PURPOSE: Regarding recombinant human growth hormone (rhGH) use in the pediatric population, no long-term follow-up data are available for Korean patients. To fill in the gap of knowledge, a registry study (LG Growth Study) was initiated to assess the safety and effectiveness of four types of rhGH products in real-life settings. METHODS: A total of 4,000 children will be registered and prospectively followed up at 6-month intervals until 2 years after epiphyseal closure to collect data on treatment and adverse events, with primary interest in malignancies and growth outcomes. RESULTS: As of 22 March 2017, approximately 50% (2,024) of the target number of patients have been included in the analysis set: growth hormone deficiency, 1,297 (64.1%); idiopathic short stature, 315 (15.6%); small for gestational age, 206 (10.2%); Turner syndrome, 197 (9.7%); and chronic renal failure, 9 (0.4%). At baseline, median age (years) was 8 (interquartile range [IQR], 5–11); 52% (1,048) were boys; and the majority were at Tanner stage I (83% based on breast/external genitalia, 97% on pubic hair). Median height standard deviation score was -2.26 (IQR, -2.69 to -2.0), and median bone age delay (years) was -1.46 (IQR, -2.26 to -0.78). CONCLUSIONS: This registry study will provide the opportunity to assess the risk of malignancies as well as the general safety data in Korean pediatric patients receiving rhGH. In addition, the long-term effectiveness of rhGH and comparative data between different disease entities will provide practical insight on the standard rhGH treatment.
Child* ; Cohort Studies* ; Follow-Up Studies ; Genitalia ; Gestational Age ; Growth Hormone ; Human Growth Hormone* ; Humans* ; Kidney Failure, Chronic ; Prospective Studies ; Turner Syndrome

PURPOSE: Mumps meningitis is a common complication of mumps infection; however, information on mumps meningitis in the postvaccine era is limited. The purpose of the present study was to determine factors associated with mumps meningitis and to discuss the effect of vaccination on this disease. METHODS: We retrospectively reviewed patients younger than 19 years with mumps, diagnosed at a university hospital in Korea between 2003 and 2013. Patients were divided into groups with and without meningitis, and the clinical features of the 2 groups were compared. RESULTS: The study enrolled 119 patients: 19 patients with meningitis and 100 patients without. Univariate analysis showed that older age (median: 15 years vs. 9.5 years, respectively), a longer interval from last vaccination (median: 10.2 years vs. 4.8 years, respectively), and febrile presentation (94.7% vs. 31.0%, respectively) were significantly associated with mumps meningitis. Sex, number of vaccination doses, bilateral parotitis, and the presence of complications other than meningitis did not differ between the 2 groups. In multivariate logistic regression analysis, age (odds ratio, 1.38; 95% confidence interval, 1.01-1.89; P=0.04) and fever (odds ratio, 30.46; 95% confidence interval, 3.27-283.61; P<0.01) remained independent factors for mumps meningitis. CONCLUSION: Clinicians in the postvaccine era should be aware of the possibility of mumps meningitis in febrile cases of mumps in adolescents, regardless of the number of vaccination doses. To establish the role of vaccination in mumps meningitis, further studies will be necessary.
Adolescent ; Child ; Fever ; Humans ; Korea ; Logistic Models ; Measles-Mumps-Rubella Vaccine ; Meningitis* ; Meningitis, Viral ; Mumps* ; Parotitis ; Retrospective Studies ; Vaccination*

PURPOSE: To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children. METHODS: A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared. RESULTS: From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases. CONCLUSION: The more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.
C-Reactive Protein ; Child* ; Fever ; Gastroenteritis* ; Gastrointestinal Hemorrhage ; Headache ; Humans ; Leukocyte Count ; Retrospective Studies ; Salmonella enterica ; Salmonella Infections ; Salmonella*

PURPOSE: To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children. METHODS: A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared. RESULTS: From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases. CONCLUSION: The more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.
C-Reactive Protein ; Child* ; Fever ; Gastroenteritis* ; Gastrointestinal Hemorrhage ; Headache ; Humans ; Leukocyte Count ; Retrospective Studies ; Salmonella enterica ; Salmonella Infections ; Salmonella*

Tularemia is a potentially severe zoonotic disease caused by Francisella tularensis. A lack of awareness about tularemia can be embarrassing and could result in delayed treatment because of improper diagnosis. The diagnosis of tularemia is difficult, because the infections are rare and the clinical spectrum is broad. As only 1 adult case has been reported in Korea thus far, pediatricians in Korea may be unfamiliar with tularemia. We report our experience with a 14-year-old male adolescent with tularemia who presented with atypical pneumonia and possible infective endocarditis. Although the infectivity and mortality rates for tularemia are very high if left untreated, we did not suspect tularemia in this case until the incidental isolation of F. tularensis. The present case suggests that clinicians in Korea should be more aware of tularemia. This case also suggests that tularemia should be considered in undetermined cases of atypical pneumonia or acute febrile illness without local signs.
Adolescent ; Adult ; Diagnosis ; Endocarditis* ; Francisella tularensis ; Humans ; Korea* ; Mortality ; Pediatrics ; Pneumonia* ; Tularemia* ; Zoonoses

BACKGROUND: Esophageal injury requires early and proper management. We want to determine the results of various esophageal injuries. MATERIAL AND METHOD: We respectively analyzed 22 patients who were managed for esophageal injury between 1999 and 2009. Based on the medical records, we reviewed the causes of injury, the diagnoses, the treatment methods, the complications and the prognosis. RESULT: The main causes of esophageal injury were a foreign body in 9 cases (41%) and vomiting in 5 cases (23%). We treated the patients with esophageal primary repair in 12 cases (55%), abscess drainage in 4 cases (18%) and conservative management in 6 cases (27%). There was esophageal leakage in 7 cases (32%) and death occurred in 3 cases (14%). CONCLUSION: For minor esophageal injury, conservative management was sometimes possible to treat the esophagus, yet aggressive and urgent surgical treatment should be applied for cases of major esophageal injury, including mediastinal abscess.
Abscess ; Drainage ; Esophageal Perforation ; Esophagus ; Foreign Bodies ; Humans ; Medical Records ; Vomiting

Genotyping of Toxoplasma gondii has been performed in 23 PCR positive blood samples from stray cats in Korea. We used 2 separate PCR-restriction fragment length polymorphism (RFLP) patterns of SAG2 gene, amplifying the 5'and 3'ends of the locus. The results revealed that all samples belonged to the type I clonal lineage. Although T. gondii organisms were not isolated from the samples, the results of the present study represent that stray cats with T. gondii infection should be seriously concerned in our environment. Adequate and continuous control programs of stray cats are needed to reduce the risk of transmission of T. gondii as a zoonotic infection threatening the public health.
Animals ; Antigens, Protozoan/genetics ; Blood/*parasitology ; Cat Diseases/*parasitology ; Cats ; Cluster Analysis ; DNA Fingerprinting/methods ; DNA, Protozoan/genetics/isolation & purification ; Genotype ; Korea ; Polymerase Chain Reaction/methods ; Polymorphism, Restriction Fragment Length ; Protozoan Proteins/genetics ; Toxoplasma/*classification/*genetics/isolation & purification ; Toxoplasmosis, Animal/*parasitology

Living related liver transplantation(LRLT) is theoretically the best treatment option for end stage liver disease and nonresectable hepatocellular carcinomas. Anastomosed hepatic artery is at high risk in thrombosis after LRLT, which directly related to the patient's life. Usually, recipient hepatic artery is so friable and intimal separation and blood clot between intima and media were noted frequently. From December 2001 to June 2003, consecutive 30 hepatic arteries were harvested from 45 LRLTs patients with end stage liver disease. All hepatic artery were anastomosed with #9-0 nylon by plastic surgeon. All hepatic arteries were patent intraoperatively and postoperatively. In the histopathologic study of hepatic artery, some had intimal thickening, myxoid change and intimal hyperplasia in 14 out of 30 cases. Since pathologic changes may develop as a result of transarterial chemoembolization(TACE) and others causes, we postulated that the prevalence of hepatic arterial thrombosis, a catastrophic graft-threatening complication of LRLT, might be increased in this subset of LRLT patients who received TACE. But, in our study, patients who underwent hepatic arterial chemoembolization statistically do not show an increased risk of developing hepatic arterial thrombosis or other hepatic arterial complications after LRLT. And pathologic changes are statistically not correlate with the TACE.
Carcinoma, Hepatocellular ; End Stage Liver Disease ; Hepatic Artery* ; Humans ; Hyperplasia ; Liver Transplantation* ; Liver* ; Nylons ; Prevalence ; Thrombosis

Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

The Mycobacterium avium complex (MAC) comprises slow-growing mycobacteria that is ubiquitous in the environment and capable of infecting diverse species with consequences ranging from asymptomatic infection to clinically significant and even fatal disease. Especially, basal pleural disease is infrequently found in immunocompetent person. We report a very rare case of M. avium pleuritis with massive pleural effusion without any predisposing conditions. A previously healthy 36-year-old man was admitted to our hospital because of generalized malaise, low-grade fever, and right pleuritic chest pain of 5 days' duration. Chest X-ray showed mottled infiltration in the right upper lung zone with minimal right pleural effusion which was exudate with lymphocyte-dominance. The pleural effusion progressively increased without responding to anti-tuberculosis treatment. Afterwards M. avium was identified from the pleural effusion using PCR-Restriction Fragment Length Polymorphism Assay(PCR-RFLP). The treatment regimen was changed to rifampine, ethambutol, clarithromycin and streptomycin afterwhich the patient recovered.
Adult ; Asymptomatic Infections ; Chest Pain ; Clarithromycin ; Ethambutol ; Exudates and Transudates ; Fever ; Humans ; Lung ; Lung Diseases* ; Mycobacterium avium Complex ; Mycobacterium avium* ; Mycobacterium* ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Rifampin ; Streptomycin ; Thorax