Prevalence of Viruses with Diarrhea among Hospitalized Children West Gyeonggi Province / 소아감염

PURPOSE: This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. METHODS: We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. RESULTS: The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. CONCLUSION: The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing.

Evaluation of changes in random blood glucose and body mass index during and after completion of chemotherapy in children with acute lymphoblastic leukemia / 소아과

PURPOSE: Improved survival of patients with childhood acute lymphoblastic leukemia (ALL) has drawn attention to the potential for late consequences of previous treatments among survivors, including metabolic syndrome. In this study, we evaluated changes in 3 parameters, namely, random blood glucose, body mass index (BMI), and Z score for BMI (Z-BMI), in children with ALL during chemotherapy and after completion of treatment. METHODS: Patients newly diagnosed with ALL from January, 2005 to December, 2008 at Saint Mary's Hospital, The Catholic University of Korea, who completed treatment with chemotherapy only were included (n=107). Random glucose, BMI, and Z-BMI were recorded at 5 intervals: at diagnosis, before maintenance treatment, at completion of maintenance treatment, and 6 and 12 months after completion of maintenance treatment. Similar analyses were conducted on 2 subcohorts based on ALL risk groups. RESULTS: For random glucose, a paired comparison showed significantly lower levels at 12 months post-treatment compared to those at initial diagnosis (P<0.001) and before maintenance (P<0.001). The Z-BMI score was significantly higher before maintenance than at diagnosis (P<0.001), but decreased significantly at the end of treatment (P<0.001) and remained low at 6 months (P<0.001) and 12 months (P<0.001) post-treatment. Similar results were obtained upon analysis of risk group-based subcohorts. CONCLUSION: For a cohort of ALL patients treated without allogeneic transplantation or cranial irradiation, decrease in random glucose and Z-BMI after completion of chemotherapy does not indicate future glucose intolerance or obesity.

Clinical Study of Influenza B-Associated Myositis / 소아알레르기및호흡기학회지

PURPOSE: Influenza B-associated myositis is an infrequent and poorly known complication of influenza B virus infection in children. The aim of this study was to describe the clinical and laboratory manifestations, diagnosis, and outcomes of influenza B-associated myositis in Korean children. METHODS: A retrospective analysis was conducted in patients aged <16 years who had been diagnosed with influenza B-associated myositis at the Catholic University Bucheon Saint Mary's Hospital between April 2010 and May 2010. RESULTS: Overall, 16 cases were analyzed. Influenza B-associated myositis typically occurred in preschool-aged children with a 3:1 male predominance. The mean age was 4.6 years (range, 3 to 7 years). The median interval between onset of influenza infection and onset of influenza B-associated myositis was 3 days (range, 1 to 7 days). Only the calf muscles were involved in all patients. Blood creatine phosphokinase concentration was elevated in most patients. Median duration to clinical recovery was 3 days (range, 1 to 4 days). No patient had rhabdomyolysis, renal failure, or related sequelae. All patients had a favorable outcome without administration of antiviral drugs. CONCLUSION: Clinical and laboratory findings of influenza B-associated myositis are very characteristic and allow a rapid diagnosis during the influenza season. Outcomes of influenza B-associated myositis are good with only proper supportive treatment.