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A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices (경피적 동맥관 폐쇄술에서 최근의 기구들의 전략적 이용과 결과)

  • Kim, Sang Yee;Lee, Soo Hyun;Kim, Nam Kyun;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.488-493
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    • 2009
  • Purpose : The aim of this study was to assess the efficacy and safety of recent-generation patent ductus arteriosus (PDA) closure devices applied by a new selection strategy according to the characteristics of each PDA. Methods : From February 2003 to January 2006, 138 patients underwent transcatheter closure of PDA (study group). According to the size and morphology of each ductus, a COOK Detachable Coil or 'flex' PFM Nit-Occlud was used for a small ductus (group 1, n=43); 'medium' PFM Nit-Occlud (group 2, n=49) for a moderate ductus; and an Amplatzer Duct Occluder (group 3, n=46) for a large ductus. The 83 patients who underwent transcatheter closure of PDA from February 2000 to January 2003 were defined as the comparison group. The Qp/Qs ratio, pulmonary/aorta pressure ratio, and MD of the ductus were compared. Immediate and follow-up results including residual shunts and complications were also evaluated and compared among groups. Results : In all 138 patients, complete occlusions were confirmed without major complications, while procedure failure (n=2, 2.2%), device embolization (n=1, 1.1%), and persistent residual shunt (n=4, 4.5%) were documented in the comparison group. Total complication rates were lower in the study group than in the comparison group (study group, 1.4%; comparison group, 9.0%; P<0.05). Conclusion : A novel strategy adopting the merits of various recent-generation devices for transcatheter closure of PDA provides excellent clinical results with minimal risk.

Questions and Answers about the Humidifier Disinfectant Disaster as of February 2017 (가습기살균제 참사의 진행과 교훈(Q&A))

  • Choi, Yeyong
    • Journal of Environmental Health Sciences
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    • v.43 no.1
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    • pp.1-22
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    • 2017
  • 'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

The Effects of Echinacea Extract on the Gene Expression of Monocytes and Monocyte-derived Dendritic Cells (Echinacea 추출물이 단구와 단구유래 수지상세포의 유전자발현에 미치는 효과)

  • Park, Jun Eun;Choi, Kang Duk;Kim, Sung Hwan;Hahm, Dae-Hyun;Seo, Jong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.779-788
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    • 2005
  • Purpose : Echinacea, a traditional plant medicine has been used as immune-stimulant. Recent studies have revealed that extract of Echinacea has immunostimulatory effects on human blood mononuclear cells. This study was designed for the purpose of screening the genes associated with immunologic effects of Echinacea on monocytes and dendritic cells using a cDNA microarray chip. Methods : $CD14^+$ monocyte cells were cultured for one day with Echinacea extract(final concentration : $50{\mu}g/mL$) in experiment 1, but were cultured without Echinacea in experiment 2. The gene expression of these cultured monocytes was analyzed using the cDNA microarray chip. Dendritic cells produced from $CD14^+$ monocyte were cultured for five days with GM-CSF and IL-4, and then cultured for one day with Echinacea in experiment 3, but were done without Echinacea in experiment 4. Results : In experiments 1 and 2, there were 17 significantly expressed genes with average expression ratios above 2.5, including interferon gamma-inducible protein 30(IFI 30), CDC(cell-division-cylcle)-like kinase 2(CLK 2), syndecan binding protein(syntenin), superoxide dismutase 2, etc. In experiments 3 and 4, there were 24 gene, with significantly expressed genes were 24 genes, which were insulin-like growth factor 2(somatomedin A), methyl-CpG binding domain protein 3, IFI 30, small inducible cytokine subfamily A, member 22, etc. The genes encoding CD44, IFI 30, mannose receptor C type 1(MRC 1), chemokine receptor 7(CCR 7), CLK 2, syntenin and cytochrome C oxidase subunit VIII were significantly expressed in both monocytes and dendritic cells cultured with Echinacea. Conclusion : This study employed a cDNA microarray chip to elicit the immune-associated gene profile; the expression was enhanced by Echinacea in CD14+ monocytes and dendritic cells. Thus we laid the basis for the quantitative and functional analysis of genes induced by Echinacea in monocytes and monocyte-derived dendritic cells.

