The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.
Cohort Studies* ; Communicable Diseases ; Female ; Health Promotion ; HIV ; Humans ; Korea* ; Male ; Methods ; Sex Distribution ; Sexually Transmitted Diseases

The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.
Cohort Studies ; Communicable Diseases ; Female ; Health Promotion ; HIV ; Humans ; Korea ; Male ; Methods ; Sex Distribution ; Sexually Transmitted Diseases

The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.

BACKGROUND/AIMS: The frequencies of opportunistic diseases (ODs) vary across countries based on genetic, environmental, and social differences. The Korean HIV/AIDS cohort study was initiated in 2006 to promote research on human immunodeficiency virus (HIV) infection in Korea, and to provide a logistical network to support multicenter projects on epidemiological, clinical, and laboratory aspects of HIV infection. This study evaluated the prevalence of ODs among HIV-infected patients in the era of highly active antiretroviral therapy, and the risk factors associated with ODs. METHODS: The study enrolled 1,086 HIV-infected patients from 19 hospitals. This study examined the baseline data of the HIV/AIDS Korean cohort study at the time of enrollment from December 2006 to July 2013. RESULTS: Candidiasis was the most prevalent opportunistic infection (n = 176, 16.2%), followed by Mycobacterium tuberculosis infection (n = 120, 10.9%), Pneumocystis jirovecii pneumonia (n = 121, 11.0%), cytomegalovirus infection (n = 52, 4.7%), and herpes zoster (n = 44, 4.0%). The prevalence rates of Kaposi’s sarcoma (n = 8, 0.7%) and toxoplasmosis (n = 4, 0.4%) were very low compared with other countries. The risk factors for ODs were a low CD4 T cell count at the time of HIV diagnosis (odds ratio [OR], 1.01; p < 0.01), current smoking (OR, 2.27; p = 0.01), current alcohol use (OR, 2.57; p = 0.04), and a history of tuberculosis (OR, 5.23; p < 0.01). CONCLUSIONS: Using recent Korean nationwide data, this study demonstrated that an important predictor of ODs was a low CD4 T cell count at the time of HIV diagnosis. Tuberculosis remains one of the most important ODs in HIV-infected patients in Korea.
AIDS-Related Opportunistic Infections ; Antiretroviral Therapy, Highly Active ; Candidiasis ; Cell Count ; Cohort Studies* ; Cytomegalovirus Infections ; Diagnosis ; Herpes Zoster ; HIV ; HIV Infections ; Humans ; Korea ; Mycobacterium tuberculosis ; Opportunistic Infections ; Pneumocystis jirovecii ; Pneumonia ; Prevalence ; Risk Factors ; Sarcoma ; Smoke ; Smoking ; Toxoplasmosis ; Tuberculosis

PURPOSE: Allergic rhinitis (AR) is a common chronic disease. Many factors could affect the development of AR. We investigated early-life factors, such as delivery mode, feeding method, and use of antibiotics during infancy, which could affect the development of AR. In addition, how interactions between these factors and innate gene polymorphisms influence the development of AR was investigated. METHODS: A cross-sectional study of 1,828 children aged 9-12 years was conducted. Three early-life factors and AR were assessed by a questionnaire. Skin prick tests were done. Polymorphisms of TLR4 (rs1927911) and CD14 (rs2569190) were genotyped. RESULTS: Use of antibiotics during infancy increased the risk of AR (aOR [95% CI] 1.511 [1.222-2.037]) and atopic AR (aOR [95% CI], 1.565 [1.078-2.272]). There were synergistic interactions between caesarean delivery, formula feeding, and use of antibiotics in the rate of atopic AR (aOR [95% CI], 3.038 [1.256-7.347]). Additional analyses revealed that the risk for the development of AR or atopic AR subjects with the TLR4 CC genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.127 [1.265-20.780] for AR; 6.078 [1.499-24.649] for atopic AR). In addition, the risk for the development of AR or atopic AR in subjects with the CD14 TT genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.960 [1.421-15.002] for AR; 6.714 [1.440-31.312] for atopic AR). CONCLUSIONS: Delivery mode, feeding method, and use of antibiotics during infancy appeared to have synergistic interactions in the development of AR. Gene-environment interactions between polymorphism of innate genes and early- life risk factors might affect the development of AR.
Anti-Bacterial Agents ; Child ; Chronic Disease ; Cross-Sectional Studies ; Delivery, Obstetric ; Feeding Methods ; Female ; Gene-Environment Interaction ; Genotype ; Humans ; Immunity, Innate* ; Infant Food ; Rhinitis* ; Risk Factors* ; Skin ; Surveys and Questionnaires

