In Vivo Cartilage Formation Using Human Bone Marrow-Derived Mesenchymal Stem Cells Mixed with Fibrin Glue / 대한정형외과연구학회지

PURPOSE: To investigate the feasibility of in vivo cartilage formation by direct injection the chondrogenic undifferentiated human bone marrow-derived mesenchymal stem cells (hBMSCs) mixed with fibrin glue including TGF-beta3. MATERIALS AND METHODS: Chondrogenic differentiation induced hBMSCs for 14 days (control group-2) and undifferentiated hBMSCs combined with TGF-beta3 mixed (experimental group-3) with fibrin glue and fibrin glue only (control group-1) were injected subcutanteously into the back of nude mouse. For evaluation of the cartilage-like tissue formed after 8 weeks after injection, real time PCR, histological analysis and immunohistochemical analysis were used. RESULTS: Control group-1 did not form any visible mass. Control group-2 as well as experimental group-3 could form new cartilage-like tissue which were demonstrated expression of type II collagen by real-time PCR, histology analysis such as H&E staining, MT staining and type II collagen specific immunohistologic analysis. As results, expression of type II collagen was shown in the both groups. CONCLUSION: Our study confirmed that cartilage-like tissues could be formed in subcutaneous layer of nude mouse by direct injection mixed with fibrin glue including TGF-beta3 without chondrogenic-induction of hBMSCs, suggesting that these model could be suitable for preliminary studies or optimizing experiments to evaluate reconstruction of cartilage.

Prevalence and allergens of allergic rhinitis in children and adolescents in Gwangju

PURPOSE: Allergic rhinitis (AR) is one of the most common childhood diseases in Korea. In this study, we aimed to investigate the prevalence and allergens of childhood AR in Gwangju. METHODS: From April 2013 to September 2013 in Gwangju, skin prick test and questionnaire survey were performed targeting 2,330 children in total (350 kindergartners, 930 elementary school students, 589 middle school students, and 461 high school students). RESULTS: The overall prevalence of AR was 23.5% (female 21.3%, male 26.1%). According to age groups, prevalence of AR was 14.9% (female 10.7%, male 19.8%) in kindergartners, 24.5% (female 18.8%, male 29.4%) in elementary school students, 23.3% (female 18.1%, male 27.6%) in middle school students, 26.2% (female 27.7%, male 23.2%) in high school students. The most common allergen was Dermatophagoides pteronyssinus (79.7%), followed by Dermatophagoides farina (72.2%), birch (14.0%), alder (12.0%), Japanese hop (9.2%), Alternaria (8.9%), cat fur (7.2%), Japanese cedar (6.9%), ryegrass (6.6%), willow (6.0%), pine (5.4%), oak (4.9%), mugwort (4.3%), orchard grass (4.0%), sheep fescue (3.7%), fat hen (3.4%), ragweed (3.4%), and maple (3.4%). CONCLUSION: This research figures out the prevalence and the detailed allergens of AR in Gwangju children. We suggest that more vegetation data of Japanese cedar should be surveyed in recent future.

Protective Field Efficacy Study of Influenza Vaccines for Korean Children and Adolescent in 2010-2011 Season / 소아감염

PURPOSE: We conducted a prospective comparative clinical study to determine the field efficacy of the 2010-2011 influenza vaccines [Influenza virus strains; A/California/7/2009 (H1N1), A/Perth/16/2009 (H3N2), B/Brisbane/60/2008] in healthy Korean children under 18 years of age. METHODS: In this study, we enrolled subjects aged between 6 months and 18 years and divided them into 2 study groups: a group who received the influenza vaccines (407 subjects), and a control group who did not receive the influenza vaccines (230 subjects). Ours was a multicenter study that involved 7 hospitals, including the Korea Cancer Center Hospital. The study was conducted between September 2010 and February 2011. We collected nasal wash or throat swab samples from subjects who presented with acute febrile respiratory or influenza-like illnesses at the hospital. We used PCR to confirm the presence of the influenza virus in the respiratory samples and characterize the virus type. RESULTS: In this study, we collected 22 respiratory samples from the influenza-vaccinated group and found 3 cases of influenza virus infection. Similarly, we collected 21 samples from the control group and found 12 cases of influenza virus infection among 10 subjects during the study period. We determined the field efficacy of the 2010-2011 seasonal influenza vaccines to be 83.2% in healthy Korean children and adolescents. CONCLUSION: In this study, we determined the field efficacy of the 2010-2011 seasonal influenza vaccines in healthy Korean children and adolescents. We found that the field efficacy of 2010-2011 seasonal influenza vaccines was adequate.

