Three Cases of Pertussis in Infants younger than Three Months without Immunization of DTaP / 소아알레르기및호흡기학회지

Pertussis is a pediatric infectious disease with one of the highest degrees of infectivity. Although pertussis may cause asymptomatic infections in children and adults with immunity, it can cause life-threatening diseases in newborn babies or infants. We report three cases of pertussis in infants <3 months of age without DTaP immunization who have received symptomatic treatment with the diagnosis of bronchiolitis from other hospitals, and subsequently correctly diagnosed and treated. The patients did not have the characteristic whooping cough, but the main symptoms were episodic cough, intermittent vomiting, and cyanosis. Based on culture results for Bordetella pertussis and PCR, pertussis was diagnosed and treated without any complications. As it is assumed that adults, adolescents, and asymptomatic patients may serve as sources of infection, immunization with Tdap vaccine is recommended to prevent dissemination of pertussis from adolescents and adults to infants, and thus maintain herd immunity.

Neurologic Complications of Novel Influenza A (H1N1) Virus Infection from 2009-2011 / 대한소아신경학회지

PURPOSE: To describe the characteristics and incidence of neurologic complications related to the novel influenza A (H1N1) virus. METHODS: We reviewed the medical records of 752 children and adolescence (< or = 18 years of age) who had been diagnosed as novel influenza A (H1N1) infection through positive results of influenza A (H1N1) RT-PCR and hospitalized or visited the outpatient clinic and emergency department of Pusan National University Hospital from July 2009 to January 2011. RESULTS: We identified 15 patients who had experienced a neurologic symptom with a mean age of 8.8 years. There were 10 (66.7%) males and five (33.3%) females. Nine patients (60.0%) presented with seizures, two (13.3%) with decreased mentality, two (13.3%) with visual hallucination, and one (6.7%) with vertigo. The mean duration from onset of respiratory illness to the beginning of neurologic symptoms was 2 days (range: 0-4 days). Three patients (patient 2, 7, and 13) (20.0%) had abnormal results on cerebrospinal fluid analysis; however, novel influenza A (H1N1) was not detected. Further, one patient (6.7%) had abnormal MRI. Antiviral therapy (oseltamivir) was administered to fourteen patients (93%) and all patients recovered fully and had no neurologic sequelae. CONCLUSION: Novel influenza A (H1N1) was a cause of neurologic symptoms during the outbreak. Pediatricians should consider influenza virus infection in the differential diagnosis for children with neurologic symptoms during an epidemic of influenza.

A Novel Mutation of the Steroid 5-Alpha Reductase Type 2 (SRD5A2) Gene in a Korean Newborn with Ambiguous Genitalia / 대한소아내분비학회지

The term "disorders of sex development" (DSD) includes congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. Steroid 5-alpha reductase type 2 deficiency (5alpha-RD2) is an uncommon autosomal recessive disorder of sexual differentiation. It results from impaired conversion of testosterone (T) to dihydrotestosterone (DHT) due to mutations in the steroid 5-alpha reductase type 2 (SRD5A2) gene. It is characterized by a lack of masculinization in XY individuals due to failure to convert testosterone to dihydrotestosterone. More than 40 mutations have been reported in all five exons of the SRD5A2 gene. Here, we report on a 17-day-old Korean newborn who was confirmed to have 5alpha-RD2 by SRD5A2 gene analysis. He manifested micropenis, hypospadia and bilateral cryptorchidism without skin hyperpigmentation. T/DHT ratio after human chorionic gonadotropin (hCG) stimulation was slightly increased and genetic analysis of SRD5A2 revealed compound heterozygous mutations, c.657C > G (p.Phe219Leu) and c.656del (p.Phe219SerfsX60), the former of which is a novel mutation. We report a novel SRD5A2 gene mutation in a Korean newborn with 5alpha-RD2.

Relation of Regular Exercise Habit to Bone Mineral Density in Korean Climacteric Women

BACKGROUND: Even if the effect of regular exercise on the prevention against osteoporosis has been confirmed by many researchers, the research which evaluates the effect of regular exercises by adjusting the differences between climacteric women with respect to the status of menopause, and other health behaviors, has been few. The main purpose of this study was to evaluate the risk of osteoporosis and its relation to regular exercise. METHODS: We studied 222 climacteric women aged 40~59 years who visited the health care centers run by Chunchon branch of Korean Association of Health for preventive health examination at 2002/3~2002/11. The study subjects were asked to self-administer to the questionnaire including the items for the evaluation of the status of regular exercise and other characteristics of health behaviors and nutritional intakes. Bone mineral density was measured in L1-4 using dual-energy X ray absorption device. RESULTS: Among the total 222 subjects, 52 women (23%) have been exercising regularly, among whom 22 subjects (42%) were in the phase of menopause. Exercise group had higher levels of intake of protein, calcium, iron, vitamin B1, niacin, and vitamin C than non-exercise group. In multiple logistic regression analysis, aged 50 years (OR: 5.87, 95% CI: 2.26~15.23), menopause (OR: 2.65, 95%CI: 1.03~6.82), body mass index over 25 (OR: 0.24, 95%CI: 0.10~0.59) were significant. There was no significant difference for the bone mineral density between exercise and non-exercise groups. T score seemed to be slightly higher in the regular exercise group (-1.88 vs -1.79) compared with non-exercise group, but the difference was not significant (p>0.05). CONCLUSION: Age, menopause, low body mass index are risk factor of osteoporosis. Postmenopausal women who do not exercise showed a tendency of decreased bone mass density and increased frequency of osteoporosis. Further study is needed to prove the relation of regular exercise to bone mass density in Korean climacteric women.