• Journal of Veterinary Clinics
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• v.39 no.1
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• pp.38-43
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• 2022

A 5-month-old Holstein downer calf was presented, and bovine viral diarrhea virus was detected in the feces and the cerebrospinal fluid. Combined treatment of recombinant bovine somatotropin (rBST) administration and standing rehabilitation had been performed for two months, and the calf could maintain the standing position for a while. However, the symptoms were not improved, and the calf died due to ruminal tympany and aspiration pneumonia. Megaesophagus, abomasal ulcer, and a normal-sized but softened cerebellum were observed in clinical necropsy. Improvement of symptoms was confirmed by rBST, but was not reached the complete recovery of gait and standing position.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.89-94
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• 2012

Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

• Journal of radiological science and technology
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• v.43 no.5
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• pp.397-404
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• 2020

Coronavirus disease(COVID-19) is highly infectious disease that directly affects the lungs. To observe the clinical findings from these lungs, the Chest Radiography(CXR) can be used in a fast manner. However, the diagnostic performance via CXR needs to be improved, since the identifying these findings are highly time-consuming and prone to human error. Therefore, Artificial Intelligence(AI) based tool may be useful to aid the diagnosis of COVID-19 via CXR. In this study, we explored various Deep learning(DL) approach to classify COVID-19, other viral pneumonia and normal. For the original dataset and lung-segmented dataset, the pre-trained AlexNet, SqueezeNet, ResNet18, DenseNet201 were transfer-trained and validated for 3 class - COVID-19, viral pneumonia, normal. In the results, AlexNet showed the highest mean accuracy of 99.15±2.69% and fastest training time of 1.61±0.56 min among 4 pre-trained neural networks. In this study, we demonstrated the performance of 4 pre-trained neural networks in COVID-19 diagnosis with CXR images. Further, we plotted the class activation map(CAM) of each network and demonstrated that the lung-segmentation pre-processing improve the performance of COVID-19 classifier with CXR images by excluding background features.

• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.397-404
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• 2011

Background: To evaluate chest CT findings of pandemic influenza A/H1N1 pneumonia without co-infection. Methods: Among 56 patients diagnosed with pandemic influenza A/H1N1 pneumonia, chest CT was obtained in 22 between October 2009 and Februrary 2010. Since two patients were co-infected with bacteria, the other twenty were evaluated. Predominant parenchymal patterns were categorized into consolidation, ground glass opacity (GGO), and mixed patterns. Distribution of parenchymal abnormalities was assessed. Results: Median age was 46.5 years. The CURB-65 score, which is the scoring system for severity of community acquired pneumonia, had a median of 1. Median duration of symptoms was 3 days. All had abnormal chest x-ray findings. The median number of days after the hospital visit that Chest CT was performed was 1. The reasons for chest CT performance were radiographic findings unusual for pneumonia (n=13) and unexplained dyspnea (n=7). GGO was the most predominant pattern on CT (n=13, 65.0%). Parenchymal abnormalities were observed in both lungs in 13 cases and were more extensive in the lower lung zone than the upper. Central and peripheral distributions were identified in ten and nine cases, respectively. One showed diffuse distribution. Peribronchial wall thickening was found in 16 cases. Centrilobular branching nodules (n=7), interlobular septal thickening (n=4), atelectasis (n=1), pleural effusion (n=5), enlarged hilar and mediastinal lymph nodes (n=6 and n=7) were also noted. Conclusion: Patchy and bilateral GGO along bronchi with predominant involvement of lower lungs are the most common chest CT findings of pandemic influenza A/H1N1 pneumonia.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.490-497
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• 2011

Background: It is difficult but important to differentiate between bacterial and viral infections, especially for respiratory infections. Hence, there is an ongoing need for sensitive and specific markers of bacterial infections. We investigated novel biomarkers for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infections. Methods: This was a prospective, observational study of patients with community acquired bacterial pneumonia, 2009 H1N1 Influenza A infection, and healthy controls. Serum samples were obtained on the initial visit to the hospital and stored at $-80^{\circ}C$. We evaluated CRP (C-reactive protein), PCT (procalcitonin), LBP (lipopolysaccharide-binding protein) and copeptin. These analytes were all evaluated retrospectively except CRP. Receiver operating characteristic curve (ROC) analyses were performed on the resulting data. Results: Enrolled patients included 27 with community acquired bacterial pneumonia, 20 with 2009 H1N1 Influenza A infection, and 26 who were healthy controls. In an ROC analysis for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection, areas under the curve (AUCs) were 0.799 for CRP (95% Confidence interval [CI], 0.664~0.934), 0.753 for PCT (95% CI, 0.613~0.892) and 0.684 for LBP (95% CI, 0.531~0.837). Copeptin was not different among the three groups. Conclusion: These findings suggest that serum CRP, PCT and LBP can assist physicians in discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection.

• Tuberculosis and Respiratory Diseases
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• v.68 no.3
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• pp.162-167
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• 2010

Background: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the development of major complications (MC). Methods: We reviewed the medical records of 41 cases of pneumonia admitted to a university-affiliated tertiary hospital between Aug 26 and Dec 10, 2009, and who had confirmed H1N1 influenza A based on real-time reverse transcriptase-polymerase-chain-reaction assay. There were 7,962 patients that fit these criteria. We compared the clinical features and demographic characteristics of patients who developed MC to with those who did not develop MC. Results: During the study period, 10 patients developed MC (required admission to the intensive care unit, n=10; required ventilator therapy, n=6; death, n=4). Patients with MC were significantly older than those without MC and more frequently had underlying medical conditions (90.0% vs 41.9%, p-value <0.01). In the patients with developed MC, the median $PaO_2/FiO_2$ ratio of 230.0 (145.0~347.3) at admission and pneumonia severity index (PSI) score of 141.5 (88.3~158.5) were higher than patients without MC. However, no differences were observed in laboratory findings or in viral shedding between the 2 groups. Conclusion: In hospitalized pneumonia patients of 2009 H1N1 influenza, old age, a history of malignancy, initial hypoxemia, $PaO_2/FiO_2$ ratio, and PSI score appear to be risk factor significantly related to developing MC. These findings might be the basis to influence strategies for admitting patients to an intensive or intermediate care unit and for pre-emptive antiviral therapy.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.145-153
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• 1996

The incidence of Adenovirus(AV) pneumonia in children is estimated at 8%. Long-term complications reported with type 7 include hyperleucent lung syndrome, bronchiolitis obliterans and may require several months to recover. We reviewed 8 case of AV pnemonia confirmed by AV culture and sero-diagnosis among selected 19 AV pneumonia suspicious cases who were admitted to the Sanggye Paik Hospital of Inje University due to clinical pneumonia from May to July 1996. From 19 children, nasal aspirates or trachial aspirates were collected: viral agents were detected by virus isolation and virus antigen was detected by indirect immunofluorescent staining. Serologic diagnosis for type-specific AV antibody was done by neutralisation test. The results are as follows: 1) Age of the patients ranged from 6 months to 47 months with a mean of $24{\pm}9$ months. 6 were male and 2 were female(M:F= 3:1). 2) Monthly distribution showed 4 cases on June, 2 cases on May and July, respectively. 3) The mean duration of admission was 20.4 days and mean duration of fever was 11.3 days 4) Peripheral leukocyte counts were elevated in 4 cases(50%) and findings of shift to left were showed in 4 cases(50%) and serum aminotransferase activities were elevated in 6 case(75%). 5) Radiologic findings include linear and streaky infiltration(1/8 cases), patchy and lobar consolidation (7/8 cases), pleural effusion(2/8 cases) and hyperleucency was seen in 3/8 cases at time of admission and increased to 6/8 cases on hospital discharge. 6) The AV serotypes were type 7, type 3, and type 1. 7) Oxygen supply was done in 4 cases(50%) and all 8 patients include 2 cases of type 7 treated with artificial ventilator were survived. In conclusion, the serotypes of AV pneumonia outbreaks in early summer of 1996 were type 7, 3, 1 and, as showed severe clinical course, continued follow up surveillance is necessary to the long term pulmonary complications.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.193-200
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• 2002

Purpose : This study was performed to investigate the epidemiology of viral acute lower respiratory tract infection(ALRI) in two different areas of Korea. Methods : A total of 796 patients hospitalized for ALRI aged 15 years or less from June 2000 to June 2001 in Samsung Seoul hospital(SSH) and Masan Fatima hospital(MFH) were enrolled. Viral etiologies were confirmed using nasopharyngeal aspirates. We compared etiologic agents, age distribution, clinical manifestations, and seasonal occurrence of viral ALRI between the two hospitals. Results : Virus was isolated in 208 patients(26.1%). The proportion of patients aged under 2 years in SSH was 60.2%, while those in MFH was 90.0%(P<0.05). Respiratory syncytial virus(RSV) was more prevalent in MFH, but adenovirus, influenza virus and parainfluenza virus were more prevalent in SSH(P<0.05). Croup and bronchiolitis occurred more frequently in MFH than in SSH(P<0.05). The most frequent viral pathogens causing bronchiolitis and croup were RSV and parainfluenza virus, respectively, in both hospitals. Adenovirus was the main cause of pneumonia in SSH, in contrast to RSV in MFH. In terms of tracheobronchitis, adenovirus was detected most frequently in SSH, whereas influenza virus-type A was mainly isolated in MFH. Similar pattern of seasonal occurrences of RSV, parainfluenza virus and influenza virus-type A was noted in both hospitals. Adenovirus was isolated sporadically throughout the study periods. Conclusion : Seasonal occurrence and clinical syndromes according to viral pathogens showed similar pattern in two areas. However, distribution of offending viruses was different, although this is mainly related to the different age distribution. An annual nationwide surveillance is necessary to understand the viral epidemiology associated with respiratory illnesses in Korea.

• Korean Journal of Veterinary Research
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• v.36 no.2
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• pp.405-415
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• 1996

This study was carried out to investigate the distribution of inclusion bodies in the tissues as well as to observe the general histopathological lesions of dogs infected with canine distemper. And also, the reliability of diagnostic values of inclusion bodies and the distribution of viral antigen in tissues were inspected by immunohistochemistry with monoclonal antibody. The results obtained were as follows; 1. Pneumonia observed in dogs infected with canine distemper virus was classified into interstitial, broncho-, and broncho-interstitial pneumonia histopathologically. Each occurring ratio was 35, 45 and 20%. 2. Histopathological classification of the canine distemper encephalitis was 20% in acute, 60% in subacute, and 20% in chronic encephalitis, respectively. 3. The organs in which inclusion bodies were predominantly distributed were stomach(82.6%), cerebellum(62.9%), lung(62.1%), cerebrum(50.0%), urinary bladder (46.1%), kidney(36.0%) and pancreas(25.0%). Intracytoplasmic inclusion bodies were mainly observed in the organs except the brain. 4. Canine distemper virus antigens were detected in the numerous tissues as well as in the inclusion bodies observed in the various organs. Antigen detection ratios in the lung, cerebellum and cerebrum were 68.9, 70.4 and 52.2%, respectively. These ratios were somewhat higher than those of inclusion bodies observed in the organs. 5. Canine distemper virus was mainly distributed in astrocytes and ependymal cells in the brain. These results suggested that the histopathologic diagnosis of canine distemper was reliable, and the spread of canine distemper virus in the brain was related with cerebrospinal fluid pathway.

• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.375-380
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• 2010

Lymphoid interstitial pneumonia (LIP) is a rare benign lymphoproliferative interstitial lung disease. LIP has been associated with autoimmune disorders, HIV, viral infections, and so on. Once underlying systemic diseases have been excluded, a diagnosis of idiopathic LIP can be made. Although 6 cases of pathologically confirmed LIP have occurred in Korea, thus far none has been associated with primary Sjogren's syndrome. A 44-year-old man was admitted to hospital due to a dry cough and dypsnea on exertion that had been ongoing for 2 months. A chest radiography showed multiple and variable-sized cystic lesions, on both lungs and both interstitial infiltration and consolidation in both lower lung fields. Tests for autoantibody showed positive results of anti-nuclear antibody and anti-Ro/La antibody. The patient underwent a video assisted thoracoscopic surgery biopsy and pathologically confirmed LIP. We report the first known case of LIP-associated with primary Sjogren's syndrome in Korea.