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Etiology and Clinical Manifestation of Acute Gastroenteritis in Children (소아 급성 위장관염에서의 원인과 임상양상)

  • Im, Ik-Jae;Lee, Mee Jeong;Chung, Eun Hee;Yu, Jeesuk;Chang, Young Pyo;Park, Woo Sung;Park, Kwisung;Song, Nak Soo;Baek, Kyung Ah;Cha, Yune Tae
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.147-155
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    • 2006
  • Purpose : The purpose of this study is to evaluate epidemiological data of pathogens obtained from stool exams and compare them with the clinical course in pediatric patients with symptoms of acute gastroenteritis. Methods : Subjects were selected from patients presenting with symptoms of acute gastroenteritis who visited the outpatient clinic or who were admitted to the Dankook University Hospital from December of 2004 to December of 2005. Stool exams for 17 pathogens was performed. RT-PCR was used to detect norovirus and enzyme-linked immunoabsorbant assay (ELISA) was used to detect rotavirus, adenovirus and astrovirus in the subjects stool samples. Ten different species of bacteria(Salmonella spp., Shigella spp., Clostridium perfrigens, Campylobacter spp., Escherichia coli, Vibrio spp., Staphylococcus aureus, Bacillus cereus, Yersinia spp., and L. monocytogenes) were each selectively cultivated and enzyme immunoassays(EIA) was used to test for antigens for C. parvum, E. histolytica and G. lamblia. Retrospective chart review was performed for comparisons of clinical manifestations. Results : A total of 215 subjects was selected and of these 89 cases(41.4%) showed positive results for at least one pathogen. Male to female ratio was 1.3:1. Age distribution showed 4 cases less than one month(4.5%), 4 cases from 1~2 months(4.5%), 24 cases from 3~12 months(26.7%), 47 cases form 13~48 months(52.8%), 10 cases greater than 48 months (21.2%). Viruses showed the greatest proportion of cases with 68 subjects(77.5%), of these rotavirus being the most commonly reported in 50 cases. Bacteria was identified in 26 cases (29.2%), of these nontyphoidal salmonella was noted in 10 cases. Protozoa followed with 21 cases(23.6%), of these C. parvum was noted in 11 cases and G. lamblia was noted in 10 cases. Mixed infections with more than two pathogens were seen in 22 cases(24.7%), of these viral infection with accompanying parasitic infection was seen in 12(54.5%) cases. Conclusion : In this study we examined various pathogens known to cause acute gastroenteritis in children. Further studies for various pathogens can provide useful information for management of the acute gastroenteritis.

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Prevalence and Clinical Characteristics of Pertussis in Children, Cheonan, Korea (천안지역 소아 백일해 감염의 유병률과 임상적 고찰)

  • Lee, Kun Song;Son, Jae Sung;Chung, Eun Hee;Bae, Hong Ki;Lee, Mee Jeong;Yu, Jeesuk;Chang, Young Pyo;Park, Woo Sung;Kim, Jae Kyoung;Rheem, Insoo;Roh, Eui-Jung
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.175-182
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    • 2009
  • Purpose : A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. Methods : We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. Results : Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9${\pm}$5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/$mm^3$). There was a statistically significant relation between vaccine being received and development of complications (P =0.033). Conclusion : We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.

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Characteristics and Clinical Correlations of Staphylococcus aureus Discovered in Stools from Children Hospitalized at a Secondary Hospital (일개 이차병원에 입원한 소아의 분변에서 발견된 황색포도알균의 특징과 임상적 연관성)

  • Shin, Eun Hye;Eun, Byung Wook;An, Young Min;Song, Mi Ok
    • Pediatric Infection and Vaccine
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    • v.25 no.2
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    • pp.61-71
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    • 2018
  • Purpose: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. Methods: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. Results: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0-2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). Conclusions: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

Incidence Density of Antibody against Hepatitis C Virus in Seoul and Gyeonggi Area; A Retrospective Cohort Study - Based on Medical Screening Data from a General Hospital - (서울 경기지역 성인의 C형 간염 바이러스 항체 양성자 평균발생률; 후향적 코호트 연구 - 일개 병원의 종합검진 자료를 중심으로 -)

