Publications by authors named "Kyung Suk Lee"

105 Publications

Association Between Allergen Sensitization and Anaphylaxis in Patients Visiting a Pediatric Emergency Department.

Front Pediatr 2021 8;9:651375. Epub 2021 Jun 8.

Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University, Gyeonggi-do, South Korea.

Anaphylaxis, a severe allergic disease, can be triggered by various causes. This study investigated the association between allergic sensitization and anaphylactic symptoms and the severity of anaphylaxis in children. A retrospective review of 107 pediatric patients with anaphylaxis was performed between January 1, 2015, and December 31, 2017; 74 patients underwent allergen testing for specific immunoglobulin E. Allergic sensitizations and associations with anaphylactic symptoms and severity were investigated. Overall, 64 (86.5%) patients were sensitized to food or inhalant allergens. In children under 2 years of age, 90.5% were sensitized to food ( = 0.001); in those over 6 years of age, 84.6% were sensitized to inhalant allergens ( = 0.001). Milk sensitization was significantly associated with severe anaphylaxis ( = 0.036). The following symptoms showed significant associations with certain allergen sensitizations: facial edema with food; wheezing with milk; dyspnea with mite, etc. Certain allergen sensitizations presenting as risk factors for anaphylactic symptoms: wheat (adjusted odds ratio [aOR] = 4.644, = 0.044) and nuts (aOR=3.614, = 0.041) for wheezing, nuts (aOR=5.201, = 0.026) for dyspnea, and milk (aOR=4.712, = 0.048) for vomiting. The allergen sensitization status differed according to the age of the children experiencing anaphylaxis. The severity, symptoms, and signs of anaphylaxis differed depending on the allergen sensitization status.
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http://dx.doi.org/10.3389/fped.2021.651375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217608PMC
June 2021

Genetic and clinical spectrums in Korean Charcot-Marie-Tooth disease patients with myelin protein zero mutations.

Mol Genet Genomic Med 2021 Jun 6;9(6):e1678. Epub 2021 Apr 6.

Department of Biological Sciences, Kongju National University, Gongju, Korea.

Background: Charcot-Marie-Tooth disease (CMT) is the most common disorder of inherited peripheral neuropathies characterized by distal muscle weakness and sensory loss. CMT is usually classified into three types, demyelinating, axonal, and intermediate neuropathies. Mutations in myelin protein zero (MPZ) gene which encodes a transmembrane protein of the Schwann cells as a major component of peripheral myelin have been reported to cause various type of CMT.

Methods: This study screened MPZ mutations in Korean CMT patients (1,121 families) by whole exome sequencing and targeted sequencing.

Results: We identified 22 pathogenic or likely pathogenic MPZ mutations in 36 families as the underlying cause of the CMT1B, CMTDID, or CMT2I subtypes. Among them, five mutations were novel. The frequency of CMT patients with the MPZ mutations was similar or slightly lower compared to other ethnic groups.

Conclusions: We showed that the median onset ages and clinical phenotypes varied by subtypes: the most severe in the CMT1B group, and the mildest in the CMT2I group. This study also observed a clear correlation that earlier onsets cause more severe symptoms. We believe that this study will provide useful reference data for genetic and clinical information on CMT patients with MPZ mutations in Korea.
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http://dx.doi.org/10.1002/mgg3.1678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222852PMC
June 2021

Single-Molecule Imaging Reveals the Mechanism Underlying Histone Loading of AAA+ ATPase Abo1.

Mol Cells 2021 Feb;44(2):79-87

Department of Biological Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Korea.

Chromatin dynamics is essential for maintaining genomic integrity and regulating gene expression. Conserved bromodomain-containing AAA+ ATPases play important roles in nucleosome organization as histone chaperones. Recently, the high-resolution cryo-electron microscopy structures of Abo1 revealed that it forms a hexameric ring and undergoes a conformational change upon ATP hydrolysis. In addition, single-molecule imaging demonstrated that Abo1 loads H3-H4 histones onto DNA in an ATP hydrolysis-dependent manner. However, the molecular mechanism by which Abo1 loads histones remains unknown. Here, we investigated the details concerning Abo1-mediated histone loading onto DNA and the Abo1- DNA interaction using single-molecule imaging techniques and biochemical assays. We show that Abo1 does not load H2A-H2B histones. Interestingly, Abo1 deposits multiple copies of H3-H4 histones as the DNA length increases and requires at least 80 bp DNA. Unexpectedly, Abo1 weakly binds DNA regardless of ATP, and neither histone nor DNA stimulates the ATP hydrolysis activity of Abo1. Based on our results, we propose an allosteric communication model in which the ATP hydrolysis of Abo1 changes the configuration of histones to facilitate their deposition onto DNA.
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http://dx.doi.org/10.14348/molcells.2021.2242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941004PMC
February 2021

Increased sensitization rates to tree pollens in allergic children and adolescents and a change in the pollen season in the metropolitan area of Seoul, Korea.

Pediatr Allergy Immunol 2021 07 13;32(5):872-879. Epub 2021 Mar 13.

Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea.

Introduction: Children with allergies are at greater risk of becoming sensitized to allergenic pollens in response to environmental changes. This study investigated the relationship between changes in pollination associated with meteorologic changes and the sensitization rates of children to tree pollen allergens in the metropolitan area of Seoul, Korea.

