• Pediatric Infection and Vaccine
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• 제14권1호
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• pp.75-82
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• 2007

목 적 : hMPV는 paramyxovirus에 속하는 RNA 바이러스로 2001년 van den Hoogen 등에 의해 처음으로 보고되었으며 늦은 겨울이나 이른 봄에 영아와 노인에서 호흡기 감염을 일으키는 바이러스로 알려져 있으나 아직 우리나라에서의 보고는 많지 않다. 최근 호흡기 증상을 보이는 환아들에서 hMPV를 확인한 바 있어 이에 보고하는 바이다. 방 법 : 2004년 10월부터 2005년 5월까지 을지병원, 서울의료원, 보라매병원 소아과에 호흡기 증상을 주소로 방문한 443명의 비인두 흡인물에서 hMPV RT-PCR을 시행하였고, 양성인 15명의 임상 양상과 검사 소견을 의무기록을 통해 후향적으로 조사하였다. 결 과 : 443명 중 15명에서 hMPV PCR 양성을 보여 양성율은 3.4%이었다. 남아가 7명, 여아가 8명이었고 연령은 1개월에서 62개월(정중값 31.5개월)이었다. 이중 24개월 미만의 환아가 53.3%(8/15)이었다. 진단명은 폐렴 9명, 모세기관지염 3명, 상기도염 2명, 후두염 1명이었다. 그 중 1명에서 천식이 있었고 나머지 환아에서는 기왕력이 없었다. 임상 증상으로는 기침이 15명(100%)으로 가장 많았고 그 외 열감 12명(80%), 콧물 10명(67%), 구토 4명(27%), 호흡 곤란 4명(27%), 설사 3명(20%), 발진 1명(7%)이 있었다. 신체 검진 상 인두 발적이 가장 흔하게 보이는 소견이었으며 나음 6례, 흉부 함몰 4례, 빈호흡 2례, 천명 2례, 천음 1례가 관찰되었다. 말초 혈액 검사만으로 hMPV 감염을 시사하는 특징적인 소견은 없었다. 15명 중 2명에서 아데노바이러스와 중복감염이 있었다. 평균 발열 기간은 $4.9{\pm}2.8$일이었으며 입원 치료를 하였던 13명의 평균 재원 기간은 $5.6{\pm}0.9$일이었고 모두 대증적 치료 후 합병증 없이 증상 호전을 보여 퇴원하였다. 결 론 : hMPV는 상기도 및 하기도 호흡기 감염의 중요 원인 바이러스 중 하나로 생각되며 우리나라에서의 임상적, 역학적 특징을 규명하기 위해서는 향후 더 많은 환자를 대상으로 한 연구가 필요할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제51권8호
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• pp.834-841
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• 2008

목 적 : 급성 바이러스성 하기도 감염의 원인으로 알려진 바이러스의 임상 양상 및 역학 을 연구하고자 하였으며, 특히 새롭게 밝혀진 hRV, HCoV-229E/NL63, HCoV-OC43, hMPV를 중심으로 하였다. 방 법 : 2005년 12월부터 2006년 11월까지 순천향대학교 천안병원 소아과에 하기도 감염으로 입원한 환아들 중 863명을 대상으로 환아들의 비인두 흡인물에서 multiplex RT-PCR 법을 이용하여 총 12개의 바이러스를 검출하였다. 결 과 : 총 12개의 호흡기 바이러스에 대하여 검사를 하였을 때 863명 중 474명(54.9%)에서 바이러스 양성이 나타났다. hMPV이 6.8%, HCoV-229E/NL63 1.4%, HCoV-OC43 2.1%, hRV 9%로 검출되었고, 혼합감염은 22.8%였다. 급성 바이러스성 하기도 감염은 1세 미만에서 가장 흔하게 나타났다. 임상진단은 폐렴이 59.5%로 가장 많았고, 세기관지염이 24.7%, 기관기관지염이 11.4%, 크룹이 4% 순이었다. 세기관지염의 가장 흔한 원인 바이러스는 RSV B이고, 반면에 hMPV, hRV, HCoV-229E/NL63은 폐렴의 주요 원인 바이러스로 나타났다. 바이러스별 유행 양상은 hMPV는 3월부터 5월까지 유행하였고, HCoV-OC43은 11월부터 2월까지 유행하였다. 반면에 HCoV-OC43, HCoV-229E/NL63과 hRV는 연중 고른 분포를 보였다. 결 론 : 본 연구는 비록 연구 기간이 1년으로 짧았지만, 다른 나라의 경우와 비교해 hMPV가 겨울엔 검출되지 않고 3월에서 4월까지 주로 검출된다는 점과 HCoV가 우리나라에서는 별로 검출되지 않아 하기도 감염에서는 그 비중이 매우 미미하다는 점을 알 수 있었다.

