OBJECTIVE : The purpose of this study was to identify the current trends of the incidence of hyperbilirubinemia and the results of the auditory evoked potential and to evaluate the correlation with early and late evidence of bilirubin-induced brain injury. METHODS : We reviewed the medical records of all neonates who were admitted to the Holy family hospital of CUMC exclusively for management of neonatal jaundice from January, 2002 to December, 2006. The gestational age, the age at peak bilirubin level, the peak bilirubin level, feeding method and brainstem auditory-evoked potential (AEP) were reviewed. RESULTS : We investigated 121 term and 101 preterm infants treated for management of neonatal jaundice. The mean peak bilirubin values of term and preterm infants were 22.7+/-0.5 and 13.7+/-0.3 mg/dL. The mean age at peak bilirubin level of term and preterm infants were 7.5+/-0.5 and 4.7+/-0.2 days. All were breastfed (46.3% vs. 30.7%) or fed a combination of breast and bottle feedings (53.7% vs. 44.5%) in term and preterm infants. Comparison of peak bilirubin levels and age at peak bilirubin level in the serum of term and preterm group with AEP results showed no significant relationship. Trend in peak serum indirect bilirubin level in term infants were significantly increased in the recent 3 years. Trend in AEP abnormality showed no significant changes during the study periods. Only two preterm infant showed abnormal AEP at follow up study. CONCLUSION : Recently, increased frequency of breast-feeding, shortened hospital stays, and inconsistent follow-up after hospital discharge may cause the increased incidence of severe hyperbilirubinemia in healthy preterm and term newborn infants. But it is not clear such early onset hyperbilirubinemia may cause acute bilirubin encephalopathy or permanent brain injury.
Bilirubin ; Bottle Feeding ; Brain Injuries ; Brain Stem ; Breast ; Evoked Potentials, Auditory* ; Evoked Potentials, Auditory, Brain Stem ; Feeding Methods ; Follow-Up Studies ; Gestational Age ; Humans ; Hyperbilirubinemia* ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Jaundice, Neonatal ; Kernicterus ; Length of Stay ; Medical Records

After global eradication of smallpox, the World Health Organization(WHO) launched a campaign to eradicate polio. In 2008 December, Global Polio Eradication Initiative(GPEI) Strategic Plan 2009-2013 was declared, and movements to reorganize the acute flaccid paralysis(AFP) surveillance were also started in South Korea. The Korea Center for Disease Control and Prevention set out to intensify the AFP surveillance by rearranging the centers to hospitals with neurology and pediatric neurology specialists, actively promoting surveillance, and modifying the transportation system of samples. This article provides a comprehensive review of newly reorganized AFP surveillance.
Centers for Disease Control and Prevention (U.S.) ; Korea ; Neurology ; Paralysis ; Poliomyelitis ; Republic of Korea ; Smallpox ; Specialization ; Transportation ; World Health ; World Health Organization

PURPOSE: The aim of this study is that the prevalence of rotavirus infection was evaluated by each group and clinical features of group A, B and C rotaviruses infections were described respectively to compare one with another. METHODS: Between January 2010 and December 2010, we enrolled a group of children below 10 years of age admitted for management of acute diarrhea at the Catholic University of Korea Bucheon St. Mary's Hospital. A total of 310 stool samples documented to be free of common bacterial pathogens were collected from children with diarrhea. The presence of group A, B or C rotavirus is indicated by amplification of DNA segments of the expected lengths after the first and second PCRs. RESULTS: In a total of 310 stool specimens, 40 (12.9%) specimens were positive for rotaviruses. These included 23 (7.4%) positive for group A, 5 (1.6%) for group B and 12 (3.9%) for group C rotaviruses. Group B rotavirus infected patients had significantly less diarrheas per day (group A: P=0.01, group C: P=0.01) and shorter duration of vomiting days (group A: P=0.03, group C: P=0.03) than those with group A and C rotaviruses infection respectively. All the group B rotaviruses had been isolated in March and October. Group C rotavirus infections were prevalent during late summer and early winter and peaked in October. CONCLUSION: These findings indicate that group B and C rotaviruses are notable causes or the contributing causes of diarrhea among infants and children in Korea.
Child* ; Diarrhea ; DNA ; Gastroenteritis* ; Gyeonggi-do ; Humans ; Infant ; Korea ; Polymerase Chain Reaction ; Prevalence* ; Rotavirus ; Rotavirus Infections ; Vomiting

Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.
Diagnosis ; Diagnosis, Differential ; Exanthema* ; Hematuria* ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Nephrotic Syndrome ; Penicillins ; Pneumonia* ; Prenatal Care ; Prenatal Diagnosis ; Serologic Tests ; Syphilis, Congenital*

PURPOSE: This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. METHODS: We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. RESULTS: The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. CONCLUSION: The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing.
Adenoviridae ; Child ; Child, Hospitalized ; Cohort Studies ; Diagnostic Tests, Routine ; Diarrhea ; Dysentery ; Enterovirus ; Gastroenteritis ; Humans ; Incidence ; Korea ; Norovirus ; Parechovirus ; Polymerase Chain Reaction ; Prevalence ; Reverse Transcription ; Rotavirus ; Viruses

