• Pediatric Infection and Vaccine
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• 제2권2호
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• pp.194-199
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• 1995

Most boys afflicted with panhypogammaglobulinemia, also known as X-linked agammaglobulinemia, remain healthy during the first 6 to 12 months of life because of protection by maternally transmitted IgG antibodies. Thereafter, they repeatedly acquire infections with high-grade pathogens, such as pneumococci, streptococci, and hemophilus unless given antibiotics or immunoglobulin replacement therapy. We experienced a case of panhypogammaglobulinemia in a 4 years old boy. He had been suffered from recurrent upper respiratory tract infection, otitis media and pneumonia since late infancy. He was admitted due to right pleural effusion with pneumonia, and streptococcus pneumoniae was isolated from pleural fluid and blood cultures. His immune status revealed panhypogammaglobulinemia and deficiency in mature B lymphocyte. He was treated with appropriate antibiotics therapy, but showed poor responses. He was transferred to department of thoracic surgery, and received minithoracotomy (decortication) operation. He was successfully treated with operation, antibiotics, and IV gammaglobulin infusions. Now he is being followed with periodic IV gammaglobulin replacement therapy.

• 약학회지
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• 제55권1호
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• pp.11-15
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• 2011

Zabofloxacin is a novel broad spectrum fluoroquinolone with excellent anti-pneumococcal activity. We investigated the in vitro activity of zabofloxacin against clinical isolates of gram-positive bacteria and the in vivo activity against systemic infection in mice. Zabofloxacin was very active against gram-positive bacteria except QRSA (Quinolone-resistant S. aureus) and VRE(Vancomycin-resistant Enterococci). Especially, zabofloxacin was extremely potent against clinical isolates of Streptococci. Zabofloxacin was as active as gemifloxacin against systemic infection in mice. In view of its improved antibacterial activities against gram-positive bacteria and good pharmacokinetic profiles in animals, the clinical usefulness of zabofloxacin should be established by further studies.

• Journal of Ginseng Research
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• 제43권2호
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• pp.218-225
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• 2019

Background: Streptococcus pneumoniae, more than 90 serotypes of which exist, is recognized as an etiologic agent of pneumonia, meningitis, and sepsis associated with significant morbidity and mortality worldwide. Immunization with a pneumococcal pep27 mutant (${{\Delta}}pep27$) has been shown to confer comprehensive, long-term protection against even nontypeable strains. However, ${{\Delta}}pep27$ is effective as a vaccine only after at least three rounds of immunization. Therefore, treatments capable of enhancing the efficiency of ${{\Delta}}pep27$ immunization should be identified without delay. Panax ginseng Mayer has already been shown to have pharmacological and antioxidant effects. Here, the ability of Korean Red Ginseng (KRG) to enhance the efficacy of ${{\Delta}}pep27$ immunization was investigated. Methods: Mice were treated with KRG and immunized with ${{\Delta}}pep27$ before infection with the pathogenic S. pneumoniae strain D39. Total reactive oxygen species production was measured using lung homogenates, and inducible nitric oxide (NO) synthase and antiapoptotic protein expression was determined by immunoblotting. The phagocytic activity of peritoneal macrophages was also tested after KRG treatment. Results: Compared with the other treatments, KRG significantly increased survival rate after lethal challenge and resulted in faster bacterial clearance via increased phagocytosis. Moreover, KRG enhanced ${{\Delta}}pep27$ vaccine efficacy by inhibiting reactive oxygen species production, reducing extracellular signal-regulated kinase apoptosis signaling and inflammation. Conclusion: Taken together, our results suggest that KRG reduces the time required for immunization with the ${{\Delta}}pep27$ vaccine by enhancing its efficacy.

• Pediatric Infection and Vaccine
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• 제14권1호
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• pp.116-119
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• 2007

범저감마글로불린혈증은 X 염색체에 의해 유전되는 질환으로 주로 1세 이전에 진단이 가능하지만, 진단이 늦어질 경우 반복된 감염 및 중증 감염으로 인한 심각한 후유증을 남길 수 있으므로 조기 진단과 치료가 매우 중요하다. 증상이 다양하게 나타날 수 있으므로 진단을 위한 각별한 주의가 요구된다. 저자들은 반복적이고 심각한 감염의 병력에도 8세가 돼서야 범저감마글로불린혈증 진단을 받은 환아와 그로 인해 함께 진단 받은 친형의 사례를 경험하였기에 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제23권3호
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• pp.194-201
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• 2016

