0.57; Mod) and homeostatic model assessment of insulin resistance (n = 7925, aSMD 0.27, 95% CI 0.19, 0.35; Mod). CONCLUSION We found varied levels of evidence for the association between early menarche and the development of subsequent health problems. Our results recommend that physicians should pay attention to these associations, as early menarche can be a potential indicator of metabolic disorders and female-specific cancer and cause death in women.
Collapse
Affiliation(s)
- Jeong-Seon Lee
- From the Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yun Jeong Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
| |
Collapse
|
23
|
Lee E, Song JH, Chung EH, Jung S, Rhee EH, Suh DI, Yang HJ. Influence of Age on Effort Required to Complete Spirometry in Children and Adolescents. Allergy Asthma Immunol Res 2022; 14:752-759. [PMID: 36426402 PMCID: PMC9709686 DOI: 10.4168/aair.2022.14.6.752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 01/18/2024]
Abstract
Although effort required to complete spirometry is known to differ by age, no studies have addressed this issue. The present study aimed to identify the difference in the effort required to complete spirometry by age in children and adolescents. Data from 707 children (mean age, 10.2 years; range, 4-25 years) from 6 medical centers were analyzed. In addition to demographics, we obtained information on the time required for as well as the number of demonstrations and spirometry demonstrations and trials from the patients' electronic medical records. A total of 398 (56.3%) male participants were included, and 300 (42.4%) participants had no prior experience receiving spirometry. The mean time required for spirometry demonstration was 2.7 minutes (standard deviation [SD], 2.1 minutes), whereas that for spirometry trial was 5.9 minutes (SD, 5.1 minutes). The total mean time required for spirometry was 8.6 minutes (SD, 6.5 minutes). Significant negative associations were observed between age and effort required to complete spirometry with respect to the time and number of demonstrations and trials. The results of the present study suggest that age may affect the degree of effort required to complete spirometry, with a pattern of increasing effort with decreasing age. This finding provides important evidence for the establishment of health care policies especially regarding lung diseases that can benefit from spirometry.
Collapse
Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jun Hyuk Song
- Department of Pediatrics, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Eun Hee Rhee
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| |
Collapse
|
24
|
Lee SY, Kim S, Kang MJ, Song KB, Choi EJ, Jung S, Yoon JS, Suh DI, Shin YH, Kim KW, Ahn K, Hong SJ. Phenotype of Atopic Dermatitis With Food Allergy Predicts Development of Childhood Asthma via Gut Wnt Signaling. Allergy Asthma Immunol Res 2022; 14:674-686. [PMID: 36426397 PMCID: PMC9709687 DOI: 10.4168/aair.2022.14.6.674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/12/2022] [Accepted: 08/23/2022] [Indexed: 07/29/2023]
Abstract
PURPOSE Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by a wide spectrum of clinical phenotype. However, specific description of phenotypes of AD depending on the comorbidities in early childhood is lacking. This study aimed to investigate whether the AD phenotype in early childhood is related to childhood asthma and to elucidate the mechanisms involved. METHODS Data on the first 3 years of life were collected prospectively from 1,699 children in the COhort for Childhood Origin of Asthma and allergic diseases (COCOA). We applied an unsupervised latent class analysis to the following five factors: food sensitization, inhalant sensitization, food allergy (FA), AD, and recurrent wheezing. The risks of developing FA, AD, allergic rhinitis (AR), and asthma in children aged 5-7 years were evaluated. Colonocyte transcriptome and ingenuity pathway analysis were performed. RESULTS Four phenotypes were identified; no allergic diseases (78.4%), AD without sensitization (16.4%), FA with AD (2.9%), and AD with sensitization (7.8%). The FA with AD had the highest risk for FA, AR, and asthma and the highest cord blood immunoglobulin E (IgE) levels. In AD without sensitization and with sensitization, scoring of AD (SCORAD) in early childhood was higher than in FA with AD. Canonical pathway analysis with the colonocyte transcriptome revealed that the key pathway in FA with AD was 'Wnt/β-catenin Signaling.' The relative abundance of Wnt6 mRNA was positively correlated with food-specific IgE levels at 1 and 3 years. CONCLUSIONS When FA is present in various phenotypes of AD at early life, regardless of severity of eczema, it may be associated with gut Wnt signaling and later development of asthma.
Collapse
Affiliation(s)
- So-Yeon Lee
- Department of Pediatrics, Childhood Asthma and Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sangrok Kim
- Department of Information Management, Medical Record Information Team, Hanyang University Medical Center, Seoul, Korea
| | - Mi Jin Kang
- Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kun-Baek Song
- Department of Pediatrics, Soonchunhyang Cheonan Hospital, University of Soonchunhyang College of Medicine, Cheonan, Korea
| | - Eom Ji Choi
- Department of Pediatrics, Childhood Asthma and Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji-Sun Yoon
- Department of Pediatrics, Chung-Ang University Hospital, Gwangmyeong, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma and Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
25
|
Park JS, Cho YJ, Yun JY, Lee HJ, Yu J, Yang HJ, Suh DI. Leukotriene-receptor antagonist and risk of neuropsychiatric events in children, adolescents, and young adults: a self-controlled case series. Eur Respir J 2022; 60:13993003.02467-2021. [PMID: 35595323 DOI: 10.1183/13993003.02467-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/19/2022] [Indexed: 11/05/2022]
Abstract
Leukotriene receptor antagonists (LTRAs) are widely used for asthma and allergic rhinitis (AR), but concerns about the risk of neuropsychiatric events (NPEs) have been raised since the first Drug Safety Communication by the US Food and Drug Administration in 2008. This study evaluates the association between LTRA and NPEs in children, adolescents, and young adults with asthma or AR.A self-controlled case series study was conducted using the Korean National Health Insurance Service claims database from two three-year observation periods (observation period 1 [Obs1]: 2005 to 2007, observation period 2 [Obs2]: 2016 to 2018). Asthma or AR patients aged 3-30 years who were prescribed LTRAs and diagnosed with NPEs were included. The incidence rate ratios (IRRs) for exposed period and risk periods (1-3, 4-7, 8-14, 15-30, 31-90, >90 days from initiation of LTRA) compared to unexposed periods were calculated using conditional Poisson regression. Subgroup analysis according to age group, type of NPEs and indication of LTRA was performed.Among 17 001 included patients, the risk of NPEs increased in Obs2 (IRR, 1.11; 95% confidence interval [CI], 1.00-1.22), but did not increase in Obs1. Risk was increased during risk periods 4-7 days (2.36, 1.99-2.76) and 8-14 days (1.78; 1.46-2.15) after initiation of LTRA, particularly in adolescents (1.28, 1.05-1.55) and young adults (1.14, 1.02-1.28), while risk was decreased in children (3-11 years). Risk was not increased for any single type of NPE. AR patients were at increased risk (1.19, 1.01-1.39), but not those with asthma.Overall, risk of NPEs with LTRA use differed between risk periods and subgroups. Physicians should prescribe LTRAs according to indications and inform patients about possible NPEs.
