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Influenza A Outbreak in a Neonatal Intensive Care Unit During the 2011-2012 Influenza Season in Korea (2011-2012년 인플루엔자 국내 유행시기에 신생아 중환자실에서 발생한 A형 인플루엔자 바이러스 집단발병)

  • Son, Ok Sung;Oh, Chi Eun;Kong, Seom Gim;Jung, Yu Jin;Hong, Yoo Rha
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.87-93
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    • 2016
  • Purpose: An outbreak of influenza virus is uncommon in neonatal intensive care unit (NICU). The clinical presentation of influenza virus infection in neonates is diverse. This study was aimed to report an outbreak of influenza A in a NICU and to investigate the clinical characteristics of influenza virus infection in neonates especially preterm infants during the 2011-2012 influenza season in Korea. Methods: We reviewed the medical records of 29 patients who were evaluated by respiratory virus multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) at NICU of Kosin University Gospel Hospital during the 2011-2012 seasonal influenza outbreak in Korea. Results: Eleven patients (37.9%) were influenza A virus RT-PCR positive during the survey periods. They were all preterm infants and three of them had no symptoms. Eight patients had symptoms and it was fever (18%, 2/11), respiratory difficulty (72.7%, 8/11) without symptoms of upper respiratory infection, and gastrointestinal symptoms (27.3%, 3/11). The median duration of symptom was 5 days. There were differences of duration of admission at the test of respiratory RT-PCR, Clinical Risk Index for Babies (CRIB) score, use of mechanical ventilation, and use of dexamethasone before infection between influenza A virus RT-PCR positive and negative group. All 11 patients with influenza A were discharged without any complications. Conclusions: The symptoms of influenza A virus infection in the preterm infants is nonspecific. Influenza A virus should be considered as a possible cause of infection in NICU during the influenza season in the community.

Congenital cystic adenomatoid malformation (선천성 낭포성 선종양기형 -1례 보고-)

  • Sun, Kyung;Baek, Kwang-Je;Lee, Chol-Sei;Chae, Sung-Soo;Kim, Hark-Jei;Kim, Hyung-Mook
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.118-124
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    • 1984
  • Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

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Differential Excretion of Urinary Eosinophil Protein X after Methacholine Challenge Test in Children with Asthma (천식 환아에서 요중 Eosinophil Protein X의 메타콜린 기관지 유발 시험 전·후의 변화)

  • Shin, Su-A;Oh, Jae-Won;Lee, Ha-Baik
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.495-499
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    • 2003
  • Purpose : Eosinophil is one of the important inflammatory cell involved in the airway inflammation in childhood asthma. It has been demonstrated that markers of eosinophil activation, including eosinophil cationic protein or eosinophil protein X(EPX), are increased in childhood asthma. Furthermore, they are related to disease activity and are assumed to be helpful in monitoring the treatment effect as urinary EPX(U-EPX) can be obtained easily and in a noninvasive way in children of all ages. Methods : Twenty-five children(22 male and three female) aged $11.87{\pm}3.82$ years with stable asthma were challenged with methacholine and urine was collected from each child during the following periods; before methacholine challenge test(MCT); 0-3 hr after the end of MCT; 4-7 hr after the end of MCT; and 8-24 hr after the end of MCT. Bronchial reactivity was determined by using Dosimeter( Jeager, Germany) with serially diluted methacholine from 0.05 to 25.0 mg. The $FEV_1$ less than 80% of baseline value were classified into positive MCT. U-EPX was measured with a sensitive and specific radioimmunoassay(Pharmacia & Upjohn AB, Uppsala, Sweden). Results were expressed as ${\mu}gEPX/mmol$ creatinine. Results : An early airway response after MCT was associated with an increase of U-EPX excretion for 0-3 hr after methacholine inhalation in comparison with beseline values. Most subjects showed a small increase in U-EPX excretion during late asthmatic response for 4-7 hr, which then decreased to normal level in 8-24 hr. Also, a tendency for a higher increase of U-EPX was associated with a lower threshold of methacholine challenge and a longer duration of asthma. Conclusion : Measurement of EPX in urine is a noninvasive and easy method to assess the severity of airway inflammation in asthmatic children. It may be a helpful index of the events underlying the airway inflammatory responses during nonspecific bronchial challenge, and in monitoring asthma management.

