Viral load and rebound in children with coronavirus disease 2019 during the first outbreak in Daegu city

Chu Mi Ae,Jang Yoon Young,Lee Dong Won,Kim Sung Hoon,류남희,박성균,Lee Jae Hee,Chung Hai Lee 대한소아청소년과학회 2021 Clinical and Experimental Pediatrics (CEP) Vol.64 No.12

Background: Viral load and shedding duration are highly associated with the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, limited studies have reported on viral load or shedding in children and adolescents infected with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Purpose: This study aimed to investigate the natural course of viral load in asymptomatic or mild pediatric cases.Methods: Thirty-one children (<18 years) with confirmed SARS-CoV-2 infection were hospitalized and enrolled in this study. Viral loads were evaluated in nasopharyngeal swab samples using real-time reverse transcription polymerase chain reaction (E, RdRp, N genes). cycle threshold (Ct) values were measured when patients met the clinical criteria to be released from quarantine.Results: The mean age of the patients was 9.8 years, 18 (58%) had mild disease, and 13 (42%) were asymptomatic. Most children were infected by adult family members, most commonly by their mothers. The most common symptoms were fever and sputum (26%), followed by cough and runny nose. Nine patients (29%) had a high or intermediate viral load (Ct value≤30) when they had no clinical symptoms. Viral load showed no difference between symptomatic and asymptomatic patients. Viral rebounds were found in 15 cases (48%), which contributed to prolonged viral detection. The mean duration of viral detection was 25.6 days. Viral loads were significantly lower in patients with viral rebounds than in those with no rebound (E, P=0.003; RdRp, P=0.01; N, P=0.02).Conclusion: Our study showed that many pediatric patients with coronavirus disease 2019 (COVID-19) experienced viral rebound and showed viral detection for more than 3 weeks. Further studies are needed to investigate the relationship between viral rebound and infectiousness in COVID-19.

소아 천식군과 영유아 천명군에서 혈청 내 가용성 ST2 상승의 의의

추미애 ( Mi Ae Chu ),이형직 ( Hyung Jik Lee ),이은주 ( Eun Joo Lee ),홍석진 ( Suk Jin Hong ),박혜진 ( Hye Jin Park ),이계향 ( Kye Hyang Lee ),정혜리 ( Hai Lee Chung ) 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.4

Purpose: Soluble ST2 (sST2) has been reported to regulate Th2 response. In this study, serum levels of sST2 and other cytokines were measured in recurrent early wheezers and asthmatic children. We aimed to investigate if there are any differences or similarities in Th1 or Th2 response between those two patient groups. Methods: Fifty-nine patients admitted with exacerbation of wheezing or asthma were enrolled. Two patient groups were defined: children with atopic asthma (≥6 years, n=21) and recurrent early wheezers (≤2 years, n=38). Recurrent early wheezers were divided based on their atopic status: 19 were atopic and 19 were nonatopic. sST2, interleukin (IL) 33, IL-5, and interferon (IFN)-γ were measured in serum samples collected on admission. Cytokine levels in both patient groups were compared with their age-matched controls and evaluated the relationship with blood eosinophils, serum IgE levels, and also with the severity of symptom. Results: sST2 and IL-5 were significantly increased both in asthmatic children (P=0.02, P=0.004) and recurrent early wheezers (P=0.01, P=0.001) compared to their age-matched controls. IL-5 was significantly higher in atopic wheezers compared with nonatopic wheezers (P=0.04). Severity score showed a positive correlation with sST2 and IFN-γ in asthmatic children, but only with IFN-γ in early wheezers. There was an inverse correlation between sST2 and blood eosinophil counts both in asthmatic children and atopic recurrent wheezers. Conclusion: Our study suggests that sST2 might regulate allergic inflammation by suppressing eosinophilia and play an important role in pathophysiology of acute exacerbation of wheezing or asthma both in asthmatic children and early wheezers. (Allergy Asthma Respir Dis 2013;1:314-320)

Respiratory syncytial virus에 의한 급성 세기관지염에서 혈청 내 surfactant protein-D 상승의 의의

추미애 ( Mi Ae Chu ),이은주 ( Eun Joo Lee ),박혜진 ( Hye Jin Park ),이계향 ( Kye Hyang Lee ),김우택 ( Woo Taek Kim ),정혜리 ( Hai Lee Chung ) 대한소아알레르기호흡기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.3

