Background: Asthma and allergic rhinitis (AR) are chronic inflammatory diseases of airway and affect the disease severity each other. Objective: We performed this study to examine whether nasal saline irrigation (NSI) improves bronchial hyperresponsiveness and clinical parameters in children with asthma and allergic rhinitis (AR). Methods: We enrolled 20 children with AR and asthma aged between 6-18 years. Patients were randomized into two groups: irrigation group (8 boys and 2 girls) and control group (8 boys and 2 girls). The irrigation group performed daily NSI. All patients received 12-week treatment with montelukast, levocetirizine, and inhaled glucocorticoids. Provocative concentrations of methacholine causing a 20% decrease in FEV1 (PC20), Asthma Control Test (ACT), the Questionnaire for Quality-of-Life Specific to Allergic Rhinitis in Korean Children (QQOL-ARK) and exhaled nitric oxide (FENO) were compared before and after the study. Results: The PC20 at week 12 was higher than baseline measurements in the irrigation group (P = 0.017), while there was no difference in PC20 before and after treatment in the control group (P = 0.333). ACT score increased after 12 weeks of NSI (P = 0.007), while QQOL-ARK score decreased compared to baseline scores (P = 0.028) in the irrigation group. No differences in ACT and QQOL-ARK were found between weeks 0 and 12 in the control group. No differences were found in the median value of changes in PC20, ACT, QQOL-ARK and FENO between the irrigation and control groups. Conclusions: Our results suggest that NSI is beneficial for treatment of asthma and AR in children.

Objectives: This study aimed to investigate the list equivalency of the Korean Standard-Sentence List for Adults (KS-SL-A) in visual-only (VO) presentation conditions and to measure sentence recognition abilities for normal and hearing impaired individuals in VO and auditory-visual (AV) conditions. Methods: Sentences from the KS-SL-A, spoken by both males and females, were filmed and subsequently presented to 32 normal-hearing subjects in VO conditions, and to 21 normal subjects and 11 hearing-impaired subjects in VO and AV (+5, +10, +15 dB SL) conditions. Subjects were asked to identify sentences in VO and AV conditions. KS sentence lists of 10 everyday sentences were determined based on keyword accuracy. Auditory and visual enhancements were also calculated. Results: ANOVA revealed significant differences in sentence lists, and post hoc tests indicated that the following four lists were determined to be equivalent: List 1, 3, 4, and 6. Subjects with hearing impairment showed significantly higher scores in VO and +5 dB AV conditions, while subjects with normal hearing had significantly better performance in +15 dB AV condition. Conclusion: These findings suggest that individuals with hearing impaired are more reliant on visual speech information than individuals with normal hearing, but have been shown to develop their speech-reading ability along with auditory information. Therefore, speech recognition should be obtained in AV conditions as well as in AO conditions for clinical use in order to provide the best recommendation and rehabilitation.

[목적] 본 연구의 목적은 청각장애 특수학교 교사들을 대상으로 공통교육과정 교과서의 활용 실태 및 요구를 파악하고 개선 방안을 제시하고자 하였다. [방법] 청각장애 특수학교에서 재직 중인 초·중·고등학교 교사 96명을 대상으로 국어, 수학, 과학, 사회 교과목에서 공통교육과정 교과서의 활용 실태와 개선 방안에 대한 요구를 설문 조사하였다. 설문 내용은 교과서 활용 정도, 교수-학습자료, 개선 및 활용에 대한 요구 사항과 관련된 7개 문항으로 구성하였다. [결과] 공통교육과정 교과서를 61% 이상 활용하는 비율이 초등학교 교사의 경우, 과학 90.9%, 수학 82.9%, 사회 81.3%, 국어 51.3% 순이었으며, 중·고등학교 교사의 경우, 국어 76.0%, 사회 73.6%, 수학 66.7%, 과학 64.3%로 나타났다. 교과서 활용 비율이 낮은 경우에서 그 이유는 학생들의 어휘력 및 이해력 부족과 교과서의 난이도가 높은 비중을 차지하였으며, 거의 모든 교과에서 교과서를 재구성하거나 대체 교수-학습 자료를 사용하는 것으로 나타났다. 학교급별 모든 교과에서 청각장애 학생들을 위한 교과서나 교수-학습자료 개발에 대한 높은 요구가 있었다. [결론] 현행 공통교육과정 교과서를 통한 청각장애 학생들의 다양한 수준과 요구에 부합하는 학습권을 보장하는 방안이 강구되어야 할 것이다.