Methods: The study population consisted of 8,295 children who visited the pediatric allergy clinics at Hanyang University Seoul and Guri Hospital for allergy symptoms between January 1, 1998, and December 31, 2019. Pollen was collected at the two hospitals during the study using a Burkard 7-day sampler. Meteorologic data were obtained from the National Weather Service.

Results: Among the major tree pollens, the largest increase in allergic sensitization was to oak, hazel, and alder pollens (0.28% annually). The pollen-sensitization rates increased annually within younger age groups. The duration of the pollen season was 98 days in 1998 and 140 days in 2019. Positive correlations were determined between the duration of the pollen season and the rates of sensitization to tree pollens, as well as between the pollen-sensitization rates and increasing temperature.

Conclusions: This study demonstrated the correlation between weather changes and the resulting changes in the pollen season with sensitization rates to allergenic pollens in children living in the Seoul metropolitan area. An annual increase in sensitization rates in younger children was determined. This pattern is expected to continue due to continuing climate change.
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http://dx.doi.org/10.1111/pai.13472DOI Listing
July 2021

Association of serum lipopolysaccharide-binding protein level with sensitization to food allergens in children.

Sci Rep 2021 01 25;11(1):2143. Epub 2021 Jan 25.

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam, Gyonggi-do, 13496, Republic of Korea.

Lipopolysaccharide (LPS)-binding protein (LBP) is an acute-phase reactant that mediates innate immune responses triggered by LPS. Recent studies indicated a positive correlation of circulating LBP level with chronic low-grade inflammation, a condition present in many non-communicable diseases. We determined the association of serum LBP concentration with allergic sensitization in a general pediatric population. Serum LBP was measured in a sample of children (n = 356; mean age = 9.6 ± 0.2 years) in this population-based cross-sectional study. Skin prick tests (SPTs) were performed to assess allergic sensitization to 22 common inhalant and food allergens. One hundred and seven children (30.1%) were nonsensitized, 160 (44.9%) were monosensitized, and 89 (25.0%) were polysensitized. Children who were mono- or polysensitized had a significantly higher median serum LBP level (25.5 ng/mL, inter-quartile range [IQR] 20.3-30.7) than those who were nonsensitized (20.3 ng/mL, IQR = 14.81-25.8, P < 0.0001). Multivariate logistic regression analysis with adjustment for confounders indicated that serum LBP level was positively associated with allergic sensitization overall (adjusted odds ratio [aOR] 1.041; 95% CI 1.007-1.076, P = 0.016), with sensitization to food allergens in particular (aOR 1.080, 95% CI 1.029-1.133, P = 0.002), but not with sensitization to aeroallergens (aOR 1.010, 95% CI 0.982-1.040, P = 0.467). LBP level was not associated with allergic diseases after adjustment. We suggest the possibility of sensitization to food allergens may be related to gut-derived low-grade inflammation, and large sized longitudinal investigations are needed to elucidate the relationship.
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http://dx.doi.org/10.1038/s41598-020-79241-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835372PMC
January 2021

Clinical and Neuroimaging Features in Charcot-Marie-Tooth Patients with Mutations.

J Clin Neurol 2021 Jan;17(1):52-62

Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.

Background And Purpose: Mutations in the ganglioside-induced differentiation-associated protein 1 gene () are known to cause Charcot-Marie-Tooth disease (CMT). These mutations are very rare in most countries, but not in certain Mediterranean countries. The purpose of this study was to identify the clinical and neuroimaging characteristics of Korean CMT patients with mutations.

Methods: Gene sequencing was applied to 1,143 families in whom CMT had been diagnosed from 2005 to 2020. duplication was found in 344 families, and whole-exome sequencing was performed in 699 patients. Magnetic resonance imaging (MRI) were obtained using either a 1.5-T or 3.0-T MRI system.

Results: We found ten patients from eight families with mutations: five with autosomal dominant (AD) CMT type 2K (three families with p.R120W and two families with p.Q218E) and three with autosomal recessive (AR) intermediate CMT type A (two families with homozygous p.H256R and one family with p.P111H and p.V219G mutations). The frequency was about 1.0% exclusive of the duplication, which is similar to that in other Asian countries. There were clinical differences among AD patients according to mutation sites. Surprisingly, fat infiltrations evident in lower-limb MRI differed between AD and AR patients. The posterior-compartment muscles in the calf were affected early and predominantly in AD patients, whereas AR patients showed fat infiltration predominantly in the anterolateral-compartment muscles.

Conclusions: This is the first cohort report on Korean patients with mutations. The patients with AD and AR inheritance routes exhibited different clinical and neuroimaging features in the lower extremities. We believe that these results will help to expand the knowledge of the clinical, genetic, and neuroimaging features of CMT.
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http://dx.doi.org/10.3988/jcn.2021.17.1.52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840330PMC
January 2021

Microfluidic approaches for research.

Anim Cells Syst (Seoul) 2020 Nov 3;24(6):311-320. Epub 2020 Nov 3.

Department of Physics Education, Kongju National University, Gongju, South Korea.

