• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.73-78
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• 1997

Purpose : Escherichia coli O157 can produce diarrhea as well as hemorrhagic colitis and hemolytic uremic syndrome. In many parts of North America, E. coli O157 often is the second or third most commonly isolated enteric bacterial pathogens. Recently, intakes of fast food, including hamburgers have increased in Korea. Therefore, E. coli O157 infection in Korea are likely to be increased. Methods : Stool samples from 317 pediatric diarrheal patients were analyzed by culture on sorbitol-MacConkey agar. Sorbitol-negative colonies were teated by E. coli O157 latex agglutination test. Results : Of the 317 specimens, one (0.3%) were E. coli O157:NM that not produced Shiga toxin. The 7 year old male patient who had complained of abdominal pain, vomiting and non-bloody diarrhea for 2 days. The patient was improved for 2 days after admission. Conclusions 1 Only one (0.3%) of all fecal samples were isolated E. coli O157 that not produced Shiga toxin. Therefore, routine stool culture for the isolation of E. coli O157 was not likely to be neccessary so far.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.10-21
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• 2001

Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.4
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• pp.232-238
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• 2014

Purpose: This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children. Methods: We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014. Results: Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment. Conclusion: This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.1
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• pp.51-58
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• 2018

Purpose: To clarify the clinical features of appendicitis in preschool children and to explore clinical appendicitis scoring systems in this age group. Methods: We retrospectively collected data on 142 children, aged 10 years or younger, with confirmed diagnosis of appendicitis based on surgical and pathologic findings. Enrolled subjects were divided into two groups: Group 1 (preschool children aged ${\leq}5$ years, n=41) and Group 2 (school children aged >5 to ${\leq}10$ years, n=101). Data analyzed included clinical presentation, laboratory findings, the pediatric appendicitis score (PAS), and the modified Alvarado score (MAS). Results: The most common presenting symptom was abdominal pain in both groups (92.7% vs. 97.0%). Other presenting symptoms were as follows: fever (65.9%), vomiting (68.3%), right lower quadrant (RLQ) localization (24.4%), anorexia (14.6%), and diarrhea (7.3%) in Group 1, and RLQ localization (74.3%), vomiting (71.3%), anorexia (52.5%), fever (47.5%), and diarrhea (11.9%) in Group 2. Perforation and abscess occurred more frequently in Group 1 than in Group 2 (43.9% vs. 12.9%, p<0.001; 34.1% vs. 5.0%, p<0.001; respectively). PAS and MAS were lower in Group 1 than in Group 2 ($4.09{\pm}1.97$ vs. $6.91{\pm}1.61$, p=0.048; $4.65{\pm}1.79$ vs. $6.51{\pm}1.39$, p=0.012; respectively). Conclusion: In preschool children, appendicitis often presents with atypical features, more rapid progression, and higher incidence of complications. This age group is more likely to have lower PAS and MAS than those of school children.

• Journal of Veterinary Clinics
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• v.11 no.1
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• pp.437-470
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• 1994

These studies were performed to establish more effective surgical method for correcting congenital atresia coli in calves. Distal colon fistulation, proximal colon fistulation and colon anastomosis which could be applied for surgical repair of intestinal obstruction were carried out in goatlings experimentally and in calves with atresia coli clinically. After treatment of the animals clinical signs, blood component values, body weight gain, survival and necropsy findings were observed. In goatlings, clinical signs after colon fistulation were diarrhea, anorexia and vitality loss, and those of proximal colon fistulation group were severer than those of distal colon fistulation group. Surviviability after operation was 9~16 weeks in distal colon fistulation group, 2~8 weeks in proximal colon fistulation group, and 2-3 days in colocolic anastomosis group, respectively. There were no alterations in blood component values among experimental groups. Weight gain rates were 54.6% in distal colon fistulation group and 42.9% in proximal colon fistulation group compared with those of control. Necropsy findings observed in experimental groups were distension of intestine and excessive fluid in abomasum and intestine. Two calves with atresia coli died 1 day and 6 days after operation but one with colon fistulation survived more than two months. Preoperative clinical signs in calves with atresia coli were abdominal distension, progressive anorexia, no defecation and postoperative clinical signs wert diarrhea and periodic abdominal distension. After operation there were no alterations in blood component values between the calf with atresia coli and control calf. Weight gain rate of calf with atresia coli was similar to that of control but revealed the tendency to decrease from the 2nd month after operation. Necropsy findings observed in two calves with atresia coli were intestinal distension. intraluminal excessive fluid, blind atretic sac and absence of intrarectal content. It was concluded that proximal or distal colon fistulation could be available for surgical correction of congenital atresla coli and prognosis of distal colon fistulation was better than of proximal colon fistulation, but that extensive colocolic anastomosis could not be compatible with life in ruminants.

• Korean Journal of Veterinary Pathology
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• v.7 no.1
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• pp.43-54
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• 2003

The purpose of this study was to investigate protective effects against transmissible gastroenteritis virus (TGEV) infection in piglets by administration of the TGEV antiserum orally at 2hrs, 24hrs and 36hrs after birth. Five piglets administered with the TGEV antiserum were experimentally challenged with TGEV at four-day-old. Control group was four piglets challenged with TGEV only. Clinical signs and gross, histopathological and immunohistochemical findings were examined. In clinical signs, piglets of the control group appeared the typical signs such as severe watery diarrhea, depression and anorexia but piglets of the TGEV antiserum adminstered group recovered progressively. In clinical signs, piglets of the control group appeared the typical signs such as severe watery diarrhea, depression and anorexia but piglets of the TGEV antiserum adminstered group recovered progressively. In mortality, control group showed 75%, but TGEV antiserum adminstered group showed 20.0 %, respectively. In gross findings, piglets of the control group appeared the typical findings of congestion, distension of lumen, contaning curdes of undigested milk in stomach. But gross findings of piglets of the TGEV antiserum adminstered group appeared milder than them of control group. In histopathological findings, piglets of the control group appeared the typical findings of villous atrophy and fusion, congesion, exfoliation, vacuolation, squamation, loss of cilia and proliferation of crypt. But histopathological findings of piglets of the TGEV antiserum adminstered group appeared milder than them of control group. In immunohistochemical findings, piglets of the TGEV antiserum adminstered group showed more intensive in reaction for IgA and IgG than them of control group. The recation for IgA was stronger than that of IgG. It was concluded that oral administration of TGEV antiserum to piglets was effective to prevent TGEV infection and reduce their mortality.

• Korean Journal of Veterinary Research
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• v.33 no.4
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• pp.753-756
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• 1993

Clinical and pathohistological findings in 16 cattle with mesotheliosis were described : pearshaped abdominal outline, poor nutritional and growth condition, reduced milk yield, diarrhea, apathy, increased peritoneal fluid, dyspnea, multiple tumors to the visceral serosa of abdominal intestine, and papilliform growth of mesotheliomas. Asbestos plays an etiologic role in bovine mesotheliosis. A proposal is made to use bovine mesotheliosis as a screening monitor for the protection of man.

• Korean Journal of Veterinary Service
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• v.23 no.3
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• pp.219-221
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• 2000

This experiment was done to determine pathological findings of swine dysentery naturally occurred in Korea. Clinical sign was characterized by mucohemorrhagic diarrhea. Characteristic mucofibrinous lesions composed of fibrin, mucus, and sloughed cell debri were mostly limited to the large intestine of affected pjgs. A myriad of coiled spirochetes were detected in the colonic crypts.

• Korean Journal of Veterinary Service
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• v.20 no.2
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• pp.191-194
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• 1997

Two cases of infection of Dipylidium caninum In dog is reported in Chonbuk area. Clinically, gravid proglotiid and eggs were present on the anal area and feces of dogs Infected with Dipylidium caninum. And the infected dogs were revealed diarrhea, wean, anorexia, emaciated and steady growth.

• Korean Journal of Veterinary Service
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• v.31 no.3
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• pp.305-313
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• 2008

The present study was conducted to investigate the epidemiological characteristics such as isolation rate and antimicrobial drug susceptibility of etiological agents. The specimens (stool or intestine) were collected from 319 calves with clinical diarrhea from 195 farms in Gyeongnam south area (Gosung, Tongyung, Hadong) from June 2005 to August 2006. The isolation rate of Salmonella spp was higher in summer (8.4%) than in winter (4.8%) and the average was 7.2% (23/319 head). Some of Salmonella spp isolated were resistant to penicillin, oxytetracycline, tetracycline, and cephalexin (>90%), but some of them were susceptible to norfloxacin, ciprofloxacin, sulfamethoxazole/trimethoprim and amikacin(>30%). There was no statistical difference in the isolation rate of Eimeria spp between summer(48.9%) and winter(42.3%). For the evaluation of infection level of Eimeria spp oocyst per gram of feces (OPG) was examined, and severe, moderate and light infection level were 11.9%, 12.5% and 22.3%, respectively. In the isolation rates of Eimeria spp the calves under 19 days was lowerthan those over 60 days, but there was not different among herd size.