Mutation Screening of the gamma-Aminobutyric Acid Type-A Receptor Subunit gamma2 Gene in Korean Patients with Childhood Absence Epilepsy

BACKGROUND AND PURPOSE: Since the gamma-aminobutyric acid type-A receptor subunit gamma2 gene (GABRG2) mutation was discovered in an Australian family with childhood absence epilepsy (CAE) and febrile convulsions, a few screening studies for the GABRG2 mutation have been conducted in sporadic individuals with CAE from other ethnic groups. The aim of this study was to determine whether or not the previously reported genetic mutations and single-nucleotide polymorphisms (SNPs) of GABRG2 can be reproduced in sporadic Korean individuals with CAE, compared to healthy Korean individuals. METHODS: Thirty-five children with CAE in Chonnam National University Hospital and healthy controls (n=207) were enrolled, and the medical records of patients with CAE were reviewed. CAE was diagnosed according to the Classification and Terminology of the International League Against Epilepsy. All nine exons of GABRG2 were directly sequenced. In addition, the two SNPs found in our CAE patients were analyzed: C315T in exon 3 (E3) and C588T in exon 5 (E5). The frequencies of the two SNPs in the CAE patients were compared with data from healthy controls (for E3 and E5) and from previously reported Korean population data (only for E3). RESULTS: No mutation of GABRG2 was found in our CAE patients. In addition, the allele and genotype frequencies of the two polymorphisms did not differ significantly between CAE patients, healthy controls, and the Korean general population (p>0.05). CONCLUSIONS: Our study of sporadic Korean individuals with CAE found no evidence that GABRG2 contributes to the genetic basis of CAE.

Development of Ancient DNA Isolation Method for Improved PCR Amplification / 체질인류학회지

Ancient DNA analyses are widely used for evolutionary and phylogenetic study of mankind in anthropology and archeology. However, the DNA extraction from particularly poorly preserved ancient human samples is often unsuccessful in these analyses. In the present study, to improve the success rate of ancient DNA analysis, we introduced a high grade ancient DNA purification method using ion-exchange columns. We compared the success rate of ancient DNA analysis of this new method with that of the two methods that have been used for ancient DNA extraction, GENECLEAN(R) kit (Qbiogene) and Qiaquick column (Qiagen). Twelve ancient bone samples from Korea and Mongolia that are about 500 to 5,000 years old by an archeological estimation were used. As the DNA analysis methods, polymerase chain reaction (PCR) methods for the amplification of a mitochondrial DNA HV1 segment, a male sex determination marker DNA and M175 marker DNA that is used for the determination of O haplogroup of Y chromosome that is reportedly a common one in modern Korean people. The method developed in this study remarkably increased the success rate of DNA analysis compared with the other two methods. Using the GENECLEAN(R) kit, only two samples were amplifiable for the mitochondrial DNA, no samples for the male sex determination marker and M175 marker DNAs. Using the Qiaquick columns, nine samples were amplifiable for mitochondirial DNA, nine samples for male sex determination marker and six samples for M175 marker. The developed method allowed for the amplification of mitochondrial DNA from all samples, male sex determination marker from eight samples and M175 marker from eight samples. The results demonstrate that ion-exchange columns can be useful for the improved ancient DNA extraction in anthropology and archeology.

Sex of Ancient Mongolian Human Bones Using Biallelic Marker RPS4Y for Y haplogroup / 대한해부학회지

Many data from ancient human remains became useful by molecular approach for ancient human DNA. In anthropology, genetic sex is essential to understand marriage and burial patterns, differential mortality rates between sexes, and differential patterns by sex of disease, diet, status, and material possessions. This study was designed to determine genotype sex of 52 ancient human bones with well preserved skulls, and to compare with the orphological sex. Parts of femur and other bones were used as ancient bones excavated in Mongolia aged between bronze and Mongol period. Morphological sex was determined by Mongolian scientist, and genotype sex was determined by using biallelic marker RPS4Y for Y haplogroup. Of 52 genetic males, 10 samples were morphologically female. In conclusion, biallelic marker RPS4Y. PCR amplication method will be useful in sex determination of ancient bones.

