Clinical characteristics of 2009 pandemic influenza A (H1N1) infection in children and the performance of rapid antigen test

PurposeIn autumn 2009, the swine-origin influenza A (H1N1) virus spread throughout South Korea. The aims of this study were to determine the clinical characteristics of children infected by the 2009 H1N1 influenza A virus, and to compare the rapid antigen and real-time polymerase chain reaction (PCR) tests.MethodsWe conducted a retrospective review of patients ≥18 years of age who presented to Soonchunhyang University Hospital in Seoul with respiratory symptoms, including fever, between September 2009 and January 2010. A real-time PCR test was used to definitively diagnose 2009 H1N1 influenza A infection. Medical records of confirmed cases were reviewed for sex, age, and the time of infection. The decision to perform rapid antigen testing was not influenced by clinical conditions, but by individual factors such as economic conditions. Its sensitivity and specificity were evaluated compared to real-time PCR test results.ResultsIn total, 934 patients tested positive for H1N1 by real-time PCR. The highest number of patients (48.9%) was diagnosed in November. Most patients (48.2%) were aged between 6 and 10 years. Compared with the H1N1 real-time PCR test results, the rapid antigen test showed 22% sensitivity and 83% specificity. Seventy-eight patients were hospitalized for H1N1 influenza A virus infection, and fever was the most common symptom (97.4%).ConclusionFor diagnosis of 2009 H1N1 influenza A virus infection, the rapid antigen test was inferior to the real-time PCR test in both sensitivity and specificity. This outcome suggests that the rapid antigen test is inappropriate for screening

Lung cancer with superior vena cava syndrome diagnosed by intravascular biopsy using EBUS-TBNA

AbstractSince superior vena cava syndrome (SVCS) is a critical condition, immediate diagnostic approach and therapy are imperative to avoid potentially life-threatening complications. Here, we report a case of lung cancer with SVCS, which was diagnosed through intravascular tumor biopsy using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA enabled us to obtain tissue sufficient for diagnosis, without significant complications. Prompt diagnosis was followed by appropriate anticancer treatment and improvement in the symptoms. For patients suspected of SVCS and requiring prompt pathologic diagnosis, we can consider EBUS-TBNA to diagnose intravascular or mediastinal tumors and provide an accurate diagnosis

Long-Term Bidirectional Association Between Asthma and Attention Deficit Hyperactivity Disorder: A Big Data Cohort Study

BACKGROUND: Previous studies have argued that attention deficit hyperactivity disorder (ADHD) is associated with asthma. However, reliable evidence to verify this association has not yet been reported. OBJECTIVES: To investigate the bidirectional association between asthma and ADHD through a 12-year big data cohort study. METHODS: The independent variable group was extracted from 3.5 million individuals randomly sampled by the National Health Insurance Service (NHIS). In Study 1, the incidence of ADHD according to asthma was evaluated, while in Study 2, the incidence of asthma according to ADHD was analyzed. Propensity score (PS) matching with several variables was used to obtain a control group. MEASUREMENTS AND MAIN RESULTS: In Study 1, the asthma group included 131,937 individuals and the non-asthma group included 131,937 individuals. The adjusted hazard ratio (aHR) for ADHD in the asthma group was 1.17 [95% confidence interval (CI): 1.11-1.23]. In subgroup analysis, the aHRs for ADHD of individuals in the subgroups male sex, 0-5 years old, 6-10 years old, atopic dermatitis, allergic rhinitis, Charlson comorbidity index (CCI) 1, and CCI \u3e 2 were significant (aHR: 2.83, 1.70, 1.79, 1.09, 1.15, 1.06, and 1.49, respectively). In Study 2, ADHD was found to significantly affect asthma in all age groups (aHRs of the subgroups 0∼60 and 0∼17 years old were 1.10 and 1.09, respectively). In the 0∼17 years old subgroup, the association of ADHD with asthma was greater with younger age (aHRs of the subgroups 0∼5 and 6∼10 years old were 2.53 and 1.54, respectively). CONCLUSION: From long-term follow-up, the incidence of ADHD was 1.17 times higher in the asthma group than in the control group. The incidence of asthma was 1.10 times higher in the ADHD group than in the control group. Asthma and ADHD have a bidirectional relationship, and childhood asthma and ADHD should be rigorously managed

