PURPOSE: Premature and low birth weighted (LBW) infants as well as small for gestational age (SGA) infants have a high death rate and increasing the prevalence rate. We compared the proportion of these high-risk neonates and the relevant factor between the four regional settings. METHODS: We reviewed the data from 2005 to 2010, from the Korea National Statistics Office and compared the proportions of premature infants, LBW infants and SGA babies and the relevant factors between Seoul, metropolitan cities and small-to-medium-sized ones. RESULTS: Premature birth rate is as follows in each area: 4.00% in Seoul, 4.21% in metropolitan areas, 4.11% in small and medium size cities, and 4.27% in small towns. SGA birth rate is slightly lower in the medium-sized cities and higher in small towns. The birth rate of low birth weight infants is higher only in small towns (3.58%). It appears that low maternal age and low maternal education levels increase these high-risk newborns. Once calibrated variables, the result showed that the risk of premature infants is higher in the metropolitan areas (OR, 1.05), and the risk of SGA (OR, 1.06) and low birth weight (1.03) is higher in a small town. CONCLUSIONS: There were significant differences in the premature infants, low birth weight infants and SGA babies between the four different regional settings. Following the adjustment of the relevant variables, the proportion premature infant was higher in metropolitan cities and SGA babies and LBW infants were higher in small ones.
Birth Rate ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea ; Maternal Age ; Mothers ; Premature Birth ; Prevalence

Pulmonary hemorrhage as the initial manifestation of systemic lupus erythematosus (SLE) has been rarely reported in children. We present the case of a 10-year-old girl who was admitted to Kangbuk Samsung Hospital with hemoptysis. She had a 5-day history of cough with dyspnea. On physical exam, breath sound was significantly decreased combined with rales on both lung fields. Blood tests revealed pancytopenia, decreased complement levels (C3, 21.28 mg/dL; C4, 3.10 mg/dL), positive antinuclear antibody (>1:640) and anti-double-stranded DNA antibody (262.5 IU/mL). Chest computed tomography revealed patchy ground glass opacity on both lung fields. She had proteinuria and diffuse lupus nephritis (International Society of Nephrology/Renal Pathology Society class IV-G(A)) confirmed by renal biopsy. High-dose methylprednisolone pulse therapy (30 mg/kg/day) was given for 3 days and then switched to a maintenance dose (1 mg/kg/day). Initially hemoptysis resolved after administration of methylprednisolone, but recurred on the 14th day of treatment. She was then treated with cyclophosphamide pulse therapy and hemoptysis subsided without recurrence. She was discharged on the 31st day of admission. She continued to receive monthly cyclophosphamide pulse therapy until the occurrence of leukopenia and then her regimen was switched to mycophenolate and hydroxychloroquine. SLE continues to be well controlled after 18 months of treatment. Recognition of pulmonary hemorrhage as a possible initial manifestation of SLE is crucial for early diagnosis. SLE was successfully treated with good outcome.
Antibodies, Antinuclear ; Biopsy ; Child ; Complement System Proteins ; Cough ; Cyclophosphamide ; DNA ; Dyspnea ; Early Diagnosis ; Female ; Glass ; Hematologic Tests ; Hemoptysis ; Hemorrhage* ; Humans ; Hydroxychloroquine ; Leukopenia ; Lung ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Methylprednisolone ; Pancytopenia ; Pathology ; Pediatrics ; Proteinuria ; Recurrence ; Respiratory Sounds ; Thorax

PURPOSE: Atopic dermatitis (AD) is a chronic inflammatory relapsing skin disorder. Vitamin D plays a pivotal role in the development of AD, and interleukin (IL) 31 is known to be related to pruritus in AD. The aim of our study was to determine whether 25-hydroxyvitamin D (25(OH)D) levels are related to IL-31 levels or to the severity of AD. METHODS: We enrolled 91 children with AD and 32 control subjects without history or symptoms of allergic diseases. Blood was drawn to evaluate complete blood cell count, total eosinophil count (TEC), and total IgE, specific IgE to common allergens, 25(OH)D, and IL-31 levels. Serum 25(OH)D and IL-31 levels were measured using high-performance liquid chromatography and enzyme-linked immunosorbent assay, respectively. The scoring atopic dermatitis (SCORAD) index was used to evaluate the severity of AD. RESULTS: The mean 25(OH)D level was significantly lower in the AD group than in the control group; 25(OH)D decreased greatly in the moderate and severe AD groups compared with the mild AD group. Children with atopic sensitization showed significantly lower 25(OH)D levels than nonatopic children. However, serum IL-31 levels were not related to AD group, SCORAD index, or 25(OH)D levels. The SCORAD index was inversely correlated with serum 25(OH)D level and positively correlated with TECs and total IgE levels. Children with moderate and severe AD had significantly higher TECs than children with mild AD. CONCLUSION: Vitamin D is related to the severity of AD independently of IL-31.
Allergens ; Blood Cell Count ; Child* ; Chromatography, Liquid ; Dermatitis, Atopic* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Humans ; Immunoglobulin E ; Interleukins ; Pruritus ; Skin ; Vitamin D

