bluuebunny/crossref_metadata_2025 huggingface dataset:
OUTBREAK OF HUMAN METAPNEUMOVIRUS INFECTION IN CHILDREN IN CHONGQING, CHINA
Authors: Zhao Xiaodong , Chen Xin , Zhang Zhiyong
Published: January 2008

INTRODUCTION: Human metapneumovirus (hMPV) is a newly discovered respiratory pathogen. Understanding of the epidemiology of hMPV infection is limited in China.

OBJECTIVE: The objective of this study was to describe an outbreak of hMPV infection in Chongqing, China, and study the high coinfection rates of hMPV and respiratory syncytial virus (RSV).

METHODS: A total of 93 nasopharyngeal aspirates (NPAs) were collected from hospitalized children with acute respiratory diseases during December 2006 to January 2007. Total RNA was extracted from NPAs by using QIAmp viral RNA minikit and amplified for hMPV F gene and RSV G gene by real-time reverse-transcription polymerase chain reaction (RT-PCR) and traditional PCR, respectively. Most of the hMPV-positive samples were confirmed by traditional RT-PCR and subsequent nucleotide sequence analysis.

RESULTS: Of 93 NPAs, 38 (40.9%) were positive for hMPV and 52 (55.9%) were positive for RSV. Twenty-three (24.7%) revealed coinfection with both viruses. Ages of patients with hMPV infection ranged from 1 month to 31 months; 78.9% were younger than 2 years, and 47.4% were younger than 6 months. Cough was the most common symptom, 78.9% (30 of 38) had wheezing, and 42.1% had fever.

CONCLUSIONS: HMPV seems to be an important respiratory pathogen in young children in Chongqing, China. Coinfection of hMPV and RSV may frequently occur during the winter season. Whether coinfection leads to more severe disease remains unknown.
HLA-DQB1*05 ASSOCIATION WITH HASHIMOTO THYROIDITIS IN CHILDREN OF NORTHERN GREEK ORIGIN
Authors: Giza Styliani , Galli-Tsinopoulou Assimina , Lazidou Panagiota , Fleva Alexandra , Goulis Dimitrios , Trachana Maria , Nousia-Arvanitakis Sanda
Published: January 2008

INTRODUCTION: Hashimoto thyroiditis (HT), an organ-specific autoimmune disorder of the thyroid gland, is considered to be associated with the major histocompatibility complex. Association studies of human leukocyte antigens (HLAs) with HT concern adults and have not revealed consistent results.

OBJECTIVE: We sought to investigate HLA-DRB1 and HLA-DQB1 gene polymorphisms in Greek children and adolescents with HT.

METHODS: We analyzed the distribution of HLA-DRB1 and HLA-DQB1 alleles in 17 Greek children and adolescents with HT and in 181 randomly chosen healthy subjects from northern Greece. The typing of HLA-DRB1 and HLA-DQB1 genes was performed by using polymerase chain reaction with sequence-specific primers. Differences of frequencies for HLA alleles were tested by the χ2 test.

RESULTS: There was no significant association detected between HT and HLA-DRB1 or HLA-DQB1 alleles. However, HLA-DRB1*16 was slightly significantly increased in patients with HT (41.2%) compared with that in controls (19.3%) (P = .057; relative risk: 2.92), and HLA-DQB1*05 was significantly increased in patients with an age of diagnosis of >10 years (87.5%) as compared with those with an age of diagnosis of ≤10 years (33.3%) (P = .05; relative risk: 14).

CONCLUSIONS: This is the first study to examine children and adolescents from northern Greece with HT and analyze the distribution of HLA-DRB1 and HLA-DQB1 alleles according to the age of onset of HT. However, this study needs to include a greater number of patients to ascertain the possibility of an association and avoid the result of a chance event or random variation.
BREASTFEEDING AND ATOPIC DISEASE IN CHILDHOOD: THE GENESIS STUDY
Authors: Kortsalioudaki Christine , Tzavara Chara , Baglatzi Labrini , Papadopoulos Nikos , Manios Yannis
Published: January 2008

INTRODUCTION: The prevalence of asthma and atopic disease in childhood is increasing yearly. A protective connection between breastfeeding and development of atopy has been suggested in several studies.

OBJECTIVE: Our goal was to investigate the correlation between breastfeeding and atopy.

METHODS: We screened 1525 children aged 2 to 5 years. Information on the outcome variables “ever wheezing,” “recurrent wheezing,” “diagnosed asthma,” “itchy rash,” “recurrent rash,” and “diagnosed atopic dermatitis” was obtained. Multiple logistic regression analysis was used to estimate the association of outcome variables with the independent variable (breastfeeding) after adjustment for gender and parental history of allergy.

RESULTS: Median duration of exclusive breastfeeding was 1 month (range: 0–2 months). Children who were breastfed exclusively for >3 months had 28% (95% confidence interval [CI]: 0.53%–0.98%) and 29% (95% CI: 0.51%–1.00%) lower likelihood of ever developing wheezing and recurrent wheezing, respectively. Partial breastfeeding seemed to place the children at significantly greater risk for ever and recurrent wheezing when compared with exclusive breastfeeding. There was no significant difference between exclusive breastfeeding versus formula feeding. Of the ever-breastfed children, 15.2% developed itchy rash versus 10.9% of those who never breastfed. Girls had a significant lower odds ratio (OR) for ever wheezing (OR: 0.76 [95% CI: 0.62–0.94]) and “diagnosed asthma” (OR: 0.60 [95% CI: 0.43–0.85]). Of the children studied, 3.7% had a positive parental background for allergy. Parental history of allergy comprised a significant factor that indicated a greater OR for all outcome variables apart from “diagnosed asthma.”

