Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

도축돈 장분변으로부터 Shiga Toxin-Producing Escherichia coli의 분리와 성상

송영환,김지영,채미경,박창식,김명철,전무형 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

Shiga toxin-producing Escherichia coli (STEC) causes various clinical signs in human and animals, and has been indicated as a global enteropathogen with zoonotic importance. In this study, the feces of healthy pigs were collected from the slaughtered pigs of Daejon abattoir during the period from December 2001 to October 2002. Of 326 specimens, 13 STEC were confirmed by culture, PCR and colony hybridization. The isolates were further studied for toxin types, pathogenic factors, plasmid profiles, and antimicrobial resistance to characterize the genetic and toxigenic properties. In PCR, all of 13 isolates were evident to have shiga toxin gene (stx). Of 13 isolates stx1 gene was detected in 4 and stx2 gene in 9. The genes of eaeA, hlyA and rfbE were not present in any isolates. In colony hybridization using shiga toxin common primer (STXc), 2 to 9 per 100 colonies subcultured from 13 isolates showed the positive reaction. In the examination for plasmid profiles of the isolates, one to eleven plasmids with varying sizes of 1.0 Kb to 100 Kb were detected, and the 13 STEC could be classified into four groups by the plasmid patterns. The antimicrobial resistance patterns of the isolates were comparably corresponded with the plasmid profile patterns.

뮤코다당증(Mucopolysaccharidosis)환아의 치은 증식

송주현,장철호,김영재,한세현,이상훈 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.1

뮤코다당증(Mucopolysaccharidosis, MPS)은 gIycosaminoglycans (GAGs)의 분해에 필요한 라이소좀 효소(lysomal enzymes)의 결함으로 GAGs의 대사 산물이 세포의 라이소좀내에 축적되어 점차 세포와 조직, 기관의 기능 이상을 초래하고 신체 질환과 정신 발달 지연을 가져오는 질환이다. 본 증례는 심각한 치은 증식을 가진 뮤코다낭증 환아를 전신 마취 하에 치은 절제술을 시행한 치험례이다. 소아치과 의사는 뮤코다당증 환아의 구강내 증상과 치과 치료시 주의 사항에 대해 숙지해야 하고, 내과의와 연계하여 환아의 전신 상태 변화에 민감하게 대처하여 치과 치료를 시행해야 한다. Mucopolysaccharidosis (MPS) is a disorder of storage in which there is excessive accumulation of glycosaminoglycans(GAGs) from lysosomal enzyme defect. Lysosomal accumulation of GAGs eventually results in cell, tissue and organ dysfunction. This patient may manifest mental retardation and physical disorders. This clinical report presents a girl with MPS having severe gingival hyperplasia. Gingivectomy was performed under general anesthesia. The pediatric dentist must be aware of oral manifestations present in the MPS. The approach to dental management will require teamwork between the dentist and the patient' s physician.

動壓密공법을 이용한 都市 廢棄物 埋立地盤의 物理的 改良을 위한 方案

宋錫哲,李大澈,金英默 大田産業大學校 1994 한밭대학교 논문집 Vol.11 No.0201

In this paper, a application mehtod for physical improvement of municipal waste landfill is presented. It is called dynamic consolidation. To this end, a case of improvement project for construction site by dynamic consolidation to the waste landfill which was formed open dumping is studied. Field tests of project area is conducted, and the results of field tests is analised. From the results of the field measurements, the municipal waste landfill was compressed considerbily, and the geotechnical properties of the waste ground was improved. The pounder was penetrated below the ground level about 1.2~2.5m depth and the volume of the crater was 7.893~ 18.255m_3 when 1st step impect was finished. The coefficient of improvement depth α is 0.34~0.4. Thus, it was founded that the dynamic consolidation was sucessful for physical improvement of municipal waste landfill.

