No abstract available.
Lung*

BACKGROUND: Adenoviruses (Ads) are a worldwide cause of endemic and epidemic respiratory infections, particularly in children, young adults and immunocompromised patients. They are responsible for 5% of the acute respiratory infections in children under the age of 4 years and account for about 10% of all cases of childhood requiring hospitalization in this age group. In this study, we report the characteristics of adenoviruses isolated from children with respiratory illness in Busan, 1999~2000. METHODS: A total of 765 children with acute respiratory illness from ten local clinics were studied. Isolation of Ads was performed by inoculating throat swab from patients into Hep-2 cells. The virus propagation was confirmed by the presence of cytopathic effect and adenoviruis specific PCR. Typing of isolated viruses was determined by sequencing analysis of hexon gene. RESULTS: Ads were isolated from throat swab of 17 (2.2%) out of 765 children. The epidemic of Ads infection was concentrated on winter months (December, January, and February). Seventeen Ad isolates showed four serotypes, with Ad3 being the most frequent strain. The distribution of Ads serotypes were eleven (64.7%) Ad3 strains, three (17.6%) Ad5 strains, two (11.8%) Ad2 srtains, and one (5.9%) Ad1 strain. CONCLUSION: Acute respiratory infections by adenoviruses in children were occurred particularly in winter season in Busan. More extended and systematic surveillance of adenovirus infection among populations is required to elucidate the extent of epidemic and disease burden of adenovirus infection.
Adenoviridae Infections ; Adenoviridae* ; Busan* ; Child* ; Hospitalization ; Humans ; Immunocompromised Host ; Pharynx ; Polymerase Chain Reaction ; Respiratory Tract Infections ; Seasons ; Young Adult

No abstract available.
Paramyxoviridae Infections* ; Polymerase Chain Reaction* ; Reverse Transcription*

Stevens-Johnson syndrome is considered to be a severe type of erythema exsudativum multiforme. It is characterized by erythema with vesicobullous and eroded lesions of skin and mucous membranes. The importance in anesthetic management of Stevens-Johnson syndrome is preventing injury of the oropharyngeal and tracheal membrane at intubation because soft oral airways may cause bleeding and push tissue debris into the pharynx and larynx. In addition, anesthesiologist should take care of complications such as transitory atrial fibrillation, interstitial myocarditis, pericarditis, pneumothrax, acute renal insufficiency and conjunctivitis. A 5-year-old male, previously diagnosed with Stevens-Johnson syndrome and treated with a steroid, was noted as having dyspnea on rest, coughing, jaundice, and fever. Even after aggressive medical management for status asthmaticus during the preoperative period, dyspnea and expiratory wheezing did not improve. He underwent a resection of the gall bladder, lung and liver biopsy in spite of a great risk of perioperative pulmonary complications. After treatment with epinephrine, and aminophylline, the peak inspiratory pressure was 40 cmH2O with mild hypercarbia (PaCO2 45 50 mmHg). We report the anesthetic considerations for a case of Steven-Johnson syndrome with status asthmaticus.
Acute Kidney Injury ; Aminophylline ; Atrial Fibrillation ; Biopsy ; Child, Preschool ; Conjunctivitis ; Cough ; Cytochrome P-450 CYP1A1 ; Dyspnea ; Epinephrine ; Erythema ; Fever ; Hemorrhage ; Humans ; Intubation ; Jaundice ; Larynx ; Liver ; Lung ; Male ; Membranes ; Mucous Membrane ; Myocarditis ; Pericarditis ; Pharynx ; Preoperative Period ; Respiratory Sounds ; Skin ; Status Asthmaticus* ; Stevens-Johnson Syndrome* ; Urinary Bladder

BACKGROUND: Lung age, calculated from sex, forced expiratory volume in one second (FEV1), and height, was developed to illustrate premature changes to the lungs and could be used to motivate smoking cessation. However, this method has not been tested in association with smoking in Korea. The purpose of this study was to investigate the association of lung age with smoking and other factors in Korean males. METHODS: We reviewed the records of 1,100 healthy men who visited a health promotion center at Ewha Womans University Medical Center from January 2008 to June 2009. Lung age was calculated from FEV1 and normal predictive values of spirometry according to age in the Korean population. The difference between lung age and chronological age was evaluated in relation to smoking status, weight, body mass index, waist, muscle mass, fat mass, and exercise. RESULTS: The age difference was significantly higher in current smokers than in non-smokers (12.47 +/- 19.90 vs. 7.30 +/- 19.52, P < 0.001). Additionally, the age difference was positively correlated with life time pack-year (beta = 0.223; P < 0.001) and fat mass (beta = 0.462; P < 0.001). Lung age increased 1 year for 4.48 pack-year increase or for 2.16% increase in fat mass. CONCLUSION: We found a significant relationship between lung age and both smoking status and fat mass in healthy Korean males. Lung age may be a useful tool for motivating cessation of cigarette smoking and management of risk factors related to obesity.
Academic Medical Centers ; Body Weight ; Female ; Forced Expiratory Volume ; Health Promotion ; Humans ; Korea ; Lung* ; Male ; Methods ; Muscles ; Obesity ; Risk Factors ; Smoke* ; Smoking Cessation ; Smoking* ; Spirometry

No abstract available.