Lung Function in Korean Adolescent Girls: in Association with Obesity and the Menstrual Cycle

Gender differences in asthma have been observed with a preponderance of boys affected before puberty and girls during and after puberty. The known influences of the menstrual cycle on asthma support a role for female sex hormones on the changing expression of asthma during adolescence. The purpose of this study was to investigate obesity, the menstrual cycle and lung function in adolescent girls. One hundred and three female high school girls (mean age: 15.9±0.8 yr) were enrolled. The investigation was performed using a questionnaire that included history of asthma, the menstrual cycle, other combined allergic disease and obesity. The skin prick and pulmonary function test during menstruation period and non-menstruation period. Analyses of these factors were compared. The forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was significantly lower in the obese group compared to the non-obese group (99.8±13.8 vs. 107.1±10.2, p=0.03). The FEV1 was significantly lower in the girls during menstruation period than in the girls who were not on menstruation (77.5±10.2 vs. 80.4±8.6, p=0.03). Our results showed that changes of pulmonary function were related to menstrual cycle and obesity in Korean adolescent girls

AKAP12 Mediates Barrier Functions of Fibrotic Scars during CNS Repair

The repair process after CNS injury shows a well-organized cascade of three distinct stages: inflammation, new tissue formation, and remodeling. In the new tissue formation stage, various cells migrate and form the fibrotic scar surrounding the lesion site. The fibrotic scar is known as an obstacle for axonal regeneration in the remodeling stage. However, the role of the fibrotic scar in the new tissue formation stage remains largely unknown. We found that the number of A-kinase anchoring protein 12 (AKAP12)-positive cells in the fibrotic scar was increased over time, and the cells formed a structure which traps various immune cells. Furthermore, the AKAP12-positive cells strongly express junction proteins which enable the structure to function as a physical barrier. In in vivo validation, AKAP12 knock-out (KO) mice showed leakage from a lesion, resulting from an impaired structure with the loss of the junction complex. Consistently, focal brain injury in the AKAP12 KO mice led to extended inflammation and more severe tissue damage compared to the wild type (WT) mice. Accordingly, our results suggest that AKAP12-positive cells in the fibrotic scar may restrict excessive inflammation, demonstrating certain mechanisms that could underlie the beneficial actions of the fibrotic scar in the new tissue formation stage during the CNS repair process

A novel gene mutation, c.82delC (p.Arg28 Alafs5), in a Korean family with X-linked agammaglobulinemia

X-linked agammaglobulinemia (XLA) is a hereditary humoral immunodeficiency that results from Bruton’s tyrosine kinase (BTK) gene mutations. These mutations cause defects in B-cell development, resulting in the virtual absence of these lymphocytes from the peripheral circulation. Consequently, this absence leads to a profound deficiency of lg all isotypes, and an increased susceptibility to encapsulated bacterial infections. A 15-month-old Korean boy presented with recurrent sinusitis and otitis media after 6 months of age, and had a family history of 2 maternal uncles with XLA. Laboratory tests revealed a profound deficiency of Ig isotypes, and a decreased count of CD19+ B cells in the peripheral circulation. Based on his family history and our laboratory test results, he was diagnosed with XLA. We performed BTK gene analysis of peripheral blood samples obtained from family members to confirm the diagnosis. Mutational analysis revealed a novel hemizygous frameshift mutation (c.82delC, p.Arg28Alafs*5), in the BTK gene. His mother and maternal grandmother were heterozygous carriers of this mutation and his two maternal uncles were hemizygous at the same position. After XLA diagnosis, intravenous immunoglobulin (400 mg/kg, monthly) treatment was initiated; recurrent sinusitis and otitis media were subsequently brought under control. To our knowledge, this is the first reported case of a Korean pedigree with a novel mutation in the BTK gene