목적: 폐렴구균은 주요 비인두 상재균으로, 주위 조직을 침범하여 침습성 감염을 일으킬 수 있어 보균율에 대한 감시가 중요하다. 본 연구에서는 임상에서 비인두 흡인물로부터 추출하고 남은 RNA를 이용하여 폐렴구균을 확인할 수 있는 실시간 중합효소 연쇄반응(real-time reverse transcription polymerase chain reaction [RT-PCR])법을 구축하고, 보균율 측정에 있어서의 정확성과 이점을 확인하고자 하였다. 방법: 2014년 9월부터 10월까지 중앙대학교병원에 입원하여 호흡기 바이러스 RT-PCR 검사를 시행받은 18세 이하의 소아들로부터 비인두 흡인물을 채취하였다. 먼저 배양법과 genomic DNA (gDNA)를 이용한 real-time PCR을 시행하여 폐렴구균 검출률의 정확성을 확인하였다. 이 중 처음 20개의 검체를 이용하여, 고전적인 배양법과 gDNA를 이용한 real-time PCR, 그리고 RNA를 이용한 real-time RT-PCR법을 시행하고 이를 비교 분석하였다. 결과: 총 157개의 검체에서 시행한 real-time PCR 검사는 기존의 배양검사와 일치율이 0.922 (P<0.01, Fisher exact test)로 매우 높았다. 배양검사에서 음성인 133개의 검체는 real-time PCR에서도 모두 음성을 보였다. 24개의 배양 양성 검체 중 21개의 검체는 real-time PCR에서도 양성이었지만, 나머지 검체는 음성 결과를 보였다. 20개의 검체에서 시행한 real-time RT-PCR 검사는 1개 검체를 제외하고 배양법 및 real-time PCR과 결과가 일치하였다. 한편, 배양법을 시행하고 결과를 확인하기까지는 총 26.5시간, real-time RT-PCR 검사에는 총 4.5시간이 소요되었다. 결론: 본 연구는 비인두 집락균 확인을 위한 real-time RT-PCR법의 확립과, 폐렴구균 보균율 측정에 있어서의 real-time RT-PCR 검사의 정확성 및 편의성을 보여주었다. Real-time RT-PCR 검사법은 주요 세균들의 보균율 연구에 있어서 시간과 노력을 줄일 수 있는 좋은 방법이며, 폐렴구균의 역학자료 수집에 큰 도움이 될 것으로 기대한다.

• Pediatric Infection and Vaccine
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• 제22권2호
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• pp.106-112
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• 2015

목적: 장기간의 항생제 치료는 중이염 어린이 환자의 중이액으로부터 원인균이 배양되는 것을 방해한다. 본 연구는 배양 음성 중이액으로부터 분자적 진단에 의한 신속한 균 검출 가능성 여부를 확인하고자 하였다. 방법: 폐구균 lytA 유전자를 표적으로 하는 PCR과 LAMP로 민감도와 특이도를 비교 결정하고, 임상중이액에서의 폐구균 검출에 적용하였다. 결과: PCR 기법에 의한 폐구균 검출 최소한계는 약 $10^4$ 집락형성단위(CFU)이고, LAMP의 검출 최소한계는 10 CFU에서 결정되었다. 한편 두 가지 검사법 모두 Haemophilus influenzae 와 Moraxella catarrhalis 에 대해 $10^6$ CFU 이상에서도 DNA를 증폭하지 않았다. 22개의 배양음성 중이액 중에서 12개 검체가 LAMP-양성(54.5%, 12/22)으로 확인되었고, 이들 12개 LAMP-양성 검체 중, 3개의 검체만이 PCR-양성으로 확인되었다(25%, 3/12). 본 연구의 결과는 LAMP 기법의 폐구균 검출 해상력이 PCR 기법에 비교하여 4배 이상 높음을 보여준다(P<0.01). 결론: lytA -특이 LAMP 기법은, 중이액 내의 타 병원균과는 교차반응 없이 10 CFU 폐구균의 DNA를 검출할 수 있는 고해상 기술로서, 중이액 폐구균 검출 및 폐구균 백신의 보급에 따른 백신 효과 평가에 적용이 기대된다.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1042-1046
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• 2008

The fluoroquinolones are an important group of antibiotics widely used in the treatment of various infectious diseases in adults, as a result of an excellent spectrum of activity, good tissue penetration and convenient ways of administration. In recent decades, there has been extensive development, clinical investigation, licensure and use of fluoroquinolone antibiotics. However, the use of fluoroquinolones in children has been limited because of their potential to induce arthropathy in juvenile animals. Despite class label warnings against use in children, prescriptions for quinolone antibiotics to treat infections in children have become increasingly prevalent. The main use of fluoroquinolones in pediatrics should be, understandably, in serious life-threatening infections for which other antibiotics therapies are not effective or available. While most of the published studies failed to detect an increased rate of articular adverse effects in children treated with fluoroquinolones, an increase in the use of these compounds, particularly in community-acquired lower respiratory infections, could accelerate the emergence of multidrug-resistant (including fluoroquinolone) pneumococcal strains. This review will discus the main issues related to the use of fluoroquinolones in children, the major problems of resistance developing among these compounds, with special emphasis on the potential side effects and skilled use of these alternative potent drugs in pediatric infection.

• Journal of Chest Surgery
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• 제12권4호
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• pp.403-410
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• 1979

A Clinical analysis of 64 patients of thoracic empyema was done who received surgical intervention at Dept. of Thoracic Surgery of the Chosun University Hospital in the period of 3 years from September 1976 to October 1979. Following was the results: 1. Seven cases [10.9%] were under the age of 15 years, 16 cases [25%] was between 15-30 years and 41 cases [64.1%] was above the age of 30 years. A proportion of children and adult was 1:8. 2. Male and female ratio was 3:1. Right and left side pleural cavity ratio was 2.4:1. 3. Predisposing factors were pneumonia [35.9%] and pulmonary tuberculosis [28.1%]. 4. Most frequently encountered symptoms were dyspnea, cough, chest pain and fever in order. 5. Etiologic organisms were confirmed in 39 cases [86.7%] which requested in 45 cases. Staphylococcal infections were 11 cases and streptococcal, pneumococcal pseudomonas infection was infected in order. 6. Pneumothorax was associated with empyema on 21 cases [32.8%]; among those 13 cases [61.9%] were tuberculous in nature. 7. Sensitivity test was revealed that Minocin was most very sensitive drug, and next Erythromycin, Gentamycin and Penbrex in order. But most resistant drugs were Penicillin, Kanamycin, Streptomycin and Tetracycline in order. 8. Treatments were combined with antibiotics therapy and several surgical procedures for empyema. 26 cases [40.6%] were treated with closed thoracotomy drainage, 17 cases [26.6%] with open thoracotomy tube drainage and 9 cases decortication and 9 cases thoracoplasty. 9. 2 death cases occurred in 64 cases of thoracic empyema, and 79.7% cases were discharged with recovery and improvement.

• 약학회지
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• 제49권6호
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• pp.484-489
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• 2005

Streptococcus pmeumoniae is the leading cause of pneumonia and bacterial meningitis. The current polysaccharide vaccine has been reported ineffective in elderly adults and children less than 2 years of age. Thus, in recent many researchers have been focused on a different approach, DNA vaccine. In our laboratory we developed a Streptococcus pneumoniae DNA (SPDNA) vaccine. This SPDNA vaccine was formulated by inserting the region encoding part of the capsule in the S. pneumoniae into the LAMP-1. In present work, with use of the SPDNA vaccine we attempted to establish a certain methodology useful for evaluation of effectiveness and immunoresponse of a DNA vaccine. Results showed that the subcutaneous route was the most effective for production of antisera specific for S. pneumoniae in mice. By isotyping analyses, IgM, IgGl, IgG2a, and IgG2b were determined. In addition, INF-$\gamma$ and IL-4 were predominantly detected. Combination of those data resulted in a pattern of IgGl < IgG2a=IgG2b and INF$\gamma\>$ >IL-4, which indicates the inmmunity towards the Thl response predominantly; furthermore, the SPDNA vaccination induced resistance of the CD4+T lymphocyte-depleted mice against disseminated pneumococcal infection. These data appear to be possibly due to activation of CDS8+T cell-activation. Taken together, this methodology can be applied for evaluating efficacy and mode of action of a DNA vaccine as minimum critera.

• Pediatric Infection and Vaccine
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• 제20권2호
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• pp.53-62
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• 2013

목 적 : 폐구균 단백결합 백신의 교차혈청형에 대한 교차방어 능력에 대한 연구는 매우 부족하다. 본 연구는 12-23개월 연령 소아에게 PCV7 추가접종 후 얻어진 면역혈청에서 교차혈청형 6A, 6C, 19A에 대한 교차 항체의 혈청학적 특성을 연구하기 위해 수행하였다. 방 법 : 백신 혈청형 6B, 19F와 교차혈청형 6A, 6C, 19A의 IgG, IgM 항체 농도와 옵소닌 인덱스를 ELISA와 OPA를 통해 측정하였다. 혈청군 6과 19에 대한 방어항체의 혈청학적 특성과 항원 특이도는 면역혈청내 IgM 제거, OPA, cOPA를 통해 확인하였다. 결 과 : 대조군 혈청에 비교하여 IgM 제거 면역혈청의 6B와 19F에 대한 옵소닌 인덱스가 감소하였고, 6A, 6C, 19A에 대한 옵소닌 인덱스도 역시 감소하였다. cOPA에서 6B 다당질, 19F다당질은 백신 혈청형 6B, 19F 뿐 아니라 6A, 6C, 19A의 방어 면역도 완전히 억제하였다. 결 론 : 6B, 19F를 포함한 PCV7은 교차혈청형 6A, 6C, 19A에 대한 IgG 및 IgM 교차방어 항체를 유도하였다. IgM 방어항체는 IgG 항체와 비교하여 백신 혈청형뿐 아니라 백신-연관 혈청형에 대해 더 높은 옵소닌 인덱스를 나타내었다. 향후 더 많은 소아와 성인의 면역 혈청으로 연구가 필요하다.