BACKGROUND: This study is aimed at evaluating immunogenicity by measuring immunoglobulin A (IgA) seroconversion rate through common mucosal immune system and adverse reactions after vaccination of oral live attenuated Salmonella typhi (S. typhi) Ty21a vaccine in Korean population. METHODS: A commercially available oral live attenuated vaccine of S. typhi strain Ty21a (Zerotyph(r) capsule, Boryung Biopharma Co., Seoul, Korea) was given to volunteers; children above 6 years, adolescents, and adults who have never infected with S. typhi nor received S. typhi vaccination. The vaccines were given in three doses, with two day interval between the doses. Seroconversion was determined by ELISPOT (enzyme-linked immunospot) assay. Adverse reactions after vaccination were evaluated in 12 institutions by direct interviewing with vaccinees. RESULTS: A total of 93 volunteers for evaluation of seroconversion were enrolled. Seroconversion rate in the the below 16 year-old group was 73.8% (31/42) and that of over 16 year-old group was 86.3% (44/51), which was not statistically different. Adverse reaction were found in 8.6% (40/465). Gastrointestinal symptoms were most common (6.5%, 30/465). Adverse reactions were found in 5.2% (24/465) after 1st administration, 4.5% (21/462) after 2nd, and 2.6% (12/461) after 3rd. Frequency of adverse reactions was significantly higher after 1st administration (P<0.05). CONCLUSION: Oral live attenuated S. typhi vaccine, Zerotyph(r) capsule, had good immnuogenicity and safety through intestinal immune system.
Adolescent ; Adult ; Child ; Enzyme-Linked Immunospot Assay ; Humans ; Immune System ; Immunoglobulin A ; Salmonella typhi* ; Salmonella* ; Seoul ; Vaccination ; Vaccines ; Volunteers

BACKGROUND: This study is aimed at evaluating immunogenicity by measuring immunoglobulin A (IgA) seroconversion rate through common mucosal immune system and adverse reactions after vaccination of oral live attenuated Salmonella typhi (S. typhi) Ty21a vaccine in Korean population. METHODS: A commercially available oral live attenuated vaccine of S. typhi strain Ty21a (Zerotyph(r) capsule, Boryung Biopharma Co., Seoul, Korea) was given to volunteers; children above 6 years, adolescents, and adults who have never infected with S. typhi nor received S. typhi vaccination. The vaccines were given in three doses, with two day interval between the doses. Seroconversion was determined by ELISPOT (enzyme-linked immunospot) assay. Adverse reactions after vaccination were evaluated in 12 institutions by direct interviewing with vaccinees. RESULTS: A total of 93 volunteers for evaluation of seroconversion were enrolled. Seroconversion rate in the the below 16 year-old group was 73.8% (31/42) and that of over 16 year-old group was 86.3% (44/51), which was not statistically different. Adverse reaction were found in 8.6% (40/465). Gastrointestinal symptoms were most common (6.5%, 30/465). Adverse reactions were found in 5.2% (24/465) after 1st administration, 4.5% (21/462) after 2nd, and 2.6% (12/461) after 3rd. Frequency of adverse reactions was significantly higher after 1st administration (P<0.05). CONCLUSION: Oral live attenuated S. typhi vaccine, Zerotyph(r) capsule, had good immnuogenicity and safety through intestinal immune system.
Adolescent ; Adult ; Child ; Enzyme-Linked Immunospot Assay ; Humans ; Immune System ; Immunoglobulin A ; Salmonella typhi* ; Salmonella* ; Seoul ; Vaccination ; Vaccines ; Volunteers

Cystathionine is well-known intermediate in the metabolism of methionine. It is cleaved to cysteine and homoserine by gamma-cystathionase. This enzyme utilize pyridoxal 5'-phosphate as coenzyme. gamma-cystathionase deficiency leads to persistent excretion of large amount of cystathionine in urine, as well as to accumulation of cystathionine in body tissues and fluids. It is inherited as an autosomal recessive trait and shows wide variety of clinical manifestations. No clinical abnormality seems to be specifically associated with gamma-cystathionase deficiency. The majority of patients responded to high dose administration of pyridoxine. We report the first case of cystathioninuric patient in Korea, 19 months of female with developmental delay. In brain MRI, there was generalized mild brain atrophy. There were several times of brief paroxysmal generalized polyspike and wave discharges in electroencephalography(EEG). In amino acid analysis of urine, there was elevated level of cystathionine. She was treated with high dose of pyridoxine. In follow up analysis of urinary amino acid, the cystathionine level was markedly decreased to normal range, and EEG was normalized. Her development shows improvement.
Atrophy ; Brain ; Cystathionine ; Cystathionine gamma-Lyase ; Cysteine ; Electroencephalography ; Female ; Follow-Up Studies ; Homoserine ; Humans ; Korea ; Magnetic Resonance Imaging ; Metabolism ; Methionine ; Pyridoxal ; Pyridoxine ; Reference Values