Epidemiological Studies on Giardia Infection Associated with environmental Pollution (Giardia에 의한 환경오염(環境汚染)과 감염(感染)에 관한 역학적(疫學的) 연구(硏究))

  • Lee, Keun-Tae;Kim, Seok-Chan;Song, Jong-Sool;Chung, Pyung-Rim
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.56-66
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    • 1984
  • Giardia lamblia is a pathogenic flagellate causing intestinal disorders such as diarrhea, abdominal pain and malabsorption of nutrients. Giardia is mainly infected by the ingestion of contaminated foods per os. Craun (1979) has recently reported that mass infection of this flagellate through the contaminated water supply systems is one of public health hazards. Also, so-called traveller's diarrhea is sometimes caused by Giardia infection (CDC, U.S.A., 1971). However, a few epidemiological studies figuring out the mode of infection or control measures of Giardia infection has been done so far in Korea. The present study was aimed to know the prevalence of Giardia infection in several Korean populations, detectability of this flagellate in water systems and the viability of the cysts against sewages and disinfectants applying to drinking water. In the present study, 388 stool specimens from orphanage children in Chun-joo, Chung-joo, On-yang and Chun-an areas and 538 stool specimens from inhabitants in Woo-do, In-chon, and Chun-joo were examined by formalin-ether concentration technique to detect out Giardia cysts. On the other hand, water samples from 14 sites of Han River and its tributaries were collected in May through July, 1984. Fifty liter of water sample in each sampling site was then filtered through water filtering system deviced by U.S. Environmental Proutection Agency and the sediments rinsed out from the thread rolls, a part of water filtering system, were examined to detect out the Giardia cysts. In order to observe the viability of Giardia cysts in the sewage samples, the cysts were treated in it at $4^{\circ}C$ or $25^{\circ}C$ for 7 through 28 days. For this purpose, the cysts were also exposed to various concentrations of disinfectants such as chlorine, iodine and ozone gas for proper time intervals. After treatment, the viability test of the Giardia cysts were carried out by method of Rice and Schaefer (1981) with minor modification. The results obtained in this study were as follows : 1) The detection rates of G lamblia cysts in the stool specimens were 18.3% in orphans and 4.3% in general examinees. 2) The prevalences of Giardia Infection were higher in the young age groups than in-adults. The highest positive rate was 18.4% in the age group less than 10. 3) Of 14 water specimens sampled from Han River system and its tributaries around the Seoul area, the Giardia cysts were detected from 4 samples, and no cyst was found in the water supply systems. 4) The cysts treated in the sewage survived for 28 days at $4^{\circ}C$ and for 13 days at $25^{\circ}C$. 5) The cysts were completely destroyed within 60 minutes by exposure to 8 mg/l of residual chlorine at 4g and within 30 minutes by exposure to the same concentration of chlorine at $25^{\circ}C$. 6) The cysts were all dead when exposed to 1 mg/1 of iodine for 60 minutes at $4^{\circ}C$ or $25^{\circ}C$. 7) The cysts were destroyed after 10 minute exposure in 0.15 mg to 0.25mg of residual ozone gas per liter. Summarizing the above results, it is considered that Giardia infection is regarded as water-borne disease and the cysts are able to be controlled by the application with the disinfectants in the water supply systems.

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Monitoring of Microorganism Contamination in Children-Preferred Confectioneries in Korea (서울·경인지역 유통판매중인 과자류의 위생지표 세균 및 식중독균 오염도 조사)

  • Koo, Eun Joo;Chung, So Young;Park, Ji Eun;Kwon, Yu Jihn;Seo, Dong Hyuk;Jung, Yu Young;Cho, Kyong Chul;Lee, Yo A;Min, Hee Eun;Kim, Eu Gene;Kim, Hyun Jung;Kim, Seul Ki;Choi, Sun Ok;Lim, Chul Ju
    • Journal of Food Hygiene and Safety
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    • v.29 no.4
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    • pp.322-326
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    • 2014
  • According to Centers for Disease Control and Prevention (CDC, USA) recently it was reported that the children (< 5 year-old children) were more susceptible to Foodborne-illness. Confectionery products should be strictly controlled because they are children-preferred foods. Ministry of Food and Drug Safety (MFDS, South of Korea) tried to monitor contamination of organisms in confectionery products (such as biscuits, candies, chewing gums and ice candies) distributed in South Korea. MFDS evaluated the levels of indicator organisms: total aerobic bacteria, coliforms, Escherichia coli as well as the levels of food-borne illness organisms: Staphylococcus aureus, Bacillus cereus, Clostridium perfringens. Experimental plans for microbiological test were in accordance with the International Commission on Microbiological Specifications for Food (ICMSF). For this study, 1,005 samples were collected and from Seoul and Gyeongin region, South Korea. The average level of total aerobic bacteria in 1,005 samples was 1.7 log Colony Forming Unit(CFU)/g and the detection rate was 26.8%. The average level of Bacillus cereus was detected in 1.7 log CFU/g and the rate was 0.9%. There was no detection of coliforms, Escherichia coli, Staphylococcus aureus and Clostridium perfringens. The results of this study will be provided as the basic data to set the reasonable microbiological criteria of Korea Food Code.