Influenza virus infection is a common respiratory disease in children. Renal complications of influenza infection were not commonly encountered until the 2009 H1N1 influenza pandemic, when acute kidney injury (AKI) frequently developed in severely ill patients. Kawasaki disease (KD) is another rare association in pandemic influenza virus infections. There are some reports about KD coincident with influenza A H1N1/09 infection. However, simultaneous AKI and KD in influenza A or B virus infections have never been reported. Herein, we report the first case of influenza B virus infection that initially presented as AKI but was subsequently diagnosed as atypical KD.

Most of the perinatally infected infants from their HBsAg carrier mothers become chronic carrier and develop chronic liver disease. Prevention of vertical transmission is most important in elliminating hepatitis B virus infection. CDC recommended passive and early active immunization in neonatal infants born to HBsAg carrier mothers to prevent perinatal vertical transmission.

The author checked anti-HBs titer at 7~9 month of age in 112 infants who were born to HBsAg carrier mothers and were received HBIG 0.5cc at birth and 0.5cc Hepavax at 0, 1, 6 month of age by CDC recommendation and studied the preventive effect of passive and early active immunization.

The results were as follows :

1) Anti-HBs was positive in 98 infants(87.5%) and negative in 14 infants(l2.5%). Because 6 positive infants had anti-HBs below 10mIU/ml. only 92 infants(82.1%) had minimal protective anti-HBs.

2) Anti-HBs positive rate in infants of HBeAg (+) mothers was 77.8% (35/45) which was significantly lower than 94.0% (63/67) in infants of HBeAg(-) mothers(p<0.05).

3) Anti-HBs positive rate in infants of positive neonatal HBeAg was 77.8% (28/46) which was significantly lower than 92.1% (70/76) in infants of negative neonatal HBeAg(p<0.05).

4) Perinatal vertical transmission has occured in 2 infants of 14 anti-HBs(-) infants(14.3%). Among 8 anti-HBs(-) infants of HBeAg(+) mothers, HBsAg was perinatally transmitted in 2 infants(25%). Six anti-HBs(-) infants of HBeAg(-) mothers were not infected.

5) Among 7 anti-HBs(-) infants with positive neonatal HBeAg, 2 infants(28.6%) was perinatally infected. Seven other anti-HBs(-) infants with negative neonatal HBeAg were not infected.

6) The maximum titer of 98 anti-HBs(+) infants by passive and early active immunization was as follows; 6 infants:<10mIU/ml. 8 infants 11~100mIU/ml. 21 infants: 101~1000mIU/ml. 36 infants 1001~10000mIU/ml. 28 infants:>10000mIU/ml The anti-HBs titer was below 1000mIU/ml in 35.9% (35/98) of anti-HBs(+) infants.

In conclusion, the preventive effect of passive and early active immunization was not complete especially in HBeAg(+) infants whose mothers had HBeAg.

We studied the postnatal development of the renal function and the incidence of the renal dysfunction in premature with reapiratory distress syndrome, admitted to NICU, E.W.U.H. from March, 1986 to August 1989.

The results were as follows.

1) Renal function in Group I, RDS premature without perinatal asphyxia, was not different from the control values.

2) Renal function in Group II, RDS premature with perinatal asphyxia was different from the control values. Serum creatinine concentration was 1.05mg% at postnatal age 3 day and decreased to 0.88mg% at P.A 7 day. But both values were significantly higher than control values(P<0.05)

Creatinine clearance, 10.8ml/min/1.73m at P.A. 3 day which was significantly lower than control, but increased to 17.4ml/min/1.73m at P.A. 7 day which was not different from control value. Urine Na excretion and FENa were 5.2lmEg/kg/d and 3.81% at P.A. 3 day and decreaed to 3.42mEg/kg/d and 1.86% at P.A. 7 day. But both values were significantly higher than control values.(P<0.05) The incidence of proteinuria, oliguria and azotemia were significantly higher than control.(P<0.05)

In conclusion, RDS per se did not compromise the renal function. But associated perinatal asphyxia delayed the postnatal development of the glomerular function and the tubular reabsorptive capacity which seemed to be transient.

The effectiveness of phototherapy in the treatment of neonatal hyperbilirubinemia is so established that it is widely used without serious side effects. The widespread use of phototherapy has caused some concern since substances other than bilirubin may be photocativated or photodecomposed. The toxic properties of these photoactivated substances might prove to be more harmful to the neonatal infants than bilirubin. The purpose of the present study was to investigate the photodynamic metabolic effects on the hepatic microsomal cytochrome P-450, cytochrome b₅, riboflavin status, hepatic microsomal DNA and RNA of newborn rats at 1 week and 3 weeks of illumination by phototherapy lights. The results are as follows: 1) Activities of hepatic microsomal cytochrome P-450 and cytochrome b_5 in newborn rats increased significantly at 3 weeks of illumination by phototherapy lights. 2) Induced cytochrome P-450 by phototherapy lights increased the ring-hydroxylation of AAF. more significantly(P<0.001) than the N-hydroxylation(P<0.01). 3) Erythrocyte glutathione reductase activity coefficient as a measure of riboflavin status increased significantly(P<0.05) at 1 and 3 weeks of illumination by phototherapy lights, and this means the riboflavin deficiency due to the photodecomposition of riboflavin by phototherapy lights. 4) The quantative measurement of hepatic microsomal DNA and RNA showed no significant change by phototherapy lights.