Epidemiological features of Kawasaki disease in Korea, 2006-2008

BACKGROUND

The aim of this study was to estimate the incidence and describe the epidemiological characteristics of Kawasaki disease among children in Korea.

METHODS

Questionnaires for surveying the epidemiology of Kawasaki disease were distributed to a total of 101 hospitals that conduct pediatric residency programs. Then, we retrospectively obtained the data, which covered a three-year period (2006-2008) and analyzed them.

RESULTS

During the three-year study period, a total of 9039 cases of Kawasaki disease were reported from 84 hospitals (response rate, 83.2%), comprising 5375 boys and 3664 girls (male:female ratio, 1.47:1). The outbreak rate per 100,000 children <5 years old was 108.7 in 2006, 118.3 in 2007 and 112.5 in 2008 (average rate, 113.1). The seasonal distribution showed a slightly higher incidence rate in winter and summer. The patients' mean age of onset was 32.6 months, while the proportions of sibling cases and recurrent cases were 0.17% and 2.2%, respectively. Coronary arterial abnormalities were detected during follow up by echocardiogram in 17.5% of all cases including dilatations (16.4%) and aneurysms (2.1%).

CONCLUSIONS

The average annual incidence rate of Kawasaki disease in Korea has been continuously increasing, and reached 113.1/100,000 children <5 years old, which is the second highest rate in the world.

Secondary subaortic stenosis after patch closure of subarterial ventricular septal defect

Subaortic stenosis usually occurs without a previous heart operation, however, it can occur after heart surgery as well, with a condition known as a secondary subaortic stenosis (SSS). SSS has been reported after surgical repair of several congenital heart defects. There are only a few recorded cases of SSS after repair of ventricular septal defect (VSD). Here we report a rare case of SSS that occurred 3 years after surgical repair of subarterial VSD. A follow-up echocardiogram is essential for detecting SSS caused by the newly developed subaortic membrane in patients who had cardiac surgery.

Successful transcatheter closure of a large patent ductus venosus with the Amplatzer vascular plug II

Patent ductus venosus is a rare form of congenital portosystemic shunt from the fetal umbilical vein to the inferior vena cava. The reported surgical treatments include ligation, banding, and liver transplantation. In addition, transcatheter closure with a coil, stent, or original Amplatzer vascular plug (AVP) has been reported. The AVP II, a redesigned version of the original vascular plug with a finer more densely woven nitinol wire and a large diameter (up to 22 mm) is available. This reported case is the first successful occlusion of a large patent ductus venosus with the new AVP II.

Eosinophilic cystitis causing spontaneous rupture of the urinary bladder in a child

We report a unique case of eosinophilic cystitis causing intraperitoneal bladder perforation in a child diagnosed by chance with no signs or history of trauma. To our knowledge, this is the first case of eosinophilic cystitis complicated by bladder rupture in children. The patient was successfully treated with primary repair. For children with non-traumatic bladder perforation, eosinophilic cystitis must be considered in the differential diagnosis.

Epidemiologic picture of Kawasaki disease in Korea, 2000-2002

BACKGROUND

The aim of this study was to investigate the incidence rate and epidemiologic patterns of Kawasaki disease in Korea for a 3 year period during 2000 to 2002.

METHODS

An epidemiologic survey on Kawasaki disease was retrospectively performed. The questionnaire was sent to all 112 hospitals having pediatric residency programs, and obtained data were analyzed.

RESULTS

The 9150 cases of Kawasaki disease from 92 hospitals which responded (response rate, 82.1%) included 5515 males and 3635 females (male : female ratio, 1.52:1). The incidence rate per 100,000 children <5 years old was 73.7 in 2000, and increased to 90.8 in 2001, and 95.5 in 2002 (average rate, 86.4). The monthly number of patients was slightly higher in May, June and July. Their mean age of onset, the proportion of sibling cases, and a rate of recurrent cases were 30.5 months, 0.17%, and 2.9%, respectively. Coronary arterial abnormalities occurred in 18.6% of cases including dilatations of 17.3% and aneurysms of 3.1%.

CONCLUSION

The average annual incidence, 86.4/100 000 in children <5 years old is the second highest rate in the world.

Synthesis and photodynamic action of diphenyl-2,3-dihydroxychlorin: a potential tumor photosensitizer

The synthesis, photophysical properties of diphenyl-2,3-dihydroxychlorin (DPCOH) and its photocytotoxicity to tumor cells are described. DPCOH exhibits photodynamic activity in terms of type I and type II mechanisms under irradiation. The quantum yield of (1)O(2) in CHCl(3) is 0.7. For the photocytotoxicity to tumor cells, DPCOH proved to be 200 times more potent than HPD, and the dark toxicity is low (dark IC(90)>32 microg/mL).

[Metabolism of ginsenoside Rb1 and panaxadiol saponins by fungi]

AIM

To study the metabolic process of ginsenoside Rb1 (G-Rb1) and panaxadiol saponins (PDS) by fungi.

METHODS

Ten strains of fungi were incubated with G-Rb1 and PDS at a certain temperature with shaking. A portion was taken out at different time and mixed up with butanol. The butanol extract was analysed by thin layer chromatography (TLC), high performance liquid chromatography (HPLC) and electrospray ionazition mass spectrometry (ESI-MS).

RESULTS

It was found that there were ginsenoside-Rd (G-Rd), ginsenoside-F2 (G-F2), compound K (CK) and 20(S) protopanaxadiol (Ppd) metabolites beside the prodrug G-Rb1 induced by fungi (No. 1, 2, 3, 6, 8, 9).

CONCLUSION

The six strains of fungi have different degrees of ability to metabolize G-Rb1 and PDS. The possible metabolic process could be as follows: G-Rb1 (or PDS)-->G-Rd-->G-F2-->CK-->Ppd.