• Title/Summary/Keyword: 혈청양성전환

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Post-exposure Treatment and Seroconversion to Blood-borne Viruses after Needlestick Injuries among Healthcare Personnel (의료종사자의 주사침 손상 사고 후 감염예방처치와 혈액매개바이러스 혈청양성전환)

  • Jeong, Jae Sim
    • Journal of Korean Biological Nursing Science
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    • v.16 no.1
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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.

Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patient (만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.483-496
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7.%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두 (100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명중 3명(23.1%)에만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되며 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성전환의 동반이 흔한 것으로 나타났다.

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Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patients (만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.329-336
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두(100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명 중 3명(23.1%)에서만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되면 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성 전환의 동반이 흔한 것으로 나타났다.

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Combined Therapy of Alfa-Interferon and Thymodulin on Children with Chronic Active Hepatitis B (소아의 B형 만성 활동성 간염에서 저용량 ${\alpha}$-Interferon과 Thymodulin의 병용 치료 효과)

  • Choe, Byung-Ho;Ko, Cheol-Woo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.79-89
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    • 1998
  • Purpose: Though many antiviral or immunomodulatory agents have been used in patients with chronic HBV hepatitis, interferon is considered to be the only effective therapeutic agent so far. Among immunomodulatory agents, thymodulin, the oral form of thymosin, is currently in clinical trial. We compared the efficacy of alfa-interferon therapy alone with a combined therapy of alfa-interferon and thymodulin in children with chronic active hepatitis B. Method: Twenty three children aged 4.4~13.7 years who were known to be positive for HBsAg and HBeAg in serum for at least 6 months and who had biopsy-proven chronic active hepatitis were given either combined therapy of alfa-interferon and thymodulin or alfa-interferon alone, and all children were HBV DNA positive in their serum at the beginning. Follow-ups have been done for at least 1 year after a 6 month course of therapy and clearance of viral replication markers has been evaluated. Results: 1) During follow up period, 11 (48%) children were seroconverted to anti-HBe and were cleared of HBV DNA from their serum. However, 2 of them relapsed after discontinuance of interferon therapy. 2) Seroconversion occurred more frequently among those who had not been vertically transmitted, had elevated serum ALT levels and low HBV DNA levels before interferon therapy. 3) There was no significant advantage of the combined therapy with thymodulin compared to interferon therapy alone. Conclusion: Combined therapy of alfa-interferon and thymodulin failed to demonstrate synergistic effect. We think that combination therapies of alfa-interferon with other antiviral or immunomodulatory agents need to be studied in order to achieve better therapeutic responses.

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Serologic follow-up Study in neurocysticercosis patients by ELISA after praziquantel treatment (프라지콴텔 치료후 효소면역측정법에 의한 뇌 유구낭미충증 환자의 혈청학적 추적검사)

  • Cho, Seung-Yull;Kim, Suk-Il;Kang, Shin-Yong
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.159-170
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    • 1986
  • A total of 69 patients of confirmed neurocysticercosis was followed serologically by ELISA up to 22 months after praziquantel treatment. The intervals and numbers of follow-up were variable by patient. Serially collected samples of serum and CSF were examined simultaneously for their specific IgG antibody levels by ELISA, using cystic fluid, saline extracts of bladder wall and scolex as antigen. Within 4 months after praziquantel treatment, the antibody levels were elevated temporarily in both serum and CSF in most patients. In some cases antibody levels exhibited steady declining tendency after the treatment. Concomitant administration of dexamethasone appeared to suppress the elevation of antibody levels. The rate of mean absorbance of antibody changed more in serum than in CSF. The rate of elevation was greater in antibodies to parenchymal antigens than that to cystic fluid, but absolute difference of antibody levels was greater in antibody to cystic fluid. Previously negative samples for IgG antibody may become positive after the praziquantel treatment, which could be used as a complementary tool (provocation test) in serodiagnosis. One month was considered to be sufficient interval for the follow-up test for that purpose. In the follow-up of up to 22 months, only few cases of chronic neurocysticercosis showed declining tendency of IgG antibody levels below negative range. During acute encephalitic attacks in chronic patients, IgG antibody to parenchymal antigen were elevated in CSF temporarily. These results indicated that serologic follow-up of every year was recommendable to differentiate the cured patients from chronic patients with slowly calcifying lesions.

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A Study on the Seropositivity of HBsAg among Biennial Health Examinees ; A Nation-wide Multicenter Survey (1998년 한국인 성인에서 혈청 HBsAg 양성률 추정을 위한 조사연구)

  • Kim, Dae-Sung;Kim, Young-Sik;Kim, Jae-Yong;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.129-135
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    • 2002
  • Objective : The primary objective of this study was to estimate the prevalence of HBsAg-positives in the late 1990's among Korean adults. In addition, we evaluated the association of age, a residential area, a vaccination rate, a family history of chronic liver diseases and a past history of acute liver disease with the seropositivity of HBsAg, and estimated the prevalence of chronic HBV infection by follow-up for 6 month or more. Methods : A total of 10 areas, six metropolitan and four small cities, were selected. In each cities, one health screening center was selected for recruitment of study subjects. The study subjects were enrolled from a general health examination program that is provided by medical insurance companies. Questionnaires on various risk factors were administered to the study subjects. Sera was drawn and tested for HBsAg by radioimmunoassay. HBeAg and ALT were also tested for those of HBsAg positive. The HBsAg positives was retest for HBsAg 6 months later Results : Among the study subjects (n= 1816), the seroprevalence of HBsAg was 5.5% (95% CI=4.5%-6.6%), 7.4% in men (95% CI=5.8-9.4) and 3.6% in women (95% CI=2.5-5.0). A past history of acute liver disease and a family history of chronic liver diseases was shown to be risk factors for HBsAg positivity. Among the 31 HBsAg-positives, negative seroconversion rate was estimated to be 3.2%, Thus, prevalence of chronic HBV infection was estimated to be 5.3% (95% CI=3.7-6.6). Conclusion : In this study, the HBsAg seroprevalence rate was lower than that of the other studies in 1980's, particularly in young adult and women. Considering the public health importance of liver cancer and chronic liver diseases, the further effort is needed to prevent and reduce the HBV infection.

The Comparison of Interferon-${\alpha}$ Treatment by Dosages and Retreatment for Chronic Hepatitis B in Children (소아 만성 B형 간염 환아에서 Interferon-${\alpha}$의 용량 차이 및 재치료에 따른 치료 효과 비교)

  • Jang, Chang-Hwan;Lee, Kyung-Hee;Hwang, Wi-Kyung;Oh, Ki-Won;Park, Woo-Saeng;Lee, Jun-Hwa;Ko, Cheol-Woo;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.152-160
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    • 2003
  • Purpose: We compared the therapeutic efficacy of low dose with that of standard dose of interferon (IFN) treatment and also compared the first IFN treatment with retreatment. Methods: We have studied 51 children (age, 2~14) treated for chronic hepatitis B from March 1990 to August 1999. Twenty seven children had been treated with $3\;MU/m^2$ ($2.66{\pm}0.66\;MU/m^2$) of IFN-${\alpha}$ three times a week for 6 months (range, 6~12 months), whereas 24 children with $6\;MU/m^2$ ($4.45{\pm}0.94\;MU/m^2$). There was no significant difference in gender, age, initial ALT and HBV DNA levels between each comparative group. Results: Among the 27 children treated with $3\;MU/m^2$ of IFN, ALT level had normalized in 11 children (41%) and anti-HBe seroconversion occurred in 9 children (33%) one year after the initiation of treatment. In comparison, among the 24 children treated with $6\;MU/m^2$ of IFN, ALT normalized in 12 children (50%) and anti-HBe seroconversion occurred in 7 children (29%). In comparing the first treatment group to retreatment group, ALT level had normalized in 23 children (45%) and anti-HBe seroconversion occurred in 16 children (31%) among the 51 children treated with the first course of IFN treatment. In comparison, ALT normalized and anti-HBe seroconversion occurred in 3 children (25%) among the retreated 12 children. Conclusion: There was no significant difference in the therapeutic efficacies between $3\;MU/m^2$ and $6\;MU/m^2$ dose of IFN treated groups in ALT normalization and anti-HBe seroconversion. The retreatment efficacy of IFN-${\alpha}$ was as effective as the first treatment.

