• Clinical and Experimental Pediatrics
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• v.64 no.11
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• pp.543-551
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• 2021

The human microbiome, which consists of a collective cluster of commensal, symbiotic, and pathogenic microorganisms living in the human body, plays a key role in host health and immunity. The human nasal cavity harbors commensal bacteria that suppress the colonization of opportunistic pathogens. However, dysbiosis of the nasal microbial community is associated with many diseases, such as acute respiratory infections including otitis media, sinusitis and bronchitis and allergic respiratory diseases including asthma. The nasopharyngeal acquisition of pneumococcus, which exists as a pathobiont in the nasal cavity, is the initial step in virtually all pneumococcal diseases. Although the factors influencing nasal colonization and elimination are not fully understood, the adhesion of opportunistic pathogens to nasopharyngeal mucosa receptors and the eliciting of immune responses in the host are implicated in addition to bacterial microbiota properties and colonization resistance dynamics. Probiotics or synbiotic interventions may show promising and effective roles in the adjunctive treatment of dysbiosis; however, more studies are needed to characterize how these interventions can be applied in clinical practice in the future.

• Journal of the Korean Society of School Health
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• v.14 no.1
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• pp.131-143
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• 2001

The primary aim of this dissertation is to contribute to the improvement of methods in physical examination by providing quality information for the current school system and advice for improving status. Present status, controversial points and possible remedies in physical examination were analyzed on a frequency and percentage basis. An $x^2$-test was used to verify the statistics between the results from the examination and each variable. In case of multiple categories of variables, an $x^2$ cs was adopted. Chronological data as well as both total and sampling physical examination data verified the statistics using an $x^2$-test. This thesis is based both on the data from middle school health care specialists in Gyunggi Province and on the analysis of physical examinations reported from local schools to the municipal education agency from 1997 to 1999. The results of the study are as follows: First, according to the survey, only 29.0% of the total schools had their school doctors examine all the students while most of the educational institutions failed to implement the whole process of physical examination on the list. It also turned out that the more students the schools have, the lower the rate of implementation of physical examination by school doctors(p=0.014). Second, the average time a school doctor spends for checkup turned out to be approximately 1.7 minutes per student This means that the quality of the physical examination is not guaranteed in the process. Third, 47.7% of those surveryed say that a dental examination was performed, each taking 21.24 seconds on average. In addition, it shows that some 31.5% wanted to have a task force team for dental checkups at the local health center. Given the fact that dental caries among students is progressively on the rise, the dental health centers that are now set up in some elementary schools should be expanded to cover the whole educational institution in order to raise awareness of the importance of dental care. Fourth, 48.5% of those surveyed say that a comprehensive physical examination should be adopted to promote the health of high schoolers. Since it takes a lot of public funds to implement a comprehensive method, it is essential to make sure that in-depth studies should be based on the frequency and methods of physical examination. Fifth, regarding such diseases among 3rd year middle school students in 1999, statistics shows that there was a slight difference in the prevalence rate of color blindness, and allergic diseases for male students ; and color blindness, hearing disturbance and allergic disease for female students. For those items, however, it is too little to say that there is a significant difference and accordingly it is assumed to be a problem of the measuring process. Sixth, the result of analysis on the sample physical examination and the total physical examination of the year 1999 shows as follows: For male students in the 3rd year of middle school, a slight difference appeared to those students in 11 items including eye problems and eye disease, otitis media, tonsillar hypertrophy, spinal shape, respiratory urinary allergic disease and other abnormal diseases(p<0.05). Particularly, the prevalence rate between students with and without disease was shown to be two times more in the following: eye problems, otitis media, tonsill hypertrophy, allergic diseases, etc. For female students in the 3rd year, prevalence rate showed little difference in 14 items(p<0.05). For items including eye problem, otitis media, tonsill hypertrophy, allergic disease, etc. it was shown that the rate was two times more between students with and without diseases. Physical examinations under the current school system are not producing any fundamental results for the health of the students. Methods and results are not trustworthy. Accordingly, a drastic overhaul of the current practices is needed in frequency, methods and items on the list in order to promote the health of the students. Cost-benefit studies as well as political considerations to ensure the development of efficient methods for physical examination are urgently needed at this moment.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.106-112
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• 2015

Purpose: The long-term administration of antibiotics interferes with bacterial culture in the middle ear fluids (MEFs) of young children with otitis media with effusion (OME). The purpose of this study is to determine whether molecular diagnostics can be used for rapid and direct detection of the bacterial pathogen in culture-negative MEFs. Methods: The specificity and sensitivity of both polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) to the lytA gene of Streptococcus pneumoniae were comparatively tested and then applied for pneumococcal detection in the clinical MEFs. Results: The detection limit of the PCR assay was approximately $10^4$ colony forming units (CFU), whereas that of LAMP was less than 10 CFU for the detection of S. pneumoniae. Both PCR and LAMP did not amplify nucleic acid at over $10^6$ CFU of H. influenzae or M. catarrhalis, both of which were irrelevant bacterial species. Of 22 culture-negative MEFs from children with OME, LAMP positivity was found in twelve MEFs (54.5%, 12/22), only three of which were PCR-positive (25%, 3/12). Our results showed that the ability of LAMP to detect pneumococcal DNA is over four times higher than that of PCR (P<0.01). Conclusions: As a high-resolution tool able to detect nucleic acid levels equivalent to <10 CFU of S. pneumoniae in MEFs without any cross-reaction with other pathogens, lytA -specific LAMP may be applied for diagnosing pneumococcus infection in OME as well as evaluating the impact of a pneumococcal conjugate vaccine against OME.

• The Journal of Pediatrics of Korean Medicine
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• v.12 no.1
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• pp.111-131
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• 1998

1. In oriental medicine, the case of sinusitis can be explained, not only external invasion such as PUNG HAN(wind-cold), PUNG YUL(wind-hot), SHUP YUL(damp-heat), but also functional disorder of internal organ such as spleen(脾), lung(肺), kidney(腎) The western medicine classified the cause of sinusitis as two factors. That is bacterial infection factor-Haemophilus influenza, streptococcus pyogeues, streptococcus pneumonia- and viral infection factor-Rhinovirus, parainfluenza, Echo28, Coxsacki21, Sinusitis is complicated to allergic rhinitis, chronic otitis media purulent, chronic tonsilitis, sinubronchitis. On the condition of nasal septum deformity, turbinates deformity, nasal septum deviation, sinusitis can be developed. the predisposing factors of sinusitis is swimming, air pollution, malnutrition, shortage of immunity.2. According to survey, sinusitis occurred that children from 4 to 12 years old and from 5 to 7 years old occupied 70% 3. From the past history data, they experienced chronic tonsillar hypertropy(20%), otitis media, atopic dermatitis, allergic rhinitis, bronchial asthma, pneumonia, bronchiolitis, chronic sore throat, urticaria, milk allergy in sequence. 4. the symptoms of sinusitis is nasal obstruction, postnasal dripping, purulunt(yellow)or white discharge, cough, nose bleeding in sequence. nasal obstruction take the portion of 95%, postnasal dripping 65%, night time or early morning cough 60%. 5. The suffering period of sinusitis is 6 month minimum, 4 years maximum, most cases are included in a year. The suffering period of children was shorter than adult. 6. Diagnosis depend on inspection of nasal cavity, postnasal dripping, X-ray finding. 75% of patient(15case) showed both maxillary sinusitis, 25%(5cases) showed left or right maxillary sinusitis. 7. Treatment of oriental medicine, consist of Herb-medicine, acupuncture and exposing of Lazer beam. Kamihyunggyeyungyotang(加味荊芥蓮翹湯) is administered mainly as the medical therapy, Kamigwaghyangjeungkisan(加味藿香正氣散) Kimizwakwieum(加味左歸飮), Kamihyangsosan(加味香蘇散) is administered for a additional symptoms which occurred by influenza recurrence. Kamijeonxibackchulsan(加味錢氏白朮散) is administered to treat gastro-intestine trouble patients who have sinusitis. 8. The period of treatment is varied with patient conditions and X-ray finding. The minimal period is 35days, maximal period is 202days. So it took about 86days in average and about 50% of patient(10cases) is recovered in one or two month.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.49-52
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• 2016

