Pediatrics International
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Molecular epidemiology of HIV: Tracking AIDS pandemic Abstract
Background
: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) epidemic is a global threat to maternal and child health, especially in developing countries. It is estimated that 800 000 children are infected and 580 000 children die of AIDS‐related illnesses every year. Molecular epidemiology has been a useful tool in analyzing the origin of HIV and tracking the course of global HIV spread. This article provides an overview of recent advances in the field of molecular epidemiology of HIV across the world, and discuss the biological implications.
Methods
: Based on the near full‐length or partial nucleotide sequence information, the phylogeny and recombinant structure of HIV strains are analyzed. Using genotype classification of HIV as a molecular marker, the origin and the genesis of HIV epidemic are investigated.
Results
: The HIV‐1 group M, a major HIV group responsible for current AIDS pandemic, began its expansion in human population approximately 70 years ago and diversified rapidly over time, now comprising a number of different subtypes and circulating recombinant forms (CRF). Of note, recent studies revealed that new recombinant strains are arising continually, becoming a powerful force in the spread of HIV‐1 across the globe.
Conclusion
: Global dissemination of HIV is a dramatic and deadly example of recent genome emergence and expansion. Molecular epidemiological investigation is expected to provide information critical for prevention and future vaccine strategies.
Pediatrics International - Tập 46 Số 2 - Trang 236-244 - 2004
Mizoribine: Mode of action and effects in clinical use Abstract Mizoribine is a new immunosuppressive drug and was authorized by the Japanese Government in 1984. The strong immunosuppressive activity of mizoribine was already demonstrated in various animal models, in renal transplantation and in steriod‐resistant nephrotic syndrome. Recently, the remarkable clinical advantages of an imidazole for adults with rheumatoid arthritis, lupus nephritis and other rheumatic diseases were reported. Mizoribine is an imidazole nucleoside and the metabolites, MZ‐5‐P, exerts its activity through selective inhibition of inosine monophosphate synthetase and guanosine monophosphate synthetase, resulting in the complete inhibition of guanine nucleotide synthesis without incorporation into nucleotides. Thus, mizoribine is superior to azathioprine, in that it may not cause damages to normal cells and normal nucleic acid.
Pediatrics International - Tập 44 Số 2 - Trang 196-198 - 2002
Delayed presentation of Morgagni hernia in a patient with Marfan syndrome
Pediatrics International - Tập 52 Số 1 - 2010
Lymphadenitis by non‐tuberculous mycobacteria in children Abstract Background Non‐tuberculous mycobacteria (NTM ) constitute an important cause of cervical lymphadenitis in immunocompetent children. The aims of this study were to estimate the incidence of lymphadenitis due to NTM in children in Cyprus and to describe the characteristics, diagnostic approach, management and outcome of such infections. Methods Children aged 1–5 years old, evaluated at Archbishop Makarios III Hospital, Nicosia, Cyprus, from 1 January 2007 to 31 December 2016 for lymphadenopathy, were included in the study. All children had positive lymph node culture for NTM . Results A total of 22 cases of culture‐positive lymphadenitis caused by NTM were reviewed. Patient age ranged from 16 to 55 months. Tuberculin skin test produced an induration in 81.0% of cases (diameter, 4–17 mm). Mycobacterium avium was isolated in 17 cases (77.3%), M. intracellulare in three (13.6%), M. paraffinicum in one (4.5%) and M. kansasii in one case (4.5%). All 22 patients underwent surgical excision of affected nodes. Additional anti‐mycobacterial treatment was given when complete excision was not achieved or for post‐surgical recurrence. Complications were few and included scar in three children and one case of transient facial nerve palsy. Conclusion Surgical excision of NTM ‐infected lymph nodes is an effective diagnostic and therapeutic approach. When total surgical excision is not feasible, a combination of partial excision with a clarithromycin‐including drug regimen appears safe, effective and causes milder and fewer complications than surgery alone.
Pediatrics International - Tập 60 Số 12 - Trang 1062-1067 - 2018
Acute myeloid leukemia in children: Current status and future directions Abstract Acute myeloid leukemia (AML) accounts for 25% of pediatric leukemia and affects approximately 180 patients annually in Japan. The treatment outcome for pediatric AML has improved through advances in chemotherapy, hematopoietic stem cell transplantation (HSCT), supportive care, and optimal risk stratification. Currently, clinical pediatric AML studies are conducted separately according to the AML subtypes: de novo AML, acute promyelocytic leukemia (APL), and myeloid leukemia with Down syndrome (ML‐DS). Children with de novo AML are treated mainly with anthracyclines and cytarabine, in some cases with HSCT, and the overall survival (OS) rate now approaches 70%. Children with APL are treated with an all‐trans retinoic acid (ATRA)‐combined regimen with an 80–90% OS. Children with ML‐DS are treated with a less intensive regimen compared with non‐DS patients, and the OS is approximately 80%. HSCT in first remission is restricted to children with high‐risk de novo AML only. To further improve outcomes, it will be necessary to combine more accurate risk stratification strategies using molecular genetic analysis with assessment of minimum residual disease, and the introduction of new drugs in international collaborative clinical trials.
