Molecular typing of uropathogenic Escherichia coli isolated from Korean children with urinary tract infection / 소아과

PURPOSE: We investigated the molecular types of uropathogenic Escherichia coli (UPEC) by using conventional phylogrouping, multilocus sequence typing (MLST), and fimH genotyping. METHODS: Samples of patients younger than 18 years of age were collected from the Chung-Ang University Hospital over 2 years. Conventional phylogenetic grouping for UPEC strains was performed by polymerase chain reaction (PCR). Bacterial strain sequence types (STs) were classified on the basis of the results of partial sequencing of seven housekeeping genes. In addition, we analyzed nucleotide variations in a 424-base pair fragment of fimH, a major virulence factor in UPEC. RESULTS: Sixty-four UPEC isolates were analyzed in this study. Phylogenetic grouping revealed that group B2 was the most common type (n=54, 84%). We identified 16 distinctive STs using MLST. The most common STs were ST95 (35.9%), ST73 (15.6%), ST131 (12.5%), ST69 (7.8%), and ST14 (6.3%). Fourteen fimH allele types were identified, of which 11 had been previously reported, and the remaining three were identified in this study. f1 (n=28, 45.2%) was found to be the most common allele type, followed by f6 and f9 (n=7, 11.3% each). Comparative analysis of the results from the three different molecular typing techniques revealed that both MLST and fimH typing generated more discriminatory UPEC types than did PCR-based phylogrouping. CONCLUSION: We characterized UPEC molecular types isolated from Korean children by MLST and fimH genotyping. fimH genotyping might serve as a useful molecular test for large epidemiologic studies of UPEC isolates.

Identification of a Novel Mutation in the CYBB Gene, p.Asp378Gly, in a Patient With X-linked Chronic Granulomatous Disease

Chronic granulomatous disease (CGD) is a rare immunodeficiency disease, which is characterized by the lack of a functional nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in phagocytes. The disease presents leukocytosis, anemia, hypergammaglobulinemia, and granuloma formation of the skin, lung, or lymph nodes. The mutation of the CYBB gene encoding gp91phox, located on chromosome Xp21.1 is one of the causes of CGD. We report a patient with X-linked CGD who carried a novel mutation, a c.1133A>G (paAsp378Gly) missense mutation, in the CYBB gene.

Identification of a Novel Mutation in the CYBB Gene, p.Asp378Gly, in a Patient With X-linked Chronic Granulomatous Disease

Chronic granulomatous disease (CGD) is a rare immunodeficiency disease, which is characterized by the lack of a functional nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in phagocytes. The disease presents leukocytosis, anemia, hypergammaglobulinemia, and granuloma formation of the skin, lung, or lymph nodes. The mutation of the CYBB gene encoding gp91phox, located on chromosome Xp21.1 is one of the causes of CGD. We report a patient with X-linked CGD who carried a novel mutation, a c.1133A>G (paAsp378Gly) missense mutation, in the CYBB gene.

Anaphylaxis to Topically Applied Sodium Fusidate

Fusidic acid is a bacteriostatic antibiotic that is effective primarily on gram-positive bacteria, such as Staphylococcus and Corynebacterium species. It is often topically applied to the skin, but is also given systemically as a tablet or injection. Allergic contact dermatitis, or urticaria, has been reported as a side effect of fusidic acid treatment, whereas anaphylaxis to topically administered fusidic acid has not been reported previously. A 16-year-old boy visited an outpatient clinic for further evaluation of anaphylaxis. He suffered abrasions on his arms during exercise, which were treated with a topical ointment containing sodium fusidate. Within 30 minutes, he developed urticaria and eyelid swelling, followed by a cough and respiratory difficulty. His symptoms were relieved by emergency treatment in a nearby hospital. To investigate the etiology, oral provocation with fusidate was performed. After 125 mg (1/2 tablet) of sodium fusidate was administered, he developed a cough and itching of the throat within 30 minutes, which was followed by chest discomfort and urticaria. Forced expiratory volume in 1 second (FEV1) dropped from 4.09 L at baseline to 3.50 L after challenge, although wheezing was not heard in his chest. After management with an inhaled bronchodilator using a nebulizer, chest discomfort was relieved and FEV1 rose to 3.86 L. The patient was directed not to use fusidate, especially on abrasions. Here we report the first case of anaphylaxis resulting from topical fusidic acid application to abrasions.