Recently, many of studies have been attempted to determine how to decrease adhesion. To effectively prevent adhesion, decrease in unnecessary surgical procedures, prevention of contact with other tissue, and drug treatment for inflammation are required. However, current anti-adhesion materials have disadvantages. To solve current problems, we prepared a biocompatible drug-loaded anti-adhesion barrier using a visible-light curable furfuryl gelatin derivative. We used riboflavin as a photo-initiator in the photo-curing process. The biocompatibility of riboflavin was estimated compared with that of Rose Bengal. In addition, the curing ratio was measured to determine whether riboflavin initiated photo-curing. We also evaluated the curing ratio of riboflavin according to the concentration of F-gelatin and the photo-irradiation time. A drug used to decrease inflammation that causes adhesion should not disappear from the surgical site and should also be released consistently. For this, we observed the release profiles of photo-immobilized ibuprofen with different concentrations of F-gelatin. Because an anti-adhesion barrier should protect from bacterial infection we evaluated the protective ability of a barrier formed by F-gelatin. In conclusion, a drug-loaded anti-adhesion barrier was prepared using a visible-light curable furfuryl gelatin derivative, with riboflavin as a photo-initiator. We expect that this drug-loaded anti-adhesion barrier effectively decrease adhesion formation.

Objectives: The purpose of this study was to investigate the speechreading abilities of the Korean population and verify the Korean viseme system by utilizing the Korean Standard Monosyllabic Word List for Adults (KS-MWL-A), a list of words selected in consideration of phonemic balance and frequency of everyday use. Methods: KS-MWL-A words spoken by both male and female speakers were filmed. The speechreading test with no auditory cues was performed on 32 subjects and the percent correct scores of words and phonemes were identified and analyzed using ANOVA. Three positions of phonemes, initial, medial and final, were classified according to a confusion matrix to determine the Korean viseme groups based on a criterion of a 60% correct response. Results: The results showed that the percent correct score of words was 13.00%. The percent correct scores of phonemes of initial, medial, and final positions were 19.04%, 48.26%, and 44.77%, respectively. The Korean visemes were classified as initial phonemes [/ k, kh, k', h, []/, / n, d, t', th, (s), []/, /m, p, ph, p'/, / s, s',.,.h/], medial phonemes [/ i, omega, omega i/, / wi/, / o, jo/, / a, ja/, / u, ju/, / Lambda, j Lambda/, /wa, empty set, (w epsilon)/, / j epsilon, ae, e/] and final phonemes [/[], k, eta/, / n, d/, / l/, / m, b/]. Conclusion: It was revealed that vowels affect both the initial and final position of consonants in the Korean viseme system. Furthermore, the sensitivity to the presence of the final consonant seemed to have the capability to affect the final consonant of the viseme system.

The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12-13 years and parents of children aged 6-7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5-4,523.1) in 3,753 children aged 6-7 years and 94.7 kU/L (range: 1.5-3,000.0) in 3,930 children aged 12-13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P < 0.001). At the cut-off value of 127.7 kU/L, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were 67.1%, 75.4%, 65.4%, and 76.7%, respectively, in elementary schoolchildren. At the cut-off value of 63.0 kU/L, sensitivity, specificity, PPV, and NPV were 81.9%, 66.6%, 75.0%, and 75.1%, respectively, in middle schoolchildren. PPV and NPV were ≥ 70% when cut-offs of 258.8 kU/L and 38.4 kU/L were used for the diagnosis of atopy in 6-7 year-olds and 12-13 year-olds, respectively. This nationwide population-based study provided the first normal reference ranges of total IgE in Korean schoolchildren.

BACKGROUND There is still considerable disagreement regarding the role of vitamin D in the development or exacerbation of allergic diseases. OBJECTIVE To investigate the association between serum vitamin D levels and recent symptoms of allergic diseases in elementary schoolchildren. METHODS A nationwide cross-sectional survey was conducted in children ages 6-7 years from 45 randomly selected elementary schools. The presence of atopic dermatitis (AD) or asthma was defined as medical treatment of children for AD or asthma within 12 months of the survey. The presence of allergic rhinitis (AR) was defined as medical treatment for AR during the past 12 months and a positive skin test response. Current AD was defined as confirmed eczema on physical examination. Serum 25-hydroxyvitamin D (25[OH]D) was measured by chemiluminescent immunoassay. RESULTS Questionnaire data and blood samples were collected from 3720 children. The overall prevalence rates of vitamin D insufficiency (20-29 ng/mL) and deficiency (<20 ng/mL) were 64.0% and 18.4%, respectively. For a 1 ng/mL decrease in 25(OH)D, the adjusted odds ratio (aOR) for AR was 1.020 (95% confidence interval [CI], 1.002-1.040) and the aOR for current AD was 1.027 (95% CI, 1.006-1.047). For each 1 ng/mL decrease in 25(OH)D, the aOR for positive skin-prick test reactivity was 1.013 (95% CI, 1.000-1.027). No significant association between vitamin D level and the prevalence of asthma was observed. CONCLUSIONS A high prevalence of vitamin D deficiency and insufficiency was found in Korean elementary schoolchildren, and low vitamin D levels were associated with recent symptoms of AD and AR.

