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The genogroups GI and GII of norovirus (NoV) ribonucleic acid (RNA) genetic variants are the most prevalent cause of acute gastroenteritis outbreaks, especially in children, worldwide. A fast, accurate and convenient tool for diagnosis of NoV may be preferable to the more complicated performance of real-time reverse transcription-polymerase chain reaction (RT-PCR).In this study, we developed and evaluated a tool using insulated isothermal PCR (iiPCR)-mediated POCKIT Central NoV GI and NoV GII assay systems for diagnosis of NoV infection in pediatric patients suspected with gastroenteritis.Performance of POCKIT Central Norovirus GI and GII assays using RT-iiPCR, compared to regular real-time RT-PCR showed the same diagnosis rate to NoV GI (100% of total percent agreement and 1.0 of Cohen's kappa value) and a similar detection rate to norovirus GII (96.3% of total percent agreement and 0.92 of Cohen's kappa value). In exclusivity tests, the POCKIT Central NoV GI and GII assays showed negative results to other viruses, indicating that the assays may be a NoV-specific detection tool.POCKIT Central NoV GI and GII Assay systems can provide a simple, rapid, sensitive, and specific point-of-need diagnostic tool for the detection of NoV GI and GII RNAs in clinical specimens from children with acute gastroenteritis.

Background/Purpose: The FUT2 gene is a histo-blood group antigen (HBGA) that determines the susceptibility to Norovirus (NoV) infection. This study investigated the clinical significance of the FUT2 gene profile and HBGA expression in NoV infection. Methods: Fecal specimens were collected from children in Chang-Gung Children's Hospital with acute gastroenteritis (AGE). The medical records were reviewed for clinical data. The viral etiology of gastroenteritis was validated using molecular methods. Genomic DNA was isolated from saliva or whole blood with the Puregene B Kit, according to the manufacturers' instructions. Single-nucleotide polymorphisms (SNPs) were determined by real-time PCR assays. Results: FUT2 gene DNA was examined in 98 children with AGE. NoV was detected by RT-PCR in 44 patients (44.8%), while 54 (55.2%) had non-NoV AGE. Of the 44 NoV patients, 38 (86.3%) were secretors (no G428A mutation) and six (13.7%) were non-secretors (G428A mutation). Of the 54 non-NoV AGE patients, 28 (51.9%) were secretors and 20 (48.1%) were non-secretors. NoV-infected patients who were secretors had more frequent vomiting (P

Aim: The present study evaluates the long-term clinical and nutritional effect to endoscopic balloon dilatation (EBD) in pediatric esophageal stricture. Methods: This was a 15-year retrospective study involving pediatric patients with esophageal stricture treated with EBD. Outcome parameters included the number of dilatations, procedural success rates, nutritional status, and complications. EBD was performed in patients with a dysphagia score greater than 2. The nutritional status was assessed by weight-for-age z-score. Clinical success was defined as no requirement for EBD for at least 1 year and/or increasing interval between dilatation and the numbers of EBD was fewer than 4 times per year. Results: A total of 50 cases (mean age, 4.41 ± 4.9 years) were enrolled. During a mean follow-up of 3.2 ± 1.9 years, a total of 268 EBD sessions were performed, with an average of 5.36 sessions per patient (range, 1–33). Patients who had short segment stricture (

Background Diagnosing intestinal strangulation as a complication of small bowel obstruction (SBO) remains a considerable challenge in children. We evaluated the clinicoradiological parameters for predicting the presence of a strangulated intestine. Methods We reviewed the medical records of 69 pediatric patients who underwent operation for acute SBO. Regression analysis was used to identify the parameters for predicting strangulated SBO. Results Of the 69 patients with SBO, 27 patients had intestinal strangulation and were awarded one point each towards the overall clinical score: intractable continuous abdominal pain, tachycardia, white blood cell count >13,600/mm 3 , and abdominal distention. Patients with a clinical score ≥2 combined with the presence of ascites in ultrasound (US) results or with wall thickness and reduced wall contrast enhancement in abdominal computed tomography (CT) scans showed strong evidence for intestinal strangulation. Conclusion The combination of two or more clinical parameters, including intractable continuous abdominal pain, tachycardia, leukocytosis, and abdominal distention with the presence of ascites in US or wall thickness and reduced wall contrast enhancement in, is useful for the identification of strangulated SBO. The type of study and level of evidence Prognosis study; Level III.

BackgroundOur objective was to analyze demographics and characteristics of Meckel's diverticulum with different manifestations in pediatric patients.MethodsThis is a retrospective study in children with symptomatic Meckel's diverticulum who underwent resection between September 1998 and October 2010. The diagnosis was confirmed by surgery and pathology. Demographic characteristics, manifestations, Meckel's scan results, surgical and histological findings were analyzed.ResultsOne hundred symptomatic Meckel's diverticula were identified in 74 boys and 26 girls aged from one day to 18 years old over 13 years. Depending on whether or not obstruction occurred, the patients were classified into two categories. Each category was further subdivided into two diagnostic groups: 17 intussusception and 24 non-intussusception bowel obstruction in the obstructive category and 44 gastrointestinal bleeding and 15 diverticulitis and/or perforation in the non-obstructive category. The sex discrepancy was higher in the non-obstructive category than in the obstructive category (male-to-female, 4.36 vs. 1.73, p < 0.05). Forty-one of 44 patients with gastrointestinal bleeding underwent a Meckel's scan with a high positive rate (92.7%). The ectopic tissues were identified in 73 patients and included 61 gastric type, two pancreatic type and 10 mixed type. Ectopic tissues were more prevalent in non-obstructive category (p < 0.05) with ectopic gastric tissue even more pronounced (p < 0.01). Ectopic pancreatic tissue was significantly more prevalent in intussusception (p < 0.01). Laparoscopic surgery was performed more frequently in Meckel's diverticulum with non-obstructive symptoms (p < 0.001).ConclusionDiverse presentations in pediatric Meckel's diverticulum are affected by different ectopic tissue types and male sex. Laparoscopic surgery is widely used for children with non-obstructive symptoms.

