Kwon, Min Kyoung;Kim, Mi Ran;Park, Eun Young;Lee, Kon Hee;Yoon, Hae Sun;Kim, Kwang Nam;Lee, Kyu Man
Clinical and Experimental Pediatrics
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v.45
no.12
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pp.1519-1527
/
2002
Purpose : Although influenza virus is one of the most important causes of acute respiratory tract infections(ARTIs) in children, virus isolation is not popular and there are only a few clinical studies on influenza in Korea. We evaluated the epidemiologic and clinical features of ARTIs by influenza virus in children. Methods : From February 1995 to August 2001, nasopharyngeal aspirations were obtained and cultured for the isolation of influenza virus in children admitted with ARTIs. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Respiratory viruses were isolated in 997(22.0%) out of 4,533 patients examined, and influenza virus was isolated in 164 cases(3.6%). Influenza virus was isolated year after year mainly from December to April of next year. The ratio of male and female was 1.9 : 1 with a median age of 15 months. The most common clinical diagnosis of influenza virus infection was pneumonia, and fever and cough developed in most patients. There was no difference between influenza A and B infection in clinical diagnoses and symptoms. All patients recovered without receiving antiviral treatment except for one patient diagnosed with pneumonia who had underlying disease of Down syndrome with ventricular septal defect. Conclusion : ARTIs caused by influenza virus developed every winter and spring during the period of study. Because fatal complication can develop in the high risk group, prevention, early diagnosis and proper management of influenza should be emphasized.
Choi, So Young;Lee, Na Young;Kim, Sung Mi;Kim, Gil Heun;Jung, Jin Hwa;Choi, Im Jung;Cho, Kyung Soon
Pediatric Infection and Vaccine
/
v.11
no.2
/
pp.158-169
/
2004
Purpose : Although influenza is one of the most important cause of acute respiratory tract infections in children, virus isolation is not popular and there are only a few clinical studies on influenza and diagnostic methods. We evaluated the epidemiological and clinical features of influenza in children and rapid antigen detection test(QuickVue influenza test) on fist half of the year 2004 in Busan. Methods : From January 2004 to June 2004, throat swab and nasal secretion were obtained and cultured for the isolation of influenza virus and tested by rapid antigen detection test(QuickVue influenza test) in children with suspected influenza infections. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Influenza viruses were isolated in 79(17.2%) out of 621 patients examined. Influenza virus was isolated mainly from March to April 2004. The ratio of male and female with influenza virus infection was 1.2 : 1 with median age of 4 years 6month. The most common clinical diagnosis of influenza virus infection was bronchitis. There was no difference between influenza A and B infection in clinical diagnosis and symptoms. All patients recovered without severe complication. The sensitivity obtained for rapid antigen detection test (QuickVue influenza test) was 93.6% and the specificity was 80.2%, the positive predictive value 40.8%, the negative predictive value 98.8%. Conclusion : With rapid antigen detection test, it is possible early detection of influenza in children. reduction in use of antimicrobial agent and early use of antiviral agent.
Bae, Kang Woo;Kim, Jong Ho;Kim, Youn Seup;Park, Jae Seuk;Jee, Young Koo;Lee, Kye Young
Tuberculosis and Respiratory Diseases
/
v.58
no.2
/
pp.167-173
/
2005
Background : Airborne particles during Yellow Sand phenomena are known to be associated with the respiratory disease. The purpose of this study was to evaluate the concentration and metal component properties of Yellow Sand particles and compare with airborne microbial concentration and species in non Yellow Sand and Yellow Sand phenomena. Methods : Samplings were carried out in 2002 in Seosan, during non Yellow Sand and Yellow Sand phenomena. Samples were taken using the 8-stage Cascade impactor and metallic elements were analyzed by XRF. Those were culture on the media for bacterial and fungal culture and celline for virus. Results : The concentration of total suspended particulate matter were respectively $80.2{\mu}g/m^3$, $40.3{\mu}g/m^3$ in non Yellow Sand and Yellow Sand phenomena. The concentration of metallic elements such as Ca, Fe, Cu and Zn in Yellow Sand phenomena were higher than its in non Yellow Sand. Two bacteria, Bacillus species and Staphylococcus were grown in two periods. In both periods, several fungal spores(Mucor species, Cladosporum, Alternaria, Aspergillus, Penicillium, and Alternaria species) were identified. The differences of bacteria and fungus species not observed in Yellow Sand and non Yellow Sand. Any viruses were not isolated in between both periods. Conclusions : The concentration of total suspended particulate matter and some metallic elements in Yellow Sand phenomena were higher than its in non Yellow Sand. The difference of bacteria and fungus species was not observed in non Yellow Sand and Yellow Sand phenomena.
