• Pediatric Infection and Vaccine
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• v.13 no.1
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• pp.78-84
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• 2006

Retropharyngeal abscess and descending necrotizing mediastinitis is a potentially life-threatening condition that rarely develops following trauma to the oropharynx in children. We describe a case of a 17-month-old girl with a retropharyngeal abscess that extended to the posterior mediastinum, producing an acute descending necrotizing mediastinitis and pyopneumothorax. Culture of blood and pleural pus yielded Streptococcus pyogenes. The patient underwent repeated drainage and debridement, was treated with antibiotics and recovered. This report aims to review the retropharyngeal abscess with descending necrotizing mediastinitis in children and to highlight the fact that minor pharyngeal trauma, although not significant at first, should be observed with suspicion for serious potential complications.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.169-186
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• 1997

Scutellariae Radix has been widely used as oriental herbal medicine for the treatment of bacterial infections in the respiratory or the gastrointestinal tract. In partition experiment for better understanding of herbal medicine with various solvents, baicalein or wogonin have more hydrophobic characteristics than baicalin or wogonoside. Unexpectedly, methylene chloride could extract more for baicalin or wogonoside over other active ingredients. New compound from baicalin is discovered casting frointier area on herbal medicine in the future. Application study with new molecule hydrolyzed from baicalin is on the way for better treatment of the patient against specific disease. The baicalin modified with reaction has been shown weak antibacterial activity against Streptococcus pyogenes 308A and Pseudomonas aeruginosa 1771. The minimum inhibitory concentration (MIC) of the baicalin modified compound against those strains were about $600\;{\mu}g/mL$, respectively. In vitro antitumor experiment, $EC_{50}$ of baicalin modified with reaction was more than $300\;{\mu}g/mL$ and $EC_{50}$ of baicalein was $100\;{\mu}g/mL$. Among these compounds, baicalin exhibited high level of antitumor activity. $EC_{50}$ of baicalin was less than $33.3\;{\mu}g/mL$.

• Clinical and Experimental Pediatrics
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• v.55 no.5
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• pp.177-180
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• 2012

OK-432 (picibanil) is an inactivated preparation of $Streptococcus$ pyogenes that causes pleurodesis by inducing a strong inflammatory response. Intrapleural instillation of OK-432 has recently been used to successfully treat neonatal and fetal chylothorax. Here we report a trial of intrapleural instillation of OK-432 in two preterm infants who were born with hydrops fetalis and massive bilateral pleural effusion. Both cases showed persistent pleural effusion, refractory to conservative treatment, up to postnatal days 26 and 46, respectively. An average of 80 to 140 mL of pleural fluid was drained daily. In case 1, the infant was treated with OK-432 during the fetal period at gestation 28 weeks and 4 days of gestation, but showed recurrence of pleural effusion and progressed into hydrops. Within two to three days after OK-432 injection, the amount of pleural fluid drainage was dramatically decreased and there was no reaccumulation. We did not observe any side effects related to OK-432 injection. We suggest that OK-432 should be considered as a therapeutic option in infants who have persistent pleural effusion for more than four weeks, with the expectation of the early removal of the chest tube and a good outcome.

• YAKHAK HOEJI
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• v.37 no.2
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• pp.136-142
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• 1993

