Antibiotic Sensitivity to the Major Causative Organisms of Acute Urinary Tract Infection in Children / 소아과

PURPOSE: We studied the changes in antibiotic sensitivity to the causative organisms of urinary tract infection (UTI), in order to provide useful information on the choice of adequate drugs in the treatment of UTI. METHODS: We retrospectively analyzed the major causative organisms and their antibiotic sensitivities in 69 patients diagnosed with UTI in the Department of Pediatrics, Samsung Cheil Hospital from 2002 to 2003. RESULTS: The frequency of UTI was the highest in infants younger than 1 year of age (88.4 percent). The male to female ratio was 3.05: 1. Escherichia coli was the most frequent organism (78.3 percent), followed by Klebsiella (116 percent), Pseudomonas (2.9 percent), Proteus (2.9 percent), Enterobacter, Morganelle, and Enterococcus (1.4 percent) in descending order. Antibiotic sensitivity of gram negative organisms was above 90 percent against imipenem, amikacin, 80 percent against aztreonam, cefepime, ceftriaxone, 50-70 percent against gentamicin, trimethoprime-sulfamethoxazole (TMP/SMX), and 23 percent against ampicillin (23.4 percent). CONCLUSION: Antibiotict sensitivity of gram negative organisms was high to amikacin and third generation cephalosporins but low to ampicillin, gentamicin and TMP/SMX. The use of ampicillin or TMP/SMX, as the first choice of the empiric and prophylactic treatment for UTI, should be reconsidered and investigated further.

Etiology and Clinical Features of Viral Lower-respiratory Tract Infections in Children in Winter, 2003 / 소아과

PURPOSE: This study was performed to characterize the etiology and clinical features of acute viral lower-respiratory tract infections (LRI). METHODS: Etiologic agents and clinical features of acute viral LRI were studied from October. 2003 through March. 2004 in hospitalized children with LRI (253 cases) at Samsung Cheil Hospital. The viruses were identified by indirect immunofluorescent method. Medical records of patients with proven viral LRI were reviewed retrospectively. RESULTS: Ninety two cases (36.4%) were confirmed as viral infections. The identified pathogens were respiratory syncytial virus (RSV, 76.0%), adenovirus (ADV, 12.0%), influenza virus type A (INFA, 9.8 %), influenza virus type B (INFB, 1.1%) and parainfluenza virus (PIV, 1.1%). Eight four point eight% of patients were younger than 2 years of age. Clinical diagnosis of LRI were pneumonia (56.5%), bronchiolitis (35.9%), tracheobronchitis (4.3%) and croup (3.3%). The clinical symptoms and signs were cough (98.8%), rhinorrhea (82.6%), fever (70.7%), rale (67.4%), wheezing (29.3%), chest retraction (28.3%) and cyanosis (4.3%). The severe respiratory symptoms and signs were more common in RSV-infected patients, even cyanosis could be observed. Seventeen point four percent of patient had fever of 38.5degrees C or higher and their most common etiologic agent was INFA (66.7%). Twenty three point nine percent had fever more than 5 days and common etiologic agent was INFA (77.8%). The elevated WBC count (> 14x10 (3)/microliter) was in 14.1%, and common etiologic agents were INFA (22.2%) and ADV (18.2%). C-reactive protein (CRP > 4.0 mg/dL) was increased in 13.0%, and common in ADV (63.6 %). Increased aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was detected in 10.9%, and the most common etiologic agent was RSV (12.9%). CONCLUSION: The common agents of acute viral LRI were RSV, ADV and INF, respectively. Because the etiologic agents present variable clinical features, it may be helpful to treat and to evaluate acute viral LRI that we should understand their etiologic variability.