CONCLUSIONS: Breastfeeding seems to have a significant protective effect against the development of wheezing and asthma but not toward the development of skin atopy. A prospective randomized, controlled trial with longer follow-up time is required to confirm our findings.
CLINICAL SIGNIFICANCE OF LINEAR SHADOWS INSIDE CORONARY ARTERIAL LESIONS ON TWO-DIMENSIONAL ECHOCARDIOGRAPHY IN PATIENTS WITH KAWASAKI DISEASE
Authors: Hamaoka Akiko , Niboshi Ayumi , Yahata Tomoyo , Ozawa Seiichiro , Shiraishi Isao , Itoi Toshiyuki , Hamaoka Kenji
Published: January 2008

INTRODUCTION: In Kawasaki disease, we have detected linear shadows inside large- or moderate-sized coronary arterial lesions (CALs) on high-resolution two-dimensional echocardiography (2DE).

OBJECTIVE: For this study, we wanted to investigate the origin and clinical significance of these linear shadows compared with findings on coronary angiography (CAG), MRI, and intravascular ultrasound.

RESULTS: Linear shadows were detected in 11 CALs on high-resolution 2DE in 9 patients with Kawasaki disease. The outer diameters of CALs on 2DE (7.0 ± 2.1 mm) were larger than those on CAG (4.4 ± 1.6 mm), whereas the inner diameters between linear shadows (3.9 ± 1.6 mm) were almost equal to the diameters of CALs on CAG. There was a statistically significant positive correlation (y = 0.99x − 0.10; r2 = 0.77) between the diameters of CALs on CAG and the inner diameters between linear shadows on 2DE. A thickened intima was revealed in the same regions that showed linear shadows on 2DE, in 7 of 11 lesions on MRI, and in all 4 lesions on which intravascular ultrasound was performed. In 3 patients who had been followed up over 3 years, linear shadows inside CALs on 2DE persisted, and the diameter between linear shadows was almost consistent with the diameter of CALs on CAG.

CONCLUSIONS: These results suggest that linear shadows inside CALs on 2DE would reflect the existence of a thickened intima. We expected that following up the changes of linear shadows inside CALs was useful for noninvasive evaluation of coronary arterial remodeling such as intimal hypertrophy or stenotic change.
MUTATIONAL ANALYSIS OF PTPN11 AND KRAS GENES IN TAIWANESE CHILDREN WITH NOONAN SYNDROME
Authors: Lo Fu-Sung , Lin Lin Ju-Li , Lee Yann-Jinn , Lin Shuan-Pei , Chao Mei-Chyn
Published: January 2008

INTRODUCTION: Noonan syndrome (NS) is an autosomal-dominant disorder that presents with a characteristic face, short stature, skeletal anomalies, and congenital heart defects. Protein-tyrosine phosphatase nonreceptor-type 11 (PTPN11), encoding SHP-2, mutation was the first reported gene involved and accounted for 31% to 60% of cases of NS. The KRAS gene was the second reported gene and was recently identified in a small number of patients with NS.

OBJECTIVE: Our goal was to perform mutational analysis of PTPN11 and KRAS genes in children with NS.

METHODS: In this study we screened for mutation of the PTPN11 and KRAS genes in 73 Taiwanese patients with NS. The mutation analysis of the 15 coding exons and exon/intron boundaries was performed by polymerase chain reaction and direct sequencing of the PTPN11 gene. The mutation analysis of 5 coding exons and exon/intron boundaries was performed by polymerase chain reaction and direct sequencing of the KRAS gene. We identified 12 different missense PTPN11 mutations in 15 (21%) patients with NS and 2 different missense KRAS (V14I and I36M) mutations in 2 (3%) patients with NS. These PTPN11 gene mutations were clustered in exon 3 (n = 6) encoding the N-SH2 domain and 13 (n = 5) encoding the PTP domain.

CONCLUSIONS: This study provides support that PTPN11 and KRAS mutations are responsible for NS in Taiwanese patients.
EFFECTS OF VITAMIN A ON LUNG DEVELOPMENT IN THE RAT FROM EARLY AGE TO ADULTHOOD
Authors: Li Ting-Yu , Wei Hua
Published: January 2008

INTRODUCTION: Epidemiologic studies show that nutritional deficiency can alter lung development and have later adverse effects on lung function and respiratory health. Vitamin A is an important nutrient and is considered important in lung development and maturation. Additional studies are required to address whether vitamin A deficiency adversely affects lung development from early age to adulthood and whether such effects can be blocked or reversed.

OBJECTIVE: Our aim was to study the effect of vitamin A on lung development in the rat from early age to adulthood.

METHODS: Female rats were divided into control, marginal vitamin A deficiency (MVAD), and vitamin A intervention (VAI) groups. Control dams and pups were fed a normal diet (6500 U/kg vitamin A). MVAD rats were fed an MVAD diet (400 U/kg vitamin A). VAI rats were fed an MVAD diet until the birth of the pups and thereafter were fed with normal diet while the pups were given vitamin A through intragastric administration. All pups were killed at 8 weeks of age. Blood serum vitamin A levels were measured. Lungs were weighed and stained for light microscopy.

RESULTS: The vitamin A level of the MVAD group was lower than that of the control group. Lung weight of MVAD rats was lower than that of the controls. Morphometric measurements showed that the alveolar number in MVAD rats was less than that of the controls, and alveolar septa were thicker than those of the controls. All results in VAI group were better than those in the MVAD group and showed no difference from the controls.

CONCLUSIONS: Vitamin A status in early life can affect the lung development from early age to adulthood. Such effects can be reversed by dietary intervention after birth.
EXPOSURE TO TOBACCO SMOKE DECREASES ELASTICITY OF THE AORTA IN CHILDREN
Authors: Kallio Katariina , Jokinen Eero , Simell Olli , Raitakari Olli
Published: January 2008

INTRODUCTION: Attenuated arterial elasticity is one of the earliest markers of atherosclerosis.

OBJECTIVE: Our aim was to investigate the relationship of passive smoking and elastic properties of the aorta.

METHODS: We studied 11-year-old healthy children (n = 386) from the randomized, prospective atherosclerosis prevention trial (STRIP). Aortic elasticity was analyzed by using M-mode ultrasound imaging on the basis of the measurement of blood pressure and arterial diameter changes during diastole and systole. Aortic compliance (AC) and aortic stiffness index (SI) were calculated. Exposure to tobacco smoke was measured by using serum cotinine concentration, which was analyzed with gas chromatography.

