• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.45-51
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• 2008

목 적 : 국내의 소아에서의 폐구균 혈청형의 분포양상 및 변화를 알아보는 것은 중이염의 예방과 치료 계획을 수립하는 데 있어 매우 중요하다. 단일기관에서의 경험을 토대로 중이염에서의 폐구균의 혈청형 분포양상을 알아보고자 하였다. 방 법 : 2001년 1월부터 2006년 12월까지 세브란스병원에서 중이염으로 진단받은 15세 미만의 소아 중 동반된 이루의 배양검사에서 폐구균이 분리된 경우를 대상으로 혈청형과 항생제 감수성을 알아보았다. 결 과 : 모두 54명의 환아로부터 54개의 검체를 얻었으며 이 들의 연령의 중앙값은 13개월이었고 5세 미만의 환아가 차지하는 비율은 81%였다. 혈청형 빈도는 19A(44%), 19F(28%), 6B(7%), 6A(4%), 9V(4%), 1(4%) 등의 순이었다. 전체 혈청형 중 19A와 19F가 차지하는 비율이 72%이었으며, 특히 5세 미만의 소아에서는 84%나 차지하여 5세 이상 소아에서의 20%에 비해 높은 비율을 보였다.(P<0.001) 연도별 19A나 19F이 차지하는 비율은 차이가 없었으며, 7가 단백결합 폐구균백신 도입 이전과 이후 시기 사이에도 차이가 없었다. 전체 폐구균 중 백신혈청형이 차지하는 비율은 43%이었다. 진단 이전 7가 단백결합 폐구균백신을 접종한 3명의 환아에서 동정된 혈청형은 모두 19A였다. 혈청형 별 항생제 비감수성 폐구균의 비율에서 19A는 다른 비백신혈청형에 비해 페니실린, erythromycin, trimethoprim-sulfamethoxazole 등에 비감수성 비율이 더 높았다. 다제 내성률도 다른 비백신혈청형에서 29%인데 반해 19A에서는 96%였다.(P=0.001) 결 론 : 5세 미만의 중이염 환아의 이루에서 분리된 폐구균 중 19A가 가장 흔한 혈청형이었고 매우 높은 다제 내성률을 보였다.

• 대한미생물학회지
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• 제34권5호
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• pp.453-459
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• 1999

Astrovirus is frequently associated with diarrhea in children. It can not be readily isolated by cell culture, and an electronmicroscope is usually used for detection of this agent. Recently in 1995 a combined method of reverse transcription-polymerase chain reaction (RT-PCR) was designed for easier detection of astrovirus, which is based on the conserved sequence in 3'-end of genomes of the 7 known serotypes of human astrovirus. As of yet there has not been any report of astrovirus data in Korea using the RT-PCR methods. The purpose of this study was to detect astrovirus incidence, severity of symptoms, seasonal variation and co infection rate with rotavirus in Korean children inpatients with diarrhea. Fecal specimens from 61 young children hospitalized with gasteroenteritis Korea from Jan. 1996 through Mar. 1997. They were examined for astroviurs infection by RT-PCR method. Results are as follows:1. Astrovirus was detected at 9.8% (6/61) from fecal specimens of children with severe diarrhea by EIA using monoclonal antibody coated plates. 2. Astorvirus was detected at 29.5% (18/61) from fecal specimens of children with severe diarrhea by RT-PCR. 3. The age of the 18 children affected by astrovirus ranged from 2 monthes to 7 years with mean of 3.0 years. 4. Mean hospital stay of the 18 children was 6.1 days. 5. Five (27.8%) astrovirus RT-PCR positive strains were confirmed in November and in December, respectively out of 18 specimens in total. 6. Astrovirus coinfection with rotavirus type G1 was confirmed in 15/16 specimens (93.8%), and with type G2 was in 1/16 specimens (6.3%).

