• Pediatric Infection and Vaccine
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• 제3권2호
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• pp.154-162
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• 1996

Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.

• Korean Journal of Radiology
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• 제25권5호
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• pp.481-492
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• 2024

Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01-2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). Conclusion: Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.

• IMMUNE NETWORK
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• 제15권2호
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• pp.83-90
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• 2015

Evaluation and screening of vaccines against tuberculosis depends on development of proper cost effective disease models along with identification of different immune markers that can be used as surrogate endpoints of protection in preclinical and clinical studies. The objective of the present study was therefore evaluation of subcutaneous model of M.tuberculosis infection along with investigation of different immune biomarkers of tuberculosis infection in BALB/c mice. Groups of mice were infected subcutaneously with two different doses : high ($2{\times}10^6CFU$) and low doses ($2{\times}10^2CFU$) of M.tuberculosis and immune markers including humoral and cellular markers were evaluated 30 days post M.tuberculosis infections. Based on results, we found that high dose of subcutaneous infection produced chronic disease with significant (p<0.001) production of immune markers of infection like $IFN{\gamma}$, heat shock antigens (65, 71) and antibody titres against panel of M.tuberculosis antigens (ESAT-6, CFP-10, Ag85B, 45kDa, GroES, Hsp-16) all of which correlated with high bacterial burden in lungs and spleen. To conclude high dose of subcutaneous infection produces chronic TB infection in mice and can be used as convenient alternative to aerosol models in resource limited settings. Moreover assessment of immune markers namely mycobacterial antigens and antibodies can provide us valuable insights on modulation of immune response post infection. However further investigations along with optimization of study protocols are needed to justify the outcome of present study and establish such markers as surrogate endpoints of vaccine protection in preclinical and clinical studies in future.

• Pediatric Infection and Vaccine
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• 제18권1호
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• pp.85-90
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• 2011

The Joint United Nations Programme on HIV/AIDS (UNAIDS)의 통계에 의하면 2008년 한 해에 43만 명의 어린이가 HIV 에 감염된 것으로 보이며 대부분 수직감염에 의한 것으로 나타났다. 수직감염의 예방 프로그램은 이러한 감염을 줄일 수 있는 가장 효과적인 방법이다. 2009년 국립중앙의료원에는 HIV에 감염된 산모로부터 출생한 신생아 3명이 입원하였다. 이들의 산모 2명은 ARV 치료제를 투여하였고 1명은 투여하지 못했으며 3명의 환아에게는 모두 ARV 치료를 하였다. 추적관찰을 4개월에서 16개월 동안 실시한 결과 아직까지는 HIV 수직감염이 의심될 수 있는 혈청학적 검사의 특이 소견은 보이지 않고 있다. 임산부에 대한 HIV 산전검사의 확대, 조기진단 및 효과적인 ARV 치료만이 수직감염을 낮출 수 있을 것이며 저자는 이에 대한 수직감염 예방치료 3례를 경험하였기에 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제21권1호
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• pp.59-64
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• 2014

부비동염은 흔하고 일반적으로 소아에서는 양성질환인 경우가 많다. 경험적으로 사용하고 있는 항생제로 인해 소아의 부비동염의 두 개강 내 합병증은 드물지만, 발생할 경우 생명에 위협적일 수 있다. 두 개강 내 합병증은 정맥동 혈전, 안와 합병증, 뇌수막염, 뇌수막하 농양 등이 있다. 이러한 합병증은 소아에서 심각한 예후를 보일 수 있다. 따라서 뇌수막하 농양을 초기에 정확하게 진단하여 치료를 시작하는 것이 중요하다. 저자들은, 급성 부비동염 치료 중이던 15세 남아가 3일간의 발열, 두통을 동반한 편마비 증상으로 내원하여 뇌 전산화 단층촬영에서 뇌수막하 농양으로 진단되어 항생제 투여 및 신경학적 수술로 치료된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제20권2호
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• pp.98-104
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• 2013

뎅기열은 아시아, 남태평양 지역, 아프리카, 아메리카 대륙의 열대지방에 걸쳐 널리 발생하며, 이러한 유행지역으로부터 돌아온 여행자들에게 중요한 감염 질환의 하나로 부각되고 있다. 풍토지역을 방문하는 여행자의 점차적인 증가로 뎅기 바이러스에 대한 노출의 위험도가 증가하고 있으며, 이로 인해 해외에서 유입되는 뎅기 감염 사례가 증가하고 있다. 뎅기열은 다양한 임상 양상을 나타내며, 종종 예측할 수 없는 임상 증상과 결과를 초래하기도 한다. 대부분의 감염자들은 저절로 회복되거나 경한 증상을 보이지만, 일부에서는 뎅기 출혈열이나 뎅기 쇼크와 같은 심각한 경과를 보이기도 한다. 따라서 뎅기열 유행지역 방문자가 발열을 보이는 경우 뎅기열을 의심하는 것은 중요하며, 일단 의심이 되면 신속한 진단과 적절한 치료를 통해 합병증을 예방하는 것이 중요하다. 저자들은 뎅기열 유행지역을 여행한 소아에서 발열, 두통, 구역, 발진 등이 발생하여 시행한 혈청검사에서 뎅기열로 진단된 2례를 경험하였기에 보고하는 바이다.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.109-116
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• 2000

Objectives : Routine vaccination against influenza is recommended for all people aged 65 years or more. Without active encouragement to receive the vaccine, the rate of compliance is generally low. A study was undertaken to assess and compare the effectiveness of two reminder systems in improving the influenza vaccination rate. Methods : A total of 2,017 patients aged 65 or over in a tertiary care hospital family practice center were randomly assigned to a control, a telephone reminder, or a postcard reminder group before the influenza season in 1998. The outcome measure, receipt of vaccination, was determined by telephone interview. Demographic and clinical characteristics were checked through the medical chart review. Results : Among the 1,312 patients who actually received reminders and interviewed, the vaccination rate was 46.7% in the control group, 56.3% in the postcard reminder group, and 63.3% in the telephone reminder group. Vaccination compliance was significantly higher in people reminded by telephone (Odds ratio [OR], 2.00; 95% confidence interval [CI], 1.52-2.64) and postcard (OR, 1.55; 95% CI, 1.18-2.02) compared to that in the control group. Of the characteristics investigated, number of high risk co-morbidity was positively associated with vaccination compliance while current smoking was negatively associated. Conclusions : This result suggests that telephone and postcard reminders can significantly improve compliance with influenza vaccination in this group of Korean elderly. However, additional strategies need to be developed to encourage vaccination among noncompliant.

• Pediatric Infection and Vaccine
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• 제13권2호
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• pp.174-179
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• 2006

국내에서는 아직도 소아연령에서 결핵 감염이 적지 않게 존재하기 때문에 폐외 결핵 환자가 발생될 위험도 지속적으로 존재한다. 이런 측면에서 폐외 결핵의 하나인 골관절 결핵은 매우 드물기는 하나, 관절염을 주소로 내원한 환자의 원인으로 고려해 볼만하다. 나이 어린 소아에서는 증상과 징후가 비특이적이기 때문에 오진이나 진단 지연이 우려되므로, 항생제 치료에 잘 반응하지 않는 관절염 환자에서는 결핵성 골관절염에 대한 진단과 치료를 시도하는 것이 중요하다.

• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.143-146
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• 2015

중동호흡기증후군 코로나바이러스(Middle East respiratory coronavirus, MERS-CoV)로 인한 질환은 2012년부터 보고되었다. 현재까지 대부분의 질환은 성인에서 발생하였으며 소아에 대한 보고는 매우 부족한 실정이다. 그리하여 본 연구에서는 소아에서 MERS-CoV 감염증의 역학적 특성과 임상 양상을 분석하였다. 전세계적으로 MERS-CoV에 감염된 소아는 34명이었으며(2015년 10월 29일 기준), 이는 전체 환자의 2.1%를 차지하였다. 소아 환자들의 중앙 연령은 13세(범위, 9개월부터 17세까지)이었으며, 성별이 보고된 자료(n=33) 중 57.6%가 남자였다. 전체 환자 중에서 약 반은 무증상 감염이었으며, 대부분의 증상이 있는 환자는 호흡기 증상을 동반하였다. MERS-CoV에 감염된 환자들의 예후는 대부분 양호하였으나, 사망한 환자는 4명이었으며 이 중 3명은 기저 질환이 있었다. 전세계적으로 소아에서 발생한 MERS-CoV 감염에 대한 보고 자료를 분석한 결과 MERS-CoV 감염은 소아에서 발생이 낮고 성인에 비해 예후가 좋은 것으로 나타났다.

• IMMUNE NETWORK
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• 제21권6호
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• pp.44.1-44.15
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• 2021

Tumor peptides associated with MHC class I molecules or their synthetic variants have attracted great attention for their potential use as vaccines to induce tumor-specific CTLs. However, the outcome of clinical trials of peptide-based tumor vaccines has been disappointing. There are various reasons for this lack of success, such as difficulties in delivering the peptides specifically to professional Ag-presenting cells, short peptide half-life in vivo, and limited peptide immunogenicity. We report here a novel peptide vaccination strategy that efficiently induces peptide-specific CTLs. Nanoparticles (NPs) were fabricated from a biodegradable polymer, poly(D,L-lactic-co-glycolic acid), attached to H-2K^b molecules, and then the natural peptide epitopes associated with the H-2K^b molecules were exchanged with a model tumor peptide, SIINFEKL (OVA_257-268). These NPs were efficiently phagocytosed by immature dendritic cells (DCs), inducing DC maturation and activation. In addition, the DCs that phagocytosed SIINFEKL-pulsed NPs potently activated SIINFEKL-H2K^b complex-specific CD8⁺ T cells via cross-presentation of SIINFEKL. In vivo studies showed that intravenous administration of SIINFEKL-pulsed NPs effectively generated SIINFEKL-specific CD8⁺ T cells in both normal and tumor-bearing mice. Furthermore, intravenous administration of SIINFEKL-pulsed NPs into EG7.OVA tumor-bearing mice almost completely inhibited the tumor growth. These results demonstrate that vaccination with polymeric NPs coated with tumor peptide-MHC-I complexes is a novel strategy for efficient induction of tumor-specific CTLs.