PURPOSE: The universal vaccination against hepatitis B during early infancy is the only effective way to control hepatitis B infection in highly endemic areas in Korea. The purpose of this study was to assess the effectiveness of simultaneous hepatitis B vaccination with DPT and oral polio at 2, 4, 6 months of age in babies of HBs antigen negative mothers. METHODS: One hundred and eighty-one infants who were admitted to the Neonatal Intensive Care Unit (NICU), Chonnam University Hospital from August, 1994 to December, 1995 were enrolled in this study. Infants received Hepavax-B 0.5ml (10 microgram) at contralateral thigh intramuscularly, simultaneously with DPT vaccination. Antibody was assessed by MEIA (microparticle enzyme immunoassay) at seven to nine months of age. RESULTS: The seroconversion rate of Hepatitis B after vaccination was 98.3%. There were no significant differences in positive rate of antibody according to gestational age, birth weight and sex. Seroconversion rate to hepatitis B in twins was lower than in singlets. Twenty-two infants among 23 infants, who were able to assess antibody titer, showed effective antibody titer, above 100mIU/ml. CONCLUSION: The results suggest that the simultaneous administration of hepatitis B vaccine with DPT/TOPV is very effective and simplifies schedule. Moreover, this schedule will improve the compliance of vaccination.
Appointments and Schedules ; Birth Weight ; Compliance ; Gestational Age ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Jeollanam-do ; Korea ; Mothers ; Poliomyelitis* ; Thigh ; Twins ; Vaccination

PURPOSE: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. METHODS: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal(UGI) endoscopy to evaluate location and severity of caustic injury. RESULTS: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12months to 9.8 years). Twenty-seven(87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia(54.8%), vomiting(48.3%), chemical burn on lips and skin(45.2%), excessive salivation(45.2%), coughing and respiratory grunting(32.3%) and aspiration pneumonia(9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children : grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children(19.4%) and gastric outlet stricture in 1(3.2%). All of them showed grade II or III caustic injury on endoscopic examination. CONCLUSION: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.
Acetic Acid ; Burns, Chemical ; Child* ; Constriction, Pathologic ; Cough ; Diagnosis ; Eating ; Emergency Service, Hospital ; Endoscopy ; Esophageal Stenosis ; Esophagitis* ; Esophagus ; Female ; Humans ; Jeollanam-do ; Lip ; Male ; Medical Records ; Retrospective Studies ; Stomach

PURPOSE: Measles is one of the most highly communicable infectious disease, but has become a rare disease with the widespread use of vaccine. Recently, however, resurgence of the disease in school aged or adolescents who had received the vaccine before or at the 15 month warrants reappraisal of the efficacy of the vaccination. The purpose of this study was to investigate positive prevalence of antibody and its quantitative titers in different age groups in order to determine necessity and appropriate time of booster vaccine. METHODS: We measured measles antibody in the sera of 192 children from different age groups(61 cases from 4-6 years of age, 40 cases from 8-9 years of age, 47 cases from 12-13 years of age, 44 cases from 15-16 years of age). Eight to ten children from each group were selected and quantitative antibody titers were measured by EIA(measles Ig G EIA SEIKEN) method. RESULTS: 1) The positive prevalence of measles antibody in four to six year age group(72%) was significantly lower than the expected positive prevalence of measles antibody(95%) (p<0.001). 2) Median antibody titer in twelve to thirteen year age group tended to be relatively lower than the other age groups. 3) There was no significant differences in the positive prevalence of measles antibody and median titers between sex. CONCLUSIONS: This data supported that the booster vaccination be needed at four to six years of age.
Adolescent ; Child ; Communicable Diseases ; Humans ; Measles* ; Prevalence ; Rare Diseases ; Vaccination*

Congenital arachnoid cysts are commonly located at sylvian cistern or middle cranial fossa which are usually asymptomatic and incidentally found. Posterior fossa cysts, however, are usually large when diagnosed, and symptomatic. Three cases of large posterior fossa cysts were recognized on the diagnostic MRI investigation for infantile spasm, developmental delay, and the precocious puberty. Surgical decompression of the cysts by craniectomy, cyst excision and fenestration were performed successfully in two patients with arachnoid cysts in the cerebellopontine cistern and the suprasellar, right cerebellopontine, and prepontine cisterns, but an additional cystoperitoneal shunt was needed in a case with the cyst in the quadrigemial cistern with obstructive hydrocephalus. Infantile spasm was treated with vigabatrin and pyridoxine, and the true precocious puberty was managed with LHRH analogue(Decapeptyl ).
Arachnoid Cysts* ; Arachnoid* ; Cranial Fossa, Middle ; Decompression, Surgical ; Gonadotropin-Releasing Hormone ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Puberty, Precocious ; Pyridoxine ; Spasms, Infantile ; Vigabatrin

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is known to induce chronic rhinosinusitis (CRS). Nasal polyp, which is frequently found in patients with CRS, seems to have close relationship with COPD, but little is known about its relationship with COPD. In this study, we investigated the relationship between COPD and nasal polyp in middle aged and elderly CRS patients. SUBJECTS AND METHOD: We analyzed the clinical data of 174 patients (age of over 50 years) with CRS. Patients were divided as COPD [forced expiratory volume (FEV1)/forced vital capacity (FVC)<70%, n=30] and non-COPD group (FEV1/FVC≥70%, n=144) according to the pulmonary function test results. Binary logistic regression analysis was used to describe the relationships between clinically relevant factors related to nasal polyp. RESULTS: On logistic regression analysis, no significant relationship was found between age [adjusted odds ratio (AOR): 1.058, 95% confidence interval for the difference (CI)=0.995-1.126, p=0.073], sex AOR: 0.897, 95% CI=0.366-2.415, p=0.897), smoking (AOR: 0.434, 95% CI=0.154-1.219, p=0.113) and obesity (underweight AOR: 3.833, 95% CI=0.781-18.808, p=0.098, overweight AOR: 5.169, 95% CI=0.996-26.814, p=0.051, obese AOR: 2.911, 95% CI=0.335-25.329, p=0.333) with polyp. However, there was a negative correlation between COPD history and nasal polyp with statistical significance (AOR: 0.288, 95% CI=0.102-0.809, p=0.018). CONCLUSION: Our findings suggest that patients with COPD are less likely to have nasal polyp than patients without COPD.
Aged* ; Humans ; Logistic Models ; Middle Aged* ; Nasal Polyps* ; Obesity ; Odds Ratio ; Overweight ; Polyps ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Sinusitis ; Smoke ; Smoking ; Vital Capacity

PURPOSE: To evaluate the effect of anti-interleukin-33 (anti-IL-33) on a mouse model of ovalbumin (OVA)-induced acute kidney injury (AKI). METHODS: Twenty-four female BALB/c mice were assigned to 4 groups: group A (control, n=6) was administered sterile saline intraperitoneally (i.p.) and intranasally (i.n.); group B (allergic, n=6) was administered i.p./i.n. OVA challenge; group C (null treatment, n=6) was administered control IgG i.p. before OVA challenge; and group D (anti-IL-33, n=6) was pretreated with 3.6 µg of anti-IL-33 i.p. before every OVA challenge. The following were evaluated after sacrifice: serum blood urea nitrogen and creatinine levels, Kidney injury molecule-1 gene (Kim-1) and protein (KIM-1) expression in renal parenchyma, and expression of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), phosphorylated endothelial NOS (p-eNOS), and phosphorylated AMP kinase (p-AMPK) proteins in renal parenchyma. RESULTS: After OVA injection and intranasal challenge, mice in groups B and C showed significant increases in the expression of Kim-1 at both the mRNA and protein levels. After anti-IL-33 treatment, mice in group D showed significant Kim-1 down-regulation at the mRNA and protein levels. Group D also showed significantly lower COX-2 protein expression, marginally lesser iNOS expression than groups B and C, and p-eNOS and p-AMPK expression at baseline levels. CONCLUSIONS: Kim-1 could be a useful marker for detecting early-stage renal injury in mouse models of OVA-induced AKI. Further, anti-IL-33 might have beneficial effects on these mouse models.
Acute Kidney Injury ; Adenylate Kinase ; Animals ; Blood Urea Nitrogen ; Creatinine ; Cyclooxygenase 2 ; Down-Regulation ; Female ; Humans ; Immunoglobulin G ; Interleukin-33 ; Kidney* ; Mice ; Nitric Oxide Synthase Type II ; Ovalbumin ; Ovum ; RNA, Messenger

BACKGROUND/AIM: The aim of this study was to evaluate the stability and simplicity of papillary balloon dilatation by retrospectively analyzing the results of performing concurrent papillary balloon dilatation in conjunction with percutaneous transhepatic biliary drainage (PTBD) in the patients with biliary obstruction due to common bile duct stones or a tumor who were difficult to treat with an endoscopic approach. METHODS: We retrospectively analyzed a total of 21 patients who were treated through a percutaneous transhepatic biliary approach after they were diagnosed with biliary obstruction due to a tumor and biliary stones in a single medical institution for four years from 2012 to 2015. RESULTS: Sixteen out of 21 patients (76.2%) underwent percutaneous transhepatic biliary drainage and papillary balloon dilatation. For 5 patients (23.8%) in whom it was difficult to perform the procedure simultaneously due to the patient's poor overall condition such as pancreatitis and septic shock, papillary balloon dilatation was performed 5-8 days after biliary drainage. Nineteen of 21 patients (90.5%) were successfully treated by a single procedure without residual stones or restenosis, but in two patients, stones were removed two times and three times. CONCLUSIONS: The use of a percutaneous transhepatic biliary approach to patients in whom endoscopy cannot be performed is considered safe and effective. In addition, unless the procedure is specifically contraindicated, the use of papillary balloon dilatation performed simultaneously with PTBD can reduce patient inconvenience and procedure frequency.
Common Bile Duct ; Dilatation* ; Drainage* ; Endoscopy ; Gallstones ; Humans ; Pancreatitis ; Retrospective Studies ; Shock, Septic