Collapse
Affiliation(s)
- Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,These authors contributed equally as co-first authors
| | - Yoo Jung Cho
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea.,These authors contributed equally as co-first authors
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea.,Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hye Jin Lee
- Department of Pediatrics, Catholic University College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Ulsan University Asan Medical Center, Seoul, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea.,These authors contributed equally as co-corresponding authors
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea .,These authors contributed equally as co-corresponding authors
| | | |
Collapse
|
26
|
Shin JI, Kim SE, Lee MH, Kim MS, Lee SW, Park S, Shin YH, Yang JW, Song JM, Moon SY, Kim SY, Park Y, Suh DI, Yang JM, Cho SH, Jin HY, Hong SH, Won HH, Kronbichler A, Koyanagi A, Jacob L, Hwang J, Tizaoui K, Lee KH, Kim JH, Yon DK, Smith L. COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2022; 26:3760-3770. [PMID: 35647859 DOI: 10.26355/eurrev_202205_28873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.
Collapse
Affiliation(s)
- J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Song KB, Park MJ, Choi EJ, Jung S, Yoon J, Cho HJ, Kim BS, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Lee SY. Food allergy in early childhood increases the risk of oral allergy syndrome in schoolchildren: A birth cohort study. Pediatr Allergy Immunol 2022; 33:e13786. [PMID: 35616894 DOI: 10.1111/pai.13786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/01/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The level of pollen in Korea has increased over recent decades. Research suggests that oral allergy syndrome (OAS) may be more frequent in childhood than previously recognized. We aimed to investigate the prevalence and characteristics of OAS in children aged 6-10 years from a general-population-based birth cohort. METHODS We analyzed 930 children from the cohort for childhood origin of asthma and allergic diseases (COCOA). Allergic diseases were diagnosed annually by pediatric allergists. The skin prick tests were performed with 14 common inhalant allergens and four food allergens for the general population of children aged 3 and 7 years. RESULTS Of the 930 eligible children, 44 (4.7%) aged 6-10 years were diagnosed with OAS. The mean age at onset was 6.74 years. OAS prevalence was 7.2% among children with allergic rhinitis (AR) and 19.1% among those with pollinosis, depending on comorbidity. OAS was more prevalent in schoolchildren with atopic dermatitis, food allergy, and sensitization to food allergens and grass pollen in early childhood. In schoolchildren with AR, only a history of food allergy until the age of 3 years increased the risk of OAS (aOR 2.971, 95% CI: 1.159-7.615). CONCLUSION Food allergy and food sensitization in early childhood were associated with OAS in schoolchildren with AR. Further study is required to elucidate the mechanism by which food allergy in early childhood affects the development of OAS.
Collapse
Affiliation(s)
- Kun-Baek Song
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Jee Park
- Department of Pediatrics, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Eom Ji Choi
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
28
|
Lee KH, Yon DK, Suh DI. Prevalence of allergic diseases among Korean adolescents during the COVID-19 pandemic: comparison with pre-COVID-19 11-year trends. Eur Rev Med Pharmacol Sci 2022; 26:2556-2568. [PMID: 35442470 DOI: 10.26355/eurrev_202204_28492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE During the coronavirus disease 2019 (COVID-19) pandemic, emergency department utilization and hospitalization rates for allergic diseases declined and the severity of allergies among admitted patients was low. This study aimed to determine the prevalence of allergic diseases among adolescents and the changes in trend during the COVID-19 pandemic compared with those during the preceding 11 years. SUBJECTS AND METHODS We analyzed data from the nationwide web-based self-report Korea Youth Risk Behavior Survey. From 2009 to 2020, adolescents aged 13-18 years participated in the survey. The survey period was divided into pre-pandemic Periods I (2009-2011), II (2012-2014), III (2015-2017), and IV (2018-2019) and the pandemic period (Period V, 2020). The current prevalence of asthma, allergic rhinitis, atopic dermatitis, allergic morbidity (having at least one of the three conditions) and changes in the prevalence before and during the COVID-19 pandemic were analyzed. RESULTS Data of 787,043 participants were analyzed after weighting the study population (mean age, 15.1 years; males, 52.3%). The prevalence of asthma, allergic rhinitis, atopic dermatitis, and allergic morbidity was 2.1%, 18.4%, 6.8%, and 23.6%, respectively. The prevalence of allergic morbidity increased between Periods I and IV but declined significantly from Periods IV to V. From Periods I to IV, the prevalence of asthma decreased, the prevalence of allergic rhinitis increased, and the prevalence of atopic dermatitis remained unchanged. During Period V, the prevalence of all three conditions decreased. CONCLUSIONS It is necessary to update management measures and develop relevant policies in response to the altered prevalence of allergic diseases since the outbreak of COVID-19.
Collapse
Affiliation(s)
- K H Lee
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
| | | | | |
Collapse
|
29
|
Park JS, Suh DI, Song DJ, Baek HS, Shin M, Yoo Y, Kwon JW, Jang GC, Yang HJ, Lee E, Kim HS, Seo JH, Woo SI, Kim HY, Shin YH, Lee JS, Yoon J, Jung S, Han M, Eom E, Yu J, Kim WK, Lim DH, Kim JT. Longitudinal asthma exacerbation phenotypes in the Korean childhood asthma study cohort. Pediatr Allergy Immunol 2022; 33. [PMID: 35470936 DOI: 10.1111/pai.13772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Asthma exacerbation (AE) leads to social and economic costs and long-term adverse outcomes. We aimed to predict exacerbation-prone asthma (EPA) in children. METHODS The Korean childhood Asthma Study (KAS) is a prospective nationwide pediatric asthma cohort of children aged 5-15 years followed every 6 months. Patients with AE during the 6 months prior to all three visits, with AE prior to one or two visits, and without AE prior to any visit were defined as having EPA, exacerbation-intermittent asthma (EIA), and exacerbation-resistant asthma (ERA), respectively. Risk factors and prediction models of EPA were explored. RESULTS Of the 497 patients who completed three visits, 42%, 18%, and 15% had exacerbations prior to visits 1, 2, and 3 and 5%, 47%, and 48% had EPA, EIA, and ERA, respectively. Univariate and multivariable logistic regression revealed forced expiratory volume in 1 s (FEV1) z-score, forced vital capacity (FVC) z-score, white blood cell (WBC) count, and asthma control test (ACT) score as relevant EPA risk factors. The EPA prediction model comprised FVC z-score, WBC count, ACT score, sex, and parental education level (area under the receiver operating characteristic curve [AUROC] 0.841 [95% confidence interval (CI): 0.728-0.954]). CONCLUSION With appropriate management, AE decreases over time, but persistent AEs may occur. Apart from asthma control level, baseline lung function and WBC count predicted EPA.