PURPOSE: Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. METHODS: We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. RESULTS: There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were: parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. CONCLUSION: AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.
Academic Medical Centers ; Anticonvulsants ; Demography ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Follow-Up Studies ; Humans ; Korea ; Neurology ; Prognosis ; Retrospective Studies ; Seizures ; Status Epilepticus

PURPOSE: We investigated the menstrual features of adolescent school girls to know the characteristics of menarche and dysfunctional uterine bleeding in adolescents. METHODS: In March, 2001, 1,434 primary and middle school girls(10-15 years of age) in Ansan City were investigated for the menacheal age and several aspects of menstruation through questionnaire. RESULTS: Mean age of the total subjects were 13.0+/-1.2 years of age, and 68.4% of them experienced menarche. 32.2% experienced menarche after age 12, but 82.9% experienced it after age 13. Mixed type(regular and irregular) menstrual cycle was the most common(35.3%), and changing type(irregular to regular) was 27.6%. In changing type, the mean duration of cycle stabilization was 6.6+/-4.9 months. The most common menstrual cycle was 'within 26-30 days'(31.4%). Abnormal cycles such as 'equal or less than 20 days' and 'equal or more than 41 days' were 17.2% and 2.0%, respectively. The most common menstrual duration was '5-6 days'(44.7%). 7.6% of the subjects experienced short or long menstrual duration. Among the subjects, only 4.0% visited the hospital with menstrual problems. The visiting reasons were 'irregular menstrual cycles'(38.5%), 'dysmenorrhea'(28.2%), 'menorrhagia'(12.8%), and 'hypermenorrhea'(28.2%). CONCLUSION: Most adolescent girls in our study experienced menarche until 13 years of age and some of them got early menarche at the age of 9. Many of them had irregular or unstable menstrual cycles after menarche at any age, but only few of them visited a health care provider. We suggest the careful attention of pediatricians, parents and teachers to the early detection and proper treatment of menstrual problems in adolescent girls.
Adolescent* ; Female ; Female* ; Gyeonggi-do* ; Health Personnel ; Humans ; Menarche* ; Menstrual Cycle ; Menstruation ; Metrorrhagia* ; Parents ; Surveys and Questionnaires

PURPOSE: Neutrophils found around an infarcted area in the brain was once considered as only the physiologic response following the brain injury, but recent studies have shown that inflammatory responses by neutrophils play an important role in the reperfusion injury. The presence of polymorphonuclear leukocytes(PML) is proven by biochemical assay of myeloperoxidase(MPO) secreted in the cytoplasmic granules. We observed the process of PML infiltration on hypoxic-ischemic brain injury of immature rats by the assay of MPO activity and changes of the MPO activity after the administration of fucoidin, inhibitor of P- and L-selectin. METHODS: We used a well characterized model of the brains of 7 day-old-rats, which had unilateral hypoxic and ischemic injuries(HI). Those injuries were induced by unilateral carotid artery ligation followed by timed exposure to hypoxic inspiratory gas mixture(8% O2). MPO activity was measured in the brain tissue homogenates of HI rats(n=18) at 0, 2, 8, 24 and 48 hrs and in rats that received fucoidin immediately before and again after hypoxia(50 mg/kg, n=6) at 8 and 24 hrs. Controls(n=2) were rats with neither hypoxia nor ischemia. The brain samples were homogenized in 20 mM potassium phosphate buffer(pH 7.4) for 50 secs. The homogenate was centrifuged at 14,000 g at 4degrees C for 15 mins and the supernatant was discarded. The tissue was pulverized, weighed, and suspended in 1 mL of 50 mM potassium phosphate buffer solution(pH 6.0) containing 0.5% cetylditrimethylammonium bromide(wt/vol). The tissue was sonicated and centrifuged at 10,000 g for 15 mins. 200 micro L of the supernatant was mixed with 1 mL of 50 mM potassium phosphate buffer solution(pH 6.0) containing 10 micro L of 1.325 mM o-dianisidine hydrochloride and 170 micro L of 3% hydrogen peroxide(vol/vol). Changes in absorbance at 460 nm were measured for 5 mins by using microplate reader. One unit of MPO activity was defined as that degrading 1 micro mol peroxide/min at 25degrees C, and the result was expressed as units of MPO/100 mg tissue. RESULTS: In HI rats, MPO activity increased at 2 hrs after HI and peaked at 24 hrs in the right hemisphere. In rats with fucoidin treatment immediately before and again after hypoxia, the MPO activity significantly decreased in both hemispheres compared with HI rats(P<0.05). MPO activity in the tissue of control rats was insignificant. CONCLUSION: The dynamic changes of the MPO activity suggest the important role of PMN on hypoxic-ischemic brain injuries in immature rats. MPO activity could be used as an index of the severity of injuries of hypoxic-ischemic brains.
Animals ; Anoxia ; Brain Injuries* ; Brain Ischemia ; Brain* ; Carotid Arteries ; Cerebral Infarction ; Cytoplasmic Granules ; Dianisidine ; Humans ; Hydrogen ; Infant, Newborn ; Ischemia ; L-Selectin ; Ligation ; Neutrophils ; Peroxidase* ; Potassium ; Rats* ; Reperfusion Injury

