• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.18-24
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• 2016

Purpose: There is a the great diagnostic challenge in pediatric tuberculosis especially in high burden setting. The purpose of this preliminary study is to evaluate the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) including T-SPOT$^{(R)}$.TB and QuantiFERON$^{(R)}$-TB Gold (QFT-G) in Korean children. Method: This retrospective study included children and adolescents who visited to Asan Medical Center to evaluate tuberculosis infection using at least two assays of TST, T-SPOT.TB and QFT-G, from January 2014 to April 2015. Results: A total of 20 patients were included, whose median age was 13.3 years (range, 3.8-18.1 years), and all of them had history of BCG vaccination. Eleven patients had underlying diseases including 7 patients with immunosuppressant medication. The concordance rate between T-SPOT.TB and QFT-G was 90%. However, the concordance rate between TST and T-SPOT.TB was 50%, and between TST and QFT-G was 42.9%. Specificity for the diagnosis of tuberculosis infection of T-SPOT.TB, QFT-G, and TST was 93.3%, 86.7%, and 58.3%, respectively. Conclusions: Although there was a discrepancy between TST and IGRA to diagnose tuberculosis, agreement between T-SPOT.TB and QFT-G was relatively high. Further prospective study to validate the clinical usefulness of each assay for immunologic evidence of tuberculosis infection in Korean children will be mandatory.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.129-135
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• 2007

Purpose : Kikuchi disease is a subacute necrotizing lymphadenitis characterized by fever, cervical lymphadenopathy and benign self-limiting course in young women especially, but rare in children. Their etiopathology is still unknown, but involved viruses and autoimmune mechanism were proposed. We investigated the clinical and laboratory characteristics of Kikuchi disease in children. Methods : Five patients were diagnosed of Kikuchi disease from January 2001 to June 2006 in Kyunghee University Hospital. We reviewed their medical records retrospectively and analyzed clinical and laboratory findings. Results : The mean age of 5 patients (male to female ratio; 2:3) was 9 yr 9 mon(range: 8 yr 2 mon-12 yr 6 mon). The chief complaints were sustained fever and cervical lymph node that was unilateral, tender and swollen. All patients were treated with antibiotics before diagnosis was made, and rash developed in 2 patients. One patient showed necrotic change in ultrasound with which we suspected Kikuchi disease. Three patients were examined by CT scan additionally. The interval between admission and cervical lymph node excisional biopsy ranged from 6 days to 15 days, and mean period was 9.6 days. All pathological findings were compatible to necrotizing lymphandenitis. Conclusion : Unnecessary laboratory and imaging studies, and treatment with antibiotics tend to be done before making diagnosis, and that caused prolonged hospitalization. Therefore we studied the clinical and laboratory characteristics of Kikuchi disease in children.

• Korean Journal of Veterinary Service
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• v.31 no.4
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• pp.533-546
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• 2008

The efficacy of bovine immune sera to correct the calves with failure of passive transfer(FPT) was evaluated. Immune sera were produced from 14 one-year-old Holstein cattle which were inoculated commercial combined viral vaccine, administered by the challenge of some main enteric or respiratory viruses, aseptically filtered and stored at $4^{\circ}C$ before used. After the treatment of bovine immune sera, Mean transfer factor($mg/d{\ell}$, of IgG administered/kg of body weight) was $5.46{\pm}2.74,\;11.17{\pm}1.27,\;1.40{\pm}0.21$ in K-IP, H-IP and K-IV group, respectively. The corrective effect of bovine immune sera to FPT calf without any clinical signs showed that intravenous route was more effective than intraperitoneal administration(P<0.01). FPT calves with severe signs were not effective response to the immunotherapy used and consequently died within 10 days after the treatment. Ten percentage of controls appeared the clinical signs including diarrhea. On the contrary, there were not any clinical signs in K-IP and H-IV group. There was significant increase of the neutralizing titer against bovine viral diarrhea virus and bovine coronavirus as well as of cell population including CD2, CD4, and monocyte in K-IP and H-IV group after the immunotherapy(P<0.05). Also, K-IP and H-IV group showed the successful correction to FPT within one week after the immunotherapy, but controls had kept the FPT two-four weeks even after the same treatment. Consequently, the results were suggesting that the bovine immune sera could be used the corrective tool to young calves with FPT.