• 환경위생공학
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• 제8권1호
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• pp.93-105
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• 1993

The major purpose of this study was to determine the effects of air pollution on respiratory diseases. From the analysis of $SO_2$, $NO_2$ and TSP levels measured at two air pollution monitoring stations(K & E area) of Seoul during Jan. 1988-Dec. 1990, pollution level of K area was higher than E area. Insurance out-patient records for the medical fee reimbusement submitted to the National Federation of Medical Insurance from Jan. to Dec. 1990 were used in order to assess the occurrence of respiratory disease. The results were as follows ; 1. The annual mean levels of $SO_2$, $NO_2$ and TSP in K area were 0.08lppm, O.03lppm and 173.4${\mu}g/m^3$, whereas those of E area were 0.044ppm, 0.02lppm and 146.0 ${\mu}g/m^3$ respectively. The mean levels of above three air pollutants between two areas showed difference about 1.2 times-1.8 times by air pollutant. 2. The monthly out-patient incidence rates of chronic obstructive pulmonary diseases, chronic bronchitis and asthma in K area were higher when compared with those of E area. The monthly out-patient incidence rates of above three chronic respiratory disease of two areas studied showed statistically significant difference about 1.3 times, 2.7 times, 1.4 times respectively. No difference were, however, shown in acute respiratory infections. 3. Highest incidence rates of out-patients could be observed among the group of children less than 10 years old, while adult out-patient incidence rates increased as age increased. 4. The relation between air pollution and chronic respiratory disease was obvious especially, the strongly significant correlation was observed between $NO_2$ and chronic bronchitis.

• Tuberculosis and Respiratory Diseases
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• 제39권3호
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• pp.271-277
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• 1992

Diffuse panbronchiollitis (DPB), a rare progressive disorder, has lately been receiving increasing attention. DPB is a disease of obscure etiology, characterized by chronic inflammation localized mainly in the region of respiratory bronchiole just distal to the terminal bronchioles. In 1983, Homma and coworkers reported 82 cases of a new clinicopathological entity, DPB, in Japan. Also DPB is a disease largely restricted geographically to Japan but the prevalence in other countries is extremely low. Histoloically, it is characterized by a suppurative bronchiolitis involving primarily the respiratory and terminal bronchioles with subsequent progression to bronchiectasis. The disease progresses rapidly and results in respiratory failure due to repeated respiratory infections. We experienced a cases of DPB accompanied with chronic maxillary sinusitis in both sinuses. Diagnosis of DPB was comfirmed by pathological results from thoracoscopic lung biopsy, typical radiological findings, clinical symptoms and pulmonary function test. After treatment with erythromycin for 6 months, the patient's condition and the typical micronodular densities on the chest radiography improved. A few case of DPB was reported in Korea. We report a case of DPB through thoracoscopic lung biopsy.

• Clinical and Experimental Pediatrics
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• 제55권12호
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• pp.470-473
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• 2012

Purpose: The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD) by using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD. Methods: RT-PCR assays were carried out to screen for the presence of respiratory syncytial virus A and B, adenovirus, rhinovirus, parainfluenza viruses 1 to 4, influenza virus A and B, metapneumovirus, bocavirus, coronavirus OC43/229E and NL63, and enterovirus in nasopharyngeal secretions of 55 KD patients and 78 control subjects. Results: Virus detection rates in KD patients and control subjects were 32.7% and 30.8%, respectively (P=0.811). However, there was no significant association between the presence of any of the 15 viruses and the incidence of KD. Comparisons between the 18 patients with positive RT-PCR results and the other 37 KD patients revealed no significant differences in terms of clinical findings (including the prevalence of incomplete presentation of the disease) and coronary artery diameter. Conclusion: A positive RT-PCR for currently epidemic respiratory viruses should not be used as an evidence against the diagnosis of KD. These viruses were not associated with the incomplete presentation of KD and coronary artery dilatation.

• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.52-64
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• 2024

Chronic respiratory diseases such as idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, and respiratory infections injure the alveoli; the damage evoked is mostly irreversible and occasionally leads to death. Achieving a detailed understanding of the pathogenesis of these fatal respiratory diseases has been hampered by limited access to human alveolar tissue and the differences between mice and humans. Thus, the development of human alveolar organoid (AO) models that mimic in vivo physiology and pathophysiology has gained tremendous attention over the last decade. In recent years, human pluripotent stem cells (hPSCs) have been successfully employed to generate several types of organoids representing different respiratory compartments, including alveolar regions. However, despite continued advances in three-dimensional culture techniques and single-cell genomics, there is still a profound need to improve the cellular heterogeneity and maturity of AOs to recapitulate the key histological and functional features of in vivo alveolar tissue. In particular, the incorporation of immune cells such as macrophages into hPSC-AO systems is crucial for disease modeling and subsequent drug screening. In this review, we summarize current methods for differentiating alveolar epithelial cells from hPSCs followed by AO generation and their applications in disease modeling, drug testing, and toxicity evaluation. In addition, we review how current hPSC-AOs closely resemble in vivo alveoli in terms of phenotype, cellular heterogeneity, and maturity.

• Tuberculosis and Respiratory Diseases
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• 제70권2호
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• pp.105-112
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• 2011

Pneumonia is frequently encountered in the clinical fields, both as a cause for admission and as a complication of the underlying disorder or as the course of treatment. Pneumonia is the second most common hospital-acquired infection and is associated with the highest morbidity and mortality rates among hospital-acquired infections. The guidelines for the management of hospital-acquired pneumonia by the American Thoracic Society include identifying individuals who have recently received antibiotics therapy or have been in medical facilities; these individuals are at higher risk for infection with multiple drug resistant organisms. Individuals, who have acquired pneumonia according to this clinical scenario, have what is known as healthcare-associated pneumonia (HCAP). Patients with HCAP should be considered to have potentially drug-resistant pathogens and should receive broad spectrum empiric antibiotic therapy directed at the potentially resistant organisms. In this paper, the diagnosis, risk factors, and treatment of HCAP are discussed.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.173-176
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• 2012

We report a rare case of lung disease caused by Mycobacterium terrae in a previously healthy woman. A 45-year-old woman was referred to our hospital due to a chronic cough with sputum. A computed tomography scan of the chest revealed bronchiolitis in conjuction with bronchiectasis in both lungs. Nontuberculous mycobacteria were identified and isolated from the bronchoalveolar lavage fluid collected from each lung. All isolates were identified as M. terrae by various molecular methods that characterized the rpoB and hsp65 gene sequences. Antibiotic therapy using clarithromycin, rifampin, and ethambutol improved the patient's condition and successfully resulted in sputum conversion.

• Tuberculosis and Respiratory Diseases
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• 제77권6호
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• pp.271-273
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• 2014

Disease flare-up after discontinuing epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) has been considered as a critical issue in lung cancer patients who have experienced radiologic progression after showing initial durable response. This is a case of systemic nocardiosis that occurred after chronic steroid use for radionecrosis from stereotactic radiosurgery. It was initially thought as a disease flare-up after stopping EGFR-TKI.

• Tuberculosis and Respiratory Diseases
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• 제39권1호
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• pp.1-6
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• 1992

The diagnosis of tuberculosis is usually established using staining and culturing techniques. Fluorescent stains have improved the sensitivity of direct microscopy. Improved culture media coupled with radiometric means of detecting early mycobacterial growth have shortened the time needed for cultural diagnosis. Rapid immunodiagnostic techniques based on the detection of mycobacterial antigen or of antibodies to theses antigens have not, however, come into widespread clinical use. The DNA or RNA hybridization tests with labeled specific probes which have been described so far are not sensitive enough to be used for clinical speicimens without prior culturing. The advent of the polymerase chain reaction (PCR) has opened new possibilities for diagnosis of microbial infections. This technique has already been applied to a number of microorganisms. In the field of mycobacteria the PCR has been used to identify and to detect DNAs extracted from various mycobacteria. However, despite the extraordinary enthusiasm surrounding this technique and the considerable investiment, PCR has not emerged from the developmental "trenches" in the passed several years. It may be a considerable lenth of time before clinical microbiology laboratories become PCR playgrounds because many details remain to be worked out.