Effect of bathing on atopic dermatitis during the summer season

BACKGROUND: There are little objective data regarding the optimal practice methods of bathing, although bathing and the use of moisturizers are the most important facets to atopic dermatitis (AD) management. OBJECTIVE: We performed this study to evaluate the effect of bathing on AD. METHODS: Ninety-six children with AD were enrolled during the summer season. Parents were educated to bathe them once daily with mildly acidic cleansers, and to apply emollients for 14 days. Parents recorded the frequency of bathing and skin symptoms in a diary. Scoring AD (SCORAD) scores were measured at the initial and follow-up visits. Patients were divided into two groups, based on the compliance of bathing; poor compliance was defined as ≥ 2 bathless days. RESULTS: There was an improvement of SCORAD score, itching, and insomnia in the good compliance group (all p < 0.001). The mean change in SCORAD score from the baseline at the follow-up visit was greater in the good compliance group than the poor compliance group (p = 0.038). CONCLUSION: Daily bathing using weakly acidic syndets can reduce skin symptoms of pediatric AD during the summer season.

Prevalence and Risk Factors of Asthma and Allergic Rhinitis in Elementary School Children in Jinan-Gun / 소아알레르기및호흡기학회지

PURPOSE: The aim of this study was to evaluate the prevalence and risk factors associated with asthma and allergic rhinitis in rural elementary school children. METHODS: Children in 12 elementary schools in Jinan-gun, Jeollabuk-do, a typical rural area in Korea, were enrolled. We conducted cross-sectional survey using a Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. RESULTS: A total of 947 questionnaires out of 1,062 were completed and the response rate was 89.1%. The symptom prevalence of asthma and allergic rhinitis (AR) in the last 12 months was 7.4% and 28.1%. The prevalence of physician-diagnosed asthma and AR was 7.2% and 22.2%. Male, passive smoking, visible mold at home, and use of antibiotics during infancy more than 3 times were associated with higher prevalence of asthma diagnosis (adjusted odds ratio [aOR] 2.35, 95% confidence interval [CI] 1.30 to 4.26; aOR 2.49, 95% CI 1.38 to 4.48; aOR 2.19, 95% CI 1.23 to 3.89; and aOR 8.45, 95% CI 4.23 to 16.59). Parental history of allergic diseases, children without siblings, use of antibiotics during infancy more than 3 times were associated with higher prevalence of AR (aOR 4.89, 95% CI 3.37 to 7.10; aOR 5.20, 95% CI 2.38 to 11.35; and aOR 2.39, 95% CI 1.36 to 4.19). CONCLUSION: In Jinan-gun, the symptom prevalence of asthma and AR in the last 12 months was 7.4% and 28.1%. The environmental factors such as passive smoking, visible mold at home, use of antibiotics during infancy and number of siblings are associated with asthma and allergic rhinitis.

Prognostic Factors in Outcome of Operative Treatment of Achilles Tendon Rupture / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to assist the optimal placement of sacroiliac screw by evaluating the anatomic and radiologic features of upper sacrum. MATERIALS AND METHODS: Fourteen fresh-frozen cadaveric pelvises and 13 normal adults were studied for the evaluation of morphology of first sacrum and dysplastic patterns. Measurement of anatomic parameters and CT imaging of pelvis were performed. Thirty-two patients with complicated pelvic fracture were evaluated for detection of variations in the sacral alar anatomy and slope found in upper sacral segmentation. RESULTS: The mean distance between midpoint of sacrum and sacroiliac joint was 52.75 mm. The height of first sacral body was 21.71 mm. The longest antero-posterior distance in sacral alar was 52.36 mm. The mean angle between the coronal plane of S1 vertebra and anterior aspect of the alar was 29.3 degree. The mean angle between the superior aspect of S1 vertebral body and superior edge of the alar was 34.8 degree. The mean angle between the superior aspect of S1 vertebral body and supero-posterior edge of the alar was 12.5 degree. The studies revealed about 28 to 33% of cases as dysplastic sacrum. CONCLUSIONS: We studied anatomic and radiologic features of upper sacrum in cadaveric and clinical cases to gain information on the optimal placement of sacroiliac screw.

