The Epidemiological Trend of Rotavirus Gastroenteritis in Children in a Single Center from 2004 to 2012: A Retrospective Study / 소아감염

PURPOSE: This study was performed to investigate the epidemiological trend of rotavirus acute gastroenteritis (RV-AGE) in children. METHODS: A retrospective review was performed in patients (1 month to 18 years of age) with acute gastroenteritis at KEPCO Medical Center from September 2004 to August 2013. Comparative analyses were performed based on periods: pre-vaccine (2004-2006) and post-vaccine (2008-2012) in all patients; 2004-2006 (period A), 2007-2009 (period B) and 2010-2012 (period C) in patients under 5 years of age. RESULTS: Proportion of RV-AGE decreased from 25.0% (337/1,346) in pre-vaccine period to 20.8% (459/2,210) in post-vaccine period (rate ratio (RR), 0.83 [95% CI, 0.73-0.93]; P=0.0029). The median age of patients with RV-AGE in post-vaccine period (2.6 years) was significantly (P<0.0001) higher than that in pre-vaccine period (1.6 years). In patients hospitalized with AGE, proportion of RV-AGE was significantly reduced in patients 6 to 23 months old (RR, 0.62 [95% CI, 0.51-0.75]; P<0.0001). Significant decline in proportion of RV-AGE was observed in patients under 5 years of age: period A, 26.9% (308/1,144); period B, 22.7% (295/1,299); period C, 20.6% (186/902) (P=0.0007). After the introduction of rotavirus vaccine, a significant decreasing trend of RV-AGE proportion was observed in patients 6 to 11 months old (P=0.0018) and 12 to 23 months old (P=0.0152). CONCLUSION: Decrease in RV-AGE proportion and increase in age of patients with RV-AGE were observed after the introduction of rotavirus vaccine in this single center study. Continued and systematic surveillance is needed to assess the impact of rotavirus vaccine.

Epidemiology and Clinical Characteristics of Enterovirus Infections in Children: A Single Center Analysis from 2006 to 2010 / 소아감염

PURPOSE: This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a secondary hospital during recent 5 years. METHODS: We collected the cerebrospinal fluid, stool and throat swab samples from the pediatric patients with suspected EV infections in KEPCO Medical Center, Seoul, Korea from July 2006 to September 2010. EV detection and genotype identification were performed by RT-PCR at Korea Centers for Disease Control and Prevention. RESULTS: A total of 386 samples were collected from 277 patients during study period. Ninety-eight patients (35.4%) were diagnosed with EV infections. The RT-PCR positive rate was the highest in throat swab samples (48.3%). The median age of patient was 4.7 years (range, 0.1-12.5 years). Aseptic meningitis (50, 51.0%) was the most common clinical manifestation; herpangina (22, 22.4%) and hand-foot-mouth disease (18, 18.4%). One hundred EVs were isolated from 98 patients and 20 genotypes of EV were identified; Echovirus 30 (28 cases, 28%), Enterovirus 71 (12 cases, 12%), Echovirus 25 (10 cases, 10%), Echovirus 9 (9 cases, 9%) and Coxsackievirus A6 (8 cases, 8%). Aseptic meningitis caused by Echovirus 30 was the most common manifestation in 2008. There was no complicated case caused by Enterovirus 71. CONCLUSION: This study showed the epidemiology of confirmed EV infection in children from 2006 to 2010. There is a need for continuous surveillance of EV infections and its clinical manifestations.

The Area of Ground Glass Opacities of the Lungs as a Predictive Factor in Acute Paraquat Intoxication

Even though plasma paraquat (PQ) levels have known to be an informative predictor, many patients succumb at low PQ levels in acute PQ intoxication. This study was designed to see whether the high resolution computerized tomography (HRCT) of the lungs would be a predictive measure in acute PQ intoxication. HRCT of the lungs was obtained from 119 patients with acute PQ intoxication on 7 days after PQ ingestion. The areas with ground glass opacities (GGOs) were evaluated at five levels with the area measurement tool of the picture archiving and communication systems. Among 119 patients, 102 survived and 17 died. The plasma PQ levels were significantly higher in the non-survivors than in the survivors (2.6+/-4.0 microgram/mL vs. 0.2+/-0.4 microgram/mL, P=0.02). The area with GGOs was 2.0+/-6.4% in the survivors and 73.0+/- 29.9% in the non-survivors (P<0.001). No patients survived when the area with GGOs was more than 40% but all of the patients survived when the area affected by GGOs was less than 20%. In conclusion, the area of GGOs is a useful predictor of survival in acute PQ intoxication, especially in patients with low plasma PQ levels.