PURPOSE: This study aimed to identify the early predictors of neurodevelopmental outcomes in infants undergoing therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy. METHODS: The medical records of 24 neonates who underwent hypothermia therapy for hypoxic ischemic encephalopathy at the neonatal intensive care unit of Yeouido St. Mary's Hospital of the Catholic University of Korea between August 2013 and May 2016 were reviewed. Patients were divided into two groups according to their neurological outcome at the age of 18 to 24 months: a normal group (n=14), which included patients with normal neurological function, and an abnormal group (n=10), which included patients with neurological deficits. The clinical characteristics, clinical outcomes, and laboratory findings before and after hypothermia treatment were compared between the groups. RESULTS: There were no significant differences in the demographic characteristics between the two groups. With regard to clinical outcomes, only brain magnetic resonance imaging (MRI) findings showed significant differences between the normal and abnormal groups (21.4% vs. 100.0%, P < 0.001). With regard to laboratory findings, there were significant differences in the white blood cell (WBC) count after hypothermia treatment between the normal and abnormal groups (9.78±3.52 vs. 14.90±3.48, P=0.003). However, logistic regression analysis showed that the WBC count was not an independent risk factor for abnormal neurodevelopment (P>0.05). CONCLUSION: The presence of abnormal lesions on MRI was the most useful predictor of poor neurodevelopmental outcome in infants treated with therapeutic hypothermia after perinatal asphyxia.
Asphyxia ; Brain ; Humans ; Hypothermia ; Hypothermia, Induced ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Leukocytes ; Logistic Models ; Magnetic Resonance Imaging ; Medical Records ; Risk Factors ; Treatment Outcome

The lymphocele after renal transplantation is usually observed around the graft. We here report an unusual case of lymphocele mimicking hydrocele. The patient was admitted due to scrotal edema. We initially diagnosed this patient as a case of hydrocele, but biochemical data of aspirated fluid was consistent with lymphatic fluid, and abdominal CT revealed fistula between scrotum and graft. This finding suggests that the lymphatic fluid accumulated around the transplant kidney has migrated to the scrotum to form a lymphocele. In conclusion, lymphocele is a rare cause of scrotal swelling but should be considered as a possibility when a transplant patient develops scrotal swelling.
Edema ; Fistula ; Humans ; Kidney Transplantation* ; Kidney* ; Lymphocele* ; Scrotum ; Testicular Hydrocele ; Tomography, X-Ray Computed ; Transplants

Hemorrhagic fever with renal syndrome (HFRS) in Korea is caused by 2 serotypes of hantavirus, Hantaan and Seoul. Even though the number of peripheral CD8' T-lymphocytes is markedly elevated in the acute phase of HFRS, the pathogenetic role of this phenomena is not clear. To elucidate the role of cell-mediated immune response in HFRS, we measured concentrations of cytokines, such as IL-1, IL-2, IL-4, IL-6, IL-10 and IFN-r in plasma samples obtained from 15 patients (15 men, 20-24 years old) at various phase of illness. Cytokines were measured by ELISA in plasma samples. The plasma concentration of IL-10 was elevated in 13/15 patients. The median maximum value, during days 4-8, was 23 ng/L (range, 0-70.2). The maximum values were significantly higher(p=0.005) than the baseline. IL-1 and IL-6 was detected in 6 patients. Other cytokine responses (IL-2, IL-4, IFN-r ) were negligible. There was no significant correlation between maximum levels of IL-10 and maximum serum concentration of creatinine (r=0.118, p=0.675), and lowest plate#let count (r=-0.088, p=0.765). Kinetics of IL-10 were quite similar in HFRS patients with maximum creatinine values >3 mg/dL and in those with values <3 mg/dL. In conclusion, plasma IL-10 levels, but not IL-2, IL-4 or INF-r were elevated in acute phase of HFRS, and it suggests that the systemic immunosuppressive activities of IL-10 might have some pathogenetic role in HFRS.
Creatinine ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Kinetics ; Korea ; Male ; Plasma* ; Seoul ; T-Lymphocytes

Azathioprine is a conventional immunosuppressant in renal transplantation but long-term administration may lead to hematologic complications. We here report a cauda equina syndrome caused by spontaneous epidural hematoma in a renal transplant recipient who had undergone long-term azathioprine treatment. A 34 year-old male was admitted to our hospital with complaints of numbness of the lower extremities and back pain. He had received renal transplantation 14 years ago and had been on sole therapy with azathioprine for 11 years. Three months before admission, the patient developed pancytopenia, and a subsequent bone marrow biopsy revealed hypocellularity. Azathioprine was replaced by tacrolimus and steroids thereafter. After a three months discontinuation of azathioprine, an epidural hematoma developed and resulted in cauda equina syndrome. Regular follow-up of complete blood count and change of immunosuppressants with less bone marrow toxicity should be considered in patients receiving azathioprine for long-term period.
Adult ; Azathioprine* ; Back Pain ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cauda Equina* ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Immunosuppressive Agents ; Kidney Transplantation ; Lower Extremity ; Male ; Pancytopenia ; Polyradiculopathy* ; Steroids ; Tacrolimus ; Transplantation