X-linked agammaglobulinemia (XLA) is a hereditary humoral immunodeficiency that results from Bruton's tyrosine kinase (BTK ) gene mutations. These mutations cause defects in B-cell development, resulting in the virtual absence of these lymphocytes from the peripheral circulation. Consequently, this absence leads to a profound deficiency of lg all isotypes, and an increased susceptibility to encapsulated bacterial infections. A 15-month-old Korean boy presented with recurrent sinusitis and otitis media after 6 months of age, and had a family history of 2 maternal uncles with XLA. Laboratory tests revealed a profound deficiency of Ig isotypes, and a decreased count of $CD19^+$ B cells in the peripheral circulation. Based on his family history and our laboratory test results, he was diagnosed with XLA. We performed BTK gene analysis of peripheral blood samples obtained from family members to confirm the diagnosis. Mutational analysis revealed a novel hemizygous frameshift mutation (c.82delC, p.Arg28Alafs*5), in the BTK gene. His mother and maternal grandmother were heterozygous carriers of this mutation and his two maternal uncles were hemizygous at the same position. After XLA diagnosis, intravenous immunoglobulin (400 mg/kg, monthly) treatment was initiated; recurrent sinusitis and otitis media were subsequently brought under control. To our knowledge, this is the first reported case of a Korean pedigree with a novel mutation in the BTK gene.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.8.3-8
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• 1978

In normal auditory systems, the difference between the bone conduction thresholds obtained with the test ear opened and occluded in low frequency signals below 1, 000Hz is about 10~25 dB. But no difference in these thresholds suggests the presence of a lesion in the conductive mechanism. Sullivan added the differences in these thresholds at 250Hz, 500Hz and 1,000Hz and called "Occlusion Index". In oder to study the audiological significance, we have measured the occlusion index in 40 ears of normal persons, 20 ears of chronic otitis media patients and 20 ears of sensori-neural hearing impairment patients. We also measured the static compliance in 40 normal ears and observed the correlation with the occlusion index. The results are as follows: 1. Occlusion index was 33. $10\pm10.63dB$ in normal group, $3.10\pm3.03dB$ in chronic otitis media; group, $28.10\pm15.17dB$ in sensori-neural group. 2. Static compliance in normal group was $0.61\pm0.31cc$ (0.22~1.75cc) 3. Occlusion index showed inverse proportion to static compliance.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.19.2-19
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• 1983

A Clinical and bacteriologcal observation was performed 128 cases of chronic otitis media who had taken middle ear surgery at Dept. of otolaryngology of St. Benedict Hospital during the period of Feb. 1981 to Feb. 1983. The following results were obtained. 1) Among total 128 cases, male were 60 cases (46.9%) and female were 68 cases (53.1 %) and age distribution showed 48 cases (37.5 %) in 3rd decade, 37 cases (28.9 %) in 2nd decade and 27 cases (21.1 %) in 4th decade. 2) Site distribution were 71 cases (55.5%) in right, 57 cases (44.5 %) in left. 3) Degree of preoperative hearing loss were 64 cases (50%) in moderate, 32 cases (25% ) in mild, 27 cases (21.1 %) in severe and 5 cases (3.9%) were normal. 4) Central perforation were observed in 65 cases (50.8 %), total perforation in 44 cases (34.4 %), attic perforation in 12 cases (9.4 %) and marginal perforation in 7 cases (5.4 %). 5) Pathologic changes of middle ear and mastoid antrum showed granulation in 81 cases (63.3 %), cholesteatoma in 47 cases (36.7%). 6) The route of approach were 123 cases (96.1%) in postauricular, 3 cases (2.3%) in transmeatal and 2 cases (1.6 %) in endaural. 7) Type of operation were 53 cases (41.4 %) in intact canal wall tympanoplasty with mastoidectomy, 42 cases (32.8 %) in tympanoplasty without mastoidectomy, 23 cases (18%) in modified radical mastoidectomy and 10 cases (7.8%) in radical mastoidectomy. 8) Type of anesthesia were 95 cases (74.2 %) by local anesthesia, 33 cases (25.8 %) were by general anesthesia. 9) Among 93 specimens of culture, proteus (31.2%), staphylococcus (28.7%), pseudomonas (23.7 %), streptococcus (7.5 %) and etc. (8.7%) in order of frequency.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.87-94
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• 2017

