OBJECTIVES: The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.METHODS: Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.RESULTS: The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.CONCLUSIONS: The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.
Asymptomatic Infections ; Coronavirus ; Coronavirus Infections ; Cross Infection ; Delivery of Health Care ; Epidemiology ; Fluorescent Antibody Technique ; Humans ; Hypertension ; Inpatients ; Korea ; Middle East Respiratory Syndrome Coronavirus ; Middle East ; Osteoarthritis

OBJECTIVES: The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status. METHODS: Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results. RESULTS: The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis. CONCLUSIONS: The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.
Asymptomatic Infections ; Coronavirus ; Coronavirus Infections* ; Cross Infection ; Delivery of Health Care ; Epidemiology ; Fluorescent Antibody Technique ; Humans ; Hypertension ; Inpatients ; Korea* ; Middle East Respiratory Syndrome Coronavirus* ; Middle East* ; Osteoarthritis

OBJECTIVES: The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status. METHODS: Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results. RESULTS: The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis. CONCLUSIONS The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.

Nephronophthisis-related ciliopathy (NPHP-RC) is a common genetic cause of end-stage renal failure during childhood and adolescence and exhibits an autosomal recessive pattern of inheritance. Genetic diagnosis is quite limited owing to genetic heterogeneity in NPHP-RC. We designed a novel approach involving the step-wise screening of Sanger sequencing and targeted exome sequencing for the genetic diagnosis of 55 patients with NPHP-RC. First, five NPHP-RC genes were analyzed by Sanger sequencing in phenotypically classified patients. Known pathogenic mutations were identified in 12 patients (21.8%); homozygous deletions of NPHP1 in 4 juvenile nephronophthisis patients, IQCB1/NPHP5 mutations in 3 Senior–Løken syndrome patients, a CEP290/NPHP6 mutation in 1 Joubert syndrome patient, and TMEM67/MKS3 mutations in 4 Joubert syndrome patients with liver involvement. In the remaining undiagnosed patients, we applied targeted exome sequencing of 34 ciliopathy-related genes to detect known pathogenic mutations in 7 (16.3%) of 43 patients. Another 18 likely damaging heterozygous variants were identified in 13 NPHP-RC genes in 18 patients. In this study, we report a variety of pathogenic and candidate mutations identified in 55 patients with NPHP-RC in Korea using a step-wise application of two genetic tests. These results support the clinical utility of targeted exome sequencing to resolve the issue of allelic and genetic heterogeneity in NPHP-RC.
Adolescent ; Diagnosis* ; Exome* ; Genetic Heterogeneity* ; Humans ; Kidney Failure, Chronic ; Korea ; Liver ; Mass Screening ; Wills

A Middle East respiratory syndrome (MERS) - coronavirus (CoV) cluster that attacked Korea in May 2015 revealed several weaknesses in Korea's health care system in the face of the crisis of an emerging infectious disease and its public health implications. This experience has shown that is necessary to prepare comprehensive countermeasures through the cooperation of civil and public agencies to prevent a second or even third MERS outbreak and to control future crises of infectious disease and public health. The MERS Policy Committee of the Korean Medical Association has thus proposed a master plan for reform of the national infectious disease prevention and management system to prepare a new framework for national infectious disease prevention and control. The specific targets of the master plan are improvement of the system of usage of medical services and of the medical culture among national health insurance subscribers, improvement of the emergency room management system to prevent the spread of infectious disease, the establishment of a support system to promote effective voluntary infectious disease prevention activities among medical institutions, the building of a public health crisis communication system in collaboration with medical organizations, the establishment of an independent Ministry of Health and capacity building of the Korea Centers for Disease Control (KCDC), the securing of an advanced research and development system in the field of prevention and control of infectious disease, and the capacity building of professional epidemiologists and personnel needed to prevent and control infectious disease. The five core strategies of the master plan have been planned by medical experts in this order of priority: the reform of the healthcare delivery system, the independence of the Ministry of Health and capacity building of the KCDC, fundraising for a public infection management fund, enforcement of medical organization infection control, and improvement of the emergency room management system.
Capacity Building ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases* ; Communicable Diseases, Emerging ; Cooperative Behavior ; Coronavirus ; Coronavirus Infections ; Delivery of Health Care ; Emergency Service, Hospital ; Financial Management ; Infection Control ; Korea* ; Middle East ; National Health Programs ; Public Health

PURPOSE: Medullary sponge kidney (MSK) is a rare congenital disease characterized by diffuse ectasia or dilatation of precalyceal collecting tubules. MSK incidence and prevalence in the general population is uncertain and only a few patients are reported especially in the pediatric age. There has been increasing reports of patients with MSK who have other malformative disorders. Also several case reports concerning about etiological association of some genes. METHODS: Collaborative study through nation-wide survey was done to investigate the incidence and etiological association of some genes such as GDNF gene, ATP6V1B1, ATP6V0A4 gene in developing MSK in Korean children. RESULTS: Four cases of MSK who have various other malformative disorders were collected. There are no mutations of GDNF gene, ATP6V1B1, ATP6V0A4 gene in all patients. CONCLUSION: MSK is one of the very rare diseases in pediatric age. The etiological association of GDNF gene , ATP6V1B1, ATP6V0A4 gene in developing MSK in Korean children is not proved.
Child ; Dilatation ; Dilatation, Pathologic ; Glial Cell Line-Derived Neurotrophic Factor ; Humans ; Incidence ; Medullary Sponge Kidney ; Prevalence ; Rare Diseases

PURPOSE:This study was performed to examine seasonal occurrences of respiratory viruses and detect viral etiologic agents, by multiplex RT-PCR in children with acute lower respiratory tract infection (ALRI). METHODS:Nasopharyngeal aspirates (NPA) were collected from 654 hospitalized children with ALRI on admission at Soonchunhyang University Cheonan Hospital and analysed by multiplex RT-PCR between January 2005 and December 2005. RESULTS:Viral agents were detected from 234 subjects (35.8%). The identified viral pathogens were respiratory syncytial virus (RSV) (34.2%), adenovirus (33.8%), parainfluenza virus (21.8%), influenza virus type A (8.1%) and influenza virus type B (2.1%). Viral ALRI occurred most frenquently during the 1st year of life. Clinical diagnoses of viral ALRI included pneumonia (72.2%), bronchiolitis (14.5%), tracheobronchitis (9.8%) and croup (3.5%). The most common cause of bronchiolitis was RSV. Common clinical symptoms and signs of viral ALRI were cough (93.4%), fever (78.2%), rhinorrhea (72.5%), rale (60.2%), and wheezing (26.2%). CONCLUSION:Viral agents were detected by multiplex RT-PCR in 35.8% of NPA obtained from 654 hospitalized patients with acute respiratory tract infections. Multiplex RT-PCR may be useful for detecting virus in children.
Adenoviridae ; Bronchiolitis ; Child ; Child, Hospitalized ; Chungcheongnam-do ; Cough ; Croup ; Diagnosis ; Fever ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Respiratory System* ; Respiratory Tract Infections ; Seasons

PURPOSE:This study was performed to examine seasonal occurrences of respiratory viruses and detect viral etiologic agents, by multiplex RT-PCR in children with acute lower respiratory tract infection (ALRI). METHODS:Nasopharyngeal aspirates (NPA) were collected from 654 hospitalized children with ALRI on admission at Soonchunhyang University Cheonan Hospital and analysed by multiplex RT-PCR between January 2005 and December 2005. RESULTS:Viral agents were detected from 234 subjects (35.8%). The identified viral pathogens were respiratory syncytial virus (RSV) (34.2%), adenovirus (33.8%), parainfluenza virus (21.8%), influenza virus type A (8.1%) and influenza virus type B (2.1%). Viral ALRI occurred most frenquently during the 1st year of life. Clinical diagnoses of viral ALRI included pneumonia (72.2%), bronchiolitis (14.5%), tracheobronchitis (9.8%) and croup (3.5%). The most common cause of bronchiolitis was RSV. Common clinical symptoms and signs of viral ALRI were cough (93.4%), fever (78.2%), rhinorrhea (72.5%), rale (60.2%), and wheezing (26.2%). CONCLUSION:Viral agents were detected by multiplex RT-PCR in 35.8% of NPA obtained from 654 hospitalized patients with acute respiratory tract infections. Multiplex RT-PCR may be useful for detecting virus in children.
Adenoviridae ; Bronchiolitis ; Child ; Child, Hospitalized ; Chungcheongnam-do ; Cough ; Croup ; Diagnosis ; Fever ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Respiratory System* ; Respiratory Tract Infections ; Seasons

Systemic lupus erythematosus(SLE), a rheumatic disease of unknown causes, is characterized by autoantibodies directed against self-antigens, resulting in inflammatory damages to target organs including kidney, blood-forming cells, and central nervous system. The prevalence rates are higher in Native Americans, Asians, Latin Americans and black people. A female to male ratio of approximately 2 : 1 occurs before puberty, and 4 : 1 after puberty. Children of SLE most frequently present with fever, fatigue, arthralgia or arthritis, and rashes. The diagnosis is confirmed by clinical and also laboratory manifestations satisfying at least 4 out of 11 criteria. A central nervous system is not rarely involved in children of SLE with the prevalence rate of 23-44%. However, cerebral infarcts are not a common phenomenon and can be seen only for 6% of children with SLE. There have been no cases reported in Korea. This is why we present a case of basal ganglia infarct associated with SLE in a 19-month old girl. We report this case with a brief review of related literature.
Adolescent ; Arthralgia ; Arthritis ; Asian Continental Ancestry Group ; Autoantibodies ; Autoantigens ; Basal Ganglia* ; Central Nervous System ; Child ; Diagnosis ; Exanthema ; Fatigue ; Female ; Fever ; Humans ; Indians, North American ; Infant ; Kidney ; Korea ; Lupus Erythematosus, Systemic ; Male ; Prevalence ; Puberty ; Rheumatic Diseases

OBJECTIVE: Immunotoxin therapy is a novel approach for the treatment of tumor, and it has been successfully used in the central nervous system. The purpose of this study is to evaluate the cytotoxicity of OKT9 ScFv-Diphtheria toxin fusion immunotoxin on various human brain tumor cell lines. METHODS: Immunotoxin which was composed of OKT9 ScFv and Diphtheria toxin was made. Its cytotoxicity on glioblastoma cell lines(U87MG, U118MG) and medulloblastoma cell line(TE671) was tested and compared with anti-cancer chemotherapeutic agents. And we also examined the relationship between its cytotoxicity and transferrin receptor expression. RESULTS: It showed most cytotoxicity on U87MG cell line and nearly no effect on U118MG cell line, moderate cytotoxicity on TE671 cell line in sixteen hours exposure experiment. In continuous exposure experiment, it showed moderate cytotoxicity on U118MG cell line, but showed strong cytotoxicity on other cell lines comparable or higher than anti-cancer chemotherapeutic agents. The relationship between its cytotoxicity and transferrin receptor expression was tested using flow cytometry, but no direct relationship could be found. CONCLUSION: Collectively, the result shows the cytotoxic effects of OKT9 ScFv-Diphtheria toxin fusion immunotoxin against various human brain tumor cell lines in continuous exposure experiment. Therefore, we suggest that this immunotoxin could be developed as a potential immunotherapeutic agent in the treatment of various human brain tumor clinically.
Brain Neoplasms* ; Brain* ; Cell Line* ; Central Nervous System ; Diphtheria Toxin ; Flow Cytometry ; Glioblastoma ; Humans* ; Immunotoxins* ; Medulloblastoma ; Receptors, Transferrin