• Journal of Korean Society of Disaster and Security
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• v.14 no.1
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• pp.23-40
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• 2021

In the era of the global coronal 19 pandemic, there is a risk of cross-infection in hospitals at the stage where treatments and vaccines are currently being developed and marketed, so individuals should enhance their acquired immunity and generalize their living systems by the performance of copper ions in the social environment. In order to prevent the spread of infection, the need for anti-bacterial film and its efficacy were analyzed through anti-viral performance tests based on research and development cases of worldwide and immemorial time. he Korea Construction Research Institute (KCL) has received anti-bacterial performance certification and anti-viral test scores from the "National Approval Performance Certification Agency." At the time, NCCP 43326 Human Corona virus (BetaCoV/Korea/KCDC03/2020), which was approved by the Centers for Disease Control and Prevention, was introduced to ensure that the activity rate of infected cells was satisfied in the anti-viral performance test. Anti-proliferation measures for the Corona 19 virus require a quality clinical trial study comparing the experimental group within the glass space where the antiviral copper film is constructed with the comparator of the same condition without copper film.

• Pediatric Infection and Vaccine
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• v.30 no.2
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• pp.55-61
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• 2023

Purpose: Urinary tract infections (UTIs) pose a significant disease burden in children. This study aims to determine whether a short-course regimen is non-inferior to a standard-course regimen in children with UTIs without complication and presence of bacteremia, and to define, in the optimal way possible, the term "short-course" in this context. Methods: We conducted a rapid systematic review of research up to April 2021 in PubMed, Embase, and Cochrane databases. We included studies that compared clinical outcomes in pediatric UTIs treated with short-course(≤4 days) or standard (≥5-7 days) courses. Results: Our analysis suggests that short-course regimes have equivalent efficacy to standard-course regimens, with similar clinical cure rates and recurrence rates. All 10 studies comparing the clinical cure rates of short- and standard-course regimens reported comparable outcomes. The study evaluating renal scarring indicated no inferiority of short-course regimens compared to standard-course ones. Regarding UTI relapse, 8 out of 10 studies reported no significant difference in outcomes between short- and standard-course regimens. Conclusions: Our results purpose that short-course UTI regimens of 6 days or less are just as effective as standard-term regimens of 7 days or more in terms of infection cure and prevention of recurrence. Considering the equivalent rates of clinical cure and relapse between short- and standard-course regimens, it could be inferred that short-course regimens might be a more optimal strategy for managing pediatric UTIs without increasing the risk of complications.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.124-134
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• 2005

Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.267-275
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• 1998

Purpose : We have studied the changes of cardiac troponin I(cTnI) level and left ventricular ejection fraction(LVEF) before and after treatment of IVGG to evaluate the efficacy of single high dose of intravenous gammaglobulin(IVGG)(2.0gm/kg) therapy for improving cardiac function and clinical symptoms and signs in patients with clinically suspected acute myocarditis. Methods : The patients consisted of 18 cases who admitted increased cTnI with clinically suspected acute myocarditis caused by viral infection, Kawasaki disease and fever unknown origin(FUO) from Jan. 1995 to Jun. 1998. The control group consisted of 20 cases suffered from hand-foot-mouth disease, herpangina and high fever with rash. The level of cTnI was measured by Chemiluminiscent immunoassay method(normal<0.1ng/ml) and cardiac function was evaluated by left ventricular ejection fraction(LVEF)(normal 64~83%) by echocardiogram. Results : The level of cTnI increased to $0.306{\pm}0.209ng/ml$ and LVEF decreased to $60.1{\pm}1.6%$ before treatment of IVGG significantly as compared with control group(P<0.05). All cases were returned to normal range of LVEF($71.4{\pm}3.7%$) and decreased cTnI significantly($0.089{\pm}0.082ng/ml$) after treated with IVGG within 1 week in patients group(P<0.05). Conclusion : The single high dose of IVGG(2.0gm/kg) therapy was rapid and effective improvement of cardiac function and clinical symptoms and signs of acute myocarditis, and the measurement of serum cTnI and LVEF may help to diagnose and evaluate efficacy of IVGG on it.

