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Correlation between the Fibrillar Pattern in Ultrasonography and Clinical Factors after Achilles Tendon Repair (아킬레스건 봉합 후 초음파에서 보이는 섬유 배열 양상과 임상적 요인과의 관계)

  • Choi, Young Jin;Ahn, Soo-Hyung;Bae, Su-Young
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.3
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    • pp.123-129
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    • 2022
  • Purpose: To evaluate the correlation between the fibrillar pattern of the Achilles tendon on ultrasonography (US) and functional outcomes in patients who underwent open tendon repair after Achilles tendon rupture. Materials and Methods: Data of 44 patients who had been subjected to US at least 6 months after repair, during the period between July 2012 and July 2019 were reviewed. Those with bilateral tendon rupture, re-rupture, open injury, and chronic or insertional rupture, were excluded from the review. We divided them into two groups, the homogenous group (HoP) and the heterogenous group (HeP) based on the fibrillar pattern on US. We also divided the HoP into linear and wavy subgroups, and the HeP into no hypoechoic lesion and hypoechoic lesion subgroups. The rupture type of the Achilles tendon, radiographic factors including US and magnetic resonance images, patient-related, surgical factors, and clinical results at the last visit after repair were assessed retrospectively. Results: The tendon thickness was 11.4±1.7 mm in the HoP, and 14.5±3.0 mm in the HeP (p<0.001). A shredded pattern was observed in 17 cases (65.4%) in the HoP, and in 17 cases (94.4%) in the HeP (p=0.031). The mean value of the number of sutures used was 8.9±3.05 in the HoP and 11.39±1.75 in the HeP (p=0.001). The mean value of the difference in calf circumference was 0.9±0.67 cm in the HoP and 1.36±0.71 cm in the HeP (p=0.037). There were no statistically significant differences in the fibrillar patterns and patient-related factors. Conclusion: The fibrillar pattern observed after repair was correlated with the functional outcome and showed a significant relationship with the rupture pattern and the number of sutures used. Therefore, we suggest a careful individualized postoperative rehabilitation protocol to maximize functional outcomes by referring to the fibrillar pattern in US, especially in shredded ruptures.

A Plan to Improve Consumer Satisfaction and Reliability of Opticians by Analyzing Consumers' Spectacles Purchasing Behavior (소비자의 안경 구매 행태 분석을 통한 만족도 및 신뢰도의 향상 방안)

  • Park, Jee-Hyun;Lee, Eun-Hee;Koo, Eun-Hye;Kim, Hee-A;Song, Da-Hye;Hyun, Jin-Hee;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.1-7
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    • 2010
  • Purpose: To plan and improve consumers' satisfaction by analyzing consumers' purchasing behavior of spectacles. Also this will show the need of improvement in reliance of an optician. Methods: A total of 307 people (10 to 60 years) participated in individual questionnaires. Questionnaires comprised of general characteristic of surveyed people, purchasing spectacles behavior, satisfaction after purchasing spectacles, reliability of optician, and improvement points of optician. Results: Most important points in selecting the product were the design and the price of the spectacles. 142 people (46.3%) replied "average" and 140 people (45.6%) replied "satisfying" out of maximum point of satisfaction level which was 5 points. 72.3% of people have regularly visiting optical shop due to the high accessibility, after-sales care, and courteous optician. On the contrary, 27.7% replied "never visit same optician shop again" because of the low accessibility, minimal range of products, and high price. Data showed that people had high re liability about the opticians' knowledge of product, and their technique of eye refraction. Data revealed that people did not show high satisfaction about opticians' knowledge of ophthalmology, and price of products. Most important improvement points were accurate spectacle prescription by Opticians rating 42% of reply. Factors most considered during spectacle selection among the 10 to 20 age group were design by 34.8% and price by 10.1%. Among the 40 to 50 age group, most considered factors were design by 14% and spectacle frame material by 10.1%. Conclusions: Satisfaction rate of purchasing spectacles for the total participant group was 4.2 average grades. Reliability of opticians' eye refraction result and prescription was 50.5%. However consumers wanted to obtain more accurate eye refraction result and prescription with more comprehensive explanations. Also, consumers wanted opticians to be sensitive and have appreciative eye in select spectacles for customers, and to offer precise spectacle dispensing services and courteous after-sales care.