Rucksack paralysis / 대한정형외과학회잡지

No abstract available.

A Clinical Study on the Fractures of the Calcaneus / 대한정형외과학회잡지

The Os Calcis is the largest bone of the tarsal bones. The incidence of fracture of the calcaneus is more frequent than that of any other tarsal bones. Fractures involving subtalar joint can usually cause serious and persistent disabilities and badly influence the patients psychologically, socislly and economically. But, there was no standardinzed treatment method for these fractures. Calcaneal fractures of 40 feet in 33 patients who were treated st department of orthopedic surgery, college of medicine, Kyungpook national university, from Jan. 1982 to Dec. 1986 were analyzed in clinical and radiological aspects. The results obtained from this study were as follows. 1. Of the 33 patients, men were 25 (76%) and the mean age was 34 and 10 were in their thirties. 2. The most common cause of injury was a fall from height 23 patients (70%) and injury of the spine was most commonly associated. 3. Fractures involving the subtalar joint were 31 cases (78%) and 27 cases (68%) were Rowes type V. Of these Rowe's typeV, those of tongue type were 12 cases (30%) and joint depression type, 15 cases (38%). 4. In 17 cases of the fractures involving the subtalar joint, we had used Essex-Lopresti axial fixation method and obtained satiofactory results in 9 cases (53%). 5. The most common complications after treatment were persistent pain about foot and ankle. Of these, pain beneath the lateral malleolus was most frequent (9 cases).6. The more restored the Bohler's angle, the better the result.

The Treatment of Trochanteric Fracture Using Jewett Nail / 대한정형외과학회잡지

The prime objective in treating the trochanteric fracture is to achieve bony stability at the fracture site by internal fixation as it provide satisfactory reduction and fixation of the fractures allowing early mobilization of the patient thus avoiding general and local complication following this sort of trauma. The operative management of trochanteric fracture using Jewett nail was performed in eighty-three patients who were admitted at the department of orthopedic surgery, Kyungpook National University Hospital from 1978 to 1985. Of eighty-three patients, only fifty-five patients were able to be analysed completely. The results were as followed: 1. Of the83 cases of the trochanteric fracture, 56 cases were in man, 27 cases were in female, with peak age at 7th decade. 2. The most common cause of fracture was traffic accident in 34 cases, fall down in 26 cases and slip down in 23 cases. 3. According to the classification of the intertrochanteric fracture by Tronzo, most common type was type III in 30 cases, and in the subtrochanteric fracture by Fielding classification, type I in 6 cases, type II in 9 cases and type III in 6 cases. 4. Of the 83 cases of the trochanteric fractures, reduction with medialization was done in 13 cases. 5. The average time until weight bearing was 7.1 weeks in intertrochanteric fracture and 10.8 weeks in subtrochanteric fracture. 6. The average bony union time was 16.8 weeks in intertrochanteric fracture, and 20.2 weeks in subtrochanteric fracture. 7. Of the 32 cases of unstable intertrochanteric fracture, late varus deformity was noticed with 6.0° in cases of anatomical reduction, 4.5° in cases of medialization and leg shorteing was 1.0cm in cases of anatomic reduction, 1.4cm in cases of medialization. 8. Complication was encountered in 14 cases. Limping in 9 cases, surgical wound infection in 2 cases, nail penetration into hip joint in 2 cases and refracture in 1 case. 9. By evaluation of overall, result was good in 34 cases, moderate in 18 cases and poor in 3 cases.