Do adolescents use choice to learn about their preferences? Development of value refinement and its associations with depressive symptoms in adolescence.

Independent decision making requires forming stable estimates of one's preferences. We assessed whether adolescents learn about their preferences through choice deliberation and whether depressive symptoms disrupt this process. Adolescents aged 11-18 (N = 214; participated 2021-22; Female: 53.9%; White/Black/Asian/Mixed/Arab or Latin American: 26/21/19/9/8%) rated multiple activities, chose between pairs of activities and re-rated those activities. As expected, overall, participants uprated chosen and downrated unchosen activities (dz = .20). This value refinement through choice was not evident in younger participants but emerged across adolescence. Contrary to our predictions, depressive symptoms were associated with greater value refinement. Despite this, more depressed adolescents reported lower value certainty and choice confidence. The cognitive processes through which choice deliberation shapes preference develop over adolescence, and are disrupted in depression.

Effect of supplementation of cryoprotectant solution with hydroxypropyl cellulose for vitrification of bovine oocytes.

BACKGROUND: Successful cryopreservation of bovine oocytes is very important for research and commercial applications. However, the survival and development rate of vitrified-thawed (VT) oocytes are lower than those of non-vitrified-thawed (non-VT) oocytes. OBJECTIVE: To investigate the effect of adding hydroxypropyl cellulose (HPC) to the vitrification solution for bovine oocytes. MATERIALS AND METHODS: For vitrification, bovine metaphase II oocytes were pretreated with a solution containing 10% ethylene glycol supplemented with 0, 10, 50, or 100 ug/mL HPC for 5 min, exposed to a solution containing 30% ethylene glycol supplemented with 0, 10, 50, or 100 ug/mL HPC for 30 s, and then directly plunged into liquid nitrogen. RESULTS: The survival rate of oocytes was significantly higher in the 50 HPC group than in the 0, 10, and 100 HPC groups. The reactive oxygen species level was lower in the non-VT and 50 HPC groups than in the other groups. The mRNA levels of proapoptotic genes (Bax) were lower in the non-VT, 0, and 50 HPC groups than in the other groups. The mRNA levels of antiapoptotic genes (BCl2) were higher in the non-VT than in the other groups. The development rates of embryos (day 8) obtained via parthenogenetic activation (PA) were determined in the non-VT, 0 HPC, and 50 HPC groups. The cleavage rate was significantly higher in the non-VT group. CONCLUSION: Supplementation of vitrification solution with HPC improves the survival of VT bovine oocytes and the development capacity of embryos derived from these oocytes via PA. doi.org/10.54680/fr23110110212.

Immune response to hepatitis B vaccination and factors associated with poor immune response among healthcare workers.

BACKGROUND: Hepatitis B virus (HBV) infection is a major global health problem, and healthcare workers (HCWs) are at high risk for HBV infection. Current guidelines strongly recommend immunization and screening for high-risk groups. AIMS: We evaluated immunization and screening for HBV vaccination, assessed post-vaccination immune status of HCW's and characterized potential risk factors associated with poor immune response. MATERIALS AND METHODS: From January 2010 to December 2018, we retrospectively analyzed comprehensive health checkup data for a total of 303 HCWs who received an HBV vaccination. After vaccination, HBV surface antibody (anti-HBs) titers were collected and the distribution of immune response types was determined. Risk factors for poor immune responses were identified using logistic regression. RESULTS: A total of 213 HCWs were analyzed after exclusion based on the exclusion criteria. In total, 28 (13.2%) HCWs had anti-HBs titers <100 mIU/mL (hyporesponsive/nonresponsive groups), and 185 (86.8%) had anti-HBs titers ≥100 mIU/mL (hyperresponsive group). Follow-up observations found that 75% (21/28) of the hyporesponsive/nonresponsive groups did not have increased anti-HBs titers or did not maintain an increased response. A multivariate analysis showed that HBV antibody titers at the time of employment were a significant risk factor (OR, 6.12; CI, 1.34-27.93; P = 0.019). CONCLUSIONS: More attention should be paid to groups that are hyporesponsive/nonresponsive after vaccination and to those with low anti-HBs titers at the beginning of employment. HCWs can be further protected from HBV if their results are discussed at postvaccination follow-ups.

Antibacterial action of lactoferricin B like peptide against Escherichia coli: reactive oxygen species-induced apoptosis-like death.

