Epidemiological Aspects of Pertussis among Adults and Adolescents in a Korean Outpatient Setting: A Multicenter, PCR-Based Study

Epidemiological data of Bordetella pertussis infection among adolescents and adults are limited in Korea. Patients (> or = 11 yr of age) with a bothersome cough for less than 30 days were enrolled during a 1-yr period at 22 hospitals in Korea. Nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and for bacteriologic culture. In total, 490 patients were finally enrolled, and 34 (6.9%) patients tested positive for B. pertussis; cough duration (14.0 days [7.0-21.0 days]) and age distribution were diverse. The incidence was the highest in secondary referral hospitals, compared to primary care clinics or tertiary referral hospitals (24/226 [10.6%] vs. 3/88 [3.4%] vs. 7/176 [4.0%], P = 0.012), and the peak incidence was observed in February and August (15.8% and 15.9%), with no confirmed cases between March and June. In the multivariate analysis, post-tussive vomiting was significantly associated with pertussis (odds ratio, 2.508; 95% confidence interval, 1.146-5.486) and secondary referral hospital showed a borderline significance. In conclusion, using a PCR-based method, 6.9% of adolescent and adult patients with an acute cough illness had pertussis infection in an outpatient setting. However, hospital levels and seasonal trends must be taken into account to develop a better strategy for controlling pertussis.

Circulating Levels of Interleukin-6 and Soluble Interleukin-6 Receptor in Acute Asthma / 결핵

BACKGROUND: The recognition of bronchial asthma as an inflammatory disease led to a search for soluble markers that would be useful in assessing airway inflammation. Interleukin-6 (IL-6) is a representative proinflammatory cytokine that has been shown to be connected with various inflammatory diseases. IL-6 acts via specific receptors that consist of the IL-6 binding glycoprotein gp80 and the signal transducer gp130. In the search for markers of airway inflammation, we investigated the role of soluble interleukin-6 receptor (sIL-6R) and IL-6 in acute asthma. METHODS: Serum levels of sIL-6R and IL-6 were measured in 78 acute asthmatics, in 15 patients with asymptomatic asthma and in 10 healthy control subjects by a specific ELISA using a murine antihuman IL-6R, IL-6 mAb (Quantikine sIL-6R, IL-6). RESULTS: Serum levels of IL-6 in acute asthmatics significantly exeeded those of control subjects. Those of sIL-6R in acute asthmatics were also significantly increased compared to those of control subjects. The serum concentration of IL-6 obtained in acute asthmatics was elevated as compared with the asymptomatic asthmatics. However, Association between eosinophilic count / IgE and IL-6 / sIL-6R in acute asthma could not found. CONCLUSION: Our results suggest that IL-6 may be involved in the pathogenesis of acute asthma and serum levels of IL-6 and sIL-6R may reflect the severity of airway inflammation.

Gene-polymorphisms of angiotensin converting enzyme and endothelial nitric oxide synthase in patients with bronchial asthma / 천식및알레르기

BACKGROUND: Angiotensin converting enzyme (ACE) is heavily expressed in the lung and plays a role in the metabolism of angiotensin II, bradykinin and substance P. Nitric oxides, including those produced by endothelial nitric oxide synthase (ecNOS), may regulate vascular and airway tone in the lung and influence various aspects of airway homeostasis. They are potentially involved in the pathogenesis of asthma, but the role of ACE and ecNOS gene in bronchial asthma is not completely understood. OBJECTIVE: To examine the possible involvement of ACE and ecNOS genes in the genetic basis for bronchial asthma, we investigated the association between genetic polymorphism and bronchial asthma, and its severity. METHOD: We determined the ACE and ecNOS genotypes by the polymerase chain reaction in 160 patients with bronchial asthma and 121 healthy subjects. Severity of asthma was classified by the guideline of NHLBI/WHO workshop. RESULTS: The frequency of the ID genotypes of ACE and bb genotype of ecNOS was highest in both groups, respectively. The distribution of ACE genotypes did not differ between the two groups (p=0.27). There was a higher frequency of the bb genotype of ecNOS in the asthma group than in the control population (p=0.004). In asthmatic patients, there were no differences in the distribution of ACE and ecNOS genotypes in different severity groups (p= 0.17, 0.06). CONCLUSION: These results suggest that the polymorphism of the ecNOS gene, not ACE gene, may be associated with development of asthma. But, the severity of asthma may not be influenced by polymorphisms of the ecNOS and ACE genes.

ADA Level In Bronchial Washing Fluid In Patients With Pulmonary Tuberculosis / 결핵

BACKGROUND: The estimation of ADA activity in pleural fluid has been proved useful tool in the diagnosis of tuberculous pleural effusions. However, there is controversy about its usefulness when estimated in bronchial washing fluid in the patients with pulmonary tuberculosis. This study aims at evaluating the usefulness of measuring ADA activity in bronchial washing fluid of tuberculous patients as biochemical marker in the early diagnosis of the disease. METHODS: We examined the difference of ADA activity in bronchial washing fluid among the group I (tuberculosis group), group II (lung cancer group) and group III (control group). RESULTS: There was significantly higher bronchial washing fluid ADA level in tuberculosis group compared to the lung cancer and control groups(p<0.01). CONCLUSION: These results suggest that bronchial washing fluid ADA activities seem to be a useful tool in the diagnosis of pulmonary tuberculosis.