Acellular pertussis vaccine has been used widely in Korea since 1984. However, because many of the former generations were not inoculated with pertussis vaccine, they may infect infants with pertussis. With this background, we investigated the prevalence of pertussis antibodies in all age groups. Enzyme-linked immunosorbent assay (ELISA) to assess IgG antibodies to pertussis toxin (PT) and filamentous hemagglutinin (FHA) and bacterial agglutination (BA) to assess antibodies to agglutinogen were compared on 842 serum samples which were donated from 11 hospitals in Seoul area. In comparison with age groups under 20 years, antibodies of adults against PT and FHA were maintained. But antibodies against agglutinogen showed no pattem in all age groups. Antibodies to PT were correlated with antibodies to FHA. There was no significant difference in antibody levels between male and female (p<0.05).
Adult ; Agglutination ; Antibodies ; Bordetella pertussis ; Enzyme-Linked Immunosorbent Assay ; Family Characteristics ; Female ; Hemagglutinins ; Humans ; Immunoglobulin G ; Infant ; Korea* ; Male ; Pertussis Toxin ; Pertussis Vaccine ; Prevalence ; Seoul ; Whooping Cough*

BACKGROUND AND OBJECTIVES: It is not known if allergies promote rhinovirus infections or aggravate the symptoms of common cold due to rhinoviruses. Histamine is an important immune mediator that induces symptoms of allergic rhinitis and asthma. We therefore investigated the effect of histamine on rhinovirus-16 infection in airway epithelial cells. MATERIALS AND METHOD: A549 cells were incubated for 24 hours with rhinovirus, histamine (10(-5), 10(-4), or 10(-3) M), both, or neither. Mean fluorescence intensity (MFI) of intercellular adhesion molecule-1 (ICAM-1) was estimated by flow cytometry, and secretion of IL-6 and IL-8 was measured by ELISA. Viral titers of rhinovirus-16 were measured by their cytopathic effects on lung fibroblasts after serial dilution. RESULTS: Histamine and rhinovirus acted synergistically to increase IL-8 secretion and enhance viral titer in the supernatants of cultured cells. In contrast, histamine and rhinovirus did not show synergistic effects on cell surface expression of ICAM-1 or on IL-6 secretion. CONCLUSION: Histamine may potentiate the secretion of IL-8 after rhinovirus-16 infection and may increase rhinovirus-16 titer in airway epithelial cells in a dose dependent manner.
Asthma ; Cells, Cultured ; Common Cold ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Fibroblasts ; Flow Cytometry ; Fluorescence ; Histamine* ; Hypersensitivity ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Interleukin-8 ; Lung ; Rhinitis ; Rhinovirus

BACKGROUNDS: Standardization of nucleic acid amplification techniques (NAT) which can be achieved by the use of standard to validate reproducibility and sensitivity in each assay run is necessary before the introduction of such methods for routine screening of blood and blood products for viral contaminants. The objective of this study was to analyze the serological and genotypic characteristics of HCV positive plasmas and to manufacture the HCV RNA national standard candidate. METHODS: We obtained three plasmas from Blood Transfusion Research Institute, Korea, with highly positive HCV RNA plasmas (#37, #40, #46) and with normal plasma for dilution. All the plasmas were confirmed by enzyme immunoassay (EIA) test for anti-HIV, HBsAg, anti-HCV and by polymerase chain reaction(PCR) for HBV DNA, HIV RNA, HCV RNA. The genotypes of those were confirmed by INNO-LiPA HCV II. HCV RNA national standard candidate was manufactured by dispensing the diluted plasma into about 2,000 vials. Each vial was rapidly frozen using liquid nitrogen and was kept in refrigerator at -70 degrees C. RESULTS: All plasmas were identified as anti-HIV, HBsAg, HBV DNA, and HIV RNA negative plasmas. The genotypes of those were confirmed as 1b for #37, 1b or 2 for #40 and 2a or 2c for #46, respectively. Sample #37 was selected as the candidate material. After manufacturing, we obtained 1,944 vials for the candidate. CONCLUSION: In this study, we analyzed HCV positive plasmas and manufactured the HCV RNA national standard candidate. In near future, this material would be established for national standard to increase in the safety of blood and blood products in Korea.
Academies and Institutes ; Blood Transfusion ; DNA ; Genotype ; Hepacivirus ; Hepatitis B Surface Antigens ; HIV ; Immunoenzyme Techniques ; Korea ; Mass Screening ; Nitrogen ; Nucleic Acid Amplification Techniques ; Plasma* ; RNA*

