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Deep Neck Abscesses in Children and Adolescents: 10 Year Experience in Two General Hospitals (소아청소년에서의 심경부 농양에 대한 임상적 고찰: 두 기관에서 도출된 10년간의 경험)

  • Kim, Eunhee;Jeon, Ju Hee;Lee, Won Uk;Kim, So Young;Kim, Eun Ryoung
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.163-172
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    • 2011
  • Purpose : The purpose of this study was to review our recent experiences with deep neck abscesses in children and adolescents and to provide helpful information in treatment and diagnosis by comparing them with those in other available literatures. Methods : Medical records of 36 children and adolescents admitted for deep neck abscess at two hospitals from January 2000 to October 2010 were reviewed retrospectively. Results : Male to female ratio was 1.4 : 1 and the mean age was 6.5 years. Painful neck swelling and fever were the most frequent symptoms in patients under thirteen years of age whereas trismus and headache were frequent symptoms in patients over fourteen years of age. Submandibular space was the most common site of deep neck abscess in patients under thirteen years of age, whereas peritonsillar space was the most common site in patients over fourteen years of age. The results of bacterial cultures were positive in 61.5% of drained cases. Staphylococcus aureus was the most commonly identified bacteria in 6 patients (37.5%) and 5 of them were under 2 years of age. Twenty six patients received surgical drainage while the others were treated with antibiotics only. There were no statistically significant differences in the durations of admission, fever after admission, and antibiotic treatment between surgical and medical treatment groups. Conclusion : The common sites of deep neck abscess, associated symptoms, and causative organisms were different between children and adolescents. As there were no differences in durations of admission, fever, or antibiotics treatments between surgical and medical treatment groups, surgical drainage may be avoided by early recognition and suspicion. However, if there is no improvement of symptoms or size of abscesses within 48-72 hours of antibiotic treatment, surgical drainage should be considered.

Clinical Characteristics and Epidemiology of Nonpolioenteroviral infections, including Enteroviruis 71 in Children in Jeju-do, Korea between April and June 2000 (제주도 소아에서 2000년 4월부터 6월까지 발생한 장 바이러스 감염의 임상 양상 및 장 바이러스 71형 감염의 특징)

  • Yun, Sohee;Kim, Eui-Chong;Hong, Jung Yun
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.73-79
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    • 2009
  • Purpose : We undertook this study to improve our understanding of the epidemiologic and clinical features of nonpolioenterovirus (NPEV) infections, especially enterovirus 71 (EV71) infections, in Korean children. Methods : Between April and June 2000, NPEVs were detected by RT-PCR and cultures of specimens obtained from patients with aseptic meningitis, acute respiratory disease, and acute gastroenteritis which were associated with enteroviral exanthem and vesicular pharyngeal enanthem, such as herpangina, and hand, foot, and mouth disease (HFMD). EV71 was identified by sequencing the VP1 gene. The clinical and epidemiologic data were analyzed retrospectively after all 87 NPEV-positive patients were divided into 4 groups, according to the clinical manifestations. Sixteen patients who mainly had symptoms of acute gastroenteritis were in group A, 21 patients with symptoms and signs of lower respiratory tract infections were in group B, 42 patients with a HFMD rash only were in group C with or without fever, and 8 patients with aseptic meningitis or paralysis were in group D. For the 11 EV71-positive patients, 1 was in group A, 2 were group B, 7 were in group C, and 1 was in group D. Results : There were 87 NPEV infections, including 11 EV71 infections. The mean age of the patients was 2 years and 11 months, ranging from 1 day to 15 years. There were no fatal cases among a total of 87 NPEV infections and no significant differences in clinical severity between the EV71 and other NPEV infections. Conclusion : NPEV infections in children were common during the 3 months in the spring of 2000. Unlike in southeast Asia, where fatal EV71 infection outbreaks have occurred since 1997, the clinical features of EV71 infection in Korean children are mild.

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Clinical Presentations and Causative Organisms in Children and Adolescents with Osteoarticular Infections: A Retrospective Study (소아청소년기에 발생한 골관절염의 임상 양상 및 원인균에 대한 고찰)

  • Lee, Soyoung;Kim, Han Wool;Cho, Hye-Kyung;Yun, Yoe Hon;Ryu, Kyung Ha;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.154-163
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    • 2015
  • Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.