A Questionnaire on Using Informed Consents of Parents or Guardians in Vaccination of Children

PURPOSE: This study was done to evaluate the parents' or guardians' compliance of obtaining individual informed consent before vaccination and the possible problems of using informed consent. METHODS: One hundred and twelve children were randomly selected among 2,820 children who visited Samsung Cheil Hospital during July 2002. A questionnaire about using informed consent of vaccination was given to all parents or guardians of these children. RESULTS: Most of the responders were mothers(80.4%). As for the places of vaccination, 87(77.7%) persons vaccinated their children at general hospitals. In response to a request for informed consent of vaccination, 73(65.2%) complied well with requests every time. In subscribing to informed consent, 62(55.4%) were pleased, 40(35.7%) stated it was necessary despite in inconveniance. Because of dislike of subscribing to informed consent(55), 33(60%) persons stated that it was difficult to subscribe to informed consent during the inconveniant time of nursing baby. Eighty(71.4%) found it useful to read informed consent for an understanding of potential negative reactions. Being informed of potential negative reactions, 105(93.8%) stated that they would vaccinate their children despite of the potential of a worrisome negative reaction. In dealing with negative reaction, 77(68.8%) said that they would contact a hospital, 32(28.6%) said that they would care for their children at home. Eleven(9.8 %) experienced negative reactions after vaccination. CONCLUSION: Compliance of parents to informed consent was relatively good. Parents or guardians should receive relevant information and the aim of informed consent also should be adequately understood.

Correlation between Ultrasonography and Diuretic Renography in Infants with Ureteropelvic Junction Obstruction / 대한비뇨기과학회지

PURPOSE: Although ultrasonography and diuretic renography are routinely performed for evaluation of ureteropelvic junction obstruction, no reported studies have systemically investigated the correlation of the two methods. We investigated the correlation and values of the two methods. MATERIALS AND METHODS: We studied 44 patients who presented with unilateral hydronephrosis due to ureteropelvic junction obstruction from 1994 to 1999. Patients were evaluated with ultrasound and nuclear renograms with furosemide. Hydronephrosis grade on ultrasonography and the severity of obstruction on diuretic renography were in accordance with the SFU (Society for Fetal Urology) system and "The Well Tempered Renogram", respectively. RESULTS: 27 patients showed grade III hydronephrosis and the remaining 17 patients showed grade IV hydronephrosis on ultrasonography. Kidneys of grade IV hydronephrosis had poorer washout patterns on diuretic renography than those of grade III hydronephrosis (p 0.05). In 37.0% (10/27) and 47.1% (8/17) of patients with grade III and grade IV hydronephrosis, hydronephrotic kidney had a differential function greater than 50%. CONCLUSIONS: Our study suggests that diuretic renography is not always indicated in the patients with grade IV hydronephrosis, but, must be performed to confirm the severity of obstruction in the patients with grade III hydronephrosis.

Anthropometric Measurement of Newborn in Women with Gestational Diabetes Mellitus

PURPOSE: To find the anthropometric characteristics of newborn in women with gestational diabetes mellitus(GDM), and the relationship between the birth weight and anthropometric measurements of newborn, maternal body habitus and glycemic control in GDM group. METHODS: Maternal weight, height, and obstetric history of 82 women with GDM and 93 women with normal glucose tolerance were recorded at the time of screening test and delivery. Within 2 days after birth, the birth weight and anthropometric measurements were obtained, and maternal glycohemoglobin concentrations were measured and umbilical cord blood samples for C-peptide were collected in GDM group at delivery. RESULTS: There were no differences in the birth weight and frequency of LGA newborn between GDM and control group, although the primary C-section of GDM group was significantly higher compared with the control group. The abdominal circumference(AC) and triceps, subscapular, and thigh skinfold thickness(SFT) of newborn in GDM group were significantly increased compared with the control group. Maternal glycohemoglobin concentration was correlated with birth weight, but not with AC and three SFTs in GDM group. Umbilical cord blood C-peptide level had a correlation with birth weight and three SFTs in GDM group. Newborn's AC had a correlation with maternal weight and weight gain in GDM group, but not in control group. CONCLUSION: Although the birth weight and frequency of LGA did not differ, AC and triceps, subscapular, and thigh SFT were increased in GDM group. These increases of anthropometric measurements were observed in AGA newborn, and were greater in LGA newborn.

