• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.91-96
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• 2007

Purpose : This study was performed to evaluate a new rapid diagnostic kit (BIOLINE $RSV^{TM}$; Standard Diagnostics Inc., Yongin, Korea), a lateral-flow immunoassay, in the detection of respiratory syncytial virus (RSV) from the nasopharyngeal aspirates (NPA) of children with lower respiratory tract infections (LRTIs) in comparison with other diagnostic methods. Methods : Three hundred and nineteen NPAs were selected from a large pool of NPAs that had been obtained from children with LRTIs. All specimens had already been tested for RSV by culture and immunofluorescent (IF) test, and had been kept frozen. Tests with BIOLINE $RSV^{TM}$ were performed at least twice. All who conducted the experiments or interpreted the test results were blinded to the results of both culture and IF tests. Results : One hundred seven (97.3%) of 110 specimens that were positive for RSV by both culture and IF test, 29 (87.9%) of 33 that were positive by IF test only, 20 (76.9%) of 26 that were positive by culture only, and 140 (93.3%) of 150 that were negative by both methods were negative for RSV by BIOLINE $RSV^{TM}$. By combining the above results, the following 5 diagnostic values of BIOLINE $RSV^{TM}$ were determined in comparison with viral culture or IF test; sensitivity, 92.3% (156/169, 95% confidence interval [CI], 87.1-97.5%); specificity, 93.3% (140/150, 95% CI, 88.4-98.2%); positive predictive value, 94.0% (156/166, 95% CI, 89.5-98.5%); negative predictive value, 91.5% (140/143, 95% CI, 86.0-97.0%); and agreement, 95.9% (306/319, 95% CI, 92.1-99.7%), respectively. Conclusion : This study revealed that BIOLINE $RSV^{TM}$ demonstrated good sensitivity and specificity for the detection of RSV antigen from NPAs of children with LRTIs. Because of simple methods and quick results, this test may be useful for the diagnosis of RSV infection during the epidemic periods.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.75-82
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• 2007

Purpose : Human metapneumovirus (hMPV) is a newly identified paramyxovirus that causes a variety of clinical syndromes in children, including upper and lower respiratory tract illnesses. hMPV is considered an ubiquitous virus causing respiratory tract diseases among children especially during late winter and spring seasons. We report clinical features of human metapneumovirus infection in Korean children. Methods : hMPV infection was diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR) in respiratory specimens obtained from patients with acute respiratory tract infections from October, 2004 to May, 2005. Medical records of all hMPV-positive patients were reviewed, retrospectively. Results : A total of 15 hMPV were identified from 443 nasopharyngeal aspirations by RT-PCR (3.4%). The range of age of the patients with hMPV infection was from 1 month to 62 months (median age, 31.5 months), with similar numbers of females (8/15) and males (7/15). Among hMPV-positive children, 53.3% (8/15) were aged less than 24 months. Fever, cough, rhinorrhea, vomiting, diarrhea, tachypnea, and chest wall retractions were common findings. Most common clinical diagnosis was pneumonia (60%). Two of the 15 hMPV-positive patients were also positive for adenovirus. Fever persisted from 0 to 10 days (mean 4.9 days). The duration of hospitalization ranged from 4 to 7 days (mean 5.6 days). Conclusion : hMPV accounted for a small but significant proportion of respiratory tract infection in infants and children. Future development and application of diagnostic tools will determine the burden of disease caused by this newly discovered pathogen.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.207-213
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• 2014

Purpose: This study aimed to investigate the association between respiratory virus infection and pneumococcal colonization in children. Methods: From May 2009 to June 2010, nasopharyngeal (NP) aspirates were obtained from patients under 18 years old who visited Seoul National University Children's Hospital for respiratory symptoms. NP samples were used to detect respiratory viruses (influenza virus A and B, parainfluenza virus 1, 2 and 3, respiratory syncytial virus A and B, adenovirus, rhinovirus A/B, human metapneumovirus, human coronavirus 229E/NL63 and OC43/HKU1) by RT-PCR and pneumococcus by culture. Results: Median age of the patients was 27 months old. A total of 1,367 NP aspirates were tested for respiratory viruses and pneumococcus. Pneumococcus was isolated from 228 (16.7%) of samples and respiratory viruses were detected from 731 (53.5%). Common viruses were rhinovirus (18.4%), respiratory syncytial virus (RSV) A (10.6%), adenovirus (6.9%), influenza virus A (6.8%). Pneumococcal isolation rate was significantly higher in the cases of positive virus detection than negative detection [21.3% (156/731) vs. 11.3% (72/636), P <0.001]. For individual viruses, pneumococcal isolation rate was positively associated with detection of influenza virus A [24.7% (23/93) vs 16.1% (205/1274), P=0.001], RSV A [28.3% (41/145) vs 15.3% (187/1222), P=0.001], RSV B [31.3% (10/32) vs 16.3% (218/1335), P=0.042], rhinovirus A/B [22.6% (57/252) vs 15.3% (171/1115), P=0.010]. Conclusion: The study revealed that pneumococcal isolation from NP aspirates is related with respiratory virus detection. The result of this study could be used to investigate how respiratory viruses and pneumococcus cause clinical diseases.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.81-87
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• 2006

Purose: This study is to evaluate the xerostomia following 3-dimensional conformal radiation therapy (3D CRT) in nasopharynx cancer patients using the xerostomia questionnaire score (XQS). Materials and Methods: Questionnaire study was done on 51 patients with nasopharynx cancer who received 3D CRT from Dec. 2000 to Aug. 2005. 3D CRT technique is based on 'serial shrinking field' concept by 3 times of computed tomography (CT) simulation. Total target dose to the primary tumor was 72 Gy with 1.8 Gy daily fractions. Xerostomia was assessed with 4-questions XQS, and the associations between XQS and time elapsed after RT, age, sex, stage, concurrent chemotherapy, and parotid dose were analyzed. Results: Concurrent chemotherapy was given to 40 patients and RT alone was given to 11 patients. The median time elapsed after 3D CRT was 20 ($1{\sim}58$) months and the mean XQS of all 51 patients was $8.4{\pm}1.9\;(6{\sim}14)$. XQS continuously and significantly decreased over time after 3D CRT ($X^2$=-0.484, p<0.05). There was no significant difference in XQS according to sex, age, and stag. However, XQS of concurrent chemotherapy patients was significantly higher than RT alone patients (P=0.001). XQS of patients receiving total mean parotid dose ${\ge}35 Gy$ was significantly higher than <35 Gy (p=0.05). Decreasing tendency of XQS over time after 3D CRT was observed. Concurrent chemotherapy and total mean parotid dose ${\ge}35 Gy$ were suggested to adversely affect radiation-induced xerostomia.

• Clinical and Experimental Pediatrics
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• v.52 no.6
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• pp.661-666
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• 2009

Purpose : To determine the prevalence and clinical features of codetected respiratory etiological agents for acute respiratory infection in hospitalized children. Methods : Nasopharyngeal aspirates were obtained from hospitalized children with acute respiratory infection at Dankook University Hospital from September 2003 through June 2005. Immunofluorescent staining and culture were used for the detection of respiratory viruses (influenza virus [IFV] types A, B; parainfluenza virus [PIV] types 1, 2, 3; respiratory syncytial virus [RSV]; adenovirus [AdV]). Polymerase chain reaction (PCR) assays were used for Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT) detection, and PCR and culture were performed for enterovirus detection. Acid-fast staining and culture were performed for tuberculosis detection. The demographic and clinical characteristics were reviewed retrospectively from the patients medical records. Results : Evidence of two or more microbes was found in 28 children: RSV was detected in 14, PIV 3 in 10, AdV in 10, MP in 8, PIV 2 in 8, CT in 4, and PIV 1 in 3. Codetected agents were found as follows: RSV＋PIV 2, 6 patients; AdV＋MP, 4 patients; AdV＋PIV, 3 patients; RSV＋MP, 3 patients; PIV 1＋PIV 3, 3 patients. Distinct peaks of codetected agents were found in epidemics of MP and each respiratory virus. Conclusion : The codetected infectious agents were RSV, PIV, AdV, and MP, with distinct peaks found in epidemics of MP and each respiratory virus. Although advances in diagnostic methods have increased the prevalence of codetection, its clinical significance should be interpreted cautiously.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.729-735
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• 2008

Purpose : Chlamydia trachomatis is one of the most common sexually transmitted diseases and is also a cause of pneumonia in infants. Respiratory infections by respiratory viruses are also common for infants. The objectives of this study were to identify the clinical manifestations and to determine the prevalence of C. trachomatis respiratory infections and coinfections by respiratory viruses in infants younger than 6 months of age. Methods : For this study, we enrolled 6 months or younger infants who were admitted to the Dankook University Hospital between January 2002 and July 2007, with respiratory symptoms. Nasopharyngeal aspirates or throat swabs were collected within s d of hospitalization and C. trachomatis was detected using polymerase chain reaction (PCR). Patients who tested positive underwent multiplex PCR for respiratory viruses. Results : A total of 690 patients underwent chlamydial PCR testing and 36 (5.2%) had positive results. Of the 36, 28 (78%) were male; 30 were vaginally delivered. From the 36 patients positive for C. trachomatis, 26 underwent multiplex respiratory viral PCR; 12 were coinfected with viruses. Respiratory syncytial virus (RSV) was the most frequent pathogen that was detected in 6 patients. Increased C-reactive protein and fever were significant in patients coinfected with respiratory viruses. Conclusion : C. trachomatis can infected in infants delivered by cesarean section as well as in 6 months old or younger infants. Infant with C. trachomatis respiratory infections can also be coinfected with respiratory infection also coinfected with respiratory viruses. Further studies are needed to better understand the prevalence rates of the this infection and its coinfection rate with respiratory viruses.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.102-113
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• 2003

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTI) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus (PIV), influenza virus(INF), adenovirus(ADV), etc. Our purpose of this study was to examine the seasonal occurrence, clinical and laboratory features of each viral infections. Methods : Nasopharyngeal aspirates(NPA) were collected from 913 hospitalized children on the first day of admission. They were all admitted to Hangang Sacred Heart hospital and diagnosed as LRTIs. The study period was from September 1998 to August 2002. Specimens were inoculated onto HEp-2 cell, LLC-MK2 cell and MDCK cell. Viruses were detected by immunofluorescent method performed at day 10 postinoculation. Respiratory viruses were detected in 251(27%) cases. Medical records of 208 cases diagnosed as acute LRTIs were all taken reviewed and analyzed. Results : The identified pathogens were RSV 122 cases(58%), PIV 30 cases(14%), INFA 20 cases(10%), INFB 21 cases(11%) and ADV 15 cases(7%) during the study period. Outbreaks of RSV infections occurred every year but mostly on December, 1998 and November, 1999. LRTIs by PIV and ADV occurred during all seasons of the year. INFA was isolated moslty on March, 1999 and January, 2000. INFB infections occurred largely on April, 2002. The clinical diagnoses were bronchiolitis 88 cases(43%), pneumonia 87 cases(42%), croup 19 cases(9%) and tracheobronchitis 14 cases(6%). Common symptoms and signs were cough, rhinorrhea, sputum and fever. WBC counts in peripheral blood showed normal findings in 123 cases(59%). Each viral infections also showed some differences in auscultatory findings and chest X-ray findings. Conclusion : We learned that viruses are one of the major and important etiologic agents of acute LRTIs of children in Korea. However, we still need to find out more about its characteristic clinical features and continue studying on their seasonal occurrence to focus on their management and also prevention.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.401-409
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• 2006

Purpose : Human metapneumovirus(hMPV) is a respiratory viral pathogen that causes a wide spectrum of illnesses, ranging from asymptomatic infection to severe bronchiolitis. The virus has been identified world widely, but so far it has not been published in Korea. Methods : We obtained clinical samples by nasopharyngeal aspiration from 218 children hospitalized due to acute lower respiratory tract infections at Soonchunhyang University Hospital in Cheonan from October, 2004 to April, 2005. We designed specific primers from conserved region of fusion glycoprotein of hMPV. Total RNA was extracted and RT-PCR was performed, and single specific 423 bp product was obtained. The PCR product was confirmed to be fusion glycoprotein RNA by sequencing. Results : We detected hMPV in 15(6.9 percent) of the 218 hospitalized children. The infected children comprised nine boys and six girls; their mean age was 2.8 years(5 mo-12 yrs) and they were diagnosed with pneumonia(60 percent), bronchiolitis(33.3 percent), croup(6.6 percent). The number of cases of detected hMPV in Korea increased dramatically during the period from March to May 2005. Conclusion : hMPV is circulating in Korean children and is associated with respiratory tract infection. Additional studies are required to define the epidemiology and the extent of diseases in the general population caused by hMPV.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.75-88
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• 2005

Ameloblastoma is the most commonly occurring odontogenic tumor in oral cavity. Although most are benign epithelial neoplasm, they are generally considered to be locally aggressive and destructive, exhibiting a high rate of recurrence. The biological behavior of this neoplasm is a slowly growing, locally invasive tumor without metastasis, therefore malignant neoplasm, changed its histological appearance to carcinoma or showed distant metastasis, is only defined clinically. In this study, we identified the differentially expressed genes(DEGs) in stages under benign or malignant ameloblastoma compared with normal patient using ordered differential display(ODD) reverse transcription(RT)-PCR and $GeneFishing^{TM}$ technology. ODD RT-PCR is rather effective when the investigation of samples containing very small amounts of total RNA must be accomplished. ODD RT-PCR used the means of amplification with anchored T-primer and adaptor specific primer. bearing definite two bases at their 3' ends and so this method could display differential 3'-expressed sequence taqs(ESTs) patterns without using full-length cDNAs. Compared with standard differential display, ODD RT-PCR is more simple and have enough sensitivity to search for molecular markers by comparing gene expression profiles, However, this method required much effort and skill to perform. $GeneFishing^{TM}$ modified from DD-PCR is an improved method for detecting differentially expressed genes in two or more related samples. This two step RT-PCR method uses a constant reverse primer(anchor ACP-T) to prime the RT reaction and arbitrary primer pairs(annealing control primers, ACPs) during PCR. Because of high annealing specificity of ACPs than ODD RT-PCR, the application of $GeneFishing^{TM}$ to DEG discovery generates reproducible, authentic, and long(100bp to 2kb) PCR products that are detectable on agarose gels. Consequently, various DEGs observed differential expression levels on agarose gels were isolated from normal, benign, and malignant tissues using these methods. The expression patterns of the some isolated DEGs through ODD RT-PCR and $GeneFishing^{TM}$ were confirmed by Northern blot analysis and RT-PCR. The results showed that these identified DEGs were implicated in ameloblastoma neoplasm processes. Therefore, the identified DEGs will be further studied in order to be applied in candidate selection for marker as an early diagnosis during ameloblastoma neoplasm processes.

• Journal of the Korean Society of Radiology
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• v.6 no.5
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• pp.365-371
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• 2012

The radiation therapy treatment technique is developed from 3D-CRT, IMRT to Tomotherapy. and these three technique was most widely using methods. We find out a comparison normal tissue doses and tumor dose of 3D-CRT, IMRT(Linac Based), and Tomotherapy on Head and Neck Cancer. We achieved radiological image used the Human model phantom (Anthropomorphic Phantom) and it was taken CT simulation (Slice Thickness : 3mm) and GTV was nasopharngeal region and PTV(including set-up margin) was GTV plus 2mm area. and transfer those images to the radiation planning system (3D-CRT - ADAC-Pinnacle3, Tomotherapy - Tomotherapy Hi-Art System). The prescription dose was 7020 cGy and measuring PTV's dose and nomal tissue (parotid gland, oral cavity, spinal cord). The PTV's doses was Tomotherapy, Linac Based - IMRT, 3D-CRT was 6923 cGy, 6901 cGy and 6718 cGy its dose value was meet TCP because its value was up to the 95% based on 7020 cGy, Nomal tissue (parotid gland, oral cavity, spinal cord) was 1966 cGy(Tomotherapy), 2405 cGy(IMRT), 2468 cGy(3D-CRT)[parotid gland], 2991 cGy(Tomotherapy), 3062 cGy(IMRT), 3684 cGy (3D-CRT)[oral cavity], 1768 cGy(Tomotherapy), 2151 cGy(IMRT), 4031 cGy(3D-CRT)[spinal cord] its value did not exceeded NTCP. All the treatment techniques are equated with tumor and nomal tissue doses. The 3D-CRT was worse than other techniques on dose distribution, but it is reasonable in terms of TCP and NTCP baseline Tomotherapy, IMRT -dose distribution was relatively superior- was hard to therapy to claustrophobic patients and patients with respiratory failure. Particularly, in case on Tomotherapy, it take MVCT before treatment so dose measurement will be unnecessary radiation exposure to patients. Conclusion, Tomotherapy was the best treatment technique and 2nd was IMRT, and 3rd 3D-CRT. But applicable differently depending on the the patient's condition even though dose not matter.