• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.77-89
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• 1998

Background: Genetic and environmental factors are known to affect the incidence and severity of asthma. Stimulation of $\beta_2$-Adrenergic Receptor ($\beta_2$AR) results in smooth muscle relaxation, leading to decrease in resistance of airflow. The gene encoding the $\beta_2$AR has recently been seguenced. The $\beta_2$AR genotype at the polymorphic loci of codons 16, 27, 34, and 164 was known to cause changes in the amino acids. The relationships between the structure of the $\beta_2$AR and its functions are being elucidated. Purpose : The gene encoding the $\beta_2$AR was carried out to assess the frequency of polymorphisms in bronchial asthma, to determine wheather these polymorphisms have any relation to the severity, or nocturnal symptoms in bronchial asthma. Methods: The subjects studied were 103 patients with bronchial asthma, which consisted of 30 mild episodic, 32 mild persistent, 17 moderate, and 24 severe asthma patients. The polymorphisms of the $\beta_2$AR gene were detected by mutated allele specific amplification (MASA) method at the codons 16,27,34, and 164. Results: The most frequent polymorphism was arginine 16 to glycine. The other two polymorphisms, valine 34 to methionine and glutamine 27 to glutamic acid occured in 11 and 6 patients respectively. The polymorphism of threonine 164 to isoleucine was not found in our enrolled patients. The homozygous polymorphism of $\beta_2$AR gene was found in only arginine 16 to glycine (12.6%). The heterozygous polymorphisms of $\beta_2$AR gene were in arginine 16 to glycine, valine 34 to methionine, and glutamine 27 to glutamic acid, as 65.1 %,10.7%, and 5.8% respectively in asthma patients. The presence of agrginine 16 to glycine heterozygous or/and homozygous polymorphism was associated in severe asthma (p=0.015), but there was no association between the other three polymorphisms and the severity of asthma. The frequency of the $\beta_2$AR gene polymorphisms was no relation in nocturnal asthma as compared with non-nocturnal asthma. Conclusion: The arginine 16 to glycine polymorphism of the $\beta_2$AR gene is the most frequently found in asthma patients and association with severe asthma. But there was no association between the polymorphism of the $\beta_2$AR gene and nocturnal asthma.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.127-135
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• 2005

Objectives: This study was conducted to investigate the trend of tuberculosis mortality rate by years and by areas. Methods: We calculated raw and age-adjusted mortality rate of tuberculosis from 1995 to 2002. The calculation was based on the data from resident registration data and death certification registration data gathered by 232 basic local authority. We used direct age standardization method for calculating age-adjusted mortality rate. We compared patterns of change in tuberculosis mortality rate of metropolitan areas, cities, and countryside by determinating the comparability of medels to explore linear relationship. We also analyzed the data of mortality rate between urban and rural area by comparing ANOVA and post-hoc by two periods: one from 1995 to 1998, and the other from 1999 to 2002. Results: In national mortality rate, both raw and age-adjusted mortality rate showed negative linear relationship. However, the graph become more horizontal: the slope line is close to zero. From 1995 to 1998, countryside showed significantly higher age-adjusted mortality rate than in metropolitan areas and cities. Ever after considering more horizontal graph in national mortality rate, the data shows that the countryside still have significantly higher mortality rate from 1999 to 2002. In model diagnostic checking, metropolitan areas and cities showed apparently linear pattern on the decrease of age-adjusted mortality rate. Pattern of mortality rate in countryside was decreased initially, but became flat. Conclusions: Further research is necessary to explore the characteristics of quality of tuberculosis control program in rural area. Different approach and strategies should be considered to decrease tuberculosis mortality rate in rural areas.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.266-275
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• 2005

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTIs) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus(PIV), influenza virus (Flu), and adenovirus(ADV), etc. Our purpose was to determine seasonal epidemiology and clinical characteristic features of each viral infection. Methods : Nasopharyngeal aspirate(NPA)s were collected from 4,554 hospitalized children diagnosed as LRTIs on the first day of admission. The study period was from September 1998(Autumn) through May 2003(Spring). Respiratory viruses were detected in 881(19 percent) cases by isolation of the virus or by antigen detection method using indirect immunofluorescent staining. We reviewed the medical records of 837 cases retrospectively. Results : The identified pathogens were RSV in 485 cases(55 percent), PIV in 152 cases(17 percent), FluA in 114 cases(13 percent), ADV in 79 cases(9 percent) and FluB in 51 cases(6 percent). Outbreaks of RSV occurred every year, mostly in the November through December period and of PIV in the April through June period. LRTIs by FluA reached the highest level in January, 2002. FluB infection showed an outbreak in April, 2002. The clinical diagnoses of viral LRTIs were bronchiolitis in 395 cases(47 percent), pneumonia in 305 cases(36 percent), croup in 73 cases(9 percent) and tracheobronchitis in 64 cases(8 percent). Conclusion : Viruses are one of the major etiologic agents of acute LRTIs in chidren. Therefore, we must continue to study their seasonal occurrence and clinical features to focus on management, and also for reasons of prevention.