Serotype Distribution of Invasive Group B Streptococcal Diseases in Infants at Two University Hospitals in Korea (영아에서의 침습 B군 사슬알균 감염증 및 혈청형 분석: 2개 대학병원 연구)

  • Cho, Hye-Kyung;Nam, Hye Na;Cho, Hye Jung;Son, Dong Woo;Cho, Yong Kyun;Seo, Yiel-Hea;Kim, Yae-Jean;Eun, Byung Wook
    • Pediatric Infection and Vaccine
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    • v.24 no.2
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    • pp.79-86
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    • 2017
  • Purpose: This study was aimed at analyzing the serotypes of group B streptococcus (GBS) isolated from Korean infants with invasive disease and evaluating their association with disease manifestation. Methods: Data were retrospectively collected from invasive GBS infections at Gachon University Gil Medical Center from January 2006 to June 2012 and at Samsung Medical Center from April 2010 to November 2012. Serotypes were determined by slide agglutination test. Results: A total of 37 cases were identified, which included 22 full-term infants and 15 preterm infants. Fifteen cases (40.5%) were early-onset, 19 (51.4%) was late-onset, and three (8.1%) was very late-onset. Early-onset diseases among preterm infants were higher than those among full-term infants (60.0% [9/15] vs. 27.3% [6/22], P=0.17). The most common manifestation was bacteremia (70.3%), followed by meningitis and septic arthritis. Among 24 isolates retrievable for serotyping, serotype III (41.7%) was most common, followed by V (16.7%), Ia, Ib, and II (12.5%, respectively), and non-typeable (4.2%). Serotype III was more common in isolates from full-term infants (10/22) than from preterm infants (0/15), whereas serotype V was more common in isolates from preterm infants (4/15) than from full-term infants (0/22) (P=0.002). No penicillin-resistant strain was detected, and resistance to erythromycin and clindamycin were both 64.9%. Conclusions: GBS is an important pathogen in both preterm and full-term infants, and serotype distribution of GBS causing invasive diseases can differ between preterm and full-term infants. It is necessary to monitor the nationwide epidemiology of GBS diseases, including in preterm infants, in order to prepare preventive measures without underestimating early-onset diseases.

Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults (건강한 한국 성인남성의 자가약물복용력에 따른 간기능 장애 발생여부 조사)

  • Bae, Jong-Myon;Park, Byung-Joo;Lee, Moo-Song;Kim, Dong-Hyun;Shin, Myung-Hee;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.801-814
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    • 1996
  • Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.

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Factors associated with Renal Scarring in Children with a First Episode of Febrile Urinary Tract Infection (소아의 첫 발열성 요로감염에서 신 반흔에 영향을 미치는 인자)

  • Jung Suk-Won;Jung Kyeong-Hun;Kim Myung-Hyun;Hong Young-Jin;Son, Byong-Kwan;Lee Ji-Eun
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.56-63
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    • 2005
  • Purpose : Development of renal scarring is associated with delayed diagnosis and treatment of urinary tract infection(UTI). This study was performed to clarify how soon treatment should be started to Inhibit renal scarring after onset of UTI and the factors associated with renal scarring in children with a first episode of febrile UTI. Methods : We retrospectively reviewed 163 patients with a first episode of febrile UTI under the age of 2 years from April 2000 to Ap,il 2004. All patients had a DMSA renal scan and voiding cystourethrogram done in the diagnostic period, 6 months after which a follow-up renal scan was done. After patients wet-e divided into 2 groups according to the duration of fever prior to start of treatment, the duration of fever after start of treatment, and total duration of fever, initial and follow-up DMSA scan findings were analyzed among the different groups. We compared the factors associated with renal scars between the groups with and without renal scars. Results : The initial DMSA renal scan identified abnormal finding in 23% of the patients who were treated $\leq$24 hr from the onset of disease and in 43% of those with fever more than 24 hr. Renal scars developed in 33% of patients who were treated $\leq$24 hr and 38% of those with fever >24 hr prior to treatment. Renal scars developed in 34% of patients with remission of fever $\leq$48 hr after treatment and ill 50% of those with fever >48 hr after treatment. The risk for renal scars was significantly higher in children who had total duration of feyer >72 hr(67%) than in those with shorter duration(19%). In children with renal scars, VUR was most highly associated with an increased risk of renal scar formation. Conclusion : Although children with a first episode of febrile UTI are treated within 24 hr after onset of the fever, renal damage cannot be prevented completely and it is mainly associated with VUR. (J Korean Soc Pediatr Nephrol 2005;9:56-63)

