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This study aimed to investigate the skin irritancy with unripe Citrus grandis Osbeck extract and to determine the effect of cotton underclothes dyed with the citrus extract on the severity of atopic dermatitis by in-vivo methodology. The skin irritancy from the extract was assessed by Kawai’s method and the severity of atopic dermatitis was evaluated by measuring the quantitative index of SCORAD for human subjects wearing the citrus-dyed underclothes. Skin reactions were not found by Kawai’s method, which suggests that the citrus extract does not cause irritancy on human skin. In a wear test, a marked clinical improvement of atopic dermatitis indicated by a decrease of SCORAD index value was observed in human subjects wearing the dyed underclothes compared to the values for subjects with undyed clothes. These results imply that Citrus grandis Osbeck could be utilized as a bioactive natural material for dermal healthcare-related textiles.

Since 1997, epidemic of hand-foot-mouth disease caused by Enterovirus 71has become an important issue in the AsiaPacific region because some patients progress to severe neurological complication such as acute flaccid paralysis, brainstem encephalitis. The authors experienced and report that an 12-month-old boy with hand-foot-mouth disease developed acute meningoencephalitis associated with quadriplesia. Enterovirus 71 was isolated in CSF and stool by RT-PCR and sequencing, but MRI showed no lesion in brain and spinal cord. Although IVIG treatment was not shown effective, the patient recovered fully by supportive treatment.

The aim of this study was to evaluate trends of mycoplasmal pneumonia and its coinfection with bacteria or respiratory viruses over the period 2007-2009 in Jeju and to confirm the necessity of bacterial culture tests and viral PCR tests in mycoplasmal pneumonia patients. This study was performed by analysing the records of 3898 pediatric patients who visited Jeju National University Hospital with pneumonia diagnosed and got anti-mycoplasmal antibody tests or Pneumobacter PCR from January 2007 to December 2009. The patients diagnosed as mycoplasmal pneumonia were 625 (16.0%). The highest incidence of age was between 2 and 5 years old (58.7%) and the sex ratio was 1:1.2. Monthly distribution of patients was high in the first hall in 2007, in the second half in 2009, and even in 2008. 150 (24.0%) of mycoplasmal pneumonia patients received bacterial culture tesls for their respiratory secretions and 39 (26.0%) among them were coinfected with more than one bacterium. There were 21 (51%) Streptococcus pneumonia, 10 (25%) Staphylococcus aureus, 5 (12%) Streptococcus pyogenes, and 5 (12%) the others. 78 (12.5%) of mycoplasmal pneumonia patients received respiratory virus multiplex PCR tests for their respiratory secretions and 42 (53.8%) among them were coinfected with more than one virus. There were 11 (20%) influenza viruses, 10 (18%) parainfluenza viruses, 9 (17%) of each adenovirus and respiratory syncytial virus(RSV), 7 (13%) of each melapneumovirus and rhinovirus A, and 1 (2%) coronavirus. The results said that trends of mycoplasmal pneumonia in Jeju were similar to that of other areas, and the rate of coinfection with bacteria or respiratory viruses was relatively high. The coinfection with bacteria and viruses are not uncommon in mycoplasmal pneumonia, so bacterial culture tests and viral PCR tests for respiratory secretion in diagnosis of mycoplasmal pneumonia is considered necessary.

Objectives: This study focused on assessing the attention deficit problem of middle school students and finding out it's relation with their sociodemographic characteristics, and their other psychopathology.Methods: Subjects of the study were 450 first grade students in a boy's middle school in Jeju. The authors tested their attention deficit problem with Korean version of Conners-Wells' Adolescent Self-Report Scale(CASS) and assessed other psychopathology with MMPI.Results: After screening by CASS, the number of students within the range of ADHD risk group was 85(20.2%) and the number of students within the normal range was 336(79.8%). And there was no significant correlations between CASS score and parent's age, education level, family income, and expenses of housing. But It had significant correlation with pocket money.In MMPI, The number of students who had comorbid psychopathology in ADHD risk group was 26(30.6%). ADHD risk group showed significant differences in comparison with normal control group. ADHD risk group showed significantly higher scores in subscales of hystery, paranoia, and obsession than normal control group.Conclusions: The results that about one third of ADHD risk group had any type of comorbid psychopathology and showed high scores in subscales of hystery, paranoia, and obsession supports the requisite need of psychiatric evaluation and treatment for adolescents complaining attention deficit problem.