• Clinical and Experimental Pediatrics
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• 제58권1호
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• pp.20-27
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• 2015

Purpose: We investigated the molecular types of uropathogenic Escherichia coli (UPEC) by using conventional phylogrouping, multilocus sequence typing (MLST), and fimH genotyping. Methods: Samples of patients younger than 18 years of age were collected from the Chung-Ang University Hospital over 2 years. Conventional phylogenetic grouping for UPEC strains was performed by polymerase chain reaction (PCR). Bacterial strain sequence types (STs) were classified on the basis of the results of partial sequencing of seven housekeeping genes. In addition, we analyzed nucleotide variations in a 424-base pair fragment of fimH, a major virulence factor in UPEC. Results: Sixty-four UPEC isolates were analyzed in this study. Phylogenetic grouping revealed that group B2 was the most common type (n=54, 84%). We identified 16 distinctive STs using MLST. The most common STs were ST95 (35.9%), ST73 (15.6%), ST131 (12.5%), ST69 (7.8%), and ST14 (6.3%). Fourteen fimH allele types were identified, of which 11 had been previously reported, and the remaining three were identified in this study. f1 (n=28, 45.2%) was found to be the most common allele type, followed by f6 and f9 (n=7, 11.3% each). Comparative analysis of the results from the three different molecular typing techniques revealed that both MLST and fimH typing generated more discriminatory UPEC types than did PCR-based phylogrouping. Conclusion: We characterized UPEC molecular types isolated from Korean children by MLST and fimH genotyping. fimH genotyping might serve as a useful molecular test for large epidemiologic studies of UPEC isolates.

• Journal of Periodontal and Implant Science
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• 제34권2호
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• pp.317-332
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• 2004

Osteoblasts from alveolar bone may have an important role in the bone regeneration for periodontium, but their culture and characterization are not determined yet. The purpose of this study was to investigate the biological characteristics of primary explant cultured osteoblasts(PECO) from alveolar bone. Osteoblasts were isolated and cultured from alveolar socket of extracted tooth in children. To compare the characteristics, osteoblasts and gingival fibroblasts were cultured with DMEM at $37^{\circ}C$, 5% $CO_2$, l00% humidity incubator, and human fetal osteoblasts cell line(hFOB1) were cultured with DMEM at $34^{\circ}C$, 5%, $CO_2$ 100% humidity incubator. To characterize the isolated bone cells, morphologic change, cell proliferation and differentiation were measured. Morphology of PECO was small round body or cuboidal shape on inverted microscope and was similar with hFOB1. PECO became polygonal shape with stellate and had an amorphous shape at 9th passage in culture. PECO had significantly higher activity than that of gingival fibroblasts and hFOB1 in alkaline phosphatase activity. The expression of osteocalcin and bone sialoprotein in PECO was notably increased when compared with hFOB1 and gingival fibroblasts. These result indicated that PECO from alveolar bone in children has an obvious characteristics of osteoblast, maybe applied for the regeneration of bone.

• Childhood Kidney Diseases
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• 제22권2호
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• pp.37-41
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• 2018

Purpose: Familial renal glucosuria (FRG, OMIM #233100) is a rare but relatively benign genetic condition characterized by persistent isolated glucosuria with a normal blood glucose level. We report three additional SLC5A2 mutations and examine their phenotypic and genetic characteristics in a Korean FRG cohort. We also reviewed the literature and summarized the genotypes of all Korean patients with FRG. Methods: A genetic analysis was conducted by directly sequencing all 14 exons of the SLC5A2 gene and their flanking regions in six unrelated Korean children with FRG and their family members. Novel non-synonymous single-nucleotide polymorphisms were identified and compared with known mutations that are repeatedly detected in the Korean population. Results: We found two novel mutations [c.274G>A (G92S) and c.1168C>T (L390F)] and one known [c.1382G>A (S461N)] mutation in each family and one recurrent mutation [c.1346G>A (G449D) (rs768392222)] in two pedigrees. The recurrent G449D was predicted to be "possibly damaging," with a score of 0.883 in Polyphen-2, while G92S, L390F, and S461N were predicted to be "probably damaging," with scores of 1.000, 0.999, and 0.996, respectively. Conclusions: Two novel, one previously reported, and one recurrent mutation were identified in six Korean FRG pedigrees as causative mutations of renal glucosuria. Sequence variations in the SLC5A2 gene were frequently detected in children with persistent isolated glucosuria. A long-term follow-up of this FRG cohort is needed to understand how these specific SGLT2 mutations impair kidney function and energy homeostasis.

