PURPOSE: This study aimed at determining the detection rate of respiratory viruses and at investigating the risk factors associated with respiratory virus detection in young infants. METHODS: From September 2011 to August 2012, nasopharyngeal swabs were obtained from 227 infants aged < or =90 days with suspected infectious diseases, including sepsis. We performed a retrospective analysis of their clinical characteristics. The prevalence of respiratory viruses in their nasopharyngeal swabs was assayed by real-time polymerase chain reaction (real-time PCR). RESULTS: In total, 157 (69.2%) infants had more than one of the following respiratory viruses: respiratory syncytial virus (n=75), rhinovirus (n=42), influenza virus (n=18), parainfluenza virus (n=15), human metapneumovirus (n=9), coronavirus (n=9), adenovirus (n=4), and bocavirus (n=3). During the same period, bacterial infections were confirmed in 24 infants (10.6%). The detection of respiratory viruses was significantly associated with the presence of cough, a family history of respiratory illness, and a seasonal preference (fall/winter). Using logistic regression analysis, these 3 variables were also identified as significant risk factors. During fall and winter, detection of respiratory viruses was significantly higher in infants who did not have a bacterial infection. CONCLUSION: Respiratory virus is an important pathogen in young infants admitted to a hospital, who are suspected with infectious diseases. Detection of respiratory viruses in young infants was associated with seasonality (fall/winter), presence of respiratory symptoms and a family history of respiratory illness.
Adenoviridae ; Bacterial Infections ; Bocavirus ; Communicable Diseases ; Coronavirus ; Cough ; Humans ; Infant* ; Logistic Models ; Metapneumovirus ; Nasopharynx ; Orthomyxoviridae ; Paramyxoviridae Infections ; Prevalence ; Real-Time Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Retrospective Studies ; Rhinovirus ; Risk Factors* ; Seasons ; Sepsis ; Virus Diseases

PURPOSE: This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection. METHODS: Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients. RESULTS: A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older (4.7+/-4.1 years vs. 3.3+/-2.5 years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups. CONCLUSIONS: No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.
Child ; Cough ; Fever ; Hospitalization ; Humans ; Influenza B virus ; Influenza, Human ; Medical Records ; Multiplex Polymerase Chain Reaction ; Pharyngitis ; Retrospective Studies ; Seasons ; Sputum ; Vomiting

PURPOSE: We aimed to compare the clinical features and antibiotic resistance of urinary tract infection (UTI) caused by pathogens other than E. coli (non-E. coli) with UTI caused by E. coli in children. METHODS: We enrolled patients with culture-proven UTI, who were admitted to the study hospital from September 2008 to August 2009. We investigated clinical data of patients with UTI and antibiotic resistance of isolated strains. For comparison, patients were divided according by results of the urine culture into E. coli and non-E. coli UTI groups. RESULTS: A total of 84 patients participated in this study. Twenty one cases (25.0%) were caused by non-E. coli pathogens. Frequency of non-E. coli UTI differed according to age and sex: 'male <6 months', 10.5%; 'male > or =6 months', 50.0%; 'female <6 months', 43.7%; and 'female > or =6 months', 25.0% (P=0.014). More patients who received previous antibiotic treatment (P=0.017), but fewer patients who showed hematuria (P=0.014) were included in the non-E. coli UTI group than in the E. coli UTI group. Comparison of antibiotic resistance showed that the non-E. coli UTI group possessed more strains that were resistant to cefazolin, cefotaxime, imipenem, trimethoprim/sulfamethoxazole (TMP/SMZ) and tetracycline than the E. coli UTI group (P<0.05). CONCLUSION: Increased incidence, different distribution by age and sex, and high antibiotic resistance of non-E. coli UTI should be considered in selection of empirical antibiotics for treatment of UTI in children.
Anti-Bacterial Agents ; Cefazolin ; Cefotaxime ; Child ; Drug Resistance ; Drug Resistance, Microbial ; Escherichia ; Hematuria ; Humans ; Imipenem ; Incidence ; Tetracycline ; Urinary Tract ; Urinary Tract Infections

Pyogenic liver abscess (PLA) is rare in healthy children. We report a case of PLA in an immunocompetent 12-year-old boy. Percutaneous catheter drainage was performed for the abscess. In addition, parenteral antibiotics were administered for 3 weeks. Klebsiella pneumoniae was detected in the culture of blood and drained fluid. Here, we present this case and a brief review of the literature on this subject.
Abscess ; Anti-Bacterial Agents ; Catheters ; Child* ; Drainage ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Male*

Lupus anticoagulant-hypoprothrombinemia syndrome (LAHPS), a very rare disease that is caused by the presence of antifactor II antibodies, is usually counterbalanced by the prothrombotic effect of lupus anticoagulant (LAC). Patients with LAHPS are treated using fresh frozen plasma, steroids, immunosuppressive agents, and immunoglobulins for managing the disease and controlling hemorrhages. Notably, steroids are the important treatment for treating hypoprothrombinemia and controlling the bleeding. However, some patients suffer from severe, life-threatening hemorrhages, when factor II levels remain very low in spite of treatment with steroids. Here, we report a case of LAHPS in a 15-year-old girl who experienced pulmonary hemorrhage with rapid progression. She was referred to our hospital owing to easy bruising and prolonged bleeding. She was diagnosed with LAHPS that presented with pancytopenia, positive antinuclear antibody, proloned prothrombin time, activated partial thromboplastin time, positive LAC antibody, and factor II deficiency. Her treatment included massive blood transfusion, high-dose methylprednisolone, vitamin K, and immunoglobulin. However, she died due to uncontrolled pulmonary hemorrhage.
Adolescent ; Antibodies ; Antibodies, Antinuclear ; Blood Transfusion ; Female ; Hemorrhage* ; Humans ; Hypoprothrombinemias* ; Immunoglobulins ; Immunosuppressive Agents ; Lupus Coagulation Inhibitor* ; Methylprednisolone ; Pancytopenia ; Partial Thromboplastin Time ; Plasma ; Prothrombin ; Prothrombin Time ; Rare Diseases ; Steroids ; Vitamin K

Despite its rare occurrence, early diagnosis and appropriate treatment for neonatal herpes simplex virus infection are mandatory due to its high morbidity and mortality. In Korea, there has been no epidemiologic data on neonatal herpes simplex virus infection, and even case reports are rare. We observed a 16-day-old neonate who presented with fever and seizures. We diagnosed her with meningoencephalitis caused by herpes simplex virus type 2 based on the polymerase chain reaction test, and treated her with intravenous acyclovir and anticonvulsants. The seroprevalence of herpes simplex virus type 2 sharply increases in women in their 30s, and the average age for childbirth has increased to older than 30 years of age in Korea; we therefore expect that the incidence of neonatal herpes simplex virus type 2 infection will rise in Korea, and more attention should be directed to neonatal herpes simplex virus type 2 infection. We report this newborn patient's case along with a literature review.
Acyclovir ; Anticonvulsants ; Early Diagnosis ; Female ; Fever ; Herpesvirus 2, Human* ; Humans ; Incidence ; Infant, Newborn ; Korea ; Meningoencephalitis* ; Mortality ; Parturition ; Polymerase Chain Reaction ; Republic of Korea ; Seizures ; Seroepidemiologic Studies ; Simplexvirus

Ion channel inhibitors are widely used for pharmacological discrimination between the different channel types as well as for determination of their functional role. In the present study, we tested the hypothesis that 4-aminopyridine (4-AP) could affect the large conductance Ca2+ -activated K+ channel (BKCa) currents using perforated-patch or cell-attached configuration of patch-clamp technique in the rabbit pulmonary arterial smooth muscle. Application of 4-AP reversibly inhibited the spontaneous transient outward currents (STOCs). The reversal potential and the sensitivity to charybdotoxin indicated that the STOCs were due to the activation of BKCa. The BKCa currents were recorded in single channel resolution under the cell-attached mode of patch-clamp technique for minimal perturbation of intracellular environment. Application of 4-AP also inhibited the single BKCa currents reversibly and dose-dependently. The membrane potential of rabbit pulmonary arterial smooth muscle cells showed spontaneous transient hyperpolarizations (STHPs), presumably due to the STOC activities, which was also inhibited by 4-AP. These results suggest that 4-AP can inhibit BKCa currents in the intact rabbit vascular smooth muscle. The use of 4-AP as a selective voltage-dependent K+ (KV) channel blocker in vascular smooth muscle, therefore, must be reevaluated.
4-Aminopyridine* ; Charybdotoxin ; Discrimination (Psychology) ; Ion Channels ; Membrane Potentials ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle* ; Patch-Clamp Techniques ; Pulmonary Artery