In the last decade, microfluidic methods have proven to be powerful tools for research, offering advanced manipulation of worms and precise control of experimental conditions. The advantages of microfluidic chips include their capability of immobilization, automated sorting, and longitudinal measurement, and more. In this review, we focus on control components that are widely used in the design of microfluidic devices, and discuss their functions and working principles that enable advanced manipulation on a chip. Understanding these components will ease the onboarding of researchers inexperienced with microfluidics and help them bring the power of microfluidics to new applications.
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http://dx.doi.org/10.1080/19768354.2020.1837951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782468PMC
November 2020

The Impact of Climate Change on Pollen Season and Allergic Sensitization to Pollens.

Immunol Allergy Clin North Am 2021 Feb 5;41(1):97-109. Epub 2020 Nov 5.

Department of Pediatrics, Hanyang University Guri Hospital, 153 Gyungchun-Ro, Guri, Gyunggi-Do 11923, South Korea; Department of Pediatrics, College of Medicine, Hanyang University, Seoul, South Korea. Electronic address:

Pollens are a major cause of seasonal allergic diseases. Weather may alter the production of pollens. Increased atmospheric temperatures lead to earlier pollination of many plants and longer duration of pollination, resulting in extended pollen seasons, with early spring or late winter. Longer pollen seasons increase duration of exposure, resulting in more sensitization, and higher pollen concentrations may lead to more severe symptoms. Climate changes in contact to pollens may affect both allergic sensitization and symptom prevalence with severity. The future consequences of climate change, however, are speculative, because the influence on humans, is complex.
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http://dx.doi.org/10.1016/j.iac.2020.09.004DOI Listing
February 2021

Quality of life of patients with nasal bone fracture after closed reduction.

Arch Craniofac Surg 2020 Oct 20;21(5):283-287. Epub 2020 Oct 20.

Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

Background: Closed reduction is the standard treatment for nasal bone fractures, which are the most common type of facial bone fractures. We investigated the effect of closed reduction on quality of life.

Methods: The 15-dimensional health-related quality of life survey was administered to 120 patients who underwent closed reduction under general anesthesia for nasal bone fractures from February 2018 to December 2019, on both the day after surgery and 3 months after surgery. Three months postoperatively, the presence or absence of five nasal symptoms (nose obstruction, snoring, pain, nasal secretions, and aesthetic dissatisfaction) was also evaluated.

Results: The quality of life items that showed significant changes between immediately after surgery and 3 months postoperatively were breathing, sleeping, speech, excretion, and discomfort. Low scores were found at 3 months for breathing, sleeping, and distress. There were 31 patients (25.83%) with nose obstruction, 25 (20.83%) with snoring, 12 (10.00%), with pain, 11 (9.17%) with nasal secretions, and 29 (24.17%) with aesthetic dissatisfaction.

Conclusion: Closed reduction affected patients' quality of life, although most aspects improved significantly after 3 months. However, it was not possible to rule out deterioration of quality of life due to complications and dissatisfaction after surgery.
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http://dx.doi.org/10.7181/acfs.2020.00507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644351PMC
October 2020

A Database of Locomotion and Body Posture Phenotypes for the Peripheral Neuropathy Model.

Mol Cells 2020 Oct;43(10):880-888

Department of Physics Education, Kongju National University, Gongju 32588, Korea.

Inherited peripheral neuropathy is a heterogeneous group of peripheral neurodegenerative disorders including Charcot-Marie-Tooth disease. Many peripheral neuropathies often accompany impaired axonal construction and function. To study the molecular and cellular basis of axon-defective peripheral neuropathy, we explore the possibility of using , a powerful nematode model equipped with a variety of genetics and imaging tools. In search of potential candidates of peripheral neuropathy models, we monitored the movement and the body posture patterns of 26 strains with disruption of genes associated with various peripheral neuropathies and compiled a database of their phenotypes. Our assay showed that movement features of the worms with mutations in , and human homologues are significantly different from the control strain, suggesting they are viable candidates for peripheral neuropathy models.
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http://dx.doi.org/10.14348/molcells.2020.0178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604027PMC
October 2020

Severe Fever With Thrombocytopenia Syndrome With Q Fever Coinfection in an 8-Year-Old Girl.

Pediatr Infect Dis J 2021 01;40(1):e31-e34

From the Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea.

We report a case of an 8-year-old Korean girl diagnosed with severe fever with thrombocytopenia syndrome with Q fever coinfection after playing with a dog and being bitten by a tick in a suburb in South Korea. The clinical findings and treatment were summarized. To the best of our knowledge, this case is the youngest patient reported to have been diagnosed with severe fever with thrombocytopenia syndrome and Q fever from South Korea.
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http://dx.doi.org/10.1097/INF.0000000000002948DOI Listing
January 2021

A retrospective study of changes in skin cancer characteristics over 11 years.

Arch Craniofac Surg 2020 Apr 20;21(2):87-91. Epub 2020 Apr 20.

Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea.

Background: The incidence of skin cancer, which is primarily caused by exposure to ultraviolet radiation, has steadily increased in recent years. The authors of the present study sought to investigate changes in the epidemiology of skin cancer by conducting a retrospective review of patients diagnosed with skin cancer who received related care at a single medical institution.
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Methods: The present study included patients who were diagnosed with skin cancer and received treatment at Gyeongsang National University Hospital from 2008 to 2018. The site and type of skin cancer, the number of patients with skin cancer each year, the sex and sex ratio of the patients, and changes in patients' age at first diagnosis were examined through retrospective chart reviews.
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Results: The number of patients with skin cancer significantly increased, but statistically significant changes were not found in patients' sex, skin cancer sites, or the types of skin cancer. However, patients' age at the first diagnosis of skin cancer showed a statistically significant decrease starting in 2015.
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Conclusion: In this study, the number of patients with skin cancer increased over time. However, patients' age at first diagnosis has decreased since 2015. Therefore, younger patients should take care to prevent skin cancer, and further research on the causes of skin cancer in younger patients is needed.
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http://dx.doi.org/10.7181/acfs.2020.00024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206466PMC
April 2020

Trends in prevalence of allergic diseases in Korean children: how and why?

Authors:
Kyung Suk Lee

Clin Exp Pediatr 2020 Jul 13;63(7):263-264. Epub 2020 Apr 13.

Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

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http://dx.doi.org/10.3345/cep.2020.00213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374004PMC
July 2020

Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea.

Biomed Res Int 2020 27;2020:2014104. Epub 2020 Feb 27.

Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University, Gyeonggi-do, Republic of Korea.

Anaphylaxis is a serious life-threatening allergic disease in children. This study is aimed at determining the characteristics of pediatric patients who experienced anaphylaxis along with treatments administered in order to determine the usefulness of tryptase level assessment as a marker of anaphylaxis in Korean children. A total of 107 patients who were diagnosed with anaphylaxis in a single pediatric emergency center over a 3-year period were included in the study. Patient clinical characteristics, symptoms, signs, allergy history, trigger factors, treatments, and laboratory findings, including serum tryptase levels, were included in the analysis. Food allergies (39.3%) were the most commonly reported patient allergic history, and 58 patients (54.2%) were triggered by food. Among this group, nuts and milk exposure were the most common, affecting 15 patients (25.9%). History of anaphylaxis and asthma were more common in severe anaphylaxis compared to mild or moderate anaphylaxis cases. Epinephrine intramuscular injection was administrated to 76 patients (71.0%), and a self-injectable epinephrine was prescribed to 18 patients (16.8%). The median tryptase level was 4.80 ng/mL (range: 2.70-10.40) which was lower than the 11.4 ng/mL value commonly documented for standard evaluation in adults with anaphylaxis. The most common cause of pediatric anaphylaxis was food including nuts and milk. The rate of epinephrine injection was relatively high in our pediatric emergency department. The median tryptase level associated with anaphylaxis reactions in children was lower than 11.4 ng/mL. Further studies are needed to help improve diagnostic times and treatment accuracy in pediatric patients who develop anaphylaxis.
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http://dx.doi.org/10.1155/2020/2014104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064841PMC
November 2020

Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea.

BMC Infect Dis 2020 Feb 12;20(1):132. Epub 2020 Feb 12.

Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, South Korea.

Background: Community-acquired pneumonia (CAP) is one of the leading worldwide causes of childhood morbidity and mortality. Its disease burden varies by age and etiology and is time dependent. We aimed to investigate the annual and seasonal patterns in etiologies of pediatric CAP requiring hospitalization.

Methods: We conducted a retrospective study in 30,994 children (aged 0-18 years) with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Mycoplasma pneumoniae (MP) pneumonia was clinically classified as macrolide-sensitive MP, macrolide-less effective MP (MLEP), and macrolide-refractory MP (MRMP) based on fever duration after initiation of macrolide treatment, regardless of the results of in vitro macrolide sensitivity tests.

Results: MP and respiratory syncytial virus (RSV) were the two most commonly identified pathogens of CAP. With the two epidemics of MP pneumonia (2011 and 2015), the rates of clinical MLEP and MRMP pneumonia showed increasing trends of 36.4% of the total MP pneumonia. In children < 2 years of age, RSV (34.0%) was the most common cause of CAP, followed by MP (9.4%); however, MP was the most common cause of CAP in children aged 2-18 years of age (45.3%). Systemic corticosteroid was most commonly administered for MP pneumonia. The rate of hospitalization in intensive care units was the highest for RSV pneumonia, and ventilator care was most commonly needed in cases of adenovirus pneumonia.

Conclusions: The present study provides fundamental data to establish public health policies to decrease the disease burden due to CAP and improve pediatric health.
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http://dx.doi.org/10.1186/s12879-020-4810-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017508PMC
February 2020

Reconstruction of nasal ala and tip following skin cancer resection.

Arch Craniofac Surg 2019 Dec 20;20(6):382-387. Epub 2019 Dec 20.

Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea.

Background: Defects of the nasal ala and tip have a complex three-dimensional structure that makes them challenging to reconstruct. Many reconstructive options have been described for nasal ala and tip defects, ranging from primary closure to local flaps and skin grafts. However, it is difficult to determine which method will yield the best cosmetic results in each individual case. Thus, the purpose of this study was to determine which surgical procedures for reconstructing defects of the nasal ala and tip have better cosmetic results.

Methods: From 2008 to 2018, 111 patients underwent surgery to reconstruct skin defects after resection of skin cancer in the nasal ala or tip. Their charts were reviewed to obtain data on age, sex, surgical location, size of the defect, surgical method, and cosmetic results using a visual analog scale (VAS).

Results: For nasal ala reconstruction, the most commonly used surgical technique was the nasolabial flap (n= 42). This method also had the highest VAS score (7/10). The most commonly selected surgical method for nasal tip reconstruction was the bilobed flap (n= 13), and bilobed flaps and primary closure had the highest VAS score (7/10).

Conclusion: Nasolabial flaps showed excellent cosmetic results for the reconstruction of nasal ala defects, while primary closure and bilobed flaps yielded excellent cosmetic results for the reconstruction of nasal tip defects.
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http://dx.doi.org/10.7181/acfs.2019.00486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949504PMC
December 2019

Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children: meta-analysis of randomized controlled trials.

BMC Pulm Med 2019 Dec 18;19(1):251. Epub 2019 Dec 18.

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Background: Mycoplasma pneumoniae is one of the most common pathogens causing community acquired pneumonia in children. Although the rate of macrolide-refractory Mycoplasma pneumoniae (MRMP) has increased, systemic glucocorticoids as a treatment option has not been validated yet. The purpose of this study was to assess the efficacy of glucocorticoids add-on in the treatment of MRMP in children through systematic review and meta-analysis.

Methods: Data sources A systematic literature search was conducted using ten electronic bibliographic databases including English, Korean, Chinese and Japanese languages, up to March 8, 2018. Study selection The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and selected randomized control trials which compared the efficacy of glucocorticoids add-on to macrolide in the treatment of MRMP in children. Data extraction Two independent reviewers extracted: primary outcomes as hospital days, fever duration, and change in C-reactive protein (CRP) and main analysis was performed through meta-analysis with random effects model.

Results: Twenty-four unique randomized controlled trials met the inclusion criteria. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in conventional macrolide-treatment group (Weighted mean difference (WMD) = - 4.03 days). The mean length of fever duration was significantly shorter in the glucocorticoid treatment group in comparison with the conventional treatment group (WMD = -3.32 days). Level of CRP after treatment was significantly lower in the glucocorticoid treatment group than that in the conventional treatment group (WMD = -16.03). Sensitivity analysis and subgroup analysis showed no significant improvement in heterogeneity. As limitations of the study, most of the studies included were from a single country and we were unable to control for heterogeneity across interventions, lack of standardized measures, and different time points of assessments across studies.

Conclusions: Glucocorticoid add-on treatment for MRMP can significantly shorten the duration of fever and hospital stay and decrease the level of CRP. These results should be confirmed by adequately powered studies in the future.
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http://dx.doi.org/10.1186/s12890-019-0990-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921474PMC
December 2019

Shared and unique individual risk factors and clinical biomarkers in children with allergic rhinitis and obstructive sleep apnea syndrome.

Clin Respir J 2020 Mar 27;14(3):250-259. Epub 2019 Dec 27.

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Introduction: Rhinitis and obstructive sleep apnea syndrome (OSAS) are different diseases, but have some similar risk factors.

Objective: The aims of this study were to compare the risk factors and clinical biomarkers for rhinitis and OSAS in children.

Methods: We examined 3917 children (age 4-13 years) who were enrolled in a cross-sectional study conducted in Seongnam, Korea. Their parents completed the Pediatric Sleep Questionnaire (PSQ) for evaluation of OSAS and the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire for evaluation of rhinitis. Clinical biomarkers, including total eosinophil count and neutrophil-lymphocyte ratio (NLR), were measured in a subset of these children.

Results: OSAS and rhinitis had prevalences of 4.0% and 43.5%, respectively. Body mass index (P < 0.001) and prematurity (P = 0.016) were significantly associated with OSAS, but not with rhinitis. Higher parental education and income increased the risk for rhinitis, but decreased the risk for OSAS. Having more siblings and birth by Cesarean delivery decreased the risk for rhinitis, but living in a new household increased the risk for rhinitis. A short distance of the residence to a main road during pregnancy significantly increased the risk of OSAS. Males, increased exposure to mould, and firstborns had increased risk of OSAS and rhinitis. The NLR was higher in OSAS patients than in those with allergic rhinitis (P = 0.001).

Conclusion: OSAS and rhinitis shared some risk factors, whereas other factors had inverse association with the two disorders. These results imply that different strategies might be used for prevention of rhinitis and OSAS.
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http://dx.doi.org/10.1111/crj.13124DOI Listing
March 2020

The clinical usefulness of closed reduction of nasal bone using only a periosteal elevator with a rubber band.

Arch Craniofac Surg 2019 Oct 20;20(5):284-288. Epub 2019 Oct 20.

Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea.

Background: Closed reduction of nasal fracture with various instrument is performed to treat nasal fracture. Depending on the type of nasal fracture and the situation in which it is being operated, the surgeon will determine the surgical tool. The objective of this study was to investigate whether a periosteal elevator (PE) was a proper device to perform closed reduction for patients with simple nasal fractures.

Methods: From March 2018 to December 2018, 50 cases of simple nasal bone fracture underwent closed reduction performed by a single surgeon. These patients were divided into two groups randomly: nasal bone reduction was performed using only PE (freer) and nasal bone reduction was performed using Walsham, Asch forcep, and Boies elevator (non-freer, non-PE).