Cortical blindness is characterized by visual sensation loss with retention of pupillary reaction to light, and a normal fundoscopic examination. The suggested causes are emboli, profound hypotension, anemia, and infarction of watershed areas in the parietal or occipital lobe. We experienced a case of cortical blindness with severely reduced visual acuity after penile cancer surgery under general anesthesia. In the acute stage, visual acuity was slightly improved, but over the course of several months, no further improvement in visual acuity occurred. In this case there was no severe hypotension or anemia during the operation. Two days after the operation, electroencephalography (EEG) was performed during the period of blindness and the recording obtained was abnormal, with no alpha rhythm. Biparieto-occipital lucency was found by magnetic resonance imaging (MRI). Therefore parieto-occipital infarction due to seizure, embolus, or thrombosis could be considered a possible etiology. We concluded that cortical blindness can unexpectedly develop perioperatively and postoperatively, and that close monitoring of the patient and adequate management are essential.
Alpha Rhythm ; Anemia ; Anesthesia, General* ; Blindness ; Blindness, Cortical* ; Electroencephalography ; Embolism ; Humans ; Hypotension ; Infarction* ; Magnetic Resonance Imaging ; Male ; Occipital Lobe ; Penile Neoplasms ; Rabeprazole ; Seizures ; Sensation ; Thrombosis ; Visual Acuity

BACKGROUND: Neostigmine has been added to local anesthetic regimen for epidural or intrathecal block, and this resulted in prolonged and improved analgesia, but evidence of its benefit in intravenous regional anesthesia (IVRA) is controversial. The purpose of this study was to evaluate the effects of neostigmine added to ropivacaine for IVRA. METHODS: Forty patients undergoing hand or forearm surgery were randomly assigned to two groups to receive IVRA: Group I received 40 ml of 0.2% ropivacaine plus 1 ml of normal saline, and group II received 40 ml of 0.2% ropivacaine plus 500microgram (1 ml) of neostigmine. Sensory block onset time, postoperative visual analogue scale (VAS) scores, recovery time from motor block after deflation, mean arterial pressure (MAP), heart rate (HR), and pulse oximeter saturation (SpO2) values were measured. The incidence of side effects was recorded. RESULTS: Group II had a shorter sensory block onset time, a prolonged motor block recovery time, and lower postoperative VAS scores. No significant difference was found between the two the groups in terms of MAP, HR, SpO2 and side effects. CONCLUSIONS: The addition of neostigmine to ropivacaine in IVRA is believed to be a useful effective method for outpatient arm surgery due to a shortened sensory onset time and improved postoperative analgesia.
Analgesia ; Anesthesia, Conduction* ; Arm ; Arterial Pressure ; Forearm ; Hand ; Heart Rate ; Humans ; Incidence ; Neostigmine* ; Outpatients

Polymerase chain reaction (PCR) has been used as a substitute for conventional serological methods in order to provide blood or blood products free from contaminating viruses and recently attempts have focused to detect 2 or 3 viruses by a single multiplex PCR (M-PCR) reaction. We were able to detect human immunodeficiency virus type 1 (HIV-1), hepatitis C virus (HCV), hepatitis B virus (HBV) and human cytomegalovirus (HCMV) simultaneously by a single M-PCR. However detection by gel electrophoresis of the products from M-PCR suffers from drawbacks such as low sensitivity and product sizes. Here we report enhanced detection systems of M-PCR based on nucleic acid hybridization with arrays built on membrane. Membrane array was manufactured by spotting appropriate probe DNAs on nylon membrane. Single or multiplex PCR was performed and the PCR products were labeled with DIG and allowed to hybridize with the membrane array. Results indicate that nonspecific hybridization was not observed for membrane DNA array. Additionally, membrane array method could detect small amount of viruses that were not detectable by conventional gel electrophoresis. At least 25-fold, and in some cases more than 125-fold increases in sensitivity was obtained with DNA array method. Thus, the nucleic acid hybridization with membrane array could be applied for the detection of M-PCR of viruses in blood or blood products.
Cytomegalovirus ; DNA ; Electrophoresis ; Female ; Hepacivirus ; Hepatitis B virus ; HIV-1 ; Humans ; Membranes ; Metrorrhagia ; Multiplex Polymerase Chain Reaction* ; Nucleic Acid Hybridization* ; Nylons ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction

BACKGROUND: Nuss et al introduced a less invasive method for inserting a stainless steel bar through the small incision on the lateral chest wall into the pectus excavatum. This study was undertaken to assess the effect of the Nuss operation on lung mechanics, CT-Index and hemodynamics. METHODS: Twenty patients (age 4 to 17 years) with severe pectus excavatum underwent the Nuss operation. CT-Index (the internal transverse distance of the thorax/the vertebral-sternal distance at greatest depression) was evaluated before operation. Lung mechanics (dynamic compliance [Cdyn], static compliance [Cstat] and airway resistance [Raw]), hemodynamic changes (heart rate [HR], systolic blood pressure [SBP], and diastolic blood pressure [DBP]), and gas exchange (arterial oxygen tension [PaO2], arterial carbon dioxide tension [PaCO2], pulse oximeter saturation [SPO2] and end-tidal carbon dioxide tension[PETCO2]) were measured before and after the operation. RESULTS: Cdyn and Cstat decreased significantly (P < 0.05), but Raw did not change. PaCO2 and PETCO2 decreased significantly (P < 0.05), and SBP and DBP increased significantly (P < 0.05) postoperatively. CONCLUSIONS: It is concluded that decreased compliance after the Nuss operation may result from reduced thoracic elastance, not to a change of lung parenchyma.
Airway Resistance ; Blood Pressure ; Carbon Dioxide ; Compliance ; Funnel Chest* ; Hemodynamics ; Humans ; Lung* ; Mechanics* ; Oxygen ; Stainless Steel ; Thoracic Wall

