BACKGROUND: We aimed to examine the effects of an experiential learning activities-focused smoking prevention (ELSP) program on the basis of the Attitude-Social Influence-Efficacy (ASE) model in elementary school students. METHODS: A non-equivalent control group pre-test and post-test design was conducted with 84 participants who were in the fifth grade of two elementary schools in Seongnam city, South Korea. The two schools were allocated into either the ELSP (n=42) or control (n=42) group. The ELSP group completed five ELSP classes, while the control group completed five traditional lecture-based classes during the 5 weeks. Both groups were examined before and after 5 weeks, using ASE measures of smoking attitude, social influence, self-efficacy for the refusal of smoking temptation, and intention not to smoke. Data were collected from August to September 2017. RESULTS: The ELSP group had significant changes in the scores of smoking attitude (t=4.75, P<0.001) and social influences (t=3.73, P<0.001), compared to those in the control group. However, the ELSP group had non-significant changes in the scores of self-efficacy for the refusal of smoking temptation and intention not to smoke, compared to those in the control group. CONCLUSIONS: The ELSP program may be effective in improving smoking attitude and perceived social influence of smoking among those in upper grades of elementary schools. However, the duration and intensity of the ELSP program must be revised to effectively enhance smoking refusal self-efficacy and non-smoking intentions.
Gyeonggi-do ; Humans ; Intention ; Korea ; Peer Influence ; Problem-Based Learning ; Smoke ; Smoking

BACKGROUND: We aimed to examine the effects of an experiential learning activities-focused smoking prevention (ELSP) program on the basis of the Attitude-Social Influence-Efficacy (ASE) model in elementary school students. METHODS: A non-equivalent control group pre-test and post-test design was conducted with 84 participants who were in the fifth grade of two elementary schools in Seongnam city, South Korea. The two schools were allocated into either the ELSP (n=42) or control (n=42) group. The ELSP group completed five ELSP classes, while the control group completed five traditional lecture-based classes during the 5 weeks. Both groups were examined before and after 5 weeks, using ASE measures of smoking attitude, social influence, self-efficacy for the refusal of smoking temptation, and intention not to smoke. Data were collected from August to September 2017. RESULTS: The ELSP group had significant changes in the scores of smoking attitude (t=4.75, P<0.001) and social influences (t=3.73, P<0.001), compared to those in the control group. However, the ELSP group had non-significant changes in the scores of self-efficacy for the refusal of smoking temptation and intention not to smoke, compared to those in the control group. CONCLUSIONS The ELSP program may be effective in improving smoking attitude and perceived social influence of smoking among those in upper grades of elementary schools. However, the duration and intensity of the ELSP program must be revised to effectively enhance smoking refusal self-efficacy and non-smoking intentions.

Objective:To study the e ects of anthopleurin-Q(AP-Q) on potassium currents of ventricular myocytes in rats and guinea pig.Methods:The ventricular cells of guinea pigs and S.D.rats were obtained by enzymatic method.Whole cell patch clamp technique was used to record potassium currents,including transient outward potassium currents(Ito),delayed recti er potassium current(IK) and inward recti er potassium current(IK1).Results:AP-Q 3-100 nmol/L blocked Ito in a concentration-dependent manner with an EC50 value of 10.5 nmol/L.With +50 mV depolarized pulse and 10nmol/LAP-Q,the Ito increased from(13.3?3.4)pA/pFto(19.46?4.3)pA/pF.AP-Q 0.1-100 nmol/Lincreased IK and tail current(IK tail) in a concentration-dependent manner with EC50 value of 4.7 nmol/Land 5.0 nmol/L,respectively.AP-Q 1 pmol/L-100 nmol/Lincrease IK1 in a concentration-dependent manner with EC50 value of 0.2 nmol/L.Conclusion:Augmented e ect of AP-Q on Ito,IK and IK1 may partly explain its e ects of shortening APD and increasing absolute value of RP.