PURPOSE: Endocrine-disrupting chemicals interfere with the endocrine system and therefore affect growth and pubertal progression. The study aim was to compare the growth and pubertal progression in wild-type female rats with different bedding types. METHODS: Twenty 5-week-old female wild-type Sprague Dawley rats were randomly assigned to two groups with different bedding types: one group received wood shaving bedding, while a second group received corncob bedding. We determined crown-rump length and body weight as anthropometric measurements and assessed the serum growth hormone (GH) and estradiol levels. The gh1 mRNA expression levels were compared using quantitative real time transcription polymerase chain reaction. The estrous cycle was evaluated by vaginal smear. RESULTS: The anthropometric measurements were not significantly different between the two groups. The mean relative expression of the gh1 gene was lower in the corncob bedding group than that in the wood shaving group (P=0.768). Meanwhile serum GH and estradiol were increased in the wood shaving bedding group; however this difference was not statistically significant. The time to first estrus and the length of the estrous cycle were increased in the corncob bedding group; the proportion of normal estrous cycles was also decreased. These findings indicate irregularities in the estrous cycle. CONCLUSION: Endocrine-disrupting chemicals in corncob bedding might be associated with time to first estrus and length of the estrous cycle. Therefore, the type of bedding should be considered as a factor affecting pubertal progression in rodents.
Adolescent ; Animals ; Bedding and Linens ; Body Weight ; Crown-Rump Length ; Endocrine Disruptors ; Endocrine System ; Estradiol ; Estrous Cycle ; Estrus ; Female ; Growth Hormone ; Humans ; Polymerase Chain Reaction ; Puberty ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Rodentia ; Vaginal Smears ; Wood

PURPOSE: This study aimed to determine the incidence, etiology, prognostic factors, and outcome of acute respiratory distress syndrome (ARDS) in children and to provide epidemiological data of children with ARDS treated at the pediatric intensive care unit (PICU) of a single center in Korea. METHODS: We conducted a retrospective medical chart review of 19 children diagnosed with ARDS at the PICU of The Catholic University of Korea, Seoul St. Mary's Hospital, between March 2009 and February 2012. RESULTS: Of the 334 PICU patients, 19 (5.6%) satisfied the American-European Consensus Conference definition of ARDS. Thirteen patients with ARDS died (mortality rate, 68.4%). Pneumonia was the most common cause of ARDS and observed in 10 patients (52.6%). There were significant differences between survivors and nonsurvivors in the PaO2/FiO2 ratio and the number of organ failure. The mortality rate was significantly higher in patients with a baseline PaO2/FiO2 ratio < or =100 mmHg than in those with a baseline PaO2/FiO2 ratio>100 mmHg (84.6% vs. 33.3%, P=0.046). We observed that a higher number of organ failure during the PICU stay, resulted in a higher mortality rate (P=0.037). Multiple logistic regression analysis showed that the PaO2/FiO2 ratio (adjusted odds ratio, 0.958) was independently associated with the increased risk of death after controlling for the number of organ failure. CONCLUSION: The mortality rate of ARDS in children was 68.4% in this study, a higher rate than those reported in other national and international studies. The PaO2/FiO2 ratio at the time of ARDS onset was a helpful prognostic factor for predicting the mortality rate of children with ARDS.
Child* ; Consensus ; Humans ; Incidence ; Intensive Care Units ; Korea ; Logistic Models ; Mortality ; Odds Ratio ; Pneumonia ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Seoul ; Survivors

