• Journal of Veterinary Science
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• 제25권1호
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• pp.11.1-11.16
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• 2024

Background: Canine parvoviral enteritis (CPE) is a fatal disease worldwide. The treatment of CPE is based mainly on supportive and symptomatic treatment. Antiviral addition to the treatment may result in a higher survival. Objectives: This study evaluated the effects of antiviral treatments with a standardized treatment (ST) on the clinical and inflammatory response of dogs with naturally occurring CPE. Methods: Twenty-eight dogs with CPE caused by canine parvovirus type 2 were divided randomly into treatment groups. The ST group received fluid, antibiotic, antiemetic, and deworming treatments. The antiviral treatment groups received the same ST with an additional antiviral drug, recombinant feline interferon omega (rFeIFN-ω), oseltamivir (OSEL) or famciclovir (FAM). Results: Compared to the healthy control, the tumor necrosis factor-α, interleukin-1β, interferon (IFN)-α, IFN-γ, haptoglobin, and C-reactive protein values were high (p < 0.05) on day zero. At presentation, mild lymphopenia, neutropenia, and a high neutrophil to lymphocyte (LYM) ratio (NLR) were also observed. Adding rFeIFN-ω to the ST produced the best improvement in the clinical score with a decreased NLR, while leucocytes remained low and inflammatory markers stayed high on day three. The survival rates of the groups were 85.7% in ST+IFN, 71.4% in ST+OSEL, 71.4% in ST+FAM, and 57.1% in ST groups on day seven. Conclusions: Antiviral drugs may be valuable in treating CPE to improve the clinical signs and survival. In addition, the decrease in NLR in favor of LYM may be an indicator of the early prognosis before the improvement of leukocytes, cytokines, and acute phase proteins in CPE.

• Journal of Veterinary Science
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• 제25권4호
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• pp.51.1-51.11
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• 2024

Importance: Feline calicivirus (FCV)-associated viral systemic disease (VSD) is a severe systemic disease caused by virulent FCV strains and has a very poor prognosis. Objective: To evaluate the clinical characteristics of a nosocomial FCV-VSD outbreak involving 18 cats in Korea. Methods: Medical records of cats diagnosed with FCV-VSD from March to September 2018 at a referral veterinary hospital were reviewed. The patient's signalment, history, clinical features, diagnosis, treatment, and prognosis were evaluated. Results: Two outbreaks involving 18 cats diagnosed with FCV-VSD occurred over a 6-month period at a referral hospital in Korea. Anorexia, lethargy, fever, and limb edema were the most commonly observed clinical symptoms. Lymphopenia and macrothrombocytopenia were the most common hematological findings, and hyperbilirubinemia and increased levels of aspartate aminotransferase, creatine kinase, and serum amyloid A were the most frequent results of serum biochemistry. FCV was detected by reverse transcription polymerase chain reaction in 11 patients and the remaining 7 were suspected with FCV-VSD. The overall mortality rate was 72.2%. The hospital was closed and disinfected twice, and no additional outbreaks have occurred since the last patient. Conclusions and Relevance: The clinical and diagnostic characteristics and outcomes of FCV-VSD described in this study can be used to recognize and contain infectious diseases through quick action. To the best of the authors' knowledge, this is the first report of a nosocomial outbreak of FCV-VSD in Asia.

• Journal of Medicine and Life Science
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• 제21권3호
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• pp.121-126
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• 2024

Disseminated tuberculosis (TB), resulting from the hematogenous spread of tubercle bacilli, typically affects immunocompromised individuals, such as those infected with the human immunodeficiency virus. However, risk factors in immunocompetent populations are not well understood. Here, we report a rare case of disseminated TB with CD4+ T-cell depletion in a previously healthy 35-year-old man. The patient presented with a 2-month history of intermittent gross hematuria, dysuria, loose stools, and weight loss. His medical history was unremarkable except for a herpes zoster infection 4 years prior to presentation. Laboratory tests revealed microscopic hematuria and pyuria; however, the urine culture was negative. Urine specimens tested positive for TB-polymerase chain reaction. Abdominal computed tomography revealed a focal filling defect in the left kidney, segmental wall thickening of the terminal ileum, and multiple enlarged lymph nodes with central necrosis. Chest computed tomography revealed active pulmonary TB. Colonoscopy confirmed intestinal TB in the terminal ileum and ileocecal valve, with positive TB-polymerase chain reaction results from sputum and ileal ulcer tissue. The patient was diagnosed with disseminated TB and was treated with standard anti-TB drugs. Although the human immunodeficiency virus test results were negative, the patient's CD4+ T-cell count was significantly low (278/μL). Follow-up tests after 1 month showed negative TB cultures; however, the patient's CD4+ T-cell depletion persisted, with counts remaining low after 1 year. This case highlights the rare occurrence of disseminated TB in immunocompetent individuals with CD4+ T-cell depletion and emphasizes the importance of CD4+ T-cell assessment in healthy patients presenting with disseminated TB.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.253-259
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• 2001

1972년에 Kikuchi씨에 의해 최초로 보고된 아급성 괴사성 림프선염은 30세 전 연령에서 주로 발병하고 여자에서 다소 높게 발생하는 역학적 특성이 있는 질환으로서 발열, 발진, 림프구감소 등의 임상증상이 동반되어 감염성 병원체에 의한 질환일 가능성을 추정하나 원인은 확인되지 않았다. 한편 Kikuchi씨 질환은 임상적으로 불명열에 준하는 장기간의 발열과 림프선 종창을 보이는 소견 이외에 특징적인 증상과 증세가 없고 진단을 위한 면역혈청학적 특이검사가 없어 진단이 매우 어려워 조기에 감염 질환, 자가면역성 질환, 교원성 질환, 림프종양질환과의 감별이 용이하지 않아 이 질환이 의심될 경우 조기에 림프절 생검을 통한 조직병리 소견으로 진단하여 불필요한 검사와 치료를 방지하는 것이 중요하다. 저자들은 기침, 객담, 경부 림프절 종창이 있으면서 발열이 30일 동안이나 지속되어 불명열 환자로 오인되었던 14세 된 남아에서 생검한 경부 림프절 조직에서 전형적인 아급성 괴사성 림프절염 소견을 확인하고, 동시에 동소 교잡법으로 EBV 잠복감염을 확인한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제51권6호
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• pp.655-659
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• 2008

전신 홍반 루푸스는 다양한 증상으로 발현되는 자가면역질환이다. 위장관 증상도 질환의 경과 중에 나타날 수 있으나, 장 가성 폐쇄로 처음 진단되는 경우는 소아에서 매우 드물다. 장 가성 폐쇄는 원발성 또는 속발성으로 장의 평활근이나 신경계에 이상이 있어 해부학적 원인 없이 장폐쇄의 증상과 징후가 나타나는 것이며, 장폐쇄로 인하여 수술을 하였다는 보고도 있다. 그러나 장 가성 폐쇄가 전신 홍반 루푸스에 속발한 경우 장간막 혈관의 폐쇄와 장괴사로 진행하기 전에 조기에 진단하고 치료하면 합병증을 예방하고 수술을 피할 수 있다. 저자들은 장 가성 폐쇄의 증상으로 내원한 13세 여아에서 전신 홍반 루푸스를 진단하여, 불필요한 수술을 피하고 조기에 치료한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제65권4호
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• pp.323-327
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• 2008

전신성 홍반성 낭창은 자가 면역 질환으로 폐와 흉막을 침범하며, 드물게 다양한 형태의 간질성 폐질환을 일으킨다. 식도 이완 불능증은 식도 운동 질환으로 전신성 홍반성 낭창과 동반한 예는 아주 드물다. 전신성 홍반성 낭창에 속발한 식도 이완 불능증의 기전에 대해서는 향후 연구가 필요할 것으로 사료된다. 전신성 홍반성 낭창에서 간질성 폐렴과 식도 이완 불능증을 동반한 환자를 경험하였기에 이를 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제64권10호
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• pp.504-510
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• 2021

Population screening of newborns is an extremely important and informative diagnostic approach that allows early identification of babies who are predisposed to the development of a number of serious diseases. Some of these diseases are known and have effective treatment methods. Neonatal screening enables the early diagnosis and subsequent timely initiation of therapy. This helps to prevent serious complications and reduce the percentage of disability and deaths among newborns and young children. Primary immunodeficiency diseases and primary immunodeficiency syndrome (PIDS) are a heterogeneous group of diseases and conditions based on impaired immune system function associated with developmental defects and characterized by various combinations of recurrent infections, development of autoimmune and lymphoproliferative syndromes (genetic defects in apoptosis, gene mutation Fas receptor or ligand), granulomatous process, and malignant neoplasms. Most of these diseases manifest in infancy and lead to serious illness, disability, and high mortality rates. Until recently, it was impossible to identify children with PIDS before the onset of the first clinical symptoms, which are usually accompanied by complications in the form of severe coinfections of a viral-bacterial-fungal etiology. Modern advances in medical laboratory technology have allowed the identification of children with severe PIDS, manifested by T- and/or B-cell lymphopenia and other disorders of the immune system. This review discusses the main existing strategies and directions used in PIDS screening programs for newborns, including approaches to screening based on excision of T-cell receptors and kappa-recombination excision circles, as well as the potential role and place of next-generation sequencing technology to increase the diagnostic accuracy of these diseases.

• IMMUNE NETWORK
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• 제22권3호
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• pp.22.1-22.25
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• 2022

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2), has spread over the world causing a pandemic which is still ongoing since its emergence in late 2019. A great amount of effort has been devoted to understanding the pathogenesis of COVID-19 with the hope of developing better therapeutic strategies. Transcriptome analysis using technologies such as RNA sequencing became a commonly used approach in study of host immune responses to SARS-CoV-2. Although substantial amount of information can be gathered from transcriptome analysis, different analysis tools used in these studies may lead to conclusions that differ dramatically from each other. Here, we re-analyzed four RNA-sequencing datasets of COVID-19 samples including human bronchoalveolar lavage fluid, nasopharyngeal swabs, lung biopsy and hACE2 transgenic mice using the same standardized method. The results showed that common features of COVID-19 include upregulation of chemokines including CCL2, CXCL1, and CXCL10, inflammatory cytokine IL-1β and alarmin S100A8/S100A9, which are associated with dysregulated innate immunity marked by abundant neutrophil and mast cell accumulation. Downregulation of chemokine receptor genes that are associated with impaired adaptive immunity such as lymphopenia is another common feather of COVID-19 observed. In addition, a few interferon-stimulated genes but no type I IFN genes were identified to be enriched in COVID-19 samples compared to their respective control in these datasets. These features are in line with results from single-cell RNA sequencing studies in the field. Therefore, our re-analysis of the RNA-seq datasets revealed common features of dysregulated immune responses to SARS-CoV-2 and shed light to the pathogenesis of COVID-19.

• Korean Journal of Radiology
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• 제21권11호
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• pp.1265-1272
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• 2020

Objective: We investigated the prevalence of pneumonia in novel coronavirus disease 2019 (COVID-19) patients using chest radiographs to identify the characteristics of those with initially negative chest radiographs, who were positive for pneumonia on follow-up. Materials and Methods: Retrospective cohort data of 236 COVID-19 patients were reviewed. Chest radiography was performed on admission, with serial radiographs obtained until discharge. The 'positive conversion group' was defined as patients whose initial chest radiographs were negative but were positive for pneumonia during follow-up. Patients with initially positive chest radiographs were defined as the 'initial pneumonia group.' Patients with negative initial and follow-up chest radiographs were defined as the 'non-pneumonia group.' Clinical and laboratory findings were compared between groups, and predictors of positive conversion were investigated. Results: Among 236 patients, 108 (45.8%) were in the non-pneumonia group, 69 (29.2%) were in the initial pneumonia group, and 59 (25%) were in the positive conversion group. The patients in the 'initial pneumonia group' and 'positive conversion group' were older, had higher C-reactive protein (CRP) and lactate dehydrogenase levels, and lower absolute lymphocyte counts than those in the 'non-pneumonia group' (all p < 0.001). Among patients with negative initial chest radiographs, age ≥ 45 years (odds ratio [OR]: 3.93, 95% confidence interval [CI]: 1.76-8.75, p = 0.001), absolute lymphocyte count < 1500 cells/μL (OR: 2.25, 95% CI: 1.03-4.89, p = 0.041), and CRP > 0.5 mg/dL (OR: 3.91, 95% CI: 1.54-9.91, p = 0.004) were independent predictors for future development of pneumonia. Conclusion: More than a half of COVID-19 patients initially had normal chest radiographs; however, elderly patients (≥ 45 years of age) with abnormal laboratory findings (elevated CRP and low absolute lymphocyte counts) developed pneumonia on follow-up radiographs.

• Clinical and Experimental Pediatrics
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• 제46권1호
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• pp.33-36
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• 2003

목 적 : 2000-2001년에 대유행한 홍역 환자에서 연령에 따른 임상 증상과 합병증 및 검사실 소견에 대해 비교해 보았다. 방 법 : 홍역으로 입원한 환자 297명 중 24개월 미만 환아 군 159명, 9-11세 군 39명, 내과에 입원한 16세 이상 군 23명을 대상으로 총 발열일, 총 입원일, 백혈구 수와 분획, 간효소 치, CRP, MMR 접종력과 IgM 홍역 항체(anti-measles IgM) 등을 비교하였다. 홍역의 합병증은 입원 기간이 8일 이상인 경우로 정의하였다. 결 과 : 총 발열일과 총 입원일에서는 각 군간의 차이가 없었다. 백혈구 수는 24개월 미만 군에서 유의하게 높았으며 백혈구 분획에서는 24개월 미만 군에서 두 군에 비해 유의하게 낮은 호중구와 높은 림프구의 분획을 보였다. 간 관련 효소로 AST/ALT의 평균값은 16세 이상 군에서 다른 두 군에 비해 유의하게 높았으며, 2배 이상 증가된 증례(70 IU/L 이상) 수에서도 16세 이상 군에서 많았다(15.0% vs 5.3% vs 30.4%). 합병증으로 8일 이상 입원한 환자의 비율에서도 통계학적인 차이가 없었다(7.5% vs 7.7% vs 4.3%). 입원시 실시한 IgM 홍역 항체는 각 군간의 통계학적 차이를 보이지 않았고(83.4% vs 80.6% vs 90.5%), 홍역 백신 접종력에서 2세 미만 군은 9.0%, 9-11세 군에서는 86.4%의 양성율을 보였다. 결 론 : 홍역에서 임상 양상과 합병증은 연령에 따라 큰 차이를 보이지 않았다. 검사실 소견에서 연령에 따른 정상치에 비해 백혈구 감소와 임파구 감소가 관찰되었으며 연장자에서 간효소 치가 상승하는 경우가 더 많았다.