• Pediatric Infection and Vaccine
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• 제4권1호
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• pp.73-78
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• 1997

목 적 : Escherichia coli (E. coli) O157은 설사, 출혈성대장염 등을 일으키며, 드물게 용혈성 요독증후군까지 일으키는 세균이다. 미국이나 유럽에서는 세균성설사의 2~3번째로 흔한 원인균이다. 우리나라는 이 세균감염이 거의 없는것으로 알려져 왔으나, 우리나라도 점차 햄버거와 같은 간이음식의 섭취가 늘어나, 이 세균감염이 생겼을 가능성이 있을 것으로 사료되어, 향후 이 세균에 대한 통상적인 변배양 검사의 필요성 여부를 알아보고자 하였다. 방 법 : 1996년 3월부터 1997년 2월까지 6개월 이상된 소아설사 환아의 변배양 검체를 대상으로 하였다. Sorbitol-MacConkey 한천에 배양한 후 형성된 집락 중 무색 집락을 대상으로 E. coli로 동정된 것을 E. coli O157 라텍스 응집검사를 실시하여 응집이 되면 양성으로 판독하였다. 결 과 : 총 317 검체중 11월에 1 검체 (0.3%)에서 Shiga 독소를 생성하지 않는 E. coli O157:NM이 분리되었다. 7세 남아로 2일간의 복통과 1일간의 설사 및 구토를 주소로 입원 한 후 특별한 치료없이 2일후 증상이 호전되어 퇴원하였다. 결 론 : 검사된 모든 대변 검체중 한 검체 (0.3%)만이 E. coli O157이 분리되었으나 Shiga 독소를 생성하지 않는 군주였다. 따라서 이 세균의 분리를 위한 통상적인 변배양 검사는 아직 불필요한 것으로 사료되었다.

• Journal of Chest Surgery
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• 제24권2호
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• pp.123-134
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• 1991

Twenty eight patients had undergone repair of an isolated complete atrioventricular septal defect between April 1986 and September 1990 in Seoul National University Children`s Hospital. The group comprised 13 male and 15 female patients. They ranged in age from 2 months to 8 years[mean 18.6months] and in weight from 3. 4kg to 23kg[mean 9.0$\pm$4.6kg]. They were analysed as Rastelli type A in 17 patients, Rastelli type B in 2 patients, and Rastelli type C in 9 patients. Seven patients had concomitant Down`s syndrome. All patients had large left-to-right shunt[mean pulmonary to systemic flow ratio 3.5 $\pm$2.2 ranging from 0.68 to 10.0] and high pulmonary systolic pressure[mean 74$\pm$18.8mmHg, ranging from 35 to 110]. In 11 patients, one patch technique was used to close the atrial and ventricular septal defect and 16 patients were undergone by two patch technique. We urgently managed only one patient by pulmonary artery banding whose anatomy was Rastelli type C and severe mitral regurgitation was identified. Postoperative complete A - V block was noted in 3 patients, two of whom were dead in operating room due to combined LVOTO and myocardial failure, and one patient with Rastelli type C was undergone by VVI type permanent pacemaker insertion 1wk later after two patch technique, but we had to manage him by modified Konno operation and total correction due to LVOTO and VSD leakage and severe mitral regurgitation 3 years later. Another two reoperation cases due to severe mitral regurgitation after two patch technique were undergone, one of whom we managed by mitral annuloplasty 3 months later but aggravated mitral regurgitation made us to control him by MVR 3 months later. Another one case of VSD leakage and tricuspid regurgitation was managed by total correction but she died of respiratory insufficiency 14 days later. We experienced pulmonary hypertensive crisis in 3 patients, who were dead in two cases comparing with one control case. So operative mortality is 9/27[33.6%], in one patch group of 3/11[29.2%] comparing with two patch group of 6/16[37.5%]. In summary, causes of death were pump weaning failure, myocardial failure and low cardiac output syndrome and pulmonary hypertensive crisis, resp. failure, complete AV block. Mean follow up period is 15.8$\pm$10.7 months[ranging from 3months to 37 months]