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7-Ketocholesterol Induces Vascular Smooth Muscle Cell Apoptosis via Akt Degradation (7-Ketocholesterol에 의한 Akt 감소와 혈관평활근세포의 세포자멸사)

  • Seo, Kyo Won;Kim, Chi Dae;Lee, Won Suk
    • Journal of Life Science
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    • v.26 no.2
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    • pp.226-233
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    • 2016
  • Vascular smooth muscle cell (VSMC) apoptosis has been identified in various vascular diseases, including atherosclerosis and restenosis after angioplasty, and has been known to precipitate atherosclerotic plaque instability and rupture. Oxysterols are known as inducers of apoptosis in VSMC, and 7-ketocholesterol (7KC) is the major nonenzymically formed oxysterol in atherosclerotic lesions. The precise mechanism underlying VSMC apoptosis is still poorly understood. In this study, we investigated whether 7KC causes apoptosis, and characterized its apoptotic mechanisms in primary cultured rat aortic VSMC. Cell viability was assessed by MTT assay and trypan blue assay. Apoptosis was assessed by flow cytometry, immunofluorescence, immunoprecipitation, and Western blot analyses. 7KC markedly decreased the VSMC viability in a time- and concentration-dependent manner, and increased the production of 4-hydroxynonenal (HNE), a major end-product of lipid peroxidation, which also decreased the VSMC viability. Pretreatment with 2,4-dinitrophenylhydrazine, a well-known reagent of lipid peroxidation-derived aldehydes, significantly restored the 7KC-decreased viability of VSMC. Furthermore, HNE, as well as 7KC, reduced the level of total Akt, a major mediator of cell survival. The 7KC-decreased level of total Akt was significantly restored by pretreatments with 2,4-dinitrophenylhydrazine and N-acetylcysteine. Lactacystin, a proteasome inhibitor, protected VSMC against apoptosis and Akt degradation, but did not inhibit HNE production. In the immunoprecipitation assay, 7KC increased HNE-modified Akt. From the results, it seems that, in atherosclerotic lesions, 7KC induces HNE production in VSMC, and this HNE binds to Akt, proceeding to proteasomal degradation of Akt, through which mechanism the atherosclerotic plaque instability may be facilitated.

Isolation and Identification of Fatty Acid and Volatile Compounds from Tuna Fish Oil with Supercritical Carbon Dioxide (초임계 이산화탄소를 이용한 참치안구유로부터 지방산 및 휘발성 성분의 분리 동정)

  • Roh, Hyung-Seob;Youn, Hyun-Seok;Park, Ji-Yeon;Sin, Sang-Kyu;Lee, Min-Kyung;Back, Sung-Sin;Chun, Byung-Soo
    • Journal of Marine Bioscience and Biotechnology
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    • v.1 no.2
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    • pp.105-118
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    • 2006
  • Isolation and Identification of fatty acid and volatile compounds in tuna fish oil were successfully carried out using supercritical carbon dioxide. Samples of the oil were extracted in a 56 ml semi-batch stainless steel vessel under conditions which ranged from 80 to 200 bar and 40 to $60^{\circ}C$ with carbon dioxide flows from 10 ml/min. Volatiles in the oil extracted from the samples with supercritical carbon dioxide were analyzed by gas chromatography, mass detector with canister system. The extracts were contained with various fatty acids, 57.0% of unsaturated fatty acids such as docosahexaenoic acid(DHA) and eicosapentaenoic acid(EPA), and 43.0% of saturated fatty acids. The aroma compounds in the oil showed over 129 peaks, of which 100 compounds were identified. Volatile components included 2,4-hepatadienal(fishy), dimethyldisulfide (unpleasant), dimethyltrisulfide (unpleasant) and 2-nonenal(fatty). The isolation efficiency of the volatile compounds from the samples was 99.4% at $50^{\circ}C$ and 200 bar.