지속성 외래 복막투석 환자에서 염증 지표와 고해상도 B 모드 경동맥 초음파 소견의 연관성에 관한 연구

송현용,송영수,안철우,강신욱,최규헌,하성규,이현철,이호영,한대석 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2

배 경 : 저알부민혈증 및 C-반응 단백(C-reactive protein, CRP)이 증가된 지속성 외래 복막투석 환자의 사망률이 높은 정확한 이유는 밝혀져 않다. 혈액투석 환자에서처럼 복막투석 환자에서 저알부민혈증 및 염증반응이 심혈관계 질환 위험인자 인지 알아보고자 하였다. 방 법: 비당뇨병성 말기 신부전, 지속성 외래 복막투석 환자 93명의 심혈관계 질환 위험인자들과 복막 투과 특성 및 알부민, CRP 등의 염증지표에 따라 고해상도 초음파를 이용한 경동맥내막-중간막 두께, 내막-중간막 면적, 플라크의 유무 등을 단면적으로 비교하였다. 결 과: 복막 투과 특성은 고투과막군 14명, 중간 고투과막군 38명, 중간 저투과막군 31명, 저투과막군 10명으로 각 군간의 경동맥 내막-중간막 두께, 플라크 유무 및 내막-중간막 면적의 차이는 없었다. 기존 관상동맥 질환 환자는 8예(8.6%)로 내막-중간막 두께는 관상동맥 질환이 없는 환자보다 증가되었고(0.79±0.21 vs 0.60±0.11 mm, p<0.05) 플라크 형성은 더 많이 보이나 통계적 유의성은 없었다(75.0 vs 63.5%, p>0.05). 혈청 알부민치와 경동맥 내막-중간막 면적은 역상관관계를 보였다(r=-0.27, p<0.05). 저알부민혈증 환자(혈청 알부민 <3.5 g/dL)는 정상 알부민혈증 환자보다 내막-중간막 두께가 증가되었고(0.67±0.15 vs 0.61±0.12 mm, p<0.05), 플라크도 유의하게 많았다(68.0 vs 55.8%, p<0.05). 혈청 CRP치와 경동맥 내막-중간막 면적은 양의 상관관계가 있었으며(r=0.21, p<0.05) CRP가 높은 환자(≥0.8 mg/dL, n=18)에서플라크가 많이 관찰되었으나(65.8 vs 50.0%, p<0.05) 경동맥 내막-중간막 두께 및 내막-중간막면적은 양군간에 차이가 없었다. 다변량 회귀 분석상 경동맥 내막-중간막 두께에 영향을 미치는 인자는 고령, 높은 CRP, 기존 심혈관계질환, 낮은 혈청 알부민 순이였다. 결 론 : 복막투석 환자에서 고해상도 초음파를 이용한 경동맥 내막-중간막 두께 측정은 심혈관계 질환 유무 예측의 비침습적 검사가 될 수 있고 저알부민혈증 및 높은 CRP과 같은 만성염증 지속상태가 복막투석 환자에서 죽상 동맥 경화증의 발생을 증가시킨다고 가정할 수 있다. Background : Continuous ambulatory peritoneal dialysis(CAPD) patients with low albumin(LA) and signs of inflammation reflected by increased C-reactive protein(CRP) level have an increased mortality, but the mechanism of this phenomenon is not clear yet. Methods : To answer whether LA and inflammation also enhance cardiovascular risk in CAPD patients, we performed cross sectional study measuring carotid artery intima-media thickness(IMT), calculated intima-media area(cIM area) and the presence of plaque by high-resolution B-mode ultrasonography in 93 non-diabetic CAPD patients. Results : Patients with coronary artery disease (CAD, n=8) had significantly increased IMT(0.79± 0.21 mm vs. 0.60±0.11 mm, p<0.05) and higher prevalence of carotid plaques(75.0% vs. 63.5%) compared to the non-CAD patients. Significant inverse correlation was observed between serum albumin (SA) level and cIM area(r=-0.27, p<0.05). Those patients with LA(SA <3.5 g/dL) had significantly increased IMT compared to non-LA patients(0.67±0.15 mm vs 0.61±0.12 mm, p<0.05). Prevalence of carotid plaques was also significantly higher in LA patients (68.0% vs. 55.8%, p<0.05). CRP level revealed a significant positive correlation with cIM area(r=0.21, p< 0.05). Patients with high CRP(≥0.8 mg/dL, n=18) had higher prevalence of carotid plaques (65.8% vs. 50.0%, p<0.05) compared to those patients with CRP <0.8 mg/dL, but IMT and cIMT area were not different. By multivariate logistic regression analysis, old age, high CRP, history of CAD and low SA were the independent risk factors affecting IMT. Conclusion : Our study strongly suggests that low albumin and chronic inflammatory state of CAPD patients could be associated with increasing atherosclerotic cardiovascular disease. (Korean J Nephrol 2002;21(2):285-294)