Purpose: 17β-Estradiol (E2) supplementation suppresses MC38 tumor growth by downregulating the expression of programmed death-ligand 1 (PD-L1). This study aims to figure out the gut microbiota that respond to anti–PD-L1 and/or estrogen treatment in MC38 colon cancer model. Materials and Methods: A syngeneic colon tumor model was developed by injection of MC38 cells into C57BL/6 background male and female mice. Three days before MC38 cells injection, E2 was supplemented to male mice daily for 1 week. Male and female mice with MC38 tumors (50-100 mm3) were injected with anti–PD-L1 antibody. Fresh feces were collected 26 days after injection of MC38 cells and 16S rRNA metagenomics sequencing of DNA extracted from feces was used to assess gut microbial composition. Results: At the taxonomic family level, Muribaculaceae was enriched only in the MC38 male control group. In male mice, linear discriminant analysis effect size analysis at the species level revealed that the four microorganisms were commonly regulated in single and combination treatment with anti–PD-L1 and/or E2; a decrease in PAC001068_g_uc and PAC001070_s (family Muribaculaceae) and increase in PAC001716_s and PAC001785_s (family Ruminococcaceae). Interestingly, in the anti–PD-L1 plus E2 group, a decrease in opportunistic pathogens (Enterobacteriaceae group) and an increase in commensal bacteria (Lactobacillus murinus group and Parabacteroides goldsteinii) were observed. Furthermore, the abundance of Parabacteroides goldsteinii was increased in both males and females in the anti–PD-L1 group. Conclusion Our results suggest that gut microbial changes induced by the pretreatment of estrogen before anti–PD-L1 might contribute to treatment of MC38 colon cancer.

Human taeniasis is presumed to have almost disappeared from Korea. Recently, we incidentally detected a Taenia saginata infection in an 8-year-old boy undergoing lymphoma diagnosis. The patient had been suffering for 4 months from intensifying snoring and obstructive sleep apnea. A neck computed tomography scan revealed a nasopharyngeal mass, and malignant B-cell lymphoma was supported by punch biopsy. On day 6 of the lymphoma workup period, the patient experienced anal itching, and two proglottids were detected in his stool. The patient had experienced four or five similar episodes within the past 2 years. He self-reported a history of raw beef and fish consumption and no history of traveling abroad. Laboratory findings revealed mild eosinophilia (eosinophil count: 791/μL).Two proglottids exhibited movement and possessed more than 15 branched uterine structures. Long segments approximately 84 cm in length were expelled after praziquantel treatment. Sequencing of the cytochrome oxidase 1 gene confirmed T. saginata, ruling out related Taenia species. After treatment, no proglottids or ova were detected in his stool, and the patient finally started chemotherapy for lymphoma. This case highlights the importance of timely diagnosis of hidden taeniasis in low-frequency endemic regions.

Background: Haemophilus influenzae is a frequently encountered pathogen responsible for respiratory tract infections in children. Following the detection of ceftriaxone-resistant H. influenzae at our institution, we aimed to investigate the resistance mechanisms of ceftriaxone in H. influenzae, with a particular focus on alterations in penicillin-binding protein 3 (PBP3) and β-lactamase production. Methods: Among H. influenzae isolates collected at Asan Medical Center Children’s Hospital from March 2014 to April 2019, ceftriaxone-resistant strains by the disk-diffusion test were included. Ceftriaxone minimum inhibitory concentrations (MICs) were determined using the E-test according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The presence of β-lactamase was assessed through cefinase test and TEM-1/ROB-1 polymerase chain reaction (PCR). PBP3 alterations were explored via ftsI gene sequencing. Results: Out of the 68 collected strains, 21 exhibited resistance to ceftriaxone in disk diffusion tests. Two strains were excluded due to failed subculture. Among 19 ceftriaxoneresistant H. influenzae isolates, eighteen were non-typeable H. influenzae, and twelve were positive for TEM-1 PCR. Isolates were classified into groups II (harboring only N526K, n = 3), III (N526K+S385T, n = 2), III+ (S385T+L389F+N526K, n = 11), and III-like+ (S385T+L389F+R517H, n = 3) according to the PBP3 alteration pattern. With a median ceftriaxone MIC of 0.190 mg/L (range, 0.008–0.750), the median ceftriaxone MIC was the highest in group III-like+ (0.250 mg/L), followed by groups III+ (0.190 mg/L), III (0.158 mg/L), and II (0.012 mg/L). All three strains belonging to group II, which did not harbor the S385T substitution, had ceftriaxone MICs of ≤ 0.125 mg/L. Conclusion The emergence of ceftriaxone-resistant H. influenzae with ceftriaxone MIC values of up to 0.75 mg/L was observed even in children in South Korea, with most associated with S385T and L389F substitutions. The N526K mutation alone does not significantly impact ceftriaxone resistance. Further large-scale studies are essential to investigate changes in antibiotic resistance patterns and factors influencing antibiotic resistance in H. influenzae isolated from pediatric patients in Korea.