Decrease of Plasma Th2 Cytokines by Interferon (IFN)-gamma Therapy in Atopic Dermatitis

PURPOSE: Atopic dermatitis is characterized by reduced IFN-gamma production and increased IL-4 production. As a result, IgE production increases in atopic dermatitis. In the previous studies, it was reported that recombinant IFN-gamma therapy is effective in treatment of severe atopic dermatitis. In this study, changes of plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration by IFN-gamma therapy were studied in atopic dermatitis. Changes of plasma IgE levels and eosinophil counts were also investigated in the present report. METHODS: Sixty-five atopic dermatitis patients were studied. Diagnostic criteria for atopic dermatitis were those used by Hanifin and Rajka. Patients received 2x106 units/m2 IFN-gamma by subcutaneous injection eighteen times for six weeks. The following investigations were performed : complete blood cell count, total IgE, eosinophil percentage and total eosinophil count in addition to plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration. RESULTS: Plasma concentrations of IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy in atopic dermatitis. However, plasma IFN-gamma concentration was not changed. No significant correlations among the changes of IgE, eosinophil counts and plasma cytokine concentrations were detected. CONCLUSION: Plasma concentrations of Th2 cytokine such as IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy. This study suggests that Th2 cytokines might not be produced simulaneously. and that changes of Th2 cytokines might not affect the quantitiative changes of IgE and of eosinophil count.

Decrease of Plasma Th2 Cytokines by Interferon (IFN)-gamma Therapy in Atopic Dermatitis

PURPOSE: Atopic dermatitis is characterized by reduced IFN-gamma production and increased IL-4 production. As a result, IgE production increases in atopic dermatitis. In the previous studies, it was reported that recombinant IFN-gamma therapy is effective in treatment of severe atopic dermatitis. In this study, changes of plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration by IFN-gamma therapy were studied in atopic dermatitis. Changes of plasma IgE levels and eosinophil counts were also investigated in the present report. METHODS: Sixty-five atopic dermatitis patients were studied. Diagnostic criteria for atopic dermatitis were those used by Hanifin and Rajka. Patients received 2x106 units/m2 IFN-gamma by subcutaneous injection eighteen times for six weeks. The following investigations were performed : complete blood cell count, total IgE, eosinophil percentage and total eosinophil count in addition to plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration. RESULTS: Plasma concentrations of IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy in atopic dermatitis. However, plasma IFN-gamma concentration was not changed. No significant correlations among the changes of IgE, eosinophil counts and plasma cytokine concentrations were detected. CONCLUSION: Plasma concentrations of Th2 cytokine such as IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy. This study suggests that Th2 cytokines might not be produced simulaneously. and that changes of Th2 cytokines might not affect the quantitiative changes of IgE and of eosinophil count.

The Perinatal Complications in Infants of Mothers with Gestational Diabetes Mellitus

PURPOSE: This study was performed to examine the impact of gestational diabetes mellitus (GDM) on perinatal outcomes, especially macrosomia and metabolic complications in Korean women. Subjects and METHODS: We studied perinatal outcomes of 65 women with GDM who delivered a singleton infant and were not complicated by medical disease that might effect the fetal growth, 65 women with normal glucose tolerance were selected to match subject with GDM matched to age, height, and prepregnancy weight. RESULTS: 1) Mean birth weight in infants of mothers with GDM was significantly heavier than that in infants of control mothers, even though the delivery was almost one week earlier (3524 vs. 3364gm). 2) Although length and head circumference of infants were not different between 2 groups, chest circumference and Ponderal index were significantly higher in infants of mothers with GDM. 3) The frequencies of LGA infants and macrosomia were higher in GDM group, but frequency of prematurity was not different between 2 groups. 4) The proportion of disproportionate growth among macrosomic infants was significantly higher in GDM group. 5) In infants of mothers with GDM, the frequencies of LGA infants were not significantly different between 2 groups which were separated according to the fasting glucose level measured at the time of diagnosis. 6) In infants of mothers with GDM, the frequencies of hypoglycemia, polycythemia, hypocalcemia and hyperbilirubinemia were 21.5%, 18.5%, 3.1% and 33.8% respectively. When infants of mothers with GDM were divided to 2 groups (LGA, AGA), the frequencies of polycythemia and hyperbilirubinemia in LGA infants were higher than those in AGA infants (30.8 vs. 10.3% and 50.5 vs. 23.1%, respectively). 6) There was a significant positive correlation between Ponderal index and chest circumference/head circumference ratio (r=0.37, p<0.01). CONCLUSIONS: Inspite of tight metabolic control of mothers with GDM, perinatal complications, such as macrosomia, hypoglycemia, hyperbilirubinemia were frequent in infants of mothers with GDM. In case of infants of mothers with GDM, perinatal complication should be treated earlier or prevented by careful physical examination and intensive management.

