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Clinical Presentations and Causative Organisms in Children and Adolescents with Osteoarticular Infections: A Retrospective Study (소아청소년기에 발생한 골관절염의 임상 양상 및 원인균에 대한 고찰)

  • Lee, Soyoung;Kim, Han Wool;Cho, Hye-Kyung;Yun, Yoe Hon;Ryu, Kyung Ha;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.154-163
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    • 2015
  • Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.

The Association of Central Obesity with Type 2 Diabetes among Koreans according to the Serum Gamma-Glutamyltransferase Level: Korean Genome and Epidemiology Study (혈청 Gamma-Glutamyltransferase에 따른 복부비만과 제2형 당뇨병간의 관련성: Korean Genome and Epidemiology Study)

  • Shin, Ji-Yeon;Hwang, Jun-Hyun;Jeong, Jin-Young;Kim, Sung-Hi;Moon, Jai-Dong;Roh, Sang-Chul;Kim, Young-Wook;Kim, Yang-Ho;Leem, Jong-Han;Ju, Young-Su;Hong, Young-Seoub;Ha, Eun-Hee;Lee, Yong-Hwan;Lee, Duk-Hee;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.386-391
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    • 2009
  • Objectives : This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. Methods : The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. Results : The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT ($p_{trend}$<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. Conclusions : Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was highnormal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.

Incidence and Risk Factors of Recurrent Urinary Tract Infections during Antibiotic Prophylaxis in Children with Primary Vesicoureteral Reflux (일차성 방광요관역류 소아에서 항생제 예방요법 중에 발생한 재발성 요로감염의 빈도와 위험인자)

  • Cho Su-Jin;Kim, Hyun-Jin;Lee Jeong-Won;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.46-55
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    • 2005
  • Purpose : Recurrent urinary tract Infection(UTI) in primary vesicoureteral reflux(VUR) may lead to serious renal scarring, a major cause of childhood hypertension and end-stage renal disease. To prevent recurrent UTI, low-dose long--term antibiotic prophylaxis has been recommended. However, recurrent UTI still develops during antibiotic prophylaxis, the efficacy of which is now being disputed. The emergence of resistant bacteria has also raised concerns. To evaluate the effect of antibiotic prophylaxis, we investigated recurrent UTI during prophylactic antibiotic use in children with primary VUR Materials : The incidence and risk factors of recurrent UTI were retrospectively evaluated in ninety-one children with primary VUR on trimethoprim- sulfamethoxazole(TMP/SMX) prophylafis during the year following their index febri]e UTI. Results : Recurrent UTI occurred in 31.9%(29/91) children and comprised 0.32 episodes/patient year. Febrile UTI was 0.26 episode/patient year and afebrile UTI was 0.07 episodes/patient year. The recurrent rate of UTI in male patients with phimosis was 37.2%(19/51), which was significantly higher than in males without phimosis 0%(0/5)(P=0.025). In the logistic regression analysis for recurrent UTI, renal scar was the significant risk factor for recurrent UTI [RR 3.8(95% CI 1.0-14.1) P=0.04]. For other well-known risk factors such as sex, age, degree of VUR, APN, and voiding dysfunction, the differences were not significant. Conclusion : TMP/SMX prophylaxis did not prevent recurrent UTI in children with primary VUR. Phimosis and renal scars were the risk factors for recurrent UTI but the grade of primary VUR was not. In VUR without phlmosis and renal scar, a randomized controlled study without antibiotic prophylaxis is required. (J Korean Soc Pediatr Nephrol 2005;9:46-55)

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An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients (소아에서 시행한 치료적 혈장교환술 9례의 임상적 고찰)

  • Lee Jee-Hyun;Jeon Ga-Won;Park Sung-Eun;Jin Dong-Kyu;Paik Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.38-45
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    • 2005
  • Purpose : The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. Methods : Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number an[;. method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. Results : The patients' ages ranged from 26 mont]Is to 16 years of age, and the mean age was 9.9 years. There were S males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic svndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly Progressive glomerulonephritis(RPGN), 1 case of focal segmental glomorulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemoIThage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. Conclusion : Although it is presumptuous to generalize the therapeutic effects of plasma pheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.

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A Clinicopathological Study of Idiopathic Membranous Nephropathy in Children (소아에서 일차성 막성 신병증의 임상-병리학적 고찰)

