PURPOSE: The kidney is a common site of end organ involvement in patients with candidemia. This study was undertaken to investigate clinical features and outcomes of renal mycetoma complicated by Candida sepsis in neonates. METHODS: A retrospective analysis of the medical records and radiologic images was conducted in a neonatal intensive care unit over a 9-year period (2002-2010). RESULTS: During the study period, there were 69 episodes of Candida sepsis. C. albicans was the most common pathogen (49.2%), and C. parapsilosis was the second (42%), but emerging. Of the 42 patients who underwent ultrasound examination in early phase of infection, renal mycetoma was observed in 8 cases (19.1%). Renal mycetoma was more frequently developed in patients with C. albicans sepsis than those with non-albicans candidemia, but the result was not significant. The demographic characteristics of the two groups of patients who had Candida sepsis (with renal mycetoma vs. without renal mycetoma) were similar. Candiduria was more common in the mycetoma group (P<0.01). In addition, the duration of antifungal medication was longer in patients with mycetoma (P<0.001). On follow-up ultrasounds, improvement and resolution of renal echogenic lesions took a median time of 2 and 5 months respectively for the mycetoma group. CONCLUSION: Candiduria may be an initial sign of renal mycetoma complicated by Candida sepsis in newborn infants. Echogenic foci on the renal ultrasound are persistent for a considerable period after antifungal therapy, and therefore follow-up evaluations are important.
Candida ; Candidemia ; Follow-Up Studies ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Kidney ; Medical Records ; Mycetoma ; Retrospective Studies ; Sepsis

No abstract available.
Carcinoma, Squamous Cell* ; Humans ; Lung, Hyperlucent*

PURPOSE: We evaluated the clinical features of croup in children according to viral etiology. METHODS: This study enrolled pediatric patients with croup, who showed positive results on respiratory virus reverse transcriptase polymerase chain reaction performed between January 2012 and December 2017. We retrospectively reviewed the medical records. RESULTS: A total of 179 patients (119 boys and 60 girls) were enrolled with the mean age of 18.9±14.7 months. The viruses commonly identified were parainfluenza, respiratory syncytial virus, rhinovirus, and influenza. Among these 4 viruses, patients with rhinovirus infection showed significantly shorter fever and admission durations. Patients with parainfluenza infection showed significantly lower incidences of epinephrine nebulization and patients with influenza infections showed significantly higher incidences of steroid treatment. CONCLUSION: Clinical manifestations of croup differ according to causative viruses. Further studies should be conducted to evaluate the severity and prognosis of croup according to viral etiology.
Child* ; Croup* ; Epinephrine ; Fever ; Humans ; Incidence ; Influenza, Human ; Medical Records ; Paramyxoviridae Infections ; Prognosis ; Respiratory Syncytial Viruses ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus

OBJECTIVE: 5-HTTLPR (5-HT transporter-linked polymorphic region), located in the promoter region of 5-HT transporter gene, was reported to be associated with several neuropsychiatric illnesses. In this study, we investigated the genotype distribution and allele frequency of serotonin transporter gene 5-HTTLPR in schizophrenic patients and normal controls using an independent Korean sample. METHODS: Subjects were 156 schizophrenic patients fulfilling the DSM-IV criteria for schizophrenia who had taken antipsychotics for at least 6 months and 96 normal controls who had no past and family history of psychiatric illnesses. Two negative symptoms of PANSS, blunted affect and emotional withdrawal, were rated in all patients by two experienced psychiatrists. We examined the genotype distribution and allele frequency of the serotonin transporter gene 5-HTTLPR in all subjects, using polymerase chain reaction (PCR) of genomic DNA with primers flanking the promoter regions of the 5-HTT gene. Between-group comparisons of the genotype distribution and allele frequency were performed by using score test for trend, Fisher's exact test, and chi-square test. RESULTS: There was no significant difference in 5-HTTLPR genotype distribution and allele frequency between schizophrenic patients and normal controls. There was also no significant difference in 5-HTTLPR genotype distribution and allele frequency between schizophrenic patients with and without the two negative symptoms, blunted affect or emotional withdrawal, respectively. CONCLUSION: These results suggest that 5-HTTLPR polymorphism had no significant association with schizophrenia and negative symptoms in a Korean sample.
Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Gene Frequency ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Psychiatry ; Schizophrenia* ; Serotonin ; Serotonin Plasma Membrane Transport Proteins