Results: The paranasal sinus computed tomography was performed on patients before and after operation to carry out an accurate measurement of reduction distance at the same level. According to the results, the interaction between instruments and fracture types had a significant influence on reduction distance (p = 0.021). To be specific, reduction distance was significantly (p= 0.004) increased by 2.157 mm when PE was used to treat patients with partial displacement compared to that when non-PEs were used.

Conclusion: Closed reduction using PE and other elevator is generally an effective treatment for nasal fracture. In partial-displacement type of simple nasal fracture, closed reduction using PE can have considerable success in comparison with using classic instruments.
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http://dx.doi.org/10.7181/acfs.2019.00388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822068PMC
October 2019

Recipient-Site Preconditioning with Deferoxamine Increases Fat Graft Survival by Inducing VEGF and Neovascularization in a Rat Model.

Plast Reconstr Surg 2019 10;144(4):619e-629e

From the Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine; the Departments of Pathology and Plastic and Reconstructive Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine; and the Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine.

Background: The authors hypothesize that ischemic preconditioning of the recipient site with deferoxamine will increase fat graft survival by enhancing angiogenesis in a rat model.

Methods: Cell viability, tube formation, and mRNA expression were measured in human umbilical vein endothelial cells treated with deferoxamine. A total of 36 rats were then used for an in vivo study. A dose of 100 mg/kg of deferoxamine was injected subcutaneously into the rat scalp every other day for five treatments. On the day after the final injection, the scalp skin was harvested from half the animals to evaluate the effects of deferoxamine on the recipient site. In the remaining animals, inguinal fat tissue was transplanted to the scalp. Eight weeks after transplantation, the grafts were harvested to evaluate the effects of deferoxamine preconditioning on fat graft survival.

Results: In human umbilical vein endothelial cells, treatment with a deferoxamine concentration higher than 400 μM decreased cell viability compared with the control (p = 0.002). Treatment with 100 and 200 μM deferoxamine increased endothelial tube formation (p = 0.001) and mRNA levels of angiogenesis-related factors (p = 0.02). Rat scalps treated with deferoxamine exhibited increased capillary neoformation (p = 0.001) and vascular endothelial growth factor protein expression (p = 0.024) compared with controls. Fat graft volume retention, capillary density (p < 0.001), and adipocyte viability (p < 0.001) in the grafted fat increased when the recipient site was preconditioned with deferoxamine.

Conclusion: This study demonstrated that recipient site preconditioning with deferoxamine increases fat graft survival by inducing vascular endothelial growth factor and neovascularization.
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http://dx.doi.org/10.1097/PRS.0000000000006036DOI Listing
October 2019

Serum Periostin Level Has Limited Usefulness as a Biomarker for Allergic Disease in 7-Year-Old Children.

Int Arch Allergy Immunol 2019 10;180(3):195-201. Epub 2019 Sep 10.

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea,

Background: Previous studies have used serum periostin levels as a biomarker of Th2-driven inflammatory responses. However, no population-based study has yet examined the association of serum periostin levels with the allergic status of children.

Objectives: The aim of this study was to determine the usefulness of periostin as a biomarker for allergy in a group of 7-year-old Korean children.

Method: This prospective cross-sectional study examined 451 children (aged 7 years to 7 years and 11 months) from the general pediatric population who attended 6 different schools between June and July 2016. A total of 249 children, all of whom completed the questionnaire and skin prick test and provided blood samples, were included in the final analysis.

Results: The geometric mean serum periostin level was 107.6 ng/mL (95% CI 104.5-110.7). After adjustment for confounding, serum periostin levels were significantly associated with sensitization to poly-allergens (adjusted odds ratio, aOR 1.032, 95% CI 1.006-1.059, p = 0.016) and pollen (aOR 1.020, 95% CI 1.002-1.039, p = 0.026). Serum periostin levels were also associated with eosinophil levels (adjusted β = 0.023, SE = 0.009, p = 0.010), but were unrelated to body mass index, sex, obesity, or presence of an allergic disease.

Conclusions: Our results suggest thatserum periostin level may have limited usefulness as a biomarker of allergic disease in children.
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http://dx.doi.org/10.1159/000501224DOI Listing
December 2019

Compound heterozygous mutations of SH3TC2 in Charcot-Marie-Tooth disease type 4C patients.

J Hum Genet 2019 Sep 21;64(9):961-965. Epub 2019 Jun 21.

Department of Biological Sciences, Kongju National University, 56 Gongjudaehak-ro, Gongju, 32588, Korea.

Charcot-Marie-Tooth disease type 4C (CMT4C) is an autosomal recessive neuropathy caused by SH3TC2 mutations, characterized by spine deformities and cranial nerve involvement. This study identified four CMT4C families with compound heterozygous SH3TC2 mutations from 504 Korean demyelinating or intermediate CMT patients. The frequency of the CMT4C was calculated as 0.79% in demyelinating and intermediate patients (n = 504), but it was calculated as 2.02% in patients without PMP22 duplication (n = 198). The CMT4C frequency was similar to patients in Japan, but it was relatively low compared to those patients in other populations. The symptom was less severe and slowly progressed compared to the other AR-CMT. A patient harboring an intermediate neuropathy showed cranial nerve involvement but did not have scoliosis. This study will be helpful in making molecular diagnoses of demyelinating or intermediate CMT due to SH3TC2 mutations.
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http://dx.doi.org/10.1038/s10038-019-0636-yDOI Listing
September 2019

Association of Sensitization to Different Aeroallergens With Airway Function and Nasal Patency in Urban Children.