  • Ryu, Seung-Ho;Kim, Dong-Il;Suh, Byung-Seong;Kim, Woon-Sool;Chang, Yoo-Soo;Beck, Sung-Ho;Lee, Soo-Jin;Kim, Yong-Kyu;Song, Jae-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.4
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    • pp.337-344
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    • 2004
  • Objectives : This study was performed to determine the incidence density and the prevalence of sero-positive hepatitis C from 1999 to 2002 among adults aged 20 and over residing in Seoul and the Gyeonggi province. Method : The data for period was obtained from 114,635 adults, residing in Seoul or the Gyeonggi province, who had undertaken comprehensive health screening tests from Jan 1999 to Dec 2002 in a University hospital in Seoul. Among them, subjects with sero-negative status against hepatitis C were selected (21,408 in 1999, 28,830 in 2000) and then followed up until Dec 2002 to determine the incidence of hepatitis C during this period. The serum was tested with the immunoradiometric assay (IRMA) which uses third generation HCV antibody. Age adjusted rates were estimated by direct standardization using a reference population of 2000 aged from 20 to 80 years. Results : The prevalence of anti-HCV from 1999 to 2002 was 2.1 per 1000 persons(95% CI $1.8{\sim}2.4$). Male showed 1.7 per 1000 persons (95% CI $1.4{\sim}2.1$), while female showed 2.7 per 1000 persons(95% CI $2.2{\sim}3.2$). Age?sex adjusted rate showed 2.8 per 1000 persons (95% CI $2.64{\sim}2.96$), which is lower than the results of some previous study. The prevalence showed a significantly increasing pattern with age both in males and females (p<0.05). The incidence density of anti-HCV among the population aged 20 and over was 1.1 per 104 person-years at risk (95% CI $0.6{\sim}2.4$); 1.2 (95% CI $0.6{\sim}2.7$) for males and 0.8 (95% CI $0.6{\sim}4.2$) for females. Age adjusted incidence density was 2.91 per 104 person-years at risk (95% CI $2.43{\sim}3.38$) for those aged 20 and over. It showed an increasing pattern with age (p<0.05), especially for those age over 50 years. Conclusion : The study subjects for this study were supposedly healthier than the general population so the prevalence and incidence for the general population are thought to be higher than the results of the present study.

Clinicopathologic Changes of IgA Nephropathy in Children During Long-term (average 10.8 yrs) Follow-up (소아 IgA 신병증의 장기 추적(평균 10.8년)에 따른 임상 경과 및 병리학적 변화)

  • Moon, Chang-Min;Kim, Pyung-Kil;Lim, Beom-Jin;Song, Ji-Sun;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.154-165
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    • 2010
  • Purpose : We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. Methods : From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. Results : Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P =0.01) and last Haas classification (P =0.007). None of the cases showed progression to CRF or ESRD. Conclusion : During a mean follow-up of $10.8{\pm}3.4$ years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.

Rice Blast Control and Race Diversity by Mixed-Planting of Two Cultivars ('Hopyeongbyeo'/'Nampyeongbyeo') with Different Susceptibility to Magnaporthe oryzae (호평벼와 남평벼의 혼합재배에 의한 도열병 방제와 레이스 다양성의 변화)

  • Oh, In-Seok;Min, Ji-Young;Cho, Myung-Gil;Roh, Jae-Hwan;Shin, Dong-Bum;Song, Jin;Kim, Myeong-Ki;Cho, Young-Chan;Kim, Byung-Ryun;Han, Seong-Sook
    • Research in Plant Disease
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    • v.14 no.3
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    • pp.143-152
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    • 2008
  • Mixed-planting of two rice cultivars, HP ('Hopyeongbyeo') and NP ('Nampyeongbyeo'), having a dissimilar susceptibility to rice blast was practiced for chemical-free control of rice blast in the field. The HP/NP combination was selected for applying under mechanized agricultural conditions. Because they have similar genetic characteristics such as seed germination and heading time, culm length, rice quality and size of rice grains except susceptibility to blast. Incidence of panicle blast was reduced 50.4 % compare with supposed blast incidence by HP/NP mixed-planting when the seeds of two cultivars were combined 1 to 1 as weight. Supposed blast incidence was estimated from reduction of rice blast caused by addition of a resistant cultivar NP. Race diversity of Magnaporthe oryzae was examined for correlation with control effect of HP/NP mixed-planting on rice blast. The population of dominant race KJ-101 was diminished and replaced with various co-existing races and eleven new races were appeared in mixed-planting plot. Total number of race isolated from mixed-planting plot was not largely different from mono-culture. However, detection frequency of the new race was increased and variation of the population size of each race was decreased in mixed-planting plots. It was shown that a biased community with a dominant race (KJ-101 or KI-181) was altered to a balanced one of coexisting races. From these results, it was supposed that the balanced diversity among co-existing races within a community might be correlated to control effect by HP/NP mixed-planting on rice blast. Further more, it should be studied that genetic characteristics of the individual race including a virulence on cv. HP and NP was examined for verifying a correlation of mixed-planting effect and race diversity.