RESULTS: Cotinine concentrations ranged from nondetectable (detection limit: 0.16 ng/mL) to 6.8 ng/mL. Cotinine values and aortic elasticity measures were similar between genders. Children were classified into 3 groups according to their cotinine concentration: the top-decile cotinine group (n = 39), the nondetectable cotinine group (n = 220), and the low cotinine group (n = 127). Conventional atherosclerosis risk factors were similar between the 3 cotinine groups. A decreasing trend in AC (P = .041) and an increasing trend in SI (P = .006) was observed across the cotinine groups with an increasing level of tobacco smoke exposure. In addition, systolic and diastolic blood pressure and BMI were independent predictors of the aortic elasticity indices. In multivariable models, cotinine level (P = .020) and systolic blood pressure (P < .001) were inversely associated with AC and directly related to SI (cotinine level, P = .005; systolic blood pressure, P = .0003).

CONCLUSIONS: These data suggest that passive smoking is associated with decreased aortic elasticity in children, indicating early arterial changes.
ASTHMA IN GREEK CHILDREN FROM BIRTH TO 18 YEARS: A LONGITUDINAL STUDY
Authors: Bacopoulou Flora , Lekea Vasso , Veltsista Alexandra , Kavadias George , Bakoula Chryssa
Published: January 2008

INTRODUCTION: The striking worldwide variation in the prevalence of asthma and its divergent changes over time necessitates regional longitudinal studies.

OBJECTIVE: We aimed to examine the asthma situation in Greece.

METHODS: Data from a longitudinal study of a representative nationwide sample derived from the National Perinatal Survey (11 049 consecutive births in April 1983) were analyzed in an attempt to describe the prevalence and natural course of asthma from birth throughout childhood to adolescence. We followed up with 2133 children (at the ages of 7 and 18 years) by using written questionnaires. The diagnostic labeling of asthma was confirmed by a physician on the basis of a history of wheeze attacks, nocturnal cough, exertional symptoms, and response to treatment.

RESULTS: Prevalence rates of current asthma were 7.7% and 4.7% and of lifetime asthma were 19.6% and 26.3% at 7 and 18 years, respectively. More than half (58.2%) of the children with early-onset asthma (onset before the age of 7 years) were free of symptoms at the age of 7 years, and only 7.6% continued to be symptomatic at 18 years. In 6.7% of the participants asthma symptoms appeared between 7 and 18 years of age (late-onset asthma). In almost half (48.2%) of these children symptoms were persisting at the age of 18 years.

CONCLUSIONS: These findings illustrate that asthma remains a significant health care problem for Greek children and adolescents. Continued surveillance of asthma prevalence and its longitudinal predictors is necessary to assist health care professionals with adequately informing children and their parents on the course of the disease.
MIDDLE-EAR FLUID STREPTOCOCCUS PNEUMONIAE SUSCEPTIBILITY AND SEROTYPE AND DISTRIBUTION IN MEXICAN CHILDREN WITH ACUTE OTITIS MEDIA
Authors: Lopez-Enriquez Claudia , Blanco-Montero A. , Espinosa-Monteros L. E. , Rodriguez R. , De La Torre C. , Gomez-Barreto D.
Published: January 2008

INTRODUCTION: Acute otitis media (AOM) is the most common microbial respiratory tract infection in early childhood: Streptococcus pneumoniae is a common pathogen isolated from patients with AOM. The American Academy of Pediatrics advises immunization with a 7-valent pneumococcal conjugate vaccine for children with recurrent AOM.

OBJECTIVE: We aimed to establish the most common S pneumoniae serotypes present in the middle-ear fluid of Mexican children with AOM and to analyze antimicrobial susceptibility patterns and assess the potential protection provided by the new conjugated S pneumoniae vaccines.

METHODS: During 2002 and 2003, 72 S Pneumoniae isolates were obtained from 138 Mexican children with AOM. Serotyping distribution was performed by the quellung reaction with antisera from Statens Serum Institute (Copenhagen, Denmark). Tests for susceptibility were performed by using the agar-dilution method according to Clinical and Laboratory Standards Institute protocol for 18 antibiotics.

RESULTS: The most common S pneumoniae serotypes isolated were 6B and 19F (16.67% each) and 6A, 14, and 23F (15.27% each). The overall rate of resistance (defined as the rate of intermediate resistance plus the rate of resistance) for penicillin was 65.38% (intermediate and resistant categories were 29.17% and 36.11%, respectively), for cefotaxime was 19.45%, for azithromycin and erythromycin was 23.61%, for trimethoprim/sulfamethoxazole was 61.11%, for amoxicillin was 5.5%, and for clindamycin was 12.5%. With amoxicillin/clavulanate, ceftriaxone, imipenem, meropenem, teicoplanin, telithromycin, and vancomycin, we found susceptibility for 100% of the isolates. The most common resistant serotypes were 19F and 23F.

CONCLUSIONS: The serotype distribution of S pneumoniae that causes pediatric AOM in Mexico is similar to that reported from developed countries. The current heptavalent pneumococcal conjugate vaccine covers 63.89% of AOM episodes in Mexican children.
EFFECTS OF MARGINAL VITAMIN A DEFICIENCY ON LONG-TERM POTENTIATION IN YOUNG RATS
Authors: Li Ting-Yu , Mao Chun-Ting , Huang Hong-Mei , Liu You-Xue , Qu Ping , Yang Li
Published: January 2008

INTRODUCTION: Vitamin A is an essential micronutrient for brain development. Marginal vitamin A deficiency (MVAD) remains a subclinical public health problem in children, but little is known about the mechanism by which it affects brain development beginning from embryonic period and early postnatal period.

OBJECTIVE: The objective of this study was to study the effects of MVAD on the hippocampal CA1 long-term potentiation (LTP) in young rats.

METHODS: The MVAD group was fed a vitamin A–deficient diet (400 IU/kg vitamin A), and the control group was fed a vitamin A–sufficient diet (6500 IU/kg vitamin A) at 3 weeks before coitus. Serum vitamin A was assessed by high-performance liquid chromatography. Hippocampal CA1 LTP was detected by electrophysiologic technique, and the ultrastructure of synapses was observed by electron microscope.

RESULTS: The changes of field excitatory postsynaptic potentials slope (25.4% ± 2.01%) in MVAD rats aged 7 weeks was much lower than that in the control group (57.5% ± 8.6%). The changes of slope of field excitatory postsynaptic potentials induced by MVAD in young rats could be replenished after addition of retinoic acid (RA); however, LTP impairment was observed again after addition of RA antagonist into the solution of the control group. No differences of LTP were found after addition of FeSO4 or ZnSO4. The curvature of the synaptic interface of the MVAD group was less than that of the MVAD group that was supplemented with RA and of the control group.

CONCLUSIONS: MVAD during the embryonic and early postnatal period can directly impair the hippocampal CA1 LTP of young rats.
PROCALCITONIN AS A PREDICTOR OF SEVERE APPENDICITIS IN CHILDREN
Authors: Velissariou Ioanna , Kafetzis Dimitris , Nikolaides Pantelis , Sklavos Michael , Maktabi Maher , Spyridis George , Kafetzis Despoina , Androulakakis Emmanuel
Published: January 2008

INTRODUCTION: Procalcitonin is an amino acid peptide that can contribute in the diagnosis and management of severe bacterial infections because it reaches high concentrations in patients with severe bacterial infection, septicemia, or meningitis and decreases rapidly after appropriate antibiotic therapy.

OBJECTIVE: The objective of this study was to assess the diagnostic value of procalcitonin in 212 children with appendicitis and compare it with the standard diagnostic modalities, C-reactive protein, white blood cell count, and abdominal ultrasonography, in relation to the surgical and histologic findings of the appendix.

METHODS: Prolactin levels were measured in 212 children with appendicitis, and the results were compared with standard diagnostic modalities such as C-reactive protein level, white blood cell count, and abdominal ultrasonography, which are useful aids for detecting severe appendicitis and/or perforation.

RESULTS: A procalcitonin value of >0.5 ng/mL was indicative of perforation or gangrene with 73.4% sensitivity and 94.6% specificity, C-reactive protein level of >50 mg/L and white blood cell count of >104/μL are useful diagnostic aids for perforation, and abdominal ultrasonography had a sensitivity of 82.8% and a specificity of 91.2%.

CONCLUSIONS: Procalcitonin seems to be a useful adjunct diagnostic tool for acute necrotizing appendicitis or perforation, and surgical exploration will probably be required in patients with procalcitonin values of >0.5 ng/mL.
LEFT-VENTRICULAR MASS INDEX IN HYPERTENSIVE CHILDREN AND ADOLESCENTS
Authors: Stabouli Stella , Kotsis Vasilios , Karagianni Christine , Toumanidis Savvas , Zakopoulos Nikos , Constantopoulos Andreas
Published: January 2008

OBJECTIVE: Our aim was to investigate differences in left-ventricular mass corrected for height2.7 (LVMI) in children and adolescents according to 24-hour ambulatory blood pressure (BP) levels.

METHODS: A total of 67 consecutive children and adolescents aged 5 to 20 years were analyzed. Patients underwent 24-hour ambulatory BP monitoring and echocardiography. LVMI was calculated by using the Devereux equation. All subjects underwent 24-hour ambulatory blood pressure monitoring on a usual school day. Ambulatory hypertension was defined as mean daytime systolic BP and/or diastolic BP at ≥95th percentile for gender and height (n = 22). Prehypertension was defined as mean daytime systolic BP and/or diastolic BP at ≥90th percentile and <95th percentile for gender and height (n = 13). Normotension was defined as mean daytime systolic BP and/or diastolic BP at <90th percentile for gender and height (n = 32).

RESULTS: LVMI was 28.3 ± 9.4 g/m2.7 (mean ± SD) in the normotensive subjects (n = 32), whereas it was 35.1 ± 8.7 g/m2.7 in the hypertensive subjects (n = 22), a difference that was significantly higher (P < .001, Mann-Whitney test). LVMI was 32.4 ± 5.4 g/m2.7 in prehypertensive subjects (n = 13), values that tended to be lower than the values of hypertensive subjects (P = .275) and significantly higher than the values of normotensive subjects (P < .05, Mann-Whitney test).

CONCLUSIONS: Children and adolescents characterized as hypertensive or prehypertensive using the ambulatory blood pressure criteria exhibited significantly higher LVMI than normotensive subjects. Prehypertensive children may be at a similar risk for cardiovascular target-organ damage as that established for hypertensive children.
HUMAN BOCAVIRUS IN GREEK CHILDREN WITH RESPIRATORY TRACT INFECTION
Authors: Haidopoulou Katerina , Eboriadou Maria , Saliakelis Stratos , Goutaki Myrofora , Damianidou Lambrini , Pavlidou Vassiliki , Papa Anna
Published: January 2008

INTRODUCTION: Human bocavirus (family Parvoviridae) was recently identified in children with respiratory tract infection (RTI), first in Sweden, and subsequently in different parts of the world.

OBJECTIVE: The aim of our study was to gain insight into the epidemiology of bocavirus in children with RTI in Greece.

METHODS: One hundred ten throat-swab samples were collected during the autumn and winter months of 2006–2007 from previously healthy children (aged 1 month to 13 years) who were hospitalized for RTI. DNA was extracted from the samples, and polymerase chain reaction was performed to amplify the NS1 gene of the bocavirus genome. Polymerase chain reaction products were sequenced and compared with respective bocavirus sequences.

RESULTS: Bocavirus DNA was detected in 10 samples (9%). Comparison with previously identified bocavirus sequences showed a high degree of identity. Mean age of the children was 1.8 years (range: 2 months to 4 years). The most common symptoms were fever, cough, and various degrees of respiratory distress. A majority of the children (9 of 10) were clinically diagnosed as having lower RTI, mainly acute bronchiolitis and pneumonia.