유방의 과립세포종양 1예: 증례보고

민인철, 유근수, 선우영, 윤효영, 송영진 충북대학교 의과대학 충북대학교 의학연구소 2013 忠北醫大學術誌 Vol.23 No.2

유방의 과립세포종양은 슈반세포에서 기원하는 아주 드문 질환이다. 대부분의 환자들은통증을동반 하 지 않는 경성의 유방 멍울을 주소로 내원하게 된다. 따라서 이학적 진찰상 유방암과의 감별이 필요하 다. 유방의 과립세포종양은 임상적으로 유방암과 매우 유사하지만, 98%에서 양성 소견을 보인다. 일 반적인 유방촬영술 및 유방초음파 상에서는 종양 특이적인 소견을 보이지 않으며, 오직 조직생검술을 통한 조직학적, 면연화학적 검사만이 병변을 확진 하는 방법이 된다. 51세 여자 환자가 유방에 만져 지는 멍울을 주소로 외래를 방문하였다. 이학적 검사 상, 좌측 중간외측 유방에 멍울이 만져졌으며, 대흉근 및 주변조직과 고착 되어있는 소견을 보였다. 유방단순촬영 상 좌외측 유방에 비대칭성이 보 였다. 유방 초음파상 1cm크기의 유방 뒤 지방층을 침범하는 종괴가 보였다. 중심 침 조직검사 상 유 방의 과립종양세포 소견을 보였으며, 조직 절제 생검으로 확진 하였다. 임상적으로 유방암과 많이 혼 돈되는 과립세포종양 1예를 보고하고자 한다.

원발성 조기 위 소세포암

송근영,강길,박정희,김경종,민영돈,박치영,임성철 朝鮮大學校 附設 醫學硏究所 2002 The Medical Journal of Chosun University Vol.27 No.2

Gastric small cell carcinoma(SCC) is defined as poorly-differentiated neuroendocrine tumor of the stomach, and their morphologic and biologic features arc similar to those of the lung. It is known that this tumor has poor prognosis even in early pathologic stage, It acounts for only 3% of all gastrointestinal SCC. that has been reported only 33 cases outside and 6 cases inside of the comitiy. Most of these reports are related to advanced gastric SCC. as pathologic stage IIIb or IV. This report describes a case of early gastric SCC. pathologic stage Ib.

하나로에서의 NTD조사를 위한 중성자속 평탄화 장치의 최적화를 위한 예비분석

송영동,이헌주,이병철,전병진,김학노 제주대학교 산업기술연구소 2001 尖端技術硏究所論文集 Vol.12 No.1

NTD(Neutron Transmutation Doping) method has several advantages of high resistivity and uniform doping in comparison with other method. To satisfy those conditions, the flux variations of radial and axial directions should be within ±5% and ±1.7%. respectively. The NTD facility in HANARO is purposed to irradiate the silicon ingot of 60cm in height. Hence, the flux flattener will be designed for 60cm. In this paper, preliminary study for optimal design is showed and the flux distribution of axial direction is calculated using MCNP4B code. The results show that the flattener model can flatten the flux to 83% of total length.