Comparison between Morphological Sex and Genotype Sex of Uzbekistan Ancient Bones Using Improved Amelogenin PCR Amplication Method / 체질인류학회지

Determination of male and female is important in anthropology, archeology and forensic science. This study was designed to compare genotype sex of improved amelogenin PCR amplication method with morphological sex of ancient human bones. Sixty human skulls which lived from the Bronze Age to twenties centuries and excavated in Uzbekistan were used in this study. Morphological sex was determined by Uzbekistan scientist, and genotype sex was determined by improved amelogenin PCR amplication developed in this study. Among 20 morphological males, 13 samples (65%) were genotypical male. Among 40 morphological females, 20 samples (50%) were genotypical male. In conclusion, morphological method might be inadequate for sex determination of ancient bones. The improved amelogenin PCR method will be useful in sex determination of ancient bones.

Clinical Entities and Etiology of Invasive Bacterial Infections in Apparently Healthy Children / 소아과

PURPOSE: Invasive bacterial infection is a major cause of morbidity and mortality in children. Previously, we reported etiology of invasive infections in healthy children in 1985-1995. This study was performed to update etiology of invasive bacterial infections in the previously healthy children. METHODS: We reviewed medical records of 98 episodes of invasive bacterial infections in immunocompetent children at the Seoul National University Children's Hospital in 1996-2004. RESULTS: The frequent pathogens identified over all age groups were Streptococcus pneumoniae (33 %) and Staphylococcus aureus (33%). The proportion of Salmonella species and Haemophilus influenzae has been declined to 4% each from 23% and 14%, respectively, compared to previous study. S. agalactiae was the most common isolate in the infants 5 years. Primary bacteremia was the most common clinical diagnosis (27%). S. pneumoniae was responsible for 42% of primary bacteremia, 50% of meningitis, and 69% of bacteremic pneumonia and empyema. S. aureus accounted for 80% of bone and joint infections. The case fatality rate was 8.1% for all invasive infections. CONCLUSION: We reviewed frequency of bacterial agents of invasive infections in children. The data may be useful for pediatricians to select adequate empirical antibiotics in the management of invasive bacterial infections.

Echocardiographic appearance of kinking of the aorta:noninvasive diagnosis

No abstract available.

Relationship between Serum Leptin Levels and Other Predictors in Obese Children

PURPOSE: The product of the ob gene, leptin is an adipocyte specific hormone that might be involved in the regulation of food intake by the central neuroendocrine system. Recent studies reported that serum leptin concentrations were correlated with Body mass index(BMI) and other obesity measurements. The aims of this study were to evaluate leptin concentrations according to degree of obesity and to assess the relationship between serum leptin concentrations and other obesity parameters. METHODS: 84 children were included in this study. BMI was calculated and body compositions such as fat mass, protein, minerals, intracellular fluid and extacellular fluid were measured by bioelectrical impedance analysis. Serum lipid and insulin were measured after 12 hours overnight fasting. Serum leptin levels were estimated using DSL-23100 leptin coated tube Immunoradiometric assay kit. RESULTS: Serum leptin concentrations were 22.7 +/- 8.2 ng/mL in obese group, 16.7 +/- 8.4 ng/mL in high risk group. In control group, serum leptin concentrations were 3.8 +/- 2.9 ng/mL. Serum leptin concentrations were significantly increased in obese group and positively correlated with degree of obesity. Serum insulin levels were significantly increased in obesity group. Serum leptin concentrations were significantly correlated with body fat percent, fat mass, BMI, subscapular skinfold thickness, triceps skinfold thickness. CONCLUSIONS: Serum leptin and insulin levels were significantly increased in obese group and highly correlated with fat percent, fat mass, BMI, subscapular skinfold thickness and triceps skinfold thickness. Serum leptin levels will be importent predictor in obesity.

Reversible brain MRI Finding in Hypertensive Encephalopathy with Poststreptococcal Acute Glomerulonephritis / 대한소아신경학회지

Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.

