Purpose: This study aimed to analyze the immunologic profile of children with postinfectious bronchiolitis obliterans (PIBO) in order to approach pathophysiology affected by host factors. Methods: A total of 10 children with PIBO were prospectively enrolled. We obtained information on demographics from their caregiver and electric medical records. Peripheral blood samples were collected before cyclic systemic methylprednisolone therapy and complete blood count, immunoglobulin level and lymphocyte subset were analyzed. Results: The white blood cell count and immunoglobulin level were within the normal range in children with PIBO. The CD4+/CD8+ ratio was not significantly different from those of the healthy control group. A decreased proportion of both central memory T cells (median [interquartile range]; 13.5% [8.3%–16.3%] vs. 18.5% [15.9%–24.1%], P = 0.01) and effector memory T cells (10.3% [5.0%–18.4%] vs. 20.9% [16.6%–26.3%], P = 0.03) in CD4+T cells was observed in the PIBO group compared with those in the control group. In CD8+T cells, the proportion of effector memory T cells (7.8% [4.2%–13.8%] vs. 24.3% [15.3%–27.9%], P = 0.02) and CD45RA+effector memory T cells (16.2% [11.0%–36.6%] vs. 24.2% [17.1%–39.7%], P = 0.04) was decreased in the patient group compared with the control group. Conclusion It is suggested that T lymphocyte subset abnormalities may be associated with a decrease in the ability to differentiate the T cells immediately upon reinfection and induce an effective response to infection. These results may partially explain the pathophysiological individual vulnerabilities to PIBO after lower respiratory tract infections in children.

BACKGROUND: Surgery has been considered the most effective and standard treatment modality in non-small cell lung cancer(NSCLC). However in stage IIIA lung cancer, the role of surgery is still controversial. To evaluate the role of surgery for stage IIIA NSCLC, we investigated the survival after surgery and the prognostic factors. MATERIAL AND METHOD: We evaluated 158 consecutive cases of stage IIIA NSCLC patients operated on between 1990 and 1996. There were 130 male patients and 28 female patients, and the mean age was 58.5 years. All patients except one underwent lung resection beyond lobectomy and extended mediastinal dissection. Postoperative adjuvant therapy were undertaken in 145(94.8%) patients. All patients(153) were followed and the mean follow-up period was 21.4months. RESULT: Twenty nine cases of the postoperative complications developed in 25 patients (15.8%). There were 5 operative mortality cases(3.2%) and the main cause of death was acute respiratory distress syndrome (ARDS). Local or distant recurrences developed in 84 patients(54.9%). The 5-year survival of 153 patients was 29.6% and the median survival time was 18.0 months. The 5-year survival of non N2 disease group(36.8%) was better than that of N2 disease group(26.6%)(p=0.35) and the 5-year survival of squamous cell carcinoma (38.1%) was better than that of adenocarcinoma(25.7%)(p=0.39) however there were no significant differences. Regarding the postoperative adjuvant therapy, in combined therapy group(84 patients), radiotherapy group(37 patients) and chemotherapy group(24 patients), the 5-year survival were 31.3%, 32.4%, and 14.6% respectively. There was no difference of survival between radiotherapy and combined therapy group(p=0.31), however the survival of the combined therapy group was better than the chemotherapy group(p=0.005). The survival of the complete resection group(31.9%) was better than the incomplete resection group(16.6%) however there was no significant difference(p=0.19). CONCLUSION: These observations indicate that the good 5-year survival(29.6%) in patients with stage IIIA NSCLC result from the agressive surgical treatment including extensive mediastinal nodes dissection.
Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Mortality ; Postoperative Complications ; Radiotherapy ; Recurrence ; Respiratory Distress Syndrome, Adult ; Small Cell Lung Carcinoma*

Double primary cancer means that more than two cancers with different origin exist independently in an individual. The diagnosis of double primary cancer was determined by following criteria. Each of the tumors must present a definite picture of malignancy, each must be distance, and the probability of one being a metastasis of the other must be excluded. Primary small cell carcinoma in the esophagus is relatively rare, and rarer when it is combined with other malignant disease. A review of the Korean medical literature failed to reveal any previously described the case of syn-chronous double primary cancer of primary esophageal small cell carcinoma and squamous cell carcinoma of lung. Recently, we have experienced a case of double primary cancer, a 65-year-old man with primary esophageal small cell carcinoma and squamous cell carcinoma of lung, which were diagnosed by endoscopic biopsy and bronchoscopic biopsy.
Aged ; Biopsy ; Carcinoma, Small Cell* ; Carcinoma, Squamous Cell* ; Diagnosis ; Esophagus ; Humans ; Lung* ; Neoplasm Metastasis

OBJECTIVE: School bullying, the most prevalent type of school violence, is known to be related to various behavioral, emotional and social problems both in victims and perpetrators. The purpose of the present study is to investigate the prevalence of school bullying and related psychopathology in a community sample of elementary school students. METHOD: Fourth to 6 th graders of two randomly selected classes in two elementary schools in Anyang City participated in a cross-sectional study. Study subjects completed Korean-Peer Nominating Inventory(K-PNI). Parents completed Korean-Child Behavior Checklist(K-CBCL), ADHD Rating Scale(ARS) and Conners Scales for parents, and teachers completed ARS and Conners Scales for teachers. Descriptive statistics, multiple linear and logistic regression were performed. RESULTS: A Total of 532 students participated in this study. Prevalence of victims, perpetrators, and victim-perpetrators were 48%, 45%, and 30% respectively. Extreme victims and perpetrators of school bullying ranged from 2.1-4.1%. Inattention-passivity in teachers' Conners Scale, social immaturity or aggression in K-CBCL were positively associated with victims and victim-perpetrators, and grade was negatively related to school bullying. Conduct problem in Conners Scale for teachers and emotional instability in K-CBCL, and male gender were positively associated with perpetrators. CONCLUSION: School bullying is very common in Korean children of elementary schools. Those who had experienced school bullying, either as victims or as perpetrators, had signifi-cantly more psychopathology than their counterparts. To clarify a causal relationship between psychopathology and school bullying, a longitudinal follow-up study is suggested.
Aggression ; Bullying* ; Child ; Cross-Sectional Studies ; Gyeonggi-do ; Humans ; Logistic Models ; Male ; Parents ; Prevalence ; Psychopathology* ; Social Problems ; Violence ; Weights and Measures

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.