• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.239-244
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• 1999

Purpose : In 1998, there was an outbreak of mumps in Taejon, Korea. We analyzed the monthly incidence, clinical manifestations, and complications during the outbreak and the annual incidence of the recent ten years. Methods : We reviewed the clinical records of 35 mumps patients who had been admitted to Taejon St. Mary's Hospital from January to December, 1998. Results : Mumps was prevalent in summer(from June to August) with 20 cases(57%). Thirthy-three patients(94.3%) received MMR at 15 months of age and no patients received a booster mumps vaccine. The mean age of the mumps patients was 10.5 years-old and the majority of mumps(71%) occurred between 5 and 12 year of age. The male female ratio was 2.2 : 1. The clinical manifestations were swelling of parotid gland(100%), fever (91%), vomiting(77%), abdominal pain(74%) and headache(66%) in order of frequency. Meningitis occurred in 20 cases(57%) and the mean WBC count of CSF was $464{\pm}263/mm^3$. In serology, the mean serum amylase level was $483{\pm}294IU/dL$ and anti-mumps IgM and IgG were positive in 11 and 15 out of 18 cases, respectively. From 1989 to 1997, the mean number of inpatients with mumps was 3.4 per year. Conclusion : We experienced an outbreak of mumps in 1998. It is suggested that there was a primary mumps vaccine failure in Korea and that further studies for vaccine faiure and method of booster mumps vaccine are necessary.

• Tuberculosis and Respiratory Diseases
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• v.62 no.5
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• pp.389-397
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• 2007

Background B-type natriuretic peptide (BNP) has been shown to be strong mortality predictors in a wide variety of cardiovascular syndromes. Little is known about BNP in patients with acute respiratory distress syndrome (ARDS). We studied whether BNP can predict mortality in patients with ARDS. Method Echocardiographic study was done to all patients with ARDS, and we excluded patient with low ejection fraction (less than 50%) or showing any features of diastolic dysfunction. 47 patients were enrolled between December, 2003 and February, 2006. Parameters including BNP were obtained within 24h hours at the time of enrollment. Result Mean BNP concentrations and APACHE II scores differed between the survivors and nonsurvivors (BNP, $219.5{\pm}57.7pg/mL$ vs $492.3{\pm}88.8pg/mL$; p=0.013, APACHE II score, $17.4{\pm}1.6$ vs $23.1{\pm}1.3$, p=0.009, respectively). With the use of the threshold value for BNP of 585 pg/mL, the specificity for the prediction of mortality was 94%. The threshold value for APACHE II of 15.5 showed sensitivity of 87%. 'APACHE II + $11{\times}logBNP$' showed sensitivity 63%, and specificity 82%, using threshold value for 46.14. Conclusion BNP concentrations and APCHE II scores were more elevated in nonsurvivors than survivors in patients with ARDS who have normal ejection fraction. BNP can predict mortality. Further study should be done.

• Tuberculosis and Respiratory Diseases
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• v.39 no.2
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• pp.159-166
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• 1992

Background:Sulfiting agents are widely used as preservatives and antioxidants in foods, beverages and drugs including bronchodilators. There have been reports of sulfite-related reactions such as anaphylaxis, urticaria, angioedema, abdominal discomfortness as well as bronchospasm. Several investigators reported that sulfite-sensitive asthmatic patients comprised from 3.9% to 8.2% of all asthmatic patients and its prevalence was higher in steroid-dependent group than in steroid-independent group. Subjects and Method:We performed oral provocation test with sodium bisulfite and aspirin in 17 asthmatic patients who have experienced aggravation of their symptoms after administration of drugs or foods. All of them were steroid dependent asthmatics. We observed clinical symptoms and steroid requirements from 1 to 18 months. Result:Ten of them showed severe bronchoconstriction after the ingestion of sodium bisulfite (50 to 200 mg) within 30 minutes. Concurrent aspirin intolerance was noted by oral provocation test in four cases (40%). Three of them showed positive responses on skin prick test with sulfite (10 or 100 mg/ml). Mean total eosinophil counts was $844/mm^3$ at asthmatic attack. And there was no significant responses on skin prick test and IgE-RAST to common inhalant allergens. After complete avoidance from sulfite containing foods and drugs as well as antiasthmatic medication for 1 to 18 months, nine of them (90%) could stop or reduce the steroid requirements. ConcIusion:It was suggested that severe steroid dependent and intrinsic type of asthmatic patients should be evaluated for sulfite-sensitivity.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.405-410
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• 2004