• 미생물학회지
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• 제9권2호
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• pp.86-93
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• 1971

위생환경이 좋지 못하고 보건사업의 혜택이 원활치 못한 지역의 소아 및 국민학동에게서 분리한 장내 세균 중 이열성 장내 독소생성 대장균주의 분포를 배양된 부신암 세포를 이용하여 살펴보았다. 이 열성 장내독소의 존재아래 부신암 세포는 세포의 원형화 및 seroid 생성력의 항진을 보이기에 이 두 성질에 기처를 두어 독소생선균주를 감별하였다. 실험의 결과 조사대상자의 약 10%에 해당하는 균주들이 독소 생성 균주로 밝혀졌다. 분리한 균주의 화학요법제에 대한 감수성 내지 내성도를 측정하였는데 특히 주목할 것은 이열성 장내독소 균주들의 대부분이 gentamycin(10mg)과 nalidixic acid(5mg)에 감수성이 있는데 비해, colistin(10mg), novobiocin(30mg), sulfa drug(50mg)에는 내성을 나타냈으며, 장내 질환에 널리 쓰이는 chloramp-henicol(10mg)에 대해서는 균에 따라 감수성 또는 내성을 보인데 있다. 이상의 조사로 우리나라 정상아동이 상당의 이열성 장내독소 생성균주를 보유하고 있음을 알수 있다. 이를 균주중 몇개는 장내질환 치료제로 널리 사용하는 항생제에 대해 내성을 지니고 있음을 볼 수 있었다.

• Advances in pediatric surgery
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• 제4권2호
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• pp.137-143
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• 1998

Intramuscular injection(IM) into the gluteal muscles is a common route of medication, but may lead to complications. A retrospective review of 32 patients who required surgical treatment for local complications of buttock injections in children was made at the Taegu Fatima Hospital during a seven-year nine-month period (March 1990 to December 1997). Local complications included acute inflammation, cellulitis and abscess(71.9 %), and fat necrosis(21.9 %), and injection granuloma(6.2 %). Over the half of injections were on the upper and outer quadrant of the buttock, but the other 43.7 % were in the upper and inner or lower and outer quadrant which are considered unsuitable sites for intramuscular injection. The majority of complications developed within fat tissue(90.6 %) rather than within muscle(9.4 %). Two-thirds of the patients were under 2 years of age, this suggests that it is technically difficult to accurately administer IM injections in small children because muscle mass is smaller compared to subcutaneous. In addition subcutaneous fat is more susceptible to chemical irritation. Staph. aureus was the predominant organism, isolated in 84.6 % of the patients with abscesses. Treatment consisted of needle aspiration, incision and drainage, curettage, or surgical excision. In conclusion, the major factor that contributes to complications following IM of the buttock appears to be the inadvertent intrafat rather than of IM injection. Accurate injection into the muscles based on a knowledge of pelvic anatomy as well as the potential complications is necessary to prevent complications.

• Child Health Nursing Research
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• 제1권1호
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• pp.47-58
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• 1995