Allergy Asthma Immunol Res 2019 Jul;11(4):572-582

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Purpose: Children with sensitization to aeroallergens have decreased lung function and nasal patency. Our purpose was to determine the association of sensitization to different aeroallergens with airway function and nasal patency.

Methods: Four hundred and eighty-six randomly selected 11 year-old children who lived in Seongnam City were examined. Serum specific immunoglobulin E (IgE) levels against 6 common allergens (, birch, cat, dog, Japanese hop and ), impulse oscillometry (IOS) results for the evaluation of airway dysfunction, and acoustic rhinometry for the determination of nasal airway patency were obtained.

Results: IOS indicated that children sensitized to (n = 38, 7.8%) and dog dander (n = 69, 14.2%) had decreased lung function, based on resistance at 10 Hz (Rrs10; aβ = 0.0072; 95% CI, 0.017, 0.127; = 0.010) and 1 Hz (Rrs1; aβ = 0.038; 95% CI, 0.001, 0.074; = 0.042). Children sensitized to (n = 281, 57.8%) had decreased post-decongestant nasal volume at 0 to 5 cm (aβ = -0.605; 95% CI, -1.005, -0.205; = 0.003), but normal IOS results at all measured frequencies ( > 0.05). Increased serum eosinophil level was associated with Rrs1 ( = 0.007) and Rrs2 ( = 0.018) and post-decongestant nasal volume at 0 to 5 cm (aβ = -0.885; 95% CI, -1.331, -0.439; < 0.001).

Conclusions: Sensitivity to specific aeroallergens, serum eosinophil count and total IgE level had different associations with upper and lower airway dysfunction in urban children.
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http://dx.doi.org/10.4168/aair.2019.11.4.572DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557775PMC
July 2019

Immediate regraft of the remnant skin on the donor site in split-thickness skin grafting.

Arch Craniofac Surg 2019 Apr 20;20(2):94-100. Epub 2019 Apr 20.

Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea.

Background: Skin defects of head and neck need reconstruction using various local flaps. In some cases, surgeons should consider skin graft for large skin defect. It is important to heal skin graft and donor sites. The authors investigated wound healing mechanisms at the donor sites with split-thick-ness skin graft (STSG). In this study, the authors compared two types of immediate regraft including sheets and islands for the donor site after facial skin graft using remnant skin.

Methods: The author reviewed 10 patients who underwent STSG, from March 2015 to May 2017, for skin defects in the craniofacial area. The donor site was immediately covered with the two types using remnant skin after harvesting skin onto the recipient site. Depending on the size of the remnant skin, we conducted regraft with the single sheet (n= 5) and island types (n= 5).

Results: On postoperative day 1 and 3 months, the scar formation was evaluated using the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS). Total POSAS and VSS scores for the island type were lower than in single sheet group after 3 months postoperatively. There was significant difference in specific categories of POSAS and VSS.

Conclusion: This study showed a reduction in scar formation following immediate regrafting of the remnant skin at the donor site after STSG surgery. Particularly, the island type is useful for clinical application to facilitate healing of donor sites with STSG.
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http://dx.doi.org/10.7181/acfs.2019.00150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505436PMC
April 2019

Serum Periostin Is Negatively Correlated With Exposure to Formaldehyde and Volatile Organic Compounds in Children.

Allergy Asthma Immunol Res 2018 Nov;10(6):716-721

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Epidemiological studies have shown that exposure to tobacco smoke causing irritation and inflammation in the airways tends to reduce serum periostin concentrations in adults. We now investigate prospective cross-sectional study on 135 Korean students aged 7 years in the first grade who were participating in the Seongnam Atopy Project for Children's Happiness 2016 (SAP₂₀₁₆) cohort. To the best of our knowledge, this is the first study to show significant inverse correlations between serum periostin concentration and exposure to xylene and formaldehyde in children. Our findings suggested the need for caution in using the serum periostin level as a marker for allergic diseases, since exposure to volatile organic compounds and formaldehyde may confound the interpretation of these results.
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http://dx.doi.org/10.4168/aair.2018.10.6.716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182191PMC
November 2018

Exposure to phthalates is associated with acute urticaria in children.

Pediatr Allergy Immunol 2018 09 3;29(6):657-660. Epub 2018 Jul 3.

Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

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http://dx.doi.org/10.1111/pai.12932DOI Listing
September 2018

A Microfluidic Platform for Longitudinal Imaging in Caenorhabditis elegans.

J Vis Exp 2018 05 2(135). Epub 2018 May 2.

Department of Physics, Harvard University; FAS Center for Systems Biology, Harvard University;

In the last decade, microfluidic techniques have been applied to study small animals, including the nematode Caenorhabditis elegans, and have proved useful as a convenient live imaging platform providing capabilities for precise control of experimental conditions in real time. In this article, we demonstrate live imaging of individual worms employing WormSpa, a previously-published custom microfluidic device. In the device, multiple worms are individually confined to separate chambers, allowing multiplexed longitudinal surveillance of various biological processes. To illustrate the capability, we performed proof-of-principle experiments in which worms were infected in the device with pathogenic bacteria, and the dynamics of expression of immune response genes and egg laying were monitored continuously in individual animals. The simple design and operation of this device make it suitable for users with no previous experience with microfluidic-based experiments. We propose that this approach will be useful for many researchers interested in longitudinal observations of biological processes under well-defined conditions.
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http://dx.doi.org/10.3791/57348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101091PMC
May 2018

The association of nasal patency with small airway resistance in children with allergic and nonallergic rhinitis.

Clin Respir J 2018 Jul 15;12(7):2264-2270. Epub 2018 May 15.

Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.

Introduction: Allergic rhinitis (AR) is immunologically and morphologically related to disorders in the lower airway. We investigated the relationship between the anatomy of the intranasal cavity and small airway resistance in subjects with nonallergic rhinitis (NAR).

Methods: We enrolled 226 children who were 7 years old and participated in the Seongnam Atopy Project 2016. We evaluated nasal patency using acoustic rhinometry to measure the volume of the nasal cavity at 0-5 cm, and measured lung function of the lower airway using an impulse oscillometry system (IOS) and spirometry. We also performed skin prick tests for 18 aero-allergens, and measured blood total eosinophil counts (TEC) and rhinitis symptom scores for the previous month using a visual analog scale (VAS, range: 0-10).

Results: We examined 226 children, 71 (31.7%) with AR, and 62 (27.7%) with NAR. Nasal patency in children with AR (median: 8.28 mm , IQR: 7.07-9.83) was lower than that of healthy children (median: 9.3 mm , IQR: 7.69-10.64, P = 0.011). Multivariate regression analysis showed that nasal patency was inversely associated with IOS resistance at 5 Hz after adjustment for compounding factors (B = -0.005, SE = 0.0032, P = 0.041). Analysis of NAR subjects, according to quartiles of nasal patency and quartiles of small airway resistance (Rrs5), indicated that nasal patency decreased as Rrs5 increased (linear trend: P = 0.020).

Conclusion: Nasal symptoms and TEC negatively correlated with nasal patency. Children with AR and NAR who had poor nasal patency had increased small airway resistance.
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http://dx.doi.org/10.1111/crj.12902DOI Listing
July 2018

The economic burden of rotavirus infection in South Korea from 2009 to 2012.

PLoS One 2018 19;13(3):e0194120. Epub 2018 Mar 19.

Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.

Rotavirus is a common cause of diarrhea worldwide, and vaccination prevents rotaviral gastroenteritis. Since the rotavirus vaccine was introduced in Korea in 2007, the prevalence of rotaviral gastroenteritis has decreased. However, little is known on the economic burden of rotavirus infection and its variations in Korea. Here, we estimated the economic costs of rotavirus infection from 2009 to 2012 using nationwide data from the National Health Insurance Service (NHIS) claims. Socioeconomic costs were subdivided into direct and indirect and measured with a prevalence-based approach. Costs were converted from Won to United States dollars (US$). The number of children <5 years old infected with rotavirus decreased from 21,437 to 10,295 during the study period, representing a decrease in prevalence from 947 to 443 per 100,000. The sum of direct and indirect costs also decreased, from $17.3 million to $9.6 million, and the days of admission decreased from 76,000 to 38,000. However, per capita expenditures slightly increased, from $809 to $934. Thus, the economic burden of rotavirus infection decreased after implementation of rotavirus vaccination. Including the vaccine as part of the national essential vaccination program could reduce the prevalence of and economic loss from rotavirus infection in Korea.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194120PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858784PMC
July 2018

A Comparison of the Local Flap and Skin Graft by Location of Face in Reconstruction after Resection of Facial Skin Cancer.

Arch Craniofac Surg 2017 Dec 23;18(4):255-260. Epub 2017 Dec 23.

Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

Background: Surgery for reconstruction of defects after surgery should be performed selectively and the many points must be considered. The authors conducted this study to compare the local flap and skin graft by facial location in the reconstruction after resection of facial skin cancer.

Methods: The authors performed the study in patients that had received treatment in Department of Plastic Surgery, Gyeongsang National University. The cases were analyzed according to the reconstruction methods for the defects after surgery, sex, age, tumor site, and tumor size. Additionally, the authors compared differences of aesthetic satisfaction (out of 5 points) of patients in the local flap and skin graft by facial location after resection of facial skin cancer by dividing the face into eight areas.

Results: A total of 153 cases were confirmed. The most common facial skin cancer was basal cell carcinoma (56.8%, 87 cases), followed by squamous cell carcinoma (37.2%, 57 cases) and bowen's disease (5.8%, 9 cases). The most common reconstruction method was local flap 119 cases (77.7%), followed by skin graft 34 cases (22.3%). 86 patients answered the questionnaire and mean satisfaction of the local flap and skin graft were 4.3 and 3.5 (=0.04), respectively, indicating that satisfaction of local flap was significantly high.

Conclusion: When comparing satisfaction of patients according to results, local flap shows excellent effects in functional and cosmetic aspects would be able to provide excellent results rather than using a skin graft with poor touch and tone compared to the surrounding normal skin.
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http://dx.doi.org/10.7181/acfs.2017.18.4.255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759659PMC
December 2017
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