The First Reported Case of Infant Botulism in Korea: Treatable Infantile Neuromuscular Disease.

Botulism is a rare neuromuscular disorder caused by neurotoxins produced by Clostridium botulinum. The diagnosis of infant botulism may be obscured or delayed, as its presentation is similar to that of infantile neuromuscular disorders. We report the first Korean case of infant botulism in an acute progressive floppy infant with poor sucking and a weak cry. No abnormalities were found in all blood, cerebrospinal fluid, genetic test, nerve conduction study, and imaging studies. A stool-toxin test was finally performed under suspicion of infant botulism, and the result was positive. The patient was immediately treated with heptavalent botulism antitoxin. Follow-up after 3 months showed normal development with a complete resolution of all symptoms. Therefore, clinical suspicion of infant botulism, which is a treatable infantile neuromuscular disease, is essential for early diagnosis and prompt treatment in the differential diagnosis of a floppy infant.

Epidemiological Correlation between Fecal Adenovirus Subgroups and Pediatric Intussusception in Korea.

We investigated the adenoviral etiology and seasonal epidemic trends in intussusception and each adenoviral subgroup. Also we confirmed whether we can use the adenovirus data of Acute Infectious Agents Laboratory Surveillance Report (AIALSR) as an epidemic predictor of intussusception. Patients with intussusception (n = 126), < 5 years old, were enrolled and matched by age and sex with controls suffering acute gastroenteritis without intussusception (n = 106), all recruited at 8 centers. All fecal specimens were assayed for adenovirus, including subgroups A, B, C, E, and F, with reverse transcriptase-polymerase chain reaction (RT-PCR). Adenovirus was detected in 53 cases and 13 controls (P < 0.001). Nonenteric adenoviruses (NEAds) were detected in 51 cases and four controls (P < 0.001). We used Spearman's correlation analysis to analyze the incidence of intussusception and adenoviral epidemic trends, and compared them with fecal and respiratory adenoviral epidemic trends in the AIALSR. The trend of intussusception correlated with total NEAds (r = 0.635; P = 0.011), as did the fecal AIALSR adenovirus trends (r = 0.572; P = 0.026). Among the NEAd subgroups, subgroup C was dominant (P < 0.001), but subgroups B (P = 0.007) and E (P = 0.013) were also significant to intussusception. However, only subgroup C showed a significant epidemic correlation (r = 0.776; P = 0.001) with intussusception. Not respiratory but fecal AIALSR adenovirus trends correlated with the incidence of NEAds and intussusception. We suggest the possibility of using fecal AIALSR adenovirus data as an approximate epidemic predictor of intussusception.

Clinical Characteristics and Long-term Outcomes of Pediatric Ulcerative Colitis: A Single-Center Experience in Korea.

Background/Aims: : Although pediatric ulcerative colitis (UC) has a different phenotype and clinical course than adult UC, its clinical features and outcomes are poorly defined, especially in Asian populations. This study investigated the clinical features and long-term outcomes of pediatric UC in a Korean population. Methods: We retrospectively analyzed 208 patients aged <18 years diagnosed with UC between 1987 and 2013. The patient characteristics at diagnosis according to the Paris classification and the clinical course were analyzed. Results: The male-to-female ratio was 1.3:1, and the median patient age was 15.5 years. At diagnosis, 28.8% of patients had proctitis (E1), 27.8%, left-sided colitis (E2); 5.2%, extensive colitis (E3); and 38.2%, pancolitis (E4). The cumulative probabilities of extension after 5, 10, 15, and 20 years were 32.7%, 40.4%, 52.5%, and 65.8%, respectively. Eighteen patients underwent colectomy, and three patients had colorectal cancer. The cumulative probabilities of colectomy after 5, 10, 15, and 20 years were 7.1%, 8.9%, 12.6%, and 15.6%, and those of colorectal cancer after 10, 15, and 20 years were 0%, 2.1%, and 12.0%, respectively. The disease extent, Pediatric Ulcerative Colitis Activity Index severity, and systemic corticosteroid therapy were significant risk factors for colectomy. The development of primary sclerosing cholangitis was significantly associated with colorectal cancer. Conclusions: This study provides detailed information on the disease phenotype and long-term clinical outcomes in a large cohort of Korean children with UC. They have extensive disease at diagnosis, a high rate of disease extension, and a low rate of cumulative colectomy.

Synthesis of Sodium Cobalt Fluoride/Reduced Graphene Oxide (NaCoF3/rGO) Nanocomposites and Investigation of Their Electrochemical Properties as Cathodes for Li-Ion Batteries.

