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Innate Immunity and Genetic Susceptibility to Severe Respiratory Syncytial Virus Infection : Lack of an Association with Mannose Binding Lectin Gene Polymorphism (심한 Respiratory Syncytial Virus 감염증과 선천성 면역에 관련된 유전적 소인에 관한 연구 : Mannose Binding Lectin 유전자 다형성)

  • Choi, Eun Hwa;Kim, Hee Sup;Yun, Bo Young;Choi, Seung Eun;Nah, Song Yi;Kim, Dong Ho;Park, Ki Won;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.13 no.1
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    • pp.63-70
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    • 2006
  • Purpose : We hypothesized that mannose binding lectin gene(MBL2), a key molecule of innate immunity, may contirbute to the development and the outcome of respiratory syncytial virus(RSV) disease in early childhood. This study was performed to investigate the genetic basis of polymorphisms and haplotypes of MBL2 for RSV disease severity in Korean children. Methods : Cases with severe RSV diseases are 99 children with severe RSV lower respiratory tract infections, who were admitted to the Seoul National University Children's Hospital through 1993~2000. The control subjects consisted of 224 anonymous healthy Korean blood donors. The frequency of promoter variant(-221, X/Y) and structural variant(codon 54) were compared between the case patient group and the control subject group. Results : The mean age of patients was 11.8 months; 49% were <6 months, 39% were 6-24 months and 12% were >24 months. In the cohort of cases of severe RSV diseases, the genotypic frequencies of structural variant in codon 54 were 61% for AA, 34% for AB, and 5% for BB. Those of the promoter X/Y variant were 85% for YY and 15% for XY. There were no significant differences in overall distribution of both structural and promoter variants between the cases and the control subjects. We did not observe statistical difference in the haplotypic frequencies of MBL2. Conclusion : Common variants of MBL2 gene most likely do not contribute to the risk for severe RSV diseases in Korean children. Further genetic association studies should be conducted in a larger propsectively recruited cohort of children with RSV infection.

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The Bacterial Colonization of Burn Wound and the Changes of Antibiotic Susceptibility in Childhood Burn (January, 1999~December, 2002) (소아 화상의 화상부위 세균 집락화와 항균제 감수성 변화(1999년 1월~2002년 12월))

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam;Lee, Kyu-Man;Oh, Suk-Joon
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.157-165
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    • 2005
  • Purpose : Children occupy a large proportion of burn victims. So we want to aid to pediatric burn care through the understanding of the bacterial distribution in burn wounds and antibiotic susceptibility against isolated microorganisms from burn wounds. Methods : We analysed the medical records of 213 pediatric burn patients(0~15 years), 406 samples that grew bacteria in burn wound sites. Results : Of the total 213 patients, male were 59.6% and female were 40.4%. Scalding burn was the most common(78.4%), flame burn was the second(16.4%). Pathogens were isolated in 406 samples. The most common was Pseudomonas aeruginosa(58.1%). Next were Enterococcus species, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus species, Acinetobacter species. P. aeruginosa was resistant to trimethoprim-sulfamethoxazole in 100%, cephalothin in 98.1%, ampicillin-sulbactam in 96.2%, ampicillin in 95.3%, ceftriaxone in 95.2%, tobramycin in 93.7%, cefoperazone in 68.9%, ceftazidime in 67.7%. Enterococcus species were resistant to tetracycline in 63.9%, streptomycin in 45.5%, gentamicin in 36.1%, penicillin G in 13.7%. S. aureus was resistant to gentamicin in 89.7%, tetracycline in 86.2%, ciprofloxacin in 86.2%, penicillin G in 84.3%, oxacillin in 78.4%, erythromycin in 76.5%. Acinetobacter species were resistant to ampicillin-sulbactam in 100%, gentamicin in 85.7%, ampicillin in 83.3%, piperacillin in 61.5%. Conclusion : P. aeruginosa was highly resistant to drugs like cefoperazone in 68.9%, ceftazidime 67.7%. S. aureus was highly resistant to penicillin G in 84.3%, oxacillin in 25.9 %, but none to vancomycin in 0%, teicoplanin in 2.2%. According to the study, Acinetobacter species turned out to be multi-resistant strains, so careful attention must be paid to the choice of antibiotics.

