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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>
F-103 Lessons learned from continued TB outbreaks in a high school
( Young Kim ),( Young Seok Lee ),( Jee Youn Oh ),( Won Jai Jung ),( Eun Joo Lee ),( Kyung Hoon Min ),( Gyu Young Hur ),( Sung Yong Lee ),( Sang Yeub Lee ),( Jae Jeong Shim ),( Eui Sook Kim ),( Yoon So 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-
Objective: Contact investigation with Tuberculin Skin Test (TST) and delayed QuantiFERON testing (QFT) had been conducted against continued tuberculosis (TB) outbreaks in a high school before Korea latent TB infection (LTBI) policy establishment. We investigated the aftereffect of confirmatory QFT added to positive TST. Methods: We reviewed the outbreaks courses, and identified the TB development in relation to initial TST and QFT with the aid of Korean national claims database. Results: Continued sequential 43 active TB cases were diagnosed in a high school for one year before LTBI investigation. After contact investigation, a total of 925 contacts were divided into three groups: TST- (n=632), TST+/QFT+ (n=25), TST+/QFT- (n=257). The mean duration of follow-up was 3.9 ± 0.9 years. QFT- was more prevalent compared with QFT+ in contacts with 10mm ≤ TST <15mm (157, 61.1%) than in contacts with TST ≥15mm (100, 38.9%) among the TST positive reactors (Odds ratio 4.97, C.I: 1.80 - 14.46, P < 0.001). Of the 257 TST+/QFT- subjects, 255 received no LTBI treatment, and 7 contacts developed TB during follow-up. Among these 7 patients, four had initial TST ≥15mm, and three 10mm ≤ TST <15mm. Conclusions: The delayed contact investigation for LTBI in a high school TB outbreak brought upon the continuous successive TB outbreaks. False negative QFT performed lately among the TST positive reactors should not be considered as a criteria for LTBI treatment. Additionally, the contacts only with strong induration size of TST (≥ 15mm) should be considered for LTBI treatment.
Hur, Gyu-Young,Koh, Dong-Hee,Kim, Hyoun-Ah,Park, Han-Jung,Ye, Young-Min,Kim, Kyoo-Sang,Park, Hae-Sim Elsevier 2008 Respiratory medicine Vol.102 No.4
<P><B>Summary</B></P><P><B>Background</B></P><P>Although baker's asthma (BA) is a common occupational asthma, there have been few reports on this disease in Korean subjects.</P><P><B>Objectives</B></P><P>We evaluated the prevalence of serum-specific IgE, IgG1, and IgG4 antibodies in relation to work-related respiratory symptoms in a single industrial bakery.</P><P><B>Methods</B></P><P>Three hundred and ninety-two bakery workers were administered and taken a questionnaire regarding respiratory symptoms. For symptomatic workers, the methacholine bronchial challenge test and specific bronchoprovocation tests with wheat extracts were carried out. Skin prick tests were performed and serum-specific IgE, IgG1, and IgG4 antibodies to wheat flour were detected. The IgE- and IgG4-binding components were identified by immunoblotting.</P><P><B>Results</B></P><P>Sixty-seven workers (17.1%) complained of work-related upper and lower respiratory symptoms. The prevalence of BA based on positive bronchoprovocation test results was 1.5%. The sensitization rate to wheat flour was 5.9% by skin prick test and 6.5% by ELISA, and was closely associated with the presence of atopy and work-related lower respiratory symptoms (<I>P</I><0.001 for both). IgE immunoblotting revealed six major IgE-binding components (27, 31, 36, 43, 54, and 72kDa). The presence of wheat-specific IgG1 and IgG4 antibodies was found to be significantly associated with exposure intensity (<I>P</I><0.05 for both).</P><P><B>Conclusions</B></P><P>The overall prevalence of wheat sensitization in a Korean bakery was 5.9%. We confirmed that an IgE-mediated response is the major pathogenic mechanism for the induction of work-related symptoms in wheat-exposed workers. Wheat-specific IgG antibodies may represent current or previous exposure to wheat dust.</P>
Serum potential biomarkers according to sputum inflammatory cell profiles in adult asthmatics
Gyu-Young Hur,Young-Min Ye,Eun-Mi Yang,Hae-Sim Park 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.4
Background/Aims: Asthma is not a single disease but, rather, a heterogeneous inf lammatory disorder with various pathogenic mechanisms. We analyzed the associations between the cellular profile of sputum and the serum levels of inflammatory mediators/cytokines in a cohort of adult asthmatics. Methods: We recruited 421 adult asthmatic patients. All subjects were classified into four groups according to their sputum cellular profiles: G1, eosinophilic; G2, mixed granulocytic; G3, neutrophilic; and G4, paucigranulocytic. Serum levels of cytokines and mediators including periostin, eosinophil-derived neurotoxin (EDN), S100A9, and folliculin were quantified. Results: Among 421 patients, G1 accounted for 149 (35.4%), G2 for 71 (16.9%), G3 for 155 (36.8%), and G4 for 46 (10.9%). Serum periostin and EDN levels were significantly higher in G1 (p = 0.004, and p = 0.031) than in the others. Serum S100A9 levels were elevated in G2 and G3 (p = 0.008). Serum folliculin levels differed significantly among the four groups, with the highest level in G4 (p = 0.042). To identify G1 from G1 plus G2 groups, the optimal serum cut-off levels were 1.71 ng/mL for periostin, and 1.61 ng/mL for EDN. When these two parameters were combined, the sensitivity was 76.0% and the specificity was 64.3% (area under the curve, 0.701; p = 0.004). Conclusions: The serum periostin and EDN levels may be used as predictors to discriminate the eosinophilic asthma group from patients having eosinophilic or mixed granulocytic asthma, and the serum folliculin level is significantly elevated in patients with paucigranulocytic asthma compared to those with different inflammatory cell profile.
Gyu-Young Hur,박해심,박한정,이현영,고동희,이병재,최길순,김승현,예영민 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.3
Purpose: Our previous study indicated that the presence of wheat-specific IgG1 and IgG4 antibodies was associated with work-related symptoms in workers exposed to wheat flour. We performed this study to investigate the genetic polymorphisms of β_2-adrenergic receptors and wheat-specific antibodies in association with the clinical parameters of baker’s asthma. Materials and Methods: In total, 379 subjects working in a single industrial bakery were enrolled in this study. The skin prick test was performed with common inhalant allergens and wheat flour extract. The presence of serum-specific IgE, IgG1, and IgG4 antibodies to wheat flour were determined by ELISA. Whole blood samples were obtained for genotype analysis. Subjects were genotyped with regard to five candidate single nucleotide polymorphisms (SNPs) of the β_2-adrenergic receptor gene (ADRB2; -47 T>C, 46 A>G, 79 C>G, 252 G>A, and 523 C>A) using a single-base extension method. Results: No significant associations were observed between the genotype/allele frequencies of any of the SNPs tested and any clinical parameters. The haplotype of ADRB2 (GAA composed of 46 A>G, 252 G>A, and 523 C>A) was significantly associated with work-related symptoms (p<0.05). Moreover, in subjects with the AG or GG genotype at 46 A>G and haplotype [GAA] of ADRB2, the prevalence rates of wheat-specific IgG1 antibodies and lower respiratory symptoms increased significantly with exposure intensity (both p<0.05). Conclusion: The findings of the present study suggest that ADRB2 genetic polymorphism may contribute to the development of work-related symptoms in workers exposed to wheat flour, which can lead to baker’s asthma.