  • Lee Bum-Hee;Cho Hee-Yeon;Kang Ju-Hyung;Kang Hee-Gyung;Ha Il-Soo;Cheong Hae-Il;Lee Hyun-Soon;Choi Yong
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.133-141
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    • 2003
  • Purpose : Idiopathic Membranous Nephropathy(IMN) is a rare renal disease in children. To help better understanding of its clinical course and treatment strategies, we reviewed the clinical manifestations and pathological findings of children with IMN. Methods : Among 58 cases with MN, from 1977 to 2003, 42(72.4%) were hepatitis B virus (HBV) associated and 16(27.6%), 6 males and 10 females, were idiopathic. All cases diagnosed aster 2000 were IMN. Several clinicopathological findings(sex, onset age, proteinuria, serum albumin, cholesterol, creatinine clearance, tubulointerstitial changes, glomerular sclerosis, hypertension, renal vein thrombosis, the use of ACE inhibitor, and immunosuppressive therapy) were compared between the remission and the non-remission group of the patients with IMN. Results : The median onset age was 13.4 years. Clinical manifestations were nephrotic syn-drome(7 cases, 43.8%), gross hematuria(5 cases, 31.3%) and microscopic hematuria with proteinuria(3 cases, 18.8%). Hypertension, hypocalcemic tetany and renal vein thrombosis were accompanied in 2, 1 and 2 cases, respectively. In addition to the typical findings of MN, the kidney biopsies showed segmental sclerosis(5 cases, 31.3%) or global sclerosis(6 cases, 37.5 %), diffuse crescents(1 case), and mild(11 cases, 68.7%) or moderate tubulointerstitial changes(3 cases, 18.8%). Thirteen cases(86.7%) received oral steroid. Among them 2 cases received cyclophophamide and 1 received cyclosporin as well. Ten cases(62.5%) received ACE inhibitors. In the patients followed up, 7 cases(46.7%) became free from proteinuria (remission group) while 8(53.3%) presented continous proteinuria (non-remission group), two (13.3%) of which progressed to renal failure. Clinicopathological findings showed no significant differences between the two groups. Conclusion : With HBV vaccination, HBV associated MN decreased markedly and IMN has taken up most of MN in children. For better understanding of this rare disease, a prospective multicenter study of the clinical course and treatment strategies should be done.

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Clinical Manifestations and Characteristics in Patients with Horseshoe Kidney (소아 및 성인 마제신 환자들의 임상적 특징과 비교)

  • Kim, Yu Kyong;Kwon, Nam Hee;Kang, Dong Il;Chung, Woo Yeong
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.73-78
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    • 2013
  • Purpose: We aimed to investigate the clinical characteristics and associated diseases in children with a horseshoe kidney and compared these data between children and adults. Method: We performed a retrospective analysis of the medical records and radiological findings of 43 patients diagnosed with a horseshoe kidney in the Busan Paik Hospital. The subjects were divided into the children's group (14 cases, age <18 years) and the adult group (29 cases, age ${\geq}18$ years). Results: The study group consisted of 17 males and 26 females with a median age of 34 years. In the children's group (14 cases), 5 subjects were male and 9 were female, with a mean age of $6.7{\pm}6.2$ years. Most of the subjects were asymptomatic and were incidentally diagnosed with horseshoe kidney during their evaluation for another disease. Among the associated diseases in the children's group, Turner syndrome was the most common (5 cases), whereas ureteropelvic junction (UPJ) stricture was observed in 2 cases (14.2%). None of the children exhibited abnormal renal function during the follow-up period. In the adult group (29 cases), 12 subjects were male and 17 were female, with a mean age of 48 years. Eighteen patients were incidentally diagnosed with horseshoe kidney during their evaluation for another disease, and 11 patients had hematuria or abdominal pain due to renal stones. Among the associated diseases in the adult group, Turner syndrome was the most common (5 cases), and UPJ stricture was observed in 5 cases; the other accompanying diseases included hydronephrosis and overactive bladder. Six patients exhibited decreased renal function (serum creatinine level >1.5) during the follow-up period. Conclusion: Horseshoe kidney is usually diagnosed incidentally in both children and adults. In the present study, we noted that Turner syndrome was the most common associated disease in children. In addition, most children were asymptomatic but had a high risk of urologic complications after the transition to adulthood. Therefore, children with horseshoe kidney require continuous follow-up.

Dietary risk assessment for suspected endocrine disrupting pesticides in agricultural products in Busan, Korea (부산지역 유통 농산물의 내분비계 장애추정농약 위해평가)

  • Kwon, Hyeon-Jeong;Ok, Yeon-Ju;Kim, Chan-Hee;Park, Mi-Jung;Hwang, Hye-Sun;Youn, Jong-Bae;Cha, Kyung-Suk;Jo, Hyun-Cheol
    • Korean Journal of Food Science and Technology
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    • v.50 no.1
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    • pp.28-36
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    • 2018
  • Studies on suspected endocrine disrupting pesticide (EDP) residues in agricultural products were carried out in 2016 in Busan, Korea. Twelve different EDPs, ranging in concentration between 0.003-2.049 mg/kg, were detected in 19.5% of 462 samples. About 0.2% of agricultural product samples exceeded the maximum residue limits (MRLs). Risk indices of all of the EDPs were less than 10% of the acceptable daily intake (ADI). The outcomes indicated that the risk groups at highest risk of exposure to diazinon (found in Korean cabbages) and carbendazim (found in apples) were females aged 40 to 49 and young males less than 10 years old, respectively. Based on the stochastic assessment at $95^{th}$ percentile (P95), risk index in these risk groups accounted for 8.38 and 2.98% of ADIs. The results showed that the occurrence of EDP residues in agricultural products could not be considered a public health problem.

