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Jee Yeon Baek,1 Ji-Man Kang,1,2 Ji Young Lee,1 Sung Min Lim,1 Jong Gyun Ahn1,2 1Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea; 2Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, KoreaCorrespondence: Jong Gyun Ahn, Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea, Tel +82-2-2228-2057, Fax +82-2-393-9118, Email JGAHN@yuhs.acPurpose: Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limited disease, characterized by cervical lymphadenopathy and fever. Herein, we analyzed the differences in its clinical manifestations and risk factors for recurrence between children and adults.Patients and Methods: We retrospectively reviewed the medical records of patients diagnosed with KFD at a tertiary referral hospital between 2005 and 2019. Patients were divided into two groups based on their age: children (< 19 years) and adults (≥ 19 years).Results: During the 14-year study period, 127 patients were diagnosed with KFD. Among these, 34 (26.8%) were children and 93 (73.2%) were adults. The fever duration was longer and the frequency of myalgia was higher in adults than in children; however, no other significant symptomatic differences were noted between the two groups. Lymph node evaluation was mainly performed using ultrasound in children (61.8%) and computed tomography in adults (78.5%). Moreover, the frequency of antibiotic use was higher in children than in adults (76.5% vs 54.8%, P = 0.027). In adults, multivariable logistic regression analysis revealed anti-nuclear antibody (ANA) positivity (titer ≥ 1:80) as a risk factor for recurrence (odds ratio: 7.813; 95% confidence interval = 1.818– 33.333; P = 0.006).Conclusion: The clinical features of KFD in children and adults were similar; however, the preferred imaging study and frequency of antibiotic use differed significantly between the two groups. Furthermore, in adults, ANA positivity was associated with KFD recurrence. Thus, patients with KFD who present with ANA positivity at diagnosis will benefit from a regular follow-up for monitoring KFD recurrence.Keywords: histiocytic necrotizing lymphadenitis, recurrence, child, adult

Background Despite its clinical usefulness, the use of tetracycline antibiotics (TCs) in children has historically been limited because of the risk of permanent tooth discoloration and enamel deformity, although age restrictions have varied across countries (e.g., contraindicated under 8 years of age in Taiwan, USA, and Canada, and under 12 years of age in Korea and UK). We explored whether the incidence of dental abnormalities in Korean children with a history of TCs use differed by age. Furthermore, the relative risk compared to the TCs non-exposed group was calculated. Methods From 2002 to 2015, 1 million standard sample subjects data was provided from National Health Insurance Service in Korea. Children younger than 18 years were included and divided into groups A (0-7 years), B (8-12 years), and C (13-17 years). Subjects in 2002 were excluded for wash-out, as were those diagnosed with dental abnormalities within 6 months after TCs prescription. For comparison, 1:4 matching between the TCs exposure and non-exposure groups was performed according to age and gender. Results Among 14,831 individuals included as study subjects (487 (3%) in group A; 1,695 (11%) in group B; and 12,649 (85%) in group C), 201 (1.4%) were diagnosed with dental abnormalities. The 5-year cumulative incidence of dental abnormalities after exposure to TCs in the group A was 4.7%, which was significantly higher than that of the control group C (0.9%; p< 0.0001), but that of group B was 1.3% and not significantly different from that of group C. In the risk analysis of dental abnormalities according to exposure of TCs, there was no significant difference (adjusted RR=1.03, 95%CI=0.71 to 1.50 in group A; adjusted RR=1.13, 95%CI=0.76 to 1.69 in group B; adjusted RR=1.18, 95%CI=0.97 to 1.43 in group C). Fig 1.Cumulative incidence rate and relative risk analysis.A. Cumulative incidence rate of dental abnormalities after TCs exposure by age group (p = Conclusion Korean children aged 0-7 years who were exposed to TCs had a higher cumulative incidence and relative risk of dental deformities compared to the 13-17-year-old group but not the 8-12-year-old group. No significant increase in dental abnormalities was observed with TCs exposure among pediatric age groups. Disclosures All Authors: No reported disclosures.

Background DiGeorge syndrome (DGS) is a syndrome accompanied by congenital heart defect, hypoparathyroidism and immunodeficiency of varying severity. Live vaccination is generally contraindicated in patients with DGS. However, in real clinical practice, there are cases in which live vaccines are immunized before the diagnosis of DGS or are incidentally immunized. We collected these cases and investigated adverse events (AEs), especially infections caused by the vaccine strains. Methods This retrospective study included all patients diagnosed with DGS at Severance Hospital Seoul, Korea, between November 2005 and June 2021. We extracted patients with ICD-10 code (D82.1) and then excluded subjects without genetic confirm. According to the immune status, subjects were categorized into three groups: group A [CD3 < 500 or CD8 < 200 (cells/mm3)], group B [CD3 ≥500 and CD8 ≥ 200 (cells/mm3)] and group C (unknown). Results Of a total 94 DGS patients, approximately 40% of subjects (38/94) underwent immunological test, of which 21% (8/38) belonged to group A and 79% (30/38) were in group B. Approximately 80% of study subjects (73/94) had a record of at least one live vaccination. By vaccine type, measles-mumps-rubella accounted for the most at 70% (66/94), followed by varicella, bacillus Calmette–Guérin, rotavirus, and live-attenuated Japanese encephalitis virus vaccine. A total of 50 AEs were observed (Figure 1): fever (n=29), URI (n=9), diarrhea (n=4), rash (n=3), thrombocytopenia (n=3), injection site pus (n=1) and febrile convulsion (n=1). Among them 26% (13/50) occurred in group A and no significant difference in the incidence rate of AEs between group A and B was observed (P = 0.14). Six cases of them turned out to be consistent with live vaccination by WHO 2009 causality analysis. Moreover, there were no serious reactions, including ICU hospitalization or death, and there was no emergence of disease caused by vaccine strains. Conclusion Our data show that live vaccines were often given without immunologic screening and generally well tolerated in our study population. Disclosures All Authors: No reported disclosures.