Pediatrics International - Tập 58 Số 2 - Trang 71-80 - 2016
Developmental characteristics of very low‐birthweight infants at 18 months’ corrected age according to birthweight Abstract Background: The objective of the present study was to describe developmental profiles of very low‐birthweight (VLBW) infants compared by birthweight, because those of infants with birthweight <750 g might be different from other VLBW infants.Methods: VLBW infants from four medical centers were followed at each site with the same protocol at 18 months’ corrected age. The protocol by the Society for the Study of Follow up for High‐Risk Infants, which includes a standardized developmental test, the Kyoto Scale of Psychological Development (KSPD), was used. Five hundred and sixty‐four VLBW infants without neurological or neurosensory impairment were divided into four groups using 250 g birthweight intervals and outcomes were compared between the four groups.Results: Developmental characteristics of extremely low‐birthweight infants (birthweight <750 g) in comparison with other VLBW infants were as follows: (i) more infants were judged clumsy in their fine motor skills; (ii) fewer were able to speak meaningful words although they were able to understand oral simple orders; (iii) developmental quotients (DQ) of KSPD was significantly lower; and (iv) more infants were judged as hyperactive.Conclusion: Developmental profiles of VLBW infants without major handicaps at 18 months’ corrected age correlated significantly with their birthweight sequence. These results provide useful information on developmental outcomes of VLBW infants.
Pediatrics International - Tập 50 Số 1 - Trang 23-28 - 2008
Measuring quality of life in Japanese children: Development of the Japanese version of PedsQL Abstract Background: Health‐related quality of life (HRQL) is perceived as an important health‐care outcome. There are several systems for measuring the HRQL in adults but there are few such systems for children in Japan. Pediatric Quality of Life Inventory (PedsQL) is valid and demonstrates excellent reliability in the USA, Europe, and Asian countries. The aim of the present study was therefore to develop the Japanese version of PedsQL.Methods: A two‐step procedure was performed: translation of PedsQL, followed by examination of the psychometric properties in a cross‐sectional study. The feasibility, reproducibility, internal consistency reliability, factor structure, and concurrent and clinical validity were examined.Results: The internal consistency reliability of the Child Self‐Reports of young children was slightly low, but that of the Child Self‐Reports of school children and adolescents was good. Further, all the Parent Proxy‐Reports had excellent alphas. The Japanese version had satisfactory feasibility for all age ranges. The intercorrelation of subscales supported the multidimensional factor structure. Clinical validity was examined by analysis of variance performed for four groups with different health conditions (healthy, chronic needs only, mental condition only, and chronic needs and mental condition). The scores of each functioning scale differed among the four groups, with the healthy group having the highest scores for all functioning scales.Conclusions: The Japanese version of PedsQL can be applied in community and school health settings in Japan. Because children with chronic health needs and mental conditions were included, the Japanese version of PedsQL is expected to be useful in clinical settings.
Pediatrics International - Tập 52 Số 1 - Trang 80-88 - 2010
Effects of iron deficiency anemia on hemoglobin A1c in type 1 diabetes mellitus
Pediatrics International - Tập 41 Số 4 - Trang 357-362 - 1999
Effective treatment of cyclic thrombocytopenia with cepharanthin
Pediatrics International - Tập 41 Số 5 - Trang 584-585 - 1999
A case of common variable immunodeficiency associated with cyclic thrombocytopenia Abstract A 12 year old boy was found to be deficient in immunoglobulins (Ig) A, G2 and G4 , and common variable immunodeficiency was diagnosed. He also had cyclic thrombocytopenia at intervals of approximately 28–30 days. His bone marrow revealed normocellular with slightly decreased megakaryocytes. In vitro colony assays showed markedly imparied megakaryocytopoiesis, erythropoiesis and granulopoiesis. Platelet‐associated IgG was elevated at his thrombocytopenic phase. Direct Coombs' test was repeatedly positive. Although not defined at present, we suggest the autoimmune nature of the disease.
Pediatrics International - Tập 36 Số 6 - Trang 690-692 - 1994
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