BACKGROUNDAir pollution is regarded as a potential reason for the development or aggravation of allergic diseases.OBJECTIVETo investigate the relationship between exposure to outdoor air pollution during the first year of life and the development of allergic diseases, and to determine the association between outdoor air pollution near the residence and recent symptoms of allergic diseases in children.METHODSA nationwide cross-sectional survey was conducted in 6- to 7-year-old children. Among them, subjects who had been born (n = 1828) or lived (n = 1894) within 2 km of the nearest air quality monitoring sites were selected. The prevalence of allergic diseases was assessed by using questionnaires. Each subject was examined by pediatricians to determine the presence of eczema. Publicly available data were used regarding the daily ambient concentrations of sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide (CO), and particulate matter.RESULTSFor a 100 ppb increase in the mean daily CO level during the first year of life, the adjusted odds ratio for lifetime allergic rhinitis was 1.10 (95% confidence interval, 1.03-1.19). For a 1 ppm increase in the annual average CO level during the past 12 months, the adjusted odds ratio for the presence of atopic dermatitis on the day of the survey was 8.11 (95% confidence interval, 1.06-62.12). However, the other air pollutants showed no statistical significance.CONCLUSIONSHigher exposure to CO during infancy increased the risk of development of allergic rhinitis. The risk of current atopic dermatitis symptoms increased in children who were exposed to higher CO levels during the past 12 months.

Objectives: The purpose of this study was to investigate the relationship between receptive vocabulary knowledge and speech perception ability in children with cochlear implant (CI) after assessing vocabulary knowledge in terms of chronological and hearing age, and speech perception ability at the sentence and discourse levels. Methods: This study included 25 children with CI who received their first CI before the age of 6, had used CIs more than 6; 6 years, had no other disabilities, and were attending regular elementary or secondary schools. Receptive vocabulary knowledge and speech perception ability were assessed with the REVT (Receptive & Expressive Vocabulary Test) and 3 subtests of KNISE-DASP (Korean National Institute of Special Education-Development Assessment of Speech Perception), Sentence Comprehension Test, Sentence Recognition Test, and Connected Speech Test. Correlation analysis was also conducted between speech perception and vocabulary. Results: The average REVT equivalent age of the CI group was delayed for 1; 10 years compared to the age-matched normal hearing peers, but was placed within the average range of normal hearing children when the hearing age was matched. The participants had some difficulties in speech perception, especially at the discourse level. The speech perception ability was highly correlated with vocabulary scores, but some students had difficulties in speech perception despite vocabulary knowledge comparable to their normal hearing peers. Conclusion: Difficulties in speech perception at the sentence and discourse levels could have resulted from a lack of vocabulary knowledge. The results suggest that aural rehabilitation programs should include treatment for the improvement of speech perception at the sentence and discourse levels.