The Effect of Intraverious Continuous Infuction Midazolam against Refractory Status Epilepticus in Children / 대한소아신경학회지

PURPOSE: Refractory status epilepticus refers to patients who do not respond properly to adequate first-line drug treatment such as diazepam, phenytoin, phenobaribital, lorazepam and show longer than 60 minute seizure. This study was designed to determine the efficacy and safety of midazolam given as a continuous infusion in the treatment of status epilepticus in children. METHODS: Midazolam was infused to twelve children with seizures, for whom two time repeated doses of 0.3mg/kg of diazepam, 20mg/kg of phenobarbital, and 20mg/kg of phenytoin failed to bring the episode under control. All patients received a bolus of midazolam(0.15mg/kg) followed by a continuous infusion at 1microgram/kg/min. The dose was increased every 15 min until the episode of seizure was brought under control. Time required to control seizures, infusion rate, and side-effects were monitored. RESULTS: The mean age of the patient population was 6.06 yrs(range 2 months to 16 yrs; 6 females and 6 males). In 11 patients, seizures were controlled in a mean time of 60.1 min(range 15-180 min). The mean infusion rate was 8.5microgram/kg/min(range 1-20). The total treatment duration was 17.6 days(range 1-54 days). One patient who was confirmed to have cortical dysplasia failed to respond. Two of the patients showed respiratory depression and bradycardia. CONCLUSION: Midazolam is an effective and safe drug to control refractory seizures in children with status epilepticus.

Aseptic Meningitis Associated with Intravenous Immunoglobulin Therapy for Myasthenia Gravis : A Report of Two Cases / 대한소아신경학회지

Intravenous immunoglobulin (IVIG) is widely used to treat various neurologic or autoimmune disorders in childhood. Aseptic meningitis has been reported as a rare complication of IVIG therapy. We describe two girls, aged 2 and 8 years, with myasthenia gravis who suffered from aseptic meningitis after an administration of high-dose IVIG. Any other etiologic agent were identified in neither case. Both patients recovered completely within a few days and left no sequelae. To our knowledge, these are the first such reported cases in children with myasthenia gravis.

The diagnostic significance of APR score in early detection of neonatal bacterial infection

No abstract available.

Body Composition by Bioelectrical Impedance Analysis in Obese Children

PURPOSE: Body composition by bioelectrical impedance analysis(BIA) is a very useful method of analysing body composition in many diseases. BIA is a simple, rapid, non-invasive and reproducible technique. There was no comparative analysis between obese and healthy children. A comparative analysis between obese and healthy children is needed to assess the effect of excercise and other interventions in the management of childhood obesity. This study is designed to analyze and compare the body composition and body fat percent measured by BIA in healthy and obese children. METHODS: Height and weight were measured. BIA was done in healthy and obese children. Body compositions were analyzed with fat mass, lean body mass, body fat percent, protein, mineral, intracellular fluid(ICF), and extracellular fluid(ECF). RESULTS: Fat mass, fat percent, ICF, and ECF were significantly higher in the obese group. Resistances were significantly lower in the obese group. The amounts of ICF and ECF were significantly higher in obese group. Fat mass showed more significant correlation with ICF and ECF than body mass index. CONCLUSION: Body composition analysis using bioelectrical impedance(BI) is considered as very useful diagnostic method in the evaluation and treatment in childhood obesity. Epidemiologic study will be needed to determine the diagnostic criteria of obesity by BI.

A Case of Mollaret's Meningitis Associated with Benign Pineal Cyst / 대한소아신경학회지

Mollaret's meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid(CSF). We describe a case of Mollaret's meningitis in a 3-year-old boy who presented with three episodes of aseptic meningitis within a 4-month period. Each episode was characterized by sudden onset of meningeal irritation followed by spontaneous remission in several days. He was free of neurological symptoms between the episodes. In the acute phase of each episode, his CSF showed polymorphonuclear pleocytosis with normal protein and glucose concentrations. In addition, some epithelial cell clusters in the CSF were evident during the third episode. No pathogenic microorganisms were identified in the CSF or the blood cultures. Brain MRI revealed a benign pineal cyst, 0.8 cm in diameter, and epithelial cell clusters were supposed to represent ruptured cystic walls and recurrent episodes of aseptic meningitis were triggered by spontaneous rupture of the cyst. Our case appears to support "spontaneous rupture of epidermoid cysts in the central nervous system" as one of the etiologies of Mollaret's meningitis.