AIMS: Emergence and rapid dissemination of antibiotic-resistant bacteria is becoming a severe problem to public health. The search for antimicrobial substitutes for antibiotics is necessary. Lactoferricin B like peptide (LBLP) is a 23-mer antimicrobial peptide (AMP), derived from the big centipede Scolopendra subspinipes mutilans. Although its antifungal effect and its mechanism have been reported, the antibacterial activity has not yet been elucidated. METHOD AND RESULTS: In this study, we investigated antibacterial activity of LBLP and its mode of action. LBLP showed potent antibacterial effect against pathogenic bacteria Escherichia coli and did not show haemolytic activity against human erythrocyte. The general antimicrobial mechanism of AMP is to disrupt the cell membrane, however, LBLP exerted its antibacterial activity by causing apoptosis-like death through reactive oxygen species (ROS) generation. LBLP-treated E. coli cells exhibited hallmarks of apoptosis, such as membrane depolarization, DNA fragmentation, caspase-like protein activation and phosphatidylserine exposure. These apoptotic features were attenuated by pretreatment of NAC, a representative ROS scavenger. CONCLUSIONS: These results demonstrate that LBLP exerted its antibacterial activity by generating ROS and inducing apoptosis-like death in E. coli. LBLP is not membrane destructive per se, but essentially a metabolic inhibitor. SIGNIFICANCE AND IMPACT OF THE STUDY: Lactoferricin B like peptide is potential candidate to replace conventional antibiotics that are less effective because of its unique properties.

Synergistic antibacterial activity of gold nanoparticles caused by apoptosis-like death.

AIMS: Metal nanoparticles are promising materials for the management of infectious diseases as known to have various antimicrobial activities in pathogenic micro-organisms. Among them, gold nanoparticles (AuNPs) are used in a wide range of fields such as photodynamic therapy, molecular diagnostics and drug delivery because of their unique physicochemical properties. However, little is known about the synergistic antibacterial activity and mechanism of AuNPs on pathogenic bacteria. METHODS AND RESULTS: Combinations of AuNPs and cefotaxime and ciprofloxacin showed synergistic interaction against all Salmonella species, however the combination with kanamycin exhibited no interaction. We determined that AuNPs and in combinations with antibiotics exert its antibacterial effect through bacterial apoptosis-like death. AuNPs caused collapse of intracellular divalent cation homeostasis, and conventional antibiotics caused accumulation of reactive oxygen species, which induced apoptotic hallmarks such as membrane depolarization, caspase-like protein activation, cell filamentation and phosphatidylserine externalization. CONCLUSIONS: The cation homeostasis disruption by AuNPs and the accumulation of reactive oxygen species by conventional antibiotics synergistically affected bacterial cell death and induced apoptosis-like death in Salmonella cells. SIGNIFICANCE AND IMPACT OF THE STUDY: The synergistic activity between AuNPs and antibiotics propose that the AuNPs are a potential antibacterial agent and adjuvant for antimicrobial chemotherapy.

Fluoroquinolones versus trimethoprim-sulfamethoxazole for the treatment of Stenotrophomonas maltophilia infections: a systematic review and meta-analysis.

BACKGROUND: Fluoroquinolones are a popular alternative to trimethoprim-sulfamethoxazole for Stenotrophomonas maltophilia infections. OBJECTIVES: To compare the effects of fluoroquinolones and trimethoprim-sulfamethoxazole on mortality of S. maltophilia infections. DATA SOURCES: PubMed and EMBASE. STUDY ELIGIBILITY CRITERIA: Clinical studies reporting mortality outcomes of S. maltophilia infections. PARTICIPANTS: Patients with clinical infections caused by S. maltophilia. INTERVENTIONS: Fluoroquinolone monotherapy in comparison with trimethoprim-sulfamethoxazole monotherapy. METHODS: Systematic review with meta-analysis technique. RESULTS: Seven retrospective cohort and seven case-control studies were included. Three cohort studies were designed to compare the two drugs, whereas others had other purposes. A total of 663 patients were identified, 332 of which were treated with trimethoprim-sulfamethoxazole (50.1%) and 331 with fluoroquinolones (49.9%). Three cohort studies were designed to compare the effect of the two drugs, whereas the others had other purposes. Levofloxacin was most frequently used among fluoroquinolones (187/331, 56.5%), followed by ciprofloxacin (114/331, 34.4%). The overall mortality rate was 29.6%. Using pooled ORs for the mortality of each study, fluoroquinolone treatment (OR 0.62, 95% CI 0.39-0.99) was associated with survival benefit over trimethoprim-sulfamethoxazole treatment, with low heterogeneity (I2 = 18%). Specific fluoroquinolones such as ciprofloxacin (OR 0.44, 95% CI 0.17-1.12) and levofloxacin (OR 0.78, 95% CI 0.48-1.26) did not show a significant difference in comparison with trimethoprim-sulfamethoxazole. In the sub-group analyses of adult and bacteraemic patients, significant differences in mortality were not observed between fluoroquinolones and trimethoprim-sulfamethoxazole. CONCLUSIONS: Based on a meta-analysis of non-randomized studies, fluoroquinolones demonstrated comparable effects on mortality of S. maltophilia infection to trimethoprim-sulfamethoxazole, supporting the use of fluoroquinolones in clinical S. maltophilia infections. Although the pooled analysis of overall studies favoured fluoroquinolones over trimethoprim-sulfamethoxazole, the studies included were observational, and sub-group analyses of certain fluoroquinolone agents did not show statistical differences with trimethoprim-sulfamethoxazole. Randomized clinical studies are needed to address these issues.

Effect of feeding duration of diets containing corn distillers dried grains with solubles on productive performance, egg quality, and lutein and zeaxanthin concentrations of egg yolk in laying hens.

This experiment was conducted to investigate the effect of feeding duration of diets containing corn distillers dried grains with solubles (DDGS) on productive performance, egg quality, and lutein and zeaxanthin concentrations of egg yolk in laying hens. A total of 300 57-week-old Hy-Line Brown laying hens were randomly assigned to one of 5 treatment groups (feeding duration) with 6 replicates consisting of 5 consecutive cages with 2 hens per cage. Diets were formulated to contain either 0% (the control diet) or 20% DDGS. Experimental diets were fed to hens for 12 wk. The feeding duration of diets containing 20% DDGS was 0, 3, 6, 9, or 12 wk before the conclusion of the experiment. Feeding the diet containing 20% DDGS for 3, 6, or 9 wk followed feeding the control diet for 9, 6, or 3 wk, respectively. The data for productive performance were summarized for 12 wk of the feeding trial. Results indicated that increasing feeding duration of diets containing 20% DDGS had no effects on productive performance of laying hens, but increased egg yolk color (linear, P < 0.01), hunter a* value (linear and quadratic, P < 0.01), and b* values (linear, P < 0.05) with a decrease in hunter L* value (linear and quadratic, P < 0.05). Lutein and zeaxanthin concentrations of egg yolks also were increased (linear, P < 0.01) by increasing the feeding duration of diets containing 20% DDGS. In conclusion, feeding diets containing 20% DDGS to laying hens has no adverse effects on productive performance. Increasing the feeding duration of diets containing 20% DDGS improves egg yolk coloration with a concomitant increase in lutein and zeaxanthin concentrations of egg yolks in laying hens.

Epidemiology of invasive fungal diseases among patients with haematological disorders in the Asia-Pacific: a prospective observational study.

We conducted a 2-year multicentre prospective observational study to determine the epidemiology of and mortality associated with invasive fungal diseases (IFDs) among patients with haematological disorders in Asia. Eleven institutions from 8 countries/regions participated, with 412 subjects (28.2% possible, 38.3% probable and 33.5% proven IFDs) recruited. The epidemiology of IFDs in participating institutions was similar to Western centres, with Aspergillus spp. (65.9%) or Candida spp. (26.7%) causing the majority of probable and proven IFDs. The overall 30-day mortality was 22.1%. Progressive haematological disorder (odds ratio [OR] 5.192), invasive candidiasis (OR 3.679), and chronic renal disease (OR 6.677) were independently associated with mortality.

Tuberculosis before hematopoietic stem cell transplantation in patients with hematologic diseases: report of a single-center experience.

BACKGROUND: Few reports discuss the optimal management of patients diagnosed with tuberculosis (TB) before scheduled stem cell transplantation (SCT), who then proceed with transplantation. METHODS: We found 13 patients with TB before SCT (proven, n = 9; probable, n = 3; possible, n = 1) in the medical records of our institution. RESULTS: Most of the patients had pulmonary TB (n = 8; disseminated, n = 2; extrapulmonary, n = 3). Eight of 9 patients with proven disease had SCT after at least 100 days of anti-tuberculous medication, ranging from 103 to 450 days. None of those patients suffered TB-related events after SCT. However, 1 patient with proven pulmonary TB who underwent SCT after only 40 days of anti-tuberculous therapy subsequently died of TB meningitis. Patients with possible and probable disease had their transplants after 6-176 days of anti-tuberculous medication, and all were alive at the time of analysis. The entire duration of anti-tuberculous medication was 12 months in most cases. With a follow-up duration ranging from 0.7 to 87.5 months, 4 patients died, but TB was the cause of death in only 1 case. CONCLUSION: In conclusion, for proven cases of TB, SCT after >100 days of anti-tuberculous medication is probably feasible and safe, in terms of TB control, in patients with various hematologic diseases.

Randomized clinical trial of the effect of gum chewing on postoperative ileus and inflammation in colorectal surgery.

BACKGROUND: Postoperative ileus (POI) is a common complication following colorectal surgery that delays recovery and increases length of hospital stay. Gum chewing may reduce POI and therefore enhance recovery after surgery. The aim of the study was to evaluate the effect of gum chewing on POI, length of hospital stay and inflammatory parameters. METHODS: Patients undergoing elective colorectal surgery in one of two centres were randomized to either chewing gum or a dermal patch (control). Chewing gum was started before surgery and stopped when oral intake was resumed. Primary endpoints were POI and length of stay. Secondary endpoints were systemic and local inflammation, and surgical complications. Gastric emptying was measured by ultrasonography. Soluble tumour necrosis factor receptor 1 (TNFRSF1A) and interleukin (IL) 8 levels were measured by enzyme-linked immunosorbent assay. RESULTS: Between May 2009 and September 2012, 120 patients were randomized to chewing gum (58) or dermal patch (control group; 62). Mean(s.d.) length of hospital stay was shorter in the chewing gum group than in controls, but this difference was not significant: 9·5(4·9) versus 14·0(14·5) days respectively. Some 14 (27 per cent) of 52 analysed patients allocated to chewing gum developed POI compared with 29 (48 per cent) of 60 patients in the control group (P = 0·020). More patients in the chewing gum group first defaecated within 4 days of surgery (85 versus 57 per cent; P = 0·006) and passed first flatus within 48 h (65 versus 50 per cent; P = 0·044). The decrease in antral area measured by ultrasonography following a standard meal was significantly greater among patients who chewed gum: median 25 (range -36 to 54) per cent compared with 10 (range -152 to 54) per cent in controls (P = 0·004). Levels of IL-8 (133 versus 288 pg/ml; P = 0·045) and TNFRSF1A (0·74 versus 0·92 ng/ml; P = 0·043) were lower among patients in the chewing gum group. Fewer patients in this group developed a grade IIIb complication (2 of 58 versus 10 of 62; P = 0·031). CONCLUSION: Gum chewing is a safe and simple treatment to reduce POI, and is associated with a reduction in systemic inflammatory markers and complications. REGISTRATION NUMBER: NTR2867 (http://www.trialregister.nl).

Hibicuslide C-induced cell death in Candida albicans involves apoptosis mechanism.

AIM: To provide the observation that hibicuslide C-induced cell death in yeast Candida albicans involves apoptosis mechanism. METHODS AND RESULTS: Hibicuslide C was isolated from Abutilon theophrasti by column chromatography. In reactive oxygen species (ROS) assay, C. albicans treated with hibicuslide C showed increase in ROS, and its accumulation induced fungal cell death. In particular, hydroxyl radicals were a large part of the ROS. Mitochondrial dysfunction including mitochondrial depolarization and release of cytochrome c, which is a pro-apoptotic factor, was detected by JC-1 assay and Western blot. CaspACE FITC-VAD-FMK staining using caspase inhibitor showed metacaspase activation. Also, the increase in intracellular Ca(2+), which is a signal molecule of apoptosis, was detected by Fura-2AM and Rhod-2AM assays. Finally, annexin V-FITC and PI double staining and TUNEL assay confirmed that hibicuslide C induces early apoptosis followed by secondary necrosis in C. albicans. CONCLUSIONS: Hibicuslide C exerts antifungal activity against C. albicans through new mechanism inducing apoptosis. SIGNIFICANCE AND IMPACT OF THE STUDY: Candida albicans is the common cause of nosocomial infections with high mortality. Our findings provide that hibicuslide C can be a model molecule that induces apoptosis in C. albicans.

Identification of a novel antimicrobial peptide, scolopendin 1, derived from centipede Scolopendra subspinipes mutilans and its antifungal mechanism.

In this study, a novel antimicrobial peptide, scolopendin 1, was identified from adult centipedes, Scolopendra subspinipes mutilans using RNA sequencing. Scolopendin 1 exerted an antimicrobial activity without inducing haemolysis of human erythrocytes. In order to understand the antifungal mechanism, a reactive oxygen species (ROS) assay was performed, which indicated that scolopendin 1 induced ROS accumulation in Candida albicans. Evaluation of fungal viability using N-acetyl cysteine, a ROS scavenger, suggested that ROS are a major factor in scolopendin 1-induced fungal cell death. Co-staining of annexin V-fluorescein isothiocyanate (FITC) and propidium iodide, and TUNEL and 4',6-diamidino-2-phenylindole (DAPI) assays confirmed that ROS-induced fungal cell death is associated with apoptosis. To further investigate the mechanism that facilitates the progression of apoptosis, changes in intracellular Ca(2+) concentration and mitochondrial dysfunction were examined. Ca(2+) , a signalling molecule in the apoptotic pathway, was increased in the cytosol and mitochondria, and ROS accumulation triggered mitochondrial depolarization and the release of cytochrome c, a pro-apoptotic factor, from the mitochondria to the cytosol. Finally, the released cytochrome c activated intracellular caspase. The present study suggests that scolopendin 1 could emerge as a model molecule that targets the apoptotic pathway and provides a novel remedy.

Stabilisation of the unstable fractured zygomatic arch with a ballooned foley catheter.

The zygomatic arch fracture is one of the most common facial bone fractures. Especially the isolated zygomatic arch fracture is usually repaired via Gillies' approach. But in the case of unstable zygomatic arch fracture, we need an additional step for stabilising the unstable zygomatic arch segment after repositioning the fractured segment. For the stabilising method we use the ballooned Foley catheter on the medial side of the zygomatic arch in the zygomaticotemporal fossa. This method is of assistance to the patient who has a zygomatic arch fracture with comminution or an old patient with weak and torn periosteum. In this study, we achieved a good result and we will introduce this simple method as one of alternatives of stabilising tool.

Idea on prevention from postoperative intraorbital hematoma in orbital surgery.

The retrobulbar hematoma is a rare complication after orbital surgery. Despite of its rareness, the retrobulbar hematoma may be disastrous to the patient's vision (Chen et al. in J Craniofac Surg 20:963--967, 2009). Since 2007, I have applied the combined use of a scalp vein set and a vacuumed blood sampling bottle in all of the orbital surgeries. In my study, I achieved a good result, and I will introduce this simple method as one of alternatives for the prevention from the postoperative intraorbital hematoma including the retrobulbar hematoma.

The outcome and efficacy of recanalization in patients with acute internal carotid artery occlusion.

BACKGROUND AND PURPOSE: Acute occlusion of the ICA is often associated with poor outcomes and severe neurologic deficits. This study was conducted to evaluate outcome of the occluded ICA and efficacy of recanalization under protective flow arrest. MATERIALS AND METHODS: Fifty consecutive patients who underwent endovascular treatment for acute ICA occlusion were identified from the prospectively collected data base. We assessed NIHSSo, occlusion type (cardioembolism vs atherosclerosis), occlusion level (supraclinoid-terminal, petrocavernous, or bulb-cervical), recanalization degree (TICI), and efficacy of recanalization (protective flow arrest vs nonprotection) leading to better outcome. RESULTS: Successful recanalization (TICI ≥ 2) was obtained in 90% of patients and good recovery (mRS ≤ 2) in 60% of patients. Good outcome was related to National Institutes of Health Stroke Scale score on admission (P < .001), TICI (P < .007), occlusion type (P = .022), and occlusion level (P = .038). Poor initial patient status, less recanalization, cardioembolism, and supraclinoid-terminal occlusion were associated with poor prognosis. Application of protective flow arrest led to better outcome in the distal ICA segment than in the bulb-cervical segment. CONCLUSIONS: In addition to the initial patient status and successful recanalization, the occlusion level or type of the occluded ICA could affect clinical outcome. In this study, treatment benefits of protective flow arrest were accentuated in patients with ICA occlusion above the bulb-cervical segment.

Recanalization of symptomatic vertebral ostial occlusion in patients with acute or subacute stroke.

SUMMARY: Vertebral artery recanalization in symptomatic stenosis/occlusion remains controversial, as no definite evidence exists regarding this topic. There are only a few reports regarding the feasibility and safety of recanalization in the first segment of the vertebral artery with atherosclerotic vertebral ostial occlusion. We report our experience treating first segment occlusion in 8 patients and present a balloon protection technique used to reduce the thromboembolic burden during the stent placement procedure. The outcome at 3 months showed an mRS ≤2 except for a patient with a poor initial status with basilar artery occlusion. Revascularization of a rather long first segment occlusion is technically feasible and can be safely performed by use of embolic protection methods.