납착 방법이 치과용 금속의 성상에 미치는 영향에 관한 연구

김철형,송영균,이종혁 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

연구 목적: 본 연구는 치과영역에서 많이 사용되는 비귀금속 합금인 니켈-크롬 합금을 산소-아세틸렌 불꽃 납착법과 적외선 용접법을 이용해 용접하고 용접부 및 그 주변을 광학 현미경과 EPMA (Electron Probe Micro Analyzer, 전자미세현미분석기)를 통해 관찰하여 용접방법이 금속의 성상(性狀)에 미치는 영향을 조사하였다. 연구 재료 및 방법:니켈-크롬 합금을 이용하여 3.0 mm 직경, 30 mm 길이의 시편을 제작하였다. 시편은 산소-아세틸렌 불꽃 납착법, 적외선 용접법의 두 개의 그룹으로 분류하였다(n = 4). 시편을 low-speed disc로 자른 후 각각을 산소-아세틸렌 토치와 적외선 용접기를 이용해 용접하였다. 용접과 마무리 후에 시편을 광학현미경으로 용접부, 5 mm 떨어진 지점, 10 mm 떨어진 지점의 3개 부위에서 관찰하고EPMA를 이용하여 분석하였다. 결과: 광학 현미경 관찰 결과 용접부에서는 두 방법 모두 다수의 파절선이 관찰되었고, 10.0 mm 떨어진 거리에서는 두 방법 모두 시편의 표면에서 파절선이 발견되지 않았으나 5.0 mm 떨어진 거리에서는 적외선 용접법에서는 시편의 표면이 다소 거칠기는 했으나 파절선은 발견되지 않았고 산소-아세틸렌 불꽃 납착 표면에서는 다수의 파절선이 관찰되었다. EPMA분석에서 적외선 용접법에 의한 방법에서는 용접부위, 5.0 mm 떨어진 부위, 10.0 mm 떨어진 부위 모두에서 시편 금속의 구성성분 비율이 제조사의 구성성분 비율과 10.0%이내의 오차를 나타내었고, 산소-아세틸렌 불꽃 납착법에서는 5.0, 10.0 mm에서는 시편금속의 구성성분이 10.0%이내의 오차를 나타내었으나, 납착 부위에서는 Ni만이 검출되어 적외선 용접법과는 차이를 나타내었다. 이와 같은 분석결과를 살펴 볼 때 적외선 용접을 시행한 시편의 구성 성분이 모금속의 성분과 유사한 것을 알 수 있었다. 결론: 이상의 결과로 산소-아세틸렌 불꽃 납착법보다 적외선 용접법을 이용할 때, 금속의 결함 및 성분의 변화가 적어서 좀 더 우수한 금속 보철물의 제작이 가능할 것으로 사료된다. PURPOSE. The purpose of this study was to compare Ni-Cr alloy property of gas-oxygen torch soldering and infrared welding using optical microscope and Electron Probe Micro Analyzer (EPMA). MATERIALS AND METHODS. Ni-Cr alloys were casted for specimens. Specimens had 3.0 mm diameter, 30.0 mm length and were divided into two groups. Each group had 4 specimens. One group was for gas-oxygen torch soldering and the other was infrared welding. Specimens were cut with low-speed disc and soldered each other with gas-oxygen torch and infrared machine. After soldering and polishing, specimens were observed at 3 points (soldering point, 5 mm distance point, 10 mm distance point) with optical microscope and analyzed 3 points (soldering point, 5 mm distance point, 10 mm distance point with EPMA. RESULTS. The results of this study were as follows: 1. The observation of gas-oxygen torch soldering at 10 mm distance point under the optical microscope was not founded any specific surface properties, but some crack lines were observed at 5 mm distance and soldering point. 2. There were no crack lines were founded at the observation of infrared welding at 10 mm distance and 5 mm distance points under the optical microscope. However, at the 5 mm distance, the surface was not smooth enough compared with at 10 mm distance point. Some crack lines were observed at the welding point as well. 3. In the EPMA analysis of the gas-oxygen torch soldering, the component of Ni was increased by 4.5%, Cr was increased by 7.5% than that of the Ni-Cr alloy at the 10.0 mm distance. At the 5 mm distance, the component of Ni was decreased by 6.1%, Mo was increased by 9.0% than that of the Ni-Cr alloy but Cr was equally shown at the 5.0 mm distance. Only Ni was shown at the soldering point. 4. In the EPMA analysis of the infrared welding, the component of Ni was increased by 9.1%, Cr was increased by 0.4% than that of the Ni-Cr alloy but Al was equal at the 10.0 mm distance. At the 5 mm distance, the component of Ni was increased by 4.7%, Cr was increased by 4.7% and Al was increased by 0.1% than that of the Ni-Cr alloy. At the welding point, the component of Ni was increased by 8.8%, Cr was increased by 8.2% than that of the Ni-Cr alloy. CONCLUSION.From these results, at the 5 mm distance from the soldering point, the surface of the infrared welding was more smoother than that of the gas-oxygen torch soldering. On the EPMA analysis, the component of the specimens with infrared welding was more similar than that of the gas-oxygen torch soldering compared with the component of the Ni-Cr alloy.