Collapse
Affiliation(s)
- Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, South Korea
| | - Young Yoo
- Department of Pediatrics, Korea University Anam Hospital, Seoul, South Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, South Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Hwan Soo Kim
- Department of Pediatrics, School of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, South Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, South Korea
| | - Sung-Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jisun Yoon
- Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, South Korea
| | - Minkyu Han
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea
| | - Eunjin Eom
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, South Korea
| | - Dae Hyun Lim
- Department of Pediatrics, School of Medicine, Inha University, Incheon, South Korea
| | - Jin Tack Kim
- Department of Pediatrics, School of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, South Korea
| |
Collapse
|
30
|
Kim HS, Yang HJ, Song DJ, Lee YJ, Suh DI, Shim JY, Yoo Y, Kim CK, Ahn YM, Kim JT. Eosinophil-derived neurotoxin: An asthma exacerbation biomarker in children. Allergy Asthma Proc 2022; 43:133-139. [PMID: 35317890 DOI: 10.2500/aap.2022.43.210001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Asthma is a heterogeneous disease, characterized by chronic airway inflammation. Asthma exacerbations (AE) are episodes characterized by a progressive increase in symptoms of shortness of breath, cough, wheezing, or chest tightness with a decrease in lung function. There have been previous studies that examined the role of eosinophil-derived neurotoxin (EDN) in asthma, but there have been no studies of the role of EDN in children experiencing AE. Objective: In this study, we aimed to examine the association of EDN with lung function and prognosis in children admitted for severe AE. Methods: We enrolled 82 children who were admitted for severe AE at two different university hospitals in South Korea between January 2018 and December 2019. Blood tests, including white blood cell count, myeloperoxidase (MPO), total eosinophil count, EDN, C-reactive protein (CRP) level, and interleukin (IL) 4, IL-5, IL-10 values, and lung function were measured on admission and at discharge in each patient. Results: We observed significant decreases in the levels of MPO, EDN, CRP, and IL-4, with significant improvement in lung function after treatment. We then classified the subjects into two groups of different clinical phenotypes: eosinophilic asthma exacerbation (EAE) group and non-EAE group. EDN levels were higher and lung functions were lower in the EAE group. Also, we found that the EDN level was a significant biomarker useful for predicting the number of days for hospital stay. Conclusion: We found that EDN can act as a biomarker that reflects lung function, and that EDN could act as a prognostic biomarker, which demonstrated the complex role of EDN in children experiencing AE.
Collapse
Affiliation(s)
- Hwan Soo Kim
- From the Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Yong Ju Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Chang Keun Kim
- Department of Pediatrics, Asthma and Allergy Center, Inje University Sanggye Paik Hospital, Seoul, South Korea; and
| | - Young Min Ahn
- Department of Pediatrics, Jang's Hospital, Seoul, South Korea
| | - Jin Tack Kim
- From the Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
31
|
Yoon J, Kim JS, Suh DI, Lee SY, Shin YH, Kim KW, Ahn K, Shin YJ, Lee KS, Park MJ, Song KB, Choi EJ, Cho HJ, Jung S, Hong SJ. Internalizing behavior problems in early life are associated with the risk of childhood asthma: The COCOA study. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
32
|
Choi YJ, Chung EH, Lee E, Kim CH, Lee YJ, Kim HB, Kim BS, Kim HY, Cho Y, Seo JH, Sol IS, Sung M, Song DJ, Ahn YM, Oh HL, Yu J, Jung S, Lee KS, Lee JS, Jang GC, Jang YY, Chung HL, Choi SM, Han MY, Shim JY, Kim JT, Kim CK, Yang HJ, Suh DI. Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study. J Clin Med 2022; 11:jcm11020306. [PMID: 35054002 PMCID: PMC8779611 DOI: 10.3390/jcm11020306] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 02/04/2023] Open
Abstract
Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae. Early discrimination of macrolide-refractory M. pneumoniae pneumonia (MrMP) from macrolide-sensitive M. pneumoniae pneumonia (MSMP) is vital; however, testing for macrolide susceptibility at the time of admission is not feasible. This study aimed to identify the characteristics of MrMP in Korean children, in comparison with those of MSMP. In this multicenter study, board-certified pediatric pulmonologists at 22 tertiary hospitals reviewed the medical records from 2010 to 2015 of 5294 children who were hospitalized with M. pneumoniae pneumonia and administered macrolides as the initial treatment. One-way analysis of variance and the Kruskal-Wallis test were used to compare differences between groups. Of 5294 patients (mean age, 5.6 years) included in this analysis, 240 (4.5%), 925 (17.5%), and 4129 (78.0%) had MrMP, macrolide-less effective M. pneumoniae pneumonia, and MSMP, respectively. Compared with the MSMP group, the MrMP group had a longer fever duration, overall (13.0 days) and after macrolide use (8.0 days). A higher proportion of MrMP patients had respiratory distress, pleural effusion, and lobar pneumonia. The mean aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and C-reactive protein levels were the highest in the MrMP group, along with higher incidences of extrapulmonary manifestations and atelectasis (during and post infection). Pre-existing conditions were present in 17.4% (n = 725/4159) of patients, with asthma being the most common (n = 334/4811, 6.9%). This study verified that MrMP patients show more severe initial radiographic findings and clinical courses than MSMP patients. MrMP should be promptly managed by agents other than macrolides.
Collapse
Affiliation(s)
- Yun Jung Choi
- Hospital Medicine Center, Seoul National University Hospital, Seoul KS013, Korea;
- Department of Pediatrics, Seoul National University Hospital, Seoul KS013, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon KS015, Korea;
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju KS018, Korea;
| | - Chul-Hong Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon KS011, Korea; (C.-H.K.); (J.S.L.)
| | - Yong Ju Lee
- Department of Pediatrics, Yongin Severance Hospital, Yongin KS009, Korea;
| | - Hyo-Bin Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul KS013, Korea; (H.-B.K.); (C.-K.K.)
| | - Bong-Seong Kim
- Department of Pediatrics, Ulsan University Gangneung Asan Hospital, Gangneung KS007, Korea;
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan KS011, Korea; (H.Y.K.); (S.J.)
| | - Yoojung Cho
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul KS013, Korea;
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan KS002, Korea;
| | - In Suk Sol
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul KS013, Korea; (I.S.S.); (J.Y.S.)
| | - Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi KS010, Korea;
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul KS013, Korea;
| | - Young Min Ahn
- Department of Pediatrics, Eulji General Hospital, Eulju University, Seoul KS013, Korea;
| | - Hea Lin Oh
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul KS013, Korea;
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul KS013, Korea;
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan KS011, Korea; (H.Y.K.); (S.J.)