• Korean Security Journal
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• no.13
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• pp.113-144
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• 2007

The entire world has lived in terror threatened by new-terrorism since the 9.11 terror. Having appeared since 9.11, new-terrorism is new kind of terror targeting victims at random. Bioterrorism is one good example. Since bioterrorism happens secretly, it's hard to identify. The case becomes even harder to detect if it takes the form of a new epidemic. This study set out to apply the four phases of crisis management regarding outbreak and measures of SARS, the latest new epidemic, and to prepare against bioterrorism taking the form of a new epidemic, It also shows the efforts to study what to prepare and what kind of actions to take in case of bioterrorism by applying the four phases. There results demonstrate that the preventive measures against bioterrorism include arranging terror-related laws and identifying and monitoring expected pathogenic organs. In the preparation phases, they should integrate the related agencies, prepare for the standard operating procedures(SOP), execute integrated training sessions among the related agencies, and secure the necessary resources such as vaccine, cures, and exploration devices. In the response phases, they need to set up a rapid diagnosis system, quarantine and then cure the patients, and pursue cooperation from the media and promotions and further an international cooperation system to take appropriate measures. And the final recovery phases should involve offering emergency support by checking the situations and engaging in activities to prevent another terror attack by providing counseling, exchanging information, and analyzing and evaluating the causes.

• Parasites, Hosts and Diseases
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• v.55 no.2
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• pp.149-158
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• 2017

Variant surface antigens (VSAs) encoded by pir families are considered to be the key proteins used by many Plasmodium spp. to escape the host immune system by antigenic variation. This attribute of VSAs is a critical issue in the development of a novel vaccine. In this regard, a population genetic study of vir genes from Plasmodium vivax was performed in the Republic of Korea (ROK). Eighty-five venous blood samples and 4 of the vir genes, namely vir 27, vir 21, vir 12, and vir 4, were selected for study. The number of segregating sites (S), number of haplotypes (H), haplotype diversity (Hd), DNA diversity (${\pi}$ and ${\Theta}_w$), and Tajima's D test value were conducted. Phylogenetic trees of each gene were constructed. The vir 21 (S=143, H=22, Hd=0.827) was the most genetically diverse gene, and the vir 4 (S=6, H=4, Hd=0.556) was the opposite one. Tajima's D values for vir 27 (1.08530, P>0.1), vir 12 (2.89007, P<0.01), and vir 21 (0.40782, P>0.1) were positive, and that of vir 4 (-1.32162, P>0.1) was negative. All phylogenetic trees showed 2 clades with no particular branching according to the geographical differences and cluster. This study is the first survey on the vir genes in ROK, providing information on the genetic level. The sample sequences from vir 4 showed a clear difference to the Sal-1 reference gene sequence, whereas they were very similar to those from Indian isolates.

• Journal of Plant Biotechnology
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• v.32 no.4
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• pp.263-268
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• 2005

Porcine epidemic diarrhea virus (PEDV) causes acute enteritis in pigs of all ages and is often fatal for neonates. In order to develop sweetpotato plants expressing PEDV antigen, we constructed the vector expressing spike gene of PEDV under the control of sweetpotato sporamin promoter or constitutive CaMV 35S promoter. The spike protein region of PEDV was synthesized by PCR and linked to each promoter, Transgenic sweetpotato [Ipomoea batatas (L.) Lam. cv. Yulmi] plants were developed from embryogenic calli following Agrobacterium tumefaciens-mediated transformation. The co-cultured embryogenic calli transferred to selective MS medium containing 1 mg/L 2,4-D, 100 mg/L kanamycin, and 400 mg/L claforan. These embryogenic calli were subcultured to the same selection medium at 3 weeks interval. Kanamycin-resistant calli transferred to hormone-free MS medium with kanamycin gave rise to somatic embryos and then converted into plantlets in the same medium. Southern blot analysis confirmed that the spike gene of PEDV was inserted into the genome of the sweetpotato plants. RT-PCR revealed that the spike gene of PEDV was highly expressed in transgenic sweetpotato plants.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.87-94
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• 2003

