• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.122-129
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• 2010

Purpose : Enteroviral infection is a common viral illness in children. We undertook this study in attempt to comprehend the epidemiologic and clinical features of enteroviral infections, particularly EV71 in children. Methods : We enrolled 63 children with enteroviral infection at Severance Children's Hospital in Seoul between May and August 2009. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed from stool or cerebrospinal fluid samples, which were then tested for enteroviral infection. Viral isolation and serotype identification also were performed by RT-PCR. Results : A total of 63 patients with clinical diagnosis of enteroviral infections were enrolled; of those, 38 (60%) were positive for enterovirus. The mean age of the patients was 2 years and 7 months and the sex ratio of male to female was 0.9 :1. Their clincal manifestations included aseptic meningitis (21 cases, 55%), HFMD (16 cases, 42%), herpangina (5 cases, 13%), neonatal fever (2 cases, 5%), encephalitis (1 case, 3%), and myocarditis (1 case, 3%). Serotypes of isolated enteroviruses were EV71 (8 cases, 21%), coxsackievirus B1 (8 cases, 21%), coxsackievirus A16 (2 cases, 6%), coxsakievirus A2 (1 case, 3%), coxsakievirus A5 (1 case, 3%), and echovirus 9 (1 case, 3%). Clinical symptoms of EV71 infection included HFMD (5 cases, 63%), aseptic meningitis (3 cases, 38%), encephalitis (1 case, 13%), and myocarditis (1 case, 13%). A positive rate of C-reactive protein in EV71 was higher than those in other enterviral infections. However, there was no statistically significant difference in other laboratory findings. Conclusion : We reported on identified enteroviruses, including EV71, during a period of 3 months in the summer of 2009. In this study, EV71 infection frequently occurred in male and clinical manifestation caused by EV71 was a more severe disease than that due to other enterviral infections. There is a need for continuous surveillance of enteroviral infection and its clinical manifestations for diagnosis and treatment of enteroviral infection.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.213-221
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• 2001

Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

• 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.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.544-548
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• 2009

Purpose : To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. Methods : We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. Results : In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. $6.8{\mu}g/L$). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. Conclusion : There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P<0.05).

• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.791-797
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• 2009

Purpose : We aimed to investigate the clinical manifestations of and antibiotic resistance in culture-proven childhood salmonellosis. Methods : Clinical manifestations and laboratory data of and antibiotic use in subjects with culture-proven childhood salmonellosis, who were treated at the Chonbuk National University Hospital between September 1998 and August 2008, were analyzed retrospectively. Patients with underlying diseases or concomitant illnesses were excluded. Results : We assessed a total of 72 patients. There were 68 stool culture-positive cases, 7 blood culture-positive cases, and 3 both stool culture- and blood culture-positive cases. Salmonella group D was the most frequent pathogen in stool (63.9%) and blood (71.4%) cultures. Salmonella typhi was isolated in 1 case. Of the 72 patients, 45 (62.5%) were male children, of which 29 (40.3%) were aged <3 years. The patients most commonly presented with diarrhea (90.2%) and fever (83.3%). Leukocytosis (leukocyte count, >$15,000/{\mu}L$) and leukopenia (leukocyte count, <$4,000/{\mu}L$) were detected in 8.3% and 5.6% of the patients, respectively. Elevated serum C-reactive protein concentration (>5 mg/dL) and erythrocyte sedimentation rate (>20 mm/h) were observed in 88.9% and 58.3% of the patients, respectively. Fifty-two (85.2%) of 61 patients who had undergone antibiotic treatment received a third-generation cephalosporin as definitive antibiotic therapy. Multidrug resistance rate was 40.0 % in the first 5 years of the study and 71.4% in the last 5 years. No fatalities occurred in this series. Conclusion : Children with culture-proven salmonellosis showed relatively benign clinical outcomes. Appropriate antibiotic treatment of <2 weeks is probably adequate for those without a suppurative focus of infection. The incidence of antibiotic resistant isolates was recently seen to increase.

• Journal of Animal Science and Technology
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• v.44 no.4
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• pp.419-426
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• 2002

We conducted two experiments to evaluate the effects of chromium picolinate(CrP) on growth performance, carcass characteristics and plasma components in Holstein bulls. In trial Ⅰ, eight finishing Holstein bulls(300${\pm}$6.99Kg) were allocated to 2 treatments(control and 0.05% CrP) with 4 replication for 10-months. In results, growth performance was not affected by CrP addition. The plasma insulin concentration in 0.05% CrP group was about 2 times higher than the control group of Holstein bulls. The levels of plasma NEFA were significantly decreased to 59.00 mEq/dl with 0.05% CrP treatment(P<0.05), but the levels of plasma glucose and PUN were not altered by 0.05% CrP treatment. The grade of carcass was not different between control and 0.05% CrP group, but back fat thickness in 0.05% CrP group was increased in 22.33% compared with control group. In trial 2, fifteen growing- finishing Holstein bulls(160${\pm}$4.63Kg) were allocated to 3 treatments(control, 0.025% CrP and 0.05% CrP) with 5 replication for 14-months. During the overall experimental period, growth performance was not affected by CrP levels. The levels of hormone and metabolites were not affected by CrP supplementa- tion. The carcass characteristics were not different between control and treatment. These results show that the CrP may have no effects for beef cattle production because of degradation of CrP conjugation in the rumen. However treatment of short term provide a possibility the effects of development for lipogenesis.

