• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1368-1372
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• 2002

Purpose : Group A streptococci have a cell wall which consists of M protein and T protein. T protein is known to be helpful in the understanding of the epidemiology of group A streptococci. To study the epidemiologic characteristics, we serotyped T protein of group A streptococci obtained from patients admitted to hospitals, or who visited OPD in five districts of Seoul the during last three years. Methods : Group A streptococci were obtained in five districts in north, northeast, central, northwest and south Seoul from 1998 through 2000. All isolated group A streptococci were serotyped with T protein antisera(Institute of Sera and Vaccine, Prague, Czech Republic). Results : In 1998, analysis of obtained total number of 92 strains revealed that T12, T4, and NT acounted for 72.2%. Among seven cases of scarlet fever, T12 was isolated in four cases and T4 was found in three cases. Two cases of tonsilar abscess produced T8 and NT. One case of cervical lymphadenitis showed T12. In 1999, 41 cases were studied showing that T12, T4, and T1 contributed 68%. Among five cases of scarlet fever, T12 and T4 make up three case. There were two cases of pneumonia(T4 and T1) and one case of cervical lymphadenitis(T8/25). In 2000, the study was performed in four districts except the central area. Among 83 isolates, T12, T4 and T1 accounted for 63.9%. There were three cases of scarlet fever(T12, T4, T5), one case of tonsillar abscess(T12), one case of pneumonia(NT) and one case of sepsis(T1). Conclusion : Serological analysis of T protein of group A streptococci shows no endemic specificity. The yearly pattern reveals that T12 had been decreasing but T1 had shown the opposite trend.

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.113-119
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• 2011

The aims of this study were to survey, evaluate the accuracy of personal immunization record of vaccination card, and to establish the applicability of personal immunization record for presuming population based immunization rate and evaluation method. In 2005, a population-based survey of 12-35 months old children was carried out in Nonsan, Korea. We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children. Total 11 vaccinations were checked in vaccination card such as BCG, hepatitis b, polio, chickenpox vaccine. For estimating accuracy of immunization status and dates of immunization, we estimated correspondence rate between data from personal vaccination card and data from medical records and immunization registry data. Accuracy of the child's vaccination card by type of National Immunization Program vaccine in whole medical institutions were from 41.8% to 83.2%. Accuracy for the date of vaccination of vaccination card in National Immunization Programme vaccine were from 55.3% to 89.7%. In spite of this study limitations, this study verified the validity of vaccination record of vaccination card substantially, but suggests more efforts to reassure the validity of vaccination card.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.341-350
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• 2007

Background: We present here the early and midterm surgical results for infective endocarditis and we especially focus on the effect of aggressive reconstruction or root implantation after wide debridement. Material and Method: Between January 1995 and Jun 2006, we enrolled 79 adult infective endocarditis patients who underwent surgical treatment. There were 63 and 16 native and prosthetic valve endocarditis cases, respectively. They included 27 cases of culture negative endocarditis. With performing valve replacement or repair, 28 of the patient underwent a more aggressive surgical option, for example, aortic root replacement or reconstruction, or heart base reconstruction etc. Result: There were statistical relationships between the in-hospital mortality and staphylococcal infection, urgent-based operation and operation during the active phase of endocarditis. Wide debridement and aggressive reconstruction were not related to either the post operative mortality or the early morbidity. Culture negative endocarditis was not related to the postoperative mortality and morbidity. Conclusion: Physicians must pay attention to patients' medical treatment during the preoperative period of the infective endocarditis. If surgery is considered for treating infective endocarditis, it should be performed before the downhill course of the disease so that the surgical outcome is improved. Wide debridement and more aggressive reconstruction are also warranted.

• Pediatric Infection and Vaccine
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• v.19 no.1
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• pp.19-27
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• 2012

Purpose : As the number of children who attend child care centers has increased, concerns has increased about the effect of child day care on childhood illness. This study was conducted to examine the relationship between experience in child care and common infectious diseases in children under 5 years of age. Methods : Data were collected by surveying 1,000 respondents with children under age 5 through online interviews using a structured questionnaire. The contents of the survey were composed of demographic characteristics, child care facilities usage, experience in infectious diseases, and immunization status Results : Among the 1,000 children <5 years of age, 78.5% attended a child care facility. Rates of common communicable illnesses were higher in children in child care than for children reared exclusively at home. The predominant communicable diseases which the respondents' children experienced, in order of decreasing frequency, were gastroenteritis (47.1%), otitis media (41.8%) and pneumonia (19.1%). The immunization rate of vaccines that are not included the national immunization program (NIP) (Haemophilus influenzae type b vaccine - 76.6%, hepatitis A vaccine - 63.3%, pneumococcal vaccine - 59.4%, rotavirus vaccine - 43.1%) was lower than that of the NIP vaccines (90.4%) Conclusion : Children in child care experience more bouts of common infectious disease, so nationwide policies to prevent or to control the spread of infectious agents in a child-care should be available and appropriate immunization should be emphasized as the most effective method for the control of infectious disease for children.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.87-94
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• 1986

