• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.12.1-12.9
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• 2020

Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

• IMMUNE NETWORK
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• 제23권4호
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• pp.31.1-31.18
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• 2023

Evidence suggests that the human respiratory tract, as with the gastrointestinal tract, has evolved to its current state in association with commensal microbes. However, little is known about how the airway microbiome affects the development of airway immune system. Here, we uncover a previously unidentified mode of interaction between host airway immunity and a unique strain (AIT01) of Staphylococcus epidermidis, a predominant species of the nasal microbiome. Intranasal administration of AIT01 increased the population of neutrophils and monocytes in mouse lungs. The recruitment of these immune cells resulted in the protection of the murine host against infection by Pseudomonas aeruginosa, a pathogenic bacterium. Interestingly, an AIT01-secreted protein identified as GAPDH, a well-known bacterial moonlighting protein, mediated this protective effect. Intranasal delivery of the purified GAPDH conferred significant resistance against other Gram-negative pathogens (Klebsiella pneumoniae and Acinetobacter baumannii) and influenza A virus. Our findings demonstrate the potential of a native nasal microbe and its secretory protein to enhance innate immune defense against airway infections. These results offer a promising preventive measure, particularly relevant in the context of global pandemics.

• 약학회지
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• 제40권1호
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• pp.95-101
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• 1996

The in vitro antibacterial activities of LB10522, a new catechol-substituted cephalosporin, were compared with those of cefpirome, ceftazidime, ceftriaxone, and cefoperaz one against clinical isolates and laboratory standard anaerobes. LB10522 had broad spectrum antibacterial activities against both gram-positive and gram-negative microorganisms. It was most active against gram-positve bacteria among the reference cephalosporins tested. Against gram-negative strains such as the family Enterobacteriaceae, LB10522 showed an activity comparable to that of cefpirome. But LB10522 was more potent than ceftazidime, ceftriaxone and cefoperazone. In particular, Pseudomonas aeruginosa was highly susceptible to LB10522, which was 32-fold and 64-fold more active than ceftazidime and cefpirome, respectively. Against anaerobic strains, the activity of LB10522 was similar to those of reference compounds. LB10522 exhibited potent therapeutic activities against experimental local infections in mice. The therapeutic effect of LB10522 against urinary tract infection (UTI) caused by P. aeruginosa 1912E in mice was superior to that of cefpirome. Against experimental respiratory tract infection (RTI) caused by K. pneumoniae DT-S in mice, LB10522 was as effective as cefpirome. The in vivo efficacy of LB10522 was correlated well with its in vitro activity.

• 한국임상약학회지
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• 제22권1호
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• pp.55-64
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• 2012

The quinolones are broad-spectrum antibiotics and enhanced antimicrobial activity has extended the use of the quinolones beyond the traditional indications for quinolone antibiotics in the treatment of urinary tract infections. The quinolones are effective in a wider variety of infectious diseases, including skin and respiratory infections. Because of their excellent safety and tolerability, they have become popular alternatives to penicillin and cephalosporin derivatives in the treatment of various infections. A retrospective study was performed to evaluate efficacy and safety of IV quinolones for inpatient use. Total 117 patients who administerd quinolones for longer than 3 continuous days at community hospital from October 1st, 2008 to December 31st, 2008 were reviewed. The criterias for drug evaluation were included the validation of indication, outcome, dosage and side effects. In the results, ciprofloxacin 13 (total 93), levofloxacin 3 (total 59) and moxifloxacin 2 (total 19) cases were not met the criterias based on the culture results. Major indications were pneumonia (ciprofloxacin 16.3%, levofloxacin 67.8%, moxifloxacin 84.2%), urinary tract infection (ciprofloxacin 44.1%), skin infection (ciprofloxacin 7.5%, levofloxacin 20.3%, moxifloxacin 10.5%), intra-abdominal infection (ciprofloxacin 10.8%, moxifloxacin 5.3%), etc.. In the results of quinolone monotherapy, the frequencies were each ciprofloxacin 74.2%, levofloxacin 50.8% and moxifloxacin 47.4%. In the results of dosage validation, the validities were each ciprofloxacin 54.8%, levofloxacin 94.9% and moxifloxacin 100.0%. In the results of duration validation, the validities were each ciprofloxacin 59.1%, levofloxacin 78.0% and moxifloxacin 89.5%. Adverse drug reactions were reported for total 49 cases and those were gastrointestinal tract effects including nausea, vomiting, diarrhea and central nervous system effects including headache, dizziness. In summary, the quinolones appropriately used for hospitalized patients based on this study. A focused approach emphasizing "correct use of quinolones" may reduce development of antimicrobial resistance and maximize class efficacy. Consequently, correct use of antibiotics will contribute to decrease medical expenses for person and community.

• Tuberculosis and Respiratory Diseases
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• 제67권5호
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• pp.409-412
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• 2009

Background: Several large outbreaks have demonstrated the threat of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in close-contact environments, such as occurs during training and quartering of military recruits training. In South Korea, which is a hospital or healthcare-associated MRSA prevalent area, military service is compulsory for all healthy young men. We surveyed and determined the extent of CA-MRSA colonization in the upper respiratory tracts of Korean military recruits. Methods: The Korean military recruits who were enrolled in a military training facility from November 2004 to March 2005 were eligible for this study. Sputum or nasopharyngeal swap was obtained from randomly selected subjects who displayed upper respiratory tract symptoms. Results: Of the 181 participants, 32 participants (17.7%) were colonized with S. aureus, and 12 participants (6.6%) were colonized with MRSA. Among the cases that were colonized with S. aureus, 37.5% (12/32) were colonized with MRSA. Antimicrobial susceptibility testing showed resistant patterns that were suggestive of the CA-MRSA strains for all of the MRSA isolates. Conclusion: This study of Korean military recruits found a great deal of showed MRSA colonization in them, and the antimicrobial resistant profile that was suggestive of a CA-MRSA strain. Further efforts to prevent the spread of MRSA infections and careful monitoring for CA-MRSA outbreaks are warranted, especially in a high risk group such as military recruits.

• Pediatric Infection and Vaccine
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• 제20권3호
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• pp.178-185
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• 2013

목적: 다양한 바이러스 감염이 혈액학적 합병증, 특히 빈혈, 호중구 감소증 및 혈소판감소증과 같은 혈구 감소증을 일으킨다. 그러나 최근 호흡기 바이러스에 의한 혈액학적 합병증에 대해서는 제한적으로 보고되었다. 따라서 저자들은 호흡기 바이러스 양성 환자들을 대상으로 혈액학적 합병증과 그 임상 경과를 평가하기 위해 본 연구를 시행하였다. 방법: 2011년 10월부터 2012년 3월까지 6개월 동안 원광대학병원 소아청소년과에 입원한 496명의 소아청소년에서 호흡기 바이러스 multiplex reverse transcription polymerase chain reaction 결과와 혈액학적 소견을 후향적으로 분석하였다. 결과: 대상 환자 중 379명에서 호흡기 바이러스가 검출 되었다. 가장 흔한 바이러스는 respiratory syncytial virus (RSV) (55.7%)였으며, influenza A (Flu A) (23.0%) 순이었다. 혈구 감소증은 RSV감염 환자 35.5%에서 보였고, Flu A 25.0%, 기타 바이러스 34%에서 발생하였다. 각각의 바이러스는 혈구 감소증의 빈도와 유사하게 세 가지 혈구 세포를 감소시켰다. 379명 중 83명에서 빈혈이 나타났으며($9.71{\pm}1.09g/dL$); 46명에서 호중구 감소증이 나타났다($803.70{\pm}263.09/mm^3$); 23명에서 일시적인 혈소판 감소증이 나타났다($142,434.78{\pm}86,835.18/mm^3$). 그러나 어떠한 환아도 치료가 필요한 경우는 없었다. RSV와 Flu A군 간의 임상적 특징을 비교하였을 때, 빈혈이 있는 RSV군에서 입원기간이 더 길었다. 호중구 감소에서는 RSV군에서 나이가 더 어렸으며 입원 전 발열 기간이 더 짧았다. 결론: 본 연구에서 호흡기 바이러스 감염, 특히 RSV와 Flu A에서 다양하게 혈구 감소가 나타났으나 이들 합병증은 대부분 치료가 필요하지 않았으며 임상 경과에도 영향을 미치지 않았다.

• 대한한방소아과학회지
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• 제29권3호
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• pp.32-53
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• 2015

Objectives : This research aimed to analyze studies on pediatric disease treated by kampo drug, kind of kampo drug used in children, treatment period, and the result of kampo drug treatment for children in Japan. Methods : We got 263 search result with searching word 'kampo medicine' and '小兒', 'children', '乳兒' in J-stage. We selected 34 articles among them which were related to objective of research to analyze studies by type of pediatric disease treated with kampo drug, kinds of kampo drug for each disease, treatment period and result of kampo drug treatment for children. We considered frequency of kampo drug use & pediatric disease treated with kampo drug and significance of research. Results : According to analyzed results, respiratory diseases are the most frequent diseases that are healed by kampo drug. Next sequenced diseases are skin disease. In Kind of kampo drug for pediatric disease. Goreisan and Shosaikoto (柴胡桂枝湯), Shokenchuto (小建中湯) are used frequently. Also, various disease treated with kampo drug were improved. Conclusions : Japanese Doctors consider the Kampo drug is safe and has a lot of merit compared to modern medication. Especially for symptom with unknown origin & immune diseases such as upper respiratory tract infections. Referring to clinical cases of kampo drug in Japan, we will use kampo drug for various pediatric diseases in future.

• Clinical and Experimental Pediatrics
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• 제55권2호
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• pp.42-47
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• 2012

$Mycoplasma$ $pneumoniae$ (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.35-48
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• 2020

Purpose: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study. Methods: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset. Results: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24). Conclusion: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.