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Implementation and Evaluation of the Electron Arc Plan on a Commercial Treatment Planning System with a Pencil Beam Algorithm (Pencil Beam 알고리즘 기반의 상용 치료계획 시스템을 이용한 전자선 회전 치료 계획의 구현 및 정확도 평가)

  • Kang, Sei-Kwon;Park, So-Ah;Hwang, Tae-Jin;Cheong, Kwang-Ho;Lee, Me-Yeon;Kim, Kyoung-Ju;Oh, Do-Hoon;Bae, Hoon-Sik
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.304-310
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    • 2010
  • Less execution of the electron arc treatment could in large part be attributed to the lack of an adequate planning system. Unlike most linear accelerators providing the electron arc mode, no commercial planning systems for the electron arc plan are available at this time. In this work, with the expectation that an easily accessible planning system could promote electron arc therapy, a commercial planning system was commissioned and evaluated for the electron arc plan. For the electron arc plan with use of a Varian 21-EX, Pinnacle3 (ver. 7.4f), with an electron pencil beam algorithm, was commissioned in which the arc consisted of multiple static fields with a fixed beam opening. Film dosimetry and point measurements were executed for the evaluation of the computation. Beam modeling was not satisfactory with the calculation of lateral profiles. Contrary to good agreement within 1% of the calculated and measured depth profiles, the calculated lateral profiles showed underestimation compared with measurements, such that the distance-to-agreement (DTA) was 5.1 mm at a 50% dose level for 6 MeV and 6.7 mm for 12 MeV with similar results for the measured depths. Point and film measurements for the humanoid phantom revealed that the delivered dose was more than the calculation by approximately 10%. The electron arc plan, based on the pencil beam algorithm, provides qualitative information for the dose distribution. Dose verification before the treatment should be mandatory.

The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis (임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과)

  • Na, Hyun Jung;Kim, Ji Young;Lee, Gyeong Hoon;Lee, Jun Hwa;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1187-1192
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    • 2005
  • Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

Development of Preliminary Quality Assurance Software for $GafChromic^{(R)}$ EBT2 Film Dosimetry ($GafChromic^{(R)}$ EBT2 Film Dosimetry를 위한 품질 관리용 초기 프로그램 개발)

  • Park, Ji-Yeon;Lee, Jeong-Woo;Choi, Kyoung-Sik;Hong, Semie;Park, Byung-Moon;Bae, Yong-Ki;Jung, Won-Gyun;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.113-119
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    • 2010
  • Software for GafChromic EBT2 film dosimetry was developed in this study. The software provides film calibration functions based on color channels, which are categorized depending on the colors red, green, blue, and gray. Evaluations of the correction effects for light scattering of a flat-bed scanner and thickness differences of the active layer are available. Dosimetric results from EBT2 films can be compared with those from the treatment planning system ECLIPSE or the two-dimensional ionization chamber array MatriXX. Dose verification using EBT2 films is implemented by carrying out the following procedures: file import, noise filtering, background correction and active layer correction, dose calculation, and evaluation. The relative and absolute background corrections are selectively applied. The calibration results and fitting equation for the sensitometric curve are exported to files. After two different types of dose matrixes are aligned through the interpolation of spatial pixel spacing, interactive translation, and rotation, profiles and isodose curves are compared. In addition, the gamma index and gamma histogram are analyzed according to the determined criteria of distance-to-agreement and dose difference. The performance evaluations were achieved by dose verification in the $60^{\circ}$-enhanced dynamic wedged field and intensity-modulated (IM) beams for prostate cancer. All pass ratios for the two types of tests showed more than 99% in the evaluation, and a gamma histogram with 3 mm and 3% criteria was used. The software was developed for use in routine periodic quality assurance and complex IM beam verification. It can also be used as a dedicated radiochromic film software tool for analyzing dose distribution.

Prognostic Factors in Children with Henoch-$Sch{\ddot{o}}nlein$ Purpura Nephritis (소아 Henoch-$Sch{\ddot{o}}nlein$ 신염의 예후 인자)

  • Choi Hyun Jin;Cho Hee Yeon;Kim Eo Jin;Lee Byong Sop;Kang Hee Gyung;Ha Il Soo;Cheong Hae Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.183-192
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    • 2005
  • Purpose : The long term disease course and prognostic factors were evaluated in childhood Henoch-$Sch{\ddot{o}}nlein$ puruura nephritis(HSPN). Methods : A total of 75 children(44 boys and 31 girls) with HSPN were included in this study. The onset age was $8.0{\pm}3.1$ years(2.3-l5.3 years), and the follow-up period was $4.3{\pm}3.6$ years(1.0-17.1 years). Kidney biopsy was done in 24 children(32$\%$). Initial clinical and laboratory findings were evaluated. In addition, polymorphisms of the renin angiotensin system(RAS) genes(insertion/deletion in intron 16 of ACE gene, M235T in AGT gene, and A1166C in AGTR gene) were analysed. The initial and last clinical states were classified into 4 groups as follows A, normal; B, minor urinary abnormalities; C, active renal disease (nephrotic-range proteinuria and/or hypertension with serum creatinine $\leq$1.5 mg/dL); D, renal insufficiency. Results : At the onset, the clinical states of the patients were B in 26(35$\%$), C in 46(61$\%$), and D, in 3(4$\%$). The distribution of the RAS gene polymorphism of HSPN were not different from that of 100 healthy control subjects. At the last follow-up, the clinical states of the patients were A in 23(31$\%$), B in 38(50$\%$), C in 9(12$\%$), and D in 5(7$\%$). A multiple logistic regression identified age at the onset and initial urine protein excretion as significant prognostic factors. Analysis of genotypes of the 3 RAS genes as prognostic values revealed no statistical significance. Conclusion : Older age at onset and severe proteinuria were identified as poor prognostic factors of childhood HSPN. Implication of the RAS gene polymorphism In HSPN could not be validated in this small-scale retrospective study. (J Korean Soc Pediatr Nephrol 2005;9:183-192)