Empyema thoracis following pneumonia, intra-abdominal pathology, trauma, and surgical procedure continues to be a source of major morbidity and mortality. Thirty seven adult and eleven pediatric patients with empyema thoracis were treated at the University of Yeungnam Medical Center from May 1983 to November 1986. Age distribution ranged from 6 months to 72 years and showed a double-peaked curve with the highest incidence between 36 and 65 years and below 15 years of age. There were male predominence in patients above 16 years of age. The most common predisposing factors was impaired consciousness due to either alcoholism or head injury. The causes of empyema were as follows: pneumonia 64.6%, lung abscess 6.4%, intraabdominal pathology 6.4%, and surgical procedure 6.4%. The cardinal symptoms were fever, cough, chest pain, dyspnea, sputum, weight loss, anorexia, and night sweat in orders. Culture of empyema fluid were positive in 50% of patients. The isolated organisms were Gram-negative bacilli 33.3%, staphylococcus aureus 25%, and streptococcus 25%. The patients received antibiotics in conjunction with various invasive procedures : chest tube drainage 77.1%, decortication 6.3%, and repeated thoracentesis 10.3%. There were 4 deaths, 1 child and 3 adults, with a overall mortality of 8.3%.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.7.1-7
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• 1979

This paper was attempted to analyze 31 cases of fiberoptic bronchoscopy during the period of 8 months from October 1978 till February 1979 in the Chung-Ang University Hospital. The results were as follows; 1) Among 31 cases. 20 cases were male, 11 cases female. Sex ratio was 2 : 1. 2) In age distribution, 22 cases (70.1%) were in 4th-7th decade, and the other age groups showed relatively even distribution. 3) The chief complaints were hemoptysis (11 cases, 35.5%), coughing (9 cases, 29.0%), chest pain (6 cases, 19.4%), dyspnea (3 cases, 9.7%) and others (2cases, 6.5%). 4) In Gram staining of bronchial secretion, Gram (-) diplococci were in 12 cases (38.7%), Gram (+) cocci 10 cases (32.3%), Gram (+) rods 6 cases (19.4%)and Gram (-) rods 3 cases (9.7%). In culture of bronchial secretion, no growth were in 17 cases (54.8%). Neisseria group 6 cases (19.4%), Proteus and Klebsiella group 1 case (3.2%) and mixed group 3 cases (9.7%). In histopathological study, 11 cases (35.5%) revealed chronic bronchitis, 9 cases (29.0%) bronchogenic carcinoma, 3 cases (9.7%) chronic granulomatous disease and 2 cases (6.5%) no specific findings. In 6 cases biopsy specimens were too small to be examined histopathologically. 5) In diagnosis by bronchoscopic appearance and by laboratory examination of bronchoscopically removed specimens, 9 cases(29.0%) were primary carcinoma of bronchus, 6 cases (19.4%) chronic bronchitis, 4 cases (12.9%) pneumonia in the order of freguency

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.33-39
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• 2007

Purpose : In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004. Methods : Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea. Results : One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels ($10.4{\pm}1.6g/dL$) and increased leukocyte counts ($16,234.3{\pm}10,601.8/{\mu}L$). Pleural fluid obtained from patients showed high leukocyte counts ($30,365.8{\pm}64,073.0/{\mu}L$), high protein levels ($522.3{\pm}1582.3g/dL$), and low glucose levels ($88.1{\pm}523.5mg/dL$). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was $28.6{\pm}15.3days$. Conclusion : We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.

• Tuberculosis and Respiratory Diseases
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• v.59 no.2
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• pp.151-156
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• 2005

Background : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in hospital-acquired infection, and is prevalent in intensive care units (ICU). The MRSA colonization rates of the nares and throat were examined in both the ICU and general ward. This study was performed to investigate the MRSA rate and necessity for MRSA screening cultures in patients admitted to ICU. Methods : Between June and September 2004, those patients admitted to both the medical ICU and general ward participated in this study. Bacterial cultures were performed on swabs of the nares and throat taken within 24 hours of admission. Clinical data were also collected. Results : One hundred and twenty one patients and 84 patients, admitted to the medical ICU and medical general ward, respectively, were investigated. The numbers of nasal MRSA colonization in the ICU and general ward were 3 (2.5%) and 3 (3.6%), respectively. There were 2 (1.7%) cases of throat MRSA colonization in the ICU, but none in the general ward. The MRSA colonization rates of the nares and throat were no different between the ICU and general ward. There were no significant differences in the previous admission, operation history and admission route between the ICU and general ward groups. Conclusion : The MRSA colonization rates of the nares and throat were 3.3 and 3.6% in the ICU and the general ward, respectively. The MRSA screening test does not appear to be required in all patients admitted to the ICU, but further studies, including high-risk patients, are recommended.