Relationship of Resistance to Benzimidazole Fungicides with Mutation of β-Tubulin Gene in Venturia nashicola (Benzimidazole계 살균제에 대한 배 검은별무늬병균 Venturia nashicola 의 저항성과 β-Tubulin 유전자 돌연변이와의 관계)

  • Kwak, Yeonsoo;Min, Jiyoung;Song, Janghoon;Kim, Myeongsoo;Lee, Hanchan;Kim, Heung Tae
    • Research in Plant Disease
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    • v.23 no.2
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    • pp.150-158
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    • 2017
  • Pear scab caused by Venturia nashicola has been reported as an important disease of pear resulting in lowering the quality of pear fruits. In this study, it was conducted to investigate the relationship between resistance of V. nashicola and mutation of ${\beta}$-tubulin gene and the fungicide resistance in field isolate group in benzimidazole fungicides. Responce of V. nashicola to carbendazim could be classified into 3 groups as sensitive that does not grow at all on PDA amended with $0.16{\mu}g/ml$ of carbendazim, low resistance that could not grow in $4.0{\mu}g/ml$ medium, and high resistance that can grow even at $100{\mu}g/ml$. Thirty isolates of V. nashicola collected from 3 regions as Wonju, Naju, and Okcheon were highly resistant to carbendazim. Analysis of the nucleotide sequence of ${\beta}$-tubulin gene of V. nashicola showed that there was no difference in the nucleotide sequence between the sensitive and the low-resistant isolate, but GAG at codon 198 (glutamic acid) was replaced with GCG (alanine) in the high-resistant isolate. Among 10 isolates obtained from the Okcheon, 5 isolates showed the substitution of glycine for glutamic acid, which were resistant to carbendazim, but more sensitive to the mixture of carbendazim and diethofencarb than others. Through these results, all isolates of V. nashicola isolated in pear orchard were found to be resistant to benzimidazoles. Also, mutants E198A and E198G at ${\beta}$-tubulin were found to be important mechanisms of V. nashicola resistance against benzimidazole fungicides.

Evaluation of the Temperature Drop Effect and the Rutting Resistance of Moisture Retaining-Porous Asphalt Pavement Using Accelerated Pavement Testing (포장가속시험을 이용한 보수형 배수성 포장의 온도저감 효과 및 소성변형 저항특성 연구)

  • Kwak, Byoung-Seok;Suh, Young-Chan;Song, Chul-Young;Kim, Ju-Won
    • International Journal of Highway Engineering
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    • v.11 no.3
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    • pp.97-109
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    • 2009
  • One of the main causes of asphalt rutting is high temperature of the pavement. Nevertheless, there has been few research on lowering the pavement temperature for reducing rutting. This study investigated the performance characteristics of moisture-retaining porous asphalt pavement, which is known to have a temperature reducing effect. The purpose of this study is to quantify the temperature reducing effect of moisture-retaining porous asphalt pavement and its effect of reducing rutting through Accelerated Pavement Testing(APT). Additionally, the possibility of reducing the thickness of the pavement in comparison to general dense grade pavement by analyzing structural layer coefficient of moisture retaining pavement. A total of three test sections consisting of two moisture-retaining porous asphalt pavement sections and one general dense-grade porous asphalt pavement section were constructed for this study. Heating and spraying of water were carried out in a regular cycle. The loading condition was 8.2 ton of wheel load, the tire pressure of $7.03kgf/cm^2$, and the contact area of $610cm^2$. The result of this experiment revealed that the temperature reducing effect of the pavement was about $6.6{\sim}7.9^{\circ}C$(average of $7.4^{\circ}C$) for the middle layer and $7.9{\sim}9.8^{\circ}C$(average of $8.8^{\circ}C$) for surface course, resulting in a rutting reduction of 26% at the pavement surface. Additionally, the structural layer coefficient of moisture retaining pavement measured from a laboratory test was 0.173, about 1.2 times that of general dense grade pavement. The general dense-grade porous asphalt pavement test section exhibited rutting at all layers of surface course, middle layer, and base layer, while the test sections of moisture-retaining porous asphalt pavement manifested rutting mostly at surface course only.