Background Antigenemia is commonly found in children with rotavirus infection, although its clinical significance is undetermined. The aim of this study was to evaluate the association of antigenemia with clinical manifestations and cytokine profiles in children infected by rotavirus. Methods In total, 68 children hospitalized with rotavirus gastroenteritis were enrolled. Serum samples were collected for detection of antigenemia and viremia. Clinical, laboratory and demographic data were analyzed. Proinflammatory, Th1 and Th2 cytokines were evaluated by bead-based flow cytometry. Results Antigenemia and viremia were found in 45.6% ( n = 31) and 5.9% ( n = 4) of the 68 rotavirus-infected children, respectively. The mean age of the antigenemia group was significantly greater than that of the non-antigenemia group (43.5 vs. 27.3 months; p = 0.034). The antigenemia group had a significantly shorter length of hospitalization (4.8 vs. 5.8 days; p = 0.0354) in comparison with the non-antigenemia group, and antigenemia was inversely associated with the length of hospitalization (β = 0.31, p = 0.021). A significantly higher tumor necrosis factor (TNF)-β level was found in the patients with antigenemia than those without (236.7 vs. 29.2 pg/mL, p = 0.026). The severity of disease and the rate of extra-intestinal manifestations did not differ between the groups. Viremia was associated with a higher fever ( p = 0.012). Conclusions Antigenemia was positively correlated with shorter hospital stay in children with rotavirus infection. Enhanced innate and T-cell-mediated immunity evidenced by up-regulation of TNF-β was found in patients with antigenemia.

ZnS:Mn2+ nano-phosphors are synthesized via a microwave irradiation technique using zinc 2-ethylhexanoate as a novel zinc precursor. The developed process produces ZnS:Mn2+ nano-particles having in situ capping of 2-ethylhexanoic acid on the surface, resulting in high luminescence intensity due to effective surface passivation. Surface characterization of the nano-particles indicates that 2-ethylhexanoic acid is chemisorbed as carboxylate onto the surface of ZnS:Mn2+ nano-particles and the two oxygen atoms in the carboxylate are coordinated symmetrically to the Zn atoms, leading to the formation of the covalent Zn–O bond. The anion bound onto the nano-particle surface prevents particle agglomeration due to electrostatic repulsion between two adjacent particles. Electron spin resonance (ESR) spectrum showed a hyperfine sextet revealing the fact that Mn2+ in ZnS was present as dispersed Mn2+ impurities rather than Mn2+ clusters, which would produce broad resonance without splitting. The samples showed bright yellow-orange luminescence at about 585 nm, characteristic of 4T1 (excited) → 6A1 (ground) transition of Mn2+ ion at Td symmetry in ZnS.

Nanosized strontium aluminate phosphors co-activated by Eu2+ and Dy3+ were prepared via a novel reverse microemulsion process. This new synthesis technique lowered the synthesis temperature of SrAl2O4: Eu2+, Dy3+ phosphors to as low as 900 °C, and also reduced the particle size to the nanometer scale (around 40 nm). In the microemulsion process, the constituent cations were trapped by numerous nano-scaled micelles, leading to a shortening of the inter-diffusion length and enhancement of the precursor reactivity. The excitation intensity and emission peaks of nanosized SrAl2O4: Eu2+, Dy3+ phosphors significantly increased with increasing heating temperatures.

Fe50Pt50/Ti double-layer films were deposited on corning 1737F glass substrates by d.c. magnetron sputtering of FePt and Ti targets. The magnetic layer FePt was deposited at substrate temperature of 600 °C in order to get ordered γ1-FePt hard magnetic phase. It is found that the degree of order (S) of FePt layer increases with increasing Ti underlayer thickness. The S value for FePt single-layer film is about 0.68, and it increases to about 0.76 as the thickness of the Ti underlayer increases to 150 nm. The average grain size of the FePt film is largely reduced as the Ti underlayer is introduced. The average grain size of the single-layer FePt film is about 25 nm, it will reduced to about 12 nm as 30 nm Ti underlayer is introduced, but the average grain size of FePt is increased as the thickness of Ti underlayer is increased. Magnetic measurement indicates that the in-plane coercivity (Hc‖) of the FePt film increases with increasing thickness of Ti underlayer, but the in-plane squareness (S‖) decreases.

The granular FePt–Ag thin films consisting of FePt particles dispersed in a Ag matrix were prepared by co-sputtering from FePt and Ag targets. The FePt particles in as-deposited film are soft magnetically disordered face-centered-cubic γ-FePt phase. The magnetic easy-direction of the as-deposited film is parallel to the film plane. The in-plane coercivities of the as-deposited films were below 700 Oe. The higher coercivity of the film will obtain after annealed treatment by transforming the γ-FePt phase into hard magnetically ordered face-centered-tetragonal (fct) γ 1 -FePt phase. The in-plane coercivity of the annealed film was much larger than out-plane coercivity. The particle size of FePt in annealed film was increased with annealing temperature but decreased with increasing Ag content. The (FePt) 70 –(Ag) 30 film with film thickness of 10 nm annealed at 600 °C for 15 min and ice–water quenched having an in-plane coercivity around 3.5 kOe. The M s value of this film is about 350 emu cm −3 and the squareness is about 0.8. The FePt particle size in this film was very uniform and the FePt particles were isolated by Ag.

1Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan 2Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan 3St Paul’s Hospital, Taoyuan, Taiwan 4Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan