• 대한본초학회지
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• 제36권5호
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• pp.37-46
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• 2021

Objective : This study aims to examine the effectiveness and safety of herbal medicines in upper respiratory tract infection by conducting systematic review against amoxicillin. Methods : Relevant randomized controlled trials (RCTs) published by December 2020 were searched in PubMED database. Study selection was conducted according to the PRISMA guideline. The Risk of Bias of the RCTs were evaluated based on the Cochrane criteria. Study selection and bias assessment were conducted independently by two researchers, and the third party was involved if there is a disagreement. Results : Three RCTs were included. Meta-analysis was not performed due to different specific disease and outcome measurements among the included studies. Herbal medicine showed statistically significant improvement in symptoms and endoscopic findings compared to amoxicillin in acute rhinosinusitis. In addition, herbal medicine showed statistically significant improvement in symptoms and a smaller dose of additional antibiotics in acute tonsillitis. However, herbal medicine showed no significant effects compared to amoxicillin in chronic sinusitis patients after functional endoscopic sinus surgery. In terms of adverse events, no significant difference was observed between the herbal medicine group and the amoxicillin group in all studies. Conclusion : Herbal medicine might be more effective than amoxicillin in the treatment of upper respiratory tract infection. Nevertheless, it is hard to clear that conclusion due to the fact that the collected studies were conducted on different specific diseases and herbal medicine, and that the included studies had flaws in the research methodology.

• Pediatric Infection and Vaccine
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• 제18권2호
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• pp.154-162
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• 2011

목 적: Respiratory syncytial virus (RSV)에 의한 급성 하기도 감염은 소아기에 입원을 요하는 중요한 질환이다. 우리나라에서는 현재 미숙아와 후기미숙아의 출생률과 생존률이 증가하고 있으며, palivizumab ($Synagis^{(R)}$) 예방요법을 시행하고 있으나 아직 경제효과에 대한 연구가 없는 실정이다. 이에 저자들은 RSV로 인한 하기도 감염으로 입원한 미숙아들의 인구학적, 임상적 특성을 알아보고 우리나라에 적절한 예방요법 대상을 정하는데 도움이 되는 정보를 제공하고자 하였다. 방 법: 2007년 1월부터 2011년 2월까지 동국대학교 일산병원에 입원한 3세 미만의 급성 하기도 감염 환자중 multiplex RT-PCR을 통해 원인 바이러스를 밝힌 167명의 의무기록을 후향적으로 조사하였다. 결 과: 167명 중 RSV 감염으로 밝혀진 환자는 총 113명이었으며, 만삭아가 90명, 미숙아가 23명이었다. 이들의 평균 입원기간은 만삭아군이 9.0일, 미숙아군이 12.6일로 통계학적인 차이를 보였으며 이외 입원당시 나이, 발열 및 호흡기 증상, 혈액소견등은 유의한 차이를 보이지 않았다. RSV 감염으로 입원한 미숙아 22명을 조사하였을때(다른 질병과의 동반감염이 있었던 한 명 제외), 28주 미만이 4명, 28주 이상 32주 미만이 2명, 32주 이상이 16명(72.7%)으로 대부분이 palivizumab 예방요법의 대상이 아닌 미숙아들이었다. 이들 중 3명은 중환자실에서의 치료를 받았고 한 명만 28주미만의 환아로 palivizumab 투여를 받았으며 나머지 두 명은 32주 이상의 환아들로 기관지폐이형성 등 다른 위험요소가 없어 palivizumab을 투여 받지 않았다. 중환자실에서 치료받은 미숙아군과 만삭아군에서도 임상양상과 혈액학적 소견은 모두 유의한 차이를 보이지 않았다. 결 론: RSV에 의한 급성 하기도 감염으로 입원하는 환자들은 대부분 만삭아이거나 기관지폐이형성증과 같은 위험요인이 없는, palivizumab 투여 대상이 아닌 미숙아들이었다. 따라서 우리나라에서도 기관지폐이형성증 이외의 위험요인을 평가하고 더욱 최적의 시기에 pali-vizumab을 투여 하는 우리나라만의 예방요법지침이 하루속히 필요하다고 생각된다.

