• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.81-90
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• 2015

Purpose: Group A rotavirus (RV) is most common etiologic agent of acute gastroenteritis (AGE) in children worldwide. Recently, vaccination has been introduced in several countries to reduce the disease burden caused by RV infections, but continuous surveillance of RV strains is necessary to detect the emergence of potential variants induced by vaccine-immune pressure. This study aimed to investigate the changing pattern of RV genotypes in children with AGE, following the introduction of vaccination in Korea. Methods: Genotyping of RVs by RT-PCR on the basis of VP7 and VP4 gene segment sequence was carried out on 201 rotavirus-positive stool samples, from children hospitalized with AGE between August 2009 and June 2013. We have directly sequenced PCR products and analyzed the phylogenetic tree. Results: The most prevalent G genotype was G9 (33.3%), followed by G1 (22.4%), G3 (15.9%), G2 (6.0%), G4 (3.0%), G10 (1.5%), and mixed G-type (15.4%), with some nontypeable cases (2.5%). The detected P genotypes were P[4] (45.3%), P[8] (43.8%), mixed P-type (10.4 %), and P[2] (0.5%). The G9P[4] genotype was predominantly observed in hospitalized cases in Seoul in 2010/2011, however G1P[8] has been re-emerged as the predominant genotype in the following season (P =0.004). Conclusions: It seems that the periodic fluctuation in predominance of the G1, G3, and G9 strains occurred in Korea during 2009-2013, following the introduction of RV vaccination.

• Microbiology and Biotechnology Letters
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• v.49 no.1
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• pp.120-129
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• 2021

Rotavirus A (RVA) is recognized as a major etiology responsible for the development of acute gastroenteritis in children worldwide. The purpose of the present study was to perform the molecular characterization of RVA. A total of 323 stool specimens collected from hospitalized children with acute gastroenteritis in Chiang Rai, Thailand, in 2016-2018 were identified for G- and P-genotypes through RT-PCR analysis. RVA was more prevalent in 2017-2018 (37.8%) than in 2016-2017 (23.2%). The seasonal peak of RVA occurred from March to April. G3P[8] was predominant in 2016-2017 (90.6%) and 2017-2018 (58.6%). Other genotypes including G1P[8], G8P[8], G9P[8], and mixed infections were also identified. G3P[8] strains clustered together in the same lineage with other novel human equine-like G3P[8] strains previously identified in multiple countries and presented a genotype 2 constellation (G3-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2). Several amino acid differences were observed in the antigenic epitopes of the VP7 and VP8* capsid proteins of the equine-like G3P[8] compared with those of the RVA vaccine strains. The homology modeling of the VP7 and VP8* capsid proteins of the equine-like G3P[8] strains evidently exhibited that these residue differences were present on the surface-exposed area of the capsid structure. The emergence of the equine-like G3P[8] strains in Thailand indicates the rapid spread of strains with human and animal gene segments. Continuous surveillance for RVA is essential to monitor genotypes and genetic diversity, which will provide useful information for selecting rotavirus strains to develop a safe and effective RVA vaccine that is efficacious against multiple genotypes and variants.

• Journal of Life Science
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• v.22 no.5
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• pp.600-604
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• 2012

Rotavirus is the main cause of severe diarrhea in infants and young children of the world. However, the frequency of genetic alterations makes it hard to control the prophylaxis. Therefore, continuous monitoring of the rotavirus's genetic change is inevitable to prevent disease prevalence and is useful in inventing an efficient vaccine. From January 2005 to December 2010, we investigated 11,607 stool samples of acute gastroenteritis patients in the Incheon metropolitan area. About 13.18% (1,530 stool samples) of all samples had a positive reaction against rotavirus using an antigen capture enzyme-linked immunosorbent assay (ELISA). Then, the 160 stool samples were searched for subtypes of group A rotavirus by using a reverse transcription polymerase chain reaction (RT-PCR) and a nested multiplex RCR. In P sub-typing, P8 (56.3%) was an extremely prevalent genotype, followed by P6 (21.3%), and P1A (10.0%). G1 (39.4%) was most widespread in the G subtype, followed by G4 (25.0%) and G3 (18.8%). G1P8 (35.5%) was the most common G and P subtype combination, followed by G4P6 (19.3%) and G3P8 (13.1%). These results might be useful data for understanding the epidemiological status of group A-rotavirus dispersion in the Incheon metropolitan area.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.148-155
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• 2018

