Respiratory syncytial virus (RSV) is the leading cause of respiratory viral infection in infants and children. However, little is known about the contribution of monocytes to antiviral responses against RSV infection. We identified the IFN-β production of monocytes using IFN-β/YFP reporter mice. The kinetic analysis of IFN-β-producing cells in in vivo RSV-infected lung cells indicated that monocytes are recruited to the inflamed lung during the early phase of infection. These cells produced IFN-β via the myeloid differentiation factor 88-mediated pathway, rather than the TLR7- or mitochondrial antiviral signaling protein-mediated pathway. In addition, monocyte-ablated mice exhibited decreased numbers of IFN-γ-producing and RSV Ag-specific CD8 + T cells. Collectively, these data indicate that monocytes play pivotal roles in cytotoxic T-cell responses and act as type I IFN producers during RSV infection.

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index. SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION: The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.
Adult ; Caregivers ; Child ; Dizziness ; Humans ; Methods ; Reproducibility of Results ; Weights and Measures

BACKGROUND AND OBJECTIVES: Several questionnaires had been developed to assess the handicap due to dizziness. The questionnaires for adults were used and these had been translated into Korean with validity and reliability. However, there is no Korean translation of dizziness inquiry form owing to the little concern of the pediatric dizziness. The objective of this study was to determine the reliability and validity of a Korean Dizziness Handicap Index for Patient Caregivers (KDHI-PC), and revealed the factor analysis of this index.SUBJECTS AND METHOD: We sampled the 24 pediatric patients who had dizziness-related symptoms and visited the hospitals. The patients completed a questionnaire (DHI-PC) that had been translated and reverse translated into Korean. The results of this investigation were analyzed using exploratory factor analysis, Cronbach's α coefficient and internal consistency reliability. RESULTS: By exploratory factor analysis, KDHI-PC was divided into two scales. This questionnaire showed a good internal consistency (Cronbach's α=0.945). All items had good item-total correlations. CONCLUSION The KDHI-PC is a reliable tool for evaluating the dizziness of pediatric patients.

PURPOSE: Crohn disease is characterized by high rates of recurrence and reoperations. However, few studies have investigated long-term surgical outcomes in Asian populations. We investigated risk factors for reoperation, particularly those associated with anti-tumor necrosis factor-alpha (anti-TNF-alpha) antibody use, and long-term follow-up results. METHODS: We reviewed the records of 148 patients (100 males and 48 females) who underwent surgery for gastrointestinal Crohn disease and retrospectively analyzed long-term outcomes and risk factors. RESULTS: The mean age at diagnosis was 28.8 years. Thirty-eight patients (25.7%) received monoclonal antibody treatment before reoperation. A small bowel and colon resection was most commonly performed (83 patients, 56.1%). The median follow-up was 149 months, during which 47 patients underwent reoperation. The median interval between the primary and the secondary surgeries was 65 months, with accumulated reoperation rates of 16.5%, 31.8%, and 57.2% after 5, 10, and 15 years, respectively. Obstruction was the most common indication for reoperation (37 patients, 25.0%). In a multivariable analysis, age <17 years at diagnosis (A1) (odds ratio [OR], 2.20; P = 0.023), penetrating behavior (B3) (OR, 4.39; P < 0.001), and no azathioprine use (OR, 2.87; P = 0.003) were associated with reoperation. Anti-TNF-alpha antibody use did not affect the reoperation rate (P = 0.767). CONCLUSION: We showed a high reoperation rate regardless of treatment with anti-TNF-alpha antibody, which indicates that recurrent surgery is still needed to cure patients with gastrointestinal Crohn diseases. Younger age at primary operation, penetrating behavior, and no azathioprine use were significant factors associated with reoperation for gastrointestinal Crohn disease.
Asian Continental Ancestry Group ; Azathioprine ; Colon ; Crohn Disease* ; Diagnosis ; Follow-Up Studies ; Humans ; Korea* ; Male ; Necrosis* ; Recurrence ; Reoperation* ; Retrospective Studies ; Risk Factors* ; Infliximab

