• Childhood Kidney Diseases
• /
• v.9 no.2
• /
• pp.143-148
• /
• 2005

Purpose : Hypogammaglobulinemia has been observed in nephrotic syndrome, but its pathophysiology remains unknown. We evaluated serum immunoglobulins, IgG subclasses, and vaccine-induced viral antibodies(anti-hepatitis B surface IgG and anti-measles IgG) in children with minimal change nephrotic syndrome(MCNS). Methods : Using the stored sera, the levels of immunoglobulin(IgC, IgM, IgA, and IgC) and IgG subclasses(IgG 1, 2, ,3, and 4), anti-HBs Ab and anti-measles IgG of 21 children with MCNS were analyzed and compared to those of 25 age-matched healthy children. Results : The mean values of IgG and IgG1 were $390{\pm}187\;mg/dL$ and $287{\pm}120\;mg/dL$ in nephrotic children, and $1,025{\pm}284\;mg/dL$ and $785{\pm}19\;mg/dL$ in control children, respectively. The values of the total IgG and the 4 IgG subclasses in nephrotic children were all significantly depressed(P<0.001), but the IgM($251{\pm}183\;mg/dL\;vs. 153{\pm}55\;mg/dL$, P=0.02) and IgE values(P=0.01) were elevated, and the IgA values were not changed. The seropositivity of anti-HBs IgG was 42.9$\%$(9 of 21 cases) in the MCNS group and 52$\%$(13/25) in the control group, and that of anti-measles IgG was 75$\%$(16/21) and 92$\%$(23/25), respectively, but there was no statistical difference between the two groups. Conclusion : IgG and IgG subclass levels in MCNS children are all depressed without significant seronegativity of the vaccine-induced viral antibodies. Further studies are needed to resolve the cause of hypogammaglobulinemia in MCNS. (J Korean Soc Pediatr Nephrol 2005;9:143-148)

• Clinical and Experimental Pediatrics
• /
• v.45 no.2
• /
• pp.166-173
• /
• 2002

Purpose : The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. Methods : We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. Results : The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father( 10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. Conclusion : Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.

• Clinical and Experimental Pediatrics
• /
• v.51 no.4
• /
• pp.377-382
• /
• 2008

Purpose : The aim of this study is to assess the usefulness of skin test by an inactivated, 1/50 diluted solution of attenuated varicella vaccine in evaluating the immune status to varicella. Methods : Total 41 subjects (22 males, 19 females, aged 1-32 years) were enrolled from July to August, 2005. Past medical history including varicella infection, varicella vaccination were investigated through questionnaires. The skin test solution was prepared from solution of attenuated varicella vaccine(Oka strain) which was inactivated by exposure to room temperature for 10 days and diluted at 1/50 with normal saline. Skin test was done by injecting 0.1 mL of the solution intradermally into the volar surface of the right forearm and sterile normal saline was used as a control on the left forearm. Positive reaction was defined when the transverse diameter of the induration was 5 mm or more. Serum varicella zoster virus specific IgG antibody test by ELISA (enzyme-linked immunosorbent assay) was done. Results : In adults, the sensitivity of the varicella zoster virus skin test compared to ELISA was 94.7% and the positive predictive value was 100%. In children, both the positive predictive value and specificity were 100% but the sensitivity and the negative predictive value were 50% and 30.7% respectively. Children showed smaller skin test reactivity compared to adults. Conclusion : The varicella zoster virus skin test using inactivated, 1/50 diluted solution of attenuated varicella vaccine was proved as one of the useful tools for evaluating the immunity and susceptibility of the varicella zoster virus.

