• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.67-75
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• 1995

Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

• 건강소식
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• v.36 no.1
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• pp.24-25
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• 2012

여러 가지 실버 세대 질환 중 폐렴은 발병률이 높고 발병시 사망률도 높은 것으로 알려졌다. 실버 세대에서 폐렴의 위험이 높은 이유는 면역기능의 저하, 인후부반사기능의 저하, 점액섬모운동의 기능 저하 및 여러 가지 심폐기능부전 등에 관여하기 때문이다. 노인성폐렴에 대해 알아보자.

• Journal of Veterinary Clinics
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• v.25 no.1
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• pp.31-36
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• 2008

One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.89-94
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• 2012

Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

• 보건세계
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• v.43 no.11 s.483
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• pp.4-7
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• 1996

폐는 산소가 많이 포함된 신선한 공기를 혈액에 공급하여 줌으로써 우리 몸의 활동유지에 필요한 산소를 공급해 줌과 동시에 신체의 활동에 의하여 생성된 이산화탄소를 몸밖으로 배출하는 작용을 주로 하는 기관이다. 따라서 폐는 본연의 기능을 유지하기 위하여 계속적으로 외부의 공기를 흡입하여야 한다. 이 과정에서 외부에서 균으로 오염된 공기를 흡인하거나 또는 폐에 도달되기 전에 공기가 거쳐 지나가게 되는 구강 및 인후가 균으로 오염되어 있다가 오염된 분비물이 기도로 흡인되거나 하는 경우에는 폐실질에 염증이 발생할 수 잇는데, 이러한 경우를 폐렴이라고 한다. 이밖에도 다른 외부장기의 감염이 혈행성으로 폐로 전이되어서 폐렴이 발생할 수도 있다. 폐렴의 원인균은 각종 세균, mycoplasma, chlamidae, rickettsiae, virus 등 매우 다양하며, 균이 아닌 자극성 물질 또 호산구의 폐침윤 등에 의해서도 폐렴이 발생할 수 있다.

• The Journal of Dong Guk Oriental Medicine
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• v.7 no.2
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• pp.121-140
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• 1999

The various oriental herbal medicines, which have usually been used for treatment of reducing fever, purging intense heat and detoxication, were screened to determine the antibacterial activity and the minimal inhibitory concentration against pulmonary disease-causing Klebsiella pneumoniae, Streptococcus pyogenes, and Streptococcus pneumoniae. The results obtained were as follows: 1. Among the 23 oriental medicines tested, the water-soluble extracts of Coptis japonica, Scutellaria baicalensis and Picrorrhiza kurrooa showed the antibacterial activity against K.pneumoniae and that of C. japonica against S. pyogenes. The antibacterial activities of C. japonica, Prunusmume, Schizandra chinesis, Scutellaria baicalensis were also found against S.pneumoniae. When C.japonica was used, the high antibacterial activity was shown against Bacillus subtilis and other extracts showed a little activity against B. subtilis and E. coli as a control. 2. The ethanol-soluble extracts of Patrinia scabriosaefolia, P. mume, S. baicalensis, S. chinesis showed the antibacterial activity against K. pneumoniae and those of S. baicalensis, C. japonica, S. chinesis, P. mume agaist S. pyogenes and S. pnuemoniae. However, those extract showed a little antibacterial activity against B. subtilis and E. coli except for that the extract of C. japonica showed comparatively high growth inhibition of B. subtilis. 3. Among the medicinal herbs tested, the water and ethanol extrats of C. japonica showed very extcellent antibacterial activity against the pathogenic bacteria and controls. 4. When the water-soluble extracts of C. japonica and S. baicalensis, minimal inhibitory concentrations (MICs) against K. pneumoniae were $10mg/m{\ell}$ and $22 mg/m{\ell}$, respectively. The MICs of the ethanol-soluble extracts of P. mume and P. scabriosaefolia were $5mg/m{\ell}$ and $20mg/m{\ell}$, respectively. 5. For the MICs against S.pyogenes, C. japonica showed $15mg/m{\ell}$ with the water-soluble extract and P. mume and C. japonica with the ethanol-souble extract did $5mg/m{\ell}$ and $10mg/m{\ell}$, respectively. 6. For the MICs against S. pneumoniae, C. japonica and P. mume with the water- and ethanol-souble extract showed $5mg/m{\ell}$ and $10mg/m{\ell}$, respectively. As a result, the highest antibacterial activity was found in the water- and ethanol-soluble extracts of C. japonica against pulmonary disease-causing bacteria, K. pneumoniae, S. pyogenes. and S. pnuemoniae. Also, the water- and ethanol-soluble extracts of S.chinesis. P.mume, S.baicalensis, and P.kurrooa showed hight antibacterial activities.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.56-63
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• 2006