Risk Factors for Fatty Liver in Obese Children

PURPOSE: The incidence of obese patients has increased recently in Korea. Obesity is associated with hypertension, hyperlipidemia, insulin resistance, and fatty liver. Since recent investigators have revealed that not only fat accumulation but also fibrosis and nonspecific hepatitis can be found in the livers of obese children, fatty liver is currently considered as an important complication. The purpose of this study is to investigate the risk factors in obese children as a predictor of fatty liver. METHODS: The objects were 146 obese children, ranging from 7 to 16 years of age, who visit obesity clinics of Ewha Womans University Hospital. They were divided into two groups, with fatty liver(n=21) and without fatty liver(n=125), as diagnosed by ultrasonography. Body Mass Index(BMI) and blood pressure were measured. Bioelectrical impedance was analyzed to estimate body composition and fat mass. Serum levels of alanine transaminase(AST), aspartate transaminase(ALT), total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, and insulin were evaluated. RESULTS: BMI, blood pressure and abdominal fat percentages were significantly higher in the children with fatty livers. Body composition of intracellular fluid, extracellular fluid, protein, and minerals were also significantly elevated in the children with fatty livers. Total cholesterol, triglyceride, serum insulin and ALT were significantly higher in the children with fatty livers. CONCLUSION: This study confirmed the close relationship between these predictors and fatty liver. Abdominal sonography is helpful to recognize the presence of liver involvement in obese children with hyperlipidemia, hyperinsulinemia, increased ALT levels, and hypertension

A Case of Langerhans Cell Histiocytosis Preceding with Central Diabetes Insipidus / 대한소아내분비학회지

A 3-year-old girl presented with polydipsia and polyuria for last 2 years. Her fluid intake was 7~8 L/day, and urinalysis showed low osmolality and specific gravity. Central diabetes insipidus (DI) was diagnosed by a water deprivation test. Intranasal 1-desamino-8-D-arginine vasopressin relieved her symptoms and normalized urinary concentrations. A T1-weighted MRI scan revealed a symmetrical thickening of the central part of the pituitary stalk. Six months after the diagnosis of central DI, she developed papular skin lesions on her forehead. The lesions were surgically removed, and histologically classified as Langerhans cell histiocytosis (LCH). We concluded that thickening of the central part of the pituitary stalk might represent the first manifestation of LCH clinically presenting with central DI. In children with central DI, special attention should be paid to the appearance of the pituitary stalk using MRI for the various manifestations of LCH in the central nervous system.

Serotypes and Penicillin Susceptibility of Streptococcus pneumoniae Isolated from Clinical Specimens and Healthy Carriers of Korean Children

PURPOSE: Pneumoccocus is one of the most important causes of invasive infection through the childhood period and the prevelance of antibiotics resistance of pneumococcus is increasing worldwide. A 7-valent conjugate vaccine has been developed. It is important to know the prevalence of each serotype of pneumococci in the countries where the vaccine is used to estimate the coverage rate by the vaccine. METHODS: One hundred and twenty seven strains of clinical isolates and 72 strains from healthy carriers recovered from Korean children during the period from 1997 to 2002 were subjected to determination of serotype by Quellung reaction and penicillin susceptibility with oxacillin disc diffusion test. RESULTS: Forty-three per cent of clinical isolates were obtained from children under two years of age. Thirty strains(24%) were isolated from normally sterile body fluids. The frequent serotypes were 19F, 19A, 23F, 6A, 6B and 9V. Fifty-six per cent of the clinical isolates were represented in the current 7-valent protein conjugate pneumococccal vaccine, and 84% when the cross-reactive serotypes were included. Frequent serotypes of strains isolated from one to five year-old healthy children were 19F, 14, 11A, 23F, 18C, and 19A. Seventy-one per cent of the carrier strains were included in the 7-valent vaccine. Ninety-three per cent of the clinical isolates and 86% of carrier strains were not susceptible to penicilline. CONCLUSION: Fifty-six to 84% of pneumococci recovered from Korean children are covered by the current 7-valent protein conjugate pneumococcal vaccine and the prevalence of penicillin resistance was very high.