• Pediatric Infection and Vaccine
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• 제7권1호
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• pp.120-128
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• 2000

Purpose : Active immunization against hepatitis A with an inactivated vaccine reveals excellent immunogenicity, tolerability and protective efficacy. Inactivated hepatitis A vaccines have been selectively used since 1996 in Korea to prevent hepatitis A. This study was performed to assess the immunogenicity and reactogenicity after two doses of HM175 strain hepatitis A vaccine in healthy Korean children. Methods : 128 healthy children(M/F; 65/63) aged 1 to 15 years, who were seronegative for hepaitatis A, participated in this study. A alum-adsorbed vaccine containing 720 EL.U of antigen form HM175 hepatitis A strain per 0.5 mL dose was injected intramuscularly on the deltoid area. The second dose was given 6 months later, Anti-HAV antibodies were measured by ELISA before and 1 month after each vaccination to assess the immunogenicity. Any local and general adverse events were reported by patients parents with the prepared questionnaire after each vaccination. Results : 120 volunteers(M/F; 60/60) completed the whole series of the study. Seroconversion occurred in all cases after primary and booster vaccination. The mean anti-HAV antibody titer after primary vaccination was 389.2mIU/mL, and 3,609mIU/mL after booster vaccination. And levels of anti-HAV antibodies after booster immunization were significantly higher in female children. The most common local adverse event was soreness on the injection site, but it was mild and resolves within 3 days. Fever was not reported after booster vaccination. Conclusion : Based on these data, we conclude that the inactivated HM175 strain hepatitis A vaccine is highly immunogenic and tolerable in healthy Korean children.

• Pediatric Infection and Vaccine
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• 제17권2호
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• pp.83-90
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• 2010

Purpose : Although the incidence of polymicrobial bloodstream infection (PBSI) has increased, only a few studies have so far focused on children. Therefore, in an effort to prevent more serious situations in pediatric patients, we analyzed the clinical features, organisms, and laboratory results of PBSI. Methods : We performed a retrospective review of the case records of 97 patients with polymicrobial bloodstream infection in the Severance hospital, from 2001 to 2008. Using t-test and chi-square test, we analyzed the underlying medical conditions, clinical characteristics, organisms, and laboratory results of those patients. Results : Annual incidence of polymicrobial bloodstream infection increased from 1.4 % in 2001 to 10.9% in 2008 in pediatric patients. Immunocompromised hemato-oncological malignancy was found in 31 (31.9%) patients, and was the most common underlying medical condition; cardiovascular disease was found in 15 patients (15.4%), neurologic disease in 10 patients (10.3%), and so on. Gram positive organisms were recovered in 143 cases and gram negative organisms were recovered in 101 cases of PBSI. Staphylococcus epidermidis was the most common organism. Factors affecting mortality included underlying medical disease, immune status, nosocomial infection, and central catheter-related infection, for which the rate of mortality showed a greater increase (P<0.05). Conclusion : Due to the close connection between PBSI and fatal conditions or high mortality, it requires more aggressive management. Compared with previous studies, we discovered that immunocompromised hemato-oncological malignancy was the most common underlying medical condition and that frequency of gram-positive bacteria and fungus isolated has increased.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.333-341
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• 1999

Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

• Childhood Kidney Diseases
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• 제6권2호
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• pp.155-168
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• 2002

Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제14권1호
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• pp.67-73
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• 2011

Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1~5 years old, 51.1% among individuals 5~10 years old, 12.9% for individuals 10~15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1~5 years old, 60.2% and 33.9% among children 5~10 years old, 14.1% and 9.7% for children 10~15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates.

• Pediatric Infection and Vaccine
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• 제5권2호
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• pp.239-244
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• 1998

Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• 제14권2호
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• pp.79-87
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• 1978

This is an experimental study on friction welding and heat treatment of engine exhaust valve materials whose welding combination is SCr4 as stem to 21-4N as head and SUH3 to 21-4N. In this study, not only the experiments of friction welding under the selected optimum welding condition and the examination of the mechanical properties were carried out, but also the heat treatment of friction welded specimens under the two selected conditions was taken to obtain the better welding character, eliminating the latent stress and the hardness peak which appeared at the welded zones of heat resisting steel(21-4N, SUH3) and low alloyed steel ($SCr_4$) friction weldments. The results obtained by the experiments and consideration in this study are as follows: I) It was experimentally proved quite reasonable that 'speed=3,OOO rpm, heating pressure Pl=8 kg/ mm2, upsetting pressure p, = 20 kg/mm', heating time $t_1$ = 3 see, upsetting time TEX>$t_2$ = 2.5 sec' was selected as the optimum welding condition for friction-welding the engine exhaust valve materials $SCr_4$ to 21-4 Nand SUH 3 to 21-4 N. 2) The results of the previous study and this one on friction welding of such dissimilar materials as SUH 3-SUH 31, SCr 4-SUH 31, SCr 4-SUH 3, SUH 3-CRK 22, SCr4-21-4 Nand SUH3-21-4 N agreed with each other substantially in the friction welding characteristics at welded interface zones. 3) It was also certified quite satisfactory that '600\ulcornerCX30 min. Xroom air cooling' as an optimum heat treatment condition of the friction welded materials SCr 4-21-4 Nand SUH 3-21-4 N was experimentally determined to eliminate the latent stress and the hardness peak at welded zones. 4) About 20% of the tensile strength before heat treatment of friction welded specimens was decreased after heat treatment 600\ulcornerCX30 min. Xair cooling, but the location of fracture was moved from heat affected zone to parent $SCr_4$ & SUH3. 5) Microscopic examination of the weld joints friction-welded and heat-treated under the above mentioned conditions revealed that the weld zone is very narrow and has a fine grained intermixed structure without any welding defects. 6) The above mentioned conditions can be also utilized as friction welding parameters of the other dissimiar materials for engine valve production.

• Food Science of Animal Resources
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• 제29권1호
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• pp.24-33
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• 2009

This study investigated the microbial contamination levels of raw meats used for short-ripened salami and changes in the microbial and physico-chemical properties of the product during storage at 10 and $25^{\circ}C$ for up to 120 days. The microbial counts of raw meats ranged between 2 and 4 Log CFU/g. Frozen-thawed sow meat showed higher total aerobe and Enterobacteriaceae counts than fresh chilled pork and pork back fat. Staphylococcus aureus was found in all raw materials except fresh chilled pork samples, and Clostridium perfringens was detected in a sample stored for 21 days at $25^{\circ}C$. The counts of total aerobes, lactic acid bacteria and Staphylococcus spp. decreased more rapidly at $25^{\circ}C$ than at $10^{\circ}C$ when the storage time was extended. The growth of Enterobacteriaceae, Pseudomonas spp., Clostridium spp., yeast, and mold were restricted to levels below 2 Log CFU/g during storage. The contents of salt, water, crude protein, crude fat, and ash of salami samples were 3.4, 33.4, 30.8, 32.7, and 4.3%, respectively, which were not affected by storage time or temperature. The pH value of the salami was initially 4.79 and increased to 5.02 and 5.26 after 120 days of storage at 10 and $25^{\circ}C$, respectively, whereas the water activity values decreased from an initial value of 0.91 to 0.90 and 0.88 after 120 days at 10 and $25^{\circ}C$, respectively. The TBA and VBN values increased slowly during storage. The redness value of the salami samples stored at $25^{\circ}C$ decreased more significantly than the samples stored at $10^{\circ}C$. With increased storage time, the values for the rheological characteristics of the salami in terms of hardness, brittleness, elasticity, cohesiveness, gumminess, and adhesiveness tended to decrease more remarkably at $25^{\circ}C$ than at $10^{\circ}C$. Based on sensory evaluation scores, it appears that short-ripened salami is no longer acceptable after 90 days at $10^{\circ}C$ and 30 days at $25^{\circ}C$.

• Tuberculosis and Respiratory Diseases
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• 제41권4호
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• pp.372-378
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• 1994

Background: Pressure support ventilation(PSV) is a new form of mechanical ventilatory support that assists spontaneous inspiraory effort of an intubated patient with a clinician-selected amount of positive airway pressure. Low level pressure support during inspiration can overcome the resistive component of inspiratory work imposed by an endotracheal tube. However the clinical efficacy of PSV as a weaning method has not been established yet. Object: The aim of study was to evaluate the efficacy of PSV when it is added to intermittent mandatory ventilation(IMV) in facilitating weaning precess compaired to IMV mode alone. Method: When the subject patients became clinically stable with their arterial blood gas analysis in acceptable range, they underwent weaning process either by IMV alone or by IMV plus PSV. The level of pressure support was held constant throught the weaning period. For the patients who required mechanical ventilation for less than 72 hr, 2h weaning trial was performed with IMV rate starting from 6/min. For the patients who required mechanical ventilation more than 72 hr, 7 hr weaning trial was performed with IMV rate starting from 8/min. For the patients who failed three consecutive trials of weaning, retrial of weaning was attempted over 3 days with IMV rate starting from 8/min. Clinical characteristics, APACHE II score and nutritional status were compared. For all patients, heart rate, mean blood pressure and respiratory rate were mornitored for 48 hrs after weaning trial started. Results: The total number of weaning trial was 37 in 23 patients(18 by IMV, 19 by IMV+PSV). Total ventilation time, APACHE II score and nutritional status were not statistically different between the two groups. The weaning success rate were not statistically different(38.3% by IMV, 42.1% by IMV+PSV) and the changes of mean blood pressure, heart rate, respiratory rate during first 48 hours were not different between the two groups. Conclusion: Low level PSV when added to IMV for weaning trial does not seem to improve the success rate of weaning from mechanical ventilation. PSV at 10cm $H_2O$ did not induce significant physiologic changes during weaning process.

• Tuberculosis and Respiratory Diseases
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• 제41권1호
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• pp.26-35
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• 1994

Background: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. Methods: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, and survival retrospectively. Results: No correlation was found between patients' age, sex and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage IIIa diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of conclusion of this study. Conclusion: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.