• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.3
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• pp.1-16
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• 2024

Objectives : The purpose of this study is to investigate the effectiveness and safety of herbal medicine treatment for acute pharyngitis. Methods : 2 databases(Wangfang Med Online, CNKI) were used to search Randomized Controlled Trials(RCTs) that used herbal medicine treatment for acute pharyngitis, which were published from January 2007 until April 2024. Results : 9 RCTs were selected in this study, and all studies compared herbal medicine alone treatment with western medicine alone treatment. The most frequently used medicine was Toxin-removing medicinal(淸熱解毒藥). Platycodonis Radix(桔梗) was the most frequently used herb. Meta-analysis of nine studies showed that the Total Effective Rate(TER) of treatment group was statistically higher than that of control group(RR:1.12, 95% CI:1.06 to 1.19, p<0.00001, I²=22%). Meta-analysis of 3 studies showed that the total symptom score of treatment group statistically improved than that of control group(MD: -1.00, 95% CI: -1.30 to -0.71, p<0.00001, I²=0%). Mild adverse events such as anorexia were identified in 4 RCTs, but no serious adverse events were reported. Conclusion : Using herbal medicine alone can be more effective and safe in improving acute pharyngitis than using western medicine. But further well-designed studies are needed because heterogeneity between studies existed and the quality of the reports needs to be improved.

• Pediatric Infection and Vaccine
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• v.10 no.2
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• pp.178-185
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• 2003

Purpose : Group A streptococci(GAS) was isolated from the patients with acute pharyngitis. Epidemiological studies using T typing and emm genotyping was performed for GAS and compared with the results of the carriers. Methods : Throat cultures were taken from 246 children(123 boys, 123 girls) from November, 2001 to May, 2002 who visited a pediatrician's office located in Jinju, Gyeongnam province. T types were identified with slide agglutination and emm genotypes were identified with DNA sequencing after amplification of emm genes. Results : One hundred thirty(52.8%) out of 246 children yielded beta-hemolytic streptococci, of which 96.1% were group A. Children from 4 to 7 years old comprised 70.4% of the GAS positive group. T12 were the most common(35.2%) and T non-typeable strains were the next(30.4%). emm12 was most frequent(28.5%), and emm75(18.7%), emm22(13.0%), emm2(12.2%), and emm8(8.1%) were relatively common. Conclusion : Since GAS is so highly prevalent in acute pharyngitis, indeed being half of the population, good clinical practice dictates the systematic employment of throat culture for acute pharyngitis before prescribing antibiotics in a pediatric setting. The distribution of the T antigens and emm genes showed similar pattern between the acute pharyngitis and the carriers.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.375-378
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• 2018

Benign acute childhood myositis (BACM) is a rare transient condition that occurs in children during the early convalescent phase of a viral upper respiratory infection. BACM is self-limiting and characterized by sudden-onset bilateral calf pain that leads to difficulty in walking. We report a case of a 5-year-old boy with BACM who presented with acute-onset bilateral calf pain after a resolved episode of viral pharyngitis and subsequently refused to walk. With conservative treatment, the patient recovered completely after approximately 1 week. Although perplexing and challenging for clinicians unfamiliar with BACM, awareness of this rare clinical condition is essential to preventing unnecessary investigations and reassuring the patient and parents of its excellent prognosis.

• Journal of agricultural medicine and community health
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• v.18 no.2
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• pp.105-119
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• 1993

The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.127-132
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• 2017

Objectives: The aim of this study was to determine the prevalence of asymptomatic carriers of group A ${\beta}-hemolytic$ streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status. Methods: Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin. Results: The carriage of ${\beta}-hemolytic$ streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate. Conclusions: The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.

• 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.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.839-844
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• 2006

Purpose : We studied clinical patterns of the febrile infants and children presenting to the Pediatric Emergency Department(ED) in the general pediatric population. Method : We analyzed 1,764 infants and children who had a history of measured body temperature of $38.3^{\circ}C$ or higher, before or after arrival at Pediatric ED of Ilsan Paik Hospital from September 2004 to August 2005. We analyzed their clinical patterns, such as the frequency of febrile illness, age distribution, monthly distribution, diagnosis. Result : The frequency of the febrile illness at Pediatirc ED was 19.9 percent (1,764/8,881 cases). The percentage of admission into hospital was 26.4 percent. The most common age group presenting to Pediatric ED with febrile illness was the 12-23 months group(22.8 percent) followed by the 4-11 months group and the 2 years group. In May, the most numerous patients presented to the Pediatric ED with febrile illness. The frequency of febrile illness was significant higher in the 'Spring & Summer group' compared to the 'Autumn & Winter group'. The ratio of male to femal was 1.4:1. The most common diagnosis was acute pharyngitis(42.5 percent), followed by acute gastroenteritis (15.3 percent), pneumonia(7.0 percent). Conclusion : The frequency of the febrile illness at Pediatirc ED was 19.9 percent. The most numerous patients visited Pediatric ED in May. And, the most common age group was 12-23 months. The proportion of non-urgent disease, such as acute pharyngitis, acute gastroenteritis, acute nasopharyngitis and acute bronchitis, was high. There is a need to educate parents and improve the medical system in Korea.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.206-212
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• 2001

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefprozil in acute pharyngitis and pharyngotonsilitis caused by Group A beta hemolytic streptococci in pediatric patients. Methods : Any patient of 3 to 14 age who visited the hospitals enrolled in this study with the signs and symptoms of pharyngitis or pharyngotonsilitis since July, 2000 to March, 2001, was taken throat culture and given Cefprozil(15 mg/kg/day, in two divided doses) for 10 days. 138 patients of whom showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Any undesirable effect was reported to determine the safety of the drug. Follow up cultures were done at the end of the study and bacteriologic efficacy was determined. Results : 138 of 256 patients who visited the hospitals with the signs and symptoms of pharyngitis or pharyngotonsilitis showed positive growth on throat culture. Mean age of the patients was $6.1{\pm}2.5$ and males and females were equally numbered. 129 of them complained fever on the first visit and 112(86.6%) of them were improved at the end of the study. Cervical lymphadenitis was seen in 58 patients and 44(75.9%) of them improved at the end of the study. Exudative pharyngitis was seen in 96 patients and 81(84.3%) of them improved. The overall clinical effcacy based on this results showed that 110(79.7%) of the patients were cured and 17(12.3%) of them improved. On the cultures and bacteriologic efficacy, 24.6% of them showed documented eradication after treatment and 62.3% of them showed presumptive eradication. Sensitivity test was done by agar dilution method and Cefprozil showed 100% sensitivity. Erythromycin, Clarithromycin and azithromycin showed 87%, 85.6 %, 90.6% sensitivity, respectively. Conclusion : Cefprozil is proved to be effective in controlling group A streptococcal pharyngitis and pharyngotonsilitis in children and showed good sensitivity. Cefprozil can be used as an effective oral cephalosporin in the patients showing penicillin hypersensitivity or patients who other drugs have failed.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.239-243
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• 2004

Acute poststreptococcal glomerulonephritis(APSGN) is the most common form of postinfectious glomerulonephritis, and acute pyelonephritis(APN) is the most severe form of urinary tract infection in childhood. However, the concurrence of two diseases is uncommon in the literature. We describe a case of APSGN accompanied with APN in a 5-year-old female who presented with fever, left flank pain, headache and facial edema. Urinalysis showed pyuria, microscopic hematuria, and mild proteinulra. Serial urine cultures grew Escherichia coli. ${^99m}$Tc-DMSA renal scan revealed a cortical defect in the upper pole of left kidney. She had a history of preceding pharyngitis, in addition, showed high blood pressure, high anti-streptolysin 0 titer, and low serum complement levels. The patient improved completely with supportive treatment, Including antibiotic and antihypertensive therapy. These findings suggested that APSGN and APN could be manifested simultaneously or be .superimposed on each other.

• 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.