• Neonatal Medicine
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• v.18 no.2
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• pp.265-271
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• 2011

Purpose: Extended spectrum $\beta$-lactamase (ESBL) producing organism is an important cause of infections in the neonatal intensive care unit (NICU) since 1990s. The aim of this study is to investigate the differences of clinical characteristics and hematologic studies between neonates with ESBL-positive organism and those with ESBL-negative organism. Methods: The subjects included 48 neonates admitted to NICU at Inje University Sanggye Paik Hospital from January 2005 to September 2010, from whom a total of 58 Escherichia coli or Klebsiella pneumonia were detected. The data were categorized in 2 groups, neonates with ESBL-positive and ESBL-negative. We compared clinical characteristics and hematologic studies between two groups. Results: Of 48 neonates and 53 isolates, ESBL-positive were 18 neonates and 20 isolates. Both ESBL-positive and ESBL-negative isolates were largely found in urine, each with 10 and 23. Of 20 ESBL-positive isolates, 13 (65%) and 7 (35%) were ESBL producing Escherichia coli and Klebsiella pneumonia, respectively. ESBL-positive neonates were associated with low 1 and 5 minutes Apgar scores (P=0.002 and P=0.001, respectively), more uses of oxygen (56% vs. 27%; P=0.005), longer duration of oxygen uses (15.8${\pm}$38.43 days vs. 4.3${\pm}$12.5 days; P=0.008) and more frequent anemia (33% vs. 7%; P=0.040). Conclusion: ESBL-positive neonates may have more anemia and lower Apgar score at birth. We can consider the use of cabapenem earlier if infant with previous antibiotics is confirmed to be infected with ESBL-positive organisms.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.464-468
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• 2008

Purpose: Effective half life of I-131 ($T_{eff}$) in patients with differentiated thyroid cancer treated by I-131 is must-know value for dose calculation and determination of release time from isolation room. There has been no report about $T_{eff}$ in Koreans. Thus, author tried to measure dose rate without radiation exposure to faculty members and calculated $T_{eff}$. Methods: Probe of radiation survey meter was fixed at the wall of isolation room, and body of survey meter was placed outside the room. With this simple arrangement, author could measure radiation frequently without radiation exposure to faculty members in 68 patient (F=55, M=13, age=$47{\pm}13.7$) treated by I-131 ($3.7{\sim}7.4\;GBq$) for differentiated thyroid cancer from Jan 2006 to Dec 2006. From this data, $T_{eff}$, 48 hr retention rate, and the time necessary to whole body retention of I-131 become less than 1.1 GBq were calculated. Serum creatinine levels were measured before and after thyroid hormone withdrawal. Results: $T_{eff}$ was $15.4{\pm}4.3\;hr$ ($9.4{\sim}32.5\;hr$). There was a loose correlation between $T_{eff}$ and serum creatinine concentration (r=0.45). 48hr retention was $4.9{\pm}4.2%$ ($1{\sim}23%$). Time necessary to whole body retention of I-131 become less than 1.1 GBq was calculated as $47.1{\pm}13.2\;hr$ for 9.25 GBq, $42.1{\pm}11.9\;hr$ for 7.4 GBq, $35.7{\pm}10.0\;hr$ for 5.55 GBq, and $26.7{\pm}7.5\;hr$ for 3.7 GBq dose of I-131. Conclusion: Author successfully measured radiation dose rates in isolated patients treated by high dose of I-131 without radiation exposure to the faculty members with simple arrangement of survey meter probe. Using those data, $T_{eff}$ and some other indices were calculated.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.126-132
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• 1997

Measles outbreak in the world was decreased since measles vaccine had been introduced. Although vaccination rate is high, measles was not eradicated and measles reappeared among vaccinated children. We measured measles-specific antibody from the vaccinated and unvaccinated groups who had experienced apparent measles in the Seongnam city in 1993. The results were as follows. 1) The data included total 126 children (M:F=1 : 1). Age distribution of measles outbreak revealed 6 children in 5yr, 11 in 6yr, 20 in 7yr, 39 in 8yr, 22 in 9yr, 11 in 10yr, 11 in 11yr, and 6 in 12yr. 2) MMR vaccination rate was 78.6%(99/126) in the children who had experienced measles. Positive rate of measles-specific IgM Ab was 80.8% (80/99) among the vaccinated group and among 9E.6.% (25/27) the unvaccinated. 3) Positive rate of measles-specific IgG Ab was 90.9% (90/99) among MMR-vaccinated group, and 85.2% (23/27) in unvaccinated group. In conclusion, measles-specific IgM antibody have been detected more than 1 month in most patients. The relatively high proportion of measles-specific IgM positivity may mean primary vaccine failure. To booster the antibody titers and to prevent measles epidemic in school-aged children, revaccination of measles should be considered.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.46-53
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• 2016

Purpose: Enterovirus (EV) infection in children can manifest various diseases from asymptomatic infection to nonspecific febrile illness, hand-foot-mouth disease, and aseptic meningitis. This study was aimed to investigate epidemiology and clinical significance of various genotypes of EV infections in pediatric inpatient. Methods: We collected the stool samples from the admitted pediatric patients in Inha University Hospital from March 2014 to March 2015. EV detection and genotype identification were performed by real-time RT-PCR and semi-nested RT-PCR. Phylogenetic trees were constructed by neighbor joining method. Results: A total of 400 samples were collected during study period and 112 patients (28%) were diagnosed with EV infections. The mean age of EV positive patients was 2.66 years (0.1-14) and sex ratio was 1.73:1. Genetic sequences of EVs were identified; coxsackievirus B5 (17, 15.2%), coxsackievirus A16 (13, 11.6%), enterovirus 71 (10, 8.9%), and coxsackievirus A2 (9, 8.0%). Nonspecific febrile illness (96, 86%) was the most common clinical manifestation and the duration of fever was 0-11 days (mean 3.1 days). Rash (44, 39%) and meningitis (43, 38%) were followed. Patients who were attending daycare center or had siblings accounted for 82.1%. Phylogenetic relationship tree revealed 6 distinct genogroups among 56 types of EVs. Conclusions: This study is the report of epidemiology, serotype distribution and clinical manifestations of children with EV infection in Incheon. This data will be helpful for further study about the epidemiology of EV infection in Korea.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.207-213
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• 2014

Purpose: This study aimed to investigate the association between respiratory virus infection and pneumococcal colonization in children. Methods: From May 2009 to June 2010, nasopharyngeal (NP) aspirates were obtained from patients under 18 years old who visited Seoul National University Children's Hospital for respiratory symptoms. NP samples were used to detect respiratory viruses (influenza virus A and B, parainfluenza virus 1, 2 and 3, respiratory syncytial virus A and B, adenovirus, rhinovirus A/B, human metapneumovirus, human coronavirus 229E/NL63 and OC43/HKU1) by RT-PCR and pneumococcus by culture. Results: Median age of the patients was 27 months old. A total of 1,367 NP aspirates were tested for respiratory viruses and pneumococcus. Pneumococcus was isolated from 228 (16.7%) of samples and respiratory viruses were detected from 731 (53.5%). Common viruses were rhinovirus (18.4%), respiratory syncytial virus (RSV) A (10.6%), adenovirus (6.9%), influenza virus A (6.8%). Pneumococcal isolation rate was significantly higher in the cases of positive virus detection than negative detection [21.3% (156/731) vs. 11.3% (72/636), P <0.001]. For individual viruses, pneumococcal isolation rate was positively associated with detection of influenza virus A [24.7% (23/93) vs 16.1% (205/1274), P=0.001], RSV A [28.3% (41/145) vs 15.3% (187/1222), P=0.001], RSV B [31.3% (10/32) vs 16.3% (218/1335), P=0.042], rhinovirus A/B [22.6% (57/252) vs 15.3% (171/1115), P=0.010]. Conclusion: The study revealed that pneumococcal isolation from NP aspirates is related with respiratory virus detection. The result of this study could be used to investigate how respiratory viruses and pneumococcus cause clinical diseases.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.811-816
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• 2007

Background: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. Material and Method: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. Result: The median age at surgery was 52 years ($4{\sim}75$ years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months ($1{\sim}95.2$ months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and $3{\sim}6$ months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). Conclusion: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.24-32
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• 1985

The worm development and egg laying pattern of Echinostoma hortense (Trematoda; Echinosto-matidae) were studied in albino rats and the brief clinical course was observed in human volunteers. A total of 21 rats were infected with 20~69 metacercariae each and two humans were with 7 and 27 metacercariae, which were collected from the loaches. For recovery of worms, the rats were sacrificed at irregular intervals from the 6th to 150th day after infection and the human volunteers were treated with praziquantel and purged with magnesium salt on the 26~27th day. The stools of the rats and humans were examined for the eggs. The results were as follows: 1. The worm recovery rate from the rats was not affected by the increase of infection time but varied individually; 9.1~50.0% (31.1 % in average). From humans, 14.3% and 37.0% (32.4% in average) of challenged were recovered. 2. In the rats, it was revealed that the worms rapidly grew for the first 14 days to become 7.59mm in average length and 1.17mm in average width but the growth became much slower thereafter until the 150th day; 7.95mm in length on the 21 th day, 9.04mm on the 28th day, 10.21mm on the 49th day and 12. 62mm on the 150th day. During the early stage of infection, the growth of genital organs (male or female) was expressed as sigmoid curves whereas non-genital organs (such as suckers) was simply as straight lines. 3. The prepatent period of this fluke was 10~12 days in the rats and 16~17 days in men. After the start of oviposition, the egg production by the worms remarkably increased, reached maximum on the 32~33th day, followed by decrease thereafter. The maximum value of E.P.G./worm was 390. 4. The major subjective symptoms in human volunteers were abdominal pain and diarrhea during the early stage of infection. The results show that human is as susceptible as the rats to E. hortense infection and the amount of egg production in the rats is greatly affected by the age of worms.