We report a case of atypical manifestation of Wernicke's encephalopathy in a 74-year-old non-alcoholic woman. T2-weighted images demonstrated symmetrical distribution of hyperintense lesions in cerebellar dentate nuclei, tegmentum of the lower pons, red nuclei, tectum of the mid brain, medial thalami, and splenium of the corpus callosum. The hyperintense lesions except corpus callosum were markedly resolved on follow-up MR images.

Adenovirus is an important cause of respiratory infections in infants and children. Fifty-one serotypes have been identified, and adenovirus type 3 (Ad3) and Ad7 have often been associated with outbreaks of severe respiratory tract infections. Each serotype can be further divided into genome types based on the patterns of digestion of their DNAs with restriction enzymes. DNA restriction analysis was performed with 56 strains of Ad3 and 98 strains of Ad7 by using 12 restriction enzymes recognizing 6 bp ( Bam HI, Bcl I, Bgl I, Bgl II, Bst EII, Eco RI, Hin dIII, Hpa I, Sal I, Sma I, Xba I, and Xho I). The virus strains were isolated during outbreaks of lower respiratory tract infections in children during an 11-year period from 1990 to 2000 in Seoul, Korea. Among the Ad3 strains, seven genome types were identified; Ad3a and six novel types (Ad3a13, Ad3a14, Ad3a15, Ad3a16, Ad3a17, and Ad3a18). Multiple genome types cocirculated during outbreaks, and some of these were isolated during the 11-year observation period, while others were restricted to particular outbreaks. For Ad7, two genome types, Ad7d and Ad7l, the latter of which is a novel genome type, were identified. A shift in genome types occurred from Ad7d to Ad7l during successive outbreaks. Mortality was 3.6% among children with Ad3 infections and 18% among children infected with either of the Ad7 genome types. In conclusion, the data confirm that Ad3 genome types are more diverse than those of Ad7 and suggest that shifts of genome types may occur during successive outbreaks of Ad3 and Ad7.

On occasion, outbreaks of infection with adenovirus types 3, 7, and 21 cause severe lower respiratory tract infections (LRTIs) in children. From 1990 to 1998, all cases of LRTI due to adenovirus at the Seoul National University Children's Hospital, Seoul, Korea, were reviewed. Adenoviruses were recovered from nasal aspirate specimens of 87 (5.9%) of 1472 children with LRTI. The principal adenovirus serotypes were type 2 (13 [15%] of 87 strains), type 3 (13 [15%]), and type 7 (36 [41%]). Of the 87 infections, 62 (71%) occurred in children

Of 72 blood isolates of Enterobacter spp. collected over an 8-year period, 50% (36 of 72) were derepressed or partially derepressed AmpC mutants. The extended-spectrum β-lactamase (ESBL) production rate was 43% (31 of 72 isolates), and 67.3% (31 of 46) of extended-spectrum cephalosporin-resistant strains produced ESBLs. Thus, a confirmatory test for ESBL production is necessary for extended-spectrum cephalosporin-resistant Enterobacter spp.

It is well known that immunoblot assay is valuable serological test for diagnosing cysticercosis. This study was performed to evaluate serodiagnosis of cysticercosis using immunoblotting among patients with neurologic disorders in Jeju Island. Immunoblot analysis of a total of thirty patients using the cyst fluid of Taenia solium metacestode as a diagnostic antigen, positive reaction was observed in six cases while active and chronic stages of the disease are not clearly known. In this regard, a combination of diagnostic methods such as radiological imaging, laboratory serological tests and clinical presentation will be necessary tor further studies and for increasing diagnostic accuracy of cysticercosis.

Condyloma acuminatum an infection caused by human papillomavirus (HPV), has became one of the most common sexually transmitted disease in adult. Spontaneous resolution of pediatric condyloma occurred in most children patients. We reported a case of recurrent condyloma which occurred at perianal area in child with a brief review of related literatures.