This study was performed to test the validity and reliability of the Health Self-Determinism Index for Children(HSDI-C), an instrument designed to measure dimensions and strength of motivation in health behavior, to improve the applicability of the tool through application to the various samples. The convenient sample of 148 (boys=75, girls=72 third grade=42, fourth grade=22, fifth grade=32, sixth grade=52 : Caucasian=72, Asian=30, African=19) comprised the children at a chatholic elementary school in Chicago. The children completed English version of HSDI-C from December 5th, 1994 to January l0th, 1995. The findings were as follows : 1. Four factors of HSDI-C were isolated through the principal component analysis and oblique rotation, and explained 48% of the variance in total score. Low correlations among four factors were anticipated because each factor contributed uniquely, All items of the tool loaded above .30 on one of 4 factors. But items loaded on each factor in this study were very different from those in the previous studies. 2. Cronbach's alpha coefficient for internal consistency was .81 for the total items and .57∼ .81 for 4 subscales. 3. The differences of HSDI-c mean scores between boys and girls and that of among races were not statistically signifcant, but the mean score of girls and the Caucasian were relatively high. The total mean score of the scale was highest at the 3rd grade, decreased at the 4th or 5th grade, and reincreased at the 6th grade. The trend of mean score of four subscales was similar to that of total mean score. According to the results, suggested below : 1. The items loaded on each factor in this study were very different from those in the previous studies. To clear away the problem of the conceptual confusion, HSDI-C needs to be performed to various and large samples. 2. Unexpectedly, the HSDI-C mean score decreased at middle school age. A longitudinal study will be helpful to search for the change trend of the intrinsic motivation. 3. To improve the applicabilty of the HSDI-C, various reliability and validity test methods besides factor analysis or internal consistency are recommended.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.192-200
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• 2006

Purpose : This study was performed to identify longitudinal changes in the prevalence of organisms isolated from urinary tract infection(UTI) and in the pattern of Escherichia coli susceptibility to antibiotics during the past 10 years in children with UTI. Methods : We performed a retrospective study of a total of 192 urine cultures from children with UTI in the Department of Pediatrics, Seoul Adventist Hospital over two periods(1st: 1995-2000, 2nd:2001-2005). Antimicrobial susceptibility of the isolates was compared between the two groups. Results : The pathogens of UTI in the two groups were similar. In the first period, E. coli was the leading uropathogen(66.2%) followed by Klebsiella pneumoniae(7.8%), Enterobacter cloacae(6.5%), and others(19.5%). In the second period, E. coli was the leading uropathogen(67%) followed by K. pneumoniae(12.2%), E. cloacae(3.5%), Enterobacter aerogenes(3.5%), and others(13.8%). The susceptibility pattern of E. coli to amoxicillin/clavulanate(87.5%, 81.0%) did not present any statistically significant difference between the two periods(P>0.05). The susceptibility of E. coli to TMP/SMX(52.4%, 50.0%) was still low with no significant difference between the two periods(P>0.05). Conclusion : Our results suggest that the use of amoxicillin/clavulanate is still an excellent therapeutic option in children with UTI. The low rate of susceptibility to TMP/SMX against uropathogens suggest that TMP/SMX may be reevaluated as the first-line therapeutic drug for UTI.

• Clinical and Experimental Pediatrics
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• 제60권7호
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• pp.221-226
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• 2017

Purpose: Escherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections. Methods: We examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University Hospital between 2011 and 2014. Bacterial strains were classified into STs by partial sequencing of seven housekeeping genes (adk, fumC, gyrB, icd, mdh, purA, and recA). Clinical characteristics and antimicrobial susceptibility were compared between ST131 and non-ST131 UPEC isolates. Results: Sixteen UPEC isolates (14.0%) were extended-spectrum ${\beta}-lactamase$ (ESBL)-producers; 50.0% of ESBL-producers were ST131 isolates. Of all the isolates tested, 13.2% (15 of 114) were classified as ST131. There were no statistically significant associations between ST131 and age, sex, or clinical characteristics, including fever, white blood cell counts in urine and serum, C-reactive protein, radiologic abnormalities, and clinical outcome. However, ST131 isolates showed significantly lower rates of susceptibility to cefazolin (26.7%), cefotaxime (40.0%), cefepime (40.0%), and ciprofloxacin (53.3%) than non-ST131 isolates (65.7%, 91.9%, 92.9%, and 87.9%, respectively; P<0.001 for all). ESBL was more frequently produced in ST131 (53.3%) than in non-ST131 (8.1%) isolates (P<0.01). Conclusion: ST131 E. coli isolates were prevalent uropathogens in children at a single medical center in Korea between 2011 and 2014. Although ST131 isolates showed higher rates of antimicrobial resistance, clinical presentation and outcomes of patients were similar to those of patients infected with non-ST131 isolates.