• IMMUNE NETWORK
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• v.3 no.3
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• pp.188-200
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• 2003

Background: Immunization of dendritic cells (DCs) pulsed with tumor antigen can activate tumor-specific cytotoxic T lymphocytes (CTL) that are responsible for protection and regression. In this study, we examined whether the uptake of necrotic tumor cells could modulate DC phenotypes and whether the immunization of necrotic tumor cell-loaded DCs could elicit efficient tumor specific immune responses followed by a regression of established tumor burdens. Methods: We prepared necrotic tumor cell-pulsed DCs for the therapeutic vaccination and investigated their phenotypic characteristics, the immune responses induced by these DCs, and therapeutic vaccine efficacy against colon carcinoma in vivo. Several parameters including phagocytosis of tumor cells, surface antigen expression, chemokine receptor expression, IL-12 production, and NK as well as CTL activation were assessed to characterize the immune response. Results: DCs derived from mouse bone marrow efficiently phagocytosed necrotic tumor cells and after the uptake, they produced remarkably increased levels of IL-12. A decreased CCR1 and increased CCR7 expression on DCs was also observed after the tumor uptake, suggesting that antigen uptake could induce DC maturation. Furthermore, co-culturing of DCs with NK cells in vitro enhanced IL-12 production in DCs and IFN-${\gamma}$ production in NK cells, which was significantly dependent on IL-12 production and cell-to-cell contact. Immunization of necrotic tumor cell-loaded DCs induced cytotoxic T lymphocytes as well as NK activation, and protected mice against subsequent tumor challenge. In addition, intratumoral or contra-lateral immunization of these DCs not only inhibited the growth of established tumors, but also eradicated tumors in more than 60% of tumor-bearing mice. Conclusion: Our data indicate that production of IL-12, chemokine receptor expression and NK as well as CTL activation may serve as major parameters in assessing the effect of tumor cell-pulsed DC vaccine. Therefore, DCs loaded with necrotic tumor cells offer a rational strategy to treat tumors and eventually lead to prolonged survival.

• Women's Health Nursing
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• v.8 no.2
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• pp.301-313
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• 2002

The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

• Korean Journal of Veterinary Research
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• v.40 no.1
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• pp.110-116
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• 2000

Duck viral hepatitis is an acutic, highly infectious viral disease of young ducklings. The most practical means for controlling duck viral hepatitis is the vaccination of ducklings or of a breeding stock. We attempted to develop a vaccine strain of duck hepatitis virus (DHV) using a Korean isolate by serial chicken embryo passages. The propagation of DHV in chicken embryos was carried 140 passages. After the $50^{th}$ passage, of which the virus was non-pathogenic for ducklings, approximately every $20^{th}$ passage of the virus was tested for vaccinal efficacy. Both the $70^{th}$ and $90^{th}$ passage of the virus gave good protection against challenge infection to a DHV-DRL reference strain(type 1) and a virulent Korean isolate. The $110^{th}$, $125^{th}$ and $140^{th}$ passage of the virus were less protective than the $70^{th}$ and $90^{th}$ passage, which means that more than $110^{th}$ passage may lead to over-attenuation of the virus. Ducklings vaccinated with the chicken-embryo-adapted virus by oral, intramuscular or eye drop administration showed earlier resistance to challenge infection from 3 to 7 days postvaccination. Of the above methods, ducklings vaccinated intramuscularly presented the most rapid resistance against challenge. The minimum immune dose of the chicken-embryo-adapted virus in ducklings was also studied. Ducklings inoculated with a dose of $10^{2.0}\;ELD_{50}$ and below were not fully protected against challenge with a virulent DHV, showing a protection rate of 67% to 73%, but ducklings inoculated with a dose of $10^{3.0}\;ELD_{50}$ and over were completely protected. The virus yield of the chicken-embryo-adapted DHV was examined at 24hrs and 48hrs of the incubation time in the allantoic fluid, embryo head and embryo minus head of the embryonating egg. In all three components, the titer of the virus was higher at 48 hours than that at 24 hours after incubation. And the titer of the virus was higher in the embryo minus head, embryo head and the allantoic fluid, in order. Field trials for evaluating the efficacy of the attenuated DHV as a live vaccine were done in duck farms with about 25% mortality of flocks resulting from duck viral hepatitis. After the use of the experimental vaccine, the mortality due to duck viral hepatitis was dramatically reduced in the farms. These results indicated that the attenuated DHV using a Korean isolate could be a good candidate as a live vaccine strain of DHV in Korea.

• Korean Journal of Veterinary Service
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• v.42 no.1
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• pp.39-42
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• 2019

Tetanus is an acute, often fatal, and infectious disease of all species of domestic animals caused by the neurotoxin of Clostridium tetani (C. tetani). This disease is usually known to develop after microbial contamination in the deep or penetrating wound sites. In February 2017, a farmer who was raising 76 cows injected foot and mouth disease vaccine to three or more cows with one syringe. Their clinical symptoms were observed 2 to 16 days after the vaccination. The initial symptoms were stiffness, rigidity of the neck and limbs, pricked ears, and prolapse of the third eyelid. Subsequently, there was recumbency with extension of the limbs, convulsions and opistotonus and the affected 20 cows were all died. Two dead cows were submitted to Animal and Plant Quarantine Agency for disease diagnosis. At necropsy, a focal edematous abscess of 15 to 20 cm in diameter was grossly observed in the subcutaneous and intramuscular tissue of scapular region and filled with a large amount of greenish pus. The feed was full in oral cavity and slightly observed in the trachea and lobes of lung. Histopathologically, focal granulomatous nodules with eosinophilic materials in the tissue were observed. In the lung, aspiration pneumonia and gram (+) bacteria were seen. The C. tetani was isolated in samples anaerobically cultured using reinforced clostridial medium and identified by PCR. To our knowledge, no previous outbreak of tetanus in cattle has affected such a high number of animals; neither has it been associated with misuse of the same syringe and needle to administer multiple individuals.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.71-80
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• 2003

Purpose : Four kinds of Haemophilus influenzae type b protein conjugate vaccines, PRPD, PRP-T, PRP-OMP and PRP-CRM197, have been developed, and PRP-T vaccines are currently produced by two manufacturer, $ActHib^{(R)}$ by Aventis and $Hiberix^{TM}$ by GlaxoSmith-Kline Biologicals. The purpose of this study is to evaluate the immunogenicity and safety of $Hiberix^{TM}$ in Korean infants. Methods : Seventy-three healthy infants(43 male infants) were recruited for this study after parental informed consent was obtained. Each infant was vaccinated at 2, 4 and 6 months of age with the study vaccine. At each visit, infants were also immunized with DTaP, trivalent oral polio vaccine and hepatitis B vaccine when indicated. The serum anti-PRP antibody was measured at prevaccination, 2 month later after the 2nd dose, and 1 month later after the 3rd dose by the ELISA method. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Immunogenicity of vaccine was evaluated in infants who received all the scheduled immunization and the adverse reactions were evaluated for infants who received at least one dose of the study vaccine. Results : Among seventy three infants, enrolled in this study; sixty three(37 male infants) completed all the scheduled immunizations. The geometric mean titer(GMT) of anti-PRP antibodies at prevaccination was 0.17 ${\mu}g/mL$(95% confidence interval[CI]; 0.13~0.22). The GMT of anti-PRP antibodies increased to 4.14 ${\mu}g/mL$(95% CI; 2.65~6.48) at 2 month later after the 2nd dose of PRP-T and 14.65 ${\mu}g/mL$(95% CI; 10.83~19.81) at 1 month later after the 3rd dose. Anti-PRP antibody ${\geq}0.15$ ${\mu}g/mL$, was observed in 98.4%(95% CI; 91.8~100) after 2 doses and 100%(95% CI; 100~100) after 3 doses. Anti-PRP antibody ${\geq}1.0$ ${\mu}g/mL$, was obtained in 77.8%(95% CI; 67.5~88.0) after 2 doses, and 98.4%(95% CI; 95.3~100) after 3 doses. Most of the adverse reaction after vaccination were mild. Irritability, the most common systemic reaction, was observed in 45.5%, followed by drowsiness(30.5%), poor feeding(26.7%) and fever(5.6%). Among the local reactions tenderness was observed in 7.9%, redness(${\geq}5$ mm) in 2.8% and swelling(${\geq}5$ mm) in 1.8%. Conclusion : The PRP-T vaccine used in this study was highly immunogenic and safe in Korean young infants. The finding that high GMT and high frequency of infants with a protective titer achieved after 2 doses is consistent with the previous studies which were done with a PRP-T vaccine of other manufacturer. This study suggests that the immunization schedule of PRP-T vaccine for Korean infants may need re-evaluation.

• Journal of agricultural medicine and community health
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• v.26 no.1
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• pp.19-35
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• 2001

This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.133-141
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• 2003

Purpose : Idiopathic Membranous Nephropathy(IMN) is a rare renal disease in children. To help better understanding of its clinical course and treatment strategies, we reviewed the clinical manifestations and pathological findings of children with IMN. Methods : Among 58 cases with MN, from 1977 to 2003, 42(72.4%) were hepatitis B virus (HBV) associated and 16(27.6%), 6 males and 10 females, were idiopathic. All cases diagnosed aster 2000 were IMN. Several clinicopathological findings(sex, onset age, proteinuria, serum albumin, cholesterol, creatinine clearance, tubulointerstitial changes, glomerular sclerosis, hypertension, renal vein thrombosis, the use of ACE inhibitor, and immunosuppressive therapy) were compared between the remission and the non-remission group of the patients with IMN. Results : The median onset age was 13.4 years. Clinical manifestations were nephrotic syn-drome(7 cases, 43.8%), gross hematuria(5 cases, 31.3%) and microscopic hematuria with proteinuria(3 cases, 18.8%). Hypertension, hypocalcemic tetany and renal vein thrombosis were accompanied in 2, 1 and 2 cases, respectively. In addition to the typical findings of MN, the kidney biopsies showed segmental sclerosis(5 cases, 31.3%) or global sclerosis(6 cases, 37.5 %), diffuse crescents(1 case), and mild(11 cases, 68.7%) or moderate tubulointerstitial changes(3 cases, 18.8%). Thirteen cases(86.7%) received oral steroid. Among them 2 cases received cyclophophamide and 1 received cyclosporin as well. Ten cases(62.5%) received ACE inhibitors. In the patients followed up, 7 cases(46.7%) became free from proteinuria (remission group) while 8(53.3%) presented continous proteinuria (non-remission group), two (13.3%) of which progressed to renal failure. Clinicopathological findings showed no significant differences between the two groups. Conclusion : With HBV vaccination, HBV associated MN decreased markedly and IMN has taken up most of MN in children. For better understanding of this rare disease, a prospective multicenter study of the clinical course and treatment strategies should be done.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.148-155
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• 2018

Purpose: The purpose of this study was to investigate the clinical significance of Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) site reaction in terms of diagnosis and outcome prediction in young children with Kawasaki disease (KD). Methods: The incidence of BCG site reaction in the respective age ranges was investigated in 1,058 patients who were admitted at Asan Medical Center between January 2006 and February 2017. The 416 patients under 18 months of age were enrolled as subjects for the analysis of the association between BCG site reaction and other laboratory and clinical findings. The analysis was performed separately in complete and incomplete KD groups. Results: The incidence rate of BCG site reaction was peaked at 6-12 months (83%) and decreased with increasing age after 12 months in 1,058 patients (P<0.001). The incidence rate was above 70% in KD aged less than 18 months and more frequent than those of cervical lymphadenopathy. The logistic regression analyses showed that the principal clinical findings including conjunctivitis (P=0.781), red lips/oral mucosa (P=0.963), rash (P=0.510), cervical lymphadenopathy (P=0.363), changes in extremities (P=0.283) and the coronary artery aneurysm (P=0.776) were not associated with the BCG site reaction. Conclusions: The BCG site reaction could be a useful diagnostic tool independent to principal clinical findings in KD developing in children aged <18 months, who underwent BCG vaccination. Outcome of KD patients was not different between groups with or without the BCG site reaction in both complete KD and incomplete KD.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.1-13
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• 1995

Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.