PURPOSE: Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib and Sp vaccination in Korean pediatric HCT recipients. METHODS: Patients were prospectively enrolled at Samsung Medical Center during 2009-2011. ELISA tests to detect anti-PRP IgG antibody and antibodies to Sp serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were performed at the Center for Vaccine Evaluation and Study, Ewha Medical Research Institute. RESULTS: Ten patients (two allogeneic, eight autologous recipients) with median age 5.4 years (range 2.7-12.2 years) were enrolled. Before Hib vaccination, 60% of patients' anti-PRP IgG titers were below 0.15 microg/mL. After vaccination, 100% of patients' anti-PRP IgG titers increased above 0.15 microg/mL (cut-off value for detection) and 1.0 microg/mL (cut-off value for seroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) of IgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 microg/mL and at 5 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. In patients older than 5 years, pre-vaccination GMCs of IgG for four serotypes (4, 9V, 14, and 23F) were below 0.35 microg/mL and at 3 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. CONCLUSION: Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed good immune responses to protective levels after vaccination.
Academies and Institutes ; Antibodies ; Antibody Formation* ; Cell Transplantation* ; Enzyme-Linked Immunosorbent Assay ; Haemophilus influenzae type b* ; Humans ; Immunoglobulin G ; Prospective Studies ; Streptococcus pneumoniae* ; Transplants* ; Vaccination*

PURPOSE: The major pelvic ganglia (MPG) provide the majority of the innervations to the lower urinary tract. The pelvic ganglia are unique autonomic ganglia that contain both sympathetic and parasympathetic neurons. It has been known that the low-threshold voltage-gated (T-type) Ca2 channels are only expressed only in the sympathetic neurons, whereas these channels are absent in parasympathetic neurons. In the present study, we examined the effect of fluoxetine, a world-wide used antidepressant, on the voltage-dependent Ca2 and K currents in the adrenergic neurons of the MPG. MATERIALS AND METHODS: The effect of fluoxetine on the voltage-dependent Ca2 and K currents in the adrenergic neurons of the MPG were examined using the whole-cell patch-clamp technique. RESULTS: Fluoxetine inhibited the voltage-activated Ca2 currents in the adrenergic neurons of the MPG. Both high-threshold (HVA) and low- threshold (LVA, T-type) Ca2 currents were inhibited by fluoxetine with an IC50 of 5.3 and 10.8microM, respectively. Fluoxetine also decreased the both the peak amplitude and the plateau of the outward K currents. The inhibition of the peak K currents by fluoxetine was concentration- dependent with an IC50 of 3.2microM. The inhibitions of the Ca2 and K currents were quickly reversible upon washout of the fluoxetine. CONCLUSIONS: These results provide evidence for the direct inhibition of the voltage dependant Ca2 and K currents by fluoxetine and these inhibitory effects could modify the synaptic transmission in adrenergic neurons of the MPG.
Adrenergic Neurons ; Animals ; Calcium Channels ; Calcium* ; Fluoxetine* ; Ganglia* ; Ganglia, Autonomic ; Inhibitory Concentration 50 ; Neurons* ; Patch-Clamp Techniques ; Potassium Channels* ; Potassium* ; Rats* ; Synaptic Transmission ; Urinary Tract

PURPOSE: As Korea is an aging society (WHO classification) and projected to be an aged society in 10 years, peripheral vascular diseases (PVD) in the elderly population has emerged as an important social and medical issue. But their prevalence was rarely reported in Korea. The purpose of this study is to define the prevalence of carotid artery stenosis (CAS), abdominal aortic aneurysm (AAA), and peripheral arterial occlusive disease (PAOD) of lower limb in the Incheon area. METHODS: Elderly men (> or =65 years) were referred randomly from the Incheon Federation of Korean Senior Citizens' Association (from Nov 2008 to Sep 2009) to Inha Univeristy Hospital, Incheon, Korea for a PVD screening program. The subjects were screened for CAS and AAA by duplex. CAS was defined as > or =50% internal CAS and AAA as > or =3 cm aortic diameter in minor axis. PAOD of lower limb was screened by measurement of ankle brachial index (ABI); ABI of < or =0.9 was considered abnormal. RESULTS: 1150 subjects were screened including 103 octogenarians (9.0%). Mean age was 72.3+/-0.2 years. Combined conditions were hypertension (54.3%), diabetes mellitus (25.2%), coronary artery disease (15.6%), dyslipidemia (18.9%), obesity (31.1%) and smoking history (71.7%). CAS was detected in 7.7% (89/1,150) subjects. Thirty-three (2.9%) were diagnosed with AAA. PAOD was detected in 50 subjects (4.4%). CONCLUSION: Prevalence of PVD in Korea is not lower compared to that of western countries, especially the USA and the UK. A nationwide program for timely detection and treatment for PVD should be developed.
Aged ; Aged, 80 and over ; Aging ; Ankle Brachial Index ; Aortic Aneurysm, Abdominal ; Arterial Occlusive Diseases ; Axis, Cervical Vertebra ; Carotid Stenosis ; Coronary Artery Disease ; Diabetes Mellitus ; Dyslipidemias ; Humans ; Hypertension ; Korea ; Lower Extremity ; Male ; Mass Screening ; Obesity ; Peripheral Vascular Diseases ; Prevalence ; Smoke ; Smoking ; Vascular Diseases

A female adnexal tumor of probable Wolffian origin (FATPWO) is a rare neoplasm believed to originate from Wolffian remnants because the tumors are located in areas where such remnants are abundant. Because FATPWO is so rare that tumor biological behavior is not well defined, especially in cases of ovarian tumors, the collection and investigation of all relevant data, including this case report, are thus crucial to identify the best possible treatment for this type of tumor. We report a 14-year-old girl presented with a huge ovarian tumor that is reminiscent of dysgerminoma on CT scan. Left salpingo-oophorectomy was perfomed. Because the pathologic report on frozen section was malignant neoplasm, additional surgical staging was performed. A ovarian tumor of probable Wolffian origin was diagnosed by the pathologist, finally. No adjuvant therapy was given and there was no clinical evidence of recurrence during the 19 months of follow-up.
Adolescent ; Dysgerminoma ; Female ; Follow-Up Studies ; Frozen Sections ; Humans ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: Endovascular treatment for peripheral arterial obstructive disease (PAOD) is replacing traditional arterial bypass in the western world. Yet there are few reports to evaluate the pattern of clinical practice pattern for PAOD in Korea. This study was conducted to evaluate the treatment pattern for PAOD between endovascular treatment and arterial bypass, and to compare their clinical characteristics. METHODS: We conducted a retrospective study on the prospectively maintained database of patients who underwent endovascular treatment and arterial bypass for PAOD from March 2005 to December 2009 in Inha University Hospital. The aortoiliac lesions and femoropopliteal lesions were categorized by the Trans Atlantic Inter-Society Consensus (TASC) II classifications. Their treatments and clinical characteristics were compared between the former period (2005~2007 y) and the latter period (2008~2009 y). RESULTS: Three hundred nine cases (178 patients) were treated for PAOD by either arterial bypass or endovascular treatment. The patients' mean age was 69.1+/-11.3 year old. There was no difference in clinical characteristics between the two periods except for age. Endovascular treatments of both aortoiliac and femoropopliteal arterial lesions were increased in the latter period (P=0.023, P<0.001). Also, the endovascular treatments were increased in the TASC C and D aortoiliac and femoropopliteal lesions in the latter period (P=0.020, P<0.001). CONCLUSION: Endovascular treatment for PAOD is increasing in clinical practice and this shows feasibility in critically ill patient with TASC C and D lesions, although arterial bypass is still important.
Angioplasty ; Arterial Occlusive Diseases ; Atherosclerosis ; Consensus ; Critical Illness ; Humans ; Korea ; Physician's Practice Patterns ; Prospective Studies ; Retrospective Studies ; Western World

BACKGROUND: We evaluated characteristics of infectious complications in pediatric patients who received monoclonal antibody (mAb) therapy after allogeneic hematopoietic cell transplantation (HCT).METHODS: Between February 2004 and May 2009, 17 pediatric patients (<19 years at diagnosis) who received mAbs were identified as a study group (mAb group). One hundred twenty-two pediatric allogeneic HCT patients (<19 years at diagnosis) who did not receive mAb during the same period were identified as a control group (non-mAb group). A retrospective chart review of medical records was performed for the incidence of infectious complications and mortality.RESULTS: In the mAb group, 12 of the 17 patients (70.6%) had 29 infectious complications (1.71 episodes per person), whereas 89 of the 122 patients (73.8%) had 162 infectious complications (1.32 episodes per person) in the non-mAb group (P=0.838). Although, there were no significant differences in characteristics or incidence of infectious complications between the two groups, the infection-associated mortality rate was significantly higher in the mAb group compared to non-mAb group (29.4% vs. 8.2% P=0.021; RR 3.44, 95% CI, 1.407 to 8.433).CONCLUSION: The mAb therapy was associated with significantly high mortality in pediatric allogeneic HCT recipients.
Cell Transplantation ; Child ; Humans ; Incidence ; Medical Records ; Retrospective Studies ; Transplants

Purpose: Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea. Materials and Methods: Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively. Results: Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020). Conclusion This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.

Background: Hereditary hemolytic anemia (HHA) is a rare disease characterized by premature red blood cell (RBC) destruction due to intrinsic RBC defects. The RBC Disorder Working Party of the Korean Society of Hematology established and updated the standard operating procedure for making an accurate diagnosis of HHA since 2007. The aim of this study was to investigate a nationwide epidemiology of Korean HHA. Methods: We collected the data of a newly diagnosed pediatric HHA cohort (2007–2016) and compared this cohort's characteristics with those of a previously surveyed pediatric HHA cohort (1997–2006) in Korea. Each participant's information was retrospectively collected by a questionnaire survey. Results: A total of 369 children with HHA from 38 hospitals distributed in 16 of 17 districts of Korea were investigated. RBC membranopathies, hemoglobinopathies, RBC enzymopathies, and unknown etiologies accounted for 263 (71.3%), 59 (16.0%), 23 (6.2%), and 24 (6.5%) of the cases, respectively. Compared to the cohort from the previous decade, the proportions of hemoglobinopathies and RBC enzymopathies significantly increased (P < 0.001 and P = 0.008, respectively). Twenty-three of the 59 hemoglobinopathy patients had immigrant mothers, mostly from South-East Asia. Conclusion In Korea, thalassemia traits have increased over the past 10 years, reflecting both increased awareness of this disease and increased international marriages. The enhanced recognition of RBC enzymopathies is due to advances in diagnostic technique; however, 6.5% of HHA patients still do not have a clear diagnosis. It is necessary to improve accessibility of diagnosing HHA.