1.Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children
Byungsun YOO ; Ilha YUNE ; Dayeon KANG ; Youngmin CHO ; Sung Yoon LIM ; Sooyoung YOO ; Miyoung KIM ; June Sung KIM ; Daehwan KIM ; Ho Young LEE ; Rong-Min BAEK ; Se Young JUNG ; Eu Suk KIM ; Hyunju LEE
Journal of Korean Medical Science 2025;40(2):e5-
		                        		
		                        			 Background:
		                        			Community acquired lower respiratory tract infection (LRTI) is a leading cause for hospitalization in children and important cause for antibiotic prescription. We aimed to describe the aetiology of LRTI in children and analyse factors associated with bacterial or viral infection. 
		                        		
		                        			Methods:
		                        			Patients aged < 19 years with a diagnosis of LRTI were identified from the Observational Medical Outcomes Partnership Common Data Model Database of Seoul National University Bundang Hospital from January 2005–July 2019, and their clinical characteristics were obtained from the electronic medical records and retrospectively reviewed. 
		                        		
		                        			Results:
		                        			Among 5,924 cases of LRTI, 74.2% were pneumonia and 25.8% were bronchiolitis/ bronchitis. Patients’ median age was 1.8 (interquartile range, 3.1) years and 79.9% were < 5 years old. Pathogens were identified in 37.8%; 69.1% were viral and 30.9% were bacterial/ Mycoplasma pneumoniae. Respiratory syncytial virus was most common (70.9%) among viruses and M. pneumoniae (94.6%) was most common among bacteria. Viral LRTI was associated with winter, age < 2 years, rhinorrhoea, dyspnoea, lymphocytosis, thrombocytosis, wheezing, stridor, chest retraction, and infiltration on imaging. Bacteria/ M. pneumoniae LRTI was associated with summer, age ≥ 2 years, fever, decreased breathing sounds, leucocytosis, neutrophilia, C-reactive protein elevation, and positive imaging findings (consolidation, opacity, haziness, or pleural effusion). 
		                        		
		                        			Conclusion
		                        			In children with LRTI, various factors associated with viral or bacterial/ M. pneumoniae infections were identified, which may serve as guidance for antibiotic prescription. 
		                        		
		                        		
		                        		
		                        	
2.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
		                        		
		                        			 Background:
		                        			We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19. 
		                        		
		                        			Methods:
		                        			Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose. 
		                        		
		                        			Results:
		                        			At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001). 
		                        		
		                        			Conclusion
		                        			HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain. 
		                        		
		                        		
		                        		
		                        	
3.Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children
Byungsun YOO ; Ilha YUNE ; Dayeon KANG ; Youngmin CHO ; Sung Yoon LIM ; Sooyoung YOO ; Miyoung KIM ; June Sung KIM ; Daehwan KIM ; Ho Young LEE ; Rong-Min BAEK ; Se Young JUNG ; Eu Suk KIM ; Hyunju LEE
Journal of Korean Medical Science 2025;40(2):e5-
		                        		
		                        			 Background:
		                        			Community acquired lower respiratory tract infection (LRTI) is a leading cause for hospitalization in children and important cause for antibiotic prescription. We aimed to describe the aetiology of LRTI in children and analyse factors associated with bacterial or viral infection. 
		                        		
		                        			Methods:
		                        			Patients aged < 19 years with a diagnosis of LRTI were identified from the Observational Medical Outcomes Partnership Common Data Model Database of Seoul National University Bundang Hospital from January 2005–July 2019, and their clinical characteristics were obtained from the electronic medical records and retrospectively reviewed. 
		                        		
		                        			Results:
		                        			Among 5,924 cases of LRTI, 74.2% were pneumonia and 25.8% were bronchiolitis/ bronchitis. Patients’ median age was 1.8 (interquartile range, 3.1) years and 79.9% were < 5 years old. Pathogens were identified in 37.8%; 69.1% were viral and 30.9% were bacterial/ Mycoplasma pneumoniae. Respiratory syncytial virus was most common (70.9%) among viruses and M. pneumoniae (94.6%) was most common among bacteria. Viral LRTI was associated with winter, age < 2 years, rhinorrhoea, dyspnoea, lymphocytosis, thrombocytosis, wheezing, stridor, chest retraction, and infiltration on imaging. Bacteria/ M. pneumoniae LRTI was associated with summer, age ≥ 2 years, fever, decreased breathing sounds, leucocytosis, neutrophilia, C-reactive protein elevation, and positive imaging findings (consolidation, opacity, haziness, or pleural effusion). 
		                        		