To establish a primary prevention strategy for atopic dermatitis (AD), it is important to identify biomarkers that can predict the occurrence of AD. This study aimed to evaluate the expression level of epidermal proteins by using a tape stripping method to determine whether these proteins can be used as biomarkers predictive of AD development in infants. In this prospective birth cohort study, we followed 75 infants in a risk group and 12 in a control group for 2 years (Fig 1). The control group consisted of infants with both parents who had neither allergy nor immediate skin test reactivity to 8 common inhalant allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, tree pollen mixture І & II, weed pollen mixture, grass pollen mixture, cat, and cockroach). The risk group was defined when at least 1 parent had both positive skin test response and a history of asthma or allergic rhinitis, or when at least 1 family member had AD. The diagnosis of AD was based on the Hanifin and Rajka criteria, and the severity was assessed using the SCORing Atopic Dermatitis (SCORAD) method. Transepidermal water loss (TEWL) was measured on the volar surface of the forearm at age 2 months by using a Tewameter TM300 (Courage & Khazaka, Köln, Germany). Tape stripping was done on the volar surface of the forearm at 2 months, and epidermal protein levels were measured by mass spectrometry as previously described to evaluate the expression of filaggrin, alpha enolase, corneodesmosin, fatty acid– binding protein, serpin B3, transglutaminase 3, and thymic stromal lymphopoietin (TSLP).1Broccardo C.J. Mahaffey S.B. Strand M. Reisdorph N.A. Leung D.Y. Peeling off the layers: skin taping and a novel proteomics approach to study atopic dermatitis.J Allergy Clin Immunol. 2009; 124 (e1-11): 1113-1115Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Methods for mass spectrometry and statistics are described in this article's Online Repository at www.jacionline.org. This study was approved by the institutional review board (IRB) at Samsung Medical Center in Seoul (IRB no. 2011-11-072), and written informed consent was obtained from all the parents. The cumulative incidence of AD was higher in the risk group than in the control group at 24 months (64.8% vs 16.7%; P = .003) (see Fig E1 in this article's Online Repository at www.jacionline.org). Eczema symptoms at age 12 months occurred mostly on the face (72.7%), but clinical AD did not appear on the forearm where tape stripping was conducted. The mean SCORAD score in affected infants was 13.3 ± 5.8 and 12.9 ± 5.4 at age 12 and 24 months, respectively. There was no difference between the risk group and the control group in sex, birth weight, intrauterine period, birth type, mother's age, family's monthly income, and maternal education levels (see Table E1 in this article's Online Repository at www.jacionline.org). To estimate risk factors predicting AD development by the age of 24 months, a logistic regression model was used. A multivariable analysis was done by adjusting for TSLP and other variables with P value of less than .1 in a univariable analysis. When TSLP expression was dichotomized into low or high levels according to its median value, 0.83 pmol/mg skin (range, 0.32-1.60 pmol/mg skin), TSLP expression at 2 months was 5.3 times more likely to develop AD by age 24 months (95% CI, 1.3-21.4). When TSLP expression was added to family history, adjusted odds ratio (aOR) for AD development was higher in subjects with family history and high TSLP expression (aOR = 20.2; 95% CI, 1.5-272.3) than in those with family history alone (aOR = 12.6; 95% CI, 1.1-143.9; Fig 2). Male gender was also independently related to AD development (aOR = 5.5; 95% CI, 1.3-24.2). In contrast, other variables such as birth type, passive smoking, mold exposure during pregnancy, exclusive breast-feeding, TEWL on the nonlesional area of the forearm at 2 months, and filaggrin level at 2 months showed no statistical significance in a logistic regression model. The expression of alpha enolase, corneodesmosin, fatty acid–binding protein, serpin B3, and transglutaminase 3 at 2 months was not predictive of AD development (see Fig E2 in this article's Online Repository at www.jacionline.org). Taken together, our birth cohort study first demonstrated that epidermal TSLP expression at as early as age 2 months is linked with AD later in life. In particular, the predictive value for AD development was further increased by high TSLP expression in subjects with family history which is the strongest risk factor. It indicates that epidermal TSLP level may be used as an early predictor of AD development.2Sano Y. Masuda K. Tamagawa-Mineoka R. Matsunaka H. Murakami Y. Yamashita R. et al.Thymic stromal lymphopoietin expression is increased in the horny layer of patients with atopic dermatitis.Clin Exp Immunol. 2013; 171: 330-337Crossref PubMed Scopus (92) Google Scholar TSLP is expressed in the horny layer of stratum corneum, promotes TH2-type inflammation, and downregulates filaggrin expression like other cytokines such as IL-4, IL-13, IL-17, IL-22, IL-25, IL-31, and IL-33.2Sano Y. Masuda K. Tamagawa-Mineoka R. Matsunaka H. Murakami Y. Yamashita R. et al.Thymic stromal lymphopoietin expression is increased in the horny layer of patients with atopic dermatitis.Clin Exp Immunol. 2013; 171: 330-337Crossref PubMed Scopus (92) Google Scholar, 3Kim J.H. Bae H.C. Ko N.Y. Lee S.H. Jeong S.H. Lee H. et al.Thymic stromal lymphopoietin downregulates filaggrin expression by signal transducer and activator of transcription 3 (STAT3) and extracellular signal-regulated kinase (ERK) phosphorylation in keratinocytes.J Allergy Clin Immunol. 2015; 136: 205-208.e9Abstract Full Text Full Text PDF PubMed Scopus (46) Google Scholar, 4Thyssen J.P. Kezic S. Causes of epidermal filaggrin reduction and their role in the pathogenesis of atopic dermatitis.J Allergy Clin Immunol. 2014; 134: 792-799Abstract Full Text Full Text PDF PubMed Scopus (268) Google Scholar, 5Seltmann J. Roesner L.M. von Hesler F.W. Wittmann M. Werfel T. IL-33 impacts on the skin barrier by downregulating the expression of filaggrin.J Allergy Clin Immunol. 2015; 135: 1659-1661.e4Abstract Full Text Full Text PDF PubMed Scopus (97) Google Scholar A recent study showed that the long isoform of TSLP exerts proinflammatory activities, whereas the short isoform plays an anti-inflammatory role.6Fornasa G. Tsilingiri K. Caprioli F. Botti F. Mapelli M. Meller S. et al.Dichotomy of short and long thymic stromal lymphopoietin isoforms in inflammatory disorders of the bowel and skin.J Allergy Clin Immunol. 2015; 136: 413-422Abstract Full Text Full Text PDF PubMed Scopus (81) Google Scholar Stratum corneum TSLP level is reduced by moisturizer application in AD patients,2Sano Y. Masuda K. Tamagawa-Mineoka R. Matsunaka H. Murakami Y. Yamashita R. et al.Thymic stromal lymphopoietin expression is increased in the horny layer of patients with atopic dermatitis.Clin Exp Immunol. 2013; 171: 330-337Crossref PubMed Scopus (92) Google Scholar and it may explain how AD development is prevented by the application of moisturizer to neonates.7Horimukai K. Morita K. Narita M. Kondo M. Kitazawa H. Nozaki M. et al.Application of moisturizer to neonates prevents development of atopic dermatitis.J Allergy Clin Immunol. 2014; 134: 824-830.e6Abstract Full Text Full Text PDF PubMed Scopus (424) Google Scholar Although TSLP is an important biomarker in the Korean cohort, it is noteworthy that having a group of biomarkers, rather than 1 biomarker, is important because it may be different according to races and AD phenotypes.8Leung D.Y. Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches.J Allergy Clin Immunol. 