PURPOSE: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. METHODS: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. RESULTS: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1+/-6.6 vs. 26.9+/-20.2; P=0.005) and shorter for patients that died (10.1+/-7.0 vs. 73.0+/-32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. CONCLUSION: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.
Adult ; Age of Onset ; Arthritis ; Bacteremia ; C-Reactive Protein ; Catheters ; Central Venous Catheters ; Child ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Lower Extremity ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Platelet Count ; Risk Factors ; Sex Ratio ; Soft Tissue Infections ; Staphylococcus ; Survivors

No abstract available.
Humans ; Pregnancy* ; Prognosis* ; Takayasu Arteritis*

PURPOSE: Hand, foot, and mouth disease (HFMD) is a common childhood illness. Enterovirus 71 (EV71) epidemics have recently been associated with HFMD-based neurologic complications in the Asia-Pacific region. This study described HFMD clinical features, and investigated clinical parameters in patients presenting with acute neurologic complications associated with HFMD. METHODS: We retrospectively reviewed medical records from 235 hospitalized patients who developed HFMD with or without neurologic complications (22 and 213 cases, respectively) in Uijengbu, Korea between 2010 and 2013. Clinical manifestations, radiologic findings, cerebrospinal fluid (CSF) analyses, virological analyses, and treatment regimens were summarized. Additionally, routinely collected baseline data from 235 patients were retrospectively analyzed to identify clinical parameters associated with neurologic complications. RESULTS: Brainstem encephalitis was the most frequent neurologic complication (11 cases), followed by aseptic meningitis (seven cases). We also found acute disseminated encephalomyelitis and meningitis retention syndrome. Both have rarely been reported in EV71-associated HFMD. Virological analyses were performed for 15 cases, and 14 demonstrated EV71 infection, while one patient demonstrated Coxsackievirus B3 infection. Multivariate logistic regression analysis indicated patients were more likely to develop neurologic complications if they experienced nausea/vomiting (OR= 13.65, P<0.001) and lethargy (OR=10.68, P=0.003). Males were more likely to develop neurologic complications compared to females (OR=2.12, P=0.005). In addition, neurologic complications were associated with a higher peak heart rate (OR=1.13, P=0.001). CONCLUSION: This study revealed usual and unusual findings of HFMD-associated neurologic complications. Male gender, nausea/vomiting, lethargy, and peak heart rate parameters predicted HFMD-associated neurologic complications. However, laboratory findings did not reliably predict HFMD-associated neurologic complications.
Brain Stem ; Cerebrospinal Fluid ; Encephalitis ; Encephalomyelitis, Acute Disseminated ; Enterovirus ; Female ; Foot* ; Hand* ; Heart Rate ; Humans ; Korea ; Lethargy ; Logistic Models ; Male ; Medical Records ; Meningitis ; Meningitis, Aseptic ; Mouth Diseases* ; Retrospective Studies

OBJECTIVE: Our purpose was to determine normal amniotic fluid alpha-fetoprotein level in midtrimester Korean pregnant women whose neonatal outcomes were normal. METHODS: Amniotic fluid alpha-fetoprotein(AFAFP) levels were measured by specific radioimmunoassay (RIA) in midtrimester pregnant women for various indications of amniocentesis from May 1992 to July 1999 at Seoul National University Hospital. Normal ranges were obtained from 640 singleton pregnancies in which neonatal outcomes were normal. RESULTS: Median values of AFAFP in Korean pregnant women were 13,250ng/mL, 12,900ng/mL, 11,150ng/mL, 9,430ng/mL, 8,019ng/mL, 6,800ng/mL, 5,850ng/mL, 5,750ng/mL, 5,210ng/mL, 3,420ng/mL at 15 week, 16 week, 17 week, 18 week, 19 week, 20 week, 21 week, 22 week, 23 week, 24 week, respectively. CONCLUSION: This determination of the median values and the normal range of AFAFP level by each gestational week in uncomplicated Korean women could be used reference values for prenatal diagnosis of various disorders like open neural tube defect.
alpha-Fetoproteins* ; Amniocentesis ; Amniotic Fluid* ; Female ; Humans ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women* ; Prenatal Diagnosis ; Radioimmunoassay ; Reference Values* ; Seoul

Far Eastern countries including Korea show the high prevalence of hepatitis B virus carriers, so that the incidence of liver cirrhosis is higher than in western countries. But pregnancies with liver cirrhosis are rarely encountered in clinical settings, since liver cirrhosis usually develops after childbearing ages and often causes the disturbance of estrogen metabolism, resulting in severe menstrual irregularity and infertility. Therefore, little is known about the interactions between liver cirrhosis and pregnancy. Liver cirrhosis and portal hypertension are not contraindications to pregnancy but necessitate intensive monitoring throughout pregnancy because the complications of liver cirrhosis, which pose additional risks during pregnancy, are numerous and unpredictable. We report 3 cases of pregnancies in patients with liver cirrhosis with brief review of the literature.
Estrogens ; Hepatitis B virus ; Humans ; Hypertension, Portal ; Incidence ; Infertility ; Korea ; Liver Cirrhosis* ; Liver* ; Metabolism ; Pregnancy* ; Prevalence