• 한국임상약학회지
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• 제13권1호
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• pp.5-12
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• 2003

Influenza virus is a major cause of respiratory infection in the epidemic season. Especially, the elderly with underlying health problems are at increased risk for complications of influenza. The objective of this study was to investigate that influenza vaccination can reduce the hospital admission rate related to the respiratory diseases. This study was a retrospective study of two age groups, who are the healthy children aged 6 months to 9 years (n=237) and the adults aged over 20 years with respiratory disease (n=327). The vaccinated groups were compared to the controls that were matched in sex and age. The children were vaccinated in winter season of 1995-96 and the adults were vaccinated in 1996-97. The efficacy of influenza vaccine was evaluated with the number of outpatient visits in children group, the admission rate and the mean admission days in both children and adult group. As results, there were not significant differences between the vaccinated and the control group of children. In the elderly over 61 years, however, the influenza vaccination can reduce the admission rate $(8.9\%\;vs.\;25.6\%,\;p<0.05)$ and the mean admission days (1.3 vs. 3.8 days, p<0.05) compared to the control. In conclusion, influenza vaccination can effectively reduce the events related to respiratory infection in the elderly than the children. The elderly should be recommended for influenza vaccination.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.132-135
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• 2014

Rhinovirus infection is typically associated with the common cold and has rarely been reported as a cause of severe pneumonia in immunocompetent adults. A 55-year-old previous healthy woman, who consumed half a bottle of alcohol daily, presented with respiratory failure after one week of upper respiratory infection symptoms. Radiography revealed bilateral, diffuse ground glass opacity with patchy consolidation in the whole lung field; bronchoalveolar lavage fluid analysis indicated that rhinovirus was the causative organism. After five days of conservative support, the symptoms and radiographic findings began to improve. We report this rare case of rhinovirus pneumonia in an otherwise healthy host along with a review of references.

• Pediatric Infection and Vaccine
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• 제20권3호
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• pp.168-177
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• 2013

목적: 본 연구는 소아에서 hMPV 감염증의 역학과 임상양상을 RSV A, RSV B와 비교하여 분석하고자 하였다. 방법: 2007년 9월부터 2012년 7월까지 호흡기 증상으로 내원한 소아들 중 RT-PCR을 통해 hMPV (n=36), RSV A (n=106), RSV B (n=51) 등의 호흡기 바이러스가 검출된 환자들의 의무기록을 후향적으로 분석하였다. 결과: 월별 분포에서 hMPV는 5월에 가장 많았고 RSV는 11-12월에 집중적으로 나타났다. hMPV 환자군의 평균 연령은 RSV에 비해 높았으며(각각 $29.9{\pm}32.5$개월 vs. $13.6{\pm}15.4$개월, P<0.001; $29.9{\pm}32.5$개월 vs. $12.1{\pm}13.5$개월, P<0.001), RSV A 환자군에 비해 발열 비율이 높았고(97.2% vs. 67.9%, P<0.001), RSV A, B 환자군에 비해서 천명 발생 비율이 낮았다(각각 16.7% vs. 47.2%, P=0.001; 16.7% vs. 37.3%, P=0.037). hMPV 환자군에서 RSV A, B에 비해 세기관지염 발생 비율이 낮았으며(각각 5.6% vs. 34.9%, P=0.001; 5.6% vs. 29.4%, P=0.006), RSV A 환자군에 비해 폐렴 발생 비율이 높았다(72.2% vs. 50.0%, P=0.047). 주사 항생제를 사용한 비율은 hMPV 환자군에서 RSV A, B 환자군에 비해 더 높았다(각각 69.4% vs. 39.6%, P=0.002; 69.4% vs. 43.1, P=0.015). 결론: 본 연구는 hMPV 감염증을 RSV A, B 감염증과 비교하여 임상적 및 역학적 특성을 비교하였다. 봄철에 발생하면서 RSV 감염에 비해 더 높은 연령에서 발생하고, 폐렴 발생이 많은 hMPV의 특징은 소아 호흡기 감염환자의 진료에 도움이 될 것으로 판단된다.

• Pediatric Infection and Vaccine
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• 제14권1호
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• pp.47-54
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• 2007

목 적 : 소아의 바이러스에 의한 급성 하기도 감염시간기능 이상을 동반하는 경우가 많다. 저자들은 바이러스성 하기도 감염시 간기능 이상이 질병의 중증도에 미치는 영향과 원인 바이러스, 연령별 분포에 대하여 알아보고자 본 연구를 시행하였다. 방 법 : 2003년 1월부터 2005년 6월까지 급성 하기도 감염으로 한림대학교 강남성심병원 소아과에 입원한 환아들의 비인두 분비물을 Hep-2세포를 이용하여 배양하였으며 의무기록지를 후향적으로 검토하였다. 비말 흡인 검사를 통한 바이러스 배양검사에서 양성결과가 나온 환아를 환자군(AST 혹은 ALT >45)과 대조군(AST 혹은 ALT ${\leq}45$)으로 나누어 연령, 성별, 진단명, 발열 기간, RR(Respiratory Rate)점수, RDAI(Respiratory Distress Assessment Instrument)점수, 산소흡입 여부, 입원 기간 등과 원인바이러스를 비교 분석하였다. 결 과 : 바이러스가 검출된 181례 중에서 기저 질환이 동반되거나 간독성 약제를 복용한 16례는 제외되었고, 환자군이 28례(17.0%), 대조군이 137례(83.0%)였다. 환자군과 대조군에서 연령, 성별 간에 유의한 차이는 없었으며 발열 기간, RR score, RDAI score, 산소흡입 여부, 입원 기간 등의 임상양상에서 유의한 차이점은 없는 것으로 나타났다(P>0.05). 바이러스 배양 결과 환자군에서는 RSV 17례(60.7%), parainfluenza virus 4례(14.3%), influenza B virus 4례(14.3%), adenovirus 3례(10.7%), influenza A virus 1례(3.6%)였고 대조군에서는 RSV 78례(56.9%) parainfluenza virus 28례(20.4%), influenza A virus 13례(9.5%), influenza B virus 9례(6.6%), adenovirus 6례(4.4%), coxsackie virus 3례(2.2%)로 양 군 간에 의미있는 차이는 없었으며 연령별 분포에서도 양 군 간에 큰 차이는 없었다. 결 론 : 본 연구에서 호흡기 바이러스 감염으로 진단된 환아 165례 중 환자군이 28례(17.0%)였고 대조군과의 비교 분석 결과 간기능 이상이 병의 중증도와 임상양상에 큰 영향을 미치지 않으며 원인 바이러스와 연령별분포 경향에서도 큰 차이는 없는 것으로 나타났다.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.52-55
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• 2010

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

• Acute and Critical Care
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• 제33권4호
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• pp.238-245
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• 2018

Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

• 보건의료산업학회지
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• 제11권3호
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• pp.37-49
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• 2017

Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

• IMMUNE NETWORK
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• 제5권2호
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• pp.117-123
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• 2005

The immune response to any stimulus is complex, requiring coordinated action by several types of cells in a tightly regulated sequence. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Although regular moderate exercise appears to be important factor for increasing immunity, Athletes are susceptible to illness, in particular upper respiratory track infection, during periods of intense training and after competition. In addition, in elite athletes, frequent illness is associated with overtraining syndrome, a neuroendocrine disorder resulting from excessive training. Through this paper, we want to investigate the effects of exercise on the immunosuppression such as exercise induced lymphopenia, asthma, anaphylaxis, URT (upper respiratory track), and TB (tuberculosis) infection. and also, we want to suggest a direct mechanism, protection and therapy of exercise induced immunosuppression.