Nontyphoidal Salmonella are gram negative bacilli organism, which may induce systemic infection such as febrile enteritis, bacteremia, and osteomyelitis. Main route of infection is known as food but also possible through reptile, amphibian, and fish raised as pets in the house. There is no known cases report of Salmonella infection through pets in Korea and also rare in the overseas. We report 2 patients who visited Severance children's hospital with chief complaint of fever and diagnosed as nontyphoidal salmonellosis. Each case had a history of raising turtle or tropical fish with possibility of Salmonella infection through these pets. Increasing incidence of raising pet reptile and fish lately, contact precaution and proper prevention and control of Salmonella infection of these pets especially in children under 5 years old are necessary due to higher risk of serious complications of salmonellosis.
Amphibians ; Bacteremia ; Child ; Enteritis ; Fever ; Fishes ; Humans ; Incidence ; Korea ; Osteomyelitis ; Reptiles ; Salmonella ; Salmonella Infections ; Turtles

PURPOSE: The aim of this study was to determine the frequency, epidemiology and the clinical manifestation of human metapneumovirus (hMPV) infection in Korean children. METHODS: From February 2010 to January 2012, we collected nasopharyngeal aspiration from 1,554 children who were hospitalized for acute lower respiratory tract infections at the Department of Pediatrics, Severance Children's Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. RESULTS: We detected hMPV in 99 of the 1,554 hospitalized children. The mean age of the hMPV infected children was 25 months, and 87% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (73%) and bronchiolitis (16%). The clinical manifestations included cough, fever, respiratory distress, hoarseness, tachypnea, and wheezing. Coinfection with other respiratory viruses was found in 43 children (43%). CONCLUSION: hMPV is one of the major virus causing acute respiratory tract infection in the age between 13 months and 48 months old with peaks during April to June. Reports of hMPV in Korea has been increasing but additional studies are required to define the epidemiology and the extent of disease caused by hMPV to determine future development of this illness in Korean children.
Bronchiolitis ; Child ; Child, Hospitalized ; Coinfection ; Cough ; Fever ; Hoarseness ; Humans ; Korea ; Medical Records ; Metapneumovirus ; Pediatrics ; Pneumonia ; Respiratory Sounds ; Respiratory Tract Infections ; Retrospective Studies ; Tachypnea ; Viruses

PURPOSE: As the number of children who attend child care centers has increased, concerns has increased about the effect of child day care on childhood illness. This study was conducted to examine the relationship between experience in child care and common infectious diseases in children under 5 years of age. METHODS: Data were collected by surveying 1,000 respondents with children under age 5 through online interviews using a structured questionnaire. The contents of the survey were composed of demographic characteristics, child care facilities usage, experience in infectious diseases, and immunization status. RESULTS: Among the 1,000 children <5 years of age, 78.5% attended a child care facility. Rates of common communicable illnesses were higher in children in child care than for children reared exclusively at home. The predominant communicable diseases which the respondents' children experienced, in order of decreasing frequency, were gastroenteritis (47.1%), otitis media (41.8%) and pneumonia (19.1%). The immunization rate of vaccines that are not included the national immunization program (NIP) (Haemophilus influenzae type b vaccine - 76.6%, hepatitis A vaccine - 63.3%, pneumococcal vaccine - 59.4%, rotavirus vaccine - 43.1%) was lower than that of the NIP vaccines (90.4%). CONCLUSION: Children in child care experience more bouts of common infectious disease, so nationwide policies to prevent or to control the spread of infectious agents in a child-care should be available and appropriate immunization should be emphasized as the most effective method for the control of infectious disease for children.
Child ; Child Care ; Communicable Diseases ; Surveys and Questionnaires ; Day Care, Medical ; Gastroenteritis ; Hepatitis A Vaccines ; Humans ; Immunization ; Immunization Programs ; Influenza, Human ; Otitis Media ; Pneumonia ; Rotavirus ; Vaccination ; Vaccines

PURPOSE: Human bocavirus (hBoV), a recently discovered virus, has been detected in children with respiratory tract infections worldwide. The aim of this study was to analyze the frequency and molecular phylogeny of hBoV in the respiratory samples of children with acute respiratory tract infections in 2010. METHODS: Nasopharyngeal samples were collected from 953 children with lower respiratory tract infections at Severance children's hospital in Korea from January 2010 to December 2010. We applied the multiplex PCR technique for the identification of 12 respiratory viruses from the samples. Among the total specimens, hBoV positive samples were subjected to phylogenetic analysis by sequencing a fragment of the VP1/VP2 gene junction. RESULTS: hBoV was detected in 141 (14.8%) among 953 patients. The 61.7% of hBoV-positive samples were found to co-exist with other respiratory viruses. The results of phylogenetic analysis showed that all 141 hBoV-positive isolates were identified as hBoV 1, revealing a high similarity among the isolates (>98%). CONCLUSION: hBoV 1 with minimal sequence variations circulated in children with acute respiratory infections during 2010. More research is needed to determine the clinical severity and outcomes of the minimal sequence variations.
Child ; Child, Hospitalized ; Human bocavirus ; Humans ; Korea ; Multiplex Polymerase Chain Reaction ; Phylogeny ; Respiratory System ; Respiratory Tract Infections ; Viruses

No abstract available.
Lymphoma, T-Cell, Cutaneous*

BACKGROUND/AIMS: As the optimal stereotactic body radiation therapy (SBRT) modality for hepatocellular carcinoma (HCC) has not been confirmed, we aimed herein to provide a practical guideline by our retrospective review. METHODS: Thirty-nine patients with primary HCC who underwent liver SBRT via 3 modalities (helical tomotherapy [HT]: 22, volumetric modulated arc therapy [VMAT]: 13, Cyberknife: 4) at our institution between July 2014 and July 2015 were included. Modalities were compared with regard to dose conformity index (CI), homogeneity index (HI), clinical results, and patient compliance. RESULTS: VMAT SBRT had favorable conformity (CI: 0.7±0.2), homogeneity (HI: 1.1±0.0), and shortest treatment time (100.2±26.1 seconds). HT SBRT yielded good dosimetric outcomes, especially in conformity (CI: 1.0±0.2). Although the Cyberknife SBRT synchrony system allowed real-time tumor targeting, the treatment time was longest (3,015.0±447.3 seconds), invasive pre-treatment procedures were required, and the HI (1.3±0.0) was lowest. CONCLUSIONS: All 3 modalities yielded competent dosimetric planning parameters. VMAT SBRT was most appropriate for tumors with residual lipiodol or patients with poor conditions. HT SBRT is available for multiple or irregular targets. Cyberknife SBRT is recommended for carefully selected patients and tumors indicated for sono-guided fiducial insertion.
Carcinoma, Hepatocellular* ; Ethiodized Oil ; Humans ; Liver ; Patient Compliance ; Radiotherapy ; Radiotherapy, Intensity-Modulated ; Retrospective Studies

PURPOSE: Methods for quick and reliable detection of Streptococcus pneumoniae are needed for the diagnosis of pneumococcal disease and vaccine studies. This study aimed to show that sequential multiplex polymerase chain reaction (PCR) is more efficient than conventional culture in achieving S. pneumoniae-positive results. METHODS: Nasopharyngeal (NP) secretions were obtained from 842 pediatric patients admitted with lower respiratory infections at Severance Children's Hospital in Korea between March 2009 and June 2010. For identification and serotype determination of pneumococci from the NP secretions, the secretions were evaluated via multiplex PCR technique with 35 serotype-specific primers arranged in 8 multiplex PCR sets and conventional bacteriological culture technique. RESULTS: Among the results for 793 samples that underwent both bacterial culture and PCR analysis for pneumococcal detection, 153 (19.3%) results obtained by PCR and 81 (10.2%) results obtained by conventional culture technique were positive for S. pneumoniae. The predominant serotypes observed, in order of decreasing frequency, were 19A (23%), 6A/B (16%), 19F (11%), 15B/C (5%), 15A (5%), and 11A (4%); further, 26% of the isolates were non-typeable. CONCLUSION: As opposed to conventional bacteriological tests, PCR analysis can accurately and rapidly identify pneumococcal serotypes.
Culture Techniques ; Humans ; Korea ; Multiplex Polymerase Chain Reaction ; Pneumonia ; Polymerase Chain Reaction ; Respiratory Tract Infections ; Serotyping ; Streptococcus ; Streptococcus pneumoniae