• Journal of Yeungnam Medical Science
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• v.25 no.1
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• pp.1-18
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• 2008

Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of $10^4$ copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the $21^{st}$ century.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.75-85
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• 2005

Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.109-116
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• 2016

Purpose: Recent observational studies have found that vitamin D deficiency is associated with respiratory tract infections. However, randomized controlled trials (RCTs) regarding the efficacy of vitamin D in childhood respiratory tract infection (RTI) have yield inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between vitamin D supplementation and the risk of RTI. Methods: A comprehensive search was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trial. Randomized controlled trials of vitamin D supplementation for prevention of RTI in children were included for the analysis. Cochrane Collaboration's tool for assessing the risk of bias was used to assess the quality of the studies. Pooled risk ratios with 95% confidence intervals (CIs) were meta-analyzed using Review Manager 5.3. Results: A total of seven RCTs were included in the meta-analysis. According to a random-effects model, the risk ratio for vitamin D supplementation was 0.82 (95% CI: 0.69-0.98) and $I^2=62%$ for heterogeneity. On subgroup analysis, heterogeneity decreased in the subgroup with follow-up less than 1 year, participants ${\geq}5years$ of age, patients subgroup, and subgroup with dosing daily. Funnel plot showed that there might be publication bias in the field. Conclusions: The present meta-analysis supports a beneficial effect of vitamin D supplementation for the prevention of RTI in children. However, the result should be interpreted with caution due to limitations including a small number of available RCTs, heterogeneity among the studies, and potential publication bias.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.199-206
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• 2014

Purpose: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. Methods: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. Results: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was $3.6{\pm}2.8$ year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period ($4.18{\pm}2.10$ vs $4.79{\pm}1.49$ days, P=.17) and total fever duration ($5.32{\pm}2.07$ vs $6.41{\pm}3.25$ days, P =.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. Conclusion: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.198-208
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• 2002

Purpose : There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists Methods : Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. Results : Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% us 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b ($54.3{\sim}77.1%$). Conclusion : Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.107-115
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• 1999

Purpose : Enterobiasis is probably one of the most common parasitic infection world-wide. Human is the only known host of Enterobius vermicularis. Children are more commonly infected with Enterobius vermicularis than adults and infections are commonly recurred. In Korea, there is a high prevalence. So, we performed this study to evaluate the present status of Enterobius vermicularis infection among children in the Masan, Changwon areas and to determine the efficacy of flubendazole against this parasitic nematode. Methods : From November to December, 1997, urban and rural elementary school children and urban preschool children were examined for the presence of Enterobius vermicularis egg. All the children were examined once by an adhesive cellotape anal swab technique in the early morning at home by their parents guided by specific instructions for the technique. Results : 1) A total of 644 adhesive cellotape anal swab specimens was collected from 205 urban elementary school children, 290 rural elementary school children and 145 urban preschool children. Among them, 114(17.7%) were positive for Enterobius vermicularis eggs. There was no significant differences in the rate with regard to sex. 2) In the preschool children, the egg detection rate was 42(29.0%) out of 145 children. This rate was significantly higher compared with 72(14.4%) of 499 school children. 3) The egg detection rates in the rural and urban school children were 15.2, 13.7% respectively. There was no significant difference in both groups. In the 3rd grade and below in elementary school children, there was a higher rate compared with above 4th grade group. 4) In day care center where egg detection rate was high as 41%, the children were given two doses of 100mg flubendazole every 3 weeks, including staffs and family members. After treatment, egg detection rate fatted as 6%. Conclusion : Our data demonstrated that there was high prevalence of Enterobius vermicularis infection. In the light of these results, it is necessary to examine and treat children as soon as possible.