Immunoscintigraphy of Colorectal and Other Gastrointestinal Cancers with Radioactive Monoclonal Antibodies to CEA and CA 19-9 (대장직장암 및 기타 소화기암에서의 단세포군항체를 이용한 방사면역신티그라피의 진단)

  • Jang, Dae-Hwan;Choi, Duck-Joo;Lee, Bum-Woo;Park, Won;Han, Chang-Soon;Kim, Hak-San;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.83-92
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    • 1988
  • The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

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A Study on the Relationship between Subjective symptoms and Psychological Symptoms on some VDT workers (일부 VDT 사용 근로자의 자각증상과 심리증상과의 관련성 연구)

  • Son, Jeong-Il;Lee, Soo-Jin;Song, Jae-Cheol;Park, Hung-Bae
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.433-449
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    • 1995
  • The study subjects in this study are 295 workers who work on one electronics industry, and they were composed of 93 VDT and 202 non-VDT workers. This study was carried out to obtain the prevalence of subjective symptoms and to compare psychological symptom scores from SCL-90-R between VDT and non-VDT work groups. And to verify the relationship between VDT work related symptoms and psychological symptoms, the author compared SCL-90-R T scores between symptom complaining and non-complaining groups. The results are summarized as follows : 1. Throughout the prevalence study of VDT work related symptoms according to VDT work state, the author could select the final 10 symptoms by sex;'eye fatigue', 'foggy vision', 'neck discomfort or pain', 'shoulder discomfort and pain', 'light headedness', 'dizziness', 'acne', 'itching sensation on face', 'difficulty in concentration', 'memory disturbance' in males, and 'blurred vision', 'foggy vision', 'neck discomfort or pain', 'shoulder discomfort and pain', 'abdominal distention', 'indigestion', 'acne', 'prickling sensation on face', 'difficulty in concentration', 'memory disturbance' in females. 2. Throughout comparison of psychological symptom scores from SCL-90-R between VDT and non-VDT workers, except 'Interpersonal sensitivity' in female, Mean T score were higher in VDT workers, but not significantly different between the two groups. These results indicate that the relation between VDT work status and psychological symptoms are not strongly correlated. 3. Because of the nonspecific characteristics of VDT work related symptoms, from the 40 subjective symptoms, the author selected the final 10 symptoms by sex, especially correlated to VDT, and divided the study subjects into symptom complaining and non-complaining groups. The mean SCL-90-R T scores between the two groups were compared. Except for the opthalmologic symptoms in females, the scores were significantly different between the two groups in all symptoms. And this indicates that the VDT work related symptoms strongly correlated with the present individual psychological conditions. 4. Due to understand that which of the 9 psychological symptom dimensions are strongly correlated with the subjective symptoms, the author excuted muliple logistic regression analysis, and the result were as follows; 'depression' and 'somatization', in male, and 'obsessive-compulsive' and 'somatization' in female.

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A Case of Posttransplant Lymphoproliferative Disease(PTLD) Following Renal Transplantation in a Child (소아에서 신이식후 발생한 Posttransplant Lymphoproliferative Disease(PTLD) 1례)

  • Eun, Byung-Wook;Park, Eun-Sil;Lee, Seong-Yong;Hahn, Hye-Won;Jang, Ju-Young;Park, Kyung-Mi;Kim, Chul-Woo;Kang, Gin-Han;Ko, Jae-Seong;Ha, Il-Soo;Lee, Hoan-Jong;Cheong, Hae-Il;Seo, Jeong-Kee
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.123-130
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    • 2002
  • Posttransplant lymphoproliferative disease (PTLD) represents a diverse lymphoproliferative disorder ranging front nonspecific reactive hyperplasia to malignant immunoblastic sarcoma developed in a setting of immunosuppression following organ or cellular transplantation. It is often associated with Epstein-Barr virus (EBV) infection and high dose immunosuppression. PTLD after renal transplantation was reported at first in adult in Korea in 1997. In children there have been several cases of PTLD after liver transplantation but PTLD after renal transplantation has not been reported. This is a case report of PTLD developed 4 months after renal transplantation in a 9-year-old boy. The major clinical manifestations were fever, multiple lymph nodes enlargement and blood-tinged stool. EBV was detected by in-situ hybridization in the enlarged cervical lymph node and the colonic tissue. Histological examination revealed B-cell lineage. Use of ganciclovir and reduction of the immunosuppression level resulted in complete remission of PTLD. This is the first pediatric case report of PTLD following renal transplantation in Korea. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 123-30)