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Angiotensin-converting Enzyme Gene Polymorphism and Cerebrovascular Disease in Korean population (한국인의 ACE(Angiotensin-converting Enzyme) 유전자의 다형성과 뇌혈관 질환과의 관계에 대한 연구)

  • Lee Jin Woo;Lee Kyung Jin;Rho Sam Woong;Kim Jae Jong;Bae Hyung Sup;Hong Moo Chang;Shin Min Kyu;Kim Young Suk;Bae Hyun Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.4
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    • pp.724-728
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    • 2002
  • Angiotensin-converting enzyme (ACE) gene polymorphism, which consists of presence (insertion, I) or absence (deletion, D) of a 250-bp fragment, is associated with ischemic heart disease, renovascular disease, systemic lupus erythematosus. Subjects with the DD genotype have higher levels of circulating ACE than subjects with the II genotype and show an increased tendency towards vascular wall thickness and contribute to the development of vascular disease. But the association between I/D polymorphism of the ACE gene and cerebrovascular disease is still controversial. The aim of this study was to determine whether the DNA polymorphism of the ACE are associated with cerebrovascular disease in Korean population. The study group comprised 377 Korean patients admitted to Kyunghee Oriental Medical Center in the year of 2000 for the treatment of brain infarction or brain hemorrhage. Magnetic resonance imaging(MRI) was performed for each patient to determine the stroke phenotype, infarction or hemorrhage. The 183 subjects without evidence of brain infarction or brain hemorrhage were selected from the some ethnical population(control group). Venous blood samples were drawn from each subject for the extraction of DNA. Genotypes of ACE were determined by polymerase chain reaction amplification of the genomic DNA. Case and control genotype frequencies were compared by chi-square testing. Both the patients and the controls were classified respectively into 4 groups: age less than forty years, age forty one to fifty, age fifty one to sixty, age greater than sixty years. There were no significant differences in the distributions of ACE genotypes among the patients with infarction, with hemorrhage and controls (Infarction: D/D 15.8%, I/D 46.7%, I/I 37.5%, Hemorrhage: D/D 15.1%, I/D 46.5%, I/I 38.4%, Control: D/D 18.6%, I/D 50.3%, I/I 31.2%). There was a significant difference in the distribution of ACE genotypes between the age greater than sixty year subgroup of patient with brain hemorrhage and the control (Hemorrhage: D/D 0%, I/D 55.6%, I/I 44.4%, Control: D/D 13.0%, I/D 63.0%, I/I 23.9%; Pearson Chi-Square value 5.956, P<0.05). Furthermore, the frequency of the ACE D/D type declined with increasing age both in the patient and control group (Patient group: age < 50 D/D 21.5%, age > 50 D/D 14.42%; Control group: age < 50 D/D 21.0%, age > 50 D/D 14.2%). In conclusion there is no clear association between ACE polymorphism and cerebrovascular disease in Korean population. Although, there was a tendency for the frequency of the ACE D/D type declined with increasing age in both patients and controls.

Comparison of Dose When Prescribed to Point A and Point H for Brachytherapy in Cervical Cancer (자궁경부암 근접치료에서 A점과 H점을 이용한 치료계획 시 선량 비교)

  • Gang, Ji-Hyeong;Gim, Il-Hwan;Hwang, Seon-Boong;Kim, Woong;Im, Hyeong-Seo;Gang, Jin-Mook;Gim, Gi-Hwan;Lee, Ah-Ram
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.61-66
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    • 2012
  • Purpose: The purpose of this study is to compare plans prescribed to point A with these prescribed to point H recommended by ABS (American Brachytherapy Society) in high dose rate intracavitary brachytherapy for cervical carcinoma. Materials and Methods: This study selected 103 patients who received HDR (High Dose Rate) brachytherapy using tandem and ovoids from March 2010 to January 2012. Point A, bladder point, and rectal point conform with Manchester System. Point H conforms with ABS recommendation. Also Sigmoid colon point, and vagina point were established arbitrarily. We examined distance between point A and point H. The percent dose at point A was calculated when 100% dose was prescribed to point H. Additionally, the percent dose at each reference points when dose is prescribed to point H and point A were calculated. Results: The relative dose at point A was lower when point H was located inferior to point A. The relative doses at bladder, rectal, sigmoid colon, and vagina points were higher when point H was located superior to point A, and lower when point H was located inferior to point A. Conclusion: This study found out that as point H got located much superior to point A, the absorbed dose of surrounding normal organs became higher, and as point H got located much inferior to point A, the absorbed dose of surrounding normal organs became lower. This differences dose not seem to affect the treatment. However, we suggest this new point is worth being considered for the treatment of HDR if dose distribution and absorbed dose at normal organs have large differences between prescribed to point A and H.