PURPOSE: A nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory characteristics between children with refractory MP requiring steroid treatment and those with macrolide-responsive MP and evaluated the risk factors associated with refractory MP. METHODS: We investigated 203 children who were admitted to our institution with MP from June to November 2011. Refractory MP was defined by persistent fever over 38.3degrees C with progressive pulmonary consolidation or pleural effusion despite administration of appropriate macrolide antibiotics for 5 days or longer after admission. Steroid therapy was initiated on the fifth day after admission for refractory cases. RESULTS: There were 26 patients with refractory MP requiring steroid therapy. The mean duration of steroid therapy was 5.4 days and most of the patients were afebrile within 24 hours after initiation of steroid therapy. The prevalence of refractory MP was higher in patients with pleural effusion, lobar pneumonia affecting more than 2 lobes, higher levels of serum lactate dehydrogenase, increased oxygen requirements, and longer duration of hospitalization. Atopic sensitization and history of asthma were also associated with refractory MP after adjusting for age and gender. CONCLUSION: Children with refractory MP had more severe pneumonia. Atopic sensitization and history of asthma may be risk factors for refractory MP requiring steroid therapy in Korean children.
Anti-Bacterial Agents ; Asthma* ; Child* ; Fever ; Hospitalization ; Humans ; Korea ; L-Lactate Dehydrogenase ; Mycoplasma ; Mycoplasma pneumoniae* ; Oxygen ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Prevalence ; Risk Factors

C-arm fluoroscopy is useful equipment in interventional pain management because it helps to guide correct needle targeting for the accurate injection and drug delivery. However, due to increased use of C-arm fluoroscopy in various pain procedures, the risk of radiation exposure is a significant concern for pain physicians. The harmful biological effects of ionizing radiation on the human body are well known. It is therefore necessary to strive to reduce radiation exposure. Lead aprons with thyroid shields are the most fundamental radiation protective devices for interventional procedures, and are very effective. However, the operator's radiation safety cannot be guaranteed because pain physicians seem to lack sufficient interest, knowledge, and awareness about radiation safety. Also, inappropriate care and use of radiation protective devices may result in a higher risk of radiation exposure. The purpose of this article was to review the literature on radiation safety with a focus on lead aprons and thyroid shields and present recommendations related to those devices during C-arm fluoroscopic-guided interventions by pain physicians.
Fluoroscopy ; Human Body ; Needles ; Pain Management ; Protective Devices ; Radiation Exposure ; Radiation Protection ; Radiation, Ionizing ; Thyroid Gland

The outbreak of human toxoplasmosis can be attributed to ingestion of food contaminated with Toxoplasma gondii. Toxoplasmosis recently increased in domestic and stray dogs and cats. It prompted studies on the zoonotic infectious diseases transmitted via these animals. Sero- and antigen prevalences of T. gondii in dogs and cats were surveyed using ELISA and PCR, and B1 gene phylogeny was analyzed in this study. Toxoplasmosis antibodies were measured on sera of 403 stray cats, 947 stray dogs, 909 domestic cats, and 2,412 domestic dogs collected at nationwide regions, Korea from 2017 to 2019. In addition, whole blood, feces, and tissue samples were also collected from stray cats (1,392), stray dogs (686), domestic cats (3,040), and domestic dogs (1,974), and T. gondii-specific B1 gene PCR was performed. Antibody prevalence of stray cats, stray dogs, domestic cats, and domestic dogs were 14.1%, 5.6%, 2.3%, and 0.04%, respectively. Antigen prevalence of these animals was 0.5%, 0.2%, 0.1%, and 0.4%, respectively. Stray cats revealed the highest infection rate of toxoplasmosis, followed by stray dogs, domestic cats, and domestic dogs. B1 gene positives were 5 of stray cats, and identified to high/moderate pathogenic Type I/III group. These findings enforce that preventive hygienic measure should be strengthened at One Health level in dogs and cats, domestic and stray, to minimize human toxoplasmosis infections.