• 대한약침학회지
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• 제24권3호
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• pp.107-121
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• 2021

Objectives: The purpose of this study is to analyze the efficacy of traditional Chinese medicine (TCM) injections specified in the clinical guideline for COVID-19 by conducting a meta-analysis of viral pneumonia data. Methods: TCM injections data on viral pneumonia were collected until July 31, 2021. CNKI, PubMed, EMBASE, and the Cochrane electronic database were used to collect the clinical data. "COVID-19," "Viral pneumonia," "Tanreqing," "Xiyanping," "Reduning," "Xingnaojing," "Xuebijing," "Shenmai," "Shengmai," and "Shenfu" were used as keywords. All data collected were mainly about TCM injections and viral pneumonia. Furthermore, studies that included results such as the total effective rate, cough disappearance time, antipyretic time, lung rhomboid disappearance time, and adverse drug reaction were collected for the meta-analysis to identify the efficacy of TCM injections. However, data unrelated to TCM injections specified in the clinical guidelines for COVID-19 or viral pneumonia were excluded. The quality of included RCTs was assessed by the Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to conduct the meta-analysis. Results: A total of 18 studies with 1540 patients were included in this study. The results of the meta-analysis showed that the total effective rate OR = 4.61 (95% CI 2.92, 7.25, p = 1.00/ I² = 0%); the cough disappearance time: SMD -1.23 (-1.37, -1.09, p < 0.00001/ I² = 94%); the antipyretic time: SMD -1.26 (-1.40, -1.11, p < 0.00001/ I²=94%); lung rhomboid disappearance time: SMD -1.17 (-1.33, -1.02, p < 0.00001/ I² = 89%); and adverse drug reaction was OR 0.36 (95% CI 0.20, 0.64, p = 0.21/ I² = 30%). From the results, the treatment group (TCM injection) showed better efficacy than the control group (Western medication). Conclusion: Xiyanping, Reduning, and Tanreqing injections may yield benefits as COVID-19 treatments. However, clinical trials on TCM injections for the treatment of COVID-19 are still lacking. More high-quality clinical trials are still required.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.283-288
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• 2009

Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia is needed to decide empiric antibiotic treatment. Antibiotics effective against the expected bacterial pathogens should be instituted where necessary. The role of emerging pathogens and the effect of pneumococcal resistance and heptavalent conjugate pneumococcal vaccines are to be considered in practice. There are reports supporting the valid and highly efficacious use of penicillin as a first-line drug for treating CAP. This review raises the issue of the overuse of unnecessary antibiotics in viral CAPs and the use of second or third-line antibiotics for non-complicated pneumonias in most clinical settings.

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.358-367
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• 2017

Background: Bacterial pneumonia occurring after respiratory viral infection is common. However, the predominant bacterial species causing pneumonia secondary to respiratory viral infections other than influenza remain unknown. The purpose of this study was to know whether the pathogens causing post-viral bacterial pneumonia vary according to the type of respiratory virus. Methods: Study subjects were 5,298 patients, who underwent multiplex real-time polymerase chain reaction for simultaneous detection of respiratory viruses, among who visited the emergency department or outpatient clinic with respiratory symptoms at Ulsan University Hospital between April 2013 and March 2016. The patients' medical records were retrospectively reviewed. Results: A total of 251 clinically significant bacteria were identified in 233 patients with post-viral bacterial pneumonia. Mycoplasma pneumoniae was the most frequent bacterium in patients aged <16 years, regardless of the preceding virus type (p=0.630). In patients aged ${\geq}16years$, the isolated bacteria varied according to the preceding virus type. The major results were as follows (p<0.001): pneumonia in patients with influenza virus (type A/B), rhinovirus, and human metapneumovirus infections was caused by similar bacteria, and the findings indicated that Staphylococcus aureus pneumonia was very common in these patients. In contrast, coronavirus, parainfluenza virus, and respiratory syncytial virus infections were associated with pneumonia caused by gram-negative bacteria. Conclusion: The pathogens causing post-viral bacterial pneumonia vary according to the type of preceding respiratory virus. This information could help in selecting empirical antibiotics in patients with post-viral pneumonia.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.89-95
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• 2012

Background: As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. Methods: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological, and radiographic differences and scoring system. Results: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). Conclusion: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