Two separate studies were conducted to establish bioequivalence (BE) for two doses of atorvastatin/metformin sustained-release (SR) fixed dose combination (FDC) versus the same dosage of the individual component (IC) tablets in healthy male subjects under fed conditions (study 1, BE of atorvastatin/metformin SR 20/500 mg FDC; study 2, BE of atorvastatin/metformin SR 20/750 mg FDC). Each study was a randomized, open-label, single oral dose, two-way crossover design. Serial blood samples were collected pre-dose and up to 36 hours post-dose for atorvastatin and 24 hours for metformin. Plasma concentrations of atorvastatin, 2-OH atorvastatin and metformin were analyzed using a validated liquid chromatography tandem mass-spectrometry. A non-compartmental analysis was used to calculate pharmacokinetic (PK) variables and analysis of variance was performed on the lognormal-transformed PK variables. A total of 75 subjects completed the study 1 (36 subjects) and study 2 (39 subjects). The 90% confidence intervals for the adjusted geometric mean ratio of Cmax and the AUC0-t were within the predefined 0.80 to 1.25 range. The number of subjects reporting at least one adverse event following FDC treatments was comparable to that following IC treatments. The two treatments were well tolerated. Therefore, atorvastatin/metformin SR 20/500 mg and 20/750 mg FDC tablets are expected to be used as alternatives to IC tablets to decrease the pill burden and increase patient compliance.
Atorvastatin Calcium* ; Chromatography, Liquid ; Cross-Over Studies* ; Humans ; Male* ; Metformin* ; Patient Compliance ; Pharmacokinetics* ; Plasma ; Tablets* ; Therapeutic Equivalency

Background: Psoriasis is a T cell-mediated disorder. Appropriate treatment of psoriasis can result in a plethora of dynamic changes in the T cells and their cytokine production. Studies on the expression of Th1 and Th17 inflammatory cytokines after various treatments have reported inconsistent results. Objective: This study aimed to investigate the changes in inflammatory cytokine expression in psoriasis skin lesions before and after psoriasis treatment. Methods: Five patients with plaque psoriasis were enrolled in the study. The tissue mRNA and protein levels of interleukin (IL)-12, IL-2, interferon (IFN)-γ, IL-23, IL-17A, and IL-22 in psoriatic skin lesions before and after psoriasis treatment were detected using real-time polymerase chain reaction and immunohistochemical staining, respectively. Results: The decrease in the psoriasis area and severity index was accompanied by a reduction in IL-12 and IL-23 mRNA levels and a concomitant reduction of IL-2 and IL-17A protein levels in psoriasis skin lesions. Both mRNA and protein levels of IFN-γ in psoriatic skin lesions increased after treatment. Conclusion The mRNA levels of tissue inflammatory cytokines (IL-12 and IL-23) and the protein levels of tissue inflammatory cytokines (IL-2 and IL-17A) significantly decreased after psoriasis treatment. The mRNA and protein levels of IFN-γ increased, even after psoriasis treatment.

BACKGROUND AND OBJECTIVES: This study aimed to review the characteristics of microbiology of peritonsillar abscess and to recommend adequate empirical antibiotics. SUBJECTS AND METHOD: Patients (437) who underwent surgical drainage for peritonsillar abscess were reviewed retrospectively. We analyzed correlations between age, gender, obesity and diabetes mellitus and cultured organisms with respect to susceptibility of antibiotics. RESULTS: The leading pathogens were α-hemolytic streptococcus (44.3%), Streptococcus viridians (12.3%), β-hemolytic streptococcus (8.2%) and Streptococcus pyogenes (6.8%). The rates of α-hemolytic streptococcus and Streptococcus pyogenes growth were p=0.002 and p=0.032, respectively; these values were significantly higher in patients under the age of 40 than those over the age of 40. Klebsiella pneumoniae infection was observed more frequently in the diabetic group than in the non-diabetic group. Antibiotics susceptibility test showed that four leading pathogens were susceptible to ampicillin/sulbactam. CONCLUSION: Only ampicillin/sulbactam was sufficient to treat peritonsillar abscess empirically. In conclusion, the use of third generation Cephalosporin or other antibiotics for anaerobes is not considered necessary for the empirical treatments of peritonsillar abscess.
Anti-Bacterial Agents ; Diabetes Mellitus ; Drainage ; Humans ; Klebsiella pneumoniae ; Methods ; Obesity ; Peritonsillar Abscess* ; Retrospective Studies ; Streptococcus ; Streptococcus pyogenes