• 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.

• Pediatric Infection and Vaccine
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• 제10권2호
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• pp.153-158
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• 2003

목 적 : B형 간염 바이러스 백신은 1983년부터 국내에서 생산되기 시작하여 1985년부터는 보편적으로 사용되면서 B형 간염 바이러스 감염의 예방에 큰 역할을 하고 있다. 그러나 국내의 B형 간염 바이러스 백신의 항체 생성률이 낮다는 보고가 있어, B형 간염 바이러스 백신의 예방 효과에 대한 평가의 필요성이 제기되고 있다. 저자들은 B형 간염 바이러스 백신이 보편적으로 사용되기 시작한 이후 출생한 연령층을 대상으로 인천지역의 HBsAg 양성률을 조사하여 B형 간염 바이러스 백신의 예방 효과에 대해 알아보고자 하였다. 방 법 : 인천시내의 초, 중, 고등학교 학생들을 대상으로 1997, 1998년 2년에 걸쳐 Reversed Passive Hemagglutination(RPHA)법으로 HBsAg을 검사하였으며, 이전에 전국적으로 주로 초, 중, 고등학생을 대상으로 RPHA법으로 조사한 19세 이하 연령군의 HBsAg 검사 결과와 비교하였다. 결 과 : 1) 1997년 초등학생은 0.7%(337/46,861), 중학생은 2.5%(381/15,026), 고등학생은 3.1%(681/21,938)의 HBsAg 양성률을 보였으며 19세 이하의 연령군 전체는 1.7%(1,404/83,984)였다. 2) 1998년 초등학생은 0.6%(257/41,946), 중학생은 2.7%(379/13,652), 고등학생은 2.4%(628/25,277)의 HBsAg 양성률을 보였으며 19세 이하의 연령군 전체는 1.6%(1,266/80,926)였다. 3) 1985년, 1990년과 1995년에 한국건강관리협회에서 RPHA법으로 전국 19세 이하 연령층에서 조사한 HBsAg 양성률은 각각 6.1%, 5.2%, 3.5%였다. 결 론 : 인천지역에서 초, 중, 고등학생의 HBsAg 양성률은 과거의 전국 조사에 비해 낮으며, 특히 초등학생의 경우 현저히 낮은 HBsAg 양성률을 보이고 있다. 이는 1997년도 및 1998년도의 초등학교 6학년 이하에서 많은 수가 출생시 B형 간염 바이러스의 예방 접종을 시작한 연령층으로 이를 HBsAg 양성률의 현저한 감소는 주로 예방 접종의 효과로 생각된다.

• 농촌의학ㆍ지역보건
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• 제31권3호
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• pp.245-253
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• 2006

남학생 3,391명과 여학생 5,136명 총 8,527명의 대학생을 대상으로 2004년 조사결과 B형간염 표면항원 양성률은 2.7%이었으며 표면항체 양성률은 61.1%이었다. 성별로 표면항원 양성률은 남학생에서 3.3%, 여학생에서 2.3%로 남학생이 유의하게 높게 나타났으며(p< .05) 표면항체 양성률은 남학생에서 59.6%, 여학생에서 62.1%로 여학생에서 양성률이 유의하게 높았다(p< .05). 출생년도에 따른 B형간염 표면항원 양성률은 1980년 이전 출생군 3.8%에서 1986년 출생군 2.3%까지로 최근 출생군에서 다소 낮게 나타났으나 일정한 양상은 보이지 않았다. 출생년도에 따른 B형간염 표면항체 양성률은 1980년 이전 출생군 38.7%에서 1984년 출생군 71.7%까지로 1983년 출생 이후군에서 다소 높게 나타났으나 일정한 양상은 보이지 않았다. B형간염 표면항원 양성자의 39.6%에서 e항원 양성률을 보였으며 비정상 간기능은 19.1%를 보였다. 이상의 결과는 적극적인 보건교육, B형간염 예방접종 등으로 인하여 B형간염 바이러스 감염의 유행지역으로 불리는 우리나라에서도 B형간염 표면항원 및 표면항체 양성률이 상당히 개선되었음을 보여주었다.

• 보험의학회지
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• 제3권1호
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• pp.245-255
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• 1986

To investigate the Positive rate of anti HBs and HBs Ag positive rate of the each group of vaccinated hepatitis B type and not-vaccinated, male 4150 female 2475, from May 1, 1984 to November 30, 1985 in the Medical department of Dae han Kyoyuk ins. Co., We examined into the HBsAg and Anti HBs by using the RPHA method and PHA method and the results which were adjusted statistically were as follows. 1. HBs Ag positive rate was 9.0%(228/2531)in 1984 and 7.0%(287/4069) in 1985, the positive rate in 1985 represented 2% lower than in 1984. 2. Anti HBs positive rate was 43.3%(1096/2531) in 1984 and 42.8%(1744/4069) in 1985, there was no significant change for two years. 3. Anti HBs positive rate in the group of the not-vaccinated hepatitis B type was 39.2%(869/2215) in 1984 and 38.8%(1333/3432)in 1985. 4. Anti HBs positive rate in the group of the vaccinated hepatitis B type more than once was 64.7%(419/647)in male and 71.5%(219/306) in female that was 66.9%(638/953) in total. 5. Anti HBs positive rate in the group of the vaccinated hepatitis B type three times was 68.7%(270/393) in male and 80.0%(156/195) in female and 72.4% in total. In this conclusion; The formation of Anti HBs in female showed more or less higher than male. 6. The cases which were detected HBs Ag and anti HBs at the same time were 4 in male and 3 in female and in the group of the vaccinated hepatitis B type, the number of HBs Ag positive cases were 8 in male and 10 in female. (On condition that we didn't distinguish $5{\mu}g/ml$, hepatitis B type vaccine, from $20{\mu}g/ml$ and after vaccinating, the lapsed time was not settled.)

• Journal of Preventive Medicine and Public Health
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• 제18권1호
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• pp.51-57
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• 1985

To attempt to measure the effect of domestic product P.H.A. kit 'Hepa-S' after completion of 'Hepa-Vax' vaccination schedule, P.H.A. test and R.I.A. test on the 330 healthy adults were carried out. The results obtained were as follow ; 1. The positive anti HBs rate after completion of 'Hepa-Vax' vaccination were; in P.H.A. test with domestic product P.H.A. kit 81.2%, in P.H.A. test with foreign product P.H.A. kit 82.7%, and in R.I.A. test 95.8% 2. Using the result of R.I.A. test as the standard, sensitivity of P.H.A. test with domestic product P.H.A. kit was 84.8% and specificity was 100.0% 3. Using the result of R.I.A. test as standard, sensitivity of P.H.A. test with foreign P.H.A. kit was 86.4% and specificity was 100.0%. 4. The concordance rate of P.H.A. test with domestic product and foreign product kit was 98.5%. On the result of this study, there was no significant difference in the validity between the domestic product P.H.A. kit 'Hepa-S' and the foreign P.H.A. kit $'Hebsgencell^{TM}'$. So that it is recommendable to use domestic product P.H.A. kit instead of foreign product P.H.A. kit.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.162-173
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• 2006

Purpose : To report the decreasing indicence of HBV(Hepatitis B virus)-associated membranous nephropathy in children after HBV vaccination and to elucidate the clinical course and treatment strategies of IMN(Idiopathic membranous nephropathy). Methods : We retrospectively reviewed the clinico-pathological findings of HBV-MN and IMN patients who underwent a renal biopsy from 1986 to 2005. We compared the HBV-MN and the IMN groups and the remission and the non-remission groups of patients with IMN. Results : Among 24 cases of MN patients, HBV-MN comprised 6 cases(25%) and IMN 18 cases(75%). Clinical masnifestations were nephrotic syndrome(3 cases, 50%), nephritic syndrome(1 case, 16.7%), asymptomatic(2 cases, 33.4%) in the HBV-MN group, asymptomatic(10 cases, 55.5%), nephrotic syndrome(5 cases, 27.8%), and gross hematuria(3 cases, 16.7%) in the IMN groups. From 1996 to 2000, there were 2 cases(28%) of HBV-MN and 5 cases(72%) of IMN. After 2001 all 10 cases were IMN. In the HBV-MN group, 4 cases(66.7%) received interferon and 1 cases received methylprednisolone pulse therapy. In the IMN group, 16 cases(88.9%) received methylprednisolone, 8 cases(44.4%) were in complete remission, 2 cases(11.1%) were in partial remission, 2 cases(11.1%) were in chronic renal failure, and 5 cases(27.8%) were lost to follow-up with sustained proteinuria, 1 case(5.6%) continued to have frequent relapse of nephrotic syndrome without renal insufficiency. In the comparison between remission and non-remission groups, nephrotic range proteinuria and hypertension were more significantly common in the non-remission group(P<0.05). Conclusion : With HBV vaccination, HBV-MN has decreased markedly. IMN is a rare glomerular disease in children. Because the prognosis for patients with nephrotic range proteinuria is poor this group needs more aggressive treatment.

• 보건행정학회지
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• 제5권1호
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• pp.59-79
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• 1995

This study intended to grasp the results of performance of school health policy and to provide information for the future policy performance in Korea. As the objects of the study we chose the secondary school(142 middle schools, 111 high schools) in Pusan, 1993. The contents of the study were about school health service and school health education. For the study we collected datum and took statistics through the existing theses, books, various statistics, and interviews with the persons concerned. Therefore the method of the study was basically emperical and demonstrative. The results of the study can be presented as follows : 1. the results of performance of health service proved to be 5.40% for vaccination against hepatitis B, 5.26% for typhoid fever, 6.65% for EH fever, and 9.84% for influenza in middle schools, In high schools' 5.76% for vaccination against hepatitis B, 0.03% for typhoid fever, 0.25 for EH fever, and 0.86% for influenza. 2. The results of policy performance of health education were found out 64.08% in middle schools, and 17.12% in high schools. 3. The factors which affected the results of performance of health service turned out 1) the improper standard of policy performace that applicants should pay their own expenses. 2) the lack of performer's will to carry out the policy owing to the improper standard. 3) the shortage of interorganizational enforcement activities and communications which influence the will of performance. 4. The affecting factors to the will of performance of health education proved to be 1) the improper standard that nurse-teachers can teach students in the classroom in case of need. 2) the lack of nurse-teachers due to the above inappropriate standard. 3) the lack of enforcement activities of supervising organs which employ and direct nurse-teachers. 4) the lack of activities of organs which should communicate one another and allot nurse-teachers of public schools without fail.

• Journal of Korean Biological Nursing Science
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• 제16권1호
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• pp.26-32
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• 2014

Purpose: Needlestick injuries (NSI) is the most frequent occupational hazard for healthcare personnel (HCP), and immediate report and adequate post-exposure prophylaxis (PEP) is essential in preventing occupational transmission of blood-borne pathogens. Methods: From June 2010 to October 2010, 544 NSI were reported through websites from 21 general hospitals in Korea. Among those, 499 cases of NSI were analyzed to identify the rate of follow-up treatment completion and for seroconversion. Results: 88.2% of the cases were completed with follow-up treatment, 8.8% of the NSI were not completed with follow-up treatment, and 5 cases were unavailable to trace. 4.2% cases of NSI required a hepatitis B vaccination concurrent with hepatitis B immunoglobulin. 41.1% of the cases and 31.1% of the cases needed to be tested for anti HCV and anti HIV, respectively. Prophylaxis medication for HIV was prescribed in 3 cases, and all cases completed required 1 month of medication. There was 1 case (0.2%) of seroconversion to HCV. Conclusion: The PEP completion rate was not satisfactory, and the importance of completion of PEP treatment should be emphasized through education and counseling. Also, a careful risk assessment is needed for HCP who are exposed to HCV or HIV.

• Journal of Preventive Medicine and Public Health
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• 제19권1호
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• pp.91-99
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• 1986

To determine relationships of supposed risk factors to positives for HBsAg and Anti-HBs and also relationships of subjective symptoms to positives for HBsAg and Anti-HBs, study of 658 people working in the hospital, university, bank and other office was performed. Positive rate for HBsAg was about 7.9% and positive rate for Anti-HBs was about 20.0%. Odds ratio of HBsAg was high and significant in individuals who are married and who have previous hepatitis B(P<0.001), medical personnel in family, more than 4 people in a room(0.01

• IMMUNE NETWORK
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• 제5권1호
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• pp.1-10
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• 2005

Background: Chronic infection with hepatitis B virus (HBV) affects about 350 million people worldwide, which have a high risk of development of cirrhosis and hepatocellular carcinoma. Treatment of chronic HBV infection relies on IFN-${\alpha}$ or lamivudine. However, interferon-${\alpha}$ is effective in only about 30% of patients. Also, the occurrence of escape mutations limits the usage of lamivudine. Therefore, the development and evaluation of new compounds or approaches are urgent. Methods: We comparatively evaluated DNA and adenoviral vaccines expressing HBV antigens, either alone or in combined regimens, for their ability to elicit Th1-type immune responses in Balb / c mice which are believed to be suited to resolve HBV infection. The vaccines were tested with or without a genetically engineered IL-12 (mIL-12 N220L) which was shown to enhance sustained Th1-type immune responses in HCV E2 DNA vaccine. Results: Considering the Th1-type cytokine secretion and the IgG2a titers, the strongest Th1-type immune response was elicited by the DNA prime-adenovirus boost regimen in the presence of mIL-12 N220L. In addition, the codelivery of mIL-12 N220L modulated differentially the immune responses by different vaccination regimens. Conclusion: Our results suggest that the DNA prime-adenovirus boost regimen in the presence of mIL-12 N220L may be the best candidate for HBV vaccine therapy of the regimens tested in this study and will be worthwhile being evaluated in chronic HBV patients.