To examine the risk of dental abnormalities after exposure to tetracycline and its derivatives (TCs) in Korean children.Children aged 0-17 years with a claim for prescriptions of TCs between 2002 and 2015 were identified from the Sample Research Database 2.0 of the National Health Insurance Service. Children not exposed to TCs were selected as the control group by matching sex and age (1:4). Cumulative incidence rate and relative risk of dental abnormalities after TCs exposure were investigated.The 10-year cumulative incidence rate in the 0-12 years group was 3.1% [95% confidence interval (CI), 2.3-3.9]. The 10-year cumulative incidence rates were 7.0%, 1.9%, and 1.6% in the 0-7, 8-12, and 13-17 years age groups (95% CI: 4.7-9.3, 1.2-2.6, and 1.3-1.9, respectively). There was no significant difference in the risk of dental abnormalities according to TC exposure among the age groups of 0-7 years [adjusted hazard ratio (aHR)=1.0], 8-12 years (aHR=1.1), and 13-17 years (aHR=1.2).Short-term exposure to TCs does not appear to increase the risk of dental abnormalities in children aged 0-7 and 0-12 years. Restrictions on the use of TCs in children aged 8-12 years, in some countries, may warrant consideration.

This study aimed to investigate whether respiratory syncytial virus (RSV) and influenza virus (IFV) infections would occur in 2021-2022 as domestic nonpharmaceutical interventions (NPIs) are easing.Data were collected from the Korean Influenza and Respiratory Virus Monitoring System database. The weekly positivity rates of respiratory viruses and number of hospitalizations for acute respiratory infections were evaluated (January 2016-2022). The period from February 2020 to January 2022 was considered the NPI period. The autoregressive integrated moving average model and Poisson analysis were used for data analysis. Data from 14 countries/regions that reported positivity rates of RSV and IFV were also investigated.Compared with the pre-NPI period, the positivity and hospitalization rates for IFV infection during 2021-2022 significantly decreased to 0.0% and 1.0%, respectively, at 0.0% and 1.2% of the predicted values, respectively. The RSV infection positivity rate in 2021-2022 was 1.8-fold higher than that in the pre-NPI period at 1.5-fold the predicted value. The hospitalization rate for RSV was 20.0% of that in the pre-NPI period at 17.6% of the predicted value. The re-emergence of RSV and IFV infections during 2020-2021 was observed in 13 and 4 countries, respectively.During 2021-2022, endemic transmission of the RSV, but not IFV, was observed in Korea.

The pear psylla, Cacopsylla pyricola (Hemiptera: Psyllidae), is a serious insect pest of commercial pear crops. The species, which resides on pear trees throughout its life cycle, is rapidly spreading in some regions of the world. The population genetic structure of the species collected from several pear orchards in Korea was studied to understand the nature of dispersal and field ecology of the species. The 658-bp region of mitochondrial COI gene and the 716-bp long complete internal transcribed spacer 2 (ITS2) of the nuclear ribosomal DNA were sequenced. Unlike other previously studied insect pests, the COI-based genetic diversity of the pear psylla was extremely low (maximum sequence divergence of 0.15%). This finding allowed us to conclude that the species may have been introduced in Korea relatively recently. ITS2 sequence-based analyses of phylogeny, population differentiation, gene flow, and hierarchical population structure all concordantly suggested that the pear psylla populations in K...

The 15,389-bp long complete mitogenome of the endangered red-spotted apollo butterfly, Parnassius bremeri (Lepidoptera: Papilionidae) was determined in this study. The start codon for the COI gene in insects has been extensively discussed, and has long remained a matter of some controversy. Herein, we propose that the CGA (arginine) sequence functions as the start codon for the COI gene in lepidopteran insects, on the basis of complete mitogenome sequences of lepidopteran insects, including P. bremeri, as well as additional sequences of the COI start region from a diverse taxonomic range of lepidopteran species (a total of 53 species from 15 families). In our extensive search for a tRNA-like structure in the A+T-rich region, one tRNA(Trp)-like sequence and one tRNA(Leu) (UUR)-like sequence were detected in the P. bremeri A+T-rich region, and one or more tRNA-like structures were detected in the A+T-rich region of the majority of other sequenced lepidopteran insects, thereby indicating that such features occur frequently in the lepidopteran mitogenomes. Phylogenetic analysis using the concatenated 13 amino acid sequences and nucleotide sequences of PCGs of the four macrolepidopteran superfamilies together with the Tortricoidea and Pyraloidea resulted in the successful recovery of a monophyly of Papilionoidea and a monophyly of Bombycoidea. However, the Geometroidea were unexpectedly identified as a sister group of the Bombycoidea, rather than the Papilionoidea.