• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.123-127
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• 1996

Purpose : The most patients with acute streptococcal pharyngitis lack of classic clinical manifestations, therefore diagnostic laboratory test such as the throat culture or a rapid antigen detection test are frequently employed in primary practices of developed countries. We'd like to know the accuracy of the throat swab culture as gold standard for diagnosis of streptococcal infection with studying the discordant and concordant rate of duplicate culture. Methods : The study included 89 normal school children (boys:50, girls:39) who were attending Uljin primary school in Uljin, Kyong Sang Buk Do on March 1996. We obtained simultaneous 2 times of throat swab from each subject, and plating and streaking on 5-7% of sheep blood agar separately. We counted the characteristic beta-hemolytic colonies after overnight incubation. Results : 1) The carrier rate of beta-hemolytic streptococci at first culture is 25.1% and second one is 29.2%. 2) Ten out of 89(11.2%) is discordant in duplicate culture. 3) Culture containing less than 50 colonies of beta-hemolytic streptococci (+2) in first culture is 70.4%, second one is 85.7%. 4) Number of colonies is less than 50 in all ten discordant children. Conclusions : The discordant rate of duplicate throat swab cullture for beta-hemolytic streptococci is 11.2%, even if the subjects are normal school children. About 5% of individuals harboring beta-hemolytic streptococci in the pharynx may be missed by a single throat culture. If we are trying to examine the patients with pharyngitis, the discordant rate will be much lower than this results.

• Pediatric Infection and Vaccine
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• v.2 no.2
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• pp.180-185
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• 1995

1. Purpose The accurate diagnosis and proper treatment of group A streptococcus should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. We would like to know the recover rate of beta-hemolytic streptococci by throat swab culture at the in-patient 2. Methods The throat swab cultures and filled up flow-sheets were undertaken on 619 children who had admitted to hospital, KyungHee university hospital from may 1994 to april 1995 prospectively. At the same time on admission, throat culture was performed. 3. Results The highest recover rate of BHS(Beta-Hemolytic Streptococci)and GAS(Group A Streptococci) were seen in above 10 years old, as 9.1% and 1.9%. BHS were obtained in 39 cases(6.3%) among 619 children while GAS was obtained in 3 cases (0.4%). Among 39 specimens of BHS, 33 specimens were classified as non-grouping streptococcus. 4. Conclusion The poor recovery rate of GAS inpatient compared with normal carrier rate is likely due to possible antibiotic abuse, errors in processing samples, and epidemiologic factors such as seasons and geographic areas. It is necessary to evaluate the clinical significance of non-A,B,C,G streptococcal infections and carriers.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.124-134
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• 2005

Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.90-93
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• 2001

Purpose : The accurate diagnosis and proper treatment of group A streptococal infection should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. Inadequate & improperance of antobiotics have resulted in increased number of antibiotic-resistant bacteria. We would like to know the clinical usefulness of rapid strep test compared with conventional throat culture in out-patients with acute pharyngotonsilitis. Methods : From Sep. 2000. to Jan. 2001, rapid strep test(LINK 2 Strep A, USA) & throat culture were taken from 87 patients with clinically suspect pharyngotonsilitis from Masan Fatima hospital & kyunghee university hospital. Results : Of 87 cases with pharyngitis, 39 cases proved to have group A streptococci by throat culture. The positive predictive value of rapid test was 92.3%(36 of 39 cases) and sensitivity test was 81.8%(36 of 44 cases). The specificity of rapid test was 93.0%(40 of 43 cases) and negative predictive value was 83.3%(40 of 48 cases). Conclusion : The positive predictive value & specificity of rapid strep test is high. And so, this test will give the pediatricians practical guidance of antibiotic use in patients with pharyngitis. But more efforts should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.299-308
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• 2007

Hwabyung is an culture-bound anger syndrome in Korea. It consists of as one or more of a wide range of physical symptoms, in response to emotional stress. In this case, a 51-years woman complained neck pain and foreign body sensation in throat. We diagnosed her Hwabyung because her chief complaint occurred from stress in process of traffic accident. We classified her Soeumin in Sasang Constitutional Medicine, and used Hwanggigyeji-tang. And we encouraged her think positive and don't worry about little matters because Soeumin tend to think negative and wony about little matters. After treatment, her condition got improved. This report suggest that treatment method of Sasang Constitutional Medicine such as herb medicine and way of thinking is effective in treatment of Hwabyung patient.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.74-78
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• 2002

Purpose : Proper diagnosis of group A streptococcal pharyngitis that may cause chronic diseases in childhood is not easy because its signs and symptoms would be nonspecific. Because results of classical throat culture delays for one to two days, we'd like to determine whether early antibiotics would be introduced with according to the clinical score system. This study was undertaken to evaluate of clinical usefulness of scoring system based on the clinical and laboratory findings. Methods : From Jan. 1998 to Dec. 2000, 10 clinical items based on modified 9 items by Breese in 1977 were checked in patients with pharyngitis who visited on outpatients clinic of pediatrics, Kyunghee University Hospital. We compared the results of throat culture with the points of clinical score system. Results : Out of 45 cases, the positive culture for Group A Streptococcus was 20 and negative culture was 25. When we applied more than 30 points of score, which correspond to 70 percentile of study population, the sensitivity and specificity were 35.0% and 96.0%, respectively. Conclusion : Although sensitivity was relatively low this scoring system, but the high specificity may be useful diagnostic tool in the areas where the rate of isolation of Group A Streptococcus is low.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.215-220
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• 1998

Purpose : Asymptomatic infections with positive throat culture for group A beta-hemolytic streptococci(GABHS) and high antistreptolysin O(ASO) concentration may lead to sequelae such as rheumatic fever or acute poststreptococcal glomerulonephritis. Children with asymptomatic infections were treated with oral penicillin V to evaluate the effectiveness of penicillin treatment on the asymptomatic infections. Methods : Throat culture and ASO concentration analysis were performed against healthy elementary school children. Thirty-six children with positive throat culture for GABHS and ASO concentrations of 400 IU/mL or more were divided into two groups. Twenty-two children were treated with oral penicillin V for 10 days, and the others were not treated. Eradication rate of GABHS and the change of ASO concentration between the two groups were compared after one month later. Results : Eradication rates of GABHS between treated and untreated children were 91%(20/22) and 50%(7/14) respectively(P<0.05). Children showing elevation of ASO levels more than 100IU/mL were 22%(4/18) in the treated group and 30%(3/10) in the untreated group, while children showing a decrease of more than 200IU/mL in the ASO level were 44%(8/18) and 40%(4/10) respectively. Conclusion : We confirmed the validity of penicillin treatment, because when we treated the asymptomatic children with penicillin V, the GABHS was eradicated effectively. But there was no significant difference of decrease in the ASO levels between the two groups due to long half-life of ASO or poor compliance. Treatment failure was 22% in terms of elevated ASO levels after penicillin treatment.

• Neonatal Medicine
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• v.18 no.2
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• pp.240-247
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• 2011

Purpose: The rationale for skin surface cultures is that bacterial colonization precedes infection and, as a result, that identification of a potential pathogen is predictive of later systemic infection in preterm infants. We aimed to analyze results of surveillance surface cultures in extremely low birth weight (ELBW) infants and seek for effective ways of performing surveillance surface cultures. Methods: We analyzed the surveillance surface cultures of 113 ELBW infants over a 4-year period. Surveillance cultures were obtained routinely from five sites: axilla, external ear canal, nasopharynx, throat (or tracheal aspirate if intubated) and anus. Each surface culture obtained during the 13 days, prior to the date of the blood culture, was compared with the blood culture obtained when sepsis was suspected. The sensitivity, specificity and positive predictive value (PPV) of the surveillance cultures were calculated among 1894 blood-surface culture pairs by surface sites, recovered organisms and interval between surveillance samples and blood cultures. Results: The overall sensitivity, specificity and PPV of surface cultures were 45.9, 22.4 and 6.8%, respectively. The PPV was highest for the throat/tracheal cultures (11.0%) and lowest for the anal cultures (2.3%). As the time of culturing progressed toward the day of blood culturing, the sensitivity and specificity of the surface cultures significantly increased. Only axillary and throat/tracheal cultures were useful in predicting the microorganisms causing sepsis. Conclusion: Surface cultures could help to predict sepsis pathogens and infection surveillance in preterm infants could be continued with a reduced number of cultured sites focusing on the axilla and throat/trachea.

• The Korean Journal of Food And Nutrition
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• v.36 no.5
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• pp.341-353
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• 2023

In this study, we aimed to develop a fermented green rice beverage with a unique flavor and physiological function activity. With glutinous green rice and rice nuruk as independent variables, we modeled the antioxidant characteristics and α-glucosidase, α-amylase inhibitory activity of glutinous green rice fermented beverage to verify its significance. The total flavonoid content and α-glucosidase inhibitory activity were selected as Quadratic models, and DPPH radical scavenging ability and α-amylase inhibitory activity were selected as linear models. For the sensory characteristics of glutinous green rice fermented beverage, sweetness, sourness, savory taste, bitterness, throat feel, nuruk scent, and overall preference increased in preference as the amount of glutinous green rice and rice nuruk increased, but significantly decreased after the center point (p<0.01). A blending ratio of 180.00 g of glutinous green rice and 400.00 g of rice nuruk had the highest preference among all the sensory items. Based on these results, we developed a green rice fermented beverage with unique flavor and physiological function activity of rice using glutinous green rice and rice nuruk, and the optimal blending ratio was determined to be 164.04 g of white rice, 195.96 g of glutinous green rice, and 414.61 g of rice nuruk.

• Korean Journal of Head & Neck Oncology
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• v.26 no.2
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• pp.225-227
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• 2010

Actinomycosis is an unusual granulomatous infection caused by gram-positive anaerobic bacteria called Actinomyces species(predominantly Actinomyces israelii), which is a common and normally nonpathogenic organism found in the nose and throat. The three major clinical presentations of actinomycosis include the cervico-facial(the most common, 55%), thoracic, and abdominopelvic region. Actinomycosis typically has a chronic, indolent course characterized by swelling and induration of the soft tissues and eventual spontaneous drainage through multiple sinus tracts. Actinomycosis is difficult to diagnose because of variable presentation mimicking neoplasm and fastidious nature of the organism in culture. We present a case of actinomycosis in the parotid tip area which was mistaken for a salivary tumor.