CONCLUSIONS: This is the first report of human bocavirus infection in Greece, which suggests that the virus is spread worldwide, and it is associated with RTI in infants and young children.
NDRG1 EXPRESSION IN CHILDHOOD LEUKEMIA AND ITS CORRELATION TO PROGNOSIS AND THERAPEUTIC RESPONSE
Authors: Gao Ju , Zhao Zhi-Yong , Yuan Li-Xing , Wang Hui-Xia , Chen Ting-Ting , Pang Ling-Li , Zhu Yi-Ping
Published: January 2008

INTRODUCTION: N-myc downstream regulated gene 1 (NDRG1) gene expression has been found to be downregulated in a variety of solid tumors and is now regarded as a suppressor gene. However, little is known about its possible role in hematologic cancers.

OBJECTIVE: Our goal was to study expression of the NDRG1 gene in childhood leukemia and explore a possible correlation between expression and prognostic factors.

METHODS: Bone marrow or peripheral blood mononuclear cells from 65 children with leukemia and peripheral blood mononuclear cells from 12 healthy control children were isolated: NDRG1 messenger RNA expression was determined by fluorescence real-time polymerase chain reaction.

RESULTS: NDRG1 messenger RNA expression in acute leukemia groups collectively (acute lymphocytic leukemia [ALL] [41 cases] and acute monocytic leukemia [24 cases]) was significantly lower than that of normal controls (normalized ratios of NDRG1 to glyceraldehyde-3-phosphate dehydrogenase copy numbers were 0.27 and 0.25 vs 0.30 and 0.86 in controls, respectively; P < .01), although there was no statistically significant difference between the ALL and acute monocytic leukemia groups. NDRG1 expression was significantly lower in prednisone nonresponder ALL (13 cases) than in prednisone good-responder ALL (15 cases) (normalized ratios: 0.13 and 0.38, respectively). Similarly, NDRG1 expression was significantly downregulated in high-risk ALL (17 cases) than that in lower-risk ALL (24 cases) (normalized ratios: 0.15 and 0.30, respectively).

CONCLUSIONS: NDRG1 expression was remarkably downregulated in childhood leukemia, as in other human solid tumors. In addition, its expression in childhood ALL was closely associated with such prognostic factors as prednisone response and risk stratification. Our research suggests that NDRG1 expression is negatively correlated to ALL prognosis and therapeutic response.
NEITHER CLINICAL NOR BIOLOGICAL DATA CAN PREDICT RENAL INVOLVEMENT IN INFANTS WITH FEBRILE URINARY TRACT INFECTION
Authors: Printza Nikoleta , Papachristou Fotios , Piretzi Kaliopi , Goga Chrissa , Arsos Georgios
Published: January 2008

INTRODUCTION: 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy is accepted as the gold standard in the diagnosis of acute pyelonephritis.

OBJECTIVE: In an attempt to reduce the number of investigations after urinary tract infections (UTIs), with this prospective study we aimed to evaluate the diagnostic value of acute-phase reactants in identifying renal involvement in infants with febrile UTI.

METHODS: Fifty-four infants (36 male, 18 female) aged 1 to 12 months were studied. For all infants, clinical findings such as duration and height of fever before antibiotic administration and laboratory parameters such as leukocytosis (white blood cell count of >15.000/μL), elevated erythrocyte sedimentation rate (ESR) (>20 mm/hour), and high levels of C-reactive protein (>10 mg/mL) were compared with the results of the DMSA scan obtained within 72 hours after referral.

RESULTS: Regarding microbial agents, Escherichia coli was identified in 42 (78%) of the 54 infants, and 16 (29.5%) of the 54 of infants were febrile for >2 days before diagnosis of UTI. Leukocytosis, elevated ESR, and high levels of C-reactive protein were present in 14 (26%), 41 (76%), and 38 (70%) infants, respectively. Acute-phase DMSA showed renal involvement in 10 (18.5%) infants. Vesicoureteral reflux was found in 16 (29.5%) infants. Gender, duration of fever before antibiotic administration, leukocytosis, elevated ESR, and high levels of C-reactive protein were not related to the severity of renal damage, as shown by DMSA. Only fever of >39°C was slightly correlated with an abnormal DMSA scan result (r = 0.3; P = .032).

CONCLUSIONS: Acute-phase DMSA scintigraphy remains superior to clinical and laboratory data for predicting renal involvement in infants with febrile UTIs.
GENETIC CHARACTERIZATION OF THE F PROTEIN OF RESPIRATORY SYNCYTIAL VIRUS STRAINS ISOLATED IN THE BEIJING, CHINA, AREA
Authors: Lu Qi , Shen Kunling , Xu Wenbo , Zhang Yang , Zhu Zhen
Published: January 2008

INTRODUCTION: Respiratory syncytial virus (RSV) is the most common viral pathogen for lower respiratory tract infection among young children. However, pathogenic mechanisms and molecular characteristics of RSV are still not completely understood, so the development of an effective vaccine has been hindered. F protein has been shown to be a potential RSV subunit vaccine candidate, so the study on genetic characteristics of F protein may be important for further investigation.

OBJECTIVE: Our goal was to determine the genetic characteristics of the F protein.

METHODS: Seventy-six strains of human RSV were isolated from 2001 to 2004 in Beijing, China, of which 6 representative strains were chosen.

RESULTS: Among the 6 Beijing isolates, 4 belonged to subgroup A. The F gene of the isolates shared 97.0% to 97.4% nucleotide sequence identity and 92.1% to 93.0% amino acid sequence identity. They were highly homologous with GenBank Nos. AY198175, AY198176, and AY198177 (China Hebei). The other 2 isolates belonged to subgroup B, and 97.3% and 98.2% sequence identity was seen at nucleotide and amino acid levels, respectively. The nucleotide sequences of subgroup B showed the highest identities with GenBank Nos. NC001781 and AF013254. Phylogenetic analysis of nucleotide sequences revealed that those 4 within group A were monophyletic and closely related to each other, but those 2 within group B were distributed in 2 distinct clusters. AA200-225 and AA259-278 on the F gene are conservative between subgroups A and B.