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Expression of Yippee-Like 5 (YPEL5) Gene During Activation of Human Peripheral T Lymphocytes by Immobilized Anti-CD3 (인체 말초혈액의 활성화 과정 중 yippee-like 5 (YPEL5) 유전자의 발현 양상)

  • Jun, Do-Youn;Park, Hye-Won;Kim, Young-Ho
    • Journal of Life Science
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    • v.17 no.12
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    • pp.1641-1648
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    • 2007
  • Yippee-like proteins, which have been identified as the homolog of Drosophila yippee protein containing a zinc-finger domain, are known to be highly conserved among eukaryotes. However, their functional roles are still poorly understood. Recently we initiated ordered differential display (ODD)-polymerase chain reaction (PCR) to isolate genes of which expressions are altered following activation of human T cells. On the ODD-PCR image, one PCR-product detected in unstimulated T cells was not detectable at the time when the activated T cells traversed near $G_1/S$ boundary following activation by immobilized anti-CD3. Cloning and nucleotide sequence analysis revealed that the PCR-product was yippee-like 5 (YPEL5) gene, which was known as a human homolog of the Drosophila yippee gene. Northern blot analysis confirmed the amount of ${\sim}2.2$ kb YPEL5 mRNA expression detectable in unstimulated T cells was sustained until 1.5 hr after activation and then rapidly declined to undetectable level by 5 hr. Ectopic expression of YPEL5 gene in human cervix epitheloid carcinoma HeLa cells caused a significant reduction in cell proliferation to the level of 47% of the control. Expression of GFP-YPEL5 fusion protein in HeLa cells showed its nuclear localization. These results demonstrated that the expression level of human YPEL5 mRNA was negatively regulated in the early stage of T cell activation, and suggested that YPEL5 might exert an inhibitory effect on the cell proliferation as a nuclear protein.

Volatile Flavor Compounds in Commercial Vinegar Beverages Derived from Fruits (과일유래 시판 식초음료류의 휘발성 향기성분)

  • Jeong, Eun-Jeong;Jeon, Seon-Young;Baek, Jeong-Hwa;Cha, Yong-Jun
    • Journal of Life Science
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    • v.21 no.2
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    • pp.292-299
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    • 2011
  • This study compared volatile flavor profiles of 4 commercial vinegar beverages (Italian vinegar beverage (IVB), Japanese vinegar beverage (JVB), Japanese Yuzu-Ponz (JYP), and Korean white wine vinegar beverage (KWVB)). Flavor components of vinegar beverages (VBs) were determined using SPME/GC/MSD. The profiles of VBs were as follows; IVB (11 acids, 17 esters, 10 alcohols, 8 aldehydes, 3 terpenes, 4 aromatic hydrocarbons, 9 ketones), JVB (7 acids, 8 esters, 9 alcohols, 7 aldehydes, 13 terpenes, 7 aromatic hydrocarbons, 1 ketones, 3 miscellaneous compounds), JYP (3 acids, 12 esters, 8 alcohols, 7 aldehydes, 63 terpenes, 6 aromatic hydrocarbons, 2 ketones, 5 miscellaneous compounds), KWVB (10 acids, 10 esters, 9 alcohols, 8 aldehydes, 2 terpenes, 5 aromatic hydrocarbons, 4 ketones, 2 miscellaneous compounds). IVB and JVB showed similar flavor compositions (acids, ketones and esters in particular), whereas major components in JYP and KWVB were terpenes (79.6%) and acids (81.0%), respectively. Five compounds including 2-phenylethyl acetate (floral, fruity, sweet odor), 2-phenylethanol (floral, rose odor), vitispirane (fruity odor), geranylacetone (fragrant odor) and acetic acid were identified as major components in balsamic vinegar beverages.