Purpose: Collectin family is an important component of innate immunity, of which surfactant protein (SP)-D and mannose-binding lectin (MBL) are the most characterized. We examined SP-D and MBL in young children with acute respiratory syncytial virus (RSV) bronchiolitis. Methods: Sixty-three children (≤24 months of age) admitted with the first RSV bronchiolitis during 2 epidemics and followed for 1 year after discharge were enrolled. The patients were defined as severe group when they had 2 of followings during admission: hypoxemia (<92% oxygen saturation), rapid breathing (and/or lower chest wall indrawing), and >7 days of hospital stay. All children were evaluated if they had recurrent wheezing during follow-up. SP-D and MBL were measured using enzyme-linked immunosorbent assay in serum collected on admission and compared with controls. Their levels were evaluated in relation to the symptom severity during admission and recurrence of wheezing after discharge. Results: Serum SP-D increased significantly in the patients (P<0.01), but MBL showed no difference compared to the controls. SP-D levels were significantly higher in severe group compared with nonsevere group (P<0.05). SP-D levels in the patients with recurrent wheezing after discharge were significantly higher than in those without (P<0.05). MBL showed no difference in relation to the symptom severity or recurrence of wheezing. Conclusion: Our study showed that serum SP-D was associated with the severity of RSV bronchiolitis and suggests that it might be a biomarker of lung injury and recurrence of wheezing illnesses in the young children admitted with their first RSV bronchiolitis. (Allergy Asthma Respir Dis 2013;1:235-240)

Respiratory syncytial virus에 의한 급성 세기관지염에서 혈청 내 surfactant protein-D 상승의 의의

추미애 ( Mi Ae Chu ),이은주 ( Eun Joo Lee ),박혜진 ( Hye Jin Park ),이계향 ( Kye Hyang Lee ),김우택 ( Woo Taek Kim ),정혜리 ( Hai Lee Chung ) 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.3

Purpose: Collectin family is an important component of innate immunity, of which surfactant protein (SP)-D and mannose-binding lectin (MBL) are the most characterized. We examined SP-D and MBL in young children with acute respiratory syncytial virus (RSV) bronchiolitis. Methods: Sixty-three children (≤24 months of age) admitted with the first RSV bronchiolitis during 2 epidemics and followed for 1 year after discharge were enrolled. The patients were defined as severe group when they had 2 of followings during admission: hypoxemia (<92% oxygen saturation), rapid breathing (and/or lower chest wall indrawing), and >7 days of hospital stay. All children were evaluated if they had recurrent wheezing during follow-up. SP-D and MBL were measured using enzyme-linked immunosorbent assay in serum collected on admission and compared with controls. Their levels were evaluated in relation to the symptom severity during admission and recurrence of wheezing after discharge. Results: Serum SP-D increased significantly in the patients (P<0.01), but MBL showed no difference compared to the controls. SP-D levels were significantly higher in severe group compared with nonsevere group (P<0.05). SP-D levels in the patients with recurrent wheezing after discharge were significantly higher than in those without (P<0.05). MBL showed no difference in relation to the symptom severity or recurrence of wheezing. Conclusion: Our study showed that serum SP-D was associated with the severity of RSV bronchiolitis and suggests that it might be a biomarker of lung injury and recurrence of wheezing illnesses in the young children admitted with their first RSV bronchiolitis. (Allergy Asthma Respir Dis 2013;1:235-240)

소아 천식군과 영유아 천명군에서 혈청 내 가용성 ST2 상승의 의의

추미애 ( Mi Ae Chu ),이형직 ( Hyung Jik Lee ),이은주 ( Eun Joo Lee ),홍석진 ( Suk Jin Hong ),박혜진 ( Hye Jin Park ),이계향 ( Kye Hyang Lee ),정혜리 ( Hai Lee Chung ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.4

Purpose: Soluble ST2 (sST2) has been reported to regulate Th2 response. In this study, serum levels of sST2 and other cytokines were measured in recurrent early wheezers and asthmatic children. We aimed to investigate if there are any differences or similarities in Th1 or Th2 response between those two patient groups. Methods: Fifty-nine patients admitted with exacerbation of wheezing or asthma were enrolled. Two patient groups were defined: children with atopic asthma (≥6 years, n=21) and recurrent early wheezers (≤2 years, n=38). Recurrent early wheezers were divided based on their atopic status: 19 were atopic and 19 were nonatopic. sST2, interleukin (IL) 33, IL-5, and interferon (IFN)-γ were measured in serum samples collected on admission. Cytokine levels in both patient groups were compared with their age-matched controls and evaluated the relationship with blood eosinophils, serum IgE levels, and also with the severity of symptom. Results: sST2 and IL-5 were significantly increased both in asthmatic children (P=0.02, P=0.004) and recurrent early wheezers (P=0.01, P=0.001) compared to their age-matched controls. IL-5 was significantly higher in atopic wheezers compared with nonatopic wheezers (P=0.04). Severity score showed a positive correlation with sST2 and IFN-γ in asthmatic children, but only with IFN-γ in early wheezers. There was an inverse correlation between sST2 and blood eosinophil counts both in asthmatic children and atopic recurrent wheezers. Conclusion: Our study suggests that sST2 might regulate allergic inflammation by suppressing eosinophilia and play an important role in pathophysiology of acute exacerbation of wheezing or asthma both in asthmatic children and early wheezers.

