• Pediatric Infection and Vaccine
• /
• v.6 no.2
• /
• pp.245-252
• /
• 1999

Purpose : The aim of this study is to determine the age-specific seropositivity and the level of measles specific IgG in adults and to evaluate herd immunity to measles in Korea, the measles specific IgG were measured from the sera of adults over ages of 20 in Korea. Methods : 156 sera were collected from 156 out-patients over ages 20, who had visited clinical laboratory from June to July in 1997 at Korea University Ansan Hospital. The histories of natural measles or vaccination were not undertaken. Measles specific IgG titers were measured using ELISA method($SIA^{TM}$ Measles IgG Kit Co. St. Louis. Mo). Results : The results obtained from this study were as follows. 1) The seropositivity of measles specific IgG in adults was 94.9%. And there were no significant differences in their age and gender. 2) The mean measles-specific IgG titer was $238{\pm}84AU/mL$. And there were no significant differences in age and gender, except significant lower in 4th decades than other age groups. And there were no significant correlations between age and measles specific IgG level. Conclusion : In conclusion, a seropositivity of in adults was 94.9% which was higher than that of adolescents(91.2% in previous study), and antibody level was similar with adolescents. The herd immunity of the adults were considered to enough for protecting the transmission of measles in the community. For the eradication of measles in Korea, more efforts will be required to increase the vaccine coverage rate in children and adolescents.

• Tuberculosis and Respiratory Diseases
• /
• v.64 no.1
• /
• pp.8-14
• /
• 2008

Background: Acinetobacter infections are difficult to treat as they often exhibit multiple resistance to the antibiotics that are currently available for the treatment of pneumonia. Colistin is active against gram-negative bacteria, including the multiple drug resistant (MDR) Acinetobacter species. However, intravenous administration of colistin was abandoned because of its nephrotoxicity and neurotoxicity. The aims of this study were to examine the efficacy and safety of colistin administered by aerosol in the treatment of pneumonia caused by MDR Acinetobacter baumannii. Methods: We retrospectively reviewed the medical records of patients admitted to the intensive care unit (ICU) from Dec. 2006 to Aug. 2007 who had been diagnosed as suffering from pneumonia due to MDR Acinetobacter baumannii and had been treated with nebulized colistin. Results: 31 patients received aerosolized colistin. The average duration of the treatment was $14{\pm}7$ days and the daily dose of ranged from 225 mg to 300 mg. All patients received concomitant intravenous antimicrobial agents. The average length of the stay in the ICU was $34{\pm}21$ days and in the hospital $58{\pm}52$ days. The overall microbiological eradication was observed in 25 patients (80.6%). 14 of these (56%) were cured, and 11 (44%) were infected with other microorganisms. The overall crude mortality of the ICU was 48%. Nephrotoxicity and significant bronchial constriction did not occur in any patient during neublized colistin treatment. Conclusion: Nebulized colistin may be a safe and effective option in the treatment of pneumonia due to MDR Acinetobacter baumannii. Its role in therapy warrants further investigation in comparative studies.