• 한국임상수의학회지
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• 제36권4호
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• pp.185-189
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• 2019

Respiratory pathogens of calves including bovine parainfluenza type 3 virus (BPI3V), bovine respiratory syncytial virus (BRSV), infectious bovine rhinotracheitis virus (IBRV) and Mycoplasma spp is well-known for winter pathogens. However, there are no studies about summer pneumonia pathogens of calves in Korea. The aim of this study was to detect respiratory pathogens from calves with summer pneumonia. Eighty calves from 5 regions were chosen and their nasal swabs were used to detect respiratory pathogens with real-time PCR. Mycoplasma spp was major primary respiratory pathogens in calves with summer pneumonia. Although, the detection rates of respiratory viruses were very low, serological assays showed that respiratory viruses exist widely in farms.

• 대한수의학회지
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• 제29권4호
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• pp.531-540
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• 1989

A new sudden death in rabbits appeared in China and Korea in 1984 and 1985, respectively, and was recognized to be an acute infectious disease caused by a virus. The disease was reported as a "new viral disease," and thereafter, a tentative name of "viral hemorrhagic disease", "hemorrhagic pneumonia" or "viral hemorrhagic pneumonia" has been described in the case reports. But authors had called the viral disease "rabbit viral hepatitis" due to picornavirus infection, because the principal lesion of the disease was an acute hepatitis. The purpose of this report is to describe the electron microscopic findings on the livers in experimentally infected rabbits. All the livers of the affected rabbits were shown to have degenerative changes of a type that is characteristic of acute hepatitis. In the liver cells, there were dilation of rER and mitochondria, vacuole formation of various sizes, and appearances of many virus-like particles in the vicinity of rER, granular bodies and crystalline arrays of viral particles in the cytoplasm with necrotic changes of the nucleus. Clusters of virus-like particles and viral crystals appeared in the cytoplasm of sinusoid endothelial cells and Kupffer's cells with morphological changes of organelles. Also viral crystals were demonstrated in the cytoplasm of macrophages among the liver cells. On the whole, the liver cells had many virus-like particles and a few crystalline arrays of viral particles. Therefore, this implies that the liver cells are the main site of the viral replication in inducing the viremia. It was concluded that the liver was the primary target organ of this viral disease, and the pathological and the ultrastructural evidence suggest that the virus may be belong to genus enterovirus.

• Tuberculosis and Respiratory Diseases
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• 제71권5호
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• pp.335-340
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• 2011

Background: Community-acquired pneumonia (CAP) is an important cause of morbidity and mortality throughout the world in all age groups. Viral causes of CAP are less well characterized than bacterial causes. We analyzed the characteristics of hospitalized patients with CAP who had a viral pathogen detected by multiplex polymerase chain reaction (PCR). Methods: Multiplex real-time PCR was performed for respiratory viruses in samples collected from 520 adults who developed CAP at Chungnam National University Hospital. Clinical, laboratory, and radiological features at presentation as well as other epidemiological data were analyzed. Results: Of 520 patients with CAP, a viral pathogen was detected in 60 (11.5%), and influenza A was the most common. The virus detection rate in patients with CAP was highest in November. Two or more pathogens were detected in 13 (21.7%) patients. Seven patients had severe disease and were administered in the intensive care unit. Most patients (49/60, 81.7%) had comorbidities. However, nine (15%) patients had no comorbidities, and their age was <60 years. The ground glass opacity pattern was the most common radiological feature. Seven (11.7%) patients died from CAP. Conclusion: Viral pathogens are commonly detected in patients with CAP, and a respiratory virus may be associated with the severity and outcome of pneumonia. Careful attention should be paid to the viral etiology in adult patients with CAP.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.24-30
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• 2010

Background: A novel 2009 influenza A (H1N1) virus emerged and disseminated to all over the world. There are few reports on the clinical characteristics of patients with complications. We describe the clinical features of pneumonia in adult patients hospitalized, who have novel influenza infection. Methods: There were 43 adult patients enrolled into the study with pneumonia of 528 hospitalized patients confirmed influenza A (H1N1) virus infection by real-time reverse transcriptase polymerase chain reaction testing, between 24 August 2009 and 31 January 2010. The clinical data of patients with pneumonia were collected retrospectively. Results: There were 22 of 43 (51.2%) influenza patients with pneumonia that had higher risk factors for complications. Compared to 28 patients with influenza A (H1N1) viral pneumonia and 15 patients, who had isolated bacteria from cultures, those with mixed viral and bacterial pneumonia were significantly more likely to have unilobar consolidations on chest radiographs (53.3 vs. 10.7%, p<0.01) and higher scores of pneumonia severity index (PSI; 90 [66~100] vs. 53 [28~90], p=0.04). Six patients required mechanical ventilation support in an Intensive Care Unit and were more likely to have dyspnea (83.3 vs. 29.3%, p=0.02) and low levels of $PaO_2$ (48.3 [37.0~70.5] vs 64.0 [60.0~74.5] mm Hg, p=0.02) and high levels of pneumonia severity index (PSI) score (108.0 [74.5~142.8] vs. 56.0 [40.5~91.0], p=0.03). Conclusion: The majority of pneumonia patients infected with novel influenza improved. Chest radiographic findings of unilobar consolidations suggest that mixed pneumonia is more likely. Initial dyspnea, hypoxemia, and high levels of PSI score are associated with undergoing mechanical ventilation support.

• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.205-211
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• 2010

Background: Procalcitonin is a well known marker in infection that plays a role in distinguishing between bacterial and viral infections in screening. The aim of the present study was to evaluate the role of procalcitonin in differentiating between 2009 H1N1 influenza pneumonia and community acquired pneumonia of bacterial origin, or mixed bacterial origin and 2009 H1N1 influenza infection. Methods: A retrospective observational study was performed over the 6-month winter period during the 2009 H1N1 influenza pandemic. Ninety-six patient-subjects were enrolled, all of whom had been diagnosed with community acquired pneumonia in emergency department during the study period. On admission, laboratory studies were performed, which included 2009 H1N1 influenza real-time polymerase chain reaction of nasal secretions and procalcitonin on serum; the laboratory values were compared between the study groups. Receiver operating characteristic curve analyses were performed on the resulting data. Results: Compared to those with bacterial or mixed infections (n=62) and bacterial pneumonia with confirmed organisms (n=30), patients with 2009 H1N1 pneumonia (n=34) were significantly more likely to have low procalcitonin levels (p=0.008, 0.001). Using cutoff of value >0.3 ng/mL, the sensitivity and specificity of procalcitonin for detection of patients with confirmed bacterial pneumonia were 76.2% and 60.6%, respectively. A significant difference in procalcitonin was found between 2009 H1N1 pneumonia and pneumonia caused by mixed influenza viral and bacterial infections (0.15 [0.05~0.84] vs. 10.3 [0.05~22.87] ng/mL, p=0.045). Conclusion: Serum procalcitonin measurement may assist in the discrimination between pneumonia of bacterial and of 2009 H1N1 influenza origin. High values of procalcitonin suggest that bacterial infection or mixed infection of bacteria and 2009 H1N1 influenza is more likely.

• 대한수의사회지
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• 제23권9호
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• pp.603-610
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• 1987

The pathological and microbiological studies were carried out to investigate an acute, febrile, highly fetal, infectious disease of rabbits that had occurred in the Winter and in the Spring and that had begun to be reported in Korea from November, 1985. The clinical signs of this disease were characterized by high fever, lethargy, piercing shriek, convulsion, and sudden death with epistaxis, but often they were not observed. The predominant pathogical findings were severe congestion and hamorrhage in trachea, dark brown discoloration of liver by diffuse necrosis or acute viral hepatitis, and hamorrhagic damages of lung, heart, spleen, kidney, etc. The etiological agent was a small round virus, in 25-35nm in diameter and without envelope, thus looking like a picorna virus. This disease resembled what was called the 'Viral Hamorrhagic Pneumonia in Rabbits'(tentative name) that had been reported for the first time in China in 1984. It will be desirable that the disease should be renamed as the 'Viral Hemorrhagic Fever in Rabbits', the 'Acute Viral Hepatitis in Rabbits', etc. because of its charateristics and the basis of pathological findings. An inactivated vaccine is now in the process of preparation for the prophylaxis of this viral disease.