Effects of the plane of nutrition for grower pigs on their grow-finish performance and meat quality in winter

Little is known about the effects of the plane of nutrition on growth performance and meat quality of grow-finish pigs under commercial production conditions. The present study was thus addressed to this virtually unanswered question. One hundred and two barrows and 102 gilts weighing approximately 24 kg were fed phase I and II grower diets with a high, medium, or low plane of nutrition (HP, MP, or LP) to approximately 43 and 70 kg, respectively, in 6 replicates (pens). Subsequently, the HP and MP groups were fed the HP and MP1 finisher diets, respectively, the LP group being fed a second MP (MP2) finisher diet (LP1 group). Moreover, 68 LP-grower-fed barrows and gilts were added to the feeding trial and fed the MP1 and LP finisher diets to approximately 95 kg and thereafter, respectively (LP2 group). All MP diets had the lysine:calorie ratios comparable to the RNC recommendations, with < 18% differences between those of the HP and LP diets. The finisher pigs were reared in 16 pens and slaughtered at approximately 115 kg. The gain:feed ratio, but not average daily gain (ADG), was greater for the HP group than for the MP and LP during the grower phase I whereas during the grower phase II, ADG was greater (p < 0.05) for the HP and LP groups vs. MP. During the finisher phase I, ADG was less for the LP (LP1 + LP2) group vs. HP and MP, with no difference between the HP and MP groups; the gain:feed ratio was less for the LP vs. MP group. Backfat thickness was greater for the LP vs. HP group. The water holding capacity of fresh longissimus dorsi muscle (LM) and the sensory juiciness score for cooked LM were greatest for the LP group, the sensory flavor and tenderness scores being greater for the LP group vs. MP. In conclusion, results suggest that compensatory growth occurred for the LP and MP groups during the grower phase II and finisher phase I, respectively, with fat deposition increased for the LP group and that meat quality could be improved by the use of LP

Effects of the plane of nutrition during the latter grower and entire finisher phases on grow-finish pig performance in summer

The present study was undertaken to investigate the effects of the plane of nutrition (PN) for growing-finishing pigs on growth performance and meat quality in summer. One hundred and two barrows and 102 gilts weighing approximately 44 kg were placed on a high-, medium-, or low-plane grower diet (HPG, MPG, or LPG) with ME and lysine concentrations ranging from 3.33 to 3.40 Mcal/kg and 0.93% to 1.15%, respectively, for 29 days in 6 replicates (pens) in total. Pigs from each grower pen were divided into two finisher pens and provided with a high-plane finisher diet (HPF) containing 3.40 Mcal ME and 9.5 g lysine/kg and a low-plane finisher diet (LPF; 3.25 Mcal ME and 8 g lysine/kg), respectively, up to approximately 110 kg, and slaughtered. Growth performance of the pigs, including average daily gain (ADG), average daily feed intake (ADFI), and gain:feed ratio, was not influenced by the grower-phase PN during any of the grower phase, a 31-d finisher phase I, and ensuing phase II. However, both the ADG and gain:feed ratio were greater (p < 0.05) for the HPF group than for the LPF group during the finisher phase I (748 vs. 653 g with SEM = 13 g and 0.333 vs. 0.299 with SEM = 0.008, respectively). The ADG, but not gain:feed ratio, was greater for the HPF group vs. LPF during the finisher phase II (673 vs. 623 g with SEM = 15 g for ADG and 0.322 vs. 0.323 with SEM = 0.005 for the gain:feed ratio). The carcass backfat thickness (BFT) was greater for the LPF group vs. HPF within the pigs which had been placed on LPG during the grower phase, but not within the pigs from the HPG or MPG group. Physicochemical characteristics of the longissimus dorsi muscle (LM) and sensory quality attributes of fresh and cooked LM were not influenced by either the grower-phase or finisher-phase PN. In conclusion, high PN is necessary for finishing pigs during the hot season to minimize the reduced rate of weight gain and also to prevent the increase of BFT that could result from low PN