Immunotherapy with Systemic Interferon-gamma in Severe Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Atopic dermatitis is characterized by immunologic abnormalities including evidence for reduced IFN-gamma production with increased IL-4 production. Previous open trials have suggested efficacy for recombinant IFN-gamma in treatment of severe atopic dermatitis. Here we report the results of treatment with IFN-gamma in 5 patients with moderate to severe atopic dermatitis. METHODS: Atopic dermatitis was diagnosed according to typical clinical symptoms. Patients were treated with IFN-gamma for 6 weeks. Patients received 2x106 units/m2 IFN-gamma by subcutaneous injection. Serum IgE levels, total eosinophil counts with hemoglobin(Hb) concentrations, hematocrit(Hct)s, white blood cell counts(WBC), lymphocyte fractions, eosinophil fractions and platelet counts were examined before treatment and 1 week and 6 week after treatment. RESULTS: The skin lesions of all patients begun to be improved after 3 times of injection. As estimated by patients, responses showed significant improvement. Three of five patients were resolved completely who showed complete clearance of skin manifestation. and remained two patients show dramatic improvement with mild some skin lesions. WBC counts, Hemoglobins, Hematocrits, lymphocyte fractions, eosinophil fractions and platelet counts was not significantly changed before and after IFN-gamma treatment. Serum IgE levels were not markedly elevated and not reduced after IFN-gamma treatment. But total eosinophil counts were decreased 1 week after treatment and reduced to normal range 6 weeks after treatment. CONCLUSIONS: Five severe atopic dermatitis patients who did not respond to previous treatment, who had showed complication to local steroid treatment and who had severe skin lesions were treated with IFN-gamma. They showed marked improvement in skin lesions after IFN-gamma treatment and three of them showed complete clearance of skin lesions. Total eosinophil count was regarded as an excellent indicator for diagnosis, evaluation of therapeutic effects of IFN-gamma. IFN-gamma may be a suitable immunotherapy modality in the treatment of atopic dermatitis and futher studies for the action mechanism of IFN-gamma in atopic dermatitis might be needed.

Increased CD5 + B Cells in Neonatal Infections / 대한면역학회지

PURPOSE: CD5+ B (B1) cell is a subpopulation of B cells and CD5+ B cells constitute a large fraction of B cells in neonates. CD5 B cells are closely related with autoimmune diseases but the roles and functions in neonates are still unknown. The quantitative changes of CD5+ B cells in neonatal infections were examined to investigate the involvement of CDS+ B cells in neonatal immune reaction to general immunologic stimuli such as infections. Methods: Ten normal neonates and eight neonates with acute febrile diseases were studied. Venous blood was drawn and mononuclear cells were separated by Ficoll-Hypaque. Half was double-stained with FITC-conjugated anti-CD5 and PE-conjugated anti-CD19, and another half with FITC-conjugated anti-CD4 and PE-conjugated anti-CD8. Stained samples were analyzed using fluorescent-activated cell sortor. ...continue...

