• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.191-198
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• 2009

목 적: 만성 B형 간염 산모로부터 분만된 신생아에게 주산기 예방조치를 실시하면 모유수유는 권장되어져야한다. 그러나 실지로 국내에서는 높은 비율에서 산모들은 모유수유를 꺼리고 있다. 설문조사를 통하여 이 같은 현상이 초래되는 요인을 찾아보았다. 방 법: 질병관리본부가 주관하는 'B형간염수직감염예방사업'에 참여하여 등록된 만성 B형 간염 산모 중 보건소에서 혈액 채취를 위해 보건소를 방문하고 동의서에 서명을 얻은 경우를 대상으로 하였다. 검사 결과를 고지할 때 이들의 모유수유에 대한 인식을 조사하기 위하여 반송봉투와 함께 설문지를 발송하였다. 결 과: 설문지를 발송한 839명 중 주소 이전 등의 이유로 반송된 114명을 제외한 725명이 설문지를 모두 받았다고 가정할 때 응답율은 17% (125명)이었다. 응답자의 수유방법은 모유 65명(52%), 분유 60명(48%)이었다. 모유수유를 한 경우 가장 영향을 미쳤던 요인은 본인 및 가족의 결정 75%, 산부인과 의사 17%이었고, 분유수유를 한 경우는 산부인과 의사 57%, 본인의 결정 28%이었다. 모유수유와 주산기 예방조치 실패간의 관련성에 대한 인식은 '관련이 있다' 45%, '관련이 없다' 50%이었고, 관련이 있다고 했을 때의 관련 정도는 '어느 정도 관련이 있다'가 55%이었다. 모유수유를 한 경우 추후에 모유수유를 하겠다는 답변은 91%이었고, 분유수유를 하였지만 '모유수유가 주산기 예방조치 실패와 직접적인 관련이 없다'는 사실이 소개된다면 추후에는 모유수유를 선택하겠다는 경우가 78%이었다. 결 론: 모유수유가 B형 간염 주산기 예방조치의 실패와 직접적인 관련이 없음에도 불구하고 많은 숫자에서 모유수유를 하지 않고 있는데, 이러한 결정을 하게 된 경우의 대부분이 의료인에 의해서였다. 교육을 통한 의료인들의 개념전환과 국민홍보가 이루어져야할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제38권2호
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• pp.170-174
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• 2005

Objectives: The aim of this study was to evaluate the response to a hepatitis B vaccination, and investigate the HBV DNA in subjects with isolated anti-HBc. Methods: 34 subjects with persistent isolated anti-HBc were included in the study. 32 subjects negative for HBsAg, anti-HBs and anti-HBc were included as a control group. They were all vaccinated with Hepaccine at 0, 1 and 2 months, and anti-HBs titers were measured 1 month after the 1st and 3rd vaccinations (1 and 3 months). The HBV-DNA was tested by polymerase chain reaction in subjects with isolated anti-HBc. Results: After the 1st & 3rd vaccinations, the anti-HBs titers$\geq$10mIU/ml were 70.6 & 70.6% in isolated anti-HBc group, and 34.4 & 81.2% in the control group, respectively. There were statistically significant differences after the 1st vaccination, but none after the 3rd, between the two groups. In the isolated anti-HBc and control groups, the primary, amnestic and no responses were 0 vs. 46.9%, 55.9 vs. 6.3% and 29.4 vs. 18.8%, respectively. The HBV DNA was not detected in all subjects with isolated anti-HBc. Conclusion: None of the subjects with isolated anti-HBc had a false positive result (primary response); therefore, they should be excluded from vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine, with a follow-up anti-HBs test, is preferable for subjects with isolated anti-HBc. An amnestic response indicates late immunity, and no response a suspect occult infection.