PURPOSE: Human metapneumovirus (hMPV) is known to result in clinical manifestation similar to respiratory syncytial virus (RSV) in children. But some recent studies showed different features. This study compared the clinical manifestation of respiratory disease between hMPV and RSV. METHODS: A total of 801 children who admitted to Seoul St. Mary's Hospital for respiratory infection from January to June, 2012 were enrolled. Respiratory viral polymerase chain reaction (PCR) using nasopharyngeal swab was performed in all children. We grouped hMPV positive children and RSV positive children and compared clinical features between them by retrospective chart review. RESULTS: Among 801 children, 365 showed one virus PCR positive with 44 showing hMPV and 41 showing RSV. Respiratory diseases were upper respiratory infection, acute bronchitis, acute bronchiolitis and pneumonia. The peak season was March and April for hMPV and February and March for RSV. Fever incidence, fever duration and neutrophil percent of complete blood cell count were higher in hMPV group than RSV group (P<0.05). The mean age of hMPV group was higher than RSV group (P<0.05). But in acute bronchiolitis children, there was no mean age difference between two group. Acute bronchiolitis incidence declined with increased age for both group (P<0.05). The hMPV group showed relatively lower bronchiolitis and higher pneumonia incidence than RSV group, suggesting relation with age. CONCLUSION: Respiratory infection by hMPV developed at late winter and spring, slightly later than RSV and at older age. The lower incidence of acute bronchiolitis for hMPV infection than RSV is maybe due to older age than RSV.
Blood Cell Count ; Bronchiolitis ; Bronchitis ; Child ; Fever ; Humans ; Incidence ; Metapneumovirus ; Neutrophils ; Pneumonia ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Seasons ; Viruses

PURPOSE: This study was to evaluate the effect of flexible bronchoscopy for the treatment of secondary atelectasis of children following respiratory infection. METHODS: The medical records for a total of 19 cases of flexible bronchoscopy were reviewed retrospectively, which were performed for the treatment of secondary atelectasis at the Department of Pediatrics of the Catholic University of Korea Seoul St. Mary's Hospital from April 2007 to January 2013. RESULTS: A total of 18 patients (11 males and 7 females) were involved in the study. The range of age was 4 months to 15 years old. The causative underlying diseases were 17 cases of pneumonia, 1 case of bronchiolitis and 1 case of bronchial asthma. The most common location of atelectasis was right middle lobe and right middle lobe with left lower lobe was next. Bronchoscopy revealed inflammatory changes in 12 cases (63.2%) such as mucus plug (n=4), profuse secretion (n=4), mucosal edema (n=3), and bronchial narrowing (n=1), although 7 cases (36.8%) showed normal airway. Other additional findings were bronchomalacia, tracheomalacia, and bronchial tree abnormality. Seven out of 19 cases who received therapeutic intervention had complete or partial reexpansion of their atelectasis. Cases who occurred atelectasis within 6 weeks showed significantly higher improvement than cases occurred after 6 weeks (70% vs. 11.1%, P=0.019). Complications including seizure, fever, hypoxia, mucous bleeding, and hypotension were observed in 6 cases. CONCLUSION: Flexible bronchoscopy revealed to be effective and safe treatment modality in treatment of secondary atelectasis of children. Timely therapeutic intervention in pediatric patients should be considered.
Anoxia ; Asthma ; Bronchiolitis ; Bronchomalacia ; Bronchoscopy ; Child ; Edema ; Hemorrhage ; Humans ; Hypotension ; Korea ; Male ; Medical Records ; Mucus ; Pediatrics ; Pneumonia ; Pulmonary Atelectasis ; Retrospective Studies ; Seizures, Febrile ; Tracheomalacia

Eosinophilic gastroenteritis, which shows characteristic eosinophilic inflammation, involves any part of the intestine from esophagus to colon. The immunopathogenesis is expected to be associated with IgE-mediated or non-IgE-mediated reaction, but the precise mechanism is not revealed yet. The clinical manifestation is variably dependent on the extent of eosinophilic infiltration. Usually the symptoms, such as abdominal pain, diarrhea, vomiting, wax and wane for a few months result in failure to thrive, which implicates the importance of early detection. Although the diagnosis is made through clinical and histopathologic evidences, we should suspect the illness in a case of anemia, hypoalbuminemia, and peripheral eosinophilia. Recently, we experienced a case of non- IgE-mediated eosinophilic colitis in a 11-year-old male who complained of diarrhea, right lower abdominal pain, body weight loss, was diagnosed with peculiar histopathologic finding of sigmoid colon specimens obtained by sigmoidoscopy.
Abdominal Pain ; Anemia ; Body Weight ; Child* ; Colitis* ; Colon ; Colon, Sigmoid ; Diagnosis ; Diarrhea ; Eosinophilia ; Eosinophils* ; Esophagus ; Failure to Thrive ; Gastroenteritis ; Humans ; Hypoalbuminemia ; Inflammation ; Intestines ; Male* ; Sigmoidoscopy ; Vomiting