• BMB Reports
• /
• v.36 no.1
• /
• pp.82-94
• /
• 2003

Although debates still exist whether Helicobacter pylori infection is really class I carcinogen or not, H. pylori has been known to provoke precancerous lesions like gastric adenoma and chronic atrophic gastritis with intestinal metaplasia as well as gastric cancer. Chronic persistent, uncontrolled gastric inflammations are possible basis for ensuing gastric carcinogenesis and H. pylori infection increased COX-2 expressions, which might be the one of the mechanisms leading to gastric cancer. To know the implication of long-term treatment of antiinflammatory drugs, rebamipide or nimesulide, on H. pylori-associated gastric carcinogenesis, we infected C57BL/6 mice with H. pylori, especially after MNU administration to promote carcinogenesis and the effects of the long-term administration of rebamipide or nimesulide were evaluated. C57BL/6 mice were sacrificed 50 weeks after H. pylori infection. Colonization rates of H. pylori, degree of gastric inflammation and other pathological changes including atrophic gastritis and metaplasia, serum levels and mRNA transcripts of various mouse cytokines and chemokines, and NF-${\kappa}B$ binding activities, and finally the presence of gastric adenocarcinoma were compared between H. pylori infected group (HP), and H. pylori infected group administered with long-term rebamipide containing pellet diets (HPR) or nimesulide mixed pellets (HPN). Gastric mucosal expressions of ICAM-1, HCAM, MMP, and transcriptional regulations of NF-${\kappa}B$ binding were all significantly decreased in HPR group than in HP group. Multi-probe RNase protection assay showed the significantly decreased mRNA levels of apoptosis related genes and various cytokines genes like IFN-$\gamma$, RANTES, TNF-$\alpha$, TNFR p75, IL-$1{\beta}$ in HPR group. In the experiment designed to provoke gastric cancer through MNU treatment with H. pylori infection, the incidence of gastric carcinoma was not changed between HP and HPR group, but significantly decreased in HPN group, suggesting the chemoprevention of H. pylori-associated gastric carcinogenesis by COX-2 inhibition. Long-term administration of antiinflammatory drugs should be considered in the treatment of H. pylori since they showed the molecular and biologic advantages with possible chemopreventive effect against H. pylori-associated gastric carcinogenesis. If the final concrete proof showing the causal relationship between H. pylori infection and gastric carcinogenesis could be obtained, that will shed new light on chemoprevention of gastric cancer, that is, that gastric/cancer could be prevented through either the eradication of H. pylori or lessening the inflammation provoked by H. pylori infection in high risk group.

• Journal of agricultural medicine and community health
• /
• v.29 no.1
• /
• pp.163-175
• /
• 2004

Objectives: This study was carried out to decrease the prevalence of human clonorchiasis and to evaluate the control effect in two Clonorchis sinensis-endemic area of Gokseong-gun and Sunchang-gun adjacent to the Sumjin River in Korea. Methods: The formalin-ether concentration method for stool egg examination or ELISA was applied for the diagnosis of clonorchiasis. As a primary survey, according to the non-probability sampling, a total of 1,2.13 inhabitants at Gokseong-gun were screened through the stool examination, and 1,004 inhabitants at Sunchang-gun were screened through the ELISA. The humans infected with C. sinensis were medicated with praziquantel and educated for the prevention of reinfection with the fluke. After 9 months, as a secondary survey, each prevalence of 616 inhabitants at Gokseong-gun and 2.637 inhabitants at Sunchang-gun was followed-up for the decrease of human clonorchiasis. Results: The prevalence before the mass control was 39.0% at Gokseong-gun and 30.1% at Sunchang-gun in average from 61.5% to 8.9% according to the villages (Myeon) of the survey. In the riverside villages to the Sumjin River the prevalences were higher than other villages located far from the river. The prevalence after the control was decreased to the level of 22.4% at Gokseong-gun(P<0.0001) and 16,3% at Sunchang-gun (P<0.0001). Conclusions: These results suggested that human clonorchiasis was still highly endemic in riverside area of the Sumjin River and could be decreased through the control activities such as diagnosis, medication and education. It was highly recommended that a integrated control such as those of the present study must be adopted in other localities along the Sumjin River for the eradication of human clonorchiasis.

• Pediatric Infection and Vaccine
• /
• v.10 no.1
• /
• pp.95-101
• /
• 2003

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefdinir in acute pharyngitis and pharyngotonsillitis caused by group A beta hemolytic streptococci in pediatric patients. Methods : Children aged 3 through 12 years who visited the hospitals enrolled in this study with signs and symptoms of pharyngitis or pharyngotonsillitis since May to December 2002, were taken throat culture and given Cefdinir(12 mg/kg/day, in three divided doses) for 7 days. Two hundred thirty five patients were enrolled and 90 patients who showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Follow-up culture were done at the end of the study and bacteriologic efficacy was determined Results : Ninety out of 235 patients who visited the hospitals with the signs and symptoms of pharyngitis showed positive growth on throat culture. Seventy nine patients were clinically and microbiologically assessable. The bacteriologic eradication rates of S. pyogenes were 100% in all the children treated with Cefdinir. Clinical cure rates were not different between less than 7 days-treated group(75%) and just 7 days-treated group(98.6%)(P=0.077). Two patients reported adverse reaction during Cefdinir treatment. Antimicrobial sensitivity of Cefdinir against S. pyogenes was 100% with range of MIC being less than 0.5 ${\mu}g/mL$. Conclusion : It seems that Cefdinir is one of reliable and well-tolerated drugs for the treatment of group A beta hemolytic streptococcal pharyngotonsillitis in children. It needs to be investigated short term efficacy in terms of improving drug compliance and impact of economic point of view. We can recognized that still high rate of the erythromycin resistant group A streptococci in our community should be monitored every year.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1107-1115
• /
• 2005

Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.41 no.5
• /
• pp.605-611
• /
• 2012

Sea cucumber, $Stichopus$ $japonicus$, is used not only as an outstanding tonic food but also as a traditional medicine for the treatment of asthma, hypertension, rheumatism, anemia, and sinus congestion. The purpose of this study was to examine sea cucumber as an anti-gastritis and anti-gastric ulcer in HCl-ethanol-induced gastric and $H.$ $pylori$-infected animal models. Thirty 7-week-old SD rats and Mongolian gerbils were divided into normal (Nor, n=6), control (Con, 60% HCl-ethanol+water, n=6), groupI (DSCI, 60% HCl-ethanol+sea cucumber 30 mg/kg, n=6), groupII (DSCII, 60% HCl-ethanol+sea cucumber 100 mg/kg, n=6), and group III (DSCIII, 60% HCl-ethanol+sea cucumber 300 mg/kg, n=6). Sea cucumber significantly suppressed gastric lesions and ulcers in the 60% HCl-ethanol-induced gastric model. Especially, 100 mg/kg of sea cucumber showed significantly inhibitory effects. In histopathological analysis of the $H.$ $pylori$ model, we found that sea cucumber augmented the eradication rates of $H.$ $pylori$ and attenuated gastric ulcer formation. Our results suggest that sea cucumber has inhibitory effects on gastritis and gastric ulcers. In addition, sea cucumber can be applied for the treatment of $H.$ $pylori$.

• Journal of Gastric Cancer
• /
• v.8 no.3
• /
• pp.160-165
• /
• 2008

Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

• Journal of the Korean Association of Geographic Information Studies
• /
• v.20 no.2
• /
• pp.60-74
• /
• 2017

To facilitate prevention of highly pathogenic avian influenza (HPAI), a GIS is widely used for monitoring, investigating epidemics, managing HPAI-infected farms, and eradicating the disease. After the outbreak of foot-and-mouth disease in 2010 and 2011, the government of the Republic of Korea (ROK) established the GIS-based Korean Animal Health Integrated System (KAHIS) to avert livestock epidemics, including HPAI. However, the KAHIS is not sufficient for controlling HPAI outbreaks due to lack of responsibility in fieldwork, such as sterilization of HPAI-infected poultry farms and regions, control of infected animal movement, and implementation of an eradication strategy. An outbreak prediction model to support efficient HPAI control in the ROK is proposed here, constructed via analysis of HPAI outbreak patterns in the ROK. The results show that 82% of HPAI outbreaks occurred in Jeolla and Chungcheong Provinces. The density of poultry farms in these regions were $2.2{\pm}1.1/km^2$ and $4.2{\pm}5.6/km^2$, respectively. In addition, reared animal numbers ranged between 6,537 and 24,250 individuals in poultry farms located in HPAI outbreak regions. Following identification of poultry farms in HPAI outbreak regions, an HPAI outbreak prediction model was designed using factors such as the habitat range for migratory birds(HMB), freshwater system characteristics, and local road networks. Using these factors, poultry farms which reared 6,500-25,000 individuals were filtered and compared with number of farms actually affected by HPAI outbreaks in the ROK. The HPAI prediction model shows that 90.0% of the number of poultry farms and 54.8% of the locations of poultry farms overlapped between an actual HPAI outbreak poultry farms reported in 2014 and poultry farms estimated by HPAI outbreak prediction model in the present study. These results clearly show that the HPAI outbreak prediction model is applicable for estimating HPAI outbreak regions in ROK.

• Journal of agricultural medicine and community health
• /
• v.12 no.1
• /
• pp.80-93
• /
• 1987

Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.