The Present State of Food Serviee by the Covered Wagon Bars (포장마차 영업실태조사(營業實態調査))

  • Yoon, Eun-Young;Choi, Kyung-Suk;Park, Young-Sook;Mo, Su-Mi
    • Journal of the Korean Society of Food Culture
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    • v.3 no.2
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    • pp.187-195
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    • 1988
  • In accordance with the rapidly growing number of street food service without a registration, a study was undertaken to determine the present state of food service by the covered wagon bar, through an investigation in Jamwondong, around the south gate market and Kangnam subway station, in Seoul, between July 25th and August 25th of 1987. The survey was comprised of three parts: 1) foodservice operation in covered wagon, 2) personal and food handling hygiene, 3) food behaviors of customers. A total of 54 covered wagon bars, consisting of 51.8% mobile bars and 48.2% non-mobile bars, operating in the above three locations, were investigated. Survey results show non-mobile covered wagon bars to be more popular among persons in their thrities and fourties than among teens or the elderly; also among males than females; among company employees and college students than others. Seventy five percent of the mobile covered wagon bars served snack type foods and others served wine and foods for wine, in contrast to hundred percent of the non-mobile covered wagon bars served wine and foods for wine. The survey found many problems of hygiene, in method of food purchasing, menu planning, food preparation, dish washing treatment of leftovers and water supply, as well as personal hygiene. However, customers prefer the casual and popular atmosphere at the counter of the covered wagon bar. Finally, the study emphasizes a need for better operation of covered wagon bar, improvement of food stuff handling and the way of food services and personal hygiene. A change of the registration system from the illegal operation are urgently needed for better quality food services of covered wagon bars.

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A study on the oral health care and the effects of nutritional and oral health education for elementary school students (초등학교 아동의 구강보건관리실태와 영양교육 및 구강보건교육 효과에 관한 연구)

  • 김혜영;원복연
    • Korean journal of food and cookery science
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    • v.20 no.1
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    • pp.1-10
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    • 2004
  • This study was executed to find the effects of dietary control and oral health care on dental caries and oral problems in elementary school students, including the effects of nutritional and oral health education on the prevention of dental caries. 1. The oral health study found that 88.9% of students brushed their teeth everyday, 63.7% 2 times a day, and 50.4% in the morning and at night. 2. According to the general characteristics whether or not, the female students had more dental caries than the males, and 29.1% of the students that had dental caries ate snacke 1 or 2 times a day. 3. After the nutritional education, more students brushed their teeth in the after meal 4. According to gender, grade and nutritional education for oral health care, male students and higher grade students were more aware that “brushing teeth after meals is better than before”. The male and higher grade students, after the nutritional education, were more aware that “Bones and teeth are made from calcium”, and “Fluorine prevents teeth from dental caries” and the differences between the genders were statistically significant in relation to both these facts (p〈0.05) and before and after education (p〈0.01). The male and higher grade students, and those nutritionally educated were more conscious that “vegetables and fruits are good for teeth”, with the differences before and after the nutritional education were statistically significant (p〈0.05). The male and higher grade students were well aware that “Foods that have sugar cause dental caries”, and significant differences were shown between grades (p〈0.05). The male and higher grade students, after the nutritional education and were well aware that “Milk is good for teeth”, with a significant gender difference (p〈0.05). The female and higher grade students, and those after nutritional education were well aware that “Dental caries can not be perfectly cured once it had already occurred”. after nutrition, but not much differences.

Investigation into the Preference and Demand for Functional Drinks (Korean Traditional Drinks) (기능성 전통 음청류 선호도와 구매도 조사)

  • Kim, Gui-Soon;Park, Geum-Soon
    • Korean journal of food and cookery science
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    • v.28 no.4
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    • pp.413-421
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    • 2012
  • This study was conducted with 418 adults 20 years or older, all of whom lived in Daegu and Gyeongbuk. According to a survey, the number of females was greater than that of males (40.7%) by 59.3%, and that for ages 30 years was the highest. The preference for Korean traditional drinks was relatively high at 51.8%, and the frequency of drinking Korean traditional drinks was 39.0%. The adults answered that they had these beverages on special days such as holidays, ritual days, and birthdays. Among the reasons for drinking a traditional beverage 'good taste' scored the highest with 27.0% of respondents, followed by 'Korean traditional food' with 24.4%. The recognition of Korean traditional drinks was high in the order of Sikhe, Soojunggwa, Cha, and Hwachae. The preference for Sikhe was the highest. The group who agreed that it was important to develop a Korean functional traditional drink was 11.5% higher than that of the negative group, as 13.4% 'agreed a lot' and 41.1% 'agreed'. Consumer awareness toward traditional drink functionality was generally positive, with 3.5 points or higher on average, and awareness of the nutritional supplementation, diabetes control, the recuperative effects of the drinks were also high. Among Korean traditional drinks Sikhe was the highest with regard to intention to purchase. As a result, the popularization of traditional Korean drinks was based on three factors: quality oriented image, popularity oriented image, and product attribute-oriented image. These factors significantly influenced the preference for and purchase of Korean functional traditional drinks.