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Concurrent Chemoradiation for Unresectable Pancreatic Cancer (절제 불가능한 췌장암의 동시항암화학방사선요법)

  • Kim, Yong-Bae;Seong, Jin-Sil;Song, Si-Young;Park, Seung-Woo;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.328-333
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    • 2002
  • Purpose : To analyze the treatment results of concurrent chemoradiation with oral 5-FU plus Gemcitabine or Paclitaxel for unresectable pancreatic cancer. Materials & Methods : The patients, who were diagnosed by imaging modalities or by explo-laparotomy, were treated with concurrent chemoradiation. Radiotherapy was delivered to primary tumor and regional lymph nodes, and the total dose was 45 Gy. Patients received Gemcitabine $1,000\;mg/m^2$ or Paclitaxel $50\;mg/m^2$ weekly and oral 5-FU daily The total number of cycles of chemotherapy ranged from 1 to 39 (median, 11 cycles). The follow-up period ranged from 6 to 36 months, Survival was analyzed using the Kaplan-Meier method. Results : Fifty-four patients between Jan. 1999 to Nov. 2001 were included in this study. Forty-two patients who completed the planned treatment were included in this analysis. The patients' age ranged from 37 to 73 years (median, 50 years) and the male to female ratio was 30:12. Treatment was interrupted for 12 patients due to: disease progression for 6 $(50\%)$, poor performance status for 4 $(33.3\%)$, intercurrent disease for 1 $(8.3\%)$, and refusal for 1 $(8.3\%)$. Response evaluation was possible for 40 patients. One patient gained complete remission and 24 patients gained partial remission, hence the response rate was $59\%$. The survival rates were $46.7\%\;and\;17.0\%$ at 1 year and 2 years, respectively with a median survival time of 12 months. Patients treated with Paclitaxel showed superior outcomes compared to those patients treated with Gemcitabine, in terms of both response rate and survival rate although this difference was not statistically significant. Grade III or IV hematologic toxicity was shown in 8 patients $(19\%)$, while grade III or IV non-hematologic toxicity was shown in 5 patients $(12\%)$. Conclusion : Concurrent chemoradiation with oral 5-FU and Gemcitabine or Paclitaxel improves both the response rate and survival rate in patients with unresectable pancreatic cancer. A prospective study should be investigated in order to improve both the patient selection and the treatment outcome as well as to reduce the toxicity.

Sequential Chemotherapy and Radiation Therapy for Advanced Nasopharyngeal Carcinoma (진행된 비인강암의 화학요법 및 방사선 치료)

  • Park, In-Kyu;Kim, Song-Bo;Yun, Sang-Mo;Kim, Jae-Cheol;Park, Jun-Sik
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.259-265
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    • 1993
  • Between January 1985 and July 1992, 52 patients with locally advanced nasopharyngeal carcinoma were studied retrospectively for the effectiveness of sequential chemotherapy and radiation therapy. The male to female ratio was 3.3:1 with a median age of 41 years. Forty patients had squamous cell carcinoma and the remaining 12 had undifferentiated carcinoma. Seven patients had stage III disease and the remainder had stage IV disease at time of presentation. All patients were treated two courses of chemotherapy followed by radiation therapy. Chemotherapy consisted of either CVB (cisplatin, vincristine and bleomycin) or CF (cisplatin and 5-FU). Total radiation dose to the primary site ranged from 6000 cGy to 7500 cGy. Neck nodes were given booster treatment to maximum of 7000 cGy, depending on the extent of disease. Local control, overall survival and disease-free survival rates were analyzed. The complete response (CR) rate to chemotherapy was $15\%$ and the partial response (PR) rate was $46\%,$ for overall major response rate of $61\%.$ The CR rate was $87\%$ after radiation therapy. Median follow-up time was 51 months. The overall survival and disease-free survival rates at 36 months were $54\%\;and\;49\%,$ respectively. Median time to relapse was 15 months. The patterns of initial relapse in CR patients was as follows: locoregional failure only, 12 patients; distant metastasis only,11: both,2. Cox's multivariate regression model revealed that nodal status was the single most important independant prognostic factor influencing disease-free survival (p=0.001). Comparision of these results with other published reports with radiation therapy alone showed that a high rate of initial response to chemotherapy did not translate into local control or survival. At present time radiation therapy alone remains the standard treatment for locoregional cancer of the nasopharyngeal cancer. More controlled clinical trials must be completed before acceptance of chemotherapy as a part of treatment of advanced nasopharyngeal carcinoma.

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