This study was conducted to evaluate age-specific seroprevalence of pertussis in Korea and to formulate a strategy to prevent and reduce the incidence of pertussis. Residual serum samples of healthy adolescents and adults 11 yr of age or older were collected between July 2012 and December 2012, and anti-pertussis toxin (PT) IgG titers were measured using a commercial ELISA kit. We compared the mean anti-PT IgG titers and seroprevalence of pertussis of the six age groups: 11-20, 21-30, 31-40, 41-50, 51-60, and > or = 61 yr. A total of 1,192 subjects were enrolled. The mean anti-PT IgG titer and pertussis seroprevalence were 35.53 +/- 62.91 EU/mL and 41.4%, respectively. The mean anti-PT IgG titers and seroprevalence were not significantly different between the age groups. However, the seroprevalence in individuals 51 yr of age or older was significantly higher than in individuals younger than 51 yr (46.5% vs 39.1%, P = 0.017). Based on these results, a new pertussis prevention strategy is necessary for older adults.
Adolescent ; Adult ; Aging ; Antibodies, Bacterial/*blood ; Bordetella pertussis/*immunology ; Child ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G/*blood/immunology ; Incidence ; Male ; Middle Aged ; Pertussis Toxin/blood/*immunology ; Pertussis Vaccine/immunology ; Republic of Korea/epidemiology ; Seroepidemiologic Studies ; Vaccination ; Whooping Cough/blood/*epidemiology ; Young Adult

Few cases of macrophage activation syndrome (MAS) or reactive hemophagocytic lymphohistiocytosis (HLH) during the acute febrile phase of Kawasaki disease (KD) have been reported. We report on a case of a 19 month-old girl with MAS or reactive HLH during the course of KD. Despite immunoglobulin and steroid therapy, she showed persistent fever with hepatosplenomegaly and evidence of hemophagocytosis in the bone marrow. A high index of suspicion for clinical features associated with MAS is necessary for KD patients in order to provide appropriate treatment.
Bone Marrow ; Fever ; Humans ; Immunoglobulins ; Lymphohistiocytosis, Hemophagocytic ; Macrophage Activation ; Macrophage Activation Syndrome ; Macrophages ; Mucocutaneous Lymph Node Syndrome ; Organic Chemicals

OBJECTIVE: To analyze the prognostic role of revised version of International Federation of Gynecology and Obstetrics (FIGO) stage (2013) in epithelial ovarian cancer and compare with previous version staging classification METHODS: We retrospectively enrolled patients with epithelial ovarian cancer treated at Samsung Medical Center from 2002 to 2012. We reclassified the patients based on the revised FIGO staging classification. RESULTS: Eight hundred seventy-eight patients were enrolled (stage I, 22.8%; stage II, 10.4%; stage III, 56.2%; stage IV, 10.7%). Previous stage IC (98, 11.1%) was subdivided into IC1 (9, 1.0%), IC2 (57, 6.4%), and IC3 (32, 4.1%). In addition, previous stage IV (94, 1.7%) was categorized into IVA (37, 4.2%) and IVB (57, 6.5%) in new staging classification. Stage IIC (66, 7.5%) has been eliminated and integrated into IIA (36, 4.1%) and IIB (55, 6.2%) in revised classification. Revised FIGO stage IC3 had significant prognostic impact on PFS (hazard ratio [HR], 3.840; 95% confidence interval [CI], 1.361 to 10.83; P=0.011) and revised FIGO stage IIIC appears to be an independent, significant poor prognostic factor for PFS (HR, 2.541; 95% CI, 1.242 to 5.200; P=0.011) but not in the case of previous version of FIGO stage IIIC (HR, 1.070; 95% CI, 0.502 to 2.281; P=0.860). However, any sub-stages of both previous and revised version in stage II and IV, there was no significant prognostic role. CONCLUSION: Revised FIGO stage has more progressed utility for informing prognosis than previous version, especially in stage I and III. For stage II and IV, further validation should be needed in large population based study in the future.
Classification* ; Gynecology ; Humans ; Neoplasm Staging ; Obstetrics ; Ovarian Neoplasms* ; Prognosis ; Retrospective Studies ; Survival Analysis*