PURPOSE: The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD) by using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD. METHODS: RT-PCR assays were carried out to screen for the presence of respiratory syncytial virus A and B, adenovirus, rhinovirus, parainfluenza viruses 1 to 4, influenza virus A and B, metapneumovirus, bocavirus, coronavirus OC43/229E and NL63, and enterovirus in nasopharyngeal secretions of 55 KD patients and 78 control subjects. RESULTS: Virus detection rates in KD patients and control subjects were 32.7% and 30.8%, respectively (P=0.811). However, there was no significant association between the presence of any of the 15 viruses and the incidence of KD. Comparisons between the 18 patients with positive RT-PCR results and the other 37 KD patients revealed no significant differences in terms of clinical findings (including the prevalence of incomplete presentation of the disease) and coronary artery diameter. CONCLUSION: A positive RT-PCR for currently epidemic respiratory viruses should not be used as an evidence against the diagnosis of KD. These viruses were not associated with the incomplete presentation of KD and coronary artery dilatation.
Adenoviridae ; Bocavirus ; Case-Control Studies ; Child ; Coronary Aneurysm ; Coronary Vessels ; Coronavirus ; Dilatation ; Enterovirus ; Humans ; Incidence ; Metapneumovirus ; Mucocutaneous Lymph Node Syndrome ; Orthomyxoviridae ; Paramyxoviridae Infections ; Prevalence ; Prospective Studies ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Viruses

Background: Ralstonia mannitolilytica is a causative organism of nosocomial infections, particularly associated with contaminated water, and resistant to various antibiotics, including carbapenems. Several clusters of R. mannitolilytica infections appeared in children at our institute from August 2018 to November 2019. Methods: From March 2009 to March 2023, all patients admitted to Asan Medical Center Children’s Hospital in Seoul, Korea, with culture-confirmed R. mannitolilytica and corresponding clinical signs of infection were identified. Epidemiological and environmental investigations were conducted. Polymerase chain reaction (PCR) was performed for the genes of OXA-443 and OXA-444 on R. mannitolilytica isolates. Results: A total of 18 patients with R. mannitolilytica infection were included in this study, with 94.4% (17/18) and 5.6% (1/18) being diagnosed with pneumonia and central line-associated bloodstream infection, respectively. All-cause 30-day mortality rate was 61.1% (11/18), and seven of the fatal cases were caused by R. mannitolilytica infection itself. The resistance rates to meropenem and imipenem werew 94.4% (17/18) and 5.6% (1/18), respectively. Although four out of nine meropenem-resistant R.mannitolilytica isolates had positive PCR results for OXA-443 and OXA-444 genes, there were no significant differences in antimicrobial susceptibility patterns. Environmental sampling identified R. mannitolylica at two sites: a cold-water tap of a water purifier and an exhalation circuit of a patient mechanical ventilator.After implementing and improving adherence to infection control policies, no additional R. mannitolilyticainfection cases have been reported since December 2019. Conclusion R. mannitolilytica can cause life-threatening infections with high mortality in fragile pediatric populations. To prevent outbreaks, healthcare workers should be aware of R. mannitolilytica infections and strive to comply with infection control policies.

PURPOSE: Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. METHODS: Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. RESULTS: An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. CONCLUSION: We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.
Adenoviridae ; Adult ; Disease Outbreaks ; Diterpenes ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Keratoconjunctivitis ; Korea ; Polymerase Chain Reaction ; Viruses

Background: Coronavirus disease 2019 (COVID-19) outbreaks emerged at two universityaffiliated hospitals in Seoul (hospital A) and Uijeongbu City (hospital S) in the metropolitan Seoul area in March 2020. The aim of this study was to investigate epidemiological links between the outbreaks using whole genome sequencing (WGS) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Fifteen patients were enrolled in the study, including four non-outbreak (A1–A4) and three outbreak cases (A5–A7) in hospital A and eight cases (S1–S8) in hospital S. Patients' hospital stays, COVID-19 symptoms, and transfer history were reviewed. RNA samples were submitted for WGS and genome-wide single nucleotide variants and phylogenetic relationships were analyzed. Results: The index patient (A5) in hospital A was transferred from hospital S on 26 March.Patients A6 and A7 were the family caregiver and sister, respectively, of the patient who shared a room with A5 for 4 days. Prior to transfer, A5 was at the next bed to S8 in the emergency room on 25 March. Patient S6, a professional caregiver, took care of the patient in the room next to S8's room for 5 days until 22 March and then S5 for another 3 days.WGS revealed that SARS-CoV-2 in A2, A3, and A4 belong to clades V/B.2, S/A, and G/B.1, respectively, whereas that of A5–A7 and S1-S5 are of the V/B.2.1 clade and closely clustered. In particular, SARS-CoV-2 in patients A5 and S5 showed perfect identity. Conclusion WGS is a useful tool to understand epidemiology of SARS-CoV-2. It is the first study to elucidate the role of patient transfer and caregivers as links of nosocomial outbreaks of COVID-19 in multiple hospitals.