• The Journal of Pediatrics of Korean Medicine
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• v.14 no.1
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• pp.9-38
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• 2000

It has been widely said in Korea that early administrations of Cervi cornu parvum (deer antler) to febrile infants affect brain functions. Traditional Oriental Medicine states that the head is easily affected by fever and only an excess of heat causes headaches. Traditional Oriental Medicine also states that Cervi cornu parvum cannot be used in febrile conditions. With the aim of investigating different febrile response to LPS, experiments using intravenous injection of LPS have been carried out on Cervi comu parvum(CCP) and Soahbohyul - tang combined with Cervi comu parvum(SB-CCP) administered rabbits. Experiments were also conducted to evaluate the effects of early administration of CCP on learning and memory in 3 week old rats with LPS fever. These were evaluated by using the Morris water maze and the radial arm maze. Changes in body weight were also observed during this period. The results of these experiments are as follows. 1. In the experiments with febrile rabbits, the CCP and SB-CCP administered group showed statistically significant reductions of fever (p<0.05). 2. In the experiments with febrile rabbits, CCP and SB-CCP administered rabbits resulted in the tendency of lower body temperatures and shorter fever periods than the control group. 3. There were no differences of mean body weight and fever patterns among the 4 groups in the experiments on young rats with LPS fever. 4. There was no statistical difference of mean response latencies among the rats in Group I (DDW administered), GroupIII (CCP administered), and groupIV (SB-CCP administered) in the Morris water maze. However, Group Ⅱ (the scopolamine administered group) showed delayed latencies on the second day of the first session (p<0.05), and the second and third day of the second session (p< 0.05). 5. There were no statistical differences of mean response latencies among the rats in Group I, III and Ⅳ in the radial arm maze, but Group Ⅱ showed delayed latencies on the first and third day of the first session (p<0.05). 6. There was no influence from the administration of CCP and SB-CCP on the general behavior of the rats in Irwin´s test. These results suggest that Cervi cornu parvum and Soahbohyul - tang combined with Cervi comu parvum have anti-pyretic actions on LPS fever. The results also suggest that these drugs have no influence on learning and memory in young rats with LPS fever in the Morris water maze and the radial arm maze.

• Journal of IKEEE
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• v.25 no.3
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• pp.430-436
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• 2021

The non-contact body temperature measurement system is one of the key factors, which is manage febrile diseases in mass facilities using optical and thermal imaging cameras. Conventional systems can only be used for simple body temperature measurement in the face area, because it is used only a deep learning-based face detection algorithm. So, there is a limit to detecting abnormal symptoms of the infants and young children, who have difficulty expressing their opinions. This paper proposes an improved facial expression recognition algorithm for detecting abnormal symptoms in infants and young children. The proposed method uses an object detection model to detect infants and young children in an image, then It acquires the coordinates of the eyes, nose, and mouth, which are key elements of facial expression recognition. Finally, facial expression recognition is performed by applying a selective sharpening filter based on the obtained coordinates. According to the experimental results, the proposed algorithm improved by 2.52%, 1.12%, and 2.29%, respectively, for the three expressions of neutral, happy, and sad in the UTK dataset.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.91-100
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• 2018

Purpose: This study investigated the factors affecting the use of empirical antibiotics in febrile infants from 1 month to less than 3 months. Methods: We retrospectively reviewed the medical records of hospitalized previously healthy infants with fever in Pusan National University Children's Hospital from January 2010 to December 2016. Clinical features, laboratory findings and antibiotic therapy were analyzed. Respiratory viruses were identified by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) and were reported after 1-3 days. Enterovirus were identified by real time polymerase chain reaction (PCR) and were reported in several hours. Results: The 129 of 366 subjects used empirical antibiotics and 237 patients didn't used empirical antibiotics. Empirical antibiotics were used more frequently when the fever was longer before admission, respiratory symptoms and ill being appearances were present and C-reactive protein was elevated. The rate of readmission was low in the group not used empirical antibiotics. Most of the patients detected by enterovirus PCR in cerebrospinal fluid didn't used empirical antibiotics. The results of respiratory virus multiplex RT-PCR showed no difference in the use of empirical antibiotics. Conclusions: In our study, empirical antibiotic prescriptions were affected not respiratory virus multiplex RT-PCR but enterovirus PCR. If multiplex RT-PCR were reported more rapid turn around time, it will affect antibiotic use.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.58-63
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• 2018

Purpose: We observed an association between obesity and UTI in infants and pediatric patients, which we aimed to validate in this study. Method: The medical records of 740 patients (${\leq}24$ months old) hospitalized with fever were retrospectively analyzed. The patients were subdivided into 2 groups, namely, the UTI and control (non UTI) groups. We analyzed the patient's height, weight. Obesity was defined as weight-for-length ${\geq}95^{th}$ percentile, and the association between obesity and UTI was evaluated. Results: Out of 740 patients, 253 and 487 patients were in the UTI group and the control group, respectively. A comparative analysis, based on 3 age groups (0-5 months, 6-11 months, and 12-24 months) showed higher proportion of obesity in the UTI group (26.4%) than in the control group (13.0%) in the 0-5months group. After adjusting for age and gender in the 0-5month group, the obesity group was 3.76 times likely to have an UTI (95% CI 1.419-9.98). Conclusion: Obesity and UTI show strong association, especially in infants aged 0-5 months. Febrile obese infant patients (${\leq}5$ months old) visiting medical centers should be advised urine tests for potential UTI.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.74-82
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• 2010