PURPOSE: To evaluate the efficacy and safety of once-daily ciclesonide in comparison to both levocetirizine alone, and a ciclesonide/levocetirizine combination in patients with seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR). METHODS: Subjects exhibiting moderate to severe allergic rhinitis for longer than 1 year were randomized in an open-label, 3-arm, parallel group, multicenter study. Subjects received 200 microg ciclesonide, 5 mg levocetirizine, or a combination of both. Changes from baseline until the end-of-study visit (2 weeks following) were evaluated by reflective total nasal symptom scores (rTNSSs), reflective total ocular symptom scores (rTOSSs), physician-assessed overall nasal signs and symptoms severity (PANS), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). RESULTS: Significant improvements in rTNSS, PANS, and RQLQ in the ciclesonide monotherapy group were observed in comparison to the levocetirizine alone group. Three individual symptoms of rTNSS, including runny nose, nasal itching, and congestion, were improved in the ciclesonide-treated group. rTOSS scores for ciclesonide monotherapy improved from baseline, but no superiority over levocetirizine was shown. The absolute score and changes in rTNSS and PANS were positively correlated. Ciclesonide spray was more effective than levocetirizine in reducing nasal symptoms in both SAR and PAR patients. Ciclesonide and levocetrizine were well tolerated alone and in combination. CONCLUSIONS: Our results provide support for an AR and its Impact on Asthma (ARIA) recommendation stipulating that ciclesonide is superior to levocetirizine for the treatment of AR, with tolerable safety. Addition of levocetirizine to ciclesonide did not give further clinical benefit over monotherapy.
Asthma ; Estrogens, Conjugated (USP) ; Humans ; Nose ; Pruritus ; Rhinitis* ; Rhinitis, Allergic, Seasonal ; Surveys and Questionnaires

PURPOSE: This study evaluates offending allergens in patients with allergic rhinitis (AR) according to age that establish a minimal panel for skin prick test (SPT) allergens required to identify if a patient is sensitized. METHODS: We retrospectively analyzed SPT results according to age to determine the minimum test battery panel necessary to screen at least 93%-95% of AR patients. Allergic skin tests (common airborne indoor and outdoor allergens) were performed on 7,182 patients from January 2007 to June 2011. All patients were classified into 9 groups according to age; subsequently, we investigated offending allergens by age group. RESULTS: A total of 5,032 (70.1%) patients were found sensitized to at least one of the 55 aeroallergen extracts tested. The annual ranking of offending allergens was not significantly different from each other over the past 5 years. House dust mites (HDM) were the most prevalent allergens ranked from first to third for all 5 years. The allergens in the minimum test panel differed slightly among all age groups; in addition, the types of sensitized allergen sources were more diverse in the older versus younger age group. HDM covered a larger proportion of the sensitized allergens in the younger age group versus the older age group. Testing with 5 allergens (Dermatophagoides farinae, Tetranychus urticae, oak, mugwort and cockroach) adequately identified over 90% of the sensitized patients. CONCLUSIONS: A SPT with around 5-7 allergens adequately detected most of the sensitization in the majority of the age groups in Korea. However, this study suggests that physicians perform the SPT with appropriately selected allergens in each age category for the screening of AR.
Allergens* ; Artemisia ; Humans ; Korea ; Mass Screening ; Pyroglyphidae ; Retrospective Studies ; Rhinitis* ; Skin Tests ; Skin*

BACKGROUND: Accurate quantitative testing of HBV DNA is very important for choosing antiviral treatment targets and evaluating treatment response in chronic HBV patients. We evaluated the performance of LG AdvanSure HBV Real-Time QPCR kit (LG) utilizing real-time quantitative PCR. METHODS: The LG kit was conducted for 201 chronic hepatitis patients undergoing treatment at the Korea University Ansan hospital and 48 normal control volunteers. The precision, limit of detection, sensitivity, and specificity of LG Kit were evaluated. Correlation analysis was done with Abbott Real Time HBV kit (Abbott) and the Cobas Amplicor HBV Monitor kit (Cobas) and the concordances rate of the three methods were calculated. RESULTS: The LG assay showed linear range of detection from 10(2) to 10(6) and coefficient of variation (CV) was 1.10~0.52% at > or =1,000 IU/mL and 1.19% at 100 IU/mL. The coefficient of determination for precision analysis was 0.997. The limit of detection for detection of 95% of positive samples was 9.71 IU/mL (54.4 copies/mL). In 201 clinical samples, the log HBV DNA/ml showed good correlation between Roche vs Abott, Roche vs LG and Abott vs LG, respectively (n=105, 108, 133, r2=0.91, 0.89, 0.94, P<0.0001). The overall concordance rate of three methods were 79.1% (159/201), 82.1% (165/201), and 85.1% (171/201), respectively, showing no stastically significant difference (P>0.05). CONCLUSION: LG AdvanSure HBV Real-Time QPCR kit showed outstanding precision, linearity, limit of detection, good correlation with previous methods, and is a valuable tool in treatment monitoring of chronic HBV infections.
DNA ; Hepatitis B ; Hepatitis, Chronic ; Humans ; Korea ; Limit of Detection ; Organothiophosphorus Compounds ; Sensitivity and Specificity

PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.
Alveolar Process ; Axis, Cervical Vertebra ; Cadaver ; Head ; Humans ; Male ; Mandible ; Maxilla ; Tooth Cervix

PURPOSE: Mitochondrial dysfunction can present with various symptoms depending on the organ it has affected. This research tried to analyze the ophthalmologic symptoms and ophthalmologic examination (OE) results in patients with mitochondrial disease (MD). METHODS: Seventy-four patients diagnosed with mitochondrial respiratory chain complex defect with biochemical enzyme assay were included in the study. They were divided into 2 groups based on the OE results by funduscopy and were analyzed on the basis of their clinical features, biochemical test results, morphological analysis, and neuroimaging findings. RESULTS: Thirty-seven (50%) of the 74 MD patients developed ophthalmologic symptoms. Abnormal findings were observed in 36 (48.6%) patients during an OE, and 16 (21.6%) of them had no ocular symptoms. Significantly higher rates of prematurity, clinical history of epilepsy or frequent apnea events, abnormal light microscopic findings in muscle pathology, diffuse cerebral atrophy in magnetic resonance imaging, and brainstem hyperintensity and lactate peaks in magnetic resonance spectroscopy were noted in the group with abnormal OE results. CONCLUSION: Although the ophthalmologic symptoms are not very remarkable in MD patients, an OE is required. When the risk factors mentioned above are observed, a more active approach should be taken in the OE because a higher frequency of ocular involvement can be expected.
Apnea ; Atrophy ; Brain Stem ; Child ; Electron Transport ; Enzyme Assays ; Epilepsy ; Humans ; Lactic Acid ; Light ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Mitochondria ; Mitochondrial Diseases ; Muscles ; Neuroimaging ; Ophthalmology ; Retina ; Risk Factors

PURPOSE: To evaluate myocardial conductivity to understand cardiac involvement in patients with mitochondrial disease. METHODS: We performed retrospective study on fifty-seven nonspecific mitochondrial encephalopathy patients with no clinical cardiac manifestations. The patients were diagnosed with mitochondrial respiratory chain complex defects through biochemical enzyme assays of muscle tissue. We performed standard 12-lead electrocardiography (ECG) on all patients. RESULTS: ECG abnormalities were observed in 30 patients (52.6%). Prolongation of the QTc interval (>440 ms) was seen in 19 patients (33.3%), widening of the corrected QRS interval in 15 (26.3%), and bundle branch block in four (7.0%). Atrioventricular block, premature atrial contraction and premature ventricular contraction were seen in two patients each (3.5%) and Wolff-Parkinson-White syndrome in one patient (1.8%). CONCLUSION: Given this finding, we recommend active screening with ECG in patients with mitochondrial disease even in patients without obvious cardiac manifestation.
Atrial Premature Complexes ; Atrioventricular Block ; Bundle-Branch Block ; Child ; Electrocardiography ; Electron Transport ; Enzyme Assays ; Heart ; Humans ; Mass Screening ; Mitochondria ; Mitochondrial Diseases ; Mitochondrial Encephalomyopathies ; Muscles ; Retrospective Studies ; Ventricular Premature Complexes ; Wolff-Parkinson-White Syndrome