• Clinical and Experimental Pediatrics
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• 제49권8호
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• pp.857-863
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• 2006

목 적 : 의료기술과 신생아학의 발전으로 생존된 극소 저출생 체중아의 질병에 대한 관리가 더욱 필요한 시점이다. 이에 본 연구는 극소 저출생 체중아에서 영아기 B형 간염 항체 생성률과 항체 생성 실패에 미치는 요인에 대하여 알아보고자 하였다. 방 법 : 1997년 1월부터 2004년 12월까지 서울아산병원과 강릉아산병원 신생아 중환자실에 입원하였던 1,500 g 미만의 극소저출생 체중아 중에서 영아기에 B형 간염 항체에 대해 검사받은 243명을 대상으로 하였다. 영아들은 역 연령 약 40주경에 첫 간염 예방접종시행 받았으며 1개월 후, 6개월 후에 간염 예방접종을 시행 받았다. 그러나 모체의 B형 간염 항원이 양성인 13명의 영아들은 출생 시에 임신주수와 출생체중과 관계없이 B형 간염 면역글로불린과 B형 간염 예방접종을 1회 더 시행 받았다. 항체검사는 마지막 간염 예방접종 3-4개월 후에 시행하였고 B형 감염 예방접종후의 항체 양전은 항체의 역가가 ${\geq_-}10mIU/mL$로 정의하였다. 결 과 : 총 243명의 극소 저출생 체중아들의 B형 간염 예방접종 후 항체 양전율은 84.4%(205/243명)였다. 항체가 음성인 38명의 극소 저출생 체중아 중에서 재접종이 가능하였던 28명 중 17명(60.7%)에서 항체가 양성으로 전환되었다. 총 243명 중 34.6%(84/243명)을 차지한 초극소 저출생체중아의 항체 양전율은 84.5%(71/84명)이었다. 13명의 항체 음성인 초극소 저출생체중아 중 재접종이 가능하였던 10명의 항체 양전율은 80%(8/10명)로 재접종 후의 극소 저출생 체중아와 초극소 저출생 체중아의 항체 양전율은 각각 95.3%, 97.5%으로 향상되었다. 출생시 임신주수별 항체 양전율은 $28^{+0}$주 미만과 $28^{+0}-36^{+6}$주인 영아들에서 각각 83.5%(66/79), 84.8%(139/164명)이었다. 이들 중 항체가 생기지 않았던 영아에서 재접종 후 각 군에서의 항체 양전율은 각각 96%, 94.9%로 향상되었다. B형 간염 보유자에게 태어난 극소 저출생 체중아의 항체 양전율은 76.9%(10/13명)였고 모두에게서 B형 간염의 항원은 음성이였다. 항체 양전율에 영향을 미치는 요소로는 첫 B형 간염 예방접종시의 체중이 작을수록 항체 양전율이 저하됨을 알 수 있었다. 결 론 : 세 번의 B형 간염 예방접종 후 항체 생성이 되지 않은 극소 저출생 체중아들에서의 재접종은 항체 양전율을 매우 향상시킬 수 있음으로 저자들은 극소 저출생 체중아들에게 아직 국내에서 보편적으로 실시되고 있지 않는 예방접종 후 항체검사를 적극적으로 권장하는 바이다.

• 대한한방소아과학회지
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• 제28권1호
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• pp.52-60
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• 2014

Objectives The purpose of this study is to report the clinical effects of oriental medical treatment on Extensive limb swelling which is rare adverse reaction of vaccination. Methods A 11 months old infant who appealed unilateral thigh swelling after immunization and signs of local inflammation was administered a complex herbal medicine consisting of five decoctions; Gwakhyangjunggisan, Binsosan, Danggwisusan, Samchulgunbitang and Gwibitang. The length of the constant regions of the thigh circumference was measured every visit. Each process was recorded by photograph. After one year from the first visit, phone call was conducted to follow-up. Results The length of the thigh after administration of herbal medicine did not change much, but the part where swelled hard became little bit softer. A year later, patient's growth and walking was normal but the swollen part not changed. Since then the similar adverse effects did not recur on booster doses vaccines. Conclusions The adverse reactions of vaccination are rarely reported and there is no specific treatment for swelling from Hepatitis B vaccine. It will be more helpful to study if more cases reported about any adverse drug reactions or any side effects from the immunization.