Purpose : This study was designed to document the etiologies and the characteristics of parapneumonic effusion in children. Methods : During a 17-year period from 1987 to 2004, parapneumonic effusion was confirmed in 86 children at Gyeongsang National University Hospital. The clinical records of these children were reviewed and radiological findings and laboratory data, especially results of thoracentesis, were analyzed retrospectively. Results : M. pneumoniae(34 subjects) was the most common pathogen at all over age, especially above 1-years-old. There were diagnosed with clinical characteristics and serologic tests. The $2^{nd}$ most common pathogen revealed non tuberculous bacteria(14 subjects). A species of bacteria at no tuberculous bacteria revealed S. aureus(5), S. pneumoniae(3), P. aeroginosa(3), other staphylococcus (2), and K. pneumoniae(1). There were confirmed with sputum culture or pleural fluid culture or blood culture. S. aureus was most common pathogen in infants. The $3^{rd}$ common pathogen was M. tuberculosis(7). There were confirmed with skin tuberculin tests and AFB stains. Another that was classified as a non bacteria was adenovirus(2). Complications of parapneumonic effusion such as pleural thickness occurred on M. tuberculosis(1). Non tuberculous bacteria, especially S. aureus revealed a serious predominance of polymorphocyte at pleural fluid, and lowest pleural pH and glucose, and highest pleural protein and LDH. Tuberculosis revealed high pleural protein and LDH. Conclusion : Age and chemistries of pleural fluid might be helpful in differentiating various etiologies of parapneumonic effusion. If there were suspicious of tuberculosis and non-tuberculous bacteria, more aggressive approaches were needed to prevent complication.

• Feed Journal
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• v.4 no.12 s.40
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• pp.136-141
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• 2006

소에서 발생하는 호흡기 질병은 가축이 가지고 있는 내적인 요인과 사육환경의 악화나 각종 스트레스 등의 외적인 요인과의 복합적인 균형의 파괴에서 시작된다고 볼 수 있다. 이와 같은 질병발생요인은 다른 축종이나 소화기 등 타 질병에서도 동인한 사항으로 생각될 수 있으나 호흡기질병의 경우 환경적인 요인이 더욱 중요한 발병이자로 작용하게 된다. 즉 밀집다두사육, 환절기의 낮과 밤의 큰 일교차, 환기불량이나 우사내의 유해가스, 장거리 수송 등의 스트레스가 일차적인 발병인자가 되며, 이타적으로 가축이 가지고 있거나 외부에서 유입된 여러 가지의 병원 미생물의 다량증식하고, 동물개체는 면역력이 떨어지면서 질병에 감염되어 단일 또는 복합적인 임상증상으로 나타나는 것이다. 호흡기질병의 원인균에는 다양한 종류의 세균 및 바이러스에 의해 이루어지며, 단일의 원인균에 의한 질병발생보다는 복합적으로 감염되어 병을 악화시키고 피해를 크게 하는 것이 일반적이다. 본고에서는 소에서 흔히 나타날 수 있는 주요한 세균성 호흡기 질병의 종류와 임상증상 및 일반적인 방제대책에 대하여 기술하고자 한다.

• Korean Journal of Microbiology
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• v.37 no.3
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• pp.221-227
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• 2001

Heat shock proteins serve as chaperone by preventing the aggregation of denatured proteins and promote survival of pathogens in harsh environments. In bacteria, ethanol shock induced the major chaperone GroEL and DnaK, but in Streptococcus pneumoniae, it induced neither GroEL nor DnaK but alcohol dehydrogenase (ADH). In this study, ADH gene encoding a 104-kDa (p104) protein was identified and characterized. The deduced amino acid sequence of pneumococcal ADH shows homology with other members of the ADH family, and particularly with Entamoeba histolytica ADH2 and E. coli ADH. S. pneumoniae adh is composed of 883 amino acids and its estimated isoelectric point is 6.09. Although ADH is conserved between S. pneumoniae and E. coli, immunoblot analysis employing antisera raised against pneumococcus ADH demonstrated no cross-reactivity with ADH analog in Eschericha coli, Staphylococcus aureus and human HeLa cells. Also secretion of ADH was demonstrated by subcellular fractionation and immunoblot analysis of proteins. These results suggest that S. pneumoniae ADH could be a highly feasible candidate for both diagnostic marker and vaccine.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.19-24
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• 2004

Background : It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. Methods : We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. Result : The male to female ratio was 1:1 and the mean age at diagnosis was $54.5{\pm}18.6$ years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). Conclusion : We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.