• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.8-16
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• 2018

Purpose: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. Methods: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. Results: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. Conclusions: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.132-136
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• 2013

Parainfluenza virus infection is one of the causes of fatal rhabdomyolysis. Rhabdomyolysis can be aggravated by mitochondrial fatty acid ${\beta}$-oxidation disorders during prolonged periods of fasting. Moreover, in patients with late-onset isovaleric acidemia, hyperammonemia may occur following catabolic stress. In the present report, we describe a case of a 4-year-old boy with parainfluenza virus infection and late-onset isovaleric acidemia that rapidly progressed to coma, seizures, and cardiorespiratory collapse. His serum ammonia and creatinine kinase (CK) levels were $385{\mu}Mol/L$ and 23,707 IU/L, respectively. Continuous renal replacement therapy (CRRT) was initiated using continuous venovenous hemodiafiltration, after which the ammonia and CK levels returned to normal. Thus, we recommend the immediate initiation of CRRT in the management of patients with life-threatening rhabdomyolysis and hyperammonemia.

• Clinical and Experimental Pediatrics
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• v.55 no.4
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• pp.147-150
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• 2012

Acute necrotizing encephalopathy (ANE) may be suspected when a young child presents with abrupt onset of altered mental status, seizures, or both. Definitive clinical diagnosis is based on magnetic resonance imaging (MRI) results. ANE is associated with influenza virus infections. Preliminary data suggests that up to 25% of ANE patients die, and up to 25% of ANE survivors develop substantial neurologic sequelae. Here, we describe a case of a comatose 22-month-old girl who was admitted to our hospital because of febrile illness and seizures. On day 13 of her illness, she died from ANE associated with infection from parainfluenza virus. Brain MRI results indicated diffuse bilateral symmetric signal changes in both basal ganglia, thalami, periventricular white matter, pons, and cerebral white matter, as well as generalized swelling of the brain.

• Microbiology and Biotechnology Letters
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• v.40 no.4
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• pp.339-347
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• 2012

Viral safety is an important prerequisite for clinical preparations of mammalian cell culture-derived biopharmaceuticals, because numerous adventitious viruses have been contaminated during the manufacturing process. In particular, Chinese hamster ovary (CHO) cells are highly susceptible to several RNA viruses including reovirus (Reo), bovine viral diarrhea virus (BVDV), and bovine parainfluenza virus (BPIV) and there have been reports of such viral contaminations. Therefore, viral detection during the CHO cell process is necessary to ensure the safety of biopharmaceuticals against viruses. In this study, a multiplex reverse transcription (RT)-PCR assay was developed and subsequently evaluated for its effectiveness as a means to simultaneously detect Reo, BVDV, and BPIV during the manufacture of cell culture-derived biopharmaceuticals. Specific primers for Reo, BVDV, and BPIV were selected, and a multiplex RT-PCR was optimized. The sensitivity of the assay for simultaneous amplification of all viral target RNAs was $7.76{\times}10^2\;TCID_{50}/ml$ for Reo, $7.44{\times}10^1\;TCID_{50}/ml$ for BVDV, and $6.75{\times}10^1\;TCID_{50}/ml$ for BPIV. The multiplex RT-PCR was proven to be very specific to Reo, BVDV, and BPIV and was subsequently applied to the validation of CHO cells artificially infected with each virus. It could detect each viral RNA from CHO cells as well as culture supernatants. Therefore, it was concluded that the multiplex RT-PCR assay can be applied to detection of the adventitious viruses during the manufacture of cell culture-derived biopharmaceuticals.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.261-266
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• 2009

Rhabdomyolysis, the clinical syndrome caused by the injury to skeletal muscle resulting in the release of muscle cell contents into the systemic circulation, has been described in association with various factors. The causes include crush injury, skeletal muscle overuse, heat, drug, abuse of alcohols and metabolic disorders as well as several types of viral and bacterial infections. We report two cases of rhabdomyolysis, which were complicated by uncommon causes, parainfluenza virus type I infection and hypernatremia.

• Korean Journal of Veterinary Research
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• v.50 no.3
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• pp.205-211
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• 2010

Fifty young calves, about five to six months old purchased from nation-wide were investigated with the prevelance of neutralizing antibody (Ab) of infectious bovine rhinotracheitis virus (IBRV), parainfluenza 3 virus ($PI_{3}V$), bovine viral diarrhea virus (BVDV) and bovine respiratory syncytial virus (BRSV). The positive detection ratio of neutralizing Ab against IBRV was only 3% and two of positive samples showed low antibody titer (below 2). Ab against BRSV showed 48% of positive ratio and among 24 positive samples, antibody titer of 23 samples were below 3. But in the case of BVDV, 68% of samples were positive and 23 samples appeared to possess high antibody titer, above 4 and the antibody titer of five samples were above 8. The highest positive result came from $PI_{3}V$. The positive ratio in the samples investigated in this study was 72%, but the antibody titer of positive samples were generally below 3 (77.8% in positive samples).

• 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.

• Journal of Environmental Health Sciences
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• v.37 no.4
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• pp.306-314
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• 2011

Objectives: Respiratory virus infections are the most common disease among all ages in all parts of the world and occur through airborne transmission. The purpose of this study was to detect and quantitate human respiratory viruses in residential environments. Methods: Air samples were collected from the residential space of apartments in the Seoul/Gyeonggi-do area. The samples were collected from indoor and outdoor air. Among respiratory viruses, influenza A virus, influenza B virus, parainfluenza virus, metapneumovirus, respiratory syncytial virus, and adenovirus were investigated by multiplex polymerase chain reaction. Among the virus-positive samples, we performed adenovirus quantification by real-time polymerase chain reaction. Results: Virus detection rates were 44.0%, 3.8%, 3.4%, and 17.3% in spring, summer, autumn, and winter, respectively. The virus detection rate was higher in winter and spring than in summer and autumn. Adenovirus was most commonly detected, followed by influenza A virus and parainfluenza virus. Virus distribution was not significantly different between indoor and outdoor environments. Conclusions: Although virus concentrations were not high in residential environments, residents in houses with detected viruses may have an increased risk of exposure to airborne respiratory viruses, especially in winter and spring.

• Korean Journal of Veterinary Research
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• v.55 no.3
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• pp.185-189
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• 2015

Bovine parainfluenza virus type 5 (bPIV5) was isolated from cattle with downer cow syndrome in 2012, and included both respiratory and neurotropic pathogens from a variety of animals. In the current study, we conducted serosurveillance using sera obtained from seven Korean farms and optimized a reverse transcription-polymerase chain reaction (RT-PCR) assay to detect bPIV5. The overall seropositive rate for Korean cattle was 21.4% (163/760). A farm located near the city of Milyang in Gyeoungnam province had a markedly elevated seropositive rate for bPIV5 compared to that of the other six farms. The regional seropositive rates were 4.2% (8/192) for Haman, 19.5% (18/55) for Hwasung, 73.9% (65/88) for Milyang, 26.0% (50/192) for Namwon, 1.0% (1/96) for Uljin, 13.5% (13/96) for Yeongju, and 32.7% (8/41) for Yongin. The sensitivity and specificity of three RT-PCR primer sets used to amplify the conserved fusion gene of bPIV5 were also evaluated. An RT-PCR assay using the bPIVFR3 primer set was 10-fold more sensitive than the assays using the two other primer sets and did not result in non-specific amplification. These results demonstrated that the bPIFR3 primer set can be used to detect bPIV5.

• Allergy, Asthma & Respiratory Disease
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• v.6 no.6
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• pp.290-294
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• 2018

Purpose: We evaluated the clinical features of croup in children according to viral etiology. Methods: This study enrolled pediatric patients with croup, who showed positive results on respiratory virus reverse transcriptase polymerase chain reaction performed between January 2012 and December 2017. We retrospectively reviewed the medical records. Results: A total of 179 patients (119 boys and 60 girls) were enrolled with the mean age of $18.9{\pm}14.7$ months. The viruses commonly identified were parainfluenza, respiratory syncytial virus, rhinovirus, and influenza. Among these 4 viruses, patients with rhinovirus infection showed significantly shorter fever and admission durations. Patients with parainfluenza infection showed significantly lower incidences of epinephrine nebulization and patients with influenza infections showed significantly higher incidences of steroid treatment. Conclusion: Clinical manifestations of croup differ according to causative viruses. Further studies should be conducted to evaluate the severity and prognosis of croup according to viral etiology.