• 대한약침학회지
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• 제16권2호
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• pp.15-22
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• 2013

Objective: Evaluations of the in-vitro anti-bacterial activities of aqueous extracts of Acacia catechu (L.F.)Willd, Castanea sativa, Ephedra sinica stapf and Shilajita mumiyo against gram-positive bacteria (Staphylococcus aureus, Streptococcus pneumonia) and gram-negative bacteria (Escherichia coli, klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa) are reasonable since these ethnomedicinal plants have been used in Persian folk medicine for treating skin diseases, venereal diseases, respiratory problems and nervous disorders for ages. Methods: The well diffusion method (KB testing) with a concentration of $250{\mu}g/disc$ was used for evaluating the minimal inhibitory concentrations (MIC). Maximum synergistic effects of different combinations of components were also observed. Results: A particular combination of Acacia catechu (L.F.) Willd, Castanea sativa, Ephedra sinica stapf and shilajita mumiyo extracts possesses an outstanding anti-bacterial activity. It's inhibiting effect on microorganisms is significant when compared to the control group (P<0.05). Staphylococcus aureus was the most sensitive microorganism. The highest anti-bacterial activity against gram-positive bacteria (Staphylococcus aureus, Streptococcus pneumonia) or gram-negative bacteria (Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, and Pseudomonas aeruginosa) was exerted by formula number 2 (table 1). Conclusion: The results reveal the presence of anti-bacterial activities of Acacia catechu, Castanea sativa husk, Ephedra sp. and Mumiyo against gram-positive and gram-negative bacteria. Synergistic effects in a combined formula, especially in formula number 2 (ASLAN$^{(R)}$) can lead to potential sources of new antiseptic agents for treatment of acute or chronic skin ulcers. These results considering the significant anti-bacterial effect of the present formulation, support ethnopharmacological uses against diarrheal and venereal diseases and demonstrate use of these plants to treat infectious diseases.

• 대한수의학회지
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• 제62권1호
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• pp.4.1-4.5
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• 2022

This paper describes a fatal case of pneumonia in a 14-day-old dog caused by extraintestinal pathogenic Escherichia coli (ExPEC). The necropsy showed that almost all of left lobes of the lungs had dark-red consolidation. A histopathology examination revealed moderate acute fibrino-hemorrhagic necrotizing pneumonia with intralesional bacterial colonies. Non-suppurative epicarditis, congestion in the liver, and necrosis in the white pulp of the spleen also were found. E. coli with cytotoxic necrotizing factor 1 and α-hemolysin was isolated from the lung. This case was confirmed to have fatal pneumonia caused by ExPEC that led to a systemic infection.

• 한국임상수의학회지
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• 제25권1호
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• pp.31-36
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• 2008

1년령 수컷 비글견이 심한 호흡곤란, 청색증, 식욕감소로 내원하였다. 외상의 병력은 없었으며, 내원 5일전에 Pseudomonas aeruginosa와 E. coli로 인한 세균성 폐렴의 진단을 받았다. 제한적인 호흡 양상을 보여 즉각적으로 산소를 투여하고 방사선검사를 실시하였다. 배복 촬영상에서 우측 흉강에 공기가 차 있었고, 우측 폐엽의 허탈, 종격, 심장과 대혈관의 좌방 변위가 관찰되었다. 외측상에서는 심첨이 흉골로부터 떨어져 있는 것이 관찰되었다. 이상의 결과로 세균성 폐렴으로 인한 속발성 자발 기흉으로 진단하고, 우측 흉강에 흉강 튜브를 삽관하였다. 삽관 3일후에 방사선 배복 촬영상에서, 우측 흉강의 공기는 제거되었으나 좌측 흉강에 기흉이 발생하여 심장이 우방변위된 것이 확인되었다. 따라서, 흉강튜브를 좌측 흉강에도 삽관하였다. 기흉이 완전히 회복되기까지, 우측 흉강 튜브는 5일간, 좌측 흉강튜브는 45일간 유지하였다. 추가로 세균성 폐렴의 치료와 튜브로 인한 역행성 감염을 방지하기 위해 항생제와 비타민 E를 처치하였다. 결과적으로, 환자는 완전히 회복되었고, 2년동안의 관찰기간 동안 재발증상 없이 정상 생활을 유지하였다.

• Clinical and Experimental Pediatrics
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• 제60권6호
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• pp.167-174
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• 2017

Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006-2007, 2011, and 2015-2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a severe and fulminant disease. Notably, since 2000, the prevalence of macrolide-resistant MPP has rapidly increased, especially in Asian countries, recently reaching up to 80%-90%. Macrolide-resistant Mycoplasma pneumoniae (MRMP) harbors a point mutation in domain V of 23S rRNA with substitutions mainly detected at positions 2063 and 2064 of the sequence. The excessive use of macrolides may contribute to these mutations. MRMP can lead to clinically refractory pneumonia, showing no clinical or radiological response to macrolides, and can progress to severe and complicated pneumonia. Refractory MPP is characterized by an excessive immune response against the pathogen as well as direct injury caused by an increasing bacterial load. A change of antibiotics is recommended to reduce the bacterial load. Tetracyclines or quinolones can be alternatives for treating MRMP. Otherwise, corticosteroid or intravenous immunoglobulin can be added to the treatment regimen as immunomodulators to downregulate an excessive host immune reaction and alleviate immune-mediated pulmonary injury. However, the exact starting time point, dose, or duration of immunomodulators has not been established. This review focuses on the mechanism of resistance acquisition and treatment options for MRMP pneumonia.

• Tuberculosis and Respiratory Diseases
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• 제73권1호
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• pp.32-37
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• 2012

Background: This study evaluates the bacterial pathogens of Ventilator-associated pneumonia (VAP) in a tertiary referral hospital. Methods: A total of 109 bacterial pathogens from 91 adult patients with VAP, who were admitted to the medical intensive care unit from January 2008 to December 2009, were examined. Clinical characteristics, bacterial pathogens, and resistance profiles were analyzed. Results: Staphylococcus aureus (44%) was the most frequently isolated. Acinetobacter baumanii (30%), Pseudomonas aeruginosa (12%), Stenotrophomonas maltophilia (7%), Klebsiella pneumoniae (6%), and Serratia marcescens (2%) were isolated from the transtracheal aspirates or bronchoalveolar lavage in patients with VAP. There was no significant difference of bacterial pathogens between early and late onset VAP. All isolated S. aureus were methicillin resistant S. aureus; the imipenem resistance rate of A. baumanii was 69%. Conclusion: The two most frequent pathogens of VAP were S. aureus and A. baumanii. There were no pathogenic differences between early and late onset VAP.

• Clinical and Experimental Pediatrics
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• 제59권3호
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• pp.132-138
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• 2016

Purpose: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. Methods: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ${\leq}18years$ who were diagnosed with pneumonia between January and December 2012. Results: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). Conclusion: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.

• Tuberculosis and Respiratory Diseases
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• 제42권1호
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• pp.67-75
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• 1995

연구배경: 최근 세균성 폐렴을 일으키는 원인균주의 변화양상, 폐렴의 임상상, 균주에 따른 항생제의 감수성 및 치료성적등을 알아보기위해 순천향대학병원에서 세균성 폐렴으로 진단된 190예를 후향적으로 입원기록 검토를 통하여 분석하였다. 방법: 1989년 1월부터 1992년 12월까지 4년간 순천향대학병원에서 폐렴으로 진단된 환자 897예 중 화농성 객담, 호흡곤란, 흉통등의 증상, 이학적 소견, 흉부 X-선에서 새로운 또는 진행하는 폐 병변, 혈액배양 및 의미 있는 객담에서 다수 또는 순수배양 상태로 나온 것을 병원균으로 간주하고, 항균제치료에 대한 반응등으로 세균성 폐렴으로 진단 받은 환자 190예를 대상으로 하였으며, 병원체는 혈액이나 객담 배양검사로 원인균이 확인된 것만을 대상으로 하여 대상 환자의 나이, 성별, 기저절환, X-선소견, 원인균에 대한 항생제 감수성 및 사망률에 대해 후향적으로 검토하였다. 결과: 1) 대상 환자는 모두 190예이었고 성별빈도는 남자가 123예(65%), 여자가 67예(35%)로서, 남녀의 비가 1.8:1이었으며, 평균연령은 61세(17~84세)이고, 60대 이상이 반수(53%)이상을 차지했다. 2) 세균성 폐렴환자의 기저질환은 175예에서 관찰되었으며 기저질환이 없었던 예는 22예 뿐이었다. 기저질환으로는 폐결핵 및 만성폐쇄성폐질환등 호흡기계 질환이 78예(43%)로 가장 많았고, 뇌혈종 및 경색의 뇌혈관계 질환은 33예(20%), 악성종양 29예(16%), 당뇨 19예(12%) 및 만성 신부전증 10예(5%) 순이었다. 3) 객담배양은 173예에서 양성을 보였고, 균주빈도는 그람음성간균이 154예(89%), 그람양성구균은 19예(11%)이었으며, 이중 가장 흔히 동정된 균주는 Pseudomonas 49예(28%), Klebsiella pneumoniae 29예(17%), Enterobacter species 25예(14%), Acinetobacter species 20예(12%) 순이었고, 원내폐렴에서도 Pseudomonas 균주가 13예(34%)로 가장 많았다. 4) 혈액배양은 16예에서 양성을 보였고, 균주빈도는 그람음성간균이 7예(43%), 그람양성구균은 9예(57%), 이중 가장 흔히 동정된 균주는 Staphylococcus aureus 6예(38%)으며, 그 다음 흔한 균주는 Pseudomonas specise 3예(19%)의 순이었다. 5) 항생제 감수성 검사에서 Pseudomonas species는 amikacin(56%), ciprofloxacin(91%), aztreonam(85%), ceftazidime(50%)에 50% 이상의 감수성을 보였고, piperacillin(60%), gentamicin(73%), carbenicillin(79%)에는 60% 이상의 내성을 보였다. Klebsiella species는 chloramphenicol(74%), gentamicin(75%), cefotetan(78%)에 70% 이상의 감수성을 보였고, carbenicillin(73%), ampicillin(81%)에는 70% 이상의 저항성을 보였다. Staphylococcus의 감수성 검사에서는 methicillin에 64%의 감수성을 보였고, Streptococcus pneumoniae의 경우 oxacillin에 94%의 감수성을 보였다. 6) 세균성 폐렴의 치료결과 154명(81%)이 치유되었고 사망 및 가사상태로 퇴원한 경우는 36명(19%)이었으며, 병원획득폐렴 환자의 사망율은 25예(75%)로 높았다. 결론: 항생제의 개발과 더불어 폐렴의 임상상의 변화, 원인균주의 변화 및 새로운 내성균의 출현등을 고려할 때 무분별한 항생제 투여를 지향하고 세균배양 및 감수성검사를 바탕으로 한 적절한 항생제의 투여가 절실히 요구된다.

• Tuberculosis and Respiratory Diseases
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• 제76권2호
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• pp.66-74
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• 2014

Background: The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality. Methods: A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality. Results: A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167). Conclusion: HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.

• Pediatric Infection and Vaccine
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• 제6권1호
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• pp.131-135
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• 1999

신생아 시기에 호흡기 바이러스 감염은 증상이 다양하게 나타나 진단하기가 힘든 면이 있으나 본 증례와 같이 뚜렷한 호흡기 증상이 있는 경우 적극적인 진단과 치료가 필요하다고 사료되며 고위험군 환자에게 RSV 유행 시기에 앞서 예방이 중요하다고 생각한다.

• 한국동물위생학회지
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• 제30권3호
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• pp.305-312
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• 2007

The present studies was to seroepidemiological investigation with the related pneumonia due to a combination of both viral and bacterial agents. In selected herd in Jeonbuk-Iksan area of swine farms in 2006. The seroprevalence of antibody titers of PRRS, PCV-2 and mycoplasmal pneumonia were 87.2%, 69.8% and 47.4%, respectively. High seroprevalence of antibody in sow indicate that the infected sow major source of the diseases, and play an important role in circulation between production stage.