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri KS013, Korea;
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon KS011, Korea; (C.-H.K.); (J.S.L.)
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service, Ilsan Hospital, Goyang KS007, Korea;
| | - Yoon-Young Jang
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu KS002, Korea; (Y.-Y.J.); (H.L.C.)
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu KS002, Korea; (Y.-Y.J.); (H.L.C.)
| | - Sung-Min Choi
- Department of Pediatrics, Dongguk University Gyeongju Hospital, Gyeongju KS010, Korea;
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam KS009, Korea;
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul KS013, Korea; (I.S.S.); (J.Y.S.)
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul KS013, Korea;
| | - Chang-Keun Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul KS013, Korea; (H.-B.K.); (C.-K.K.)
| | - Hyeon-Jong Yang
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul KS013, Korea;
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul KS013, Korea
- Correspondence: (H.-J.Y.); (D.I.S.); Tel.: +82-02-709-9114 (H.-J.Y.); +82-2-2072-7559 (D.I.S.)
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul KS013, Korea
- Correspondence: (H.-J.Y.); (D.I.S.); Tel.: +82-02-709-9114 (H.-J.Y.); +82-2-2072-7559 (D.I.S.)
| |
Collapse
|
33
|
Affiliation(s)
- Yun Jung Choi
- Department of Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Soyoung Lee
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Hang-Rae Kim
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
34
|
Kim HY, Hong SJ, Ahn K, Suh DI, Noh SH, Kim SY, Yu J, Ko JM, Lee MG, Kim KW. Multicenter Surveillance of Cystic Fibrosis in Korean Children. Allergy Asthma Immunol Res 2022; 14:494-504. [PMID: 36174992 PMCID: PMC9523417 DOI: 10.4168/aair.2022.14.5.494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/29/2022] [Accepted: 06/14/2022] [Indexed: 11/20/2022]
Abstract
Purpose Methods Results Conclusions
Collapse
Affiliation(s)
- Hyung Young Kim
- Department of Pediatrics, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Shin Hye Noh
- Department of Pharmacology, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Yeon Kim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Min Ko
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Min Goo Lee
- Department of Pharmacology, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
35
|
Yoon SY, Jung JW, Park SY, Kim GW, Son K, Kang SY, Park HJ, Kang MK, Kim JH, Park KH, Lee DH, Kim SH, Kwon HS, Kang HR, Suh DI. Management of hereditary angioedema in pediatric, pregnant, and breast-feeding patients: An expert opinion. Allergy Asthma Respir Dis 2022. [DOI: 10.4168/aard.2022.10.3.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sun Young Yoon
- Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - So Young Park
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Gun-Woo Kim
- Department of Internal Medicine, St. Carollo General Hospital, Suncheon, Korea
| | - Kyunghee Son
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Sung-Yoon Kang
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min-Kyu Kang
- Departmemt of Internal Medicine, Chungbuk National University Hospital and Chungbuk National College of Medicine, Cheongju, Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Hee Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Hun Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyouk-Soo Kwon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye-Ryun Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
36
|
Kim JY, Lee S, Suh DI, Kim DW, Yoon HJ, Park SK, Rhee CS, Han DH. Distinct Endotypes of Pediatric Rhinitis Based on Cluster Analysis. Allergy Asthma Immunol Res 2022; 14:730-741. [DOI: 10.4168/aair.2022.14.6.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/23/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Jin Youp Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
- Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Sangjun Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Woo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyung-Jin Yoon
- Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
- Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
- Sensory Organ Research Institute, Seoul National University Biomedical Research Center, Seoul, Korea
| | - Doo Hee Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
37
|
Kim SR, Kim S, Kim SH, Park JS, Park HJ, Suh DI, Sim DW, Yang MS, Lee JH, Lee HY, Jung JW, Choi M, Kang HR. Expert opinion: The clinical usefulness of skin tests prior to the administration of beta-lactam antibiotics. Allergy Asthma Respir Dis 2022. [DOI: 10.4168/aard.2022.10.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sung-Ryeol Kim
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Sujeong Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong-Sook Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Da Woon Sim
- Department of Allergy and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Min Suk Yang
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Jae-Hyun Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hwa Young Lee
- Division of Allergy, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mira Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Hye-Ryun Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | | |
Collapse
|
38
|
Kim JH, Suh DI, Park JD. S/F and ROX indices in predicting failure of high-flow nasal cannula in children. Pediatr Int 2022; 64:e15336. [PMID: 36564344 DOI: 10.1111/ped.15336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND A high-flow nasal cannula (HFNC) is a useful respiratory support for children with respiratory distress; however, it elevates the risk of belated intubation. Recently, indices based on percutaneous oxygen saturation, a fraction of inspired oxygen, and respiratory rate (RR) have been suggested for the prediction of HFNC failure. We aimed to evaluate various indices predicting HFNC failure in children who started receiving HFNC at a tertiary center for 27 months. METHODS Cases of HFNC failure were classified as hypoxic respiratory failure (HRF) or non-HRF (NHRF) depending on the cause of intubation. The ratio of percutaneous oxygen saturation to the fraction of inspired oxygen (S/F), the ratio of S/F to RR (ROX), the ratio of S/F to RR/median RR (ROX-M), and the ratio of S/F to z-score of RR (ROX-Z) were calculated and compared between groups. RESULTS Of the 152 cases, 45 (29.6%) failed to wean from the HFNC support, of which 21 (46.7%) were HRFs and 24 (53.3%) were NHRFs. The S/F and ROX-M at 6 h and 3 h, respectively, predicted HRF well with a high area under the curve. Initial hypercapnia and low weight were good predictors for NHRF. CONCLUSIONS For the management of children with HFNC, these risk factors and indicators should be monitored to make an early decision regarding intubation.
Collapse
Affiliation(s)
- Ji Hye Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - June Dong Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| |
Collapse
|
39
|
Jung JW, Park SY, Yoon SY, Kim GW, Sohn KH, Kang SY, Park HJ, Kang MK, Kim JH, Park KH, Suh DI, Lee DH, Kim SH, Kwon HS, Kang HR. Diagnosis and treatment of hereditary angioedema: An expert opinion. Allergy Asthma Respir Dis 2022. [DOI: 10.4168/aard.2022.10.2.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - So-Young Park
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Young Yoon
- Division of Pulmonology and Allergy, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Gun-Woo Kim
- Department of Internal Medicine, St. Carollo General Hospital, Suncheon, Korea
| | - Kyoung-Hee Sohn
- Division of Pulmonology and Allergy, Department of Internal Medicine, KyungHee University Medical Center, Seoul, Korea
| | - Sung-Yoon Kang
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min-Kyu Kang
- Departmemt of Internal Medicine, Chungbuk National University Hospital, Chungbuk National College of Medicine, Cheongju, Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Hee Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Hun Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyouk-Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye-Ryun Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
40
|
Lee HK, Lim JG, Park JS, Shin SH, Kwon SK, Suh DI. An infant with subglottic cysts presenting as abruptly-progressed stridor and respiratory distress 2 months after extubation. Allergy Asthma Respir Dis 2022. [DOI: 10.4168/aard.2022.10.2.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ha Kyung Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Gyu Lim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Han Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Keun Kwon
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
41
|
Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association between ambient air pollution and perceived stress in pregnant women. Sci Rep 2021; 11:23496. [PMID: 34873215 PMCID: PMC8648786 DOI: 10.1038/s41598-021-02845-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Air pollution may influence prenatal maternal stress, but research evidence is scarce. Using data from a prospective cohort study conducted on pregnant women (n = 2153), we explored the association between air pollution and perceived stress, which was assessed using the 14-item Perceived Stress Scale (PSS), among pregnant women. Average exposures to particulate matter with an aerodynamic diameter of < 2.5 µm (PM2.5) or < 10 µm (PM10), nitrogen dioxide (NO2), and ozone (O3) for each trimester and the entire pregnancy were estimated at maternal residential addresses using land-use regression models. Linear regression models were applied to estimate associations between PSS scores and exposures to each air pollutant. After adjustment for potential confounders, interquartile-range (IQR) increases in whole pregnancy exposures to PM2.5, PM10, and O3 in the third trimester were associated with 0.37 (95% confidence interval [CI] 0.01, 0.74), 0.54 (95% CI 0.11, 0.97), and 0.30 (95% CI 0.07, 0.54) point increases in prenatal PSS scores, respectively. Furthermore, these associations were more evident in women with child-bearing age and a lower level of education. Also, the association between PSS scores and PM10 was stronger in the spring. Our findings support the relationship between air pollution and prenatal maternal stress.
Collapse
Affiliation(s)
- Dirga Kumar Lamichhane
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- grid.444037.00000 0000 9208 7123Department of Rehabilitation, Hanshin University, Osan, Gyeonggi-do Republic of Korea
| | - So-Yeon Lee
- grid.413967.e0000 0001 0842 2126Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- grid.414964.a0000 0001 0640 5613Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- grid.15444.300000 0004 0470 5454Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- grid.413793.b0000 0004 0624 2588Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
| |
Collapse
|
42
|
Lee S, Hur S, Suh DI, Moon JS, Moon J, Kim MJ, Cheon JE, Kim WS. Transcatheter Dynamic Contrast-Enhanced MR Lymphangiography for Nontraumatic Lymphatic Disorders: Technical Feasibility and Imaging Findings. J Vasc Interv Radiol 2021; 32:1654-1660.e2. [PMID: 34844704 DOI: 10.1016/j.jvir.2021.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/19/2021] [Accepted: 08/29/2021] [Indexed: 12/01/2022] Open
Abstract
This study aimed to evaluate the feasibility and added value of transcatheter dynamic contrast-enhanced magnetic resonance (MR) lymphangiography for nontraumatic lymphatic disorders. Five patients (2 males and 3 females; median age, 16.0 years; range, 3-74 years) who underwent both intranodal and transcatheter dynamic contrast-enhanced MR lymphangiography for suspected nontraumatic lymphatic leakages from June 2017 to January 2020 were included in this retrospective study. The imaging findings of both dynamic contrast-enhanced MR lymphangiography techniques were assessed for the presence of chylolymphatic reflux or direct sign of leakage. Intranodal dynamic contrast-enhanced MR lymphangiography demonstrated chylolymphatic reflux into the thoracic area in 2 patients (40%) but no direct evidence of leakage in any of the 5 patients. Transcatheter dynamic contrast-enhanced MR lymphangiography revealed chylolymphatic reflux and extravasation of the contrast agent in all 5 patients (100%). In conclusion, transcatheter dynamic contrast-enhanced MR lymphangiography may reveal additional signs of reflux and extravasation even when the findings of intranodal dynamic contrast-enhanced MR lymphangiography are negative.
Collapse
Affiliation(s)
- Seunghyun Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Saebeom Hur
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jangsup Moon
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Genomic Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Man Jin Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung-Eun Cheon
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Woo Sun Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| |
Collapse
|
43
|
Kim S, Yang S, Lim H, Lee S, Park MJ, Song K, Choi EJ, Oh HY, Kim H, Shin Y, Lee K, Choi KY, Suh DI, Shin YH, Kim KW, Ahn K, Hong S. Prenatal PM 2.5 affects atopic dermatitis depending on maternal anxiety and gender: COCOA study. Clin Transl Allergy 2021; 11:e12070. [PMID: 34691390 PMCID: PMC8519998 DOI: 10.1002/clt2.12070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/13/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The prevalence of atopic dermatitis (AD) is increasing worldwide. Prenatal particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and maternal anxiety during pregnancy has been suggested as a potential causes of AD. This study investigated the effects of prenatal PM2.5 and maternal anxiety on AD and identified the critical period of PM2.5 exposure for AD in infants. METHODS This study included 802 children from the COCOA birth cohort study with follow-up data at 1 year of age. PM2.5 was estimated by land-use regression models and prenatal anxiety was measured with a questionnaire. AD was diagnosed by doctor at 1 year of age. Logistic regression analysis and Bayesian distributed lag interaction models were applied. RESULTS Higher PM2.5 during the first trimester of pregnancy, higher prenatal maternal anxiety, and male gender were associated with AD at 1 year of age (adjusted odds ratio [aOR] and 95% confidence interval [CI]: 1.86 [1.08-3.19], 1.58 [1.01-2.47], and 1.54 [1.01-2.36], respectively). Higher PM2.5 during the first trimester and higher maternal anxiety during pregnancy showed an additive effect on the risk of AD (aOR: 3.13; 95% CI: 1.56-6.28). Among boys exposed to higher maternal anxiety during pregnancy, gestational weeks 5-8 were the critical period of PM2.5 exposure for the development of AD. CONCLUSIONS Higher PM2.5 exposure during gestational weeks 5-8 increased the probability of AD in infancy, especially in boys with higher maternal anxiety. Avoiding PM2.5 exposure and maternal anxiety from the first trimester may prevent infant AD.
Collapse
Affiliation(s)
- Sangrok Kim
- Department of Medical ScienceAsan Medical Institute of Convergence Science and TechnologyAsan Medical CenterUlsan University College of MedicineSeoulRepublic of Korea
| | - Song‐I Yang
- Department of PediatricsHallym University Sacred Heart HospitalHallym University College of MedicineAnyangRepublic of Korea
| | - Hyeyeun Lim
- Department of PediatricsChildhood Asthma Atopy CenterHumidifier Disinfectant Health CenterAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - So‐Yeon Lee
- Department of PediatricsChildhood Asthma Atopy CenterHumidifier Disinfectant Health CenterAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Min Jee Park
- Department of PediatricsUijeongbu Eulji Medical CenterUijeongbuRepublic of Korea
| | - Kun‐Baek Song
- Department of PediatricsChildhood Asthma Atopy CenterHumidifier Disinfectant Health CenterAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Eom Ji Choi
- Department of PediatricsChildhood Asthma Atopy CenterHumidifier Disinfectant Health CenterAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Hea Young Oh
- Department of MedicineAsan Medical CenterUlsan University College of MedicineSeoulRepublic of Korea
| | - Hwan‐Cheol Kim
- Department of Occupational and Environmental MedicineInha University School of MedicineIncheonRepublic of Korea
| | - Yee‐Jin Shin
- Department of PsychiatryYonsei University College of MedicineSeoulRepublic of Korea
| | - Kyung‐Sook Lee
- Department of RehabilitationHanshin UniversityOsanRepublic of Korea
| | - Kil Yong Choi
- Department of Environmental Energy EngineeringAnyang UniversityAnyangRepublic of Korea
| | - Dong In Suh
- Department of PediatricsSeoul National University College of MedicineSeoulRepublic of Korea
| | - Youn Ho Shin
- Department of PediatricsCHA Gangnam Medical CenterCHA University School of MedicineSeoulRepublic of Korea
| | - Kyung Won Kim
- Department of PediatricsYonsei University College of MedicineSeoulRepublic of Korea
| | - Kangmo Ahn
- Department of PediatricsSamsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
| | - Soo‐Jong Hong
- Department of PediatricsChildhood Asthma Atopy CenterHumidifier Disinfectant Health CenterAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| |
Collapse
|
44
|
Park MJ, Lee SY, Lee SH, Kang MJ, Song KB, Jung S, Yoon JS, Suh DI, Shin YH, Kim KW, Ahn K, Hong SJ. Effect of early-life antibiotic exposure and IL-13 polymorphism on atopic dermatitis phenotype. Pediatr Allergy Immunol 2021; 32:1445-1454. [PMID: 33960015 DOI: 10.1111/pai.13531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although atopic dermatitis (AD) is associated with certain gene variants, the rapidly increasing incidence of AD suggests that environmental factors contribute to disease development. In this study, we investigated the association of AD incidence and phenotype with antibiotic exposure within 6 months of age, considering the dose administered and genetic risk. METHODS This study included 1637 children from the COCOA cohort. Pediatric allergists assessed the presence of AD at each visit and obtained information about antibiotic exposure for more than 3 days. IL-13 (rs20541) polymorphism was genotyped by the TaqMan method. We stratified the AD phenotypes into four groups and used multinomial logistic regression models for analysis. RESULTS Antibiotic exposure within 6 months of age was found to increase the risk of AD within 3 years of life (aOR = 1.40; 95% CI, 1.09-1.81) in dose-dependent manner. Antibiotic exposure more than twice increased the risk of the early-persistent AD phenotype (aOR = 2.50; 95% CI, 1.35-4.63). There was a weak interaction between genetic polymorphisms and environmental factors on the development of AD (p for interaction = 0.06). Children with the IL-13 (rs20541) GA + AA genotype have a higher risk of the early-persistent AD phenotype when exposed to antibiotics more than twice than those with the IL-13 (rs20541) GG genotype and without exposure to antibiotics (aOR = 4.73; 95% CI, 2.01-11.14). CONCLUSION Antibiotic exposure within 6 months was related to the incidence of early-persistent AD and a dose-dependent increase in the incidence of AD in childhood, whose effect was modified by the IL-13 (rs20541) genotype.
Collapse
Affiliation(s)
- Min Jee Park
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Si Hyeon Lee
- Asan Institute for Life Science, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
| | - Mi-Jin Kang
- Humidifier Disinfectant Health Center, Asan Medical Center, Seoul, South Korea
| | - Kun Baek Song
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ji-Sun Yoon
- Department of Pediatrics, Incheon Sejong Hospital, Incheon, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| |
Collapse
|
45
|
Park JS, Suh DI, Choi YJ, Ahn K, Kim KW, Shin YH, Lee SY, Cho HJ, Lee E, Jang GC, Kwon JW, Sun YH, Woo SI, Youn YS, Park KS, Kook MH, Cho HJ, Chung HL, Kim JH, Kim HY, Jung JA, Woo HO, Choi YK, Lee JR, Lee YA, Shin CH, Kim BN, Kim JI, Lee KS, Lim YH, Hong YC, Hong SJ. Pulmonary function of healthy Korean children from three independent birth cohorts: Validation of the Global Lung Function Initiative 2012 equation. Pediatr Pulmonol 2021; 56:3310-3320. [PMID: 34375041 DOI: 10.1002/ppul.25622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/16/2021] [Accepted: 08/08/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Global Lung Function Initiative (GLI) 2012 equations were developed to resolve the age-related disparity in interpreting spirometry results. Local validation of the equation is needed, especially in Northeast Asian children. This study evaluated the GLI equation in Korean children. METHODS Spirometry indices (FEV1, FVC, FEV1/FVC, and FEF25%-75%) and clinical information were gathered from three population-based birth cohorts. Predicted GLI reference values and z scores of spirometry results were calculated for 1239 healthy children. The mean, standard deviation of z scores were compared with the expected 0 and 1. Probabilities of falling below the lower limit of normal (LLN) (z score: -1.64) were compared with the expected value 5%. GLI z scores were assessed according to low (<-2), normal (≥-2 and ≤2), and high (>2) BMI z score groups. RESULTS Mean z scores significantly differed from 0 for FEV1/FVC in males (mean [95% confidence interval]: 0.18 [0.08, 0.27]) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in females (-0.23 [-0.31, -0.15] and -0.26 [-0.36, -0.16], respectively). The standard deviation was larger than 1 for all variables in males and FVC and FEV1/FVC in females. The probability of falling below the LLN was significantly larger than 5% for FEV1 (12.13% [9.64, 14.77]), FVC (15.86% [13.06, 18.81]), and forced expiratory flow at 25%-75% of forced vital capacity (FEF25%-75%) (7.31% [5.29, 9.49]) in males and FVC (11.91% [9.40, 14.60]) in females. FEV1 and FVC z scores increased across low to high body mass index (BMI) groups, and FEV1/FVC decreased from low to high BMI groups. CONCLUSION GLI equations marginally differ from real-world values, which should be considered by pulmonologists in practice or research.
