Non-Mandatory Influenza Vaccination Rates among Healthcare Workers during the 2017–2018 Influenza Season: a Multicenter Study in Korea

강지만,이진홍,박윤수,박윤선,곽이경,송제은,최영주 대한소아감염학회 2019 Pediatric Infection and Vaccine Vol.26 No.3

Purpose: Annual influenza vaccination is the best strategy to prevent healthcare-associated influenza transmission. Influenza vaccination rates among healthcare workers (HCWs) vary by country, region, and year. We investigated the influenza vaccination rates for HCWs during the 2017–2018 influenza season in South Korea, where a non-mandatory vaccination campaign was conducted. Methods: We retrospectively investigated factors affecting the influenza vaccination rate among HCWs during the 2017–2018 influenza season in three tertiary hospitals in Goyang City, where the non-mandatory influenza vaccination program is conducted. Results: Consequently, 6,994 of 7,180 HCWs (97%) were included, and the overall vaccination rate was 85%. Nurses had the highest rate with 92%, followed by health technicians (88%), physicians (84%), and non-medical HCWs (79%, P<0.001). Vaccination rates differed, depending on the frequency of contact with patients in the non-medical HCWs (frequent contact vs. less-frequent contact; 90% vs. 73%, P<0.001). Conclusions: The influenza vaccination rate among HCWs during the 2017–2018 influenza season in Korea was 85%, which is among the highest rates compared with previously reported non-mandatory vaccination rates in other countries. The vaccination rate may vary depending on the HCW's occupational characteristics, including the extent of contact with the patient. Therefore, a multifaceted strategy is needed to increase the vaccination rate of HCWs.

A case of Hyper-IgE syndrome with a mutation of the STAT3 gene

강지만,서정민,김지현,김희진,김예진,이훈석,신영기,안강모,이상일,Kang, Ji-Man,Suh, Jung-Min,Kim, Ji-Hyun,Kim, Hee-Jin,Kim, Yae-Jean,Lee, Hun-Seok,Shin, Young-Kee,Ahn, Kang-Mo,