No abstract available.
Child ; Croup ; Humans ; Korea

Clinical studies were performed on 32 cases of infectious cuoup prevailing in winter of 1975, admitted to department of pediatrics. The symptoms were critical and clinical course was more repidly progressed, so incidence of emergent tracheostomy was increased than previous years. Incidence of complicated Pulmonary disease was high, but prognosis was good relatively. According to these findings, specific prevalent viral infection was suspected, but identification of virus was not performed.
Croup* ; Incidence ; Lung Diseases ; Pediatrics ; Prognosis ; Tracheostomy

PURPOSE: To evaluate the effect f nebulized budensonide and intramuscular dexamethasone in relieving laryngeal obstruction of croup. METHODS: Forty patients with moderate croup (croup scores of 3 to 7 out of 17) were randomly assigned to budesonide group [1 mg(2 ml) of nebulized budesonide, N=15], dexamethasone group [intramuscular dexamethasone(0.5 mg/kg) and nebulized saline, N=10] and control group(2 ml of nebulized saline, N=15). The changes of croup scores, heart rate, respiratory rate, and arterial oxygen saturation(SaO2) were observed at post-treatment of 2, 24, 36 and 48 hours. The duration of admission and the rates of improvement to the croup score of < or = 1 at the post-treatments were compared. RESULTS: Croup scores at 12, 24 and 36 hours post treatments were 1.7+/-0.8, 1.1+/-0.7 and 0.8+/-0.7 in budensonide group and 2.2+/-0.7, 1.2+/-0.8 and 1.0+/-0.5 in dexamethasone group respectively, which were significantly lower rate, and SaO2 were not significantly different among the three groups. Improved rates to croup score of <1 in budesonide group at post-treatments of 12, 24, and 36 jpirs were 53%, 73% and 87%, which were significantly higher than 0%, 13%, and 47% in control group (p<0.05). Improved rate to croup score of < or = 1 in dexamethasone group was 60^ which was significantly hgier than 13% in control group only at post-treatment of 24 hours (p<0.05). CONCLUSION: Nebulized budesonide and intramusculan dexamethasone are both effective in reducing obstructive symptoms in patients with moderate croup. The effect of nebulized budesonide was more rapid than that of intramuscular dexamethasone.
Budesonide* ; Croup ; Dexamethasone* ; Heart Rate ; Humans ; Oxygen ; Respiratory Rate

To evaluate the change of perception, attitude and practice toward Group Health Care Systerl for small and medium industries, a survey using self-administered questionnaire was conducted to a part of industries in Inchon area, in year 1992 and 1993. major dependent variables were perception, attitude, and practical behavioral change related with Croup Health Care System ; these variables were measured by 3-point Likert like scale. 47 industries were used in analysis. Psrception of year 1993 was higher (1.25) than that (1 34) of 1992. Attitude of yeal. 1993 was also slightly higher (1.46) than that (1.43) of 1992. Both data indicated positive attitude. Practice of year 1993 was slightly lewer (0.86) tHan that (0.90) of 1992, but its change didn't have any statistical significance. In year 1992, major determinants of perception, attitude and behaviral change were sex and age of industrial health care manager ; they had positive efffct upon perception and practice. In yeal. 1993, it was sex of health care manager; it had influenced upon practice. Both year 1992 and 1993, perception was higher and attitude was more positive. In the case of higher perception or positive attitude, practice was active accordingly. To accelerate the behavioral change of health care manager, it is necessary to eaucate them continuously.
Croup ; Delivery of Health Care* ; Incheon ; Occupational Health* ; Questionnaires

PURPOSE: Dexamethasone intramuscular injection and oral prednisolone have been known to be effective in the treatment of croup. The aim of this study was to determine whether nebulized budesonide leads to clinically important improvement in respiratory symptoms within four hours for child with mild to moderate croup. METHODS: Patients with croup visited to the department of Pediatrics, Han Il General Hospital from March 1995 to June 1996 were enrolled in this study. Patients were eligible if their age was between six months and six years, their total croup score was higher than 2 after breathing humidified air for at least 15 minutes. 28 patients were treated with 2mg (8ml) of nebulized budesonide and 8 patients with 8ml of normal saline as control group over the 30 minutes. Croup score, heart rate and respiratory rate were then assessed hourly for up to four hours. Side effects were also observed. RESULTS: 1) The croup score was improved from 3.6+/-0.8 to 1.9+/-0.9 at 4 hours after the nebulized budesonide treatment. 2) No significant differences in changes in heart rate were observed until 4 hours after both the nebulized budesonide group and control group. 3) Significant decrease in respiratory rate was observed at 4 hours after the nebulized budesonide group. 4) No specific side effects were noted during and 4 hours after the nebulized budesonide treatment. CONCLUSIONS: We concluded that nebulized budesonide leads to a prompt and important clinical improvement in children with mild to moderate croup without any specific side effects.
Budesonide* ; Child ; Croup* ; Dexamethasone ; Heart Rate ; Hospitals, General ; Humans ; Injections, Intramuscular ; Pediatrics ; Prednisolone ; Respiration ; Respiratory Rate