PURPOSE: Appropriate reference values are needed for assessment of pulmonary function during childhood. We performed pulmonary function test with simple computerized spirometry to establish reference values of air flow rates in healthy Korean children. METHODS: We examined 1,317 children aged 6 to 15 years at their schools by standardized method during May, 2001. The children with poor cooperation, respiratory symptom, and chronic disease were excluded. Regression analysis was applied for FVC, FEV1, PEF, FEF25-75% predicted from sex, age, standing height, weight, and body surface area. RESULTS: In 1,317 children(Male : 716, Female : 601), the distribution of height was from 106.7 cm to 173.5 cm, weight was from 16.5 kg to 75.5 kg. We could get regression equations and determinant coefficients between anthropometric parameters and air flow rates. In both sexes, height showed very close correlation with lung function variables, and FEV1 showed very close correlation with all anthropometric parameters. Reference values of pulmonary function test were generally higher in boys than in girls. CONCLUSION: After performing the pulmonary function test in healthy Korean children, we report their normal values of air flow rates and regression equations for the predicted values. Among anthropometric parameters, height showed most close correlation with lung function variables in both sexes.
Body Surface Area ; Child* ; Chronic Disease ; Female ; Humans ; Lung* ; Reference Values* ; Respiratory Function Tests ; Spirometry

Melkersson-Rosenthal syndrome(MRS) is a rare disorder, having a symptom triad of recurrent facial palsy, orofacial swelling and fissured tongue(lingua plicata). This disorder is usually recurrent or progressive, and monosymptomatic or oligosymptomatic forms have been reported to be more common than classic forms. Generally, MRS occurs in young adults at the end of the second decade of life and incidence of the disease in childhood is known to be very low. Although the clinical manifestation of MRS in children is similar to that in adults, early diagnosis and management is essential to avoid long-lasting functional disorders and psychological problems. We experienced MRS in a 13 year old boy with a history of recurrent facial palsy. We report this case with review of related literature.
Adolescent ; Adult ; Child ; Early Diagnosis ; Facial Paralysis ; Humans ; Incidence ; Male ; Melkersson-Rosenthal Syndrome* ; Young Adult

PURPOSE: To assess the clinical characteristics of the 2000-2001 measles outbreak in the Seoul metropolitan area, Korea, the clinical data of measles inpatients were analyzed. METHODS: Three hundred and five children diagnosed with measles by clinical manifestation from July, 2000 to February, 2001, in Seoul, Ilsan and Ansan City were grouped according to their age and investigated for clinical manifestations, vaccination history and measles-specific IgM/IgG antibody positivity. RESULTS: Thirty eight point seven percent of the subjects were less than 12 months of age, 27.5 % were 12-47 months of age and 33.8% were 48 months of age or older. There was no significant sexual difference(male : female=1.2 : 1). This epidemic started in June, 2000 and the number of patients increased abruptly in October, peaked in December and finally decreased after February, 2001. It started from the older age group and moved to the younger. Sixty five point two percent had a history of more than 1-dose vaccination and 13.6% of the patients equal or more than 48 months of age had a history of 2-dose vaccination. Primary vaccine failure rate was 59.4%(107/ 180) and secondary vaccine failure rate was 3.9%(7/180) in 1 dose vaccinees. Sixty one point six percent showed more than one complication and 38.4% had no complication. The most common complication was pneumonia(31.8 %), followed by bronchitis(11.5%) and acute otitis media(4.6%). Vaccination and dose were not related significantly with the occurrence of complications. CONCLUSION: Compared with previous outbreaks in Korea, clinical features showed no specific change in the 2000-2001 measles epidemic. However, primary vaccine failure rate was so high that the second vaccination at four to six years of age must be emphasized in Korea.
Child ; Disease Outbreaks ; Gyeonggi-do ; Humans ; Inpatients ; Korea ; Measles* ; Otitis ; Seoul* ; Vaccination

Pulmonary arteriovenous fistula is an uncommon capillary abnormality. It may be accompanied by neurological complications such as cerebral abscess and be associated with or without hemorrhagic telangiectasia. We recently experienced a case of cerebral abscess with pulmonary arteriovenous fistula(PAVF), which was not associated with hereditary hemorrhagic telangiectasia. We report this case with review of the related literature.
Arteriovenous Fistula* ; Brain Abscess* ; Capillaries ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis