• Tuberculosis and Respiratory Diseases
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• 제55권4호
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• pp.370-377
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• 2003

연구배경 : 주폐포자충은 HIV 감염자에서 폐렴을 일으키는 주요 원인인데, 최근에 면역 기능이 저하된 환자들이 중가하면서 HIV 비감염자에서 발생되는 PCP가 늘어나고 있다. 연구자들은 HIV 감염자 및 비감염자에서 PCP의 임상 양상을 비교해 보고자 하였다. 방 법 : 1996년부터 2002년까지 연세대학교 의과대학 세브란스 병원에서 PCP로 진단 받은 환자를 대상으로 의무기록을 후향적으로 조사하여 환자들의 연령, 성별, 기저 질환, 면역 억제제의 사용, 검사 소견, 임상적 경과, 치료 및 예후 등에 대하여 알아보았고, HIV 감염자와 비감염자의 임상 양상을 비교하였다. 결 과 : PCP로 진단받은 25명의 환자 중에서 HIV 감염자는 16명, HIV 비감염자는 9명이었다. HIV 감염자의 평균 연령이 ($41.0{\pm}9.6$세) 비감염자보다($47.7{\pm}17.9$세) 낮았으나 통계적 의의는 없었다. HIV 비감염자에서 동반된 기저 질환으로는 혈액학적 악성질환이 7예, 장기 이식 l예, 염증성 질환 l예 등이 있었다. HIV 비감염자 중 77.8%가 2개월 이내에 면역억제제를 복용한 적이 있었다. 방사선 소견은 HIV 감염자에서는 12예(75%)에서 PCP에 전형적인 양측성의 폐문 주위 간유리혼탁 소견을 보였는데, 비감염자에서는 4예(44.4%)에서 전형적 방사선 소견을 나타냈다. HIV 비감염자에는 치료를 위해 스테로이드를 같이 사용한 경우가 6예(66.7%)였는데, 감염자에서는 스테로이드를 같이 사용한 경우는 12 예(75.0%) 였다. 인공 호흡기 치료를 시행한 경우는 HIV 비감염자에서는 2예(22.2%)였고, 감염자에서는 6예(37.5%)였다. HIV 비감염자의 사망률은 11.1% 였으나, 감염자의 사망률은 50.0% 였다. 결 론 : PCP는 HIV 감염자와 비감염자에서 다른 임상양상을 나타내는 경향이 있었으며, 향후 HIV 감염자 및 비감염자에서의 PCP의 위험 인자, 치료 및 예후, 예방 요법의 적응 및 지침 등에 대한 보다 많은 예에서의 전향적인 연구가 필요하다고 생각된다.

• Pediatric Infection and Vaccine
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• 제19권3호
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• pp.89-110
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• 2012

Meningococcal Disease, manifesting as meningitis and septicemia, is a life-threatening bacterial infection that results in significant morbidity and mortality, particularly in childhood. Its epidemic potential and limited opportunities for clinical intervention due to its rapid course present unique public health and clinical challenges. Incidence is highest in infants and young children, with a secondary peak of risk in adolescents. Approximately 10% of cases are fatal and survivors can be left with serious and permanent sequelae including amputations, hearing loss and cognitive impairment. Transmission is only from human-to-human, by infected respiratory tract secretions or saliva and therefore crowding poses a tremendously elevated risk for disease development. Military recruits and university students are at high risk due to the high carriage rate in adolescents, their behavior patterns and close contact. Menveo$^{(R)}$ (Novartis Vaccines and Diagnostics), a novel quadrivalent meningococcal conjugate vaccine directed against meningococcal serogroups A, C, W-135 and Y, has been shown to be immunogenic and well tolerated in all age groups and was recently licensed for use in Korea. Recent cases and deaths among military recruits drew public attention to their elevated risk and the Korean government has recommended vaccination of all new military recruits. Many Korean students seek to attend school, university, or language institutes in countries where routine meningococcal vaccination is required - clinicians should be aware of such requirements to ensure that students are vaccinated prior to arrival in the destination country.

• Journal of Preventive Medicine and Public Health
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• 제50권3호
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• pp.195-200
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• 2017

Objectives: Q fever is a zoonotic disease that occurs worldwide; however, little is known about its prevalence in South Korea. We attempted to determine the prevalence of Q fever seroreactivity among Korean slaughterhouse workers and the risk factors for seroreactivity according to the type of work. Methods: The study was conducted among 1503 workers at a total of 73 slaughterhouses and 62 residual-product disposal plants. During the study period, sites were visited and surveys were administered to employees involved in slaughterhouse work, and serological tests were performed on blood samples by indirect immunofluorescence assays. Serological samples were grouped by job classification into those of slaughter workers, residual-product handlers, inspectors and inspection assistants, and grading testers and testing assistants. Employee risk factors were analyzed according to the type of work. Results: Out of 1481 study subjects who provided a blood sample, 151 (10.2%) showed reactive antibodies. When these results were analyzed in accordance with the type of work, the result of slaughter workers (11.3%) was similar to the result of residual-product handlers (11.4%), and the result of inspectors and assistants (5.3%) was similar to the result of grading testers and assistants (5.4%). Among those who answered in the affirmative to the survey question, "Has there been frequent contact between cattle blood and your mouth while working?" the proportions were 13.4 and 4.6%, respectively, and this was identified as a risk factor that significantly varied between job categories among slaughterhouse workers. Conclusions: This study found a Q fever seroreactivity rate of 10.2% for slaughterhouse workers, who are known to be a high-risk population. Contact with cattle blood around the mouth while working was the differential risk factor between job categories among slaughterhouse workers.

• Journal of Microbiology
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• 제43권spc1호
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• pp.65-84
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• 2005

Invasive candidiasis is associated with high morbidity and mortality. Clinical diagnosis is complicated by a lack of specific clinical signs and symptoms of disease. Laboratory diagnosis is also complex because circulating antibodies to Candida species may occur in normal individuals as the result of commensal colonization of mucosal surfaces thereby reducing the usefulness of antibody detection for the diagnosis of this disease. In addition, Candida species antigens are often rapidly cleared from the circulation so that antigen detection tests often lack the desired level of sensitivity. Microbiological confirmation is difficult because blood cultures can be negative in up to 50% of autopsy-proven cases of deep-seated candidiasis or may only become positive late in the infection. Positive cultures from urine or mucosal surfaces do not necessarily indicate invasive disease although can occur during systemic infection. Furthermore, differences in the virulence and in the susceptibility of the various Candida species to antifungal drugs make identification to the species level important for clinical management. Newer molecular biological tests have generated interest but are not yet standardized or readily available in most clinical laboratory settings nor have they been validated in large clinical trials. Laboratory surveillance of at-risk patients could result in earlier initiation of antifungal therapy if sensitive and specific diagnostic tests, which are also cost effective, become available. This review will compare diagnostic tests currently in use as well as those under development by describing their assets and limitations for the diagnosis of invasive candidiasis.

• 한국물환경학회지
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• 제28권2호
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• pp.305-312
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• 2012

Avian influenza (AI) and foot and mouth disease (FMD) are two main contagious pathogenic viruses causing massive mortality burial, as burial is a primary measure to quaranteen the causative viruse(s). Biosecurity is a set of preventive measures designed to reduce the risk of propagation of infectious diseases. Main objectives of this paper were to discuss the needs of biosecurity and develop protocol outlines for environmental management of burial sites. Pathological characteristics of contagious viruses should be considered during environmental management practices. Current practice prescribes to minimize the potential for on-farm pollution and the spread of infectious diseases, policy makers should understand robust knowledge regarding biosecurity to make informed decisions on future legislation.

• 대한수의학회지
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• 제46권2호
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• pp.159-164
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• 2006

A stochastic simulation model incorporated with Reed-Frost approach was derived for evaluating diagnostic performance of a test used for a screening program of an infectious disease. The Reed-Frost model was used to characterize the within-herd spread of the disease using a hypothetical example. Specifically, simulation model was aimed to estimate the number infected animals in an infected herd, in which imperfect serologic tests are performed on samples taken from herds and to illustrate better interpreting survey results at herd-level when uncertainty inevitably exists. From a risk analysis point of view, model output could be appropriate in developing economic impact assessment models requiring probabilistic estimates of herd-level performance in susceptible populations. The authors emphasize the importance of knowing the herd-level diagnostic performance, especially in performing emergency surveys in which immediate control measures should be taken following the survey. In this context this model could be used in evaluating efficacy of a survey program and monitoring infection status in the area concerned.

• 한국환경보건학회지
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• 제41권2호
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• pp.102-115
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• 2015

Objectives: A learning organization was designed and implemented on the basis of the selection criteria and essential elements of knowledge translation theory. Methods: The learning organization was designed on the basis of biosafety harmonization criteria and risk management strategy and was implemented as the learning organization for biosafety management by the National Institute of Health, Korea Centers for Disease Control & Prevention. The effect of knowledge translation in the research institutions by evidence-based policy was verified. Results: The result of applying the knowledge translation theory involving all stakeholders showed a positive reaction in establishing and implementing biosafety management strategy and embodied risk assessment criteria and evoked sympathy with the necessity of learning and using of expert knowledge about risk assessment and risk management. All stakeholders initiated voluntarily action toward new human-network construction and communication between similar organizations. The learning organization's capability expanded the base of knowledge translation. Conclusion: These results showed that a learning organization could enhance the autonomous safety management system by diffusion of knowledge translation.

• 보건행정학회지
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• 제25권2호
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• pp.140-148
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• 2015

Vaccination is the most powerful and useful preparation against infectious diseases. However, developing vaccines costs a lot and requires extensive long-term efforts. Therefore, the government should research and develop vaccines with a national-level policy. To greatly enhance the success rate of vaccine development, the policy should be set up considering priorities such as the current status of domestic research, the importance for public health, the urgency of research. The Delphi technique was utilized to draft this survey, through a brainstorming stage, then two inquiries, and finally the final panel meeting where unresolved items were discussed, to draw the conclusion. Among the results, firstly, the highest ranked item on centralized fields for vaccine development by the Ministry of Health was 'self-sufficiency of vaccines.' Secondly, 'emerging infectious disease' was most highly ranked in prioritized fields of vaccine development and research. Thirdly, for the vaccine that needs to be improved and developed further by the government to improve its efficacy and safety, BCG (Bacille de Calmette) for tuberculosis was ranked the highest on both types (intradermal and subcutaneous injection) from National Immunization Programme (NIP) and non-NIP. As for the high risk pathogens, 'anthrax' and 'smallpox' were first and second, consecutively. Lastly, 'development and control of vaccine candidates' was ranked the highest for the area in need for technique development in order to improve domestic vaccine's research level. The results of this study will be put to good use as basic data for the national vaccine research and development (R&D) policy of the country. This study was first step and more studies should be carried out for the final decision of the national vaccine R&D priority.

• Parasites, Hosts and Diseases
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• 제59권5호
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• pp.507-512
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• 2021

Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggi-do of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
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• pp.340-340
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• 2005