• Title/Summary/Keyword: acute respiratory infection

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Utility of Serum Procalcitonin for Diagnosis of Sepsis and Evaluation of Severity (혈청 프로칼시토닌(serum procalcitonin) 측정을 통한 패혈증 진단 및 중등도 평가의 유용성)

  • Park, Tae-Jin;Lim, Chae-Man;Koh, Youn-Suck;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.51-57
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    • 2011
  • Background: Early recognition and treatment of sepsis would improve patients' outcome. But it is difficult to distinguish between sepsis and non-infectious conditions in the acute phase of clinical deterioration. We studied serum level of procalcitonin (PCT) as a method to diagnose and to evaluate sepsis. Methods: Between 1 March 2009 and 30 September 2009, 178 patients had their serum PCT tested during their clinical deterioration in the medical intensive care unit. These laboratories were evaluated, on a retrospective basis. We classified their clinical status as non-infection, local infection, sepsis, severe sepsis, and septic shock. Then, we compared their clinical status with level of PCT. Results: The number of clinical status is as follows: 18 non-infection, 33 local infection, 39 sepsis, 26 severe sepsis, and 62 septic shock patients. PCT level of non-septic group (non-infection and local infection) and septic group (sepsis, severe sepsis, septic shock) was $0.36{\pm}0.57$ ng/mL and $18.09{\pm}36.53$ ng/mL (p<0.001), respectively. Area under the curve for diagnosis of sepsis using cut-off value of PCT >0.5 ng/mL was 0.841 (p<0.001). Level of PCT as clinical status was statistically different between severe sepsis and septic shock ($^*severe$ sepsis; $4.53{\pm}6.15$ ng/mL, $^*septic$ shock $34.26{\pm}47.10$ ng/mL, $^*p$ <0.001). Conclusion: Level of PCT at clinical deterioration showed diagnostic power for septic condition. The level of PCT was statistically different between severe sepsis and septic shock.

Epidemiological Characterization of Adenovirus and Human Bocavirus Detected Acute Respiratory Patients in Busan (부산지역 호흡기감염증 환자로부터 분리한 아데노바이러스와 보카바이러스의 유행양상 분석)

  • Hwang, Su-Jeong;Kim, Nam-Ho;Park, Dong-Ju;Ku, Pyung-Tae;Lee, Mi-Ok;Jin, Sung-Hyun
    • Journal of Life Science
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    • v.27 no.3
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    • pp.275-282
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    • 2017
  • Adenovirus (ADV) and human bocavirus (hBoV) cause acute respiratory tract infections, and are often associated with increased rates of hospitalization and death, particularly in infants and young children. The aim of this study was to analyze the clinical features and molecular phylogeny of ADV and hBoV isolated in Busan, from January 2011 to November 2013. In total, 3,230 specimens (throat swabs) were collected from patients with influenza-like illnesses and acute respiratory tract infections. Multiplex real-time RT-PCR was performed to detect eight respiratory viru [rhinovirus, adenovirus, respiratory syncytial virus, human coronavirus, human metapneumovirus, human bocavirus, parainfluenza virus and influenza virus] and detected 1,485(46.0%) cases. Among 1,485 positive specimens, 257(8.0%) cases were ADV and 68(2.1%) cases of hBoV. A significant clinical feature of ADV is fever and headache whereas hBoV is wheezing. Serotypic distributions of isolated ADV and hBoV were analyzed by sequencing of hexon and VP1/VP2 gene, respectively. ADV was identified seven different serotypes(1~6, 8), revealing a high similarity among the isolates (>97%). The predominant types of ADV were type 1 in 2011, type 3 and 4 in 2012, type 3 in 2013, respectively. ADV type 3 was major causative type during outbreaks in 2013. All of the hBoV was identified as hBoV type 1.

Clinical and laboratory profiles of hospitalized children with acute respiratory virus infection

  • Choi, Eunjin;Ha, Kee-Soo;Song, Dae Jin;Lee, Jung Hwa;Lee, Kwang Chul
    • Clinical and Experimental Pediatrics
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    • v.61 no.6
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    • pp.180-186
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    • 2018
  • Purpose: Despite the availability of molecular methods, identification of the causative virus in children with acute respiratory infections (ARIs) has proven difficult as the same viruses are often detected in asymptomatic children. Methods: Multiplex reverse transcription polymerase chain reaction assays were performed to detect 15 common respiratory viruses in children under 15 years of age who were hospitalized with ARI between January 2013 and December 2015. Viral epidemiology and clinical profiles of single virus infections were evaluated. Results: Of 3,505 patients, viruses were identified in 2,424 (69.1%), with the assay revealing a single virus in 1,747 cases (49.8%). While major pathogens in single virus-positive cases differed according to age, human rhinovirus (hRV) was common in patients of all ages. Respiratory syncytial virus (RSV), influenza virus (IF), and human metapneumovirus (hMPV) were found to be seasonal pathogens, appearing from fall through winter and spring, whereas hRV and adenovirus (AdV) were detected in every season. Patients with ARIs caused by RSV and hRV were frequently afebrile and more commonly had wheezing compared with patients with other viral ARIs. Neutrophil-dominant inflammation was observed in ARIs caused by IF, AdV, and hRV, whereas lymphocyte-dominant inflammation was observed with RSV A, parainfluenza virus, and hMPV. Monocytosis was common with RSV and AdV, whereas eosinophilia was observed with hRV. Conclusion: In combination with viral identification, recognition of virus-specific clinical and laboratory patterns will expand our understanding of the epidemiology of viral ARIs and help us to establish more efficient therapeutic and preventive strategies.

A Retrospective Review of the Preventive Effect of Sambok-go on Upper Respiratory Tract infection (삼복고의 상기도감염 예방 효과에 대한 후향적 관찰연구)

  • Han, Jong-Min;Yang, Su-Young;Sung, Hyun-Kyung;Lee, Jin-Woo;Oh, Young-Seon;Kang, Weechang;Park, Yang-Chun
    • Journal of Haehwa Medicine
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    • v.21 no.2
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    • pp.139-147
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    • 2013
  • Objectives: The aim of this study was to investigate the preventive effects of Sambok-go for upper respiratory tract infection. Methods: Sambok-go was performed to outpatients which had visited Daejeon university oriental medicine hospital. The number of participants who received Sambok-go at least once were 85, 21 patients did not receive Sambok-go three times were excluded first. Participants who received treatment three times were 64 patients. After the 2011 winter, 2012.05 we follow-up by telephone, except eight, 56 patients were analyzed. Sambok-go is composed of 8 kinds of medicinal herbs. Each Sambok-go weighs about 1.1g and attatchment surface diameter is about 1.5 cm. Sambok-go was attached to both side of 폐유(肺兪)(BL13), 심유(心兪)(BL15), 폐유(膈兪)(BL17), patients under the age of 15 were attached for an hour, patients over 15 years age were attatched for 3 hours. Results: Among the finally analyzed 56 participants, we compared the number of flu outbreak during winter before and after treatment. Before treatment measured $6.14{\pm}6.57$, after treatment measured $1.57{\pm}1.14$. In conclusion, the number of flu outbreak was significantly decreased(p<0.001). To investigate the effect of worsening factors on the pre-existing upper respiratory diseases, we checked whether the patients had pre-existing upper respiratory diseases. The patients who already had old upper respiratory diseases were 34. The increase in the frequency of deterioration in 5 patients, 4 patients no change, decreased in 24 cases, one patient was unresponsive. After evaluating the satisfaction of The patients who were treated with the Sambok-Go, the 29 cases were very satisfied, the 23 were satisfied, None of the paitents showed dissatisfaction or bad dissatisfaction. Conclusion: Sambok-go seems to be effective in the prevention of URI. Further studies are recommended to confirm this effect.

Clinical Manifestation of Human Metapneumovirus Infection in Korean Children (소아에서 human metapneumovirus 감염증의 임상적 고찰)

  • Paek, Hyun;Lee, Yang-Jin;Cho, Hyung-Min;Eu, Eun-Jung;Jung, Gwun;Kim, Eun-Eoung;Kim, Yong-Wook;Kim, Kyoung-Sim;Seo, Jin-Jong;Chung, Yoon-Seok
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.129-137
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    • 2008
  • Purpose : Human metapneumovirus (hMPV) was recently discovered in children with respiratory tract infection. The aim of this study was to determine the frequency and the clinical manifestation of hMPV infection in Korean children. Methods : From January to December, 2005, we collected throat swabs from 1,098 children who were hospitalized for acute respiratory illness at the Department of Pediatrics, Kwang-Ju Christian 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 25 (2.2%) of the 1,098 hospitalized children. The mean age of the hMPV infected children was 2.3 years, and 84% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (60%) and bronchiolitis (20 %). The clinical manifestations included cough, fever, coryza, rale, wheezing and injected throats. Peribronchial infiltration and consolidation were the common chest X-ray findings. Four (16%) of 25 patients with hMPV infection had exacerbation of asthma. Coinfection with other respiratory viruses was found in six children (24%). Conclusion : hMPV is the cause of an important proportion of acute respiratory tract infection in Korean children. Additional studies are required to define the epidemiology and the extent of disease caused by hMPV and to determine future development of this illness in Korean children.

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Acute viral lower respiratory tract infections in children (소아 급성 바이러스 하기도염)

  • Park, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.269-276
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    • 2009
  • Viruses are the most common cause of lower respiratory tract infections (LRTIs) in infants and young children and are a major public health problem in this age group. Viruses were identified in 54.9-70.4% of hospitalized infants and children with LRTIs in Korea. The viral pathogens identified included respiratory syncytial virus (RSV) A and RSV B, influenza (Inf) A, Inf B, parainfluenza (PIV)1, PIV2, human bocavirus (hBoV), human rhinovirus (hRV), adenovirus (ADV), human metapneumovirus (hMPV), human coronavirus (hCoV)-OC 43, hCoV-229E, hCoV-NL63, hCoV-HKU1, and human enterovirus (hEV). Coinfections with ${\geq}$2 viruses were observed in 11.5-22.8% of children. The occurrence of LRTIs was the highest in the first year of life. The specific viruses are frequently associated with specific clinical syndromes of LRTIs. LRTIs caused by RSV were predominant among younger infants. hRV accounted for a larger proportion of LRTIs in young infants than ADV and hBoV. hMPV was frequently detected in children >24 months old. The number of hMPV infections peaked between February and May, whereas hRV was detected throughout the year. Thus far, hCoV is a less common respiratory pathogen in cases of ALRI and URI in Korean children.

Post-Coronavirus Disease 2019 Pulmonary Fibrosis: Wait or Needs Intervention

  • Yoon, Hee-Young;Uh, Soo-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.320-331
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    • 2022
  • Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 450 million confirmed cases and 6 million deaths. Although the acute phase of COVID-19 management has been established, there is still a long way to go to evaluate the long-term clinical course or manage complications due to the relatively short outbreak of the virus. Pulmonary fibrosis is one of the most common respiratory complications associated with COVID-19. Scarring throughout the lungs after viral or bacterial pulmonary infection have been commonly observed, but the prevalence of post-COVID-19 pulmonary fibrosis is rapidly increasing. However, there is limited information available about post-COVID-19 pulmonary fibrosis, and there is also a lack of consensus on what condition should be defined as post-COVID-19 pulmonary fibrosis. During a relatively short follow-up period of approximately 1 year, lesions considered related to pulmonary fibrosis often showed gradual improvement; therefore, it is questionable at what time point fibrosis should be evaluated. In this review, we investigated the epidemiology, risk factors, pathogenesis, and management of post-COVID-19 pulmonary fibrosis.

Surgical Treatment of the Funnel Chest by Sternoturnover method (우두흉(漏斗胸)의 외과적(外科的) 치료(治療) (Sterno-turnover 방법(方法)에 의(依)한))

  • Choi, Soon Ho
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.143-147
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    • 1976
  • A case of congenital funnel chest which was observed in 6 year old male was reported. The patient represented clinical status of depression of lower sternum, recurrent upper respiratory tract infection, and slight exertional dyspnea. The treatment was carried out by "turnover" method, and it was easy to do viable on sternum, costal cartilage, and intercostal muscles. And it is fit to reimplantation by free autograft when repair was indicated. The plane of the manubrium, an acute hump on the sternum, and asymmetry constitute limiting factors in the cosmetic results.

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A Case of Miller Fisher Syndrome (Miller Fisher 증후군 1례에 대한 임상적 고찰)

  • 정은정;최동준;고창남;조기호;김영석;배형섭;이경섭
    • The Journal of Korean Medicine
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    • v.20 no.4
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    • pp.98-105
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    • 2000
  • Miller Fisher syndrome is characterized by acute external ophthalmoplegia, ataxia and areflexia in the abscence of significant motor or sensory deficit in the limbs and usually results in a complete recovery. Most cases have anteceding events like upper respiratory infection or other viral infections. Its accurate anatomic lesion sites and pathogenesis is still unknown. Recently we experienced a 47 year-old man who had a sudden onset of complete total ophthalmoplegia, ataxia, diplopia and whose condition was improved through Oriental medical treatment.

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An Impaired Inflammatory and Innate Immune Response in COVID-19

  • Park, Sung Ho
    • Molecules and Cells
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    • v.44 no.6
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    • pp.384-391
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    • 2021
  • The recent appearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of people around the world and caused a global pandemic of coronavirus disease 2019 (COVID-19). It has been suggested that uncontrolled, exaggerated inflammation contributes to the adverse outcomes of COVID-19. In this review, we summarize our current understanding of the innate immune response elicited by SARS-CoV-2 infection and the hyperinflammation that contributes to disease severity and death. We also discuss the immunological determinants behind COVID-19 severity and propose a rationale for the underlying mechanisms.