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The alteration of the positive rate of cytomegalovirus IgG antibody among preschool period children (학령 전기 소아에서 거대세포바이러스 IgG 항체 양성률의 변동)

  • Seo, Se-Young;Park, Sang-Jun;Hwang, Ja-Young;Hahn, Seong-Hoon;Kim, So-Young;Kim, Hyun-Hee;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.51-55
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    • 2006
  • Purpose : In order to evaluate the time of disappearance of cytomegalovirus(CMV) IgG antibodies from mothers, and the alteration of the positive rate of CMV IgG antibodies among preschool period children, we investigated the positive rate of CMV antibodies among preschool children. Methods : We studied 391 children who visited the Department of Pediatrics from March, 2001 to February, 2004. We measured the serum CMV IgG of 217 children and the serum CMV IgM of 358 children. Results : The positive rate of CMV IgG antibodies is 83.9 percent(the number of positive IgG children is 182 out of 217). The alteration of the positive rate is 92.9 percent in 0-3 months, 75.0 percent in 4-6 months and the nadir was 20.0 percent in 7-9 months. Then, the positive rate increased to 83.9 percent in 22-24 months. After 22 months, the positive rate was 92.1 percent(the number of positive IgG children was 105 out of 114). The positive rate of CMV IgM antibody by age is 3.3 percent in 0-1 months, 3.6 percent in 1-2 months, 10.5 percent in 2-3 months, 14.3 percent in 3-4 months, 14.3 percent in 4-5 months, and then the results of five children among 148 children were positive. The distribution was one in 22-23 months, one in 25-26 months, one in 27-28 months, one in 28-29 months, one in 40-41 months. We discovered IgM positive children succesively from birth to 5 months, but sporadically after 5 months. Conclusion : The CMV IgG from mothers has decreased since birth and the time of nadir is 7-9 months. But it increases to a mean value of 83.9 percent at 22-24 months because of perinatal or postnatal infections.

Assessment of the Value and Distribution of Geological Heritages in Korea: Jeolla Province (한국의 지질유산 분포와 가치평가: 전라권)

  • Cho, Hyeongseong;Kang, Hee-Cheol;Kim, Jong-Sun;Cheong, Daekyo;Paik, In Sung;Lim, Hyoun Soo;Choi, Taejin;Kim, Hyun Joo;Roh, Yul;Cho, Kyu-Seong;Huh, Min;Shin, Seungwon
    • The Journal of the Petrological Society of Korea
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    • v.28 no.4
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    • pp.319-345
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    • 2019
  • Recently planification and effort for management, assessment and discovery of geological heritagesare being increasingly demanded with institutional strategies such as geopark, as their preservation is asked socially. In this study, we discovered geological heritages in the Jeolla Province and then performed assessment of the value and grading of them and finally suggested a promising and suitable site for the National Geopark. A total of 325 geological heritages are listed on literature review and then detailed description in field and assessment of the value for selected 158 geoheritages are completed. The assessment items are categorized into intrinsic value, subsidiary value, and preservation/management part. The intrinsic value is subdivided into scientific/educational value, composed of representativeness, rarity, geodiversity, typicality, reproducibility, and particularity, and geomorphological/landscape value composed of scale, naturality (integrity), scenery (aesthetic value). Also, subsidiary value consist of 7 subsections of soil function, ecological function, tourism value, geological resource, historical value, folk tale or legend and symbolic value, and accessibility, convenient facility (infrastructure), management condition (legal protection) is evaluated in preservation/management part. The heritages in the Jeolla Province subdivided into three types: 73 geological heritages, 42 geomorphological heritages, and 42 composite heritages. Based on points acquired in intrinsic value, all geological heritages are graded Class-I to -V. As a result, numbers of geoheritage belong to Class-I (protection at world level), -II (protection at national level), -III (nationdesignated management), -IV (involved management list), -V (candidate management list) are 12, 39, 52, 34, 21, respectively. Finally, we construct database based on Arc-GIS with all informations for each geological heritage and suggest three promising and suitable sites, 'Jirisan-Seomjingang Area' and 'south coast area of Jeolla Province', for the National Geopark.