Association Between Parkinsonism and Participation in Agriculture in Korea

Background and purpose: Environmental factors might influence the pathogenesis of Parkinson's disease (PD) or multiple-system atrophy (MSA), and previous examinations of pesticide exposure, well-water drinking, and farming have produced inconclusive results. Because agriculture has been of considerable importance to Korean society, and hence the risk of exposure to pesticides was high in Korea, this study investigated whether such exposure is associated with elevated risks of developing PD and MSA. Methods: Two hundred and thirty-five PD patients, 133 MSA patients, and 77 normal control subjects were examined. Data concerning environmental factors were collected by face-to-face interviews using a structured questionnaire. Odds ratios (ORs) were calculated by binary logistic regression. Results: ORs for environmental risk factors for developing PD were 1.06 [95% confidence interval (CI) = 1.02-1.10] for age and 2.37 (95% CI = 1.32-4.27) for rural well-water drinking for >10 years. Smoking >10 pack-years (OR = 0.31; 95% CI = 0.11-0.64) was a preventable factor for developing PD in this study. However, no significant risk factors were identified for MSA. Conclusions: These results suggest that exposure to certain environmental risk factors plays a role in the development of PD. However, the development of MSA appears to be independent of environmental risk factors in Korean patients.

A Case of Meckel-Gruber Syndrome / 대한주산의학회잡지

Meckel-Gruber syndrome is a rare autosomal recessive disorder characterized by the triad of posterior meningoencephalocele, cystic change of kidney and polydactyly. It is associated with varying degree of multiple congenital anomalies. So the karyotype is normal, but the phenotype is highly variable. This syndrome is lethal and the patient seldom survive more than a few days to weeks. Prenatal diagnosis may be possible by elevated alpha fetoprotein level in amniotic fluid and sonographic examination. Regarding the 25% recurrence risk, obstetrician and pediatrician should do genetic counseling and serial antenatal examination. Here we describe a female neonate who showed multiple congenital anomalies including cystic change of left kidney, polydactyly of left hand, short neck, micrognathia, low set ears, subaortic stenosis, patent ductus arteriosus and atrial septal defects which could best be designate as Meckel-Gruber syndrome. She died at 22 days of life. We report a case of Meckel-Gruber syndrome with brief review of some related literatures.

Changes of the Prevalence and the Allergens of Atopic Dermatitis in Children: In between the Year of 1992 and 2002 / 소아알레르기및호흡기학회지

PURPOSE: The prevalence of atopic dermatitis has been increased in the last decade. The purpose of this study is to compare the prevalence, and the etiologic allergens of atopic dermatitis in children between the year of 1992 and 2002. METHODS: The study was done on 90 cases of atopic dermatitis who visited the pediatric allergy clinic in Soonchunhyang University Hospital from August 2001 to July 2002. We reviewed their age, sex, severity, blood eosinophile count, serum IgE level and specific IgE antibody by uni-CAP, secondary skin infection, and compared with the data of 1992 year. RESULTS: The age distribution of patients were 20%(18 cases) under 1 yearold, 35.6%(32 cases) in 1 to 3 years old, 22.2%(20 cases) in 4 to 6 years old, and 22.2%(20 cases) over 7 years old. The proportion of the patients over 7 years old was increased compared with 1992 years. The sex ratio showed male predominance under 7 years old and female predominance over 7 years old. Specific IgE antibodies detected in patients under 1 year old was exclusively food. But for the age over 7 years old, food and inhalant allergen are detected in the year of 2002 in compare with that of 1992. Thirty patients had staphylococcal skin infection which were were susceptible to cephalosporin, oxacillin, vancomycin and resistant to penicillin, macrolide antibiotics. CONCLUSION: This result shows that the proportion of the children with atopic dermatitis was increased especially in the age over 7 years old and secondary skin infection are common. More active approach for the treatent and prevention of atopic dermatitis in children are needed.

Types of Nasal Septal Deformities Related to Nasal Symptoms: A Preliminary Report / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal septal deformity (NSD) is one of the most common cause of nasal obstructions. However, many patients with NSD complain various symptoms besides nasal obstruction such as rhinorrhea, sneezing, nasal discomfort, etc. This study aims to investigate the frequencies of various types of NSD, and to analyze the relationship between types of NSD with nasal symptoms. MATERIALS AND METHOD: We prospectively analyzed the relationship between the patients with different types of NSD and their various nasal symptoms in 693 cases visited Severance Health Center from March to May 1997. We thoroughly evaluated them with careful history taking for their symptoms and meticulous physical examination for classifying the types of NSD using the anterior rhinoscope, nasal endoscope as well as palpation with cotton applicators. RESULTS: 273 cases (39.4%) had a certain type of NSD and 176 cases (25.3%) were suffering from nasal symptoms. According to the Mladina's Classification, the most common type was type I, and the overall prevalence of the nasal symtoms in NSD group was higher than the control group. The most common symptom was nasal obstruction, and its degree and other symptoms were positively correlated with the types of NSD. CONCLUSION: The NSD showed a positive correlation with various nasal symptoms and, therefore, the surgical treatment of NSD will not only improve nasal obstruction but also other various nasal symptoms.

The Simultaneous Binaural Bithermal Caloric Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The simultaneous binaural bithermal caloric test is performed by stimulating both ear canals with the water of same temperature at the same time. There are some reports that the simultaneous binaural bithermal caloric test appears to be more sensitive than the alternative bithermal caloric test in detecting caloric vestibular abnormalities. However, it is not well known yet what effect simultaneous binaural bithermal caloric test has on the vestibulo-ocular reflex. We attempted to verify the clinical usefulness of the simultaneous binaural bithermal caloric test. MATERIALS AND METHODS: Otoneurologically normal subjects (n=20) and patients who have complaints of dizziness (n=141) were tested. The regular bithermal caloric test was performed, using Life-Tech water irrigator and the water of temperatures 30degreesC and 44degreesC. The simultaneous binaural bithermal test was performed using Brooker-Grams closed loop irrigator with 27degreesC and 44degreesC water. The irrigation time was 40 seconds and nystagmus was detected for more than 120 seconds by electronystagmography. We divided the test response into six types with the reference value of canal paresis (CP) of the regular bithermal caloric test. RESULTS: The distribution of nystagmus type did not show regular pattern in the normal controls. The distribution of type I and II was 77.4% when CP was more than 25% in patients, 50.6% when CP was less than 25% in patients, and 42.5% in the normal group. The maximal velocity of slow component increased in the unilateral canal paresis patients (CP>25%), compared with the normal controls and no unilateral canal paresis patients (Cp<0.05). CONCLUSION: We observed that the simultaneous binaural bithermal caloric test has advantages of being less time-consuming and more comfortable. When the maximal velocity of slow component is more than 22.6 deg/sec with type I or II response, we could predict canal paresis; however, further studies should be made for abnormal response of simultaneous caloric response on the central nervous ststem.

Variations of the ventral rami of the brachial plexus

We studied the variations in the ventral rami of 152 brachial plexuses in 77 Korean adults. Brachial plexus were composed mostly of the fifth, sixth, seventh and eighth cervical nerves and the first thoracic nerve (77.0%). In 21.7% of the cases examined, the fourth, fifth, sixth, seventh and eighth cervical and the first thoracic nerves contributed to the plexus. A plexus composed of the fourth, fifth, sixth, seventh and eighth cervical and the first and second thoracic nerves, and a plexus composed of the fifth, sixth, seventh eighth cervical nerves were also observed. The plexuses were classified into three groups according to cephalic limitation, and the plexus of group 2 in which the whole fifth cervical nerve enters the plexus, were observed the most frequent. The average diameter of the sixth and the seventh cervical ventral rami of the plexus was greatest and that of the fifth cervical was smallest. The largest nerve entering the plexus was the sixth or the seventh cervical nerve in about 79% of cases. The dorsal scapular nerve originated from the fifth cervical ventral ramus in 110 cases (75.8%). The long thoracic nerve was formed by joining of roots from the fifth, sixth, and seventh cervical nerves in 76.0% of cases. Also, a branch to the phrenic nerve, the suprascapular nerve, a nerve to the pectoralis major muscle and a nerve to the subscapular muscle arising from the ventral rami of the plexus were observed.

The ontogeny of excitatory amino acid receptors in the rat brain quantitative autoradiographic study: I. N-methyl-D-aspartate receptors / 대한해부학회지

No abstract available.

Morphometric Study on the Development of the Human Fetal Heart after Mid-term / 체질인류학회지

A total of 23 human fetal hearts from 18 to 40 weeks of gestation were provided for histologic and morphometric studies. The fetuses were the products of spontaneous or artificial abortions and were found to have no congential anomalies or associated lesions at autopsy. Maxima thickness of the left anterior, left lateral, left posterior, right anterior, right lateral, right posterior ventricular wall, and of the interventricular septal wall were measured and the left / right wall thickness ratio was calculated. The cross-sectional area of each ventricle parallel to the base of the heart at about 3-5mm below from the origin of the aorta was measured under drawing attachment-equipped light microscope with the application of point counting or cut-and-weigh method. Data were analyzed by the Anderson-ell ABSTAT dBASE ll statistical package program. The ventricular wall consisted of endocardium, myocardium and epicardium. The myocardium showed epithelial character by stratification of barrel-shaped myocardial cells, but the epithelial character progressively changed to as in adult myocardial tissue from the myocardial area close to the epicardium with increasing fetal age. However, any significant histologic difference between the left and the right ventricular wall at the same fetal age was not found. The growth pattern of both ventricular wall, the interventricular septal wall, and of the cross sectional area were linear (p0.1).