Purpose : The Dipslide culture test is a rapid method for diagnosis of urinary tract infection (UTI). The aim of this study is to determine the diagnostic availability of a urine Dipslide test for evaluation of UTI in febrile children. Methods : Urine specimens from 151 febrile infants were inoculated by a routine blood agar urine culture method and the Dipslide test at the same time. Following incubation for 16-24 hours, the results of the Dipslide test were read at the next visit. Both results of Dipslide and those of routine culture were compared. Results : The mean age of subjects was 15${\pm}$10.6 months. There were 150 infants (99.3%) who had fever with a mean duration of 2.6${\pm}$2.6 days. Thirty two infants (21.2%) were diagnosed as having UTI. Sensitivity and specificity of Uricult Trio CLED medium were 59.4% and 84.8%, respectively. Sensitivity and specificity of Uricult Trio E. coli medium were 60.0% and 96.2%, respectively. The Pearson correlation coefficient between results of Uricult Trio CLED medium and urine culture was 0.438 (P=0.01). Correlation between results of Uricult Trio E. coli medium and urine culture was 0.617 (P=0.01). Conclusion : The Dipslide test requires only 16-24 hours with high specificity in terms of UTI caused by E. coli without the problems associated with specimen delay. This test seems to be helpful for exclusion of UTI in febrile infants and it may reduce unnecessary hospitalization and antibiotic use. However, further studies are required before the product can be recommended as a routine diagnostic tool.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.54-59
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• 2017

Purpose: Urinary tract infection (UTI) is the most common serious bacterial infection in infants younger than 3 months of age. Lumbar puncture is routinely performed to evaluate febrile young infants for sepsis. However, there is no clear consensus on the use of routine lumbar puncture to diagnose concomitant meningitis in infants with UTI. We evaluated the prevalence of coexisting bacterial meningitis and sterile cerebrospinal fluid (CSF) pleocytosis in young infants with UTI. Methods: We retrospectively reviewed the medical records of 85 infants with UTI, aged from 29 to 99 days, who were admitted to Daegu Catholic University Medical Center from January 2013 to May 2016. We included 80 patients who had undergone lumbar puncture. Demographic features, clinical features, and laboratory findings were analyzed. Patients were divided into two groups based on the presence of sterile CSF pleocytosis and we compared these groups and assessed the differences between them. Results: Of the 80 UTI patients enrolled, 34 (43%) had sterile CSF pleocytosis. None had bacterial meningitis, and CSF polymerase chain reaction for enterovirus was positive in two patients without CSF pleocytosis. There were no significant differences between the two groups with regards to age, body temperature, peripheral white blood cell count, urinalysis, and duration of hospital stay. Conclusions: Though sterile CSF pleocytosis is common in young UTI patients, coexisting bacterial or viral meningitis is very rare. Indications for lumbar puncture in these patients depend on clinical condition.

• Neonatal Medicine
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• v.15 no.1
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• pp.61-66
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• 2008

Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

• Pediatric Infection and Vaccine
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• v.30 no.2
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• pp.84-90
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• 2023

Purpose: Infants aged ≤90 days with fever are susceptible to severe infections. This study aimed to analyze the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this particular age group. Methods: Infants aged ≤90 days who were diagnosed with coronavirus disease 2019 (COVID-19) and hospitalized between March 1, 2020, and May 1, 2022 were included. Medical records of patients were retrospectively reviewed. Results: A total of 105 infants with COVID-19 were included; 27 (25.7%) neonates aged <28 days, and 48 (45.7%) and 30 (28.6%) infants aged 28-59 days and 60-90 days, respectively. Five (4.7%) patients remained asymptomatic and 68 (62.8%) were febrile, with a median fever duration of 2 days. The most common symptoms were respiratory including cough (66.6%), nasal stuffiness (51.4%), and rhinorrhea (40.9%). Blood cultures were performed in 10 infants but no organisms were detected. Cultures of bag-collected urine specimens from 8 infants were grown, resulting in positive growth for 2 without pyuria. Nine (8.6%) infants were treated with empirical antibiotics for a median duration of 2.3 days (range, 1-7 days). All 105 infants showed improvement without any complications, and there were no fatal cases. Conclusions: In this study, most infants aged ≤90 days with COVID-19 presented with mild symptoms and none of those evaluated had documented bacterial co-infection. The favorable prognosis among young infants with SARS-CoV-2 may aid clinicians in tailoring their approach to evaluation and management during outbreaks.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.92-100
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• 2021

Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire^® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire^® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert^® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at -70℃ until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire^® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire^® ME panel testing. Conclusions: Compared with the currently available etiologic tests for CNS infection, BioFire^® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire^® ME panel testing in children must be evaluated for its wider application.

• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.207-209
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• 2003

Kawasaki disease is an acute febrile vasculitis affecting primarily infants and young children. In addition to the cardiovascular involvement, it may cause inflammatory changes in various organs and body systems : digestive, respiratory, urinary, nervous and musculoskeletal. A case is reported of atypical Kawasaki disease associated with acute renal failure and necrotizing myositis in the right gastrocnemius in a 10-year-old boy. In older children, uncommon age of onset and additional features less commonly associated with Kawasaki disease may contribute to a delayed diagnosis.