• Journal of the Mineralogical Society of Korea
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• v.20 no.3
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• pp.193-201
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• 2007

We used $^6Li$ and $^7Li$ MAS NMR to investigate the fate and local environments of Li in the interlayer of clay minerals such as hectorite, Woming-montmorillonite, beidellite, and lepidollite at room and high ($250^{\circ}C$) temperature. Although $^6Li$ NMR spectra show narrower peaks than those of $^7Li$ NMR, S/N ratio is low and there are no obvious differences in chemical shifts suggesting that it is difficult to apply $^6Li$ NMR to have information on the local environments of Li in the clay interlayers. $^7Li$ NMR spectra, however, show changes in the peak width and quadrupole patterns providing information on the local environments of Li in the interlayer even though changes in the chemical shift are not observed. In montmorillonite, two different local environments of Li are observed; one has a narrow peak with typical quadrupole patterns whereas another has a broad peak without those of the patterns. Changes in the peak width is also observed from broad to narrow in the $^7Li$ NMR spectra for beidellite but not for hectorite at high temperature. Our results suggest that the peak width change in the broad peak is attributed to the coordination changes in the water molecules around Li which is tightly bonded on the basal oxygen of Si tetrahedra as inner-sphere complexes. The narrow peak in montmorillnoite can be assigned to the Li bended as outer-sphere complexes.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.65-72
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• 2013

Purpose: Urinary tract infection (UTI) caused by gram-positive uropathogens is usually hospital-acquired and associated with predisposing conditions. However, the incidence of gram-positive bacteria in community-acquired UTIs has recently increased worldwide. We aimed to investigate the clinical significance of UTI and associated genitourinary malformations in young children with febrile UTIs caused by gram-positive bacteria. Methods: We retrospectively reviewed the medical records of 566 patients (age, <1 year) who visited the Korea University Medical Center for febrile UTIs between January 2008 and May 2013. We classified the patients into the following two groups: gram-positive (P group) and gram-negative (N group), according to the results of urine culture. The fever duration; white blood cell (WBC) counts and C-reactive protein (CRP) levels in peripheral blood; and the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR), and renal scarring were compared between the two groups. Results: The number of patients with gram-positive bacteria was 23 (4.1%) and with gram-negative bacteria was 543 (95.9%). The most common pathogen was Escherichia coli, and Enterococcus faecalis showed the highest incidence among gram-positive uropathogens. Patients with gram-positive bacteria showed longer fever duration compared to that in patients with gram-negative bacteria (P vs. N, $3.4{\pm}1.2$ vs. $2.9{\pm}1.6$ days, P <0.05). The incidence of VUR was increased in the gram-positive group compared to that in the gram-negative group (P vs. N, 55.6 vs. 17.8%, P<0.05). However, there were no significant differences in other laboratory and radiologic findings. Conclusion: The findings of our study show that community-acquired UTIs in patients younger than 1 year of age, caused by gram-positive uropathogens, can be associated with prolonged fever duration and the presence of VUR.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.239-247
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• 2017

Among the commonly known tools to diagnose diabetes are fasting plasma glucose (FPG), HbA1c., and OGTT known as gold standard. However, there can be many disagreements on the ways to diagnose diabetes. In this study, we examined the differences of the types of diabetes according to the applicability of FPG and HbA1c. Moreover, we evaluated the concordance of diagnosis. We excluded subjects with missing glucose and HbA1c data, as well as those previously diagnosed with diabetes, and those who fasted less than 8 hours. The data of 4,502 subjects (1,956 men and 2,546 women) from the 2015 KNHNES were analyzed. We divided these patients into three categories which are normal, prediabetes, and diabetes, based on the FPG and HbA1c. In men, the number of subjects with FPG ranging from 100 to 125 mg/dL and HbA1c ${\geq}6.5%$ was 23 out of 664, and the number of subjects with FPG < 126 mg/dL and HbA1c ${\geq}6.5%$ was 39 out of 86 newly diagnosed diabetes patients. The concordance rate was as follows: Normal 80.3%, prediabetes 44.9%, and diabetes 54.7%. The coefficient of Cohen's Kappa was 0.322 in men and 0.362 in women; this suggests that both gender showed a low concordance rate. However, when we divided them into two categories (nondiabetes and diabetes), Kappa was 0.582 in men and 0.637 in women, showing a relatively high concordance rate. While all subjects with FPG ${\geq}126mg/dL$ showed a significantly high HOMA IR, all subjects with FPG < 126 mg/dL showed a significantly high QUICKI. Considering the low concordance rate for the diagnosis of diabetes and characteristic of diagnostic tests, it is necessary to combine the related tests for diagnosing diabetes.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.33-36
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• 2003

Purpose : We evaluated clinical manifestations and laboratory findings in patients with measles according to age distribution. Methods : Retrospective analyses were performed using medical records of patients with measles admitted to The Catholic University of Korea, Daejon St. Mary's Hospital from October 2000 to May 2001. We divided the patients with measles into three age groups, i.e., those who were under two years of age(159 patients), those between 9-11 years of age(39 patients), and those older than 16 years of age who were hospitalized in the department of internal medicine(young adult group; 23 patients). We compared clinical and laboratory characteristics among these three groups. Results : Almost all patients with measles were presented with fever, skin rash and cough. No statistical differences were present between the three groups in total fever duration, number of hospitalization days, complications determined with longer hospitalization for more than eight days, and positive values of anti-measles IgM. Patients under 2 years of age showed statistically higher levels of white bood cell and lymphocyte counts. However, neutropenia and lymphopenia were observed in all age groups compared with age-matched standard values. Campared with the other two age groups, the young adult group showed a higher mean level of liver enzymes(AST/ALT) and more patients with a level twice as high as the normal values. Conclusion : Clinical manifestations including complications according to age groups showed no significant differences in patients with measles. Hepatic involvement was more prevalent in the young adult group.