CONCLUSIONS: Subgroup A and B strains cocirculated, which indicates that there were different transmission chains in Beijing from 2001 to 2004. AA200-225 and AA259-278 are potential segments to develop an effective vaccine in Beijing or even in China.
SEROEPIDEMIOLOGY OF HEPATITIS A IN GREEK CHILDREN
Authors: Kyrka Amalia , Tragiannidis Athanassios , Pantelaki Katerina , Tzivaras Andreas , Athanasiadou Fotini , Konstantopoulos Andreas , Papaevangelou Vassiliki
Published: January 2008

INTRODUCTION: Hepatitis A is a vaccine-preventable disease with epidemiology that has changed over the past decades. In Greece, the vaccine has been available and recommended, but no universal mass vaccination has been implemented as yet.

OBJECTIVE: We sought to study the seroepidemiology of hepatitis A in Greek children.

METHODS: The seroepidemiology of hepatitis A in children 0 to 14 years of age living in Greece was studied. We collected 100 sera per year of age, stratified by geographic region. Demographic data and documented hepatitis A vaccine history was entered into a specially designed anonymous database. Sera were tested for the presence of anti–hepatitis A virus immunoglobulin G antibodies (AxSYM, Abbott Laboratories, Hellas, Greece).

RESULTS: Data from 948 children analyzed revealed that 40.7% of the children had received at least 1 dose of hepatitis A vaccine. To date we have examined 498 sera. Among fully vaccinated children who had received at least 2 doses of vaccine, 91.2% were immune. The overall prevalence of anti–hepatitis A virus antibodies in unvaccinated children was 15.4%. In unvaccinated children >12 months of age, the rate of natural immunity was 11.7% (33 of 282). Interestingly, neither age nor ethnicity were associated with higher rates of natural infection. Among unvaccinated infants, the rate of passively maternal antibodies was surprisingly high (15 of 30 [50%]), mainly because of children from immigrant or Gypsy families, reflecting maternal natural infection.

CONCLUSIONS: The implementation of universal vaccination against hepatitis A in Greece should be discussed because, according to our results, 11.7% of unvaccinated children have serologic evidence of past natural infection.
SUPPRESSION OF THE OLIVOCOCHLEAR REFLEX: A NEUROTOXIC ADVERSE EFFECT OF VINCRISTINE
Authors: Varvoutsi Maria , Riga Maria , Douniadakis Dimitris , Psarommatis George , Bouhoutsou Despina , Baka Margarita , Pourtsidis Apostolos , Doganis Dimitrios , Kosmidis Helen
Published: January 2008

OBJECTIVE: The purpose of this study was to examine the effects of a known neurotoxic regimen, such as the acute lymphocytic leukemia (ALL) Berlin-Frankfurt-Münster 95 (ALL-BFM-95) protocol, on the function of the medial olivocochlear bundle, which was assessed by recording suppression of the amplitudes of distortion-product otoacoustic emissions (DPOAEs) when white noise was applied simultaneously to the contralateral ear.

METHODS: Our population consisted of 3 groups of children with ALL. A baseline examination was performed before the beginning of therapy. DPOAE-suppression measurements were repeated after 4 weekly doses of vincristine in the first group (n = 12), after 8 weekly doses in the second group (n = 12), and 3 years after completion of the protocol in the third group (n = 23). In the third group, a subgroup of 12 children who were exposed to low-dose gentamicin (<13 days) and another 11 children who were exposed to high gentamicin doses (>23 days) were evaluated.

RESULTS: At baseline examination, all groups presented significant suppression at all frequencies. Efferent mediated DPOAE suppression was still present after 4 sessions of vincristine. However, after 8 vincristine sessions, instead of suppression, an increase of amplitudes was noted at 5 (of 12) frequencies. In the subgroups examined 3 years after ALL-BFM-95, the olivocochlear reflex had recovered.

CONCLUSIONS: Enhancement or no significant suppression of OAEs by contralateral noise indicates a probable vincristine-induced insult to the efferent cochlear innervation. This adverse effect seems to take place early in the course of chemotherapy and is slowly reversed a few years after chemotherapy. The clinical implications of these findings may need additional investigation.
LITERATURE REVIEW OF ROTAVIRUS PREVALENCE IN AFRICA
Authors: Waggie Zainab , Hawkridge Anthony , Hussey Gregory
Published: January 2008

INTRODUCTION: Diarrhea kills 1.6 million children younger than 5 years annually, with rotavirus causing 600 000 of those deaths. Eighty-five percent of these deaths occur in sub-Saharan Africa and southeast Asia.

OBJECTIVE: We aimed to review rotavirus prevalence studies of children in Africa from 1975 to 2006.

METHODS: Three multilingual Medline searches (limited to humans) were performed: “RV,” country/Africa, and epidemiology/diarrhea. Additional inclusion criteria included children <5 years of age, conducted over >3 months, and including >50 children. Data were analyzed in 4 periods.

RESULTS: Of the initial 189 studies identified, 75 in 18 countries met the additional inclusion criteria (Table 1). More than half of the studies were hospital based. In all studies the most common serotypes were G1 (25%), G4 (16%), G2 (13%), G3 (12%), P[8] (37%), P[6] (35%), and P[4] (11%). From 1996 to 2006 the common serotypes were G1 (22%), G4 (17%), G2 (13%), G3 (13%), P[6] (37%), P[8] (35%), and P[4] (11%).

CONCLUSIONS: The current prevalence rate is 30% (range: 17%–38%). Present serotypes include G1 through G4, G8, G9, P[8], P[6], and P[4]. Rotavirus diarrhea represents a significant disease burden. Current rotavirus prevalence studies are important, because there are effective rotavirus vaccines available to prevent mortality and severe disease.