탄산음료 유발 법랑질 침식에 대한 항우식 제품의 예방 효과

송주현,김영재,김정욱,장기택,김종철,한세현,이상훈 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

본 연구는 항우식 제품인 Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP)를 포함하는 치아크림, 불소 바니쉬, 저농도 불소 양치액을 치아에 도포하는 것이 단시간 탄산음료에 의한 법랑질의 침식을 예방할 수 있는지 살펴보기 위해 계획되었다. 법랑질 시편에 다음과 같은 항우식 제품을 도포하였고, 인공타액에 24시간 보관한 후, 콜라에 1분 증류수에 1분씩 5회 번갈아 처리하였다. 1군: 대조군(무처치) 2군: CPP-ACP 치아크림군 3군: 불소 바니쉬군(1,000 ppm F) 4군: 저농도 불소 양치액군(227 ppm F) 5군: 불소 바니쉬 + CPP-ACP 치아크림군 6군: 저농도 불소 양치액 + CPP-ACP 치아크림군 미세경도와 침식깊이를 측정하였고, Quantitative light-induced fluorescence(QLF)를 이용하여 안정된 형광 격자에 대한 부피 형광 변화인 ΔQ를 측정하여 무기질 감소량을 평가하였다. 6일 동안 실험을 반복하여 다음과 같은 결과를 얻었다. 1. 미세경도는 1군≤2군≤4군<6군<3군≒5군 순이었다. 2. 평균 침식깊이는 5군≒3군<6군<4군≒2군≒1군 순이었다. 3. ΔQ는 1군≒2군≤4군≤6군≤3군≒5군 순이었다. ΔQ의 감소율은 1군과 2군, 4군과 6군, 3군과 5군이 각각 유사하였다. 4. ΔQ는 미세경도와 강한 양의 상관관계를 나타냈고(r=0.96, p<0.05), 침식깊이와는 강한 음의 상관관계를 보였다(r=-0.96, p<0.05). The aim of this study was to evaluate the preventive effect of commercially available anticariogenic products, specifically, the tooth cream containing Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP), fluoride varnish and low-level fluoride mouthrinse on enamel erosion induced by carbonated beverage in a short period of time. Enamel specimens were treated as follows and were then kept in artificial saliva for 24 hours followed by further processing by alternately soaking them in Cola beverage and in distilled water for 1 minute each five times. Group 1: control group (no treatment) Group 2: tooth cream with CPP-ACP Group 3: fluoride varnish (1,000 ppm F) Group 4: low-level fluoride mouthrinse (227 ppm F) Group 5: fluoride varnish + tooth cream with CPP-ACP Group 6: low-level fluoride mouthrinse + tooth cream with CPP-ACP Microhardness and erosion depth were measured and the mineral loss of each specimen was evaluated by measuring the volumetric fluorescence change(ΔQ) against the stable fluorescent grid using quantitative lightinduced fluorescence(QLF). The experiment lasted for 6 days repeated each day. The results were as follows: 1. The microhardness was increased as follows: Group 1≤2≤4<6<3≒5. 2. The mean erosion depth was increased as follows: Group 5≒3<6<4≒2≒1. 3. The ΔQ was increased as follows: Group 1≒2≤4≤6≤3≒5. The decrement of ΔQ was similar between group 1 and 2, group 4 and 6 and group 3 and 5. 4. The ΔQ showed positive correlation with microhardness (r=0.96, p<0.05), while it was negatively correlated to erosion depth (r=-0.96, p<0.05).