• Journal of agricultural medicine and community health
• /
• v.26 no.2
• /
• pp.79-96
• /
• 2001

In order to ascertain the utilization patterns and Perception and attitudes of Primary Health Post(PHP) by rural residents in farm areas, a survey was conducted of 753 households(1,803 persons) in 24 PHPs in Sangju-si, Gyeongsangbuk- do, from December 10, 2000 to January 15, 2001. The morbidly rate of acute illnesses for last two weeks for all households was 29.6%, and the rate of use of medical facilities to treat acute illness was 98.3%. The morbidly rate was highest between the ages of 60 and 69, with a rate of 35.4%. The higher their ages and the lower their educational levels were, the higher the morbidly rate was. The morbidly rate of chronic illnesses for one year for all households was 19.2%, and the rate of use of medical facilities to treat chronic illness was 92.8%. The elderly over 70 years old had the highest morbidly rate of 37.2%. The higher their ages and the lower their educational levels were, the higher the chronic illnesses rate was. For the rate of use of medical facilities to treat acute diseases, the use of PHPs was 89.5%, accounting for the majority of the time. However, for chronic diseases, hospitals and clinics were used more often, with a rate of 48.9%, compared to the use of PHPs, 40.2%. Their previous experiences on the use of PHPs one year before the survey showed that 94.8% used PHPs, 72.2% just visited them, not for the purpose of getting any medical assistance, and 73.3% received health education from PHPs. 98.5% remembered the locations of PHPs, 98.6% thought that PHPs were helpful for their health management, and 84.3% said that PHPs were playing great roles in development of their communities. 97.4% said that they found PHPs necessary. They understood the main job of PHPs as in the order of disease treatment, vaccination and health counseling. The work that they mostly wanted PHPs to do was health counseling and health management, which 31.6% answered. 88.9% said the examination fee was not expensive, 98.4% said CHPs were kind, and 97.0% said they were satisfied with the services at PHPs. Complaints about PHPs included a lack of a variety of medications, said by 42.9%, and poor facilities, by 15.8%. According to the above results, it is concluded that local residents on survey were frequently using PHPs due to their geographical and economical conditions. Also, the residents appeared to be satisfied with the services at PHPs, and they had a high demand for public health service as well as disease treatment. Considering the complaints about medications and medical facilities and equipment, active supports are required to manage PHPs in a way it can provide desirable services to the residents in remote villages through the readjustment of PHPs' functions, reinforcement of facilities and equipment and enhancement of CHPs ' training.

• Pediatric Infection and Vaccine
• /
• v.15 no.2
• /
• pp.121-128
• /
• 2008

Purpose : The seasonality of influenza virus and rotavirus are well recognized in winter and so viral surveillance and laboratory-based diagnostics are important to guide the timing of prophylaxis and other interventions. Yet the seasonality of these two viruses are changing in Korea. We evaluated the prevalence and clinical features of influenza virus and rotavirus. Methods : From September 2001 to August 2005, nasopharyngeal aspirates were cultured from the hospitalized patients with lower respiratory infections and the stools from hospitalized patients with gastroenteritis were tested for rotavirus. We retrospectively analysed the medical records. Results : During the study period, respiratory virus was isolated in 578 (18.5%) out of 3,121 patients. Influenza virus was isolated in 143 cases. The seasonal distribution of influenza infection was from December to June of the next year. The ratio of males to females was 1.3:1 and the median age was 17 months. The most common diagnosis of influenza infection was bronchiolitis. Fever and cough were present in 94.4% and 83.9% of the patients, respectively. During the same period, 3,850 patients were admitted for gastroenteritis and 1,047 (27%) patients were positive for rotavirus. Rotavirus was prevailed from December to June of the next year and it presented in year-round. The ratio of males to females was 1.1:1 and the median age was 16 months. Diarrhea and vomiting were the most common symptoms. Conclusion : The recent peak prevalence of influenza virus and rotavirus in Korea was in winter and the late spring, respectively. So we need to expand surveillance and carefully consider the correct period to vaccinate people.

• Pediatric Infection and Vaccine
• /
• v.10 no.2
• /
• pp.159-166
• /
• 2003

Purpose : Streptococcus pneumoniae is part of the normal flora but is also responsible for causing many invasive diseases such as pneumonia, meningitis, and sepsis in addition to noninvasive diseases such as otitis in children. Multi-drug resistant strains has raised a lot of concern worldwide and thus the importance of prevention has been emphasized. We have analyzed the current serotypes and antibiotic sensitivity of each serotype as a baseline study to estimate the efficacy of the pneumococcal vaccine in Korean children. Methods : One hundred sixteen cases of pneumococcus cultured at Yonsei Medical Center from September 2001 to January 2003 were analyzed. The serotyping was done with the Quellung reaction and penicillin resistance was tested using the oxacillin disc diffusion method. Results : Pneumococcus were cultured from the sputum in 76 cases(65.5%), from the blood in 13 cases(11.2%), from the ear discharge in 12 cases(10.3%), from the throat in 7 cases(6.0%), from the nasal cavity in 2 cases(1.7%), and one case(0.9%) each from the cerebrospinal fluid, eye discharge, peritoneal fluid, post-operational wound, brain abscess, and catheter tip. Serotyping was possible with 98 cases and the following serotypes were found; 15 cases of type 19F(15.3%), 11 cases of 19A(11.2%), 8 cases of 11A(8.2%), 7 cases each of 6A, 14 and 3(7.1%), 6 cases each of 35, 6B and 23F(6.1%). Eighty two cases(70.7%) out of 116 cases were penicillin resistant and serotypes 19F, 19A, 11A, 23F, 6A, 9V constituted the majority, 48 cases(59.8%). These serotypes showed resistance to cotrimoxazole (74.4%), tetracycline(69.5%), and erythromycin(90.3%) as well. In the 22 cases cultured from children, 19A and 19F were found in 25.0%, 6A, 6B, and 23F in 10.0%, 11A, 14, 19, and 29 in 5.0%. Fifty percent(10/20) of the clinical isolates were represented in the current 7-valent pneumococcal protein conjugate vaccine, and 85%(17/20) when the cross-reacting serotypes were included. Penicillin resistance was found in 86.4%(19/22). Conclusion : The percentage of serotypes included in the 7 valent pneumococcal protein conjugate vaccine found in our study was 40.8% which was less than other prior studies. In anticipation of a change of pneumococcal serotypes, a nationwide multicenter study is needed before the initiation of pneumococcal vaccines in Korea.

• The Korean Journal of Food And Nutrition
• /
• v.25 no.1
• /
• pp.26-31
• /
• 2012

For the purpose of production of GABA-rich tomato paste, this study was carried out to investigate GABA producing lactic acid bacteria from Korean traditional fermented food, Kimchi and optimize the culture conditions. As a result of fermentation, Lactobacillus brevis B3-20 among lactic acid bacteria isolated at the pre-experiments was the best producer of GABA at the tomato paste medium with 50%(wet-base) levels of dionized water. At the result of fermentation on the tomato paste medium with 0.5%(w/w) yeast extract, as a source of nitrogen, 3%(w/w) MSG(monosodium glutamate) and dionized water(the ratio of tomato paste and water was 2:8), Lb. brevis B3-20 produced the maximum GABA concentration, 143.38 mM. GABA-rich tomato paste showed the activity of free radical scavenging. Because GABA-rich tomato paste have functional ingredients such as ascorbic acid, lycopene, carotenoid, as well as GABA by lactic acid bacteria fermentation, GABA-rich tomato paste can be considered high functional materials.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.2 s.46
• /
• pp.337-365
• /
• 1994

Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

• Journal of agricultural medicine and community health
• /
• v.28 no.1
• /
• pp.67-77
• /
• 2003

Objectives: This study is designed to suggest the health service goals necessary for providing the more efficient services relevant to the requests of the community, through the evaluation on the operating status of the unified health subcenters. Methods: We visited total 5 unified health subcenters comprising 3 ones located in Gyeongsangbuk-do and 2 ones located in Gyeongsangnam-do from December 2000 to January 2001, and interviewed about the pre- and post-unified status related to manpower, facilities, equipment, medical service and health service quality, and the problems and improvement plans of the unified management. Results: According to the evaluation on the manpower before and after the unification of the health subcenters, the total employees increased by 2.8 persons on average from 6.8 to 9.6 persons in the investigated subjects. The numbers of doctors, dentists and nurses were almost the same as before. There were no clinical pathologic technician and radiological technician before but they were appointed to duty in 3 unified health subcenters later. The unification of the health subcenters has produced slight increases in the frequency of the medical service and dental treatment and considerable increases in that of the physical therapy and laboratory tests. In relating to the changes of the health service, the cases of visiting health care and ambulatory medical service, and the total number of health education participants were greatly increased after the unification. The number of cases undergoing the vaccination and cervical cancer screening was similar to that of the pre-unification while the patient number of the registration to hypertension or diabetes showed a tendency to increase a little. Since the unification of the health subcenters, the frequency of laboratory tests has been increased, but the quality of health service has not been improved yet. Nevertheless, the unification seems to be positive according to the result of the great improvement in visiting health care, ambulatory medical service and health education service. The problems of the unification of the health subcenters were indicated in indefiniteness of the service details between the workers; excessively large building hard to be effectively managed; insufficient medical instruments, inappropriation of working expenses, lack of professional training for the health education, etc. Conclusions: For further active functions of the unified health subcenters, the minimal allocation basis to appoint doctors, nurses and administrative workers to do the duty should be differentiated from the basis for a health subcenter, and the fundamental instruments needs to be expanded to improve the quality of the medical service and visiting health care service. Moreover, the unified health subcenter needs to have definite service details between the workers, and should improve the working efficiency through the development of service-related guidelines.

• Journal of Preventive Medicine and Public Health
• /
• v.3 no.1
• /
• pp.1-16
• /
• 1970

The present status of control measures for public health important helminthic infections in Korea was surveyed in 1969 and the following results were obtained. The activities of parasitic examination and Ascaris treatment for the positives which were done during 1966 to 1969 were brought in poor result and could not decrease the infection rate. It is needed to improve or strengthen the activities. The mass treatment activities for paragonimiasis and clonorchiasis in the areas which were designated by the Ministry of Health were carried out during 1965 to 1968 with no good results in decrease of estimated number of the patients. There were too many pharmaceutical companies where many kinds of anthelmintics were produced. It may be better to reduce the number of anthelmintics produced and control the quality. The human feces, the most important source of helminthic infections, was generally not treated in sanitary ways because of the poor sewerage system and no sewage treatment plant in urban areas and insanitary latrines in rural areas. The field soils of 170 specimens were collected from 34 areas out of 55 urban and tourist areas where night soil has been prohibited by a regulation to be used as a fertilizer, and examined for parasites contamination with the result of Ascaris egg detection in 44%. Some kinds of vegetables of 64 specimens each from the supply agents of parasite free vegetables and general markets were collected and examined for parasites contamination with the results of Ascaris egg detection in 25% and 36% respectively. The parasite control activities and the ability of parasitological examination techniques in the health centers of the country were not satisfactory. The budget of the Ministry of Health for the parasite control was very poor. The actual expenditure needed for cellophane thick smear technique was 8 Won per a specimen. As a principle the control of helminthic infections might be led toward breaking the chain of events in the life cycle of the prasites and eliminating environmental and host factors concerned with the infections, and the following methods nay be pointed out. 1) Mass treatment might be done to eliminate human reservoirs of an infection. 2) Animal reservoirs which are related with human infections night be eliminated. 3) The excretes of reservoirs, particularly human feces, should be treated in sanitary ways by the means of sanitary sewerage system and sewage treatment plant in urban areas and sanitary latrines such as waterborne latrine, aqua privy and pit latrine in rural areas. The increase of national economical development and prohibition of the habit of using night soils as a fertilizer might be very important factors to achieve the purpose. 4) The control of vehicles and intermediate hosts might be done by the means of prohibition of soil contamination with parasites, food sanitation, insect control and snail control. 5) The improvement of insanitary attitudes and bad habits which are related with parasitic infections night be done by the means of prohibition of habit of using night soils as a fertilizer, and improving eating habits and personal hygiene. 6) Chemoprophylactic measure and vaccination may be effective to prevent the infections or the development of a parasite to adult in the bodies when the bodies were invaded by parasites. Further studies and development of this kind of measures are needed.