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Effect of Lead(IV) Acetate on Procoagulant Activity in Human Red Blood Cells

  • Kim, Keun-Young;Lim, Kyung-Min;Shin, Jung-Hun;Noh, Ji-Yoon;Ahn, Jae-Bum;Lee, Da-Hye;Chung, Jin-Ho
    • Toxicological Research
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    • v.25 no.4
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    • pp.175-180
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    • 2009
  • Lead (Pb) is a ubiquitously occurring environmental heavy metal which is widely used in industry and human life. Possibly due to a global industrial expansion, recent studies have revealed the prevalent human exposure to Pb and increased risk of Pb toxicity. Once ingested by human, 95% of absorbed Pb is accumulated into erythrocytes and erythrocytes are known to be a prime target for Pb toxicity. Most of the studies were however, focused on $Pb^{2+}$ whereas the effects of $Pb^{4+}$, another major form of Pb on erythrocytes are poorly understood yet. In this study, we investigated and compared the effects of $Pb^{4+}$, $Pb^{2+}$ and other heavy metals on procoagulant activation of erythrocytes, an important factor for the participation of erythrocytes in thrombotic events in an effort to address the cardiovascular toxicity of $Pb^{4+}$. Freshly isolated erythrocytes from human were incubated with $Pb^{4+}$, $Pb^{2+}$, $Cd^{2+}$ and $Ag^+$ and the exposure of phosphatidylserine (PS), key marker for procoagulant activation was measured using flow cytometry. As a result, while $Cd^{2+}$ and $Ag^+$ did not affect PS exposure, $Pb^{4+}$ and $Pb^{2+}$ induced significantly PS exposure in a dose-dependent manner. Of a particular note, $Pb^{4+}$ induced PS exposure with a similar potency with $Pb^{2+}$. PS bearing microvesicle (MV), another important contributor to procoagulant activation was also generated by $Pb^{4+}$. These PS exposure and MV generation by $Pb^{4+}$ were well in line with the shape change of erythrocyte from normal discocytes to MV shedding echinocytes following $Pb^{4+}$ treatment. Meanwhile, nonspecific hemolysis was not observed suggesting the specificity of $Pb^{4+}$-induced PS exposure and MV generation. These results indicated that $Pb^{4+}$ could induce procoagulant activation of erythrocytes through PS exposure and MV generation, suggesting that $Pb^{4+}$ exposure might ultimately lead to increased thrombotic events.

Mixed Chimerism to Achieve Donor-Specific Transplantation Tolerance for Lung Allografts in Rats (혼합형 동종이인자형 키메라쥐에서 특정공여군의 동종 폐이식펀에대한 관용)

  • Youm, Wook
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.713-722
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    • 1996
  • Poor long term patient survival (60% at 2 years) in lung allograft recipients are mainly due to rejection and complications associated with the use of nonspecific immunosuppressants. Better means to achieve waft acceptance is desperately needed. 1 have investigated whether mixed allogeneic chimerism in the form of bone marrow stem cell engraftment would induce donor-specific tolerance for lung allografts. Fisher (F344) and Wistar Forth (WF)rats were lethally irradiated (1100c0y) and reconstituted with a mixture of T-cell depleted syngeneic and allogeneic bone marrow (F344+WFIWF, ACI +F344- F344). After Mixed chimerism was documented by peripheral blood Ipnphocyte typing at 28 days, orthotopic left single lung transplantation was performed, using donor-s ecific or third party allografts. No immunosuppressants were administered. Graft rejection was monitored by chest rentgenography, and con- firmed by histology Mixed chimeric rats accepted lung allografts permanently, and it was not strain specific effect. Tolerance was all or none phenomenon which had nothing to do with the percentage of chimerlsm. Mixed chimeras rejected third party allografts in less than 10 days, a time course similar to that of unmanipulated controls. No acute or chronic rejection was observed in donor specific grafts more than 150 days posttransplant. These data suggest that mixed chimerism in the form of bone marrow stem cell engraftment results in stable, systemic donor-specific transplantation tolerance for lung allografts.

