• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.142-149
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• 2009

Purpose : The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants<6 months of age. Methods : A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/${\mu}L$) and an increased CRP level (>1.06mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis. Conclusion : Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.497-503
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• 2005

Backgrounds : The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. Methods : 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. Results : The mean $FEV_1/FVC$ in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. Conclusions : This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.

• Journal of Chest Surgery
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• v.8 no.2
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• pp.109-118
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• 1975

This is a report on four cases of the lobar emphysema due to proximal bronchial obstruction in the Department of Thoracic Surgery, Hanyang University Hospital, during the period of three and half years from 1972 to 1975. First case, a two years old male child was referred to our Department with the lobar emphysema of the lower lobe of the right lung with pneumonia. This emphysema was developed after aspiration of a piece of peanut. Bronchoscopy revealed that the bronchus of the right lower lobe was obstructed with the foreign body, however removal of the peanut through bronchoscope was not attempted because of corruption and softening of the peanut. The removal of the peanut by bronchotomy was performed after subsiding of acute phase of pulmonary infection. Postoperative course was uneventful and the emphysema was disappeared. Second case, a twenty months old female baby was referred to our Department with lobar emphysema of the lower lobe of the left lung. The emphysema was suddenly developed with coughing and dyspneic symptoms and the diagnosis was made roentgenologically. She gave a history of reccurrent infections of the respiratory tract after birth. Bronchoscopy showed an obstruction of the left main bronchus with the growing of fibrinous tissue on the bronchial mucosa. The protruded tissue in the left main bronchus taken out about O.8ml with biopsy forceps for histological examination. After this procedure, the emphysema of the left lung was disappeared. Histological finding was reported to be a chronic inflammatory granulation tissue. Third case, a two and half years old male child was referred to our Department with roentgenological lobar emphysema. Two weeks prior to admission he had an episode of sudden onset of coughing attack with dyspnea. Bronchoscopy revealed that the bronchus of the left lower lobe was obstructed with a mass which was strongly suspected of a neoplastic tissue. At operation, there was found a perforation of enlarged tuberculous lymph node in the bronchus of the left lower lobe and protrusion of granulation tissue into the bronchus. Ruptured orifice on themembranous wall of the left lower lobe bronchus was closed with interrupted suture after the" removal of a perforated tuberculous lymph node. Postoperative course was uneventful and antituberculous chemotherapy was given. Fourth case, a 47 years old man was admitted to our Department with the complaint of severe dyspnea of few months duration. Twenty years ago, he had a history of lung tuberculosis and was treated for many years. X-ray examination including tomography and bronchography revealed that the upper lobe of the right lung was destroyed with cavities, the lower lobe was completely shrunk, and the right middle lobe was strongly overdistended with narrowing bronchial trees. Differential bronchospirometry and lung scanning confirmed that the respiratory function of the affected lung was impaired almost totally. The value of the right lung was calculated on 6% of oxygen uptake, 1% of Minute volume, and 32% of vital capacity. The right pneumonectomy was performed under the careful consideration of anesthetic and surgical procedures. Postoperative course was uneventful and the respiratory function was improved nearly to the normal level.evel.

• Parasites, Hosts and Diseases
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• v.55 no.4
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• pp.433-437
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• 2017

Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

• Biomolecules & Therapeutics
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• v.5 no.2
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• pp.187-193
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• 1997

The in vivo and in vivo antibacterial activity of DW-116, a newly synthesized fluoroquinolone, were compared with those of other quinolones. DW-116 exhibited more potent antibacterial activity than rufloxacin and lower activity than ofloxacin and ciprofloxacin in in vivo assay But, DW-116 particularly showed strong activity against the family of staphylococci including methicillin-sensitive staphylococcus and its activity was more active than that of ciprofloxacin. The time-kill curve studies showed rapid bactericidal activity for DW-116. The post-antibiotic effect of DW-116 was observed between 0.66 and 5 hours. The therapeutic efficacy of DW-116 against respiratory infection with P. aeruginosa was as strong as that of ciprofloxacin and its effect against urinary tract in(traction with E. coli was more effective than rufloxacin. The excellent therapeutic efficacy of DW-116 against these local infections is due to its good pharmacokinetic profiles.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.123-132
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• 2004

The purpose of this study was to obtain normative nasalance scores for adult subjects speaking the Korean language. Additional objectives of the study were to determine if speaker sex played a role in differences in nasalance score and there was significantly correlation of nasalance score with nasalance slope score. The subjects include 75 healthy young Korean adults with normal oral and velopharyngeal resource and function. They had no history of speech problem, were judged as having normal speech and resonance at the time of testing, and had no upper respiratory tract infections or allergies at the time of testing. The Nasometer II 6400 was used to obtain nasalance scores and nasalance slope scores for /a/, /i/, /e/, /o/, /u/, /ja/, /je/, /wi/, /p'ap'i/ and /sasi/. The data of nasalance and nasalance slope were analyzed statistically. The mean nasalance score of the female was significantly higher than that of male at /a/, /i/, /wi/, /p'ap'i/ and /sasi/(p <0.10). The mean nasalance score of /i/ was highest and that of /o/ was the lowest. In this study, we could not and the relationship of the nasalance score and the closing slope score. However, there was negative correlation between the mean nasalance score and the opening slope score at ie/ and /;ai, positive to /sasi/. These normative nasalance scores for normal young adults speaking the Korean language provide important reference information for Korean cleft palate teams. In the future study of velopharygneal activity with the Nasometer, the opening slope score will be able to be the important parameter.

• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.202-207
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• 2004

Group A streptococcus, also known as Streptococcus pyogenes, is a common bacterial pathogens of the upper respiratory tract and skin infections in children, but this organism is a less common cause of pneumonia, pericarditis. However, pneumonia that is caused by Streptococcus pyogenes, may be rapidly progressive course with developing severe consequences. It may be focal but often is bilateral and diffuse involvement of lung. Empyema is commonly developed, and pleurocentesis often yields thin, watery fluid that continues to flow out when a chest tube is inserted. Antimicrobial resistance to the ${\beta}$-lactam antibiotics has not been reported against group A streptococci, whereas increasing resistance to the macrolides seems to be directly related to the consumption of specific antimicrobial agent use in the community. Clindamycin resistance is uncommon but does occur. We experienced one case of group A streptoccoccal pneumonia with empyema and pericardial effusion, and treated successfully with amoxicillin-clavulanate, clindamycin and roxithromycin.

• Analytical Science and Technology
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• v.30 no.1
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• pp.39-48
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• 2017

Roxithromycin (RXT), which is an antibiotic used to treat respiratory tract and urinary infections, is official in Korean Pharmacopoeia (KP) and is marketed in various dosage forms including tablet, granule, suspension, and tablet for suspension in Korea. This study presents how a universal and reliable method to quantify RXT in bulk drug and formulations was developed. Effects of factors including column type, buffer concentration, type and concentration of organic solvent, buffer pH, and type and concentration of mobile phase additive, were examined, and some categorical or crucial factors including the types of column, organic solvent, mobile phase additive and the buffer pH were optimized by one-factor-at-a-time approach. Subsequently, concentrations of the buffer and additive and column temperature were optimized by response surface methodology using Box-Behnken design aiming to acquire the RXT peak of good shape. The optimized method employed a Phenomenex Gemini $5{\mu}$ C18 110A ($150{\times}4.60mm$, $5{\mu}m$) maintained at $30^{\circ}C$ with the mobile phase consisting of 25 mM phosphate buffer (pH 6.0) with 0.3 % tetrabutylammonium hydroxide and methanol at a ratio of 37:63 (v/v). Method validation results showed that the developed method was linear, precise, and accurate. Compared to the compendial methods in KP 10 that exhibited a significant tailing of the RXT peak despite using unfavorably high buffer concentrations and were not harmonized among bulk drug and formulations, this method could be universally applied to RXT bulk drug and marketed products in various dosage forms and thus was adopted in KP 11.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.169-186
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• 1997

Scutellariae Radix has been widely used as oriental herbal medicine for the treatment of bacterial infections in the respiratory or the gastrointestinal tract. In partition experiment for better understanding of herbal medicine with various solvents, baicalein or wogonin have more hydrophobic characteristics than baicalin or wogonoside. Unexpectedly, methylene chloride could extract more for baicalin or wogonoside over other active ingredients. New compound from baicalin is discovered casting frointier area on herbal medicine in the future. Application study with new molecule hydrolyzed from baicalin is on the way for better treatment of the patient against specific disease. The baicalin modified with reaction has been shown weak antibacterial activity against Streptococcus pyogenes 308A and Pseudomonas aeruginosa 1771. The minimum inhibitory concentration (MIC) of the baicalin modified compound against those strains were about $600\;{\mu}g/mL$, respectively. In vitro antitumor experiment, $EC_{50}$ of baicalin modified with reaction was more than $300\;{\mu}g/mL$ and $EC_{50}$ of baicalein was $100\;{\mu}g/mL$. Among these compounds, baicalin exhibited high level of antitumor activity. $EC_{50}$ of baicalin was less than $33.3\;{\mu}g/mL$.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.81-89
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• 2020

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.