TABLE 1.Results of 75 Studies on Rotavirus Prevalence in Children <5 Years Old in AfricaAll Studies1976–19851986–19951996–2006Total No. of studies75123924Duration, mo12 (8.0–15.5)12 (8.0–12.5)12 (8.0–12.5)14 (11–24)Rotavirus-positive, %26252530Studies with serotyping, n180216Rotavirus-positive with serotyping, %24—567— indicates that data were not available.
PROSPECTIVE FOLLOW-UP OF PATIENTS WITH EWING SARCOMA WITHIN THE LATE EFFECTS SURVEILLANCE SYSTEM
Authors: Paulides Marios , Dirksen Uta , Stohr Wolfgang , Jürgens Heribert , Dorr Helmuth-Gunther , Bolling Tobias , Willich Normann , Beck Jorn-Dirk , Langer Thorsten
Published: January 2008

INTRODUCTION: It is known that antineoplastic treatment may induce early and late organ toxicities depending on treatment modalities and intensity.

OBJECTIVE: The aim of this study was to determine the cumulative incidence of sequelae within our cohort of patients treated within the EICESS-92 (European Intergroup Cooperative Ewing's Sarcoma Study, 1992) treatment trial.

METHODS: Since 1998, the Late Effects Surveillance System (LESS) of the German Society for Pediatric Oncology and Hematology has prospectively registered late effects in patients of all ages with relapse-free bone and soft tissue sarcoma in Austria, Germany, and Switzerland. The follow-up is conducted locally in accordance with LESS guidelines. Data are reported to the LESS center for collation and analysis.

RESULTS: There were 67 patients available for analysis (42 male, 25 female) with a median age at diagnosis of 13 years and a median follow-up of 3.5 years. Registration had to be terminated for 17 patients as a result of relapse. In total, 43.3% (29 of 67) of the patients were reported to have at least 1 sequelae of treatment. Sixteen patients suffered toxicity in 1 organ system, 9 patients developed toxicity in 2 organ systems, and there were 3 organ systems affected in 4 patients. Nephrotoxicity was reported in 10.4% (7 of 67), cardiotoxicity in 8.9% (6 of 67), peripheral polyneuropathy in 5.9% (4 of 67), and other toxicities in 34.3% (23 of 67) of the patients.

CONCLUSIONS: Sequelae of treatment for Ewing sarcoma within this cohort of the EICESS-92 study were not more frequent than reported previously. Patients are at risk for the development of several toxicities after treatment for Ewing sarcoma, and they should receive adequate medical follow-up.
LONG-TERM PROGNOSIS OF HENOCH-SCHÖNLEIN NEPHRITIS IN CHILDREN
Authors: Oner Ayse , Erdogan Φzlem , Eren Tuba , Demircin Gülay , Bülbül Mehmet , Baysun Sahika , Arda Nilufer
Published: January 2008

INTRODUCTION: The long-term prognosis in Henoch-Schönlein purpura is determined principally by the development of progressive glomerulonephritis (>10% progress to end-stage renal failure).

OBJECTIVE: In this study we aimed to investigate the long-term prognosis of Henoch-Schönlein nephritis (HSN) in childhood.

METHODS: Between 1991 and 2003, 156 patients with HSN were investigated retrospectively.

RESULTS: There were 86 boys and 70 girls with a mean age of 9.6 years. They were graded according to the degree of renal involvement: grade 1, isolated microscopic hematuria (n = 31); grade 2, hematuria and mild proteinuria (n = 60); grade 3, acute nephritic syndrome (n = 4); grade 4, nephrotic syndrome ± hematuria (n = 18); grade 5, acute nephritic and nephrotic syndrome (n = 43). Renal biopsy was performed on 43 patients with grade 4 or 5 disease. Twenty patients had extensive crescent formation (>50%) as shown by the renal biopsy and were given triple therapy (intravenous pulse methylprednisolone [30 mg/kg per day for 3 days] followed by oral prednisolone [OP], oral cyclophosphamide [2 mg/kg per day for 2 to 3 months], and dipyridamole). The other 23 patients with <50% crescent formation were given methylprednisolone followed by OP and dipyridamole. The patients with grade 3 or 4 disease were given OP and dipyridamole. Those with grade 1 or 2 disease were not given any immunosuppressive agent. During the follow-up period (mean: 30 ± 3.5 months; range: 12–96 months), 23 patients with grade 1, 38 patients with grade 2, 2 patients with grade 3, 8 patients with grade 4, and 21 patients with grade 5 disease showed complete remission (59%). Of the 5 patients with extensive fibrosis shown by renal biopsy, 2 (1%) had persistent nephropathy and 3 (2%) developed end-stage renal failure. The remaining 59 patients showed near-complete recovery with minimal urinary abnormalities (38%).

CONCLUSIONS: Although initial presentation of renal involvement determines the prognosis for those with HSN, intensive treatment with triple therapy seems to be effective for severe renal disease, especially if started before the development of fibrotic changes in crescents and tubulointerstitial tissue.
PROTECTIVE EFFECT OF N-ACETYLCYSTEINE ON HYPEROXIA-INDUCED LUNG INJURY AND ITS INTERACTION WITH P38 MITOGEN-ACTIVATED PROTEIN KINASE SIGNALING PATHWAY
Authors: Xu Feng , Tan Li-Ping , Kuang Feng-Wu , Fang Fang , Lu Zhong-Yi , Wang Xing-Yong
Published: January 2008

INTRODUCTION: N-Acetylcysteine (NAC) is an effective oxidation inhibitor, but the protection of NAC in hyperoxia-induced lung injury is unknown.

OBJECTIVE: The objective of this study was to explore the protective effect of NAC on hyperoxia-induced lung injury and change of p38 mitogen-activated protein kinase (MAPK) expression caused by NAC treatment.

METHODS: Forty Wistar rats were randomly assigned to room air (A), hyperoxia injury (B), hyperoxia + NAC (C), hyperoxia + SB203580 (D), or hyperoxia + NAC + SB203580 (E). The lung wet/dry ratio, pathology, and location and quantity of p38 protein were detected.

RESULTS: Although pathologic changes in group B included severe alveolar edema with inflammatory cell aggregation and red blood cell leakage, the lung micrographic pictures in groups C, D, and E were improved significantly compared with group B; p38-positive cells increased in group B compared with that in group A and labeled in many types cells in lung tissue, especially in infiltrative inflammatory cells. In groups C, D, and E, the positive cells remarkably decreased compared with those in group B; the quantity of p38 MAPK was higher in group B than in group A, and p38 expression in groups C, D, and E decreased significantly compared with group B but was higher than that in the control group. There was no significant difference of p38 quantity among the 3 groups.