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Isolation and charaterization of a microbial antihemorrhagic substance on snake venom (사독의 출혈인자에 작용하는 미생물성 유출혈물질)

  • 서정훈
    • Microbiology and Biotechnology Letters
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    • v.14 no.2
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    • pp.145-153
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    • 1986
  • For the inactivation of venoms, the chemical methods are generally applied. In the chemical method many works have been carried out with the chemical reagents and immunological antiserums. However, all inhibitory effect of these chemicals acting on snake venomes may well be due not to the specific, but to the nonspecific inhibitory action. Therefore, it is necessary to separate venom into its compositional active proteins and develop specific inhibitor which acts on the each protein. Until now, there have not been any reports about the substance which acts on snake venom as a specific inhibitor. Recently in 1979, we had actually isolated a specific venom inhibitor(ISV) which has a strong inhibitory activity against the proteinase of snake venom of Colubridae. In our experiments described here, a strain of Aspergillus sp., isolated from soil, was able to produce a biological active substance. The partial crystallized substance had a strong inhibitory activity against hemorrhagic action of snake venom of Colubridae. For the inhibitory action of the sample on the lethality of venom, the substance prevented completely the lethal action of the hemorrhagic factor when they were treated with enough amount of the substance. The edema factor of whole venom of Agristrodon bromohoffi brevicaudus was completely inhibited, but those of HR-I and HR-II of Trimeresurus flavoviridis venom were inhibited about 50%, when they were treated with the substance of half amount of venom. On the other hand, from the result of subcutaneous hemorrhage in a rabbit, it was concluded that two kinds of antihemorrhagic substance might be produced by the strain used in this work.

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Effect of Panax Ginseng Saponin on Metabolism and Ion Transport in Human Erythrocytes (인삼이 적혈구세포의 해당과정 및 막 투과도에 미치는 영향)

  • Kang, Bok-Soon;Han, Kyung-Hee
    • The Korean Journal of Physiology
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    • v.17 no.2
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    • pp.125-133
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    • 1983
  • Red cell glycolytic intermediates, metabolites and metabolic ratios were studied. Glycolytic intermediates were measured in neutralized perchloric acid extracts of red cell suspensions after 3 hr incubation at $37^{\circ}C$ in the presence and absence of saponin. Adenosine triphosphate(ATP), adenosine diphosphate(ADP), pyruvate and lactate were measured by enzymatic procedures involving stoichiometric oxidation or reduction of a pyridine nucleotide. Glucose was determined using glucose oxidase after zinc hydroxide extraction. The redox state was calculated from the lactate dehydrogenase equilibrium. Adenosine triphosphatase activity(ATPase) was measured by determining the amount of phosphate released from ATP by washed erythrocyte membranes(ghost) during 20 min. incubation. Both total hydrolysis and the amount of hydrolysis that occured in the presence of ouabain were measured. The second measurement yields Mg-ATPase and represents nonspecific ATPase activity of the membranes. The difference between total and Mg-ATPase activity can be attributed to Na-K-ATPase. For the measurement of sodium fluxes, human erythrocytes were preincubated in $^{22}Na$ for 3 hr at $37^{\circ}C$, washed and suspended in a tracer-free medium. The amount of $^{22}Na$ transported out of cells at any time was determined by analysis of supernatant samples taken at various time after addition of the labeled cells to isotope-free medium. The cells and medium were separated and the radioactivity appearing in the medium was measured. From the total radioactivity in the suspension and the radioactivity appearing in the medium at known time, the rate constant for sodium release was computed. The results are summarized as follows: 1) ATP and ATP/ADP were found to increase at every concentration of saponin tested whereas ADP declined at every cone. of saponin. The increase in pyruvate and lactate were observed at every cone, of saponin and thus $NAD^+/NADH$ computed from pyruvate/lactate also increased. Glucose utilization was stimulated by saponin. 2) $Na^+-K^+-ATPase$ activities showed a biphasic response to saponin, first increasing in lower concentration and then decreasing in higher concentration of saponin. 3) The efflux of sodium was significantly increased by saponin in the range of 5 to 10 mg%. The stimulatory effect of saponin on the rate constants for active(ouabain-sensitive) sodium efflux was inhibited by addition of ouabain.

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