2014; 134: 769-779Abstract Full Text Full Text PDF PubMed Scopus (301) Google Scholar In an Irish birth cohort study, increased TEWL was found before the occurrence of AD and the authors suggested that measurement of TEWL at ages 2 days and 2 months was predictive of AD development at 1 year.9Kelleher M. Dunn-Galvin A. Hourihane J.O. Murray D. Campbell L.E. McLean W.H. et al.Skin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year.J Allergy Clin Immunol. 2015; 135: 930-935.e1Abstract Full Text Full Text PDF PubMed Scopus (200) Google Scholar However, we failed to find an association between TEWL at age 2 months and later development of AD in our Korean cohort. This may be explained by the extent of inflammation in the skin. Interestingly, the mean SCORAD score in the Irish study at 6 and 12 months was 21.54 ± 16.29 and 18.56 ± 14.92, respectively, showing that the Irish infants had more severe AD than did ours. It is plausible that subclinical skin inflammation of the Irish study population at age 2 months could impair the skin barrier function as opposed to our cohort, although clinical AD was not apparent in both studies. Another possibility is that the pathobiology of AD is different in Korea versus Ireland.10Noda S. Suárez-Fariñas M. Ungar B. Kim S.J. de Guzman Strong C. Xu H. et al.The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased Th17 polarization.J Allergy Clin Immunol. 2015; 136: 1254-1264Abstract Full Text Full Text PDF PubMed Scopus (362) Google Scholar Indeed, levels of TH17- and TH22-related cytokines have been found to be higher in Asian than in European American AD skin biopsies. In conclusion, epidermal TSLP protein expression may serve as an early biomarker to predict the development of infantile AD. To facilitate AD prevention studies, additional skin tape stripping studies are needed to identify biomarkers that predict infants at risk of developing AD in different racial groups. We tried to select the study population according to very strict criteria. We excluded parents with asthma or allergic rhinitis from the risk group unless they were sensitized to common inhalant allergens as well. Subjects with a history of AD were also excluded if eczema symptoms were not found on site. Likewise, all parents with asymptomatic sensitization were excluded from the control group even though they had never presented with asthma or allergic rhinitis symptoms. Finally, we excluded 279 subjects out of 388 after initial screening, and successfully followed 75 infants in the risk group and 12 in the control group for 2 years. Patients were directed to avoid showering on the day of the collection. A total of 20 consecutive D-Squame tape strips (22 mm diameter, CuDerm, Dallas, Tex) were applied on the volar surface of the right forearm at age 2 months. On application of the first tape disc, 4 marks were placed around the disc with a pen so that subsequent discs could be applied to the same location. Each tape disc was placed adhesive side up in its own 6-well plate and then frozen at −80°C. Proteins were extracted by using a buffer composed of 0.01% 3-(3-[1,1-bisalkyloxyethyl] pyridin-1-yl)propane-1-sulfonate (Protein Discovery, Knoxville, Tenn) in 50 mmol/L ammonium bicarbonate with 1 × HALT protease inhibitors, EDTA-free (Thermo Fisher Scientific, Rockford, Ill), and 50 mmol/L dithiothreitol (Bio-Rad, Hercules, Calif) and incubated on a rocker at room temperature for 1 hour. Extraction buffer was pooled from tape disc, transferred into polypropylene 1.5-mL microcentrifuge tubes, lyophilized, and stored at −80°C. Proteins were precipitated in 300 mL ice-cold precipitation buffer consisting of 0.1% formic acid in 80:20 methanol:water (VWR, West Chester, Pa, and Thermo Fisher Scientific, respectively). Samples were incubated at −20°C and vortexed for 30 seconds every 10 minutes for 1 hour, and then centrifuged at 18,000g at 4°C for 20 minutes. The supernatant was removed, and the protein pellet was resuspended in 8 mol/L urea (Sigma Ultra, St Louis, Mo) in 100 mmol/L TRIS HCl (pH 8.5; Thermo Fisher Scientific). Proteins were reduced with 5 mmol/L tris[2-carboxyethyl]phosphine (Thermo Fisher Scientific) for 20 minutes and alkylated with 500 mmol/L iodoacetamide (Bio-Rad, Hercules, Calif) for 15 minutes. Urea was diluted to 2 mol/L with 100 mmol/L TRIS HCl (pH 8.5), and samples were incubated at 37°C overnight with 100 ng trypsin (Trypsin Gold; Promega, Madison, Wis). Samples were then cleaned by using PepClean C-18 spin columns (Thermo Fisher Scientific) following the manufacturer's protocol. All reagents were of the highest grade available for mass spectrometry. Mass spectrometry was carried out as previously described.E1Broccardo C.J. Mahaffey S.B. Strand M. Reisdorph N.A. Leung D.Y. Peeling off the layers: skin taping and a novel proteomics approach to study atopic dermatitis.J Allergy Clin Immunol. 2009; 124 (e1-11): 1113-1115Abstract Full Text Full Text PDF PubMed Scopus (42) Google Scholar Samples were run in triplicate on an Agilent 1200 series HPLC (Agilent Technologies, Santa Clara, Calif) and Agilent ETD ion trap (model 6340) mass spectrometer with an HPLC chip to evaluate the expression of filaggrin, alpha enolase, corneodesmosin, fatty acid–binding protein, serpin B3, transglutaminase 3, and TSLP. Data were analyzed using SPSS for Windows (version 23.0, SPSS, Chicago, Ill). The Fisher exact test was applied to determine differences in the proportions of sex, delivery mode, parental history of allergic diseases, parental atopy, monthly income, maternal education levels, and the incidence of AD between the risk group and the control group. The Mann-Whitney U test was used to analyze differences in birth weights, intrauterine periods, and maternal ages between the risk group and the control group. To estimate risk factors predicting AD development by the age of 24 months, univariable and multivariable logistic regression analyses were used. In a univariable analysis, candidate variables for adjustment included epidermal protein levels, sex, parental history of allergic diseases, delivery mode, maternal education levels, move to a new house during pregnancy, mold exposure during pregnancy, exclusive breast-feeding during the first 4 months of life, and TEWL at age 2 months. TSLP and epidermal protein levels were dichotomized according to their median values. In a multivariable regression analysis, TSLP and other variables with a P value of less than .1 in univariable analysis were selected and adjusted for each other. The combined effect of TSLP and family history was also evaluated using a multivariable logistic regression. A P value of less than .05 was considered to be significant.Fig E2Univariable analysis for epidermal proteins influencing AD development by age 24 months. OR, Odds ratio.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Table E1Characteristics of study participantsCharacteristicRisk group (n = 75)Control group (n = 12)P valueSex: male43 (57.3)8 (66.7).754Birth weight (kg)3.2 ± 0.43.1 ± 0.5.434Intrauterine period (wk)39.5 ± 6.139.4 ± 6.3.696Mother's age at child's birth (y)32.1 ± 2.832.8 ± 3.3.555Birth type.746 Vaginal delivery53 (70.7)8 (66.7) Cesarean section22 (29.3)4 (33.3)Paternal history of allergic diseases Atopic dermatitis19 (25.3)0 (0).041 Allergic rhinitis25 (33.3)0 (0).012 Asthma5 (6.7)0 (0).467Maternal history of allergic diseases Atopic dermatitis18 (24.0)0 (0)<.001 Allergic rhinitis46 (63.0)0 (0)<.001 Asthma3 (4.0)0 (0).637Paternal atopy∗Positive skin prick test result to common allergens.46 (63.0)0 (0)<.001Maternal atopy∗Positive skin prick test result to common allergens.50 (66.7)0 (0)<.001Monthly income (US $).971 ≤17999 (12.0)1 (8.3) 1800-359936 (48.0)6 (50.0) 3600-539922 (29.3)4 (33.3) ≥54008 (10.7)1 (8.3)Maternal education.546 College4 (5.3)0 (0) High school or less71 (94.7)12 (100.0)Values are n (%) or mean ± SD.∗ Positive skin prick test result to common allergens. Open table in a new tab Values are n (%) or mean ± SD.