This randomized single-blind study in Korea evaluated noninferiority of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) versus the 7-valent pneumococcal conjugate vaccine (7vCRM) when both were coadministered with H. influenzae type b (Hib) conjugate vaccine, as opposed to coadministration with diphtheria-tetanus-acellular pertussis-based combination vaccines in previous studies.Infants received 3 primary doses at 2, 4, and 6 months and a booster dose at 12 to 18 months of PHiD-CV (N = 374) or 7vCRM (N = 129), both coadministered with Hib vaccine. Immune responses were measured 1 month postdose 3 and postbooster using 22F-inhibition enzyme-linked immunosorbent assay and functional opsonophagocytic activity assay.PHiD-CV-induced antibody responses against each of the vaccine pneumococcal serotypes and protein D. Noninferiority to 7vCRM was demonstrated for all 10 PHiD-CV serotypes in terms of percentages of subjects reaching an antibody concentration ≥0.2 μg/mL after primary vaccination. Postprimary and postbooster, percentages of subjects with antibody concentration ≥0.2 μg/mL or opsonophagocytic activity titer ≥8 were generally consistent between groups for each pneumococcal serotype common to both vaccines. The safety and reactogenicity profiles of PHiD-CV and 7vCRM were generally comparable after both primary and booster vaccination.In this Korean study, 3-dose PHiD-CV priming followed by a booster dose was immunogenic for all 10 vaccine pneumococcal serotypes and protein D. Noninferiority to 7vCRM in terms of enzyme-linked immunosorbent assay threshold responses postpriming was demonstrated. The safety and reactogenicity profiles of both vaccines when coadministered with Hib vaccine were generally comparable.

CTX-M-14 β-lactamase was identified in a stool isolate of Shigella sonnei and in blood isolates of Escherichia coli (one isolate) and Klebsiella pneumoniae (two isolates) from different parts of Korea. The amino acid sequence differed by one amino acid from CTX-M-9 (Ala-231→ Val) and was identical to that of β-lactamases recently found in China and Japan.

Tuberculosis is a disease with high morbidity and mortality in children worldwide. Despite the decrease in the incidence of tuberculosis in Korea, more than 30,000 new patients are diagnosed each year. Active tuberculosis is less frequent in children compared to adults but the risk of miliary tuberculosis and CNS tuberculosis is much higher. The diagnosis of tuberculosis in children and adolescents is difficult due to the nonspecific symptoms upon presentation. Diagnostic work up is based on the confirmation of tuberculosis infection by tuberculin skin test, abnormal radiologic findings, and contact with an adult with active tuberculosis. Anti-tuberculosis medications are prescribed according to the drug susceptibility of the index patient. Latent tuberculosis infection plays an important role in adult tuberculosis by reactivation. Thus, it is critical to accurately diagnose latent tuberculosis in children to prevent reactivation in adulthood. Korean guidelines for diagnosis and treatment of tuberculosis in children and adolescents provide evidence based recommendations in the optimal diagnosis and treatment for active and latent tuberculosis in children and adolescents based on the current Korean situation.

Received:April 19, 2011, Revised:May 15, 2010, Accepted:May 19, 2011 Responsible author:Ki Soo Kang, M.D., Department of Pediatrics, Jeju National University School of Medicine, 102 Jejudaehakno, Jeju 690-756, Korea Tel: +82-64-7791-3232, Fax: +82-64-725-2593, E-mail: kskang@jejunu.ac.kr This work was supported by the research grant of the Jeju National University in 2008. 급성 로타바이러스 장염 소아에서 질환의 중증도와 로타바이러스 VP7 & VP4 유전형의 분포에 대한 연구

To confirm the effect of 7-valent pneumococcal conjugate vaccine (PCV7), pneumococcal nasopharyngeal (NP) carriage was compared between vaccinated (3 + 1 doses PCV7) and non-vaccinated children. Vaccinated subjects were recruited from highly vaccinated regions (≥ 60%), Seoul and Incheon whereas control subjects were recruited from Jeju Island where vaccination rates are low (< 15%). NP swabs were obtained from 400 children aged 18-59 months. Serotype and antibiotic susceptibility was analyzed. Pneumococcal carriage rate was 18.0% (36/200) and 31.5% (63/200) for the vaccinated and control group, respectively. Among those vaccinated, 41.7% (15/36) of the serotypes were vaccine-related type (VRT: 6A, 6C, 19A) with the most common serotype 6C. The next common type was non-typable/non-capsule 30.6% (11/36) followed by non-vaccine type 16.7% (6/36) and vaccine type (VT) serotypes were found in only 11.1% (4/36). In contrast, 52.4% (33/63) of the isolates in the control group were VT. Resistance rates for penicillin and erythromycin were lower in the vaccine group (vaccine vs control; penicillin 45.2% vs 71.4%, erythromycin 74.2% vs 90.5%, P < 0.05). Multi-drug resistance was also lower in vaccinated subjects (vaccine vs control; 45.2% vs 69.8%, P < 0.05). PCV7 reduces carriage in VT which leads to replacement of pneumococci by antibiotic susceptible VRT or non-vaccine type strains.