To a suspension of 1-cyclopropyl-6,8-difluoro-1,4-dihydro-7-{3,7-diazabicyclo[3.3.0]oct-1(5)-en-3-yl}-4-oxo-3-quinoline carboxylic acid(C1) in sodium hydroxide solution and water is added dropwise with stirring carbon disulfide. [6R-[6$\alpha$, 7$\beta$(Z)]]-7-[[[2-Amino-4-thiazoly)methoxyimino]-acetyl]amino]-3-[[[[7-( 3-carboxy-1-cyclopropyl-6,8-difluoro-1,4-dihydro-4-oxo-7-guinolonyl)-3,7-diazabicyclo[3.3.0]oct-1(5)-en-3-yl]thioxomethyl]thio]methyl]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-2-carboxylic acid (DACD) was synthesized from 1-cyclopropyl-6,8-difluoro-1,4-dihydro-7-[7-(mercapto) thioxomethyl-[3,7-dia zabicyclo[3.3.0]oct-1(5)-en-3-yl}]-4-oxo-3-quinoline carboxylic acid disodium salt(C2) and cefotaxime. The invitro activity of novel dual-action cephalosporin, DACD, was compared with the in vitro activities of CENO(cefotaxime 3'-norfloxacin dithiocarbamate), cefotaxime, and norfloxacin against a variety of bacterial species. In vitro activity of DACD was superior to that of norfloxacin against Streptococcus pyogenes. Against Gram-positive and Gram-negative bacteria, its activity was almost equal to that of CENO.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.31-40
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• 2008

Purpose: The probiotic effects of lactic acid bacteria have widely been researched in diverse human pathogens, but only a few effects are reported against oral pathogens. The antimicrobial effects of the Enterococcus faecium 7413 isolated from Korean infants on the 9 pathogen including 6 oral streptococci were investigated the clinical use of the antimicrobial peptide for oral microflora control. Materials and Methods: E. faecium 7413 was identified by morphological, biochemical tests and 16S rDNA sequence analysis. Inhibitory effects of culture supernatants were determined for their ability to grow on agar plate containing pathogenic bacteria. Result: The culture supernatant of Enterococcus faecium 7413 showed inhibitory effects on oral pathogens, namely Streptococcus pyogenes KCTC 3556, S. pneumoniae KCTC 5080, S. mutans ATCC 25175, S. anginosus ATCC 33397, S. constellatus KCTC 3268, S. intermedius ATCC 27823 and Shigella flexneri KCTC 2008. Whereas it did not affect the multiplication of E. coli strains, KCTC 1041 and ATCC 43894. Conclusion: The data obtained in this study could be useful for future development of effective probiotics allowing prevention for oral pathogens.

• Journal of Preventive Medicine and Public Health
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• v.52 no.3
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• pp.188-194
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• 2019

Objectives: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. Methods: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ${\leq}14years$ residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. Results: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. Conclusions: The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.

• Pediatric Infection and Vaccine
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• v.27 no.2
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• pp.83-89
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• 2020

Purpose: Group A streptococcus (GAS) is a common pathogen in pediatric patients and often causes acute pharyngotonsillitis and skin and soft tissue infections. In addition, bacteremia with significant morbidity and mortality can also occur. This study was conducted to describe the clinical manifestations and treatment outcomes of pediatric GAS bacteremia patients in Korea. Methods: This was a single-center, retrospective study. From January 2000 to December 2016, pediatric patients aged ≤18 years with GAS bacteremia were studied. Clinical manifestations, underlying diseases, intensive care unit stay, and antibiotic susceptibility were evaluated. Results: During the study period, 19 patients had GAS bacteremia. Ten (53%) were male, and the median age was 7.4 years (range, 0.3-17.4 years). Fourteen (74%) had chronic underlying diseases. Five (26%) were immunocompromised (leukemia and chronic kidney disease). Eight (42%) had lymphatic or vascular malformations, of which seven had lesions with signs of inflammation. Three (16%) developed pneumonia, and two of them received ventilator care. The 30-day mortality rate was 6% (1/19), and the cause of death was bacteremic pneumonia. All GAS isolates were sensitive to penicillin. Fifteen (79%) were sensitive to both erythromycin and clindamycin. Conclusions: This study identified various clinical manifestations of GAS bacteremia. GAS should be considered as a potential pathogen that can cause bacteremia and result in a serious clinical course.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.95-101
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• 2003

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefdinir in acute pharyngitis and pharyngotonsillitis caused by group A beta hemolytic streptococci in pediatric patients. Methods : Children aged 3 through 12 years who visited the hospitals enrolled in this study with signs and symptoms of pharyngitis or pharyngotonsillitis since May to December 2002, were taken throat culture and given Cefdinir(12 mg/kg/day, in three divided doses) for 7 days. Two hundred thirty five patients were enrolled and 90 patients who showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Follow-up culture were done at the end of the study and bacteriologic efficacy was determined Results : Ninety out of 235 patients who visited the hospitals with the signs and symptoms of pharyngitis showed positive growth on throat culture. Seventy nine patients were clinically and microbiologically assessable. The bacteriologic eradication rates of S. pyogenes were 100% in all the children treated with Cefdinir. Clinical cure rates were not different between less than 7 days-treated group(75%) and just 7 days-treated group(98.6%)(P=0.077). Two patients reported adverse reaction during Cefdinir treatment. Antimicrobial sensitivity of Cefdinir against S. pyogenes was 100% with range of MIC being less than 0.5 ${\mu}g/mL$. Conclusion : It seems that Cefdinir is one of reliable and well-tolerated drugs for the treatment of group A beta hemolytic streptococcal pharyngotonsillitis in children. It needs to be investigated short term efficacy in terms of improving drug compliance and impact of economic point of view. We can recognized that still high rate of the erythromycin resistant group A streptococci in our community should be monitored every year.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.4
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• pp.595-601
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• 2010

This study was conducted to detect and identify Staphylococcus aureus, Vibrio parahaemolyticus, and Salmonella enterica subsp. using simultaneous multiplex polymerase chain reaction (multiplex PCR) assay. 23S rRNA partial gene (S. aureus), tox R gene (V. parahaemolyticus), and inv A gene (S. enterica subsp.) as diagnostic marker gene were suggested, and their amplicon sizes were 482 bp, 368 bp, and 284 bp, respectively. Non specific amplicons by STA-5F/STA-5R primer, ToxR-F/ToxR-R primer, and 139/141 primer were not observed in genomic DNA of pathogen bacteria as Bacillus cereus, Listeria monocytogenes, Escherichia coli, Proteus vulgaris, Streptococcus pyogenes, Candida albicans, and Shigella sonnei. The extracted crude DNA of targeted bacteria was detected as PCR template successfully. The detection limits were $10^5\sim10^4$ CFU/mL and 10 pg of purified genomic DNA of S. aureus, V. parahaemolyticus, and S. enterica subsp. by using simultaneous multiplex PCR.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.161-167
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• 2013

Purpose: This study was performed to describe the clinical manifestations of hospitalized children due to varicella-zoster virus (VZV) infection Methods: This study included 40 children who were hospitalized for varicella or herpes zoster at Seoul National University Children's Hospital, 2009-2012. Diagnosis of VZV infection was confirmed by VZV PCR or culture from vesicular fluid. Medical records were reviewed to collect clinical features and outcome, antiviral treatment, history of varicella vaccination, and underlying diseases. Results: Sixteen patients with varicella and 24 patients with herpes zoster were included. Their median age was 10.5 years (16 days-19 years). Thirty-five (87.5%) patients had underlying diseases. Among 24 patients with herpes zoster, 11 patients had previous history of varicella and 1 had herpes zoster. Twenty patients (50%) had a history of varicella vaccination, and 19 immunocompromised patients had VZV infection despite of vaccination. Most (95%) patients were treated by intravenous or oral acyclovir, and no treatment failure of intravenous acyclovir was found. The median duration of fever was 4.4 days (1-10 days), and that of antiviral treatment was 12 days (7-23 days) in immunocompromised patients. Immunocompromised patients received longer duration of antiviral treatment than imunocompetent patients (P=0.014). Eleven (27.5 %) immunocompromised patients had postherpetic neuralgia, 2 (5%) had proven co-infection by Streptococcus pyogenes and Klebsiella oxytoca, and 1 (2.5%) complicated with pneumonia. Conclusion: Immunocompromised children require longer duration of treatment and are at risk of severe complication associated with VZV infection. Early initiation of antiviral therapy and close monitoring are necessary for those in immunocompromised conditions.