CONCLUSIONS: Reactive oxygen species activated phospho-p38 MAPK signaling pathway, and NAC and SB203580 treatments reduced the extent of hyperoxia-induced lung injury, as evidenced by reduction of the wet/dry ratio and lung pathology. NAC may exert a protective effect on hyperoxia-induced lung injury through attenuation of reactive oxygen species–induced p38 MAPK activation.
DETECTION OF HUMAN BOCAVIRUS IN CHINESE CHILDREN WITH RESPIRATORY TRACT INFECTION
Authors: Zhao Xiaodong
Published: January 2008

INTRODUCTION: Human bocavirus (HBoV), a parvovirus discovered in 2005, was identified as a respiratory pathogen in a proportion of respiratory tract diseases with an unknown causative agent.

OBJECTIVE: Our goal was to investigate the role of HBoV in acute lower respiratory tract infection in Chinese children.

METHODS: Two hundred forty-five nasopharyngeal aspirates collected from January to December 2006 from hospitalized children with acute lower respiratory tract infection were tested for the presence of HBoV DNA by using polymerase chain reaction (PCR) that targeted the NP-1 gene. Bulk PCR products were subjected to nucleotide sequence analysis. Medical charts were reviewed for clinical features of HBoV infection.

RESULTS: HBoV DNA was detected in 11 (4.5%) of the 245 nasopharyngeal aspirates. HBoV infection occurred year-round and peaked in winter. The age range of the children was from 48 days to 18 months. Coinfections of HBoV and respiratory syncytial virus were found in 2 (18.2%) of 11 samples. Nucleotide sequence of the NP-1 gene PCR products showed considerably high identity (99%). Clinical symptoms included cough and wheezing.

CONCLUSIONS: HBoV seems to be one of the respiratory pathogens for acute respiratory tract infection in the Chongqing area, particularly in young children. Understanding of the clinical relevance of HBoV infection will require additional studies.
TWO-DECADE EXPERIENCE AND LONG-TERM SURVIVAL IN PEDIATRIC NON-HODGKIN'S LYMPHOMA
Authors: Papadakis Vassilios , Parcharidou Agapi , Paisiou Anna , Tourkantoni Natalia , Papargyri Sofia , Stefanaki Kalliopi , Polychronopoulou Sophia
Published: January 2008

INTRODUCTION: Treatment results for pediatric non-Hodgkin's lymphoma (NHL) continue to improve internationally.

OBJECTIVE: Our goal was to evaluate patient characteristics in our series of patients with NHL and outcomes for the last 16 years (1990–2006).

METHODS: Our patients included 52 newly diagnosed children (11 girls) with a median age of 8.40 years (range: 0.33–14.5 years). Histology results included B-lymphocyte NHL, T-lymphocyte NHL, and Ki-1 in 35, 12, and 5 patients, respectively. In each 5-year period, 14 (3), 17 (3), and 21 (5) patients (girls) were diagnosed, respectively. Common presenting sites were the mediastinum (16), neck area (14), and abdomen (10). Disease was at stage I, II, III, and IV in 3, 14, 23, and 7 patients, respectively. Treatment varied over time. Berlin-Frankfurt-Munich (BFM) protocols had been applied since 1995 (BFM-NHL-90), and since 1997 the BFM-NHL-95 protocol had been applied. Irradiation was given to 5 patients (2 with B-NHL, 3 with T-NHL), and autologous stem cell transplantation was performed on 4 patients, all with B-NHL (1 with central nervous system disease, 1 with residual disease at the end of treatment, and 2 at relapse).

RESULTS: At this writing, 41 patients are alive; 39, 2, and 1 are in first, second, and third remission, respectively. In total, 9 have succumbed (2 died soon after admission in other hospitals as a result of acute-phase complications), and 5 patients died during the first decade of our retrospective study (with T-histology and extensive disease). The event-free survival rate is 74.4% (39 of 52 patients), and the overall survival rate is 80.9% (41 of 52 patients), for a median follow-up time of 6.1 years (range: 0.01–14.7 years) for all patients. For the 39 patients treated with the BFM-95 protocol since 1997, event-free survival and overall survival rates are 79.4% and 88.2%, respectively, for a median follow-up time of 4.8 years.

CONCLUSIONS: Overall and event-free survival rates and outcome of our patients with NHL treated during the last 16 years are standing high. There has been limited use of irradiation and stem cell transplantation.
EFFECT OF DURATION OF STATUS CONVULSION ON NEURONAL APOPTOSIS AND EARLY APOPTOTIC EVENTS IN HIPPOCAMPUS OF RATS
Authors: Jiang Li , Guo Yi , Yuan Ai-yun , Hu Yue
Published: January 2008

OBJECTIVE: Our goal was to explore the influence of duration of status epilepticus on neuronal apoptosis, mitochondrial membrane potential, and cytochrome c release in hippocampus in Wistar rats after status epilepticus (SE).

METHODS: SE that lasted for 30 minutes or 3 hours was induced by intraperitoneal injection with lithium chloride and pilocarpine. Rats were killed at different time points. The apoptosis, mitochondrial membrane potential, and intracellular cytochrome c level were investigated by flow cytometry.

RESULTS: The proportion of apoptotic cells, the decrease of mitochondrial membrane potential, and the release of intracellular cytochrome c significantly changed 30 minutes after 30-minute SE. The peak level was at the 12th hour after SE and 6th hour after SE in apoptosis and the 2 early apoptotic events, respectively. Compared with the same time point after 30-minute SE, the levels of apoptosis and the 2 early apoptotic events after 3-hour SE were much higher. The neuronal apoptosis and the 2 early apoptotic events in hippocampus after SE had a positive correlation with the duration of SE in partial correlation analysis.

CONCLUSIONS: Severe seizures could induce the changes of neuronal apoptosis and the early apoptotic events in hippocampus after SE; the longer the duration of SE, the more serious the change of apoptosis and early apoptotic events were.