• 대한한방소아과학회지
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• 제13권2호
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• pp.149-170
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• 1999

The author measured IL-2, IL-4, IL-6, TNF-${\alpha}$ and total protein(TP) level of middle ear effusion(MEE) of 24 ears - 13 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang - of pediatric recurrent otitis media with effusion(PROME) using ELISA assay, and compared the level of cytokines(pg/ml)/TP(mg/dl). And investigated the clinical finding in those children. The results were obtained as follows: 1. The level of IL-2／TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.05). 2. The level of IL-4/TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.0l). 3. The level of IL-6/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.05). 4. The level of TNF-${\alpha}$/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.01) 5. 79.1% of children with recurrent otitis media with effusion(ROME) were also complicated to chronic sinusitis. The children's t-test was used to make a statistical comparison between the groups. According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by control produce of cytokines which are connected with inflammatory reaction.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.45-51
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• 2008

목 적 : 국내의 소아에서의 폐구균 혈청형의 분포양상 및 변화를 알아보는 것은 중이염의 예방과 치료 계획을 수립하는 데 있어 매우 중요하다. 단일기관에서의 경험을 토대로 중이염에서의 폐구균의 혈청형 분포양상을 알아보고자 하였다. 방 법 : 2001년 1월부터 2006년 12월까지 세브란스병원에서 중이염으로 진단받은 15세 미만의 소아 중 동반된 이루의 배양검사에서 폐구균이 분리된 경우를 대상으로 혈청형과 항생제 감수성을 알아보았다. 결 과 : 모두 54명의 환아로부터 54개의 검체를 얻었으며 이 들의 연령의 중앙값은 13개월이었고 5세 미만의 환아가 차지하는 비율은 81%였다. 혈청형 빈도는 19A(44%), 19F(28%), 6B(7%), 6A(4%), 9V(4%), 1(4%) 등의 순이었다. 전체 혈청형 중 19A와 19F가 차지하는 비율이 72%이었으며, 특히 5세 미만의 소아에서는 84%나 차지하여 5세 이상 소아에서의 20%에 비해 높은 비율을 보였다.(P<0.001) 연도별 19A나 19F이 차지하는 비율은 차이가 없었으며, 7가 단백결합 폐구균백신 도입 이전과 이후 시기 사이에도 차이가 없었다. 전체 폐구균 중 백신혈청형이 차지하는 비율은 43%이었다. 진단 이전 7가 단백결합 폐구균백신을 접종한 3명의 환아에서 동정된 혈청형은 모두 19A였다. 혈청형 별 항생제 비감수성 폐구균의 비율에서 19A는 다른 비백신혈청형에 비해 페니실린, erythromycin, trimethoprim-sulfamethoxazole 등에 비감수성 비율이 더 높았다. 다제 내성률도 다른 비백신혈청형에서 29%인데 반해 19A에서는 96%였다.(P=0.001) 결 론 : 5세 미만의 중이염 환아의 이루에서 분리된 폐구균 중 19A가 가장 흔한 혈청형이었고 매우 높은 다제 내성률을 보였다.

• Clinical and Experimental Pediatrics
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• 제49권3호
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• pp.235-241
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• 2006

Streptococus pneumoniae is an important cause of invasive infections as well as non-invasive infections such as acute otitis media and sinusitis both in children and adults. Resistance of S. pneumoniae to multiple antimicrobials is increasing and poses therapeutic challenges, and prevention became more important. 23-valent polysaccharide vaccine has been used for the last several decades, but is not effective in children <2 years of age, the highest risk group of invasive diseases. Recently, a 7-valent pneumococcal protein conjugate vaccine(PCV) which is effective in infants and young children has been developed. The efficacy of PCVs against invasive pneumococcal disease and pneumonia is well established and is documented in several well-conducted studies. However, the effect of PCVs on otitis media is less obvious and more complex. PCVs clearly reduce diseases caused by vaccine-type(VT) pneumococci, but replacement of VT serotypes by non-VT serotypes in nasopharyngeal carriage of S. pneumoniae is responsible for the increase in acute otitis media caused by non-VT serotypes. Three years after introduction of PCV in the US, some increase of invasive infections with serotype 19A possibly due to serotype switching within certain vaccine type strains has been noted. Since most antibiotic-resistance in S. pneumoniae is confined to VT serotypes, vaccine use also reduces antibiotic resistance. With development of PCV, there was a great advance in the prevention of pneumococcal diseases, but replacement with potential virulent organisms and development of antibiotic resistance in non-VT pneumococci is a possibility that needs careful monitoring.

• Pediatric Infection and Vaccine
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• 제3권1호
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• pp.94-100
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• 1996

Streptococcal pneumoniae is the second most coomon cause of meningitis in infancy and a major respiratory pathogen. It is the one of the most common cause of acquired pneumonia and otitis media in childhood. Intracranial extesion of acute otitis media occur somewhat more often from poorly pneumatized than from well-pneumatized temporal bones and in ears with a history of previous attacks of otitis media. We experienced a case of pneumococcal meningitis with 3 time recurrences in a 6 year-old male patient who had hospitalized with high fever, headache, vomiting and stupor mental state. He was diagnosed as CSF study and brain CT. Brain CT showed poorly pneumatized right mastoid region of temporal bone at that time. We report a case of pneumococcal meningitis with 3 time recurrences due to poorly pnematized mastoid region of temporal bone. A review of literatures was also presented briefly.

• 대한한방소아과학회지
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• 제15권1호
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• pp.131-153
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• 2001

The author measured IgG1, IgG2, IgG3 and IgG4 levels of 22 ears-11 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang-of pediatric recurrent otitis media with effusion using ELISA assay, and compared them. The results were obtained as follows. 1. The level of IgG1 in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P=0.002). 2. The level of IgG2 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.178). 3. The level of IgG3 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.215). 4. The level of IgG4 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.198). According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by controlling the production of immunoglobulins.

• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.13-23
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• 2009

Acute otitis media (AOM) and pneumonia are among the most common infectious diseases of children. Both are mucosal infections and share many common features such as etiological agents, pathogenesis and immunity. Influenza plays an important role in the pathogenesis of AOM and pneumonia. A vaccine against influenza may have substantial impact on these diseases during the influenza season. In clinical trials, influenza vaccine has reduced the incidence of AOM and pneumonia complicating influenza in children. However, the efficacy of vaccines has been controversial in children less than 2 years of age. Similarly, vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), both common causes of AOM and pneumonia, have the potential to reduce the impact of disease. Clinical trials showed that the currently licensed 7-valent pneumococcal conjugate vaccine (PCV), administered during infancy, had an efficacy of 6-7% for the prevention of AOM, however, visits to the clinic for AOM were reduced by up to 20-30% after routine use in the U.S. Both Hib and PCVs have a proven effectiveness of >20% for prevention of radiologically confirmed pneumonia in children. The recently introduced pnuemococcal vaccine conjugated with protein D is expected to reduce AOM and pneumonia caused by non-typable H. influenzae, in addition to its effects on pneumococcal diseases. Considering their high incidence in children, recent achievements in the prevention of AOM and pneumonia with vaccines may have a significant economic and social impact.

• 한국임상수의학회지
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• 제20권3호
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• pp.308-311
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• 2003

Clinical outcomes of dogs treated for end-stage otitis extema with total ear canal ablation (TECA) combining lateral bullar osteotomy (LBO) at Veterinary medical teaching hospital of Seoul National University from 2001 to 2003 were evaluated. In 14 dogs, 23 ears, the operation was successful in alleviating all clinical signs of otitis externa and media. The main complication after TECA combining LBO were facial nerve paralysis and the others were recurrent infection and the formation of fistula and cyst. Two cases were tumors. One was ceruminous gland adenoma and the other was squamous cell carcinoma. The operation successfully resolved the original problems in 100% (23 of 23) of the surgically treated ears of these dogs.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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• pp.3.2-3
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• 1979