BACKGROUNG: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leakage and observed the effects and efficiency of treatment. MATERIAL AND METHOD: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. RESULTS Continuous air leakages disappeared in all 16 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complicaitons were transient and disappeared without specific treatment. CONCLUSION: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. Long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.
Aprotinin ; Calcium Chloride ; Cefazolin ; Chest Pain ; Chest Tubes ; Empyema ; Fever ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Humans ; Length of Stay ; Leukocytosis ; Lung* ; Pleurodesis ; Recurrence ; Rubber ; Syringes ; Thrombin ; Tissue Adhesives

OBJECTIVE: Kawasaki disease is a systemic vascular disease which is caused by an immunologic response. The purpose of this study is to see how a high IgE level affects Kawasaki disease, in two groups of high IgE level and low IgE level. METHODS: A retrospective study was done from 2008 to 2010, among patients, who were admitted in Severance Children's Hospital for Kawasaki disease with IgE levels checked. Age groups with an IgE level above reference ranges and those with normal ranges were done. Also, clinical characteristics were analyzed. Statistical method was done by SPSS 18. RESULTS: A total of 198 Kawasaki patients were analyzed from 2008 to 2010. Among them 123 (62%) patients showed elevated IgE levels. Patients with high IgE had a significantly higher lymphadenopathy prevalence (p=0.006), however they had no connection with quantitative values. Patients with BCG site redness appeared to have lower IgE levels than patients without redness. Coronary complication had no relation with IgE levels. There was no correlation between laboratory results and IgE levels. CONCLUSION: 62% of Kawasaki disease patients show high IgE levels in our study. The symptoms of BCG site redness aged less than 1 year seemed to be related with IgE level. To understand the pathophysiology of Kawasaki disease, more studies should be performed on the role of IgE.
Aged ; Humans ; Immunoglobulin E ; Immunoglobulins ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome ; Mycobacterium bovis ; Prevalence ; Reference Values ; Retrospective Studies ; Vascular Diseases

OBJECTIVE: Kawasaki disease is a systemic vascular disease which is caused by an immunologic response. The purpose of this study is to see how a high IgE level affects Kawasaki disease, in two groups of high IgE level and low IgE level. METHODS: A retrospective study was done from 2008 to 2010, among patients, who were admitted in Severance Children's Hospital for Kawasaki disease with IgE levels checked. Age groups with an IgE level above reference ranges and those with normal ranges were done. Also, clinical characteristics were analyzed. Statistical method was done by SPSS 18. RESULTS: A total of 198 Kawasaki patients were analyzed from 2008 to 2010. Among them 123 (62%) patients showed elevated IgE levels. Patients with high IgE had a significantly higher lymphadenopathy prevalence (p=0.006), however they had no connection with quantitative values. Patients with BCG site redness appeared to have lower IgE levels than patients without redness. Coronary complication had no relation with IgE levels. There was no correlation between laboratory results and IgE levels. CONCLUSION: 62% of Kawasaki disease patients show high IgE levels in our study. The symptoms of BCG site redness aged less than 1 year seemed to be related with IgE level. To understand the pathophysiology of Kawasaki disease, more studies should be performed on the role of IgE.
Aged ; Humans ; Immunoglobulin E ; Immunoglobulins ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome ; Mycobacterium bovis ; Prevalence ; Reference Values ; Retrospective Studies ; Vascular Diseases