CD5 mRNA Overexpression in Lymphocytes of Allergic Patients / 대한면역학회지

PURPOSE: The CD5 molecules are pan-T cell antigens and are found on a minor subpopulation of B cells. CD5 antigens are involed in an intracellular signal transduction as well as in an intercellular signal transduction between CDS+ T cell/CD72+ B cell by CD5/CD72 interaction. CD5 antigens are known to be participated in classic immune reactions and in this study CDS mRNA expressions by lymphocytes were examined in allergic patients controls, acute febrile infectious disease controls and normal controls to elucidate the possibility of CDS involvement in allergic immune reactions. METHODS: Fifteen allergic patients, ten patients of acute febrile infectious disease patients and ten normal controls were studied. Venous blood was drawn and mononuclear cells were separated. T cells and B cells were separated using immunomagnetic beads. Total RNA was extracted and RT-PCR (reverse transcriptase - polymerase chain reaction) was done to detect CDS antigen mRNA expression. RESULTS: 1) CDS mRNA overexpressions were detected in allergic patient controls as compared to that in acute febrile infectious controls. CDS mRNA was not detected in normal controls. Semiquantitative CD5 mRNA expressions were measured as relative expressions of CD5 to GAPDH. Relative quantities of CD5 mRNA expressions were 90.656.24% in allergic patient controls and 23.76+3.58% in acute febrile infectious patients. CONCLUSIONS: CDS mRNA overexpression is a characteristic phenomenon in allergic immune reactions. From these result, CD5/CD72 pathway might be the preference immune mechanism in allergic immune reaction and the further study for the exact mechanism of CDS involvement in allergic immune reactions may be necessary

CD5 mRNA Expression in Pepherial Blood Mononuclear Cell of Neonate / 대한주산의학회잡지

PURPOSE: The CD5 molecules of mice (Ly-1) and humans (T1) are pan-T cell antigens and are also found on a minor subpopulation of B cells. Cl)5+ B cells constitute a large fraction of the B cells early in development and in neonate. There are many reports about the production and mRNA expression of CD5+ B cells and in this study CD5 mRNA expression by peripheral blood mononuclear cell (PBMC) was examined in neonate and compared with those in normal children and childrens of acute febrile diseases. METHODS: Ten normal neonate(mean age, 1.2 days), ten children of acute febrile disease (mean age, 8.5 months) and ten nomal children (mean age 9 months) were studied. One mililiter of venous blood was drawn and immunophenotypes were determined using FACS (fluorescent activated cell sortor) with FITC-conjugated anti-CD5 and PE-conjugated anti-CD 19. PBMC was separated and CD5 mRNA expression was examined in these groups. RESULTS: 1) From the analysis using FACS, there was no significant difference for the CD5+ 1' cell fractions in white blood cells among neonates(78.52+13.98 %), acute febrile infectious disease controls (l0.86 + 5.56 %) and normal controls (73.53 + 4.62 %) (p>0.05). 2) The fractions of CD5+ H cell in B cells were markedly high in neonate (65.18+ 13.67 %) as compared to that in children of acute febrile disease controls (27.14+5.96 %) and normal controls (20.04+5.92 %) (p<0.001). 3) CD5 mRNA expression was detected only in neonate and not in children of acute febrile disease controls or normal controls. CONCLUSIONS: Neonate has a large fraction of CD5+ B cells in total H cells as compared to that of children of acute febrile diseases or normal controls. PHMC of neonate normally expressed CD5 mRNA but that of acute febrile group or normal control group did not. Further study about the roles and meanings of CD5 mRNA expression may be needed.

Urinary Tract Infection Caused by Escherichia coli

No abstract available.

Serum IgE Level in Patients with Minimal Change Nephrotic Syndrome

No abstract available.

Statistical Analysis of Pediatric Diseases in Korea(1987)

No abstract available.

Cerebrospinal Fluid Lymphocytosis in Acute Bacterial Meningitis on Children

No abstract available.

Statistical Analysis of Pediatric Diseases in Korea

No abstract available.

A Prospective Study of Urinary beta2 -Microglobulin in Infants with Meconium-Stained Amniotic Fluid

No abstract available.

A Clinical Study of Hospitalized Neonates with Fever

No abstract available.

Intermittent Hydronephrosis

No abstract available.