BACKGROUND: Invasive Streptococcus agalactiae (group B streptococcus, GBS) infection most commonly occurs in infants; however, cases of GBS infection in adults, particularly in the elderly with significant underlying diseases, are being increasingly reported. We analyzed the serotype specific opsonophagocytic antibodies (the major mechanism of protection against GBS) in infants, adults, and the elderly. METHODS: The opsonization indices (OIs) of antibodies against serotype Ia, Ib, II, III, and V GBS were studied in 89 infants, 35 adults (age, 30–50 years), and 62 elderly individuals (age, 65–85 years) according to the University of Alabama at Birmingham GBS opsonophagocytic killing assay protocol (www.vaccine.uab.edu). RESULTS: In infants, adults, and elderly groups respectively, geometric mean of OI against GBS serotype Ia were 3, 7, and 32; against GBS serotype Ib were 7, 242, and 252; against serotype II were 93, 363, and 676; against serotype III were 8, 212, and 609; and against serotype V were 4, 639, and 610. The seropositive rate (% of subjects with OI ≥ 4) increased significantly in older age group for all five serotypes. CONCLUSION: During infancy, only a limited proportion of infants have functional immunity against serotype Ia, Ib, II, III, and V GBS. Furthermore, a lack of opsonic activities against GBS observed in some adults and the elderly might predispose such individuals to the risk of invasive GBS infection. Epidemiological monitoring and development of suitable vaccine for these populations are needed.
Adult ; Aged ; Alabama ; Antibodies* ; Epidemiological Monitoring ; Homicide ; Humans ; Infant ; Prevalence ; Seroepidemiologic Studies* ; Serogroup* ; Streptococcus agalactiae ; Streptococcus*

Dengue fever (DF) is endemic throughout tropical and subtropical regions; however, it is not endemic in Korea. Imported infectious diseases should be suspected when encountering returned travelers with non-specific symptoms such as fever, rash, and headache. Persistent vomiting, abdominal pain, hemorrhagic tendency, hepatic enzyme abnormalities, and proteinuria are risk factors for the development of severe DF in a patient with DF. Severe hyperglycemia is also known to be related to poor prognosis in acute illness, and with certain underlying diseases that present with hyperglycemia, such as diabetes, it is related to the progression of severe DF. We report a DF case with severe hyperglycemia in an adolescent returning from India. Pediatric DF cases reported in Korea were also reviewed.

Objectives: We sought to identify a clinically useful method of analyzing orbital dystopia to aid in diagnosis and treatment planning and to quantify vertical discrepancies in eye level and variations in canthal tilt in Koreans. Patients and Methods: In 76 Korean patients with a mean age of 23.12 years, mean differences in the level of the pupils, lateral canthi, medial canthi, and canthal tilt were measured. The difference in pupil level was calculated from the perpendicular lines drawn from the midpupil area of each eye to the midline of the face to determine the amount of skeletal discrepancy of the eye. Soft tissue discrepancies were determined according to the vertical difference between the lines drawn from the lateral or medial canthus of each eye perpendicular to the midline of the face. The canthal tilt was determined from the inclination of a line connecting the lateral and medial canthi, then classified as class I, II, or III. Results: Mean differences in pupil level, medial canthi, and lateral canthi were 1.57±1.10 mm, 1.14±1.07 mm, and 2.03±1.64 mm, respectively. The mean degree of canthal tilt were 8.45°±3.53° for the right side and 8.42°±3.81° for the left side. No study participants presented with class III canthal tilt. The mean canthal tilt values for those with class I tilt were 3.21°±1.68° for the right side and 3.18°±1.63° for the left side, while, for those who had class II tilt, the values were 9.60°±3.66° for the right side and 9.54°±2.99° for the left side. Conclusion The presented diagnostic method of orbital dystopia can be used to effectively establish a treatment plan that takes into consideration the patient’s skeletal and soft-tissue discrepancies.

Objectives: We sought to identify a clinically useful method of analyzing orbital dystopia to aid in diagnosis and treatment planning and to quantify vertical discrepancies in eye level and variations in canthal tilt in Koreans. Patients and Methods: In 76 Korean patients with a mean age of 23.12 years, mean differences in the level of the pupils, lateral canthi, medial canthi, and canthal tilt were measured. The difference in pupil level was calculated from the perpendicular lines drawn from the midpupil area of each eye to the midline of the face to determine the amount of skeletal discrepancy of the eye. Soft tissue discrepancies were determined according to the vertical difference between the lines drawn from the lateral or medial canthus of each eye perpendicular to the midline of the face. The canthal tilt was determined from the inclination of a line connecting the lateral and medial canthi, then classified as class I, II, or III. Results: Mean differences in pupil level, medial canthi, and lateral canthi were 1.57±1.10 mm, 1.14±1.07 mm, and 2.03±1.64 mm, respectively. The mean degree of canthal tilt were 8.45°±3.53° for the right side and 8.42°±3.81° for the left side. No study participants presented with class III canthal tilt. The mean canthal tilt values for those with class I tilt were 3.21°±1.68° for the right side and 3.18°±1.63° for the left side, while, for those who had class II tilt, the values were 9.60°±3.66° for the right side and 9.54°±2.99° for the left side. Conclusion The presented diagnostic method of orbital dystopia can be used to effectively establish a treatment plan that takes into consideration the patient’s skeletal and soft-tissue discrepancies.

We evaluated the safety of matrix metalloproteinase (MMP) inhibitor in experimental glaucoma filtration surgery in an animal model. Fifteen New Zealand white rabbits underwent an experimental trabeculectomy and were randomly allocated into 3 groups according to the adjuvant agent: no treatment group (n = 5), 0.02% mitomycin C (MMC) soaking group (n = 5), and MMP inhibitor (ilomastat) subconjunctival injection group (n = 5). Slit lamp examination with Seidel testing, pachymetry, and specular microscopy was performed preoperatively and postoperatively. The conjunctiva and ciliary body toxicity were evaluated with scores according to the pathologic grading systems. Electron microscopy was used to examine the structural changes in cornea, conjunctiva, and ciliary body. In the ilomastat-treated group, there was no statistically significant change in central corneal thickness preoperatively and at 28 days postoperatively (P = 0.655). There were also no significant changes in specular microscopy findings over the duration of the study in the ilomastat-treated group. The conjunctival toxicity score was 1 in the control group, 1.5 in the ilomastat-treated group, and 2 in the MMC-treated group. When assessing ciliary body toxicity scores, the ilomastat-treated group score was 0.5 and the MMC-treated group score was 1.5. Transmission electron microscopy did not show structural changes in the cornea and ciliary body whereas the structural changes were noticed in MMC group. A single subconjunctival injection of MMP inhibitor during the experimental trabeculectomy showed a less toxic affect in the rabbit cornea, conjunctiva, and ciliary body compared to MMC.

PURPOSE: To evaluate the relations between progression of glaucoma in visual field and peripapillary area change in normal tension glaucoma (NTG). METHODS: We respectively evaluated 66 patients (66 eyes) with normal tension glaucoma; these patients were classified as progressive glaucoma group and non-progressive glaucoma group by visual field test. Interobserver and intraobserver agreement was evaluated for qualitative assessment. Zone beta change was measured by Image J (National Institute of Health, Bethesda, USA) by two methods. One method used paired t-test and the other method used CV (correlation of variation) to define significant progression of zone beta. RESULTS: 46 patients (46 eyes) were classified as progressive glaucoma and 20 patients (20 eyes) were classified as non-progressive glaucoma. There was no statistically significant different change of zone beta between two groups and there were no changes of zone beta over coefficient of variation (CV). CONCLUSIONS: The measurement of change of zone beta seems to be of no use in recognition of progression in normal tension glaucoma.
Atrophy ; Glaucoma ; Humans ; Low Tension Glaucoma ; Visual Field Tests ; Visual Fields

Hepatitis A can cause serious illness among adolescents and adults with low vaccination coverage. Even though hepatitis A vaccine is one of the strong candidates for Korean national immunization program, adolescents aged older than 12 yr would not benefit. Our purpose was to assess the willingness and analyze the correlates of Korean mothers for hepatitis A (HepA) vaccination to develop strategies for HepA vaccination. A national telephone survey on 800 mothers with children aged 7-18 yr was conducted with random-digit dialing method. Sixty-two percent and 92% of the mothers reported that they were willing to HepA vaccination at current cost and at half of the current cost, respectively. However, at current cost, only 79% wished to vaccinate their child in an epidemic and 32% wished to vaccinate promptly. Having two or more children, not having future plans to send the child overseas, and low family income were significantly associated with not willing to HepA vaccination. Low perception of the susceptibility for hepatitis A and perception of the current cost as barrier increased the odds of unwillingness to vaccination at current cost and to prompt vaccination. The mothers' willingness to HepA vaccination for the children aged 7-18 yr in Korea was not very high at current cost and associated socioeconomic status and health-belief. Targeted intervention or strategies are needed to increase the HepA vaccination rate among children in Korea.
Adolescent ; Adult ; Child ; Demography ; Female ; Health Status ; Health Surveys ; Hepatitis A/economics/*prevention & control ; Hepatitis A Vaccines/economics/*immunology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Mothers/psychology ; Republic of Korea ; Social Class ; *Vaccination

PURPOSE: To investigate the clinical manifestation and the structural optic disc changes according to the development of reproducible visual field defects in a group of preperimetric patients converting to early glaucoma. METHODS: Standard automated perimetry (Humphrey Field Analyzer) was performed every six months in 294 preperimetric patients. Each subject was classified as either converter or non-converter according to glaucomatous visual field changes, and the clinical manifestations were analyzed retrospectively. Sequential optic disc images were obtained using the TopSS scanning laser ophthalmoscope (TopSS(TM)) and optic disc parameters were measured to determine if any change had occurred. RESULTS: A total of 44 eyes from 44 subjects (14.9%) in 294 patients subsequently developed early glaucomatous field loss (converters). The progression rate of visual field defect is 0.43dB/year. In respect to age, sex, refractive error, and diabetes mellitus, no significant differences were observed. Elevated IOP, hypertension, and family history of glaucoma were detected more frequently in the converter group than in the non-converter group. Among TopSS parameters, cup-to-disc ratio, effective area, volume above, maximum slope, and neuroretinal rim area showed statistically significant change. Changes of the neuroretinal rim were prominent in superior and inferior sectors. CONCLUSIONS: Among TopSS parameters, cup-to-disc ratio, effective area, volume above, and neuroretinal rim are useful in detecting the progression of glaucoma. Furthermore, neuroretinal rim changes in each sector may provide clinically relevant information in detecting and monitoring the progression of glaucoma.
Diabetes Mellitus ; Glaucoma* ; Humans ; Hypertension ; Ophthalmoscopes ; Optic Disk* ; Optic Nerve* ; Refractive Errors ; Retrospective Studies ; Visual Field Tests ; Visual Fields

PURPOSE: To investigate the clinical manifestation and the structural optic disc changes according to the development of reproducible visual field defects in a group of preperimetric patients converting to early glaucoma. METHODS: Standard automated perimetry (Humphrey Field Analyzer) was performed every six months in 294 preperimetric patients. Each subject was classified as either converter or non-converter according to glaucomatous visual field changes, and the clinical manifestations were analyzed retrospectively. Sequential optic disc images were obtained using the TopSS scanning laser ophthalmoscope (TopSS(TM)) and optic disc parameters were measured to determine if any change had occurred. RESULTS: A total of 44 eyes from 44 subjects (14.9%) in 294 patients subsequently developed early glaucomatous field loss (converters). The progression rate of visual field defect is 0.43dB/year. In respect to age, sex, refractive error, and diabetes mellitus, no significant differences were observed. Elevated IOP, hypertension, and family history of glaucoma were detected more frequently in the converter group than in the non-converter group. Among TopSS parameters, cup-to-disc ratio, effective area, volume above, maximum slope, and neuroretinal rim area showed statistically significant change. Changes of the neuroretinal rim were prominent in superior and inferior sectors. CONCLUSIONS: Among TopSS parameters, cup-to-disc ratio, effective area, volume above, and neuroretinal rim are useful in detecting the progression of glaucoma. Furthermore, neuroretinal rim changes in each sector may provide clinically relevant information in detecting and monitoring the progression of glaucoma.
Diabetes Mellitus ; Glaucoma* ; Humans ; Hypertension ; Ophthalmoscopes ; Optic Disk* ; Optic Nerve* ; Refractive Errors ; Retrospective Studies ; Visual Field Tests ; Visual Fields

PURPOSE: Body composition is important to define and manage obesity and undernutrition. Obesity is a significant health problem with medical and psychological consequences for children and adolescents. Body composition analysis (BIA) is a simple, rapid, noninvasive, and reproducible technique. However, comparative analysis of body composition has not been done in young children below 7 years old. The aim of this study is to estimate antropometric data and body composition by BIA, and to investigate the correlation between anthropometric data and fat mass or fat percent in young children. METHODS: We measured height, weight, body mass index (BMI), fat mass, and fat percent by BIA in 1,376 children aged 3-6 years of whom 688 were males and 688 were females. RESULTS: Fat mass, fat percent, intracellular fluid, extracellular fluid, protein, and minerals were significantly higher in the obese group. A significant positive correlation exists between fat mass and BMI or weight. A significant positive linear correlation was also noted between fat percent and BMI. Protein, weight, fat mass, and fat percent were significantly different among groups. CONCLUSION: BIA is an objective, accurate method to estimate body fat in childhood obesity cases. Fat mass and fat percent data acquired by using BIA highly correlated with BMI. However, a large-scale study is needed to diagnose obesity in young children.
Adipose Tissue ; Adolescent ; Aged ; Body Composition ; Body Weight ; Child ; Electric Impedance ; Extracellular Fluid ; Female ; Humans ; Intracellular Fluid ; Male ; Malnutrition ; Minerals ; Obesity