• Biotechnology and Bioprocess Engineering:BBE
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• 제10권4호
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• pp.309-314
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• 2005

We performed a basic experiment for the rapid, on-line, real-time measurement of hepatitis B surface antigen using a surface plasmon resonance biosensor. We immobilized anti­HBsAg (hepatitis B surface antigen) polyclonal antibody, as a ligand, to the dextran layer on a CM5 chip surface that had previously been activated by N-hydroxysuccinimide. A sample solution containing HBsAg was fed through a microfluidic channel, and the reflecting angle change due to the mass increase from the binding was detected. The binding characteristics between HBsAg and its polyclonal antibody followed the typical monolayer adsorption isotherm. When the entire immobilized antibody had interacted, no additional, non-specific binding occurred, suggesting the immunoreaction was very specific. The bound antigen per unit mass of the antibody was independent of the immobilized ligand density. No significant steric hindrance was observed at an immobilization density of approximately $17.6 ng/mm^2$. The relationship between the HBsAg concentration in the sample solution and the antigen bound to the ligand was linear up to ca. $40{\mu}g$/mL. This linearity was much higher than that of the ELISA method. It appeared the anti­gen-antibody binding increased as the immobilized ligand density increased. In summary, this study showed the potential of this SPR biosensor-based method as a rapid, simple and multi­sample on-line assay. Once properly validated, it may serve as a more efficient method for HBsAg quantification for replacing the ELISA.

• IMMUNE NETWORK
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• 제21권5호
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• pp.37.1-37.17
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• 2021

Hepatitis B virus X (HBx) protein has been reported as a key protein regulating the pathogenesis of HBV-induced hepatocellular carcinoma (HCC). Recent evidence has shown that HBx is implicated in the activation of autophagy in hepatic cells. Nevertheless, the precise molecular and cellular mechanism by which HBx induces autophagy is still controversial. Herein, we investigated the molecular and cellular mechanism by which HBx is involved in the TRAF6-BECN1-Bcl-2 signaling for the regulation of autophagy in response to TLR4 stimulation, therefore influencing the HCC progression. HBx interacts with BECN1 (Beclin 1) and inhibits the association of the BECN1-Bcl-2 complex, which is known to prevent the assembly of the pre-autophagosomal structure. Furthermore, HBx enhances the interaction between VPS34 and TRAF6-BECN1 complex, increases the ubiquitination of BECN1, and subsequently enhances autophagy induction in response to LPS stimulation. To verify the functional role of HBx in liver cancer progression, we utilized different HCC cell lines, HepG2, SK-Hep-1, and SNU-761. HBx-expressing HepG2 cells exhibited enhanced cell migration, invasion, and cell mobility in response to LPS stimulation compared to those of control HepG2 cells. These results were consistently observed in HBx-expressed SK-Hep-1 and HBx-expressed SNU-761 cells. Taken together, our findings suggest that HBx positively regulates the induction of autophagy through the inhibition of the BECN1-Bcl-2 complex and enhancement of the TRAF6-BECN1-VPS34 complex, leading to enhance liver cancer migration and invasion.

• 대한임상검사과학회지
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• 제47권2호
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• pp.78-82
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• 2015