In this study, sodium cobalt fluoride (NaCoF3)/reduced graphene oxide (NCF/rGO) nanocomposites were fabricated through a simple one-pot solvothermal process and their electrochemical performance as cathodes for Li-ion batteries (LIBs) was investigated. The NCF nanoclusters (NCs) on the composites (300-500 nm in size) were formed by the assembly of primary nanoparticles (~20 nm), which were then incorporated on the surface of rGO. This morphology provided NCF NCs with a large surface area for efficient ion diffusion and also allowed for close contact with the conductive matrix to promote rapid electron transfer. As a cathode for LIBs, the NCF/rGO electrode achieved a high reversible capacity of 465 mAh·g-1 at 20 mA·g-1 via the conversion reaction, and this enhancement represented more than five times the reversible capacity of the bare NCF electrode. Additionally, the NCF/rGO electrode exhibited both better specific capacity and cyclability within the current density testing range (from 20 to 200 mA·g-1), compared with those of the bare NCF electrode.

A Review of Functional Separators for Lithium Metal Battery Applications.

Lithium metal batteries are considered "rough diamonds" in electrochemical energy storage systems. Li-metal anodes have the versatile advantages of high theoretical capacity, low density, and low reaction potential, making them feasible candidates for next-generation battery applications. However, unsolved problems, such as dendritic growths, high reactivity of Li-metal, low Coulombic efficiency, and safety hazards, still exist and hamper the improvement of cell performance and reliability. The use of functional separators is one of the technologies that can contribute to solving these problems. Recently, functional separators have been actively studied and developed. In this paper, we summarize trends in the research on separators and predict future prospects.

Systematic functional profiling of transcription factor networks in Cryptococcus neoformans.

Cryptococcus neoformans causes life-threatening meningoencephalitis in humans, but its overall biological and pathogenic regulatory circuits remain elusive, particularly due to the presence of an evolutionarily divergent set of transcription factors (TFs). Here, we report the construction of a high-quality library of 322 signature-tagged gene-deletion strains for 155 putative TF genes previously predicted using the DNA-binding domain TF database, and examine their in vitro and in vivo phenotypic traits under 32 distinct growth conditions. At least one phenotypic trait is exhibited by 145 out of 155 TF mutants (93%) and ∼85% of them (132/155) are functionally characterized for the first time in this study. The genotypic and phenotypic data for each TF are available in the C. neoformans TF phenome database (http://tf.cryptococcus.org). In conclusion, our phenome-based functional analysis of the C. neoformans TF mutant library provides key insights into transcriptional networks of basidiomycetous fungi and human fungal pathogens.

A framework for unpacking cognitive benefits of distributed complex visual displays.

What are the advantages and disadvantages of spatially stacked (i.e., when information sources are presented side-by-side) versus distributed (i.e., when information sources are sitting on top of one another with only the top source fully visible) organizations of information? We introduce a new theoretical decomposition of these advantages and disadvantages (information internalization, information access, and information externalization costs), along with a new analytic technique for measuring each theoretical aspects using eye tracking. Thirty-eight scientists-in-training solved a complex data interpretation problem using either a distributed or a stacked display. Display format influenced all 3 factors, but in opposing ways: stacked displays increase internalization and externalization costs but decrease information access costs. The framework reveals trade-offs among the 3 factors that can be precisely characterized to guide interface user design and optimization.

Placement of covered retrievable expandable metallic stents for pediatric tracheobronchial obstruction.

PURPOSE: To evaluate the safety and clinical effectiveness of placement of covered retrievable expandable metallic stents in seven children with tracheobronchial obstruction. MATERIALS AND METHODS: Using bronchoscopic and fluoroscopic guidance, stent placement was performed in seven children (median age, 12 y; range, 2 mo-14 y). The stents were electively removed 6 months after placement or whenever there were symptom-producing complications. During the follow-up period, technical and clinical success, complications and related reinterventions, and long-term prognosis were retrospectively evaluated. RESULTS: Stent placement was technically successful for a total of eight stents in all seven patients. Stent removal was also successful for six stents in five patients; two stents were removed electively 6 months after placement, and four stents were removed due to symptom-producing complications. Clinical success defined as ventilator weaning, extubation, or dyspnea improvement was achieved in all patients 1 week after stent placement. A possible infection source in one stent and abundant granulation tissue caused by three stents necessitated removal of four stents in three patients. During the mean follow-up period of 18.7 months (range, 1-31 mo) after stent placement, three patients died due to the progression of underlying cardiopulmonary disease or malignancy. There were no deaths directly related to stent placement or related complications. CONCLUSION: Although the findings were based on a small series, placement of covered retrievable expandable metallic stents seems to be safe and effective for the treatment of pediatric tracheobronchial obstruction. Ventilator weaning, extubation, or dyspnea improvement was possible in all patients after stent placement.