Background : Moxifloxacin is an 8-methoxyquinolone compound which has been shown to have the best activity of the quinolones against M. tuberculosis but there is no literature showing the rate of cross-resistance between moxifloxacin and the other quinolones such as ofloxacin. Therefore, we tested the activity of moxifloxacin against ofloxacin resistant M. tuberculosis by a study of cross-resistance. Methods : We tested MIC's of moxifloxacin and ofloxacin by proportion method against 34 M. tuberculosis isolates showing resistance against ofloxacin at $2.5{\mu}g/m{\ell}$ concentration and 13 ofloxacin susceptible isolates from specimens submitted to clinical laboratory of National Masan Hospital from March 2003 to March 2004. Results : For ofloxacin susceptible isolates, $MIC_{50}$ and $MIC_{90}$ of ofloxacin were all $1.25{\mu}g/m{\ell}$, and $MIC_{50}$ and $MIC_{90}$ of moxifloxacin were $0.31{\mu}g/m{\ell}$ and $0.63{\mu}g/m{\ell}$ respectively. For ofloxacin resistant isolates, $MIC_{50}$ of ofloxacin was over $10{\mu}g/m{\ell}$ and $MIC_{50}$ of moxifloxacin was $5{\mu}g/m{\ell}$, $MIC_{90}$ of ofloxacin and moxifloxacin were all over $10{\mu}g/m{\ell}$. The rate of cross-resistance between the two was 67.6%(23/34) at $2.5{\mu}g/m{\ell}$ concentration. Conclusions : Moxifloxacin showed activity against 82.4%(28/34) of ofloxacin resistant M. tuberculosis at $10{\mu}g/m{\ell}$, but more studies are needed so that moxifloxacin will be used for patient with multi-drug resistant tuberculosis including oflokacin resistance.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.98-102
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• 2018

Purpose When examining patients with digestive system Leakage, it is not easy to distinguish between bile leakage and bleeding only with Planar images. I would like to evaluate the utility of leakage of bile, confirmation of gastrointestinal bleeding and location discrimination using SPECT-CT. Materials and Methods SPECT-CT was performed according to the request of the reading room after acquiring Planar image for a total of 13 patients, including 8 patients suspected of bile leakage and 5 patients suspected of gastrointestinal bleeding, among patients visiting this specification went. We used Symbia T16 from SIEMENS and Discovery 670 from GE. Planar and SPECT-CT images were evaluated with a score of 1 to 10 by 4 experienced nuclear medicine doctors. Using the sensitivity and the specificity, the evaluation of the inspection by the ROC curve was carried out. The final diagnosis was confirmed by follow-up observation as a result of reoperative surgery. Results The sensitivity, specificity and accuracy of SPECT-CT were 91.7%, 100% and 94.2%, respectively. Planar images were 83.3%, 68.8% and 78.8%, respectively. Planar images showed lower diagnostic accuracy compared to SPECT-CT (78.8%, 94.2%, p<0.05). Moreover, the reliability of the diagnosis of SPECT-CT by ROC curve analysis showed a more useful result than the Planar image (p<0.05). Conclusion SPECT-CT had high sensitivity and specificity for diagnosis of biliary leakage and gastrointestinal bleeding and location discrimination. When SPECT-CT is additionally performed together with Planar images, it may be considered to improve bile leakage and diagnosis of gastrointestinal bleeding patients and position discrimination evaluation. There is usefulness depending on the patient's age and position, but consideration of additional CT exposure may be done sufficiently.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.97-105
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• 1997