Collapse
Affiliation(s)
- Ji Soo Park
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, School of Medicine, CHA University, Seoul, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, International St. Mary's Hospital, Catholic Kwandong University Hospital, Incheon, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong Han Sun
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Sung-Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - You-Sook Youn
- Departments of Pediatrics, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Kang Seo Park
- Department of Pediatrics, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Myung-Hee Kook
- Department of Pediatrics, Gwangju Veterans Hospital, Gwangju, Republic of Korea
| | - Hwa Jin Cho
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Ja Hyung Kim
- Department of Pediatrics, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jin A Jung
- Department of Pediatrics, Anatomy, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Hyang-Ok Woo
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Yoon Kyung Choi
- Korea Institute of Child Care and Education, Seoul, Republic of Korea
| | - Jeong Rim Lee
- Korea Institute of Child Care and Education, Seoul, Republic of Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Boong Nyun Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Johanna I Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Kyung-Shin Lee
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youn Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
46
|
Cho HJ, Lee SH, Lee SY, Kim HC, Kim HB, Park MJ, Yoon J, Jung S, Yang SI, Lee E, Ahn K, Kim KW, Suh DI, Sheen YH, Won HS, Lee MY, Kim SH, Lee KJ, Choi SJ, Kwon JY, Jun JK, Choi KY, Hong SJ. Mid-pregnancy PM 2.5 exposure affects sex-specific growth trajectories via ARRDC3 methylation. Environ Res 2021; 200:111640. [PMID: 34302828 DOI: 10.1016/j.envres.2021.111640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/15/2021] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Abstract
Prenatal particulate matter <2.5 μm (PM2.5) is associated with adverse birth growth. However, the longitudinal growth impacts have been little studied, and no mechanistic relationships have been described. We investigated the association between prenatal PM2.5 exposure and growth trajectories, and the possible role of epigenetics. We enrolled 1313 neonates with PM2.5 data measured by ordinary kriging from the COhort for Childhood Origin of Asthma and allergic diseases, followed up at 1, 3, and 5 years to evaluate growth. Differential DNA methylation and pyrosequencing of cord blood leukocytes was evaluated according to the prenatal PM2.5 levels and birth weight (BW). PM2.5 exposure during the second trimester (T2) caused the lowest BW in both sexes, further adjusted for indoor PM2.5 levels [female, aOR 1.39 (95% CI 1.05-1.83); male, aOR 1.36 (95% CI 1.04-1.79)]. Bayesian distributed lag models with indoor PM2.5 adjustments revealed a sensitive window for BW effects at 10-26 weeks gestation, but only in females. Latent class mixture models indicated that a persistently low weight-for-height percentile trajectory was more prevalent in the highest PM2.5 exposure quartile at T2 in females, compared to a persistently high trajectory (36.5% vs. 20.3%, P = 0.022). Also, in the females only, the high PM2.5 and low BW neonates showed significantly greater ARRDC3 methylation changes. ARRDC3 methylation was also higher only in females with low weight at 5 years of age. Higher fetal PM2.5 exposure during T2 may cause a decreased growth trajectory, especially in females, mediated by ARRDC3 hyper-methylation-associated energy metabolism.
Collapse
Affiliation(s)
- Hyun-Ju Cho
- Department of Pediatrics, International St. Mary's Hospital, Catholic Kwandong University, Incheon, South Korea
| | - Seung-Hwa Lee
- Asan Institute for Life Science, University of Ulsan College of Medicine, Seoul, South Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Min Jee Park
- Department of Pediatrics, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, South Korea
| | - Jisun Yoon
- Department of Pediatrics, MediplexSejong Hospital, South Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Environmental Health Center for Atopic Disease, Samsung Medical Center, Seoul, South Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Youn Ho Sheen
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Hye-Sung Won
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mi-Young Lee
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Soo Hyun Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Kyung-Ju Lee
- Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, South Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ja-Young Kwon
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea
| | - Kil-Yong Choi
- Department of Environmental Energy Engineering, Anyang University, Anyang, South Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| |
Collapse
|
47
|
Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association of ambient air pollution with depressive and anxiety symptoms in pregnant women: A prospective cohort study. Int J Hyg Environ Health 2021; 237:113823. [PMID: 34364017 DOI: 10.1016/j.ijheh.2021.113823] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Air pollution is associated with depressive and anxiety symptoms in the general population. However, this relationship among pregnant women remains largely unknown. OBJECTIVE To evaluate the association between pregnancy air pollution exposure and maternal depressive and anxiety symptoms during the third trimester assessed using the Center for Epidemiologic Studies-Depression and State-Trait Anxiety Inventory scales, respectively. METHODS We analyzed 1481 pregnant women from a cohort study in Seoul. Maternal exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and <10 μm (PM10), as well as to nitrogen dioxide (NO2) and ozone (O3) for each trimester and the entire pregnancy was assessed at participant's residential address by land use regression models. We estimated the relative risk (RR) and corresponding confidence interval (CI) of the depressive and anxiety symptoms associated with an interquartile range (IQR) increase in PM2.5, PM10, NO2, and O3 using modified Poisson regression. RESULTS In single-pollutant models, an IQR increase in PM2.5, PM10, and NO2 during the second trimester was associated with an increased risk of depressive symptoms (PM2.5 RR = 1.15, 95% CI: 1.04, 1.27; PM10 RR = 1.13, 95% CI: 1.04, 1.23; NO2 RR = 1.15, 95% CI: 1.03, 1.29) after adjusting for relevant covariates. Similarly, an IQR increase in O3 during the third trimester was associated with an increased risk of depressive symptoms (RR = 1.09, 95% CI: 1.01, 1.18), while the IQR increase in O3 during the first trimester was associated with a decreased risk (RR = 0.89, 95% CI: 0.82, 0.96). Exposure to PM2.5, PM10, and NO2 during the second trimester was significantly associated with anxiety symptoms. The associations with PM2.5 and O3 in single-and multi-pollutant models were consistent. CONCLUSIONS Our findings indicate that increased levels of particulate matter, NO2, and O3 during pregnancy may elevate the risk of depression or anxiety in pregnant women.