Changing Prevalence of Helicobacter pylori Infections in Korean Children with Recurrent Abdominal Pain

Jang, Kyung Mi,Choe, Byung-Ho,Choe, Jae Young,Hong, Suk Jin,Park, Hyo Jung,Chu, Mi Ae,Cho, Seung Man,Kim, Jung Mi The Korean Society of Pediatric Gastroenterology 2015 Pediatric gastroenterology, hepatology & nutrition Vol.18 No.1

Purpose: The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. Methods: Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0‰ for children aged ${\geq}6$ years and 7‰ for children aged <6 years. Results: A total of 2,530 children (1,191 boys) with a mean age of $10.0{\pm}3.0years$ (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and ${\geq}12$ years of age (p=0.018). Conclusion: The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those ${\geq}12$ years old.

COBE Spectra를 이용한 말초혈액조혈모세포 채집을 위한 AutoPBSC법과 수기법의 비교

이미애,이정수,이석,성주명,정화순 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

연구배경: 말초조혈모세포채집은 채집방법과 채집자에 따라 수확량이 달라질 수 있다. COBE Spectra (COBE BCT, USA)를 이용한 조혈모세포 채집시에 주로 수기법을 사용하여 왔는데 이는 interface를 눈으로 조절하기 때문에 채집하는 사람에 따라 수확량이 달라질수 있고 interface가 불안정한 환자인 경우는 채집하기가 어렵고 수확량도 적어질 수 있다. 저자들은 최근 개발된 자동화된 AutoPBSC법의 사용경험을 소개하고 두가지 방법을 비교하여 두기기의 효율성을 평가하고자 하였다. 방법: 1997년 9월부터 1998년 10까지 말초혈액 조혈모세포 채집을 시행한 고형 및 혈액종양환자 39명과 정상공여자 6명을 대상으로 COBE Spectra의 수기법(4.7판)과 AutoPBSC법(6.0판)을 이용하여 총 85회의 대용량 백혈구 성분 채집술을 시행하였는데 52회는 수기법으로 33회는 AutoPBSC법으로 시행하였으며 이중 16명에서는 한 환자에서 수기법과 AutoPBSC법을 번갈아 시행하였다. 각 방법에 따른 채집용량, 채집시간, 수확량, 적혈구 및 혈소판 혼입, 채집효율 등을 비교하였다. 결과: 수기법과 AutoPBSC법의 평균채집용량은 각각 199±32mL, 120±45mL, 혈소판 혼입은 2.0±1.2×10^(11), 1.3±0.9×10^(11)으로 AutoPBSC에서 통계적으로 의의있게 적었으나 (P<0.05), 적혈구 혼입은 각각 10.5±3.4 mL, 10.8±5.5 mL로 차이가 없었고 채집시간은 수기법과 AutoPBSC법이 각각 204±30분, 220±21분으로 AutoPBSC법이 다소 길었다(p<0.05). 채집효율은 AutoPBSC 59±31%와 수기법 71±30%로 차이가 없었다(p>0.05). 1회당 채집된 총 백혈구 수는 수기법과 AutoPBSC법이 각각 4.3±2.0×10^(8)/kg, 3.8±2.0×10^(8)/kg, 총 단핵구 수는 각각 3.5±2.0×10^(8)/kg, 2.7±1.2×10^(8)/kg, 총 CD34+ 세포 수는 각각 2.3±2.8×10^(6)/kg, 1.6±1.6×10^(6)/kg로 통계학적으로 차이는 없었다(p>0.05). 환자에 따른 차이를 배제하기 위해 수기법과 AutoPBSC법을 동시에 시행한 환자에서는 총 단핵구 수는 수기법과 AutoPBSC법이 각각 3.0±1.3×10^(8)/kg, 2.4±1.1×10^(8)/kg이었고, 총 CD34+ 세포수는 각각 0.9±1.0×10^(6)/kg, 1.0±1.0×10^(6)/kg로 통계학적 차이가 없었다(p>0.05). 결론: AutoPBSC법은 수기법에 비해 평균 채집용량, 혈소판 혼입이 적었으며 채집효율이나 채집된 총 단핵구 수 및 CD34^(+) 세포 수는 차이가 없는 것으로 보아 AutoPBSC를 사용하여 보다 쉽고 편리하게 조혈모 세포를 채집할 수 있다고 생각된다. Background: The purity and yields of the peripheral blood progenitor cell (PBPC) collection depend not only the use of cell separators used but also the skill of the operators. The PBPC collection using COBE Spectra (version 4.7) permits the operator to manually position the interface, but if the buffy-coat becomes unstable and unexperienced operator collects, the collection yields would be low. In this study, we compared the new software version 6.0 (AutoPBSC) with that of version 4.7 (manual method) using COBE Spectra (COBE BCT, USA) for the PBSC collection. Methods: From September 1997 to October 1998, forty-five patients (39 solid and hematologic malignacies and 6 normal donors) undergoing PBPC collection were collected with either manual method (n=52) of AutoPBSC (n=33) using COBE Spectra. And 16 patients were alternately collected with manual method and AutoPBSC. The collection volume, yields, collection time, RBC and platelets contamination and collection efficiency were compared. Results: The collection time was longer with the AutoPBSC (220±21 min) than manual method (240±30 min)(p<0.05), whereas the contamination of platelets and the collection volume were significantly lower with the AutoPBSC) (1.3±0.9×10^(11) and 120±45 mL) than manual method (2.0±1.2×10^(11) and 199±32 mL)(p<0.05). The collection efficiency for mononuclear cells was no significant difference between the AutoPBSC(59±31%) and manual method (71±30%)(p<0.05). Them mean values of total nucleated cells (TNC), total mononuclear cells (MNC) and total CD34+ cells collected in the PBPC bags were no statistical differences between the AutoPBSC (TNC 3.8±2.0×10^(8)/kg, MNC 2.7±1.2×10^(8)/kg, CD34^(+) cells 1.6±1.6×10^(6)/kg. respectively) and manual method (TNC 4.3±2.0×10^(8)/kg, MNC 3.5±1.8×10^(8)/kg, CD34^(+) cells 2.3±2.8×10^(6)/kg, respectively)(p<0.05). In the 16 patients undergoing concurrent the AutoPBSC and manual method, the MNC and CD34^(+) cells were also not significant differences between the AutoPBSC and manual method (p>0.05) Conclusion: The collection volume and the platelets contamination of PBPC bags were significantly lower using the AutoPBSC than manual method, whereas the collection efficiency and yields were not significant differences between the AutoPBSC and manual method. We will use more convenient and easier PBPC collection using the AutoPBSC

P025 : Reconstruction of large wounds using a combination of negative pressure wound therapy (NPWT) and punch skin grafts

( Howard Chu ),( Ji Myung Seo ),( Ji Hee Kim ),( Hong Sun Jang ),( Dan Bi Lee ),( Byung Ho Oh ),( Mi Ryung Roh ),( Kyoung Ae Nam ),( Kee Yang Chung ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Objectives: The objective of this study was to evaluate the efficacy of a combination of NPWT and punch skin grafts in the reconstruction of large wounds. Methods: This study is a retrospective review of 9 patients, who were treated using the combination treatment during the period of Oct. 2013 and Apr. 2014. Results: Of the 9 cases, 8 were the result of melanoma wide excision and 1 was a nonhealing wound after a fracturesurgery. Mean patient age was 58 years (range, 32~82). Mean period of NPWT was 22.5 days before skin graft and 13.6 days after skin graft. Among the 9 cases, sole was the most common location of the wound (4 cases) followed by heel (2 cases), right 5th toe (1 case), left popliteal fossa (1 case) and right shin (1 case). NPWT induced rapid growth of granulation tissue and seemed to facilitate graft take and survival. Conclusion: A combination treatment of NPWT and punch skin graft can be a viable option to treat large wounds. Theresulting scar is much smaller than the size of the wound due to contraction and also cosmetically and functionally superior to the wound treated by other methods.

당침에 의한 천년초(Opuntia humifusa) 추출액의 품질특성

추지애(Ji-Ae Chu),조용식(Yong-Sik Cho),박신영(Sin-Young Park),최윤희(Yoon-Hee Choi),김은미(Eun-Mi Kim),모혜원(Hye-Won Mo) 한국지역사회생활과학회 2009 한국지역사회생활과학회 학술대회 자료집 Vol.2009 No.5

영유아 급성 설사의 영양 공급: 탈수 치료 후 연령별 식이요법을 중심으로

추미애,최병호,Chu, Mi Ae,Choe, Byung-Ho 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.suppl1

The mainstay in the management of mild to moderately dehydrated children is fast rehydration by using hypotonic ORS (oral rehydration solution) and complete resumption of normal diet, including lactose-containing formula after 4 hours rehydration. Since the majority of young children with uncomplicated acute diarrhea will tolerate large amounts of undiluted non-human milk, withholding food and milk from children during diarrhea is not recommended anymore, regarding time to resolution and diarrhea control. In addition, routine dilution of milk and routine use of lactose-free formula are not necessary after fast ORS therapy. Breastfed infants and children fed with solid foods may safely continue receiving their usual diets during diarrhea instead of gradual reintroduction of feeding. However, young infants or children with severe diarrhea or malnutrition should be carefully treated under supervision if fed with lactose containing, non-human milk exclusively.