Purpose : Respiratory viruses are one of the most infectious agent in human. Acute lower respiratory tract infection(ALRTIs) is associated with significant morbidity and mortality in children. This study is performed to investigate the etiologic organism, age and sex distribution, clinical manifestations and seasonal occurrence of ALRTIs in children. Methods : Viral agent was evaluated with nasopharyngeal aspirates, rhinorrhea and saliva collected from 568 patients. We confirmed viral agents in 54 patients who were younger than 15 year old. They had visited Maryknoll Hospital, Busan in Korea from January, 2002 to December, 2002 for ALRTIs. Results : The viral pathogens identified were Influenza A virus(59.3%), Enterovirus(33.3%), Adenovirus(5.6%), and Influenza B virus(1.9%). Parainfluenza virus and Respiratory syncytial virus were not detected. The occurrence of acute lower respiratory infections was high between 3 & 6 years old. The clinical patterns include pneumonia(51.9%), bronchitis(31.5%), croup(9.3%), bronchiolitis(7.4%). The respiratory viral agents had their characteristic seasonal patterns. Conclusion : Influenza A virus was the most common cause of acute lower respiratory tract infections in Busan area during the 2002. ALRTIs had high occurrence between 3 to 6 years old. And the most common clinical patterns were pneumonia and bronchitis.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.48-53
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• 2011

Purpose : Early diagnosis of active tuberculosis (TB) in children is difficult. The widely used tuberculin skin test has low sensitivity and cross reactivity with non-tuberculous mycobacteria or Bacille Calmette-Gu$\acute{e}$rin vaccination. Interferon gamma release assays have been shown good diagnostic accuracy for active in adults. But studies in children were limited. The purpose of this study was to examine the performance of enzyme-linked immunospot assay (ELISpot) as an initial test in the diagnosis of active tuberculosis in children. Methods : In a hospital-based study, we prospectively examined the performance of ELISPot in 33 children suspected of active TB. TB was confirmed bacteriologically or histologically. Results : Among 33 patients, 9 had active tuberculosis. When tested, they all had a positive test result from the ELISpot. The sensitivity and specificity of the assay were 100% (95% CI, 66.4-100%) and 95.8% (95% CI, 78.9-99.9%) respectively. Conclusion : ELISpot might be an useful and improved clinical diagnostic method for the detection of active TB in children.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.80-84
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• 2011

Empyema necessitatis refers to empyema that extends into the extrapleural space through a defect in the pleural surface. Tuberculous empyema necessitatis is a rare complication of tuberculosis. We experienced a 21-month-old boy with tuberculous empyema necessitatis with osteomyelitis in the right $7^{th}$ rib. He presented with a mass on the right lateral chest wall, which was soft and nontender, enlarging for one month. He also had mild fever. The plain radiograph of his chest revealed soft tissue swelling and calcified lymph node on the left axilla, and his PPD skin test was positive. CT scan of the chest showed empyema necessitatis at the right lower chest and upper abdominal walls with osteomyelitis of the right $7^{th}$ rib. He did not have concurrent pulmonary tuberculosis. Surgery was performed for diagnosis and treatment. In histopathologic findings, chronic granulomatous inflammation with caseation necrosis was shown and was positive for acid fast bacilli stain. In addition, M. tuberculosis complex was found as etiology by polymerase chain reaction. The patient has been treated with anti-tuberculous medication without any specific complication.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.54-60
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• 2011

Purpose : In this study, we listed common diseases in pediatric inpatients and evaluated the distribution of diseases by period and age group, in order to estimate the epidemiologic trend. Methods : Patients who were admitted to the Department of Pediatrics between 1997 and 2008 were included. Demographic characteristics, date of admission, and International Classification of Diseases (ICD) code of patients were indentified. Study period was divided into two; early (1997-2002) and late (2003-2008), and age of patients were grouped into four; infancy, early childhood, late childhood, and adolescence. Results : A total of 33,513 patients were admitted for 12 years. In the list of ICD code, Pneumonia (J12-J18; 21.2%) was the most prevalent, followed by gastroenteritis (A00-A09; 17.8%), bronchiolitis (J21; 11.9%), and so on. Common diseases ranked from 1 to 10 comprised the majority (79.1%) of all the inpatients. There was increase in the number of inpatients with respiratory infectious disease (bronchiolitis, otitis media, and sinusitis), enlarged lymph node, or impetigo/cellulitis, but decrease in the number of inpatients with aseptic meningitis, intussusceptions, measles, or nephritic/nephrotic syndrome. The distribution of diseases also showed age group-specific difference. Conclusion : The distribution of diseases by period and age group was different. The epidemiologic trend should be considered in developing the management of strategy for the Department of Pediatrics.