BACKGROUND AND OBJECTIVES: This study attempted to evaluated the bacteriology of the postoperative mucocele of the maxillary sinus. MATERIALS AND METHOD: We performed a retrospective review of intraoperative bacteriology culture results and clinical records of patients with the postoperative mucocele of the maxillary sinus between July 1997 and October 2002. The number of patients was 33 (25 male and 8 female). RESULTS: Cultures were found positive in 20 of 33 patients (61%)(One culture had two organisms). There was no growth in the cultures of 13 patients (39%). The most common organism observed was Coagulase-negative Staphylococcus (10 isolates). The mean duration between the previous Caldwell-Luc operation and the second operation was 18.9 years (4-40 years). CONCLUSION: These findings illustrate the bacteriology of the postoperative mucocele of the maxillary sinus and suggest that bacterial infection may play a certain role in the pathogenesis of the postoperative mucocele of the maxillary sinus.
Bacterial Infections ; Bacteriology* ; Humans ; Male ; Maxillary Sinus* ; Mucocele* ; Retrospective Studies ; Staphylococcus

BACKGROUND AND OBJECTIVES: It is reported that positional therapy, i.e. the avoidance of the supine posture during sleep, is a simple behavioral therapy effective for many OSA patients and that the efficacy of this positional therapy influences RDI and BMI. However, there are no available data on Asians related to positional therapy and little has been studied about the anatomic characteristics of the upper airway. So, we attempted to observe in Korean OSA patients to see how RDI is influenced according to sleep positions and estimate the efficacy of positional therapy according to the degree of tonsillar hypertrophy and the degree of obstruction of oropharynx and hypopharynx. SUBJECTS AND METHOD: We evaluated 112 patients whose RDI were over 5 and whose sleep time of supine position/non-supine position went over 30 minutes as a result of overnight polysomnography taken from December 2003 to July 2004 at the Asan Medical Center. RESULTS: RDI was reduced to the average of 68.7% on non-supine position. The prevalence of positional patients in Korean OSA patients was 76.8%. Positional RDI reduction rate of the obese class II (BMI>30), grade IV oropharyngeal obstruction group on Muller maneuver was significantly lower compared to the other groups. CONCLUSION: The positional therapy was more effective in the Korean OSA patients than in the western OSA patients. However, in the obese class II and the grade IV oropharyngeal obstruction, the efficacy of the positional therapy was lower compared to the other groups.
Asian Continental Ancestry Group ; Body Mass Index ; Chungcheongnam-do ; Humans ; Hypertrophy ; Hypopharynx ; Obesity ; Oropharynx ; Polysomnography ; Posture* ; Prevalence ; Sleep Apnea, Obstructive* ; Supine Position

OBJECTIVES: Vaccinations against diphtheria and tetanus are essential in providing immunity against these bacterial infections. The potency of diphtheria and tetanus toxoid vaccines can be measured using the in vivo toxin neutralization assay. The limit of potency of this assay was determined only for children. Therefore, we assessed the potency of adult vaccines using this assay to identify the feasibility of limit for adult vaccines. METHODS: Fifteen lots of tetanus-reduced diphtheria and tetanus-diphtheria-acellular pertussis vaccines were used. In vivo toxin neutralization and lethal challenge assays were conducted on each vaccine to calculate the potencies of the toxoids. National reference standards for toxins and antitoxins were used for in vivo toxin neutralization assay. RESULTS: All 15 lots satisfied the limits of potency for lethal challenge assay. The potency of diphtheria and tetanus toxoids exceeded 1 and 8 units/mL, respectively, for in vivo toxin neutralization assay. CONCLUSION: Although additional studies are required for new assays and limits, the current level of potency for adult vaccines as determined by in vivo toxin neutralization assay, was demonstrated in this study. Such efforts to improve assays are expected to promote the development of diphtheria and tetanus vaccines for adults and to contribute to vaccine self-sufficiency.
Adult* ; Antitoxins ; Bacterial Infections ; Child ; Diphtheria Toxoid ; Diphtheria* ; Humans ; Tetanus Toxoid* ; Tetanus* ; Toxoids ; Vaccination ; Vaccines* ; Whooping Cough