Prevalence and timeline of pulmonary complications after Hematopoietic Stem Cell Transplantation in children : Comparison of Infectious and Non-infectious origin

전윤홍,원설믜,김환수,이재욱,윤종서,정낙균,조빈,김현희,김진택 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.0

The success of allogeneic hematopoietic stem cell transplantation(HSCT) is often restricted by pulmonary complications(PCs). The object of this study is to investigate the prevalence and perceived timeline of PCs following allogeneic HSCT according to infectious and non-infectious origins in children. A retrospective chart review of 174 pediatric patients of aged between 4 to 28 years, receiving allogeneic HSCT between 2009 and 2012 was performed. We compared demographic and pretransplant data of patients with PCs according to the infectious and noninfectious origins. Eighty three PCs developed in 66 patients(37.9%): 57 infectious(24.7%), 26 noninfectious(14.9%), and 3 both infectious and noninfectious(1.7%). The cumulative incidence of infectious PCs was increased earlier than noninfectious PCs after HSCT(p=0.027). The main infectious PCs were unspecified pneumonia(18 [10.3%]), fungal pneumonia(14 [8%]), acute bronchitis(7 [4%]) and viral pneumonia(7 [4%]). Bronchiolitis obliterans, air trapping, cryptogenic organizing pneumonia were the common noninfectious complications. Independent factors associated with PCs included cell source of HSCT and severity of chronic GVHD(p<0.001). The mortality risk following noninfectious PCs was much increased during the first year and relatively stable thereafter. Whereas, the mortality risk following infectious PCs showed continuous increase until second year. The infectious PCs were more prevalent and occurred earlier than noninfectious PCs. The development of infectious complications was more related to decreased survival.

Rhinovirus-Infected Epithelial Cells Produce More IL-8 and RANTES Compared With Other Respiratory Viruses

전윤홍,박주영,이휘수,김현숙,원술미,조현정,윤종서,김현희,김진택,이준성,정우진 대한천식알레르기학회 2013 Allergy, Asthma & Immunology Research Vol.5 No.4

Purpose: The environmental factors human rhinoviruses (HRVs) and house dust mites (HDMs) are the most common causes of acute exacerbationsof asthma. The aim of this study was to compare the chemokine production induced by HRVs in airway epithelial cells with that induced by other respiratoryviruses, and to investigate synergistic interactions between HRVs and HDMs on the induction of inflammatory chemokines in vitro. Methods:A549 human airway epithelial cells were infected with either rhinovirus serotype 7, respiratory syncytial virus (RSV)-A2 strain, or adenovirus serotype3 and analyzed for interleukin (IL)-8 and regulated on activation, normal T-cell expressed and secreted (RANTES) release and mRNA expression. Additionally, activation of nuclear factor (NF)-κB and activator protein (AP)-1 were evaluated. The release of IL-8 and RANTES was also measured incells stimulated simultaneously with a virus and the HDM allergen, Der f1. Results: HRV caused greater IL-8 and RANTES release and mRNA expressioncompared with either RSV or adenovirus. NF-κB and AP-1 were activated in these processes. Cells incubated with a virus and Der f1 showedan increased IL-8 release. However, compared with cells incubated with virus alone as the stimulator, only HRV with Der f1 showed a statistically significantincrease. Conclusions: IL-8 and RANTES were induced to a greater extent by HRV compared with other viruses, and only HRV with Der f1acted synergistically to induce bronchial epithelial IL-8 release. These findings may correspond with the fact that rhinoviruses are identified more frequentlythan other viruses in cases of acute exacerbation of asthma.

폐농양과 심막삼출이 동반된 A군 연구균에 의한 폐렴 1례

전윤홍,이수영,최상림,정대철,정승연,강진한,Chun, Yoon Hong,Lee, Soo Yong,Choi, Sang Lim,Jeong, Dae Chul,Chung, Seung Yeon,Kang, Jin Han 대한소아감염학회 2004 Pediatric Infection and Vaccine Vol.11 No.2

A군 연구균 감염으로 인한 폐렴이나 기관지염등 하기도의 감염은 흔하지 않은 것으로 되어 있다. 그러나 일단 발생할 경우에는 심한 경과와 함께 폐농양이나 심장염을 포함해 다양한 염증성 합병증을 동반하며 빠르게 진행한다. 본 저자들은 A군 연구균 감염에 의한 농양성 폐렴을 항생제와 흉강 삽관술로 치료하였고, 연속적으로 발현된 심외막염에 의한 심막삼출을 이뇨제로 치료하여 증상호전을 보인 여자 환아 1례를 경험하였기에 보고하는 바이다. Group A streptococcus, also known as Streptococcus pyogenes, is a common bacterial pathogens of the upper respiratory tract and skin infections in children, but this organism is a less common cause of pneumonia, pericarditis. However, pneumonia that is caused by Streptococcus pyogenes, may be rapidly progressive course with developing severe consequences. It may be focal but often is bilateral and diffuse involvement of lung. Empyema is commonly developed, and pleurocentesis often yields thin, watery fluid that continues to flow out when a chest tube is inserted. Antimicrobial resistance to the ${\beta}$-lactam antibiotics has not been reported against group A streptococci, whereas increasing resistance to the macrolides seems to be directly related to the consumption of specific antimicrobial agent use in the community. Clindamycin resistance is uncommon but does occur. We experienced one case of group A streptoccoccal pneumonia with empyema and pericardial effusion, and treated successfully with amoxicillin-clavulanate, clindamycin and roxithromycin.