만성중이염에서 나타나는 감각신경성난청은 고음역난청이며 이는 중이염의 흔하고 또 중요한 합병증이기도 하다. 자자들은 과거 1년간 경험한 233예의 만성중이염수술례중 187예를 대상으로 수술전 청력소견상 골도치에 대하여 임상소견을 중심으로 통계학적 분석을 하였으며 또한 기니픽의 자연발생한 만성화농성중이염의 병리조직학적소견을 관찰하여 보고하는 바이다. 대상의 평균연령은 24.5재이었다. 1) 일측성만성중이염에서 건측과 환측의 골도치를 이원배치산분석법으로 비교한 결과 건측과 환측간 및 각 주파수간에 유의한 차이가 있었으며 그들 사이에 유의한 상호작용이 인정되었다. 특히 2KHz와 4KHz 사이에서 유의한 차이(P<0.01)가 있었다. 2) 상병기간에 따른 일원배치분산 분석에서는 11∼15연군과 15∼20년군 사이를 제외한 각군간에서 유의한 차이(P<0.05)가 있었다. 3) 등골손상유무에 따른 분석에서 골도치를 t 검정으로 비교한 결과 각 주파수에서 모두 유의한 차이(p<0.01)가 있었으며, 등골손상의 주파수에 대한 영향을 일원배치분산분석법으로 비교한 결과 250Hz와 500Hz 사이 및 2KHz와 4KHz 사이에서 유의한 차이(P<0.05)가 있었다. 4) 정원창폐쇄유무에 따른 골도변화를 t 검정으로 비교한 결과 각 주파수에서 모두 유의한 차이(p<0.01)가 있었다. 정원창폐쇄의 각 주파수에 대한 효과를 일원배치분산분석법으로 비교한 결과 250Hz와 500Hz사이 및 2KHz와 4KHz사이에서 유의한 차이(P<0.01)가 있었다. 5) 진주종유무에 따른 골도변화를 t 검정으로 비교한 결과 진주종성중이염에서는 2KHz와 4KHz에서만 유의한 차이(p<0.01)를 보였으나 수도평균치에서는 유의한 차이를 보이지 않았다. 6) 기니픽의 만성화농성중이염의 측두골 병리조직학적 병변의 검경상 만성염증성병소의 내이, 특히 와우침입로로서의 정원창의 병변이 뚜렷하여 이로 인한 외임파강내의 염증성병변이 뚜렷이 나타나 있으며 와우관의 특히 기저회전에서의 유모세포의 손실이 심한 것으로 보아 중이염으로 인한 골도의 고음역에서의 손실이 발생함을 알 수 있다.

• 한국임상수의학회지
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• 제25권3호
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• pp.192-194
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• 2008

A 15-month-old, intact male, domestic short hair cat was presented with ataxia, protrusion of the right third eyelid, and anorexia. Clinical signs were firstly noted after ear cleaning at home. Symptoms of the Homer's syndrome were evident. However, postural and proprioceptive reaction deficits were not detected on neurologic examination. Otoscopic examination revealed foreign body in right ear canal. A diagnosis of peripheral vestibular syndrome was made based on results of physical examination including neurologic and otic examination, blood work, and magnetic resonance imaging (MRI). Based on these examinations, the present patient was definitely diagnosed as otitis medial interna induced by foreign body. The vestibular signs were resolved 10 days after removal of cotton tips in right ear canal. This case report indicates that home-care cotton swab can iatrogenically induce otitis media/interna in cats.

• 한방안이비인후피부과학회지
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• 제5권1호
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• pp.133-142
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• 1992

We analyzed clinical study in 47 patients, who had visited to the Dept. of Otolaryngology, Hospital of Oriental Medicine, Kyung Hee University to treat Otitis media with effesion from March, 1991 to February, 1992. The clinical etiology of O.M.E. was tubal occlusion, acute otitis, and allergy. The clinical symptoms were hearing loss, tinnitus, sneezing, coughing, Chun-I(纏耳), and BEE-Yeon(鼻淵) in the Oriental Medicine. The results were as follows. 1. There were 26 males ($55\%$) and 21 females ($45\%$) in sex. 2. The peak age at onset was 1-4 years old (11Cases). 3. Bilateral effusion was in $62\%$, and unilateral in $38\%$. 4. The etioloigic factors were upper respiratory infection 16 cases, Allergic rhinitis 13 cases, Sinusitis 8 cases, etc. 5. The most common chief complaint was hearing loss ($30\%$). 6. There was no significant difference between blood types in O.M.E., ( A type $30\%,\;B\;type\;25\%,\;AB\;type\;13\%,\;0\;type\;13\%$, Unknown recorded $9\%$ ). 7. $21\%$ patients prefered warm and the others cold 8. As for digestion, good was in 31 cases ($81\%$), and poor 9 cases ($19\%$). 9. Man-Hyung-Ja-San Extract was most used in treatments as $38\%$, O-Ryung-San $35\%$ in descending order. 10. As for treatment period, 14 cases were treated over 12 weeks, 9 cases below 1 week