Objectives: Rotavirus is one of the main causes of severe diarrhea in children under five. Two types of rotavirus vaccines [$Rotarix^{(R)}$ (RV1) and $Rotateq^{(R)}$ (RV5)] have been introduced and its administration was optional in South Korea. A systematic review (SR) on economic evaluation (EE) of RV was conducted to examine whether the introduction of rotavirus vaccine to national vaccine program (NIP) is cost-effective. Methods: Previous SR studies of EE for RV were searched in August 2017 through databases such as MEDLINE and EMBASE. Additional search was performed to include literatures published after or unincluded in the previous SR studies. Among the 11 SR studies identified, 2 studies were reviewed via inclusion/exclusion criteria. A previous SR study including 104 original articles was selected by A MeaSurement Tool to Assess systematic Reviews. Among the 36 original articles identified through additional search, 10 were selected, resulting in 114 studies included in our analysis. Results: RV1-only, RV5-only, and evaluating-both studies account for about 44%, 22%, and 33%, respectively. Among RV1-only, RV5-only, or evaluating-both studies, 90%, 64%, or 68% of the studies concluded RV as being cost-effective, respectively. RV5-only studies were usually executed in high-income countries (68%), whereas RV1-only studies were executed mostly in lower (32%) and upper (26%) middle-income countries. When classifying studies by their funding sources, RV1-only studies (82%; 28 of 34 studies specifying funding sources) were chiefly supported by non-profit organization, and 100% of these studies were concluded as being cost-effective. RV5-only studies were mostly supported by profit organization (68%; 13 of 19 studies specifying sources), and 92% of these studies concluded as being cost-effective. Conclusion: By reviewing global EE studies for RV, we have learned that about 70% of these studies was shown to be cost-effective and RV1 appeared to be more cost-effective than RV5.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.176-183
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• 2018

Purpose: Acute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon. Methods: We prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon. Results: Males had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032). Conclusion: Our findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.

• Pediatric Infection and Vaccine
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• v.7 no.1
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• pp.113-119
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• 2000

Purpose : Rotavirus is a most common etiologic agent of pediatric gastroenteritis. The standard method to diagnose rotavirus infection was the detection of viral particles in specimens through electron microscopy. But it was complex. Enzyme immunoassay and latex agglutinin are preferred because they are relatively handy, inexpensive and take a short time, in comparison with electron microscopy. However, several reports have shown that the use of ELISA to diagnose rotavirus infection in neonates can result in false positive reactions. The main purpose of this study is to compare ELISA and RT-PCR in the diagnosis of neonatal rotavirus infection. Methods : Data presented in this study were obtained form 123 newborn babies in the nursery of the Fatima Hospital, Masan, Korea, form Jury to December, 1997. We obtained two samples of stool from each of the newborn babies and then performed the Rotazyme test and the RT-PCR. In the Rotazyme test, the results were interpreted according to visual findings. The samples were used for the RT-PCR test after at stock $-30^{\circ}C$ to identify rotavirus group A. The result of the two tests were compared. Results : The informations are divided into 73 males and females. Out of the total informations 15 were transferred from other hospitals. Their average gestational age was $38.5{\pm}1.6$ weeks. The average birth weight was $3134.8{\pm}539gm$. In the Rotazyme test, 75 samples turned out to be positive. Out of them, 55 samples(75.3%) were positive and 18 samples(24.7%) were negative in the RT-PCR. On the other hand, in the Rotazyme test, 50 samples turned out be negative. Out of them, 27 samples(54%) were positive and 23 samples(46%) were negative in the RT-PCR. Conclusion : Rotavirus infection in uncommon in neonates. The diagnosis based on visual findings using Rotazyme test has a disadvantage in the sense that it can result in false positive reactions and false negative reactions in the diagnosis of neonatal rotavirus infection.

• Clinical and Experimental Pediatrics
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• v.64 no.6
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• pp.260-268
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• 2021

Since the 2000s, the major causes of acute gastroenteritis in children in Korea have been identified by classifying the pathogens into viruses, bacteria, and protozoa. For viruses, the detection rate is 20%-30%, and norovirus is being increasingly detected to account for the majority of viral gastroenteritis cases. In addition, despite the dissemination of the rotavirus vaccine, many rotavirus infections persist, and its seasonal distribution is changing. The detection rate of bacterial pathogens is 3%-20%, with Escherichia coli and Salmonella spp. infections being the most common, while the incidences of Bacillus cereus and Campylobacter spp. infections are gradually increasing. Owing to intermittent outbreaks of gastroenteritis caused by individual bacteria as well as the inflow of causative bacteria, such as E. coli, Vibrio spp., and Campylobacter spp., from overseas, continuous surveillance of and research into the characteristics and serotypes of each bacterium are needed.

• Journal of Microbiology and Biotechnology
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• v.12 no.3
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• pp.463-469
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• 2002

Rotaviruses are the world-wide leading causative agents of severe dehydrating gastroenteritis in young children and animals. The outer capsid glycoprotein VP7 and inner capsid glycoprotein VP6 of rotaviruses are highly antigenic and immunogenic. An SFV-based expression system has recently emerged as a useful tool for heterologous protein production in mammalian cells, exhibiting a much more efficient performance compared to other gene expression systems. Accordingly, the current study adopted an SFV-based expression system to express the VP7 of a group A human rotavirus from a Korean isolate, and the VP6 of a group B bovine rotavirus from a Korean isolate, in mammalian cells. The genes of the VP6 and VP7 were inserted into the SFV expression vector pSFV-1. The RNA was transcribed in vitro from pSFV-VP6 and pSFV-VP7 using SP6 polymerase. Each RNA was then electroporated into BHK-21 cells along with pSFV-helper RNA containing the structural protein gene without the packaging signal. The expression of VP6 and VP7 in the cytoplasm was then detected by immunocytochemistry. The recombinant virus was harvested by ultracentrifugation and examined under electron microscopy. After infecting BHK-21 cells with the defective viruses, the expressed proteins were separated by SDS-PAGE and analyzed by a Western blot. The results indicate that an SFV-based expression system fur the VP6 and VP7 of rotaviruses is an efficient tool for developing a diagnostic kit and/or preventive vaccine.

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.59-72
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• 2004

Purpose : Rotaviruses are the major cause of gastroenteritis in infants and young children worldwide. It is important to get the epidemiologic data of rotavirus genotype for the application of rotavirus vaccine. So we tried to investigate the distribution of rotavirus genotypes with RT-PCR. Methods : A total of 120 rotavirus latex agglutinin test positive stool samples were collected continually from 120 children from Sep. 2000 to Apr. 2001. Rotavirus P(VP4), G (VP7) genotypes were determined by RT-PCR. Results : The genotype was identified in 116 stool samples of total 120 samples(96%). The incidence of G genotype was as follow; G1 17(14.2%), G2 74(61.7%), G4 1(0.8%), G9 1(0.8%). There were four cases of multiple genotypes; G1/G2, G1/G4, G1/G9, G8/G9 and genotype of G3, G8 were not found. Twenty three(19.2%) samples were nontypeable. The incidence of P was as follow; P[4] 77(64.2%), P[6] 22(18.3%), P4/P6 12(10%), P[4]/P[8] 1(0.8%) p[8] 1(0.8%). Seven(5.9%) samples were nontypeable. Conclusion : Various combinations of G and P genotypes were observed. Most rotavirus strains were P[4]G2 62(51.74%), followed by P[6]G2 7(5.8%), and P[6]G1 7(5.8%), P[4/P[6] G1 4(3%), P[4]/P[6]G2 4(3%), P[4]G1 3(2.5%), P[8]G2 1(0.8%), P[4]G4 1(0.8%) in Kyoungsangnamdo, Korea during 2000~2001.

• Pediatric Infection and Vaccine
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• v.19 no.1
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• pp.28-36
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• 2012

Purpose : This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. Methods : We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. Results : The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. Conclusion : The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing.