• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.355-362
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• 2007

Purpose : We conducted the study to evaluate the immunogenicity and safety of three component DTaP vaccine ($Infanrix^{(R)}$) in a group of Korean healthy infants on a three-dose primary vaccination. And we compared the immunogenicity of this DTaP vaccine with two component DTaP vaccine which has been widely used in Korea. Methods : We enrolled one hundred fifty one healthy infants aged 8-9 weeks. These infants were vaccinated at age 2, 4 and 6 months of age with three component DTaP vaccine. Solicited adverse events were actively monitored for 72 hours following each vaccination, and all adverse events after each vaccination were observed for three weeks. Anti-diphtheria toxoid Ab., anti-tetanus toxoid Ab., anti-pertussis toxin Ab., anti-filamentous hemagglutinin Ab., and anti-pertactin Ab. were measured using ELISA for assessing immunogenicity of study vaccine in 60 infants. Immunogenicity analysis of two component DTaP vaccine was performed with same methods in 14 infants as control. Results : The seroconversion rates of anti-diphtheria toxoid Ab, anti-tetanus toxoid Ab. anti-filamentous hemagglutinin Ab. were 100% in both group. Seroconversion rate of anti-pertactin Ab in study group was 100%, but the rate in control group was 50%. However, geometric mean concentration of anti-pertussis toxin Ab. was higher in control group. Mild local and systemic reactions were observed within three days after vaccination, and no serious adverse events related study vaccine were happened during study period. Conclusion : Our study results suggest that three component DTaP vaccine ($Infanrix^{(R)}$) is a well-tolerable and high immunogenic vaccine, especially anti-Pertactin Ab. of the study vaccine is very immunogenic. It can be available as routine DTaP vaccination in our infants.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.29-36
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• 2013

Purpose: Proprioceptive function has been known to be important to shoulder stability. However, the function in rotator cuff tear patients is rarely investigated. The purpose of current study is to report the proprioceptive function in rotator cuff tear patients and to analyze the proprioceptive function regarding the tear size and the presence of subscapularis tear. Materials and Methods: Between 2011 and 2012, total 76 patients (male 28 and female 48) were recruited and average age was 61.7 years old (range, 38~76). Preoperatively, joint position senses in internal and external rotation were measured for proprioceptive function testing by method of active re-positioning technique. The absolute difference from set point was measured. Proprioceptive function was further analyzed according to tear size of rotator cuff, the presence of subscapularis tear, visual analogue scale of pain, shoulder functional score (American society of elbow and shoulder score), and ranges of motion in shoulder. Results: The absolute difference for external rotation was $4.9^{\circ}{\pm}2.9^{\circ}$, in normal joint and $4.9^{\circ}{\pm}3.0^{\circ}$for involved joint in rotator cuff tear patients. This difference was not significant statistically (p=0.87). The absolute difference for internal rotation was $4.0^{\circ}{\pm}2.7^{\circ}$in normal joint whereas $4.8^{\circ}{\pm}3.7^{\circ}$ for involved joint showing statistically significant difference (p=0.043). There was some trend that the proprioceptive function of internal rotation was more impaired in the bigger tear size group (more than medium tear) compared to the smaller tear size group (partial thickness and small tear, 5.0 vs. 4.0, p=0.061). The impairment of internal rotation proprioception was also accentuated in patients with subscapularis tear (4.8 vs. 4.0, p=0.065). The proprioceptive function of internal rotation was decreased when the pain visual analogue scale was increased (5.2 vs. 4.0 p=0.04), shoulder functional score was decreased (6.1 vs. 4.2, p=0.005), or range of motion in shoulder joint was restricted (5.3 vs. 3.7, p=0.041). Conclusion: The deficit of proprioceptive function was observed in rotator cuff tear patients. Proprioception for internal rotation was impaired in patients with the bigger tear size and subscapularis tear. Pain, shoulder function score, and range of motion were also shown to be related with the deficit in proprioceptive function.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.267-274
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• 2006

The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.20-26
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• 2011

Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.6-12
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• 2011

Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

• Radiation Oncology Journal
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• v.27 no.4
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• pp.218-227
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• 2009

Purpose: To investigate the radiobiologic effects of neutron and X-ray irradiation on DU-145 prostate carcinoma cells by identifying the differences of HIF-$1\alpha$ expression and apoptosis. Materials and Methods: Nude mice were injected with the human prostate cancer cell line, DU-145, and then irradiated with 2 Gy and 10 Gy X-rays, or 0.6 Gy and 3.3 Gy neutrons, respectively. The mice were sacrificed at 24 hours and 120 hours after irradiation. The expression levels of HIF-$1\alpha$, Bcl-2 and Bax were compared with immunohistochemical staining and western blotting. The apoptotic indexes were compared with the Terminal deoxynucleotidyl biotin-dUTP nick and labeling (TUNEL) assay. Results: At day 1, HIF-$1\alpha$ and Bcl-2 expression decreased, while Bax expression and the number of TUNEL positive cells increased in neutron irradiated groups for the control and X-ray irradiated groups. The Bcl-2/Bax ratio was significantly lower in the neutron irradiated groups regardless of dose (p=0.001). The same pattern of the differences in the expressions of the HIF-$1\alpha$, Bcl-2, Bax, Bcl-2/Bax ratio, and apoptotic indexes were indentified at day 5. HIF-$1\alpha$ expression was related with Bcl-2 (p=0.031), Bax (p=0.037) expressions and the apoptotic indexes (p=0.016) at day 5. Conclusion: Neutron irradiation showed a decrease in HIF-$1\alpha$, Bcl-2 expression, and Bcl-2/Bax ratio, but increased Bax expression regardless of dose. This study suggests that the differences radiobiological responses between photon and neutron irradiation may be related to different HIF-$1\alpha$ expression and subsequent apoptotic protein expressions.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.864-878
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• 2006

Purpose : Panax ginseng(PG) is considered to have salutary effects and stimulant actions on physical capacity. However, the effects of PG on the inflammatory cytokine secretion and hypoxia condition are still not understood. This study wasto elucidate the effect of PG on inflammatory cytokine secretion such as interleukin (IL)-1, IL-6, granulocyte macrophage colony stimulating factor (GM-CSF), and tumor necrosis factor $(TNF)-{\alpha}$. Also, the effects on the expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF-1) were measured. Methods : The water extract of PG was administrated to HMC-1 cells before phorbol myristate acetate (PMA)+A23187 treatment. $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, GM-CSF, and VEGF secretion were measured by a modified enzyme-linked immunosorbent assay (ELISA). HIF-1 activation was measured by transcription factor enzyme-linked immunoassay (TF-EIA) Results : PG significantly decreased secretion of $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, and GM-CSF in PMA+A23187-induced HMC-1 cells. VEGF secretion was not changed but HIF-1 activation was decreased by the treatment of PG. Conclusions : PG inhibited the secretion of inflammatory cytokines, which impliesPG might contribute to treatment of mast cell-mediated inflammatory disease. Also, PG inhibited PMA+A23187-induced $HIF -1{\alpha}activation}$ and DNA-binding activity for HIF-1. Therefore, these data demonstrate that PG modulates inflammatory cytokines through inhibition of $HIF-1{\alpha}activation}$ activation.

• 대한예방의학회:학술대회논문집
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• 2002.07b
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• pp.3-17
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• 2002

국민건강은 국가발전의 기본조건이다. 국민건강은 건강한 어린이의 출산에서 비롯되고, 건강한 어린이의 출산을 위하여 여성이 건강해야 한다 따라서 여성과 어린이 건강보호와 증진을 위한 모자보건사업은 국가보건사업 중 최우선 사업으로 추진되어야 한다. 우리나라의 모자보건사업은 1960대부터 보건소를 통하여 가족계획, 산전관리, 안전분만유도, 예방접종을 중심으로 하였다. 1980년대에 들어와 전국민의료보험의 실현과 국민생활수준의 향상 등으로 산전관리 수진율과 시설분만율이 급격히 증가하여 1990년대 후반에는 거의 100%에 도달하였고, 가족계획실천율도 1991년에 79.4%까지 증가하여 합계출산율이 1.6으로 감소하였고, 어린이 기본예방접종률도 90%이상이 되어 전염병 발생률이 현저히 감소하였다. 전통적인 모자보건사업 관련 지표들이 이렇게 향상되자 일선 보건요원에서부터 중앙정부의 정책결정권자에 이러기까지 모자보건사업에 대한 관심도가 떨어져 중앙부처의 모자보건업무 담당 부서도 축소되고, 모자보건 사업도 쇠퇴하였다. 그러나 어린이와 여성의 건강실태를 자세히 들여다보면 심각한 문제들이 대두되고 있다. 시설 분만율의 증가에 따라 제왕절개분만율이 40%대까지 급증하였고, 모유수유률은 10%대로 떨어졌다. 어린이의 체격은 커지고 있으나 체력은 떨어지고, 비만한 어린이가 급증하여 당뇨병과 같은 성인병 유병률이 어린이들에게 증가하고, 사고에 의한 어린이 사망과 장애가 늘고 있다. 또한 청소년들의 흡연율과 음주률이 증가하고, 성적 성숙이 빨라지고 사회의 개방풍조로 성(性)활동 연령이 낮아지고 성활동이 증가하여 혼전임신과 성폭력이 증가하고 있다. 여성들은 일찍 단산하고, 폐경 연령은 높아지고, 평균수명은 길어져 중년기와 장년기 그리고 노년기가 길어져 각종 만성질환에 이환될 기회가 늘어났다. 이러한 시기의 중요 건강문제들은 뇌혈관질환, 폐암, 유방암, 골다공증, 뇨실금 등과 같이 해결하기 어려운 것들이다. 이렇게 어린이와 여성들에게 새로운 건강문제들이 대두되고 있으나 이에 대한 대응정책이 없었고, 따라서 새로운 모자보건사업이 개발되지 않았으며 일선 보건요원의 훈련도 없었다. 그리고 이러한 건강실태를 파악하여 대책을 마련하고, 보건사업을 평가할 수 있는 보건정보체계가 없는 실정이다. 1990년대 중반에 소수의 학자들이 어린이와 여성건강문제의 심각성을 제기하고, 모자보건사업 활성화의 필요성을 주장하여 보건복지부가 '모자보건선도보건사업'이라는 이름으로 1999년부터 2001년까지 3년간 23개 보건소에서 시범사업을 시행하였다. 이 시범사업에서는 한정된 자원으로 여성과 어린이 보건문제를 효과적으로 해결하기 위해 새로운 보건사업의 개발과 효율적으로 수행하는 방법의 개발에 역점을 두어 많은 성과를 거두었다. 시범사업의 경험을 바탕으로 2002년에는 전국의 45개 보건소로 확대해나가고 있다. 모자보건선도보건사업에서는 임산부가 대상이었던 기존의 모자보건사업과는 달리 신생아, 영유아, 학동기 어린이, 청소년, 그리고 신혼부부에서부터 장년기 여성에 이르기까지 사업대상을 확대하고 생애주기에 따라 지역사회 건강문제해결을 목표로 한 보건사업을 수행하도록 하였다. 사업수행 과정에서 보건소는 지역내 대학과 협력체계를 구축하여 기술적 지원을 받고, 보건요원의 교육 훈련을 통해 사업기획 능력과 전문지식과 기술을 향상시켰고, 보건교육에 필요한 시설과 장비를 구입하였고, 민간의료기관과 연계하여 보건서비스의 질을 향상시켰다. 모자보건 선도보건소에서 제공하는 서비스는 취약계층 중심의 보건교육, 상담 및 지도, 고위험대상자 조기발견 및 민간기관 의뢰 및 주구관리, 질병 조기발견을 위한 검진 의뢰, 지역 보건통계 생산과 관리, 그리고 지역내 가용자원 안내 등이며, 저소득층에 대해서는 민간의료기관에 의뢰 또는 검진비용을 지원하였다. 이와 같이 지역사회 민간기관과 협력체계를 구축함에 따라 대상자를 지속적으로 관리할 수 있는 정보를 공유하게 되었고, 건강증진 및 질병예방, 치료, 사후관리를 포함한 지속적이고 포괄적인 서비스를 제공할 수 있게 되었다. 특히 고위험 및 건강의심 대상, 임부와 장년기 여성에 대해서는 건강검진서비스를 과감히 민간기관에 의뢰, 위탁하친 보건소는 상담자, 정보관리자로서의 역할로 전환할 수 있었다. 그러나 사업관리자의 양적 평가에 대한 고정관념과 질적 평가에 대한 인식부족, 기본 생정통계와 정보체계의 미비로 인한 부정확한 통계생산, 사업요원의 전문지식과 기술 부족, 그리고 인력부족 등이 문제점으로 대두되었다. 효율적인 사업확산과 조기 정착을 위해 중앙정부의 일관성 있는 정책과 재정적 지원이 필수적이며, 보건정보체계확립, 그리고 공공보건기관과 민간의료기관간의 공식적인 협력체계확립이 필요하다. 사업추진 모니터링 및 평가, 조정을 위하여 중앙에 '모자보건 선도사업 기술지원단'을 구성하여 운영하고, 프로그램 운영이 잘되는 보건소를 특성화 보건소로 지원 육성하고, 사업요원의 업무 적정화를 위한 보건소 조직과 기존 보건사업체계의 평가와 재편이 필요하다. 보건사업요원의 자질 향상을 위한 지속적인 교육 훈련 시스템과 보건통계생산 관리를 위한 정보체계의 구축이 요구된다. 모자보건사업관련 보건교육자료를 수집하고 개발하여 전국 보건소에 공급하는 중앙 보건교육자료 및 정보센터가 필요하다.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.170-175
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• 1997

Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

• Journal of Chest Surgery
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• v.36 no.2
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• pp.63-72
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• 2003

Although a variety of synthetic vascular grafts are available in modern vascular surgery, no ideal prosthesis ha,4 yet been developed. Small-caliber vascular grafts with low flow, as used in the lower extremity, continue to become thrombosed at unacceptable rates. We have developed and evaluated the new antithrombogenic blood contacting surfaces in canine model. Material and Method: Two now antithrombogenic blood contacting surfaces(Polyvinylalcohol -Polyurethane(PVA-PU) blend and natural Graphite-polyurethane(G-PU) blend) have been developed and evaluated in canine model, using vascular grafts and patches. The luminal surfaces of the test vascular grafts(5 mm ID) were fabricated by dipping a glass rod in PVA-PU blend solution(50 % PVA) using phase separation method. Mongrel dogs of either sex weighing 18-22 kg were anesthetized by endotracheal intubation using halothane and their lungs were ventilated with a volume-cycled ventilator, Maintenance anesthesia with 0.5-1.0% halothane and supplemental oxygen was used. Two pairs were used for comparison in the bilateral femoral arteries for both vascular grafts(PVA-PU vs. PU) and vascular patches(G-PU vs. PU). Bilateral groin incisions were made and the arteries were exposed and clamped. After an excision of 1 cm of the artery between clamps, a grail of 2.5 cm in length was implanted end-to-end using 6-0 polypropylene suture. The vascular patch was implanted as a form of on-lay patch. Animals were sacrificed at 1, 2, 4, 6, 8 and 16 weeks for vascular grafts and 1, 2. 4 and 6 weeks for vascular patches. Result The vascular grafts of PVA-PU blends showed patent lumina in the 2 and 16 weeks animals, while those of PU showed a patent lumen in 2 weeks animal. PVA-PU graft of 16 weeks showed a fairly clean luminal surface. A light microscopic finding of this graft demonstrated good tissue infiltration through porosity, The animals with vascular patches showed patent arteries in both groups except 2 weeks animal. Scanning electron microscopy of the luminal surfaces of G-PU patches in 4 and 6 weeks animals showed endothelial cell covering with microvilli. PU patches showed qualitatively less endothelial cell covering. Conclusion: In conclusion, PVA-PU and G-PU blends can be a promising blood contacting surfaces for application in a synthetic vascualr graft. However, further animal study is needed to determine the real long-term effects of these methods of surface modifications.