Purpose: The inappropriate prescription of antibiotics in children with upper respiratory tract infection (URTI) is common. This study evaluated the factors that influence antibiotics use in hospitalized children with viral URTI confirmed by reverse transcriptase-polymerase chain reaction (RTPCR) assay. Methods: The medical records of admitted patients who performed RT-PCR assay for respiratory virus pathogens from January 2013 to November 2014 were examined. The demographic and clinical features were compared between patients who were administered antibiotics at admission and those who were not. We also investigated differences between children who continued antibiotics and those who stopped antibiotics after a viral pathogen was identified. Results: In the total 393 inpatients, the median age was 23 months (interquartile range, 13 to 41.3 months). Antimicrobial agents were prescribed in 79 patients (20.1%) at admission. Patients with acute otitis media (AOM) had higher rates of antibiotics prescription than those without AOM (48.1% vs. 2.2%, P<0.001), with an adjusted odds ratio of 91.1 (95% confidence interval, 30.5 to 271.7). Level of high-sensitivity C-reactive protein and the proportion of acute rhinosinusitis were also significantly associated with antibiotics use (P<0.001). Among the 44 patients with viruses identified using the RT-PCR method during hospitalization, antibiotic use was continued in 28 patients (63.6%). AOM was statistically associated with continued antibiotic use in the patients (P=0.002). Conclusions: Although the respiratory virus responsible for URTI etiology is identified, clinicians might not discontinue antibiotics if AOM is accompanying. Therefore, careful diagnosis and management of AOM could be a strategy to reduce unjustified antibiotic prescriptions for children with URTI.

• Herbal Formula Science
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• v.16 no.1
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• pp.79-94
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• 2008

Although inflammatory mediators such as nitric oxide(NO) and pro-inflammatory cytokines are involved in host defense mechanism, these overproduction contributes to the pathogenesis of several diseases such as otitis media, hearing loss, periodontitis, bacterial sepsis, rheumatoid arthritis, chronic inflammation and autoimmune diseases. We investigate the anti-inflammatory effects of water extract from Ji-Pae-San(JPSWE) fomulated with Angelica dahurica plus Fritillaria Verticillata, Angelica dahurica(ADWE), and Fritillaria Verticillata(FUVE) in vitro and in vivo. Each extract inhibited the production of inflammatory mediators(NO, $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, and prostaglandin $E_2$) and the expression of inducible NO synthase(iNOS) and cyclooxygenase-2(COX-2) in lipopolysaccharide(LPS)-stimulated RAW 264.7 macrophages in a dose-dependent manner. These inhibitory effects were synergistically increased by their combination. JPSWE also inhibited $TNF-{\alpha}$, $IL-1{\beta}$, IL-6. and $PGE_2$ production as well as COX activity in LPS-stimulated mice. Moreover, JPSWE significantly suppressed death by LPS-septic shock in mice(survival rate: 100%). These results suggest that Ji-Pae-San may be useful for therapeutic drugs against inflammatory immune diseases, probably by suppressing the production of inflammatory mediators.

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.103-108
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• 2015

Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.