Collapse
Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- Department of Rehabilitation, Hanshin University, Gyeonggi-do, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
| |
Collapse
|
48
|
Shin YH, Shin JI, Moon SY, Jin HY, Kim SY, Yang JM, Cho SH, Kim S, Lee M, Park Y, Kim MS, Won HH, Hong SH, Kronbichler A, Koyanagi A, Jacob L, Smith L, Lee KH, Suh DI, Lee SW, Yon DK. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol 2021; 3:e698-e706. [PMID: 34179832 PMCID: PMC8213376 DOI: 10.1016/s2665-9913(21)00151-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Real-world evidence on the association between autoimmune inflammatory rheumatic diseases, therapies related to these diseases, and COVID-19 outcomes are inconsistent. We aimed to investigate the potential association between autoimmune inflammatory rheumatic diseases and COVID-19 early in the COVID-19 pandemic. Methods We did an exposure-driven, propensity score-matched study using a South Korean nationwide cohort linked to general health examination records. We analysed all South Korean patients aged older than 20 years who underwent SARS-CoV-2 RT-PCR testing between Jan 1 and May 30, 2020, and received general health examination results from the Korean National Health Insurance Service. We defined autoimmune inflammatory rheumatic diseases (inflammatory arthritis and connective tissue diseases) based on the relevant ICD-10 codes, with at least two claims (outpatient or inpatient) within 1 year. The outcomes were positive SARS-CoV-2 RT-PCR test, severe COVID-19 (requirement of oxygen therapy, intensive care unit admission, application of invasive ventilation, or death), and COVID-19-related death. Adjusted odds ratios (ORs) with 95% CIs were estimated after adjusting for the potential confounders. Findings Between Jan 1 and May 30, 2020, 133 609 patients (70 050 [52·4%] female and 63 559 [47·6%] male) completed the general health examination and were tested for SARS-CoV-2; 4365 (3·3%) were positive for SARS-CoV-2, and 8297 (6·2%) were diagnosed with autoimmune inflammatory rheumatic diseases. After matching, patients with an autoimmune inflammatory rheumatic disease showed an increased likelihood of testing positive for SARS-CoV-2 (adjusted OR 1·19, 95% CI 1·03–1·40; p=0·026), severe COVID-19 outcomes (1·26, 1·02–1·59; p=0·041), and COVID-19-related death (1·69, 1·01–2·84; p=0·046). Similar results were observed in patients with connective tissue disease and inflammatory arthritis. Treatment with any dose of systemic corticosteroids or disease-modifying antirheumatic drugs (DMARDs) were not associated with COVID-19-related outcomes, but those receiving high dose (≥10 mg per day) of systemic corticosteroids had an increased likelihood of a positive SARS-CoV-2 test (adjusted OR 1·47, 95% CI 1·05–2·03; p=0·022), severe COVID-19 outcomes (1·76, 1·06–2·96; p=0·031), and COVID-19-related death (3·34, 1·23–8·90; p=0·017). Interpretation Early in the COVID-19 pandemic, autoimmune inflammatory rheumatic diseases were associated with an increased likelihood of a positive SARS-CoV-2 PCR test, worse clinical outcomes of COVID-19, and COVID-19-related deaths in South Korea. A high dose of systemic corticosteroid, but not DMARDs, showed an adverse effect on SARS-CoV-2 infection and COVID-19-related clinical outcomes. Funding National Research Foundation of Korea.
Collapse
Affiliation(s)
- Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Yong Moon
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - Hyun Young Jin
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jee Myung Yang
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Sungeun Kim
- Yonsei University College of Medicine, Seoul, South Korea
| | - Minho Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | - Youngjoo Park
- Yonsei University College of Medicine, Seoul, South Korea
| | - Min Seo Kim
- Korea University College of Medicine, Seoul, South Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Sung Hwi Hong
- Yonsei University College of Medicine, Seoul, South Korea
| | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University of Innsbruck, Innsbruck, Austria
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,ICREA (Catalan Institution for Research and Advanced Studies), Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Keum Hwa Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - Dong Keon Yon
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
49
|
Jeon MJ, Kim MJ, Kim JH, Park JS, Yim J, Kim M, Kwon SK, Lee S, Ko JM, Chae JH, Suh DI. Multilevel Airway Stenosis Being Bypassed by a Customized Tracheostomy Tube in an Infant with Myhre Syndrome. Pediatr Allergy Immunol Pulmonol 2021; 34:83-87. [PMID: 34143683 DOI: 10.1089/ped.2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Myhre syndrome is a rare connective tissue disorder caused by heterozygous pathogenic variants in the SMAD4 gene. Although recognizing Myhre syndrome in early childhood is challenging, it is important to manage airway stenosis in patients with Myhre syndrome. Case Presentation: We report the case of a 2-month-old boy who initially presented with severe multilevel airway stenosis, dysmorphic face, and multiple abnormalities. Lung fibrosis and mild aortic valve stenosis were additionally observed on follow-up examinations. A heterozygous missense variant, c.1499T>C (p.Ile500Thr), in SMAD4 was identified through exome sequencing. Tracheostomy was performed, and the patient has maintained stable respiration through a customized tracheostomy tube with a home ventilator. Conclusions: Patients who have dysmorphic face, airway stenosis, and cardiovascular anomalies that do not fit the diagnosis of common syndromes should be evaluated for rare diseases, including Myhre syndrome. Since respiratory complications can be life threatening, early diagnosis and suitable intervention are necessary.
Collapse
Affiliation(s)
- Min Jin Jeon
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Min Jung Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hye Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Soo Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jisook Yim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myungshin Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Soyoung Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Ko
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.,Rare Disease Center, Seoul National University Hospital, Seoul, Korea
| | - Jong-Hee Chae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.,Rare Disease Center, Seoul National University Hospital, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
50
|
Park MJ, Lee SY, Song KB, Lee SH, Choi KY, Lee KW, Jung S, Suh DI, Sheen YH, Kim KW, Ahn K, Hong SJ. Dog Ownership in Early Life Increased the Risk of Nonatopic Asthma in Children. Int Arch Allergy Immunol 2021; 182:980-988. [PMID: 33957625 DOI: 10.1159/000516057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is still debatable whether dog ownership during early childhood is a risk factor for the development of allergic diseases. OBJECTIVE We investigated the association of dog ownership in early life with sensitization and asthma in childhood. METHODS Data from the Cohort for Childhood Origin of Asthma and Allergic diseases were used to investigate the association between dog ownership at any time from pregnancy to 1 year of age and sensitization to aeroallergens at 3 and 7 years old, bronchial hyperresponsiveness (BHR), and asthma at 7 years old. We analyzed the cytokine levels in cord blood (CB) and indoor environmental measurement concentrations in the mother's residence obtained at 36 weeks of pregnancy. RESULTS Sensitization to dogs at age 3 and 7 did not differ between dog ownership and nonownership, but dog ownership during early life decreased the risk of sensitization to aeroallergens at age 7 (aOR = 0.44, 95% CI 0.21-0.90). Dog ownership significantly increased the risk of nonatopic BHR (aOR = 2.86; 95% CI 1.32-6.21). In addition, dog ownership was associated with asthma, especially nonatopic asthma at 7 years old (aOR = 2.73, 95% CI 1.02-7.32; aOR = 7.05, 95% CI 1.85-26.90, respectively). There were no significant differences in the concentrations of IL-13 or interferon-γ in CB or indoor environmental measurements according to dog ownership during pregnancy. CONCLUSION Early-life dog exposure in this birth cohort has been shown to reduce atopy but increase the risk of nonatopic BHR and nonatopic asthma at 7 years old.
Collapse
Affiliation(s)
- Min Jee Park
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kun Baek Song
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Si Hyeon Lee
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kil Yong Choi
- Department of Environmental Energy Engineering, Anyang University, Anyang, Republic of Korea
| | - Ki Won Lee
- Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Sheen
- Department of Pediatrics, CHA University School of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|