Acute bleeding in the head and neck: angiographic findings and endovascular management.

BACKGROUND AND PURPOSE: Life-threatening bleeding in the head and neck requires urgent management. This study evaluated the angiographic findings related to head and neck bleeding and presents endovascular management techniques. MATERIAL AND METHODS: Sixty-one consecutive patients who presented with acute bleeding in the head and neck areas and subsequently underwent endovascular therapy between January 2002 and October 2012 were included in our study. We evaluated the angiographic findings, techniques, and results of endovascular management. RESULTS: Contrast leakage (n = 10), pseudoaneurysm (n = 20), or both (n = 10) were the most common life-threatening angiographic findings (66%) and were the foci of immediate embolization or endoluminal vessel reconstruction. Seventeen patients (28%) had hypervascular staining of the tumor or mucosa, and 4 patients (6%) did not have any abnormal findings. The acute bleeding was successfully controlled by endovascular management according to the bleeding foci. Carotid arterial lesions, so-called "carotid blowout," required reconstructive or deconstructive therapy. Bleeding of the external carotid artery required specific branch embolization by a combination of various embolic materials. No procedure-related complications occurred except in 1 patient who experienced acute infarction caused by thromboemboli from the covered stent. Seventeen patients (28%) were retreated due to rebleeding after the mean 20-month follow-up. CONCLUSIONS: Contrast leakage or a pseudoaneurysm or both seen on angiography are active bleeding foci and targets for therapy in patients with acute bleeding in the head and neck area. Despite different bleeding-control strategies according to vessel involvement, endovascular treatment is safe and effective for controlling hemorrhage.

Effect of laser-induced temperature field on the characteristics of laser-sintered silver nanoparticle ink.

Laser sintering of metal nanoparticles is a key technology for high-performance printed electronics fabricated on heat-sensitive substrates such as glass or plastic. Although laser-sintered electronic devices have been successfully fabricated, the role of the induced temperature field in the laser sintering process has not been reported thus far. In this work, the effect of temperature on the laser sintering process is described for the first time using a two-dimensional transient heat conduction equation for inkjet-printed silver nanoparticle ink. The in situ electrical resistance was measured to estimate the transient thermal conductivity and hence the temperature of the sintered ink during the laser sintering process. To verify the estimated laser sintering temperature, the morphology of furnace-sintered silver nanoparticle ink was compared with that of laser-sintered ink. The electrical characteristics and surface morphology of laser-sintered ink are found to be related to the process temperature.

Clinical characteristics and antibiotic susceptibility of viridans streptococcal bacteremia in children with febrile neutropenia.

PURPOSE: This retrospective study was performed in order to investigate the clinical characteristics and antibiotic susceptibility of viridans streptococcal bacteremia (VSB) in febrile neutropenic children in the context of the increase in incidence and antibiotic resistance of VSB. METHODS: We conducted this study among neutropenic children with underlying hematology/oncology diseases who were diagnosed with VSB at a single institution from April 2009 to June 2012. Clinical and laboratory characteristics of the children as well as antibiotic susceptibility of the causative viridans streptococci were evaluated. RESULTS: Fifty-seven episodes of VSB were diagnosed in 50 children. Severe complications occurred in four children (7.0%), and a death of one child (1.8%) was attributable to VSB. Acute myeloid leukemia was the most common underlying disease (70.2% of all cases), and 71.9% of all cases received chemotherapy including high-dose cytarabine. VSB occurred at a median of 13 days (range 8-21 days) after the beginning of chemotherapy, and fever lasted for a median of 4 days (range 1-21 days). The C-reactive protein level significantly increased within a week after the occurrence of VSB (p < 0.001) and the maximum C-reactive protein level showed a positive correlation with fever duration (r = 0.362, p = 0.007). Second blood cultures were done before the use of glycopeptides in 33 children, and negative results were observed in 30 children (90.9%). Susceptibilities to cefotaxime, cefepime, and vancomycin were 58.9, 69.1, and 100%, respectively. CONCLUSIONS: Severe complications of VSB in neutropenic febrile children were rare. We suggest glycopeptide use according to the results of blood culture and antibiotic susceptibility tests based on the susceptibility to cefepime and the microbiologic response to empirical antibiotic treatment not including glycopeptides in this study.