A Study of the Construction of Nursing Theory in Korean Culture - View of Medicine- (한국문화에 따른 간호정립을 위한 기초조사연구 III -의료관을 중심으로-)

  • Park, Jeong-Sook;Ok, Yun-Jung
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.143-162
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    • 1998
  • This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

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A Study on The Diaspora-Consciousness of Author in the travel-siga of Korean-American Writer Hong-Eun$(1880{\sim}1951)$ (재미작가 홍언의 미국기행시가에 나타난 디아스포라적 작가의식)

  • Park, Mi-Young
    • Sijohaknonchong
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    • v.25
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    • pp.175-209
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    • 2006
  • This study focuses on Korean-American writer Hong-Eun$(1880{\sim}1951)'s$ American travel gasaes and sis who played an active role under the rule of Japanese imperialism. This study also investigates Hong-Eun's experience and expression on American travel and culture and discusses his changes in stream of consciousness. According to American travel sigaes which were published in the New Koren Times in 1936. 1937, and 1949, his consciousness can be summarized as follows. First travel siga depicts his inner conflict as a refugee who lost one's home country. That is to say. by observing Indians' losing identity and their miserable labor conditions, he developed his own critical eyes on American society. Eventually he missed his country desperately and sought for the ways of his returning there. Second travel sijo reveals his own agony about not be able to return his home country where he could Possibly visit. In other words, after suffering from his agony, it is evident that he started to take positive attitude towards American society and establish his own identity. Based upon Hong-Eun's changes in consciousness as a writer, the researcher hypothesizes that there exists Diaspora-Consciousness in his work. His consciousness is strongly related with his attitude towards his home country whether it Is positive or vice versa. When his home country declared her independence. his attitude towards immigrant society was positively changed, which was quite contradictory from his previous one. In this transition period, not only he accepted American ideology and life, but he re-conceptualized them as a Korean mode. In sum, Hong-Eun's mental traces lie on the core of hybrid and diaspora which Post-Colonial literature values highly of.

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The Result of Bone Grafting for Fibrous Dysplasia (섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석)

  • Jeong, Won-Ju;Kim, Tae-Seong;Cho, Hwan-Seong;Yoon, Jong-Pil;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.74-79
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    • 2014
  • Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.

Research on Visitor Behavior and Satisfaction with the Nature Trail in Hallasan National Park (한라산국립공원 자연학습탐방로의 이용행태와 이용객만족에 관한 연구)

  • Kim, Jeong-Min
    • Korean Journal of Environment and Ecology
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    • v.21 no.3
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    • pp.223-234
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    • 2007
  • The study, executed with Hallasan National Park, which deserves to be a typical ecotourism destination, aims to provide basic information on park management for early establishment of ecotourism in a national park by assessing its visitors' behavior and satisfaction with a nature trail established as a series of an environmental interpretation program. The questionnaire survey was conducted at Eorimok Square in the weekday and on the weekend for two months of August and September in 2006, and finally 144 valid samples were used for the analysis. As a result of the research, it revealed that the demographic characteristics of the visitors to Hallasan National Park tended to coincide with those of the visitors to other national parks In Korea. On the whole, it showed their low recognition level of nature trails built up in national parks and less experience in using them. However, the visitors' satisfaction level and intention of re-visit, and recommendation to others were comparatively higher after actually using the nature trail at the site of Hallasan National Park, which hints at the possibility of national parks' much weightier role as the ground for ecology education and the functional expansion of the environmental interpretation-related facilities and programs. As for the attributes having effects on users' satisfaction with a nature trail, substantial aspects such as accessibility, safety, uniqueness and interest in environmental interpretation, and educational quality as well as physical facility management were revealed to have equal effects on users' satisfaction level, so there still remain a lot of pending issues over the reality of national parks in the initial stage of ecotourism staying at the level of the introduction and establishment of the facilities for environmental interpretation. This research had surveyed visitors to Hallasan National Park and limited to the nature trail only. For more systematic and practical ecological management of a national park, the in-depth understanding of the attributes affecting satisfaction of ecotourists, including nature trails and other environmental interpretation programs, and more sophisticated measuring tools are needed.

Distributional Characteristics and Population Substantiality of Viola mirabilis L.; Rear edge Population in Korea (한국이 후방가장자리 개체군인 넓은잎제비꽃(Viola mirabilis L.)의 분포특성과 지속가능성)

  • Chae, Hyun-Hee;Kim, Young-Chul;An, Won-Gyeong;Kwak, Myoung-Hai;Nam, Gi-Heum;Lee, Kyu-Song
    • Korean Journal of Environment and Ecology
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    • v.33 no.4
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    • pp.422-439
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    • 2019
  • The rear edge population is considered to have low genetic diversity and high risk of extinction according to a highly isolated distribution. However, the rear edge population is observed to have persisted for an extended period despite the low genetic diversity. As such, it is necessary to understand the ecological process involved in the persistence of the population. Viola mirabilis L. in Korea is considered the rear edge population from the perspective of the worldwide distribution. We surveyed the distribution range of V. mirabilis, which shows the isolated distribution in the central area of Korea, to find out the factors of its persistence. Next, we investigated and accessed the vegetational pattern of habitats, soil environment, phenology, self-compatibility, population structure, and extinction risk factors observed in the distribution area. V. mirabilis was distributed in the understory of the deciduous forest, planted forest of the deciduous conifer and deciduous broad-leaved trees, shrubland, and grassland in the limestone area. We also observed the re-establishment of seedlings in the population, and most of them showed a stable population structure. For chasmogamous flowers, the visit by pollinators has a significantly positive relationship with the production of fruits. However, we found that the production of the cleistogamous flowers was more numerous in all studied populations and that only the cleistogamous flowers were produced despite a more substantial plant size in some populations. The plant size was more related to the production of the cleistogamous flowers than that of the chasmogamous flowers. Accordingly, the cleistogamous flowers significantly contributed to seedling recruitment in the population. We found that the production of the chasmogamous flowers and the cleistogamous flowers did not have a correlation with the factors of the soil analysis except for phosphoric acid. V. mirabilis showed the self-incompatibility characteristics most likely due to the production capability of the cleistogamous flowers. Potential extinction risk factors observed in the distribution area was included the development of limestone mine, the expansion of agricultural fields, and the construction of houses. Although V. mirabilis showed an isolated distribution in the limestone area in the Korean peninsula, it showed a diverse distribution in a wide habitat environment ranging from the grassland to the understory of the trees with relatively low canopy closure rate. Moreover, we concluded that the persistence of the population was possible if we can maintain the current state of multiple populations and stable population structure.

Re-review of the Structure of the Jeongsa-Kisun (Senior Envoy Ship) in the Joseon Dynasty from the Perspective of Professional Shipbuilding Engineering (조선통신사 정사 기선(騎船) 구조의 조선기술 연구)

  • HONG Sunjae
    • Korean Journal of Heritage: History & Science
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    • v.55 no.4
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    • pp.242-275
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    • 2022
  • This study tries to reveal the structure of the "Kisun"(senior envoy ship) taken by senior envoys for the 10th to 12th visits to Japan from the perspective of professional shipbuilding engineering focusing on the theory of the ship in the travel logs of royal envoys to Japan (Sahaengrok) written by Joseon Tongsinsa that includes 12 visits to Japan for about 200 years from 1607 to 1811. The results of the study showed that the size of Kisun for the 10th to 12th envoy visits was 19 Pa (把) and a half in length and 6 Pa (把) and 2 Cheok (尺) in width. The height of the Sampan was found to be 2 Pa (把) and 1 Cheok (尺) based on records in Gyemisusarok and Jeungjeonggyorinji. The structure of Kisun was different for each visit but, it was found that Kisun was mainly composed of a main deck, bow (bow plate, stem plate), stern (stern plate), Sampan, Meonge (support), Garyong (support), Sinbang, Gungji, deck, two masts and sail, Gurejjak (mast support), Panok, stern Panok, Taru, dodger, anchor reel, stairs, rail, rudder, oar, and anchor. In addition, wood and iron nails were used together for connection. It was also found that the sail was made of herbage and cotton. This study found that Kisun, which was operated for the 10th and 12th envoy visits, was big in terms of length and height among the Joseon Tongsinsa fleet to show the authority and dignity of Joseon and that it had passages outside on the sides of the vessel and paddles were located between the sides and Panok structure and rails were installed on four sides on the Panok, improving stability and linear beauty. The walls of Panok were decorated with the royal Dancheong pattern and fancy murals. In addition, it was found that they wished for a safe voyage by drawing a demon face on the bow. Therefore, it was revealed that Kisun, which was taken by envoys as recorded in travel logs, was made by the state and equipped with structures and functions that enabled international voyages.

REPORT OF EXPERIENCE WITH KIMURA'S DISEASE (기무라씨 질환, 5 예 보고)

  • Seel David J.;Park Yoon-Kyu;Lee Kwang-Min
    • Korean Journal of Head & Neck Oncology
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    • v.5 no.1
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    • pp.39-46
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    • 1989
  • Kimura's Disease is a chronic inflammatory and proliferative condition producing subcutaneous masses especially in the head and neck area. This report of our experience with 5 patients with this disease is the first in the Korean surgical literature. Kimura's Disease is thought to be part of the larger spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). It is characterized pathologically by hyperplastic lymphoid follicles, eosinophilic infiltration, and vase 비 ar proliferation. It produces masses which are most common in the area of the parotid, submandibular gland and upper neck. These masses occupy the subcutaneous tissues but also extend into salivary tissue and into upper neck nodes. One of our patients had masses in the groin. The tumors are extremely vascular due to the presence of new proliferative vessels and sinusoids. The average age of our 5 patients was 35, but all but one case were younger than 38 years of age. The male: female ratio was 3 : 2, and the average duration of symptoms was 5,2years. All patients had peripheral blood eosinophilia. All had multiple masses, sometimes symmetrical. The management was surgery alone in one case, surgery and steroids in one case, surgery and radiotherapy in two cases, and all three modalities in one case. The relationship of this entity to ALHE and our experience in the management of this disease are presented. A clinicopathological discrepancy alerted us to the existence of Kimura's Disease. A nineteen-year old male presented with subcutaneous masses over both mastoid areas present for 3 years (Case III). When biopsy on each side was reported as 'eosinophilic granuloma' we submitted the slides to an internationally expert pathologist. Symmetrically occurring tumors in the peri-parotid subcutaneous areas did not fit any category of neoplasm or granuloma known to us. The diagnosis, made by Dr. Gist Fan at the Ochsner Clinic, was Kimura's Disease. We found two additional cases in a review of soft tissue eosinophilic granuloma previously reported at Presbyterian Medical Center, and since then have diagnosed two new cases. These five cases constitute the basis for this, the largest series to be reported in Korea. These vascular, tumor-like lesions of the skin, subcutaneous areas and subjacent structures of the head and neck have been a variety of names, such as angiolymphoid hyperplasia with eosinophilia, eosinophilic hyperplastic lymphogranuloma, angioblastic lymphoid hyperplasia with eosinophilia, histioid hemangioma, and epithelioid hemangioma. The history of this disease spectrum dates back to 1937 when Kimm and Szeto (1) reported 7 cases of 'eosinophilic hyperplastic lymphogranuloma' in the Proceedings of the Chinese Medical Journal. In 1948 Kimura and his associates(2) reported additional cases in Japan under the title 'On the unusual granulation combined with hyperplastic changes of lymphatic tissue.' From then until 1966 several hundred cases were reported in China and Japan. The first report from the West was by Wells and Whimster(3) in the British Journal of Dermatology, in 1969. These authors coined the term, angiolymphoid hyperplasia with eosinophilia (ALHE). Since that time a debate has ensued as to whether Kimura's Disease and ALHE are distinct entities, or whether Kimura's is part of the larger spectrum of ALHE, perhaps a later or advanced phase. From the clinical perspective, surgeons should be aware of the diagnosis of Kimura's Disease not only as part of the differential diagnosis of head and neck tumors but also because these lesions are indolent, and generally require conservative surgical removal as part of