마우스의 장내 농양(intraabdominal abscess)형성에 대한 연구

박장환,정용훈,조양자,김정목,전윤홍 한양대학교 의과대학 1992 한양의대 학술지 Vol.12 No.1

Intraabdominal abscesses (IAA) are produced microbiologically by mixed infection. And clinical treatment of IAA is limited because duration of the these diseases are prolong and the their nature is mixed infection. This study was carried out to develop a standardized IAA model used in B.fragilis. Encapsulated B.fragilis and autoclaved colonic and cecal contents produced IAA> And encapsulated B.fragilis produced IAA more than unencapsulated B. fragilis. Only E.coli was not effective to produce IAA but combination with encapsulated B.fragilis produced IAA. Abscesses were usually found in the serosal surface adherent to pancrease or colon and in the fatty tissue around the uterus. This study will subsequently support a development of IAA treatment.

소아 알레르기비염의 위험 인자와 보호 인자

전윤홍 ( Yoon Hong Chun ),김민지 ( Minji Kim ),김효빈 ( Hyo-bin Kim ),나영호 ( Yeong-ho Rha ),박양 ( Yang Park ),박용민 ( Yong Mean Park ),성명순 ( Myongsoon Sung ),신윤호 ( Youn Ho Shin ),염혜영 ( Hye Yung Yum ),이경석 ( Kyung S 대한천식알레르기학회 2022 Allergy Asthma & Respiratory Disease Vol.10 No.2

Among allergic diseases of the Korean pediatric population, allergic rhinitis shows the most rapidly increasing prevalence. Its economic burden is substantial in many Asian countries including South Korea. This investigation of its risk factors aims to reduce the socioeconomic burden by blocking exposure of susceptible individuals to identified causes. However, the risk factors of allergic rhinitis varied considerably depending on the seasons, geographical locations, and populations involved. This review article primarily deals with studies on the risk factors for allergic rhinitis in Korean children that were published during the last 10 years and additionally investigates associated large scale international studies. Our investigation identified several single-nucleotide polymorphisms, inhalant allergens, pollution, tobacco smoke, chemicals, and family affluence as risk factors for allergic rhinitis. In contrast, breastfeeding, older sibling, and microbial diversity were protective factors against allergic rhinitis. This suggests that various genetic and environmental factors might affect the manifestation and presentation of allergic rhinitis complexly. These findings are beneficial as they can provide insights into modifiable risk factors that may hinder the development of allergic rhinitis. (Allergy Asthma Respir Dis 2022;10:73-79)

소아에서 굴곡성 기관지 내시경술을 이용한 무기폐 치료의 유용성

전윤홍 ( Yoon Hong Chun ),강성실 ( Sung Shil Kang ),방경원 ( Kyung Won Bang ),김환수 ( Hwan Soo Kim ),이의경 ( Eu Kyoung Lee ),윤종서 ( Jong Seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ),이준성 ( Joon Sung Lee ) 대한소아알레르기호흡기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.3

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. (Allergy Asthma Respir Dis 2013;1:274-279)

소아에서 굴곡성 기관지 내시경술을 이용한 무기폐 치료의 유용성

전윤홍 ( Yoon Hong Chun ),강성실 ( Sung Shil Kang ),방경원 ( Kyung Won Bang ),김환수 ( Hwan Soo Kim ),이의경 ( Eu Kyoung Lee ),윤종서 ( Jong Seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ),이준성 ( Joon Sung Lee ) 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.3

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. (Allergy Asthma Respir Dis 2013;1:274-279)

90도 요철이 설치된 회전덕트에서 유출이 열/물질전달에 미치는 영향

박석환,전윤홍,김경민,이동현,조형희 한국유체기계학회 2006 한국유체기계학회 논문집 Vol.9 No.1

The present study investigates the effects of bleed flow on heat/mass transfer and pressure drop in a rotating channel with transverse rib turbulators. The hydraulic diameter(Dh) of the square channel is 40.0 mm. The bleed holes are located between the rib turbulators on leading surface and the hole diameter(d) is 4.5mm. The square rib turbulators are installed on both leading and trailing surfaces. The rib-to-rib pitch is 10.0 times of the rib height(e) and the rib height-to-hydraulic diameter ratio(e/Dh) is 0.055. The tests were conducted at various rotation numbers(0, 0.2, 0.4), while the Reynolds number and the rate of bleed flow to main flow(BR) were fixed at 10,000 and 10%, respectively. The results suggest that the heat/mass transfer characteristics in the internal cooling passage are influenced by rib turbulators, bleed flow and the Coriolis force induced by rotation. For the rotating ribbed passage with bleed flow, the heat/mass transfer on the leading surface is hardly affected by bleed flow, but that on the trailing surface decreases due to the diminution of main flow. The results also show that the friction factor decreases with the bleed flow.1. 서 론* 연세대학교 대학원 기계공학부

F-143 : Free Paper Presentation ; Late-Onset Non-Infectious Pulmonary Complications after Pediatric Allogeneic Hematopoietic Stem Cell Transplantation

윤종서,전윤홍,이재욱,장필상,정낙균,조빈,김학기,이준성 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.-

Purpose: The incidence, characteristics, and outcomes of late-onset non-infectious pulmonary complications (LONIPCs) in children have not been well studied. Methods: We retrospectively reviewed the medical records of patients aged between 6 and 17 years who underwent allogeneic HSCT. Bronchiolitis obliterans (BO) was diagnosed based on persistent radiographic changes consistent with BO. Bronchiolitis obliterans with organizing pneumonia (BOOP) was diagnosed when there were appropriate HRCT findings without clinical evidence of infection by bronchoalveolar lavage. Results: Of the 103 patients who were included in the study, 17 (16.5%) developed LONIPCs, and 10 and 7 were further diagnosed with BO and BOOP, respectively. Multivariate analysis revealed that the only predictive factor for the development of LONIPCs was chronic GVHD in sites besides the lungs. When these patients were analyzed separately, early development of chronic GVHD in sites besides the lungs was a risk factor of the development of LONIPCs. Conclusions: The present study verifies the increasing incidence and prevalence of LONIPCs after allogeneic HSCT in children. Chronic GVHD in sites besides the lungs was confirmed as a risk factor associated with LONIPC development. In addition, early development of chronic GVHD in sites besides the lungs was a risk factor of LONIPCs. These findings may be used to establish new approaches for diagnosing, monitoring, treating, and investigating LONIPCs. Purpose: The incidence, characteristics, and outcomes of late-onset non-infectious pulmonary complications (LONIPCs) in children have not been well studied. Methods: We retrospectively reviewed the medical records of patients aged between 6 and 17 years who underwent allogeneic HSCT. Bronchiolitis obliterans (BO) was diagnosed based on persistent radiographic changes consistent with BO. Bronchiolitis obliterans with organizing pneumonia (BOOP) was diagnosed when there were appropriate HRCT findings without clinical evidence of infection by bronchoalveolar lavage. Results: Of the 103 patients who were included in the study, 17 (16.5%) developed LONIPCs, and 10 and 7 were further diagnosed with BO and BOOP, respectively. Multivariate analysis revealed that the only predictive factor for the development of LONIPCs was chronic GVHD in sites besides the lungs. When these patients were analyzed separately, early development of chronic GVHD in sites besides the lungs was a risk factor of the development of LONIPCs. Conclusions: The present study verifies the increasing incidence and prevalence of LONIPCs after allogeneic HSCT in children. Chronic GVHD in sites besides the lungs was confirmed as a risk factor associated with LONIPC development. In addition, early development of chronic GVHD in sites besides the lungs was a risk factor of LONIPCs. These findings may be used to establish new approaches for diagnosing, monitoring, treating, and investigating LONIPCs.

소아 알레르기질환에서 감작 패턴에 따른 혈중 호산구와 총 IgE의 비교

이혜진,양은애,전윤홍,김현희,김환수 대한 소아알레르기 호흡기학회 2024 Allergy Asthma & Respiratory Disease Vol.12 No.1

. Purpose: Eosinophils and total immunoglobulin (IgE) have served as a histologic hallmark of allergic conditions. Many investigators have used total eosinophil count (TEC) and total IgE for evaluating allergic diseases. We examined differences in TEC and total IgE in allergic diseases and whether it differs according to sensitization. Methods: In this retrospective study, we enrolled 551 patients who visited Uijeongbu St. Mary’s Hospital from January 1, 2009 through December 31, 2012 for allergic diseases. We included patients with a diagnosis of atopic dermatitis (AD), allergic rhinitis (AR), asthma (AS), or urticaria (UC). We compared the TEC and total IgE level according to sensitization patterns. Results: There were 235 cases of AD, 179 cases of AS, 112 cases of AR, and 82 cases of UC. Regarding sensitization, 106 were not sensitized to any allergens, 206 were sensitized to inhalants, 109 were sensitized to food allergens, and 49 were sensitized to both food and inhalant allergens. TEC was significantly higher in the AD and AR group than in the UC group. TEC was significantly higher in those sensitized to both inhalant and food than those not sensitized. The total IgE levels were significantly higher in those sensitized to both inhalant and food than those not sensitized or sensitized to food. Total IgE levels were significantly higher in those sensitized to inhalant than those not sensitized or sensitized to food. Conclusion: Eosinophils appear to play differential roles in the expression of different types of allergic diseases. Total IgE level may play a significant role in sensitization.