Purpose : A wide, epidemic outbreak of M. pneumoniae pneumonia occurred throughout Korea in late 2003. Compared with previous years, the 2003 outbreak resulted in more severe cases and in an increased incidence of extrapulmonary symptoms and/or complications. We compared the clinical characteristics for M. pneumoniae pneumonia of 2003 to those of the past years. Methods : One hundred six children diagnosed with M. pneumoniae pneumonia by serologic tests at Bundang Cha General Hospital between Aug 2003 to April 2004 were enrolled. Medical records were reviewed retrospectively, for clinical, laboratory and radiological aspect as well as complications. The pleural effusions of 3 patients who underwent thoracentesis were also analyzed. Results : The duration of fever, cough, rhinorrhea, and sore throat was $8.2{\pm}4.7$, $22.1{\pm}4.8$, $8.4{\pm}2.1$, $4.3{\pm}1.2$ days, respectively. The incidence (percentage) and duration of abdominal pain, vomiting, diarrhea, headache, skin rash, arthralgia was $5.1{\pm}2.5$ (21.9%), $3.4{\pm}2.1$ (17.1%), $4.3{\pm}1.8$ (16.2%), $3.5{\pm}2.1$ (14.4%), $5.5{\pm}0.7$ (5.9%) and $4.6{\pm}1.3$ days (4.9%), respectively. The mean duration of admission and treatment were $7.4{\pm}4.3$ days and $21.6{\pm}11.1$ days. Higher values of CRP and ESR on admission were positively correlated with the duration of fever and length of admission. The findings of pleural effusion were similar to those seen in TB pleurisy. Complications, including myocarditis (2 cases), arthritis (3 cases), vasculitis (5 cases), asthma (3 cases), ARDS (1 case), and DIC (2 cases) were observed in 14.1% of patients. Conclusion : We found a number of characteristics of M. pneumoniae pneumonia among cases from late 2003 that were different from those of previous years. This outbreak resulted in more severe cases and in an increased incidence of extrapulmonary symptoms and/or complications. A multicenter study is needed to verify the changes in clinical characteristics observed during the 2003 outbreak from previous ones.
Purpose : We performed a study of clinical findings of Mycoplasma Pneumonia in children, to know differences between recent clinical manifestations of Mycoplasma pneumonia and previous studies. Methods : The subjects of this study were 393 children who were diagnosed as Mycoplasma pneumonia with high titers of Mycoplasma antibody(${\geq}1$ : 160) or fourfold rises of Mycoplasma antibody at Chung Ang University Hospital from January 1998 to December 2003. We practiced a retrospective study on the clinical manifestations of Mycoplasma pneumonia based on their medical records. Results : Male to female ratio was 1.06 to 1 and mean age was $4.32{\pm}2.94years$. The highest incidence was in the age of 2 to 3 years(18.6 percent). Most frequent months were October, and November in 2000, April in 2002, and October and, December in 2003. Twenty six point seven percent showed allergic diseases. Second degree relatives of 10.7 percent patients had allergic diseases. Forty three point three percent were admitted before this admission for pneumonia. Allergic tests were positive in 65.7 percent. Cough, and sputum were the most common symptoms and abdominal pain, and vomiting were the most frequent extrapulmonary symptoms. Atelectasis and pleural effusion were seen in 2.5 percent and 1.8 percent. Infiltrations were more common on the right side. Titers of each simultaneous test for cold agglutinin and mycoplasma antibody were not in proportion to each other (P=0.163). Conclusion : The onset age of mycoplasma pneumonia was found to be lower than it used to be. More patients had a past medical history or a family history of allergic disease, and more wheezing was heard and associated with recurrent pneumonia.
Purpose : The seasonality of influenza virus and rotavirus are well recognized in winter and so viral surveillance and laboratory-based diagnostics are important to guide the timing of prophylaxis and other interventions. Yet the seasonality of these two viruses are changing in Korea. We evaluated the prevalence and clinical features of influenza virus and rotavirus. Methods : From September 2001 to August 2005, nasopharyngeal aspirates were cultured from the hospitalized patients with lower respiratory infections and the stools from hospitalized patients with gastroenteritis were tested for rotavirus. We retrospectively analysed the medical records. Results : During the study period, respiratory virus was isolated in 578 (18.5%) out of 3,121 patients. Influenza virus was isolated in 143 cases. The seasonal distribution of influenza infection was from December to June of the next year. The ratio of males to females was 1.3:1 and the median age was 17 months. The most common diagnosis of influenza infection was bronchiolitis. Fever and cough were present in 94.4% and 83.9% of the patients, respectively. During the same period, 3,850 patients were admitted for gastroenteritis and 1,047 (27%) patients were positive for rotavirus. Rotavirus was prevailed from December to June of the next year and it presented in year-round. The ratio of males to females was 1.1:1 and the median age was 16 months. Diarrhea and vomiting were the most common symptoms. Conclusion : The recent peak prevalence of influenza virus and rotavirus in Korea was in winter and the late spring, respectively. So we need to expand surveillance and carefully consider the correct period to vaccinate people.
Kim, Young-Whan;Park, Gye-Young;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
Tuberculosis and Respiratory Diseases
/
v.41
no.2
/
pp.127-134
/
1994
Background : Diffuse panbronchiolitis(DPB) is a chronic inflammatory lung disease of unknown etiology which has characteristic clinical, radiological and pathological features, and is distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. Clinically, patients with DPB have chronic cough, purulent sputum, exertional dyspnea, and finally respiratory failure. Until a few years ago, the prognosis of DPB had been thought to be very grave, because there had been no effective treatment for the disease. But recent1y, low-dose long-term erythromycin was found to be very effective on DPB. Even though DPB is prevalent in Japan, and is known to be rare outside of Japan, we have a1ready reported the clinical features of 16 DPB cases in Korea. We tried low-dose long-term erythromycin on DPB patients and analyzed the clinical effect of erythromycin. Methods : We analyzed the changes of subjective symptoms, physical signs, pulmonary function tests and chest X-rays on 14 DPB patients with more than 6 months erythromycin treatment during the period from September 1989 to August 1992 in Seoul National University Hospital. Results : 1) Subjective symptoms improved in all patients within 2-3 months, and 54.5% of the patients showed no symptom after one year of treatment. 2) Crackles and wheezing decreased in 92.9% of the patients after 3 months and completely disapppeared in 63.5% of the patients after one year of treatment. 3) FVC and FEV1 increased remarkably during the first 3 months, and slowly increased thereafter, reaching normal level after one year of treatment. 4) Small nodular lesions on chest X-ray decreased in all patients, and chest PA was normal in 36.4% of the patients after one year of treatment. 5) There was side effect in one patient, stopping medication because of dyspepsia. One patient stopped medication because of no symptom after 16 months of treatment, but her symptom recurring after one month, improving again after retreatment. Conclusion: Low-dose long-term erythromycin showed ramarkable effectiveness on DPB. Further studies are needed on the mechanism of the drug and the duration of the treatment.
Park, Gwi Ok;Kim, Ji Hyun;Lee, Jae Hee;Lee, Jung Ju;Yun, Sin Weon;Lim, In Seok;Lee, Dong Keun;Choi, Eung Sang;Yoo, Byoung Hoon;Lee, Mi Kyung;Chae, Soo Ahn
Clinical and Experimental Pediatrics
/
v.52
no.3
/
pp.330-338
/
2009
Purpose : The causes of acute lower respiratory tract infection (ALRTI) are mostly attributable to viral infection, including respiratory syncytial virus (RSV), parainfluenza virus (PIV), influenza virus A/B (IFV A/B), or adenovirus (ADV). Several Korean studies reported human metapneumovirus (hMPV) as a common pathogen of ALRTI. However, studies on seasonal distribution and clinical differences relative to other viruses are insufficient, prompting us to perform this study. Methods : From November 2006 to October 2007, we tested nasopharyngeal aspiration specimens in children hospitalized with ALRTI with the multiplex reverse transcriptase-polymerase chain reaction to identify 6 kinds of common pathogen (hMPV, RSV, PIV, IFV A/B, and ADV). We analyzed positive rates and clinical features by respiratory chart review. Results : We detected 38 (8.4%) hMPV-positive cases out of 193 (41.8%) virus-positive specimens among 462 patients. HMPV infection prevailed from March to June with incidence peaking in April. HMPV-positive patients were aged 15 years (76.3%), and the ratio of boys to girls was 1.2:1. The median age was 27 months. HMPV primarily caused pneumonia (76.3 %) (P=0.018). Average hospitalization of HMPV-associated ALRTI patients was 5.8 days. In addition, they showed parahilar peribronchial infiltration (100%) on chest X-ray, normal white blood cell count (73.7%), and negative C-reactive protein (86.8 %) (P>0.05). All hMPV-positive patients recovered without complication. Conclusion : HMPV is a common pathogen of ALRTI in Korean children, especially in 1-5 year olds, from March to May. Immunocompetent children diagnosed with hMPV-associated ALRTI may have a good prognosis.
Yoon, Ho Joo;Kim, Mi Ok;Sohn, Jang Won;Kim, Jung Mogg;Shin, Dong Ho;Park, Sung Soo
Tuberculosis and Respiratory Diseases
/
v.54
no.1
/
pp.104-113
/
2003
Background : Rhinovirus(RV) infections frequently trigger dyspnea and paroxysmal cough in adult patients with asthma and are the most prevalent cause of the common cold. However, the mechanisms of a RV-induced airway inflammation is unclear. Since the RV does not directly destroy the airway epithelium, it is presumed that the immune response to the RV contributes to the pathogenesis of the respiratory symptoms. In order to test this hypothesis, this study characterized the time-sequenced alterations in interleukin(IL)-8 elaboration from the human bronchial epithelial cells and evaluated the role of NF(nuclear factor)-${\kappa}B$ in the RV-induced IL-8 production by pretreating the inhibitors of NF-${\kappa}B$ activation. Methods : The ability of RV-infected human bronchial epithelial cells and BEAS-2B cells to produce the IL-8 was compared with the controls. This study infected BEAS-2B cells with the RV14 obtained from the American Type Culture Collection. The supernatants were harvested from the RV infected BEAS-2B cells and the controls at 2hr, 4hr, 6hr, 12hr, 24hr, 48hr from the inoculation time. This study measured the IL-8 concentration using the ELISA kits. In order to elucidate the role of NF-${\kappa}B$ in the RV-induced IL-8 production, the effect of the NF-${\kappa}B$ inhibitors was evaluated on RV-induced IL-8 production. Results: The BEAS-2B cells produced small amounts of IL-8 that accumulated slowly with time in the culture. The RV was a potent stimulator of the IL-8 proteins production by BEAS-2B human bronchial epithelial cells. Antioxidants, N-acetyl-L-cysteine(NAC),\ and pyrrolidine dithiocarbamate(PDTC), blocked the IL-8 elaboration by the RV-infected BEAS-2B cells, which was dose-dependent, but N-Tosyl-L-phenylalanine chloromethyl ketone(TPCK) did not. Conclusion: Some antioxidants inhibited the RV-induced IL-8 production by blocking the NF-${\kappa}B$, which may have a therapeutic potential in asthma.
Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
Korean Journal of Culture and Social Issue
/
v.11
no.2
/
pp.143-181
/
2005
This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.
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