the management program. CASE I. A 37-year-old female company employee presented in August 1982 with submental swelling of 12 years' duration and with inguinal swelling of 7 years' duration. The submental mass measured 5x5cm. and the inguinal mass was 8x4cm. in size. Peripheral eosinophilia varying from 14% to 40% was found. On August 20, 1982, the submental mass was removed and a superficial groin dissection was done. In May 1983 an intraoral lesion of the palate was removed. The patient is free of disease. CASE II. A 23-year-old unemployed man visited this hospital for the first time in July, 1984, with swelling of the right cheek present for 6 years. The mass was soft and ill-defined but measured 10x20cm. and extended from the submandibular upper neck to the zygomatic arch, and from the mastoid to the cheek, over the parotid gland. Eosinophilia varying from 27% to 29% was noted in the peripheral blood. On March 21, 1986, the lesion was resected. The procedure comprised an extended superficial parotidectomy from the temporalis fascia to the upper neck. Post-operatively radiotherapy 3000 rad tissue dose was administered using the 6 MeV linear accelerator. The patient remains free of disease. CASE III. A 19-year-old student came to the clinic with masses over both mastoid areas, present 3 years. On the right there were two adjacent lesions, one over the mastoid, the other in the upper jugular level of the neck. On the left it was a single mass over the mastoid. Eosinophilia varied from 13 to 32% in the peripheral blood, and 11.6% in the bone marrow. Incisional biopsy revealed 'eosinophilic granuloma' and a trial of predisolone was employed. The mass increased in size so a small dose of radiation (600 rads) was used, with substantial regression,. The lesion on the left was excised and follwed by 1000 rads radiotherapy. Finally recurrent tumor on the right side was removed on November 5, 1985. The patient remains free of disease. CASE N. A 29-year-old local merchant had had swelling of both upper necks since childhood. At the time of his first visit on March 17, 1986, the right submandibular mass measured 5x3.5cm. and the ,right upper neck and parotid tail mass measured 2.5cm. On the left there were masses in the upper neck, the largest of which measured 2.5cm, and of the parotid tail, 2.0cm. in size.(See Fig. 1) Peripheral eosinophilia of 39% was recorded. Left side partial parotidectomy and resection of the upper neck and subdigstric mases was done on May 2, 1986. The mass involving the right parotid tail and upper neck nodes was removed on Angust 7,1986. Postoperatively the patient was placed on prednisolone 30 mg. per day. No definite masses are palpable. CASE V. A 66-year-old housewife informed us, at the time of her first visit in May, 1986, that she had had multiple neck masses since 10 years ago. On the right side there was a 2.5cm. subcutaneous mass of the upper neck, over the upper jugular chain. On the left there was a 9x4.5cm. mass involving the entire parotid, the post-auricular area and the upper neck. A third mass presented in the submental area and measured 3.5cm. (See Fig. 2) Eosinophilia of 51% was noted in the peripheral blood. partial excision of the left upper neck lesion and complete excision of the submental mass were performed on june 6, 1986. post-operatively she was placed on 20 mg. of prednisolone daily, but when the mass re-grew after two months she was referred to Radiation Therapy for a 2500 rad course of treatment. A barely palpable thickening remains.

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Immunogenicity and Safety of a Haemophilus influenzae Type b Polysaccharide-Tetanus Toxoid Conjugate Vaccine (PRP-T: HiberixTM) in Korean Infants (우리나라 영아에서 PRP-T(HiberixTM)백신의 면역원성 및 안전성에 대한 연구)

  • Chung, Eun Hee;Kim, Yae Jean;Kim, Yun Kyung;Kim, Dong Ho;Seo, Jeong Wan;Lee, Hoan Jong
    • 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.

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