• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.339-346
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• 2018

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and $^{18}F$-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT. Methods: Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study. Results: Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ${\geq}65$, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT. Conclusion: These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.

• The Journal of Pediatrics of Korean Medicine
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• v.23 no.3
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• pp.109-119
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• 2009

Objectives The purpose of this study is to collect the statistics of pediatric problems and to develop more effective oriental medical treatments for pediatric diseases, their clinical applicability, and chief complaints on pediatric inpatients in oriental hospitals. Methods The study was composed of seventy inpatients that were age from 0 to 20, had received hospital treatment at the pediatrics in Dongguk Bun-Dang Oriental Medicine Hospital for seven years from 1 January 2002 to 31 December 2008. The chief complaints were mainly categorized by oral examination on their patients. Results 1. In this study, male children were thirty one and female children were 39. Thus, sex ration of male to female was 0.79:1. 2. In age distribution, one month to one year were three (4.3%), 1 to six years were forty two (60%), six to ten years were fifteen (21.4%), and ten to twenty years were ten (14.3%). 3. In November, the number of inpatients was the highest (15.7%) in a year. However, there were no significant seasonal differences. 4. In the systemic division, the respiratory diseases : 44(62.9%), the digestive diseases : 11(15.7%), the infectious diseases : 5(7.1%), the musculoskeletal diseases : 3(4.3%), the diseases of nervous system : 3(4.3%), the gynecologic diseases : 1(1.4%), the liver and biliary disorders : 1(1.4%), and etc. : 3(4.3%). 5. The chief complaint of the inpatients is pneumonia, a common cold, respiratory complex symptoms, rhinitis, sinusitis, bronchitis, tonsillitis, diarrhea and etc. Conclusions The two main causes of inpatients were respiratory diseases and digestive disease. More data of inpatients are required for further study. Thus, the new diseases and treatment methods should be studied as a field of oriental medical treatment.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.114-120
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• 2014

Purpose: The objective of this study was to assess and investigate the epidemiology of pertussis in infants under 6 months of age. Methods: A prospective study was conducted between October 1, 2011 and April 30, 2013 in CHA Bundang Medical Center, Seongnam, South Korea. Polymerase chain reaction (PCR) or culture was used to detect Bordetella pertussis in nasopharyngeal aspirates from case patients who were hospitalized for acute lower respiratory tract infection (LRTI). In addition, multiplex real-time PCR assays were also performed to detect 6 etiologic viruses, including adenovirus, human metapeumo-virus, influenza virus, parainfluenza virus, respiratory syncytial virus and rhinovirus. Results: Of the 79 enrolled case patients, whose median age was 2 months of age, the most common diagnoses uncovered in this study were acute bronchiolitis (60%) and pneumonia (28%). B. pertussis infection was found in 13 cases (16%), in which 7 (53%) was coinfected with respiratory syncytial virus and 1 (7%) with influenza A virus. Of the 13 patients with B. pertussis infection, 6 (46%) were not vaccinated with the diphtheria, tetanus toxoid, and acellular pertussis vaccine, while 6 (46%) received 1 dose, and 1 (8%) received 2 doses. Conclusion: B. pertussis infection was present in 16% of under 6 month-old infants, who were hospitalized for acute LRTI. Therefore, a nationwide epidemiological surveillance of pertussis, including institutions that cater to infants under 6 months of age is necessary and needed.

• Pediatric Infection and Vaccine
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• v.20 no.1
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• pp.28-35
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• 2013

Purpose : The aim of this study was to determine the frequency, epidemiology and the clinical manifestation of human metapneumovirus (hMPV) infection in Korean children. Methods : From February 2010 to January 2012, we collected nasopharyngeal aspiration from 1,554 children who were hospitalized for acute lower respiratory tract infections at the Department of Pediatrics, Severance Children's Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. Results : We detected hMPV in 99 of the 1,554 hospitalized children. The mean age of the hMPV infected children was 25 months, and 87% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (73%) and bronchiolitis (16%). The clinical manifestations included cough, fever, respiratory distress, hoarseness, tachypnea, and wheezing. Coinfection with other respiratory viruses was found in 43 children (43%). Conclusion : hMPV is one of the major virus causing acute respiratory tract infection in the age between 13 months and 48 months old with peaks during April to June. Reports of hMPV in Korea has been increasing but additional studies are required to define the epidemiology and the extent of disease caused by hMPV to determine future development of this illness in Korean children.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.1-10
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• 2020

A cluster of severe pneumonia of unknown etiology in Wuhan City, Hubei province in China emerged in December 2019. A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was isolated from lower respiratory tract sample as the causative agent. The current outbreak of infections with SARS-CoV-2 is termed coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). COVID-19 rapidly spread into at least 114 countries and killed more than 4,000 people by March 11, 2020. WHO officially declared COVID-19 a pandemic on March 11, 2020. There have been 2 novel coronavirus outbreaks in the past 2 decades. The outbreak of severe acute respiratory syndrome (SARS) in 2002-2003 caused by SARS-CoV had a case fatality rate of around 10% (8,098 confirmed cases and 774 deaths), while Middle East respiratory syndrome (MERS) caused by MERS-CoV killed 858 people out of a total 2,499 confirmed cases between 2012 and 2019. The purpose of this review is to summarize known-to-date information about SARS-CoV-2, transmission of SARS-CoV-2, and clinical features of COVID-19.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.7-15
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• 2017

Purpose: Influenza vaccination coverage in adolescents is an important goal of informed vaccination policies and programs. This study aimed to estimate the influenza vaccination coverage rate and investigate the factors influencing influenza vaccination coverage in Korean adolescents. Methods: The study population consisted of 5,213 adolescents (aged 12 to 18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2007 to 2014 (except for 2013). We analyzed influenza vaccination coverage in relation to the demographics, lifestyle, and medical characteristics of the participants. Results: The influenza vaccination coverage rate, during the study period, was 23.2% (range, 21.1% to 24.7%). Logistic regression analysis revealed that factors influencing influenza vaccination were elementary school age (odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526 to 1.906), good self-rated health status (OR, 1.192; 95% CI, 1.057 to 1.344), a drinking status of non-drinker (OR, 1.769; 95% CI, 1.474 to 2.122), a smoking status of non-smoker (OR, 1.459; 95% CI, 1.144 to 1.860), and a past diagnosis of pneumonia (OR, 1.469; 95% CI, 1.076 to 2.006). Conclusions: Influenza vaccination coverage in Korean adolescents is relatively low. Special efforts are needed to increase vaccination coverage for adolescent groups with low vaccination rates including adolescent smokers and drinkers, middle and high school age adolescents, and adolescents with a poor self-rated health status.

• Journal of Chest Surgery
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• v.26 no.6
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• pp.475-482
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• 1993

90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

• Journal of Life Science
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• v.25 no.12
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• pp.1399-1407
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• 2015

Klebsiella pneumoniae is found in the normal flora of the skin, mouth, respiratory tract, urinary tract, and intestines in human. However, the stain is opportunistic pathogen, which is the causative agent of community acquired pneumonia. Corn silk has been known to be effective for antimicrobial activity against pathogenic bacteria, including K. pneumoniae, Staphylococcus aureus, Bacillus subtilis, Shigella spp., Salmonella spp., Escherichia coli, Pseudomonas aeruginosa, et al. In this study we focused on the antimicrobial properties of con silk water extract of K. penumoniae. K. pneumoniae isolates K. pneumoniae ATCC 13883 and broad-spectrum β-lactamase (BSBL), exteded-spectrum β-lactamase (ESBL), carbapenemase-producers. Antimicrobial susceptibilities were determined by the disk diffusion method. Searches for bla genes were performed by PCR amplication and direct sequencing. MacConkey agar plate medium was prepared using the corn silk extracts (50% or 100%) instead of distilled water for antimicrobial activity test. The microbial growth inhibitory potential of K. pneumoniae was determined by using the MacConkey agar plate spreading method, and the plate was incubated 18 hr at 37℃. Genes encoding β-lactamases including SHV-1 (n=8), SHV-2a (n=8), SHV-5 (n=2), SHV-11 (n=2), SHV-12 (n=18), TEM-1 (n=10), CTX-M-3 (n=2), CTX-M-14 (n=2), CTX-M-15 (n=1), GES-5 (n=5), KPC-2 (n=6), KPC-3 (n=4), and NDM-1 (n=2) were detected. The corn silk extract showed significantly antimicrobial activity against K. pneumoniae ATCC 13883, but BSBLs, ESBLs, and carbapenemase producers were not. Therefore, corn silk extract is thought to be able to assist in the prevention and rapid recovery of infectious disease caused by K. pneumoniae.

• The Korea Journal of Herbology
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• v.31 no.5
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• pp.93-98
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• 2016

Objectives : Hwangheuk-san is a complex prescription composed of oriental traditional medicine and has been reported for antioxidant, antimicrobial and anticancer effects in the recent study. Methicillin-resistant Staphylococcus aureus (MRSA) is one of important causes of fatal infectious diseases such as septicemia, endocarditis, toxic shock syndrome, pneumonia, skin and soft tissue infections (SSTIs). S. aureus is reported as being for a variety of human diseases and its epidemiological relevance is mainly due to their ability of becoming highly resistant to common antimicrobials such as tetracycline, penicillin, cphalosporin and aminoglycoside. The objective of this study is to determine the antimicrobial effect of Hwangheuk-san ethanol extracts (HHS) and synergistic effects with antibiotics oxacillin against MRSA.Methods : The antimicrobial activity of HHS was measured by the disc diffusion method, broth microdilution method and the checkerboard dilution test, time-kill curve assay was performed to investigate synergistic effects with antibiotics oxacillin against MRSA.Results : HHS showed antimicrobial activity against MRSA with a MIC value of 125 ㎍/㎖. In the checkerboard test, the interaction of HHS with antibiotics oxacillin produced almost synergy or partial synergy against MRSA. This study showed that HHS reduced the MICs of oxacillin tested, and a remarkable antibacterial effect of HHS, with membrane permeability enhancers.Conclusions : These results suggest that HHS has the antimicrobial effect and synergistic effects with antibiotics oxacillin against MRSA. This study thus can be a valuable source for the development of a new drug with low MRSA resistance.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.603-608
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• 2002

Purpose : Pertussis is a highly communicable infectious disease in children with high mortality, especially in young infants. The incidence of pertussis in South Korea has decreased to about 10 cases a year in late '90s. Doubting previously reported incidences of pertussis, we designed this study to establish exact epidemiology and a diagnostic basis of pertussis. Methods : From Mar. 2000 to Mar. 2001, polymerase chain reaction(PCR) and cultures of nasopharyngeal aspirates were taken from 49 patients who were clinically suspected of pertussis in Kangdong Sacred Heart Hospital. Results : Among 49 patients suspected of pertussis, 10 cases showed positive results by PCR method. Four out of those 10 cases were positive in culture. The peak outbreak was noticed in the spring(Mar.-May) and the autumn(Sep.-Nov.). The mean age of the patients was 3.6 months. Eight of the 10 cases which were PCR positive results proved not to be immunized against pertussis. Conclusion : Most of the pertussis patients in our study were diagnosed as bronchiolitis, pneumonia or bronchitis at the beginning of the disease and only a few patients showed typical clinical manifestations of pertussis, including whooping. When the above results are taken together, we suggest the possibility that the actual prevalence of pertussis in South Korea might be higher than that of previous reports. The importance of pertussis screen tests should be emphasized in children with severe coughs.