Purpose : Aseptic meningitis mainly caused by enterovirus is common in pediatric population especially during summer & fall. Most of pediatric patients restore their health without any complications with proper management. Between May to August of 1996, Masan and surrounding areas of the Kyoungsangnamdo were epidemic areas for the aseptic meningitis. The purpose of this study was to determine causative virus and describe correlation between disease and clinical symptoms in aseptic meningitis patients and those with fever and characteristic rashes without apparent meningitis symptoms. Methods : Between May to August, 1996, 57 patients with high fever and characteristic feature of rashes were reviewed. From 22 cerebrospinal fluid & 57 stool obtained specimens, viral culture and detection of enterovirus RNA were conducted. Collected specimens were kept in $-30^{\circ}C$ environment until sending of specimens to labortory. The virus identified through indirect immunofluorescence. RT-PCR method was used to identify enterovirus RNA in cerebralspinal fluid. Results : 1) One hundred fifty five pediatric patients with viral infection required hospitalization. Disease occurred higher rate in male than female with ratio of 1.94:1. Examined patients' age ranged from 15days old to 15years old. But most of patients(74.8%) were under age of 5years old. The time of occurrence was between May to August of 1996. 2) All patients had high fever and physical symptoms in those patients include headache, vomiting, abdominal pain, diarrhea, and rashes. The rashes observed mainly in patients under age of 4 years and were predominantly commom patients under age of 18 months olds)<0.001). 3) Between sampled patients and non-sampled patients, clinical course was similar. Echovirus type 9 was cultivated in 41 out of 57 cases of collected stool specimens. RT-PCR that used on CSF showed positive results in 10 out of 22 cases. Three cases of positive cultivated of positive results in RT-PCR were echovirus type 9. Conclusions : Echovirus type 9 was thought to be the causative agent of aseptic meningitis that was prevalent throughout mid areas of Kyoungsangnamdo from May to August, 1996. Additionally causative agent that responsible for high fever with rashes without meningitis symptoms also thought to be the same echovirus type 9.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.172-182
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• 1988

To reveal the association between blood selenium level and the gastric diseases, 180 persons received the gastrofiberscopic examination at the outpatients department of the two university hospitals from July to September 1987, after the exclusion of the persons having the esophageal varix, were randomly selected. Their general characteristics such as age, sex and educational level and so on, were inverstigated. Five mi venous blood was collected from each subjects and stored at $0^{\circ}C$ in heparinized vaccum tube. The blood selenium level was measured by the flameless atomic absorption spectrophotometry. In the procedure of data analysis, five subjects having benign tumor and anomaly of the stomach, were also excluded. The mean blood selenium levels of the $155.5{\mu}g/{\ell}$ among gastritis cases, the $154.8{\mu}g/{\ell}$ gastric ulcer and the $133.0{\mu}g/{\ell}$ gastric malignancy were significantly lower(p<0.05) than that of the $173.3{\mu}g/{\ell}$ among normal controls. In men the mean blood selenium levels .among gastritis, gastric ulcer and gastric malignancy cases were significantly lower(p<0.05) than that among normal controls. In females, the mean blood selenium levels among gastritis and gastric maligancy cases were significantly lower(p<0.05) than that among normal controls($169.7{\mu}g/{\ell}$), but that among gastric ulcer cases($177.7{\mu}g/{\ell}$) was not significantly higher. In the logistic analysis, coefficient of the blood selenium level was -0.0436(p<0.05 : odds ratio 0.957) for gastritis, -0.0197(p=0.17 : 0.981) for gastric ulcer, -0.4876(p<0.05 : 0.614) for gastric malignancy and -0.0411(p<0.05 ; 0.960) for gastric diseases including the gastritis, the gastric ulcer and the gastric malignancy. These data support the hypothesis that the gastric diseases are to be associated with the low selenium level but, for the gastric ulcer, the further research is recommended.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.146-153
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• 2010

Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children. Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture. Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79${\pm}$4.54 years. Of the 61 patients, 22 (36.1%) were <1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005). Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.

• Korean Journal of Food Science and Technology
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• v.39 no.3
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• pp.237-245
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• 2007

We tested for residual pesticide levels in agricultural products purchased from 5 provinces within the middle region of Korea during 2006. A Total of 488 samples of 23 different types of agricultural products were analyzed by GC/MS, GC-NPD, and LC/MS/MS. We used multi-analysis methods to analyze for 231 different pesticide types; a single residual pesticides were detected in 92 samples (18.9%), of which 9 samples (1.9%) exceeded the Korea Maximum Residue Limits (MRLs). we detected pesticide residue in more than 50% of the pepper leaf and welsh onion samples. For the welsh onions, 16 among the 30 analyzed samples contained pesticide residue, and 4 samples exceeded the Korea MRLs. Among the 234 kinds of pesticides we tested for, 42 were detected, and 21 of them were detected more than twice. Six pesticide residue types, including cypermethrin, iprodione, fludioxonil, ethoprophos, flutolanil, and lufenuron, exceeded the MRLs. No residual pesticides were detected in 396 of the samples (81.1%), and the residual pesticide levels in 83 samples (17.0%) were lower than the Korea MRLs, indicating that 98.1% of the samples were relatively safe.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.731-736
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• 2005

Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.