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EFFECT OF LIPOPOLYSACCHARIDE AND INTERFERON-${\gamma}$ ON THE FORMATION OF OSTEOCLAST-LIKE MULTINUCLEATED CELL FROM CHICKEN BONE MARROW CELLS IN VITRO (세포 배양시 닭 골수세포로부터 파골세포앙 세포형성에 지질다당류와 인터페론 감마가 미치는 영향)

  • Oh, Hong-Kyun;Kim, Jung-Keun;Lee, Jae-Hyun
    • Journal of Periodontal and Implant Science
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    • v.25 no.3
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    • pp.659-667
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    • 1995
  • 파골세포는 조혈기관 단핵의 세포로부터 생성되어 골 홉수에 중요한 역할올 담당하며, 지질다당류는 그람음성균의 세포벽을 이루는 성분으로서 치주질환시 치조골 홉수에 관여한다고 알려져 왔다. 활성화된 림프구, 대식세포와 단핵세포로부터 생성되는 당단백질인 인터페론 감마는 파골세포에 의한 골홉수를 억제한다고 밝혀졌다. 이 연구 논문의 목적은 지질다당류와 인터페론 감마가 닭 골수의 미분화세포가 파골양세포로 전환되는데 어떠한 영향올 주는지를 알아보기 위함이다. 16${\sim}$18 일째의 닭의 배 (chick embryo) 에서 경골을 분리하고 횡절개하여 혈청없는 M-199 배양액에 보관했다. 이것을 9${\mu}m$ filter로 여과시켜서 이미 분화된 파골세포와 기타 다른 분화 세포를 분리했다. 여기에서 파골세포의 전구세포를 얻어 LPS와 IFN-${\gamma}$를 단독 또는 복합처리 하고나서 4일 후에 tartrate resistant acid phosphatase (TRAP) Stain을 시행하고 TRAP 양성이며 핵이 세개 이상인 다핵의 세포형성을 관찰하여 세포를 계수하여 다음과 같은 결과를 얻었다. 1. 닭에서 분리해낸 미분화세포에 0.1. 0.5. 1.0 ${\mu}/ml$ 의 LPS 농도를 처리하고 1 주일간 배양한 결과. 0.1 ${\mu}/ml$ 의 농도에서는 대조군에 비해 TRAP 양성인 파골양세포가 증가하는 경향을 보였으며, 반면에 LPS는 0.5 와 1.0 ${\mu}/ml$ 의 농도에서 세포독성을 보였다.(P<0.05) 2. IFN-${\gamma}$는 50. 500U/ml 의 농도에서 대조군에 비해 TRAP 양성인 파골양세포의 수가 감소하는 경향올 보였다 .3. INF-${\gamma}$는 LPS 에의해 유도된 TRAP 양성인 파골양세포의 형성을 감소시켰고 특히 . 250.500U/ml 의 농도에서 유의 성 있는 감소를 보였다. 위의 결과로부터 LPS는 닭의 골수세포로부터 파골양세포의 형성을 증가시키며 IFN-${\gamma}$는 LPS에의해 유도된 파골양세포수를 감소시킨다는 결론을 얻었다.

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A Clinical Study of Tsutsugamushi Fever in Children during 1997~2000 in the Western Kyungnam Province (최근 4년간 서부 경남지역의 소아에서 발생한 쯔쯔가무시열의 임상적 고찰)

  • Ju, Hye Young;Lee, Jun Su;Kim, Jeong Hee;Yoo, Hwang Jae;Kim, Chun Soo
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.213-221
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    • 2001
  • Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

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Unstable Data of HBe Antigen during Seroconversion from HBe Antigen to Antibody in Chronic Type B Hepatitis (만성B형 간염에서 HBe 항원에서 항체로의 혈청 전환 중에 불안정하게 나타나는 HBe 항원)

  • Shin, Sun-Young;Min, Gyeong-Sun;Noh, Kyung-Woon;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.78-81
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    • 2008
  • Purpose: In this study, we evaluated unstable serum data of HBe antigen (HBeAg) or HBe antibody (HBeAb) in patients who experienced HBeAg seroconversion. This study have been performed to assist a medical technologist in the recognition of patients who were chronically infected with the hepatitis B virus (HBV). Materials and Methods: A total number of 3 patients were enrolled in this study. All patients experienced HBeAg seroconversion. Serum data of HBeAg and HBeAb were measured by radioimmunoassay. Results: The data of HBeAg or HBeAb showed an unstable change during seroconversion from HBeAg to HBeAb in chronic type B hepatitis (CBH). Conclusions: Serum data of HBeAg or HBeAb can change during HBe seroconversion. These data suggest that patients with HBe seroconversion can experience an unstable oscillation of HBeAg or HBeAb value from positive to negative. Unstable data can appear naturally due to the seroconversion process.

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