Changes in the Occurrence of Rotavirus Gastroenteritis before and after the Introduction of Rotavirus Vaccine among Hospitalized Pediatric Patients and Estimates of Rotavirus Vaccine Effectiveness

PURPOSE: This study aimed to investigate the changes in the occurrence of rotavirus gastroenteritis (RGE) after the introduction of rotavirus vaccine and estimate rotavirus vaccine effectiveness in hospitalized children. METHODS: We compared the retrospective data of 671 patients with acute gastroenteritis (AGE) admitted to the Department of Pediatrics, Hanyang University Seoul Hospital from January 1, 2014, to December 31, 2015, with retrospective data of 1,243 patients admitted to the same institution with AGE from January 1, 2004, to December 31, 2005. The vaccine effectiveness was estimated using a case-positive control test-negative study. RESULTS: The proportion of RGE in AGE was significantly lower in 2014 to 2015 (9.0%, 48/531) than in 2004 to 2005 (22.7%, 282/1,243) (P <0.001). In particular, there was a significant decrease in the 6- to 11-, 12- to 23-, and 24- to 35-month-old groups (P <0.001), whose rotavirus vaccination rates were higher than the remaining age groups. The monthly distribution of patients with RGE in 2004 to 2005 was higher from November to May, peaked in January, followed by December and February. In 2014 to 2015, the monthly distribution of patients with RGE slightly peaked in January. In 2014 to 2015 study, the complete rotavirus vaccination rate was 66.0% (332/503) and incomplete vaccination rate was 6.2% (31/503). Presumed rotavirus vaccine effectiveness was 83.3% (95% confidence interval [CI], 60.5% to 92.9%) in the complete vaccination group and 27.4% (95% CI, –163.7% to 80.0%) in the incomplete group. CONCLUSIONS: The proportion of RGE in AGE has markedly decreased since the introduction of rotavirus vaccines, and improving vaccination coverage will further reduce the burden of RGE in Korea.

Evaluation of Allergenicity to Genetically Modified Organic Foods / 소아알레르기및호흡기학회지

PURPOSES: The aim of this study was to clarify whether genetically modified organic (GMO) foods cause any allergic reactions in patients with food allergy, by means of their serum tests. In addition, it was also attempted to perform follow-up observation on targeting proteins contained in GMO food, using the serum of patients with food allergy, and to show the improvement for evaluating GMO food as allergens. METHODS: To identify the targeting proteins in GMO food and to evaluate their allergenic risks, several genes including CP4 EPSPS in genetically modified soybean, and Cry1f, Cry1Ab and Pat in genetically modified corn were cloned. The genes were transformed to synthesize proteins to induce protein expression of their target genes. The serums were divided allergy-positive and allergy-negative to soybean and corn, and SDS-PAGE and Western blotting were conducted, and finally allergenic risks were evaluated. RESULTS: This study showed that the allergenic risks of 4 targeting proteins were insignificant. Although some non-specific bands appeared, it was considered that they were not associated with allergenic risk as they often appeared in other proteins. Additionally, as a result of analyzing DNA sequences for each targeting protein with the intention of protein identification, they perfectly matched. CONCLUSION: As a way to evaluate the allergenic risk of GMO food, it is reasonable to use the purified serum proteins of allergic patients as performed in this study. However, this evaluation method is carefully applied to the future practice.

Neurologic Complications Associated with Respiratory Syncytial Virus Infection in Childhood / 대한소아신경학회지

PURPOSE: Respiratory syncytial virus(RSV) mainly brings about respiratory complication, but it can also be related to neurologic complication. We have studied clinical aspect and incidence of neurologic complication associated with RSV infection. METHODS: We reviewed the medical records of 732 children with RSV infection who were admitted to the department of pediatrics, Hanyang University hospital from November 2002 to June 2007 and studied on existence of neurologic complication, age, sex, clinical symptom, characteristics of seizure, and laboratory findings. RESULTS: Neurologic complications were occurred in 52 patients(7.1%) among 732 patients. Among them, 14 patients(1.9%) had seizure and 38 patients(5.2%) had alteration of mental status such as drowsy, lethargy. Age distribution of patients with neurologic complication was from 1 month to 5 years(mean 16.4 months). There were 30 boys and 22 girls. Among 14 patients who had seizure, 2 patients had convulsion disorder, 3 patients had febrile convulsion, and 9 patients had no seizure before. Their age distribution was from 1 months to 4 years(mean 18.4 months) and there were 8 boys and 6 girls. All of 14 patients showed generalized tonic clonic seizure and durations were from 30sec to 15 min(mean 4.4 min). All of the investigations were normal. None of 52 patients had recurrence and neurologic sequelae. CONCLUSION: It is important to know that RSV can cause CNS complications because we know how many patients infected by RSV. RSV-related seizure can be considered as benign seizure which does not need any long-term antiepileptic medication.

Long-term Effect of Recombinant Interferon-Gamma on Moderate and Severe Atopic Dermatitis in Childhood / 소아알레르기및호흡기학회지

PURPOSE: A number of studies on the treatment of atopic dermatitis have focused on the therapeutic effects of interferon-gamma (IFN-gamma) in patients with severe atopic dermatitis, although therapeutic protocols such as duration and dosage of recombinant IFN-gamma were different among studies. The beneficial effects of IFN-gamma have probably been attributed mainly to its immune modulating effect on the expression of several immunologic mediators although the mechanism of action of IFN-gamma therapy in atopic dermatitis is not clear. OBJECTIVE: The purpose of the present study was to evaluate the therapeutic effect of recombinant IFN-gamma on moderate to severe atopic dermatitis with changes in immunologic markers such as IgE level and eosionophil cationic protein (ECP). METHODS: Thirty children with moderate to severe atopic dermatitis were selected for the treatment with recombinant IFN-gamma, and 10 children with atopic dermatitis were recruited for the controls without IFN-gamma treatment. They were followed up every 4 weeks for 3 months after IFN-gamma treatment. We evaluated the SCORAD index and immunologic markers including serum IgE and ECP and total eosinophil and neutrophil counts. RESULTS: Significant clinical improvement in reduced SCORAD index was observed 12 weeks after treatment with regimen of recombinant IFN-gamma. This clinical outcome was correlated more with changes in eosinophil counts and ECP levels than with those in serum IgE levels. CONCLUSIONS: The efficacy of recombinant human IFN-gamma therapy for children with moderate to severe atopic dermatitis was maintained without serious side effects for 6 months after final injection of recombinant IFN-gamma. Recombinant IFN-gamma therapy corrected cellular immune deficits, but not humoral immune defects in patients with atopic dermatitis.