Post-intubation croup and tidal volme leak during ventilator support may occur when unsuitable size of endotracheal tube is used. Malposition of endotracheal tubes(ETT) are particularly common in pediatric ICU patients, and may lead to serious complications such as inadvertent endobronchial intubation and accidental extubation. Due to the inaccuracy of physical examination for ETT placement and although there is additional time consumption and expense, the chest X-ray is still considered the gold standard for ETT position evaluation. We assessed the predetermined endotracheal tube size and the distance from the incisor to the carina according to the patient's age, weight and height. The chest X-ray was used for evaluation of these patients who were admitted to the intensive care unit of Severance Hospital Yonsei Medical Center from March to August, 1990. We divided the 430 intubated patients into two groups. Group 1 included 163 patents who were intubated by a endotracheal tube without a cuff. Group 2 included 237 patients who were intubated by a endotracheal tube with a cuff. The conclusion from our results were as follows: 1) The coefficient of determination of the endotracheal tube size, R(2), was highest according to weight, 0.40 and 0.50 in Group 1 and 2. The regression equation of endotracheal tube size using weight was Y=0.11X+3.42 and Y=0.04X+5.46 in Group 1 and Group 2. 2) The coefficient of determination of the distance from the incisor to the carina was highest according to weight 0.57 and 0.33 in Group I and 2. The regression equation of the distance from the incisor to the carina using weight was Y=0.47+10.74 and Y=0.11X+20.17.
Croup ; Humans ; Incisor* ; Intensive Care Units ; Intubation ; Physical Examination ; Thorax* ; Ventilators, Mechanical

PURPOSE: We suspect there is a difference in the clinical manifestations and treatment response to antiviral drugs for influenza A and B. This study was conducted to investigate this difference. METHODS: We collected information on pediatric patients, infected with the influenza virus, admitted to Dongguk University Ilsan Hospital from October 2013 to May 2015. We investigated the clinical manifestations of influenza and differences in treatment response to oseltamivir treatment for the two types of influenza. RESULTS: A total of 138 patients were included. The mean age was 3.5±4.0 years. When comparing the diseases associated with influenza A and B, croup (19.2% vs. 1.7%, P=0.001) was more common with influenza A infection. Myositis (0% vs. 6.7%, P=0.021) and gastroenteritis (29.5% vs. 46.7%, P=0.038) were more common with influenza B infection. When comparing the total fever duration from the start of oseltamivir administration, patients treated with oseltamivir within 2 days of fever had the shortest duration. Among the patients treated with oseltamivir, the duration of fever, after the start of oseltamivir treatment, for was shorter for influenza A infection than for influenza B infection (16.0±19.1 hours vs. 28.9±27.9 hours, P=0.006). CONCLUSIONS: There appear to be differences in the accompanying diseases and antiviral medication responses between the two types of influenza. It is important to administer oseltamivir within 2 days of fever.
Antiviral Agents ; Child ; Croup ; Fever ; Gastroenteritis ; Humans ; Influenza, Human* ; Myositis ; Orthomyxoviridae ; Oseltamivir

Tension pneumothorax is a rare but critical complication of mechanical ventilation. Many researchers regard elevated peak inspiratory pressure as a major etiology for pneumothorax during ventilatory care. Bronchospasm is another adverse events under general anesthesia and it has been reported that the risk of bronchospasm is increased in the children with recent upper respiratory infection. We have experienced a case of recurrent bronchospasm which finally ends up with bilateral tension pneumothorax and debilitating consequences. A 2 year-old boy with a history of croup one week before neuroblastoma excision operation developed several times of bronchospasm attacks during the operation. Episodes of bronchospasm continued in the ICU and complicated with sudden postoperative bilateral tension pneumothorax. Pneumothorax possibly associated with bronchospasm was rarely reported until now. Therefore, we present this case with the literature review.
Anesthesia, General ; Bronchial Spasm* ; Child ; Child, Preschool ; Croup* ; Humans ; Male ; Neuroblastoma ; Pneumothorax* ; Respiration, Artificial

PURPOSE: This prospective study was conducted to evaulate the effect of nebulized steroid (budesonide) and parenteral steroid (dexamethasone) on chidren with croup. METHODS: Twenty nine infants and children (6months-5years of age) admitted to hospital with croup were randomly assigned to receive either 1mg (4ml) of nebulized budesonide (17 patients) or 0.6mg/kg intramuscular injection of dexamethasone sodium phosphate (12 patients). Total croup score, heart rate and respiratory rate of patients were assessed on admission, 30 minutes, 2 hours, 6 hours, 12 hours and 24 hours after treatment, respectively. RESULTS: 1) In total cases, total croup score were significantly decreased at 30 minutes after treatment in the group treated with nebulized budesonide (p<0.01) but at 2 hours after treatmetn in the group treated with dexamethasone (p<0.05). 2) In mild cases (total croup score<5), total croup score were significantly decreased at 2 hours after treatment in the both group (p<0.05). 3) In moderate to severe cases (total croup score> or =5), total croup score were significantly decreased at 30 minutes after treatment in the group treated with nebulized budesonide (p<0.05). But in group treated with dexamethasone, there were no statistical significance because of small cases. 4) Respiratory rate was decreased after treatment in the both group, but significantly decreased at 2 hours after treatment in the group treated with dexamethasone (p<0.05). 5) Heart rate was decreased after treatment in the both group, but significantly decreased at 30 minutes after treatment in the group treated with dexamethasone (p<0.05). 6) There were no significant side effects in the both group. CONCLUSIONS: We conclude that both nebulized budesonide and parenteral dexamethasone were effective in treatment of croup, and that nebulized budesonide leads to more rapid clinical improvement in children with croup, especially moderate to severe one.
Budesonide ; Child* ; Croup* ; Dexamethasone ; Heart Rate ; Humans ; Infant ; Injections, Intramuscular ; Prospective Studies ; Respiratory Rate ; Sodium

PURPOSE: Most patients suffer from croup only once in a life time. However, a small group of patients suffer from it several times. A type of croup from which they suffer more than 3 times is called recurrent croup. The cause of recurrent croup has not been clearly described, but in recent years the allergic reaction is considered as a cause of recurrent croup. ECP is one of the 4 major basic proteins of eosinophil, means eosinophil activation, and has been reported as a clinical indicator of bronchial asthma and other an allergic diseases. We measured serum ECP levels in recurrent croup patients in order to evaluate the roles of ECP as a diagnostic tools and eosinophil activation as part of the pathophysiology of recurrent croup. METHODS: 25 patients with 1st croup episode were enrolled in the study between April and August 1994. We phoned the 22 patients if they had ever caught any respiratory and allergic diseases including croup about 2 years since their discharge from the hospital. Three patients could not be connected. We divided these patients into two groups according to the recurrent rate of attack after discharge. The patients with more than three times of episode were diagnosed as recurrent croup patients, and others with one time of episode were diagnosed as single croup patients. The patients with two times episode were dropt out. Non-allergic 10 patients of the same age with acute viral enteritis were enrolled as a control group. Blood sampling was done at admission. Serum ECP levels were measured by ECP radioimmunosorbent assay kit (Phamarcia, Sweden). RESULTS: 1) Recurrent croup (n=9): The ECP level was 52.1+/-17.3 g/L. Single croup (n=12): The ECP level was 11.6+/-7.0 g/L. Control (n=10): The ECP level was 6.3+/-3.2 g/L. 2) There was no meaningful difference between the control and the single croup patients (p>0.05). 3) There was a meaningful difference between the control and the recurrent croup patients (p<0.05). 4) There was a meaningful difference between the single croup and the recurrent croup patients (p<0.05). 5) There was a linear correlation between eosinophil count and serum ECP levels (r=0.63, p<0.01). 6) For 2 years after discharge, pneumoniae was developed in 2 single croup patients. The recurrent rate of croup was 3-6 times in recurrent croup patients. Asthma was developed in 4 recurrent croup patients. And bronchiolitis was developed in 2 recurrent croup patients. CONCLUSIONS: The investigation of serum ECP levels enables us to distinguish recurrent croup patients from single croup patients. It suggests that eosinophil activation may play an important role in the pathophysiology of recurrent croup.
Asthma ; Bronchiolitis ; Croup* ; Enteritis ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Hypersensitivity ; Pneumonia