		                        			Conclusion
		                        			In children with LRTI, various factors associated with viral or bacterial/ M. pneumoniae infections were identified, which may serve as guidance for antibiotic prescription. 
		                        		
		                        		
		                        		
		                        	
4.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
		                        		
		                        			 Background:
		                        			We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19. 
		                        		
		                        			Methods:
		                        			Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose. 
		                        		
		                        			Results:
		                        			At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001). 
		                        		
		                        			Conclusion
		                        			HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain. 
		                        		
		                        		
		                        		
		                        	
5.Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children
Byungsun YOO ; Ilha YUNE ; Dayeon KANG ; Youngmin CHO ; Sung Yoon LIM ; Sooyoung YOO ; Miyoung KIM ; June Sung KIM ; Daehwan KIM ; Ho Young LEE ; Rong-Min BAEK ; Se Young JUNG ; Eu Suk KIM ; Hyunju LEE
Journal of Korean Medical Science 2025;40(2):e5-
		                        		
		                        			 Background:
		                        			Community acquired lower respiratory tract infection (LRTI) is a leading cause for hospitalization in children and important cause for antibiotic prescription. We aimed to describe the aetiology of LRTI in children and analyse factors associated with bacterial or viral infection. 
		                        		
		                        			Methods:
		                        			Patients aged < 19 years with a diagnosis of LRTI were identified from the Observational Medical Outcomes Partnership Common Data Model Database of Seoul National University Bundang Hospital from January 2005–July 2019, and their clinical characteristics were obtained from the electronic medical records and retrospectively reviewed. 
		                        		
		                        			Results:
		                        			Among 5,924 cases of LRTI, 74.2% were pneumonia and 25.8% were bronchiolitis/ bronchitis. Patients’ median age was 1.8 (interquartile range, 3.1) years and 79.9% were < 5 years old. Pathogens were identified in 37.8%; 69.1% were viral and 30.9% were bacterial/ Mycoplasma pneumoniae. Respiratory syncytial virus was most common (70.9%) among viruses and M. pneumoniae (94.6%) was most common among bacteria. Viral LRTI was associated with winter, age < 2 years, rhinorrhoea, dyspnoea, lymphocytosis, thrombocytosis, wheezing, stridor, chest retraction, and infiltration on imaging. Bacteria/ M. pneumoniae LRTI was associated with summer, age ≥ 2 years, fever, decreased breathing sounds, leucocytosis, neutrophilia, C-reactive protein elevation, and positive imaging findings (consolidation, opacity, haziness, or pleural effusion). 
		                        		
		                        			Conclusion
		                        			In children with LRTI, various factors associated with viral or bacterial/ M. pneumoniae infections were identified, which may serve as guidance for antibiotic prescription. 
		                        		
		                        		
		                        		
		                        	
6.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
		                        		
		                        			 Background:
		                        			We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19. 
		                        		
		                        			Methods:
		                        			Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose. 
		                        		
		                        			Results:
		                        			At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001). 
		                        		
		                        			Conclusion
		                        			HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain. 
		                        		
		                        		
		                        		
		                        	
7.Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children
Byungsun YOO ; Ilha YUNE ; Dayeon KANG ; Youngmin CHO ; Sung Yoon LIM ; Sooyoung YOO ; Miyoung KIM ; June Sung KIM ; Daehwan KIM ; Ho Young LEE ; Rong-Min BAEK ; Se Young JUNG ; Eu Suk KIM ; Hyunju LEE
Journal of Korean Medical Science 2025;40(2):e5-
		                        		
		                        			 Background:
		                        			Community acquired lower respiratory tract infection (LRTI) is a leading cause for hospitalization in children and important cause for antibiotic prescription. We aimed to describe the aetiology of LRTI in children and analyse factors associated with bacterial or viral infection. 
		                        		
		                        			Methods:
		                        			Patients aged < 19 years with a diagnosis of LRTI were identified from the Observational Medical Outcomes Partnership Common Data Model Database of Seoul National University Bundang Hospital from January 2005–July 2019, and their clinical characteristics were obtained from the electronic medical records and retrospectively reviewed. 
		                        		
		                        			Results:
		                        			Among 5,924 cases of LRTI, 74.2% were pneumonia and 25.8% were bronchiolitis/ bronchitis. Patients’ median age was 1.8 (interquartile range, 3.1) years and 79.9% were < 5 years old. Pathogens were identified in 37.8%; 69.1% were viral and 30.9% were bacterial/ Mycoplasma pneumoniae. Respiratory syncytial virus was most common (70.9%) among viruses and M. pneumoniae (94.6%) was most common among bacteria. Viral LRTI was associated with winter, age < 2 years, rhinorrhoea, dyspnoea, lymphocytosis, thrombocytosis, wheezing, stridor, chest retraction, and infiltration on imaging. Bacteria/ M. pneumoniae LRTI was associated with summer, age ≥ 2 years, fever, decreased breathing sounds, leucocytosis, neutrophilia, C-reactive protein elevation, and positive imaging findings (consolidation, opacity, haziness, or pleural effusion). 
		                        		
		                        			Conclusion
		                        			In children with LRTI, various factors associated with viral or bacterial/ M. pneumoniae infections were identified, which may serve as guidance for antibiotic prescription. 
		                        		
		                        		
		                        		
		                        	
8.Neutralizing Activity and T-Cell Responses Against Wild Type SARSCoV-2 Virus and Omicron BA.5 Variant After Ancestral SARS-CoV-2 Vaccine Booster Dose in PLWH Receiving ART Based on CD4 T-Cell Count
Na Young HA ; Ah-Ra KIM ; Hyeongseok JEONG ; Shinhye CHEON ; Cho Rong PARK ; Jin Ho CHOE ; Hyo Jung KIM ; Jae Won YOON ; Miryoung KIM ; Mi Yeong AN ; Sukyoung JUNG ; Hyeon Nam DO ; Junewoo LEE ; Yeon-Sook KIM
Journal of Korean Medical Science 2025;40(9):e28-
		                        		
		                        			 Background:
		                        			We evaluated severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-specific humoral and cellular responses for up to 6 months after the 3rd dose of ancestral coronavirus disease 2019 (COVID-19) vaccination in people living with HIV (PLWH) and healthy controls (HCs) who were not infected with COVID-19. 
		                        		
		                        			Methods:
		                        			Anti-spike receptor-binding domain IgG (anti-RBD IgG) concentrations using chemiluminescence immunoassay and neutralizing antibodies using focus reduction neutralization test (FRNT) were assessed at 1 week after each dose of vaccination, and 3 and 6 months after the 3rd dose in 62 PLWH and 25 HCs. T-cell responses using intracellular cytokine stain were evaluated at 1 week before, and 1 week and 6 months after the 3rd dose. 
		                        		
		                        			Results:
		                        			At 1 week after the 3rd dose, adequate anti-RBD IgG (> 300 binding antibody unit /mL) was elicited in all PLWH except for one patient with 36 CD4 T-cell count/mm3 . The geometric mean titers of 50% FRNT against wild type (WT) and omicron BA.5 strains of SARS-CoV-2 in PLWH with CD4 T-cell count ≥ 500 cells/mm3(high CD4 recovery, HCDR) were comparable to HC, but they were significantly decreased in PLWH with CD4 T-cell count < 500/mm3 (low CD4 recovery, LCDR). After adjusting for age, gender, viral suppression, and number of preexisting comorbidities, CD4 T-cell counts < 500/mm3 significantly predicted a poor magnitude of neutralizing antibodies against WT, omicron BA.5, and XBB 1.5 strains among PLWH. Multivariable linear regression adjusting for age and gender revealed that LCDR was associated with reduced neutralizing activity (P = 0.017) and interferon-γ-producing T-cell responses (P = 0.049 for CD T-cell; P = 0.014 for CD8 T-cell) against WT, and strongly associated with more decreased cross-neutralization against omicron BA.5 strains (P < 0.001). 
		                        		
		                        			Conclusion
		                        			HCDR demonstrated robust humoral and cell-mediated immune responses after a booster dose of ancestral SARS-CoV-2 vaccine, whereas LCDR showed diminished immune responses against WT virus and more impaired cross-neutralization against omicron BA.5 strain. 
		                        		
		                        		
		                        		
		                        	
9.Is the Current Lights-Off Time in General Hospitals Too Early, Given People’s Usual Bedtimes?
Eulah CHO ; Junseok AHN ; Young Rong BANG ; Jeong Hye KIM ; Seockhoon CHUNG
Psychiatry Investigation 2024;21(12):1415-1422
		                        		
		                        			 Objective:
		                        			This study aimed to investigate how shift-working nursing professionals perceive the current lights-off time in wards as early, appropriate, or late and how their perceptions can be influenced when considering people’s usual bedtimes. 
		                        		
		                        			Methods:
		                        			An online survey was conducted comprising queries about the current lights-off time in wards and respondents’ opinions, self-rated psychological status, and perceptions of the current lights-off time considering others’ usual bedtimes. Psychological status was evaluated using the Insomnia Severity Index, the Patient Health Questionnaire-9, the Dysfunctional Beliefs and Attitudes about Sleep-16, and the Discrepancy between Desired Time in Bed and Desired Total Sleep Time (DBST) Index, along with the expected DBST Index of others. 
		                        		
		                        			Results:
		                        			Of 159 nursing professionals, 88.7% regarded the current lights-off time of 9:46±0:29 PM as appropriate. However, when considering others’ usual bedtimes, the proportion perceiving the lights-off time as too early rose from 6.9% to 28.3%. Participants recommended delaying the lights-off time to 10:06±0:42 PM for patients’ sleep and 10.22±0:46 PM for nursing care activities. Nursing professionals’ insomnia severity was significantly higher among who responded that current light off time is too early after considering usual bedtime of other people. 
		                        		
		                        			Conclusion
		                        			This study underscores the need to reassess lights-off times in wards given individuals’ typical bedtimes. The findings emphasize the need to address nursing professionals’ perspectives and insomnia severity when optimizing lights-off schedules in healthcare settings. 
		                        		
		                        		
		                        		
		                        	
10.Is the Current Lights-Off Time in General Hospitals Too Early, Given People’s Usual Bedtimes?
Eulah CHO ; Junseok AHN ; Young Rong BANG ; Jeong Hye KIM ; Seockhoon CHUNG
Psychiatry Investigation 2024;21(12):1415-1422
		                        		
		                        			 Objective:
		                        			This study aimed to investigate how shift-working nursing professionals perceive the current lights-off time in wards as early, appropriate, or late and how their perceptions can be influenced when considering people’s usual bedtimes. 
		                        		
		                        			Methods:
		                        			An online survey was conducted comprising queries about the current lights-off time in wards and respondents’ opinions, self-rated psychological status, and perceptions of the current lights-off time considering others’ usual bedtimes. Psychological status was evaluated using the Insomnia Severity Index, the Patient Health Questionnaire-9, the Dysfunctional Beliefs and Attitudes about Sleep-16, and the Discrepancy between Desired Time in Bed and Desired Total Sleep Time (DBST) Index, along with the expected DBST Index of others. 
		                        		
		                        			Results:
		                        			Of 159 nursing professionals, 88.7% regarded the current lights-off time of 9:46±0:29 PM as appropriate. However, when considering others’ usual bedtimes, the proportion perceiving the lights-off time as too early rose from 6.9% to 28.3%. Participants recommended delaying the lights-off time to 10:06±0:42 PM for patients’ sleep and 10.22±0:46 PM for nursing care activities. Nursing professionals’ insomnia severity was significantly higher among who responded that current light off time is too early after considering usual bedtime of other people. 
		                        		
		                        			Conclusion
		                        			This study underscores the need to reassess lights-off times in wards given individuals’ typical bedtimes. The findings emphasize the need to address nursing professionals’ perspectives and insomnia severity when optimizing lights-off schedules in healthcare settings. 
		                        		
		                        		
		                        		
		                        	
            
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