PURPOSE: We evaluated the clinical/laboratory characteristics and progress of pediatric patients hospitalized for pneumonia and laboratory-confirmed H1N1 influenza infection. METHODS: A total of 101 patients were enrolled. They were divided into 2 groups: group 1 with a fast respiration rate for age (n=66) and group 2 with an appropriate respiration rate for age (n=35). We retrospectively reviewed the medical charts to collect data on the hospitalized patients. RESULTS: Patients were significantly older in group 1 than in group 2 (median age, 7 vs. 4 years, p<0.001) and 59.0% were between 6 and 8 years of age. Sixteen patients (24.2%) in group 1 had underlying medical conditions, most of whom had asthma, and 50 were previously healthy. Oxygen saturation on admission day was significantly lower in group 1 than in group 2 (92% vs. 98%, p<0.001) and 42 patients (63.6%) in group 1 had hypoxia (oxygen saturation <= 92%). The frequency of lymphopenia was significantly higher in group 1 than in group 2 (n=59 vs. 11, p<0.001). Some patients in group 1 received systemic corticosteroid therapy, intravenous immunoglobulin infusion and oxygen supplement (n=28, n=16, n=48, respectively). The frequency of systemic corticosteroid therapy and oxygen supplement was higher in group 1 than in group 2 (p<0.001 for each). CONCLUSION: H1N1 influenza infection complicated by pneumonia can cause severe illness in previously healthy children more than 6 years old and in children with uncontrolled allergic disease. Multi-center studies are needed to evaluate the clinical and epidemiologic characteristics of pediatric patients with 2009 H1N1 influenza.
Anoxia ; Asthma ; Child ; Humans ; Immunoglobulins ; Influenza, Human ; Lymphopenia ; Oxygen ; Pneumonia ; Respiratory Rate ; Retrospective Studies ; Tachypnea

Pure red cell aplasia (PRCA) is a rare cause of anemia associated with systemic lupus erythematosus (SLE), and fewer than 20 cases have been reported. The development of PRCA may be mediated by an autoimmune mechanism which is supported by the presence of antibodies that impair various stages and mechanisms of erythropoiesis, by the association with immunological disorders or lymphoma, and by a favorable response to immunosuppressive drugs, antilymphocyte globulin, thymectomy, and splenectomy. However, these therapies have not been successful in all patients with PRCA. We report our experience with a 31-year-old female patient with SLE who developed PRCA that did not respond to immunosuppressive therapies. However, complete normalization of erythropoiesis was achieved after the removal of the autoantibodies by plasmapheresis, and the patient has now maintained a normal hemoglobin level for more than eight months. We suggest that plasmapheresis might be tried in the treatment of PRCA cases before other more aggressive therapies are commenced.
Adult ; Bone Marrow/pathology ; Case Report ; Erythropoiesis ; Female ; Human ; Lupus Erythematosus, Systemic/*complications ; *Plasmapheresis ; Red-Cell Aplasia, Pure/*complications/pathology/physiopathology/*therapy

BACKGROUND AND OBJECTIVES: The purpose of the present study was to investigate the advantages and disadvantages of verifying genetic abnormalities using array comparative genomic hybridization (a-CGH) immediately after diagnosis of congenital heart disease (CHD). METHODS: Among neonates under the age of 28 days who underwent echocardiography from January 1, 2014 to April 30, 2016, neonates whose chromosomal and genomic abnormalities were tested using a-CGH in cases of an abnormal finding on echocardiography were enrolled. RESULTS: Of the 166 patients diagnosed with CHD, 81 underwent a-CGH and 11 patients (11/81, 13.5%) had abnormal findings on a-CGH. 22q11.2 deletion syndrome was the most common (4/11, 36.4%). On the first a-CGH, 4 patients were negative (4/81, 5%). Three of them were finally diagnosed with Williams syndrome using fluorescent in situ hybridization (FISH), 1 patient was diagnosed with Noonan syndrome through exome sequencing. All of them exhibited diffuse pulmonary artery branch hypoplasia, as well as increased velocity of blood flow, on repeated echocardiography. Five patients started rehabilitation therapy at mean 6 months old age in outpatient clinics and epilepsy was diagnosed in 2 patients. Parents of 2 patients (22q11.2 deletion syndrome and Patau syndrome) refused treatment due to the anticipated prognosis. CONCLUSIONS: Screening tests for genetic abnormalities using a-CGH in neonates with CHD has the advantage of early diagnosis of genetic abnormality during the neonatal period in which there is no obvious symptom of genetic abnormality. However, there are disadvantages that some genetic abnormalities cannot be identified on a-CGH.
Ambulatory Care Facilities ; Comparative Genomic Hybridization ; Diagnosis ; DiGeorge Syndrome ; Early Diagnosis ; Echocardiography ; Epilepsy ; Exome ; Heart Defects, Congenital ; Humans ; In Situ Hybridization, Fluorescence ; Infant, Newborn ; Mass Screening ; Noonan Syndrome ; Parents ; Prognosis ; Pulmonary Artery ; Rehabilitation ; Williams Syndrome

BACKGROUND AND OBJECTIVES: The purpose of the present study was to investigate the advantages and disadvantages of verifying genetic abnormalities using array comparative genomic hybridization (a-CGH) immediately after diagnosis of congenital heart disease (CHD). METHODS: Among neonates under the age of 28 days who underwent echocardiography from January 1, 2014 to April 30, 2016, neonates whose chromosomal and genomic abnormalities were tested using a-CGH in cases of an abnormal finding on echocardiography were enrolled. RESULTS: Of the 166 patients diagnosed with CHD, 81 underwent a-CGH and 11 patients (11/81, 13.5%) had abnormal findings on a-CGH. 22q11.2 deletion syndrome was the most common (4/11, 36.4%). On the first a-CGH, 4 patients were negative (4/81, 5%). Three of them were finally diagnosed with Williams syndrome using fluorescent in situ hybridization (FISH), 1 patient was diagnosed with Noonan syndrome through exome sequencing. All of them exhibited diffuse pulmonary artery branch hypoplasia, as well as increased velocity of blood flow, on repeated echocardiography. Five patients started rehabilitation therapy at mean 6 months old age in outpatient clinics and epilepsy was diagnosed in 2 patients. Parents of 2 patients (22q11.2 deletion syndrome and Patau syndrome) refused treatment due to the anticipated prognosis. CONCLUSIONS Screening tests for genetic abnormalities using a-CGH in neonates with CHD has the advantage of early diagnosis of genetic abnormality during the neonatal period in which there is no obvious symptom of genetic abnormality. However, there are disadvantages that some genetic abnormalities cannot be identified on a-CGH.

Spontaneous pneumomediastinum (SPM) is a rare condition in children which is triggered by respiratory infection and inflammation, although it occurs most commonly in asthmatics. It is caused by alveolar rupture and dissection of air into the mediastinum and hilum, and the prognosis is usually benign. We report two cases of SPM and subcutaneous emphysema complicating pneumonia in children with severe H1N1 infection. The patients were admitted to the intensive care unit and treated with oxygen, inhalation of a bronchodilator, intravenous systemic corticosteroid (methyprednisolone, 2 mg/kg/day for 5 days) and antibiotics, together with antiviral therapy. On day 4 after admission, there was no further evidence of SPM. SPM associated with severe H1N1 infection in children resolves with aggressive supportive care, without progression to pneumothorax. We should remain aware of this air leak complication in children with severe respiratory infection.
Anti-Bacterial Agents ; Child ; Emphysema ; Humans ; Inflammation ; Influenza, Human ; Inhalation ; Intensive Care Units ; Mediastinal Emphysema ; Mediastinum ; Oxygen ; Pneumonia ; Pneumothorax ; Prognosis ; Rupture ; Subcutaneous Emphysema

BACKGROUND: Nitric oxide (NO), a cytotoxic molecule is produced in various tissues including tumor cells during interleukin-2 (IL-2) therapy . Lymphokine-activated killer (LAK) cells are induced during IL-2 therapy, and have cytotoxic activity against tumor cells. The current study investigated the effects of NO synthesized in target cells or exposure of target cells to NO on the sensitivity of target cells to LAK cell cytotoxicity. METHODS: Cytotoxicity was measured using 4 h chromium release assays. LAK cells which were induced by a 4 day incubation of BALB/c mouse splenocytes with IL-2 (6,000 IU/mL) were employed as effector cells. RD-995 skin tumor cells originated from a C3H/HeN mouse were employed as target cells. NO synthesis in target cells was induced by a 24 h incubation of RD-995 cells with IFN gamma (25 U/mL), TNF (50 U/mL) and IL-1 (20 U/mL). S-nitrosyl acetylpenicillamine (SNAP), an NO donor, was used to expose target cells to NO. N(G) -monomethyl-L-arginine (MLA) and carboxy-PTIO were added during cytotoxicity assays to inhibit NO synthesis, and to scavenge NO produced by target cells, respectively. RESULTS: Sensitivity of NO-producing RD-995 cells to LAK cell cytotoxicity was decreased by addition of MLA and carboxy-PTIO during cytotoxicity assays. However, the two reagents had no effect on the sensitivity of non-NO-producing RD-995 cells. Pretreatment of RD-995 target cells with SNAP increased the sensitivity in comparison with untreated cells. CONCLUSIONS: Sensitivity of target cells to LAK cell cytotoxicity is increased by target cell NO synthesis or exposure to NO. Further studies are needed to evaluate whether these in vitro results have relevance to in vivo phenomena.
Animals ; Chromium ; Humans ; Indicators and Reagents ; Interleukin-1 ; Interleukin-2 ; Killer Cells, Lymphokine-Activated* ; Lymphocytes ; Mice ; Nitric Oxide* ; Skin ; Tissue Donors