우리나라는 1995년부터 영유아를 대상으로 국가차원의 B형 간염백신 예방접종을 시작하였다. 현재 우리나라의 20대 대학생들은 신생아 정기 예방접종 시작 전후에 태어난 세대이며 영유아기에 접종을 받고 20여년이 경과되었다. 영유아를 대상으로 B형 간염 정기예방 접종 시작 후 장시간이 경과한 현 시점에서 B형 항체 보유율과 역가에 대한 확인은 매우 중요하다. 본 연구에서는 20대 대학생들의 B형 간염항체 양성률과 역가를 조사하였으며 연구대상은 2014년 4월부터 2014년 10월까지 경남 소재 대학의 대학생 262명을 대상으로 하였다. 추가접종자는 제외하였으며 간염항체의 양성판정은 10 mIU/mL이상으로 정하였다. 연구결과, B형 간염 항체의 양성률은 55.3% (145명)이었고 음성률은 44.7% (117명)이었다. 성별에 따라 양성률을 분류했을 때 여자는 57.9% (88명), 남자는 51.8% (57명)로 여자가 남자보다 높았으나 통계적으로 유의한 차이는 없었다. 연령에 따라 역가 차이를 비교했을 때 19~20세 연령군이 21세 이상의 연령군 보다 낮은 역가를 나타냈다. 이는 본 연구의 연구대상자들이 연령군간에 나이 차이가 적고 각 연령군의 측정 대상자수가 일정하지 않았으며 인원수가 적은 군에서 역가가 높게 나오는 경우가 발생하면 해당 연령군이 상대적으로 역가가 높은 분포에 속하게 되는 것으로 생각되어 추후 고려해야할 사항으로 사료된다. 양성으로 판명된 연구대상자의 62%가 역가의 하한선인 10-99.9 mIU/mL의 낮은 역가를 나타냈다. 소아기에 접종 후 일정기간이 지나면 항체 확인검사를 하고 국가차원에서 추가접종을 추진해야 할 것으로 사료된다.

• IMMUNE NETWORK
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• 제9권1호
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• pp.20-26
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• 2009

We previously reported that $IFN-{\gamma}$ producing T cell responses induced by the combined therapy of DNA vaccine and lamivudine for one year are important for the induction of sustained virological response (SVR). However, $IFN-{\gamma}$ production is not sufficient to predict sustained viremia control in chronic hepatitis B (CHB) carriers treated. Methods: Twelve CHB carriers were intramuscularly immunized 12 times at a 4-week interval with 8mg of HBV DNA vaccine during the standard lamivudine treatment (100mg/daily/1 year). The level of cytokines during and after the combined therapy in plasma of all 12 CHB carriers treated was determined by each ELISA kit. Six out of 12 CHB carriers revisited the clinic, and their HBV DNA levels were examined. Results: The combined therapy increased plasma IL-12 and IL-12/p40 ratio during the treatment (baseline vs. peak level: $41.8{\pm}8.3$ vs. $163.1{\pm}29.2\;pg/ml$; p<0.01 and $0.96{\pm}0.25$ vs. $3.58{\pm}0.86$; p<0.01, respectively), and the peak level of plasma IL-12 and IL-12/p40 ratio was evoked at 6 to 10 months during the combined therapy. In particular, CHB carriers with SVR had two and three-fold higher level of the peak plasma IL-12 and plasma IL-12/p40 ratio than non-virological responders (NVRs), respectively ($218.0{\pm}41.4$ vs. $108.1{\pm}28.6\;pg/ml$; p=0.09 and $5.35{\pm}1.38$ vs. $1.80{\pm}0.29$; p<0.05, respectively), while p40 level was consistent during the combined therapy. In addition, there was no significant temporal correlation between the peak IL-12/p40 ratio and the elevation of serum alanine amino-transferase (ALT) in this study, contrast to $IFN-{\alpha}$ therapy which induced peak IL-12 level following ALT flares. Conclusion: Our results indicate that the combined therapy induces the increase of plasma IL-12 and IL-12/p40 ratio, which are associated with long-term SVR in CHB carriers.

• Clinical and Experimental Pediatrics
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• 제59권12호
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• pp.461-465
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• 2016

This report includes the recommended immunization schedule table for children and adolescents based on the 8th (2015) and revised 7th (2012) Immunization Guidelines released by the Committee on Infectious Diseases of the Korean Pediatric Society (KPS). Notable revised recommendations include: reorganization of the immunization table with a list of vaccines on the vertical axis and the corresponding age on the horizontal axis; reflecting the inclusion of Haemophilus influenzae type b vaccine, pneumococcal conjugate vaccine, and hepatitis A vaccine into the National Immunization Program since 2012; addition of general recommendations for 2 new Japanese encephalitis (JE) vaccines and their interchangeability with existing JE vaccines; addition of general recommendations for quadrivalent meningococcal conjugate vaccines and scope of the recommended targets for vaccination; and emphasizing catch-up immunization of Tdap vaccine. Detailed recommendations for each vaccine may be obtained from the full KPS 8th Immunization Guidelines.

• 대한수의학회지
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• 제46권3호
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• pp.225-234
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• 2006

In the present study toxicity and immunostimulating activity of the lectin(KML-C), which was extracted from Korean mistletoe(Viscum album coloratum) were investigated in swine. To determine the toxicity, lectin was injected into thigh or cervical muscles of 4-week-old piglets(Landrace) and observed clinically and pathologically. For determination of the immnunostimulating activity, lectin($0.7{\mu}g/kg$ of body weight)-adjuvanted vaccine of Aujeszky's disease virus(ADV)(NYJ1-87) which was inactivated by 0.2% formalin was injected into the cervical muscle of antibody-negative piglets in the same age group. Subpopulation of the immune cells and serum neutralizing(SN) antibodies in the piglets were examined after vaccination, and resistance of the piglets against challenge by virulent NYJ1-87 was further examined. The results were also compared with those from piglets injected with aluminum hydroxide [$Al(OH)_3$]-adjuvanted vaccine of inactivated NYJ1-87 and NYJ1-87 vaccine without adjuvant, and the results are as follows. By injection of lectin with $30{\mu}g/kg$ of body weight to the thigh muscle, all of 12 piglets died after signs such as dyspnea, fever, systemic erythema and subcutaneous hemorrhages, and lesions pertaining to poisonous hepatitis and dysfunction of kidney were observed. By injection of lectin with $7{\mu}g/kg$ of body weight to the thigh muscle, all of 12 piglets showed signs such as edema and cutaneous hemorrhage in the injected area, lameness and depression, and lesions pertaining to poisonous hepatitis and dysfunction of kidney were observed. By injection of lectin with 1, 3 and $5{\mu}g/kg$ of body weight to the thigh muscle of each one piglet, signs such as congestion, induration and grayish coloration in the injected area, depression and inappetence were observed in all piglets. Toxic changes were also observed in the liver and kidney of piglets by lectin of 3 and $5{\mu}g$. By injection of lectin with 0.5 and $0.7{\mu}g/kg$ of body weight to the cervical muscle of each 9 piglets, all piglets were clinically normal and there were no significant changes in blood counts and chemistry values. Whereas, epithelial swelling and vacuolation of convoluted tubules were observed from one piglet injected with lectin of $0.7{\mu}g$, and necrosis and fibrosis of muscular fiber were observed in the muscle of one piglet injected with lectin of $0.5{\mu}g$. Only population of sIgM+ B lymphocytes increased among immune cells in all of 15 piglets immunized with lectin($0.7{\mu}g/kg$ of body weight)-adjuvanted vaccine, while compared to those in $Al(OH)_3$-adjuvanted vaccine and vaccine without adjuvant. No additional stimulation to the immune cells was recognized when lectin was added to $Al(OH)_3$-adjuvanted vaccine. In piglets immunized with lectin-adjuvanted vaccine, SN titers in reciprocal values for loge were 1.3-4.0 at 1-4 weeks after vaccination, which was similar to those with 1.0-3.3 by vaccine without adjuvant but lower than those with 2.0-5.7 by $Al(OH)_3$-adjuvanted vaccine. Also, no additional increase in the SN titers was recognized when lectin was added to $Al(OH)_3$-adjuvanted vaccine. Piglets immunized with lectin-adjuvanted vaccine were resistant to challenge by the virulent NYJ1-87 at 4 weeks after vaccination, and the SN titers reached to 5.0 one week after challenge, which was higher than those with 4.0 by vaccine without adjuvant but somewhat lower than those with 7.7 by $Al(OH)_3$-adjuvanted vaccine.