We aimed to evaluate whether prenatal exposure to heavy metals affects the development, severity, and persistence of atopic dermatitis (AD) in a birth cohort study. A total of 312 subjects from the Cohort for Childhood Origin of Asthma and allergic diseases (COCOA) were followed from birth for a mean duration of 35.5 months. The presence and the severity of AD was evaluated at ages of 6 and 12 months, and regularly once a year thereafter. The concentrations of lead, mercury, chromium, and cadmium in cord blood were measured by inductively coupled plasma mass spectrometry (ICP-MS). Cord blood mononuclear cells (CBMC) were isolated and stimulated to analyze cytokine production by using ELISA. AD developed in 121 (38.8%) children, and heavy metal levels in cord blood were not different between subjects with and without AD. However, the duration of AD was linearly associated with lead levels in cord blood (P=0.002). A positive correlation was also observed between AD severity and mercury concentrations (P= 0.004). IL-13 production in CBMC showed positive correlation with lead levels in cord blood (P=0.026), while there were no associations between mercury, chromium, and cadmium levels and IL-13 levels. Our findings suggest that prenatal exposure to lead and mercury is associated with persistence and severity of AD.

가정환경 아동듣기평가 (Children’s Home Inventory for Listening Difficulties, CHILD)는 청각장애 아동의 가정환경에서의 듣기 어려움을 평가하기 위한 부모용 설문지로 임상에서 널리 사용되고 있는 도구이다. 본 연구의 목적은 CHILD를 한국어로 번역하고 국내의 인공와우 착용 유아 및 학령기 아동을 대상으로 실시함으로써 검사의 내적 신뢰도를 평가하고 아동의 가정환경 내 의사소통 및 청각 이해도를 파악하고자 하였다. 본 연구에서는 국내 인공와우를 착용한 청각장애 아동의 부모 55명(유아 27명, 초등 28명)을 대상으로 한국어 버전 CHILD 부모용 설문지 검사를 실시하였다. 내적일치도를 확인하였으며, 연령대(유아, 초등)와 평가요인(조용한 상황, 소음 상황, 먼거리 상황, 사회적 상황, 미디어 상황)를 비교하기 위하여 혼합요인 반복측정 분산분석 및 사후분석을 실시하였다. 그 결과, 한국어 버전 CHILD의 전체 크론바흐 알파값은 .96(조용한 상황 .96, 소음 상황 .93, 먼 거리 상황 .82, 사회적 상황 .93)이었다. 연령대와 평가요인 간 상호작용은 유의하지 않았으나, 초등 연령대의 점수가 유아 연령대에 비해 모든 상황에서 유의미하게 높았다. 전체 연령대에서 조용한 상황 요인이 가장 높은 점수를 보이는 것으로 나타났다. 유아와 초등 연령대 양쪽에서 가장 낮은 점수를 보인 것은 사회적 상황 요인이었으며 분석 결과, 인공와우 착용아동들은 사회적 상황이 다른 듣기 어려운 상황과 결합될 때 특히 어려워하는 것으로 나타났다. 본 연에서 CHILD 부모용 설문지를 한국어로 번역하고 국내 임상에 적용한 결과는 유효하였으므로 한국어 버전 CHILD를 국내 가정환경에서 활용할 수 있을 것이다.The Children’s Home Inventory for Listening Difficulties (CHILD) questionnaire has been applied for assessing listening and communication difficulties in various home situations for children with hearing loss. The purpose of the study was to translate the CHILD questionnaire for parents into Korean and verify reliability and validity of Korean version of CHILD(CHILD-K). CHILD-K was completed by 55 parents of children (from ages 3~12 years) using cochlear implants (CI). Among the 55 children, 27 were in preschool and 28 in elementary. Internal consistency reliability of CHILD-K was verified by Chronbach’s alpha. The mixed factorial ANOVA was conducted to compare the effects of the age group and situation factors (Quiet, Noise, Distance, Social, and Media factors) on the score of CHILD. The results indicated that CHILD-K showed excellent internal consistency reliability (α=.96). The CHILD scores among age groups were significantly different as the older age group resulted in higher scores in all situations except Distance. For both groups the mean scores for the Quiet situation were significantly higher than other situations, and the mean scores for the Social situation were significantly lower than other situations. Moreover, analysis showed that children with CI had difficulties in the Social situation combined with other situation factors. The results indicate that the Korean version of CHILD questionnaire is a reliable tool for the assessment of communication abilities in home situation in Korean-speaking children using CI.

BACKGROUND Drug provocation tests (DPTs) are difficult to perform in clinical practice, even though they are the gold standard for the diagnosis of adverse drug reactions (ADRs). OBJECTIVE The aims of this study were to evaluate the common causative drugs of type B ADRs and to analyze the relationships between host factors and the results of DPTs in Korean children. METHODS We retrospectively reviewed the medical records of all children younger than 19 years of age who underwent a DPT between November 1994 and November 2014. Open provocation tests were performed with non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, aminopenicillins, cephalosporins, non-β-lactam antibiotics, antiepileptic drugs, or other drugs. RESULTS Overall, 84 DPTs were performed in 56 patients whose median age was 7.5 years (range, 6 months to 18 years). DPTs were positive in 25 (29.8%) of 84 cases, which translated to 18 (32.1%) positive findings in 56 patients. Drugs that provided positive results included NSAIDs (7 cases, 28.0%), aminopenicillins (5 cases, 20.0%), acetaminophen (4 cases, 16.0%), cephalosporins (3 cases, 12.0%), and non-β-lactams (2 cases, 8.0%). Anaphylaxis was noted in 5 (20.0%) of 25 cases. There were no serious complications of DPTs in any of the subjects. The median age was 10.5 years for children who had a positive result following the DPT and 5.0 years for those with negative results (P value = 0.019). CONCLUSIONS DPTs can be performed safely in children with suspected ADRs in order to achieve a correct diagnosis.

We aimed to investigate the association between concentration of serum vitamin D levels and recent symptoms of allergic diseases in elementary schoolchildren. A nationwide cross-sectional survey was conducted in the first grade students from randomly selected 45 elementary schools. Recent symptoms of atopic dermatitis (AD) or asthma were defined as those who were medically treated for AD or asthma. Recent symptoms of allergic rhinitis (AR) were considered to be present if a child had the experience of treatment for AR during the last 12 months and showed a positive skin prick test responses to common 18 inhalant allergens. All the children were examined by a pediatrician to determine the presence of eczema in their neck and flexural areas of both arms. Serum 25-hydroxyvitamin D [25(OH)D] was measured by chemiluminescent microparticle immunoassay. The overall prevalence rates of vitamin D insufficiency (20 to 29 ng/mL) and deficiency (<20 ng/mL) were 64.1% and 18.4%. The adjusted odds ratio (aOR) for the presence of AR was 0.980 (95% CI: 0.962–0.998) for each increase of 1 ng/mL in 25(OH)D, while no association was found between 25(OH)D levels and the prevalence of AD or asthma. The aOR per increase of 1 ng/mL in 25(OH)D was 0.974 (95% CI 0.955-0.994) for the presence of eczema on the day of survey. A high prevalence of vitamin D deficiency and insufficiency was found in Korean elementary schoolchildren, and vitamin D level was associated with recent symptoms of AD and AR.

Food-dependent exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening clinical reaction in which anaphylaxis develops when physical activity occurs within a few hours after ingesting a specific food. An 18-year-old girl experienced generalized urticaria, periorbital swelling, and dyspnea repeatedly by exercise after intake of a red ginseng health supplement. A confirmed diagnosis was established in this case by using an exercise challenge test after ingesting mixed-plant extract containing red ginseng health supplement. To the best of our knowledge, this is the first case of FDEIA caused by components in a red ginseng health supplement. (Allergy Asthma Respir Dis 2015;3:219-223)

Purpose:The purpose of this study was to evaluate the utility of specific IgE (sIgE) concentrations for the diagnosis of immediate-type egg and cow's milk (CM) allergies in Korean children and to determine the optimal cutoff levels.Methods: In this prospective study, children ≥12 months of age with suspected egg or CM allergy were enrolled.Food allergy was diagnosed by an open oral food challenge (OFC) or through the presence of a convincing history after ingestion of egg or CM.The cutoff levels of sIgE for egg white (EW) and CM were determined by analyzing the receiver operating characteristic curves.Results: Out of 273 children, 52 (19.0%) were confirmed to have egg allergy.CM allergy was found in 52 (23.1%) of 225 children.The EW-sIgE concentration indicating a positive predictive value (PPV) of >90% was 28.1 kU/L in children <24 months of age and 22.9 kU/L in those ≥24 months of age.For CM-sIgE, the concentration of 31.4 kU/L in children <24 months of age and 10.1 kU/L in those ≥24 months of age indicated a >90% PPV.EW-sIgE levels of 3.45 kU/L presented a negative predictive value (NPV) of 93.6% in children <24 months of age, while 1.80 kU/L in those ≥24 months of age presented a NPV of 99.2%.The CM-sIgE levels of 0.59 kU/L in children <24 months of age and 0.94 kU/L in those ≥24 months of age showed NPVs of 100% and 96.9%.Conclusions: Our results indicate that different diagnostic decision points (DDPs) of sIgE levels should be used for the diagnosis of egg or CM allergy in Korean children.The data also suggest that DDPs with high PPV and high NPV are useful for determining whether OFC is required in children with suspected egg or CM allergy.

Purpose: This study aimed to analyze the prevalence of allergic diseases in Korean schoolchildren according to their residential areas in 2010.Methods: A nationwide, cross-sectional study was conducted in children aged 6-7 years (n = 4,003) and adolescents aged 12-13 years (n = 4,112) who were randomly selected. Demographic and disease- related information was obtained through a Korean version of ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, and skin prick tests for 18 inhalant allergens were performed.Results: There was statistically significant regional difference in the prevalence of allergic rhinitis (AR) (P < 0.05). The regions with highest and lowest prevalence in 12- to 13-year-old children were as follows: Chungcheong and Honam in "Diagnosis of AR, ever" (33.7% vs. 24.5%), Jeju and Yeongnam in "Treatment of AR, last 12 months" (25.5% vs. 18.0%), Chungcheong and Yeongnam in "Rhinitis with sensitization" (31.6% vs. 23.6%). The regions with highest and lowest prevalence in 6-7 years old children were as follows: Yeongnam and Seoul in "Diagnosis of AR, ever" (42.1% vs. 31.0%), Yeongnam and Jeju in "Treatment of AR, last 12 months" (31.8% vs. 21.9%), Jeju and Seoul in "Rhinitis with sensitization" (26.0% vs. 18.4%). We also found a regional difference in inhalant allergens among the children with "rhinitis with sensitization".Conclusion: The prevalence of AR in children differs according to residential areas in a nationwide survey in 2010 while there is no significant regional difference in the prevalence of asthma and AD.

PURPOSE:This study was aimed to investigate the relationship between the allergen components and moderate-to-severe allergic reactions in patients with buckwheat allergy.METHODS:Fifteen patients with a history of buckwheat ingestion and a buckwheat specific IgE level≥0.35 kU/L were enrolled. They were divided into 2 groups according to clinical severity scores, with 0-1 being asymptomatic-to-mild and 2-4 being moderate-to-severe symptoms. Immunoblotting was performed to investigate IgE reactivity toward buckwheat allergens and to measure intensity of each component by using a reflective densitometer.RESULTS:The proportions of positive band to the 16 kDa (62.5% vs 0%, P=0.026) and 40-50 kDa (87.5% vs 28.6%, P=0.041) buckwheat allergens in the grade 2-4 group were higher than those in grade 0-1 group. The level of buckwheat specific IgE of grade 2-4 group was higher than that of grade 0-1 group (41.3 kU/L vs 5.5 kU/L, P=0.037). The median optical densities (ODs) of IgE antibody binding to 40-50 kDa protein were higher in the grade 2-4 group, compared with those in the grade 0-1 group (130% OD vs 60.8% OD, P=0.037).CONCLUSIONS:The 40-50 kDa protein is implicated as an important allergen to predict moderate-to-severe clinical symptoms in Korean children with buckwheat allergy.