• Clinical and Experimental Pediatrics
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• 제56권4호
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• pp.165-175
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• 2013

Purpose: There was a global increase in the prevalence of oseltamivir-resistant influenza viruses during the 2007-2008 influenza season. This study was conducted to investigate the occurrence and characteristics of oseltamivir-resistant influenza viruses during the 2007-2008 and 2008-2009 influenza seasons among patients who were treated with oseltamivir (group A) and those that did not receive oseltamivir (group B). Methods: A prospective study was conducted on 321 pediatric patients who were hospitalized because of influenza during the 2007-2008 and 2008-2009 influenza seasons. Drug resistance tests were conducted on influenza viruses isolated from 91 patients. Results: There was no significant difference between the clinical characteristics of groups A and B during both seasons. Influenza A/H1N1, isolated from both groups A and B during the 2007-2008 and 2008-2009 periods, was not resistant to zanamivir. However, phenotypic analysis of the virus revealed a high oseltamivir $IC_{50}$ range and that H275Y substitution of the neuraminidase (NA) gene and partial variation of the hemagglutinin (HA) gene did not affect its antigenicity to the HA vaccine even though group A had a shorter hospitalization duration and fewer lower respiratory tract complications than group B. In addition, there was no significant difference in the clinical manifestations between oseltamivir-susceptible and oseltamivir-resistant strains of influenza A/H1N1. Conclusion: Establishment of guidelines to efficiently treat influenza with oseltamivir, a commonly used drug for treating influenza in Korean pediatric patients, and a treatment strategy with a new therapeutic agent is required.

• 생명과학회지
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• 제27권3호
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• pp.275-282
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• 2017

부산지역 급성호흡기감염증으로 내원한 환자에서 호흡기바이러스 검사를 시행하여 아데노바이러스 및 보카바이러스의 특징적인 임상증상 및 유행양상을 알아보고자 하였다. 3,230명의 환자에서 총 1,485건(46.0%)의 호흡기바이러스가 검출되었고 이 중 아데노바이러스 257건(8.0%), 보카바이러스 68건(2.1%)을 확인하였다. 성별 발생양상은 남자가 여자보다 아데노바이러스, 보카바이러스로 인한 호흡기감염증에 취약하였으며, 모두 1~5세 연령군에서 높은 검출률을 보여 영 유아의 주요 감염요인임을 확인할 수 있었다. 주요 임상증상으로 아데노바이러스는 발열, 두통이 보카바이러스는 천명음이 통계적으로 유의하였다. 아형분석결과, 아데노바이러스는 1~6, 8형의 혈청형을 확인하였고 기존 분리주와 97% 이상의 상동성을 보였다. 연도별 유행 혈청형은 2011년 아데노바이러스 1형, 2012년 3형과 4형, 2013년에는 3형이 우점적으로 유행하였다. 아데노바이러스 3형의 경우, 대유행을 유발하는 아형으로 보인다. 보카바이러스는 모두 1형으로 나타났다.

• 대한바이러스학회지
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• 제26권1호
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• pp.9-22
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• 1996

Respiratory Syncytial virus (RSV) is an important cause of acute lower respiratory tract infections in human, with infants and young children being particularly susceptible. In the temperate zones, sharp annual outbreaks of RSV occur during the colder months, in both the northern and the southern hemisphere. RSV is unusual in that it can repeatedly reinfect individuals throughout life and infect babies in the presence of maternal antibody. RSV isolates can be divided into two subgroups, A and B, on the basis of their reactions with monoclonal antibodies, and the two subgroups are also distinct at the nucleotide sequence level. The specific diagnosis of RSV infection was best made by isolation of virus in tissue culture, identification of viral antigen, or by specific serologic procedures. Recently, rapid detection of RSV and analysis of RSV strain variation became possible by development of methods of reverse transcription and polymerase chain reaction amplification. In this study, to determine the genetic diversity of RSV found in Korea, 173 bp and 164 bp spanning selected regions of the RSV F and SH genes were enzymatically amplified and sequenced, respectively. Eight for F gene and three for SH gene were detected in 66 nasopharyngeal swap samples tested. Two major antigenic subgroups, A and B were confirmed from Korean samples (seven for subgroup A and one for subgroup B). At the nucleotide level of the F gene region, Korean subgroup A strains showed 95-99% homologies compared to the prototype A2 strain of subgroup A and 93-100% homologies among Korean subgroup A themselves. For the SH gene region, Korean subgroup A strain showed 97.5% homology compared to the prototype A2 strain of subgroup A, and Korean subgroup B strain showed 97% homology compared to the prototype 18537 strain of subgroup B. Most of base changes were transition and occured in codon position 3, which resulted in amino acid conservation. Using the maximum parsimony method, phylogenetic analysis indicated that Korean RSV strains formed a group with other RSV strains isolated from the United States, Canada, the Great Britain and Australia.

• 대한바이러스학회지
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• 제30권2호
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• pp.101-112
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• 2000

Rotaviruses are the most common cause of severe vomiting and diarrhea in children worldwide and classified as a genus in the family Reoviridae. Rotavirus has eleven segmented dsRNAs and the virion consists of three shells. Outer capsid VP7 and VP4 induce neutralizing antibodies and are classified into G types (glycoprotein VP7) and P types (protease-sensitive VP4). Characterization of VP7 gene of Korean isolates of human rotavirus was performed using multiplex PCR and nucleotide sequence analysis. After RT-PCR amplification of full length (1,062 bp) of VP7 genes, the amplified PCR products were G typed by multiplex PCR and the nucleotide sequences were compared with those of reference rotavirus from GenBank. The G type analysis revealed that 25% (2/8) belong to G1, whereas 37.5% (3/8) benong to G2 and G4, respectively. The Korean isolates within the same serotypes showed high homology of nucleotide sequences and could be discriminated from foreign isolates exception with two strains (CAU009 and CAU022). But Korean isolates CAU009 and CAU022 were close related into japanease isolates 417 (99.2%) and indian isolates (97.6%) than Korean isolatese. Our results showed that these two strains were supposed to be originated from abroad. As a results, The G typing and nucleotide sequence analysis of VP7 gene of rotavirus isolated from infants in Korea could be used for identification, serotying and determination of novel or unusual strains of rotaviruses.

• Radiation Oncology Journal
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• 제7권2호
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• pp.269-277
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• 1989

1979년 8월부터 1986년 12월까지 관해유도 치료 후 골수 관해(M1)가 온 134예의 소아 급성 임파구성 백혈병 환아가 18Gy또는 24Gy의 전뇌 방사선 조사와 척수강내 methotrexate주입의 예방적 중추신경계 치료를 받았다. 중추신경계에서 처음 재발한 환자는 14.2%(19/134)였고 이중 증추신경계에서만 재발한 예는 5.2%(7/134), 골수 또는 고환에서의 재발과 동시에 재발한 예는 9%(12/134)였다. 남아와 연령이 많을수록 중추신경계 재발이 높았으며 진단당시 말초혈액내의 백혈구수가 50,000/ul이상인 예의 재발율이 높았다. 방사선 조사량 24Gy에서의 중추 신경계 재발율이 18Gy인 경우보다 높았으나 유의하지는 않았다. 전체 중추신경계 재발예 중 89%가 예방적 중추신경계 치료개시 후 4년 이내에 발생하였으며, 중추신경계에서만 재발예는 100%가, 중추신경계와 골수 또는 고환의 재발과 동시에 재발한 예의 83%가 각각 관찰되었다. 재발의 위험이 있는 환자를 감안한전체 중추신경계 재발율은 유지 화학요법 기간 중에는 11.9%였고 유지 화학 요법 종료 이후의 기간에서는 4.9%였다.

• 대한임상검사과학회지
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• 제49권4호
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• pp.439-445
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• 2017

2010~2016년에 병원을 내원한 환자를 대상으로 분석 결과 전체 분리균은 인체 친화성 감염환자는 33,575명으로 37.24%가 분리되었으며 동물친화성 감염환자는 334명으로 0.37%가 분리되었다. 토양친화성 감염환자는 30명으로 0.03%가 분리되었고 그 외에 배양이 되지 않거나 오염균이 56,217명(62.35%)으로 분리되었다. 동물친화성 피부사상균을 대상으로 남녀 성별에 따른 분포를 살펴 본 결과 T. mentagrophytes는 남자(51.1%), 여자(48.9%)가 분리되었기에 성별에 연관성이 거의 없었으나 T. verrucosum은 남자(38.9%)에 비해 여자(61.1%)가 다소 높게 분리되었다. M. canis는 남자(23.7%)에 비해 여자(76.3%)가 분리율이 높게 나타났다. 연령에 따른 분석 결과 T. mentagrophytes는 50대(26.4%), 60대(16.1%)에 높게 분리되었고 T. verrucosum은 50대(27.8%), 60대(16.7%), 그리고 10대 미만(16.7%)의 순서로 분포하였다. M. canis는 10대 미만(19.4%), 10대(22.0%), 그리고 20대(15.0%)의 순서로 분리되었다. 계절에 따른 분석 결과 T. mentagrophytes는 봄(34.1%), 겨울(29.5%)에 높게 분리되었고 T. verrucosum은 봄(44.4%), 겨울(27.8%)에 높게 분리되었다. M. canis는 봄(18.9%), 여름(27.2%), 가을(25.9%), 그리고 겨울(28.1%)에 비슷하게 분리되었다. 이는 T. mentagrophytes와 T. verrucosum은 계절에 따라 연관성을 보이나 M. canis는 계절에 따른 연관성이 나타나지 않았다. 부위에 따른 분석 결과로 T. mentagrophytes는 얼굴(28.4%), 팔(25.0%)에서 높게 분리되었으며 T. verrucosum도 얼굴(38.9%), 팔(27.8%)에서 높게 분리되었다. 그러나 M. canis는 다소 다양하게 머리(24.5%), 팔(21.5%), 얼굴(15.8%), 등(12.7%) 등의 순으로 분리되었다. 임상 질환별 분석 결과 T. mentagrophytes는 몸백선증(48.9%)이 많이 분리되었고 다음으로 얼굴백선증(28.4%), 수부백선증(11.4%)으로 분리되었다. T. verrucosum는 몸백선증(55.6%)이 가장 많이 분리되었고 얼굴백선증(38.9%)이 분리되었다. M. canis는 몸백선증(54.4%)이 가장 많이 분리되었고 두부백선증(24.5%), 얼굴백선증(15.8%)의 순서로 분리되었다. 본 조사를 통해 동물친화성 감염의 분포의 변화를 확인하였으며 향후 지속적인 자료수집을 통해 동물친화성 감염의 분포 추이를 조사함에 도움이 될 것으로 사료된다.

• 한국축산식품학회:학술대회논문집
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• 한국축산식품학회 2004년도 정기총회 및 제33차 춘계 학술대회
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• pp.89-119
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• 2004

This study was conducted to isolate lactobacilli having probiotic characteristics to be used as health adjuncts with fermented milk products. Acid tolerant strains were selected in Lactobacilli MRS broth adjusted to pH 4.0 from 80 healthy persons (infants, children and adults). And bile tolerant strains were examined in Lactobacilli MRS broth in which 1.0% bile salt was added. By estimation above characteristics, the strains No. 27, which was isolated from adult feces, was selected and identified as Lactobacillus salivarius subsp. salivarius based on carbohydrate fermentation and 16S rDNA sequencing. It was used as a probiotic strain in fermented milk products. The pH of fermented milk decreased from pH 6.7 to 5.0 and titratable acidity increased from 0.3% to 1.0% by L. salivarius subsp. salivarius (isolation strain 20, 35, and 37), when incubated for 36 h at $37^{\circ}C$. The number of viable cell counts of fermented milk was maximized at this incubation condition. The SDS-PAGE evidenced no significant change of casein but distinct changes of whey protein were observed by isolated L. salivarius subsp. salivarius for titratable acidity being incubated by $0.9{\sim}1.0%$ at $37^{\circ}C$. All of the strains produced 83.43 to 131.96 mM of lactic acid and 5.39 to 26.85 mM of isobutyric acid in fermented products. The in vitro culture experiment was performed to evaluate ability to reduce cholesterol levels and antimicrobial activity in the growth medium. The selected L. salivarius subsp. salivarius reduced $23{\sim}38%$ of cholesterol content in lactobacilli MRS broth during bacterial growth for 24 hours at $37^{\circ}C$. All of the isolated L. salivarius subsp. salivarius had an excellent antibacterial activity with $15{\sim}25$ mm of inhibition zone to E. coli KCTC1039, S. enteritidis KCCM3313, S. typhimurium M-15, and S. typhimurium KCCM40253 when its pH had not been adjusted. Also, all of the isolated L. salivarius subsp. salivarius had partial inhibition zone to E. coli KCTC1039, E. coli KCTC0115 and S. enteritidis KCCM3313 when it had been adjusted to pH 5.7. The selected strains were determined to have resistances of twelve antibiotic. Strains 27 and 35 among the L. salivarius subsp. salivarius showed the highest resistance to the antibiotics. Purified ${\alpha}$-galactosidase was obtained by DEAE-Sephadex A-50 ion exchange chromatography, Mono-Q ion exchange chromatography and HPLC column chromatography from L. salivarius subsp. salivarius 27. The specific activity of the purified enzyme was 8,994 units/mg protein, representing an 17.09 folds purification of the original cell crude extract. The molecular weight of enzyme was identified about 53,000 dalton by 12% SDS-PAGE. Optimal temperature and pH for activity of this enzyme were $40^{\circ}C$ and 7.0 respectively. The enzyme was found to be stable between 25 and $50^{\circ}C$. ${\alpha}$-galactosidase activity was lost rapidly below pH 5.0 and above pH 9.0. This enzyme was liberated galactose from melibiose, raffinose, and stachyose, and also the hydrolysis rate of substrate was compound by HPLC. These results indicated that some of the L. salivarius subsp. salivarius (strain 27 and 35) are considered as effective probiotic strains with a potential for industrial applications, but the further study is needed to establish their use as probiotics in vivo.

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.777-783
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• 2006

목 적 : 최근 소아 요로감염의 가장 흔한 원인균인 E. coli에 대한 항생제 내성 문제가 점차 대두되고 있다. 본 연구에서는 소아 원외 요로감염 환아에서 분리된 E. coli에 대한 cefixime을 포함하여 흔히 사용되고 있는 경구용 항생제의 시험관 내 감수성 연구를 시행하여 적합한 치료 항생제 선택의 기초 자료를 얻고자 하였다. 방 법 : 2004년 10월부터 2005년 9월까지 연구 참여 병원 소아과 외래에서 요로감염으로 진단된 206명 환아의 요 배양검사에서 동정된 211개 균주 중 188개 E. coli를 대상으로 경구용 항생제(ampicillin, amoxillin, ampicillin-sulbactam, cefaclor, TMP-SMX, cefixime)에 대한 시험관 내 감수성 검사를 실시하였다. 결 과 : 분리된 E. coli 균주에 대한 항생제별 감수성 결과에서 내성률은 각각 ampicillin 81.4%, amoxicillin 85.6%, ampicillin-Sulbactam 77.2%, cefaclor 93.6%, TMP-SMX 50.5%, cefixime 13.3%이었다. ESBL 생성 E. coli는 7.0%이었다. 결 론 : Aminopenicillins계, cefaclor, sulfa약제들은 E. coli에 대한 내성률이 매우 높아 소아 요로감염의 일차 선택 항생제로 유용하지 못한 것으로 추정할 수 있었다. 그러나 cefixime과 같은 3세대 cephalosporin은 일차 치료 실패할 경우 이차 선택항생제로 유용할 수 있으며, 일차 선택 항생제로도 사용될 수 있을 것으로 추정되었다. E. coli의 항생제 내성 양상에 대한 광범위한 연구와 지속적 감시를 통하여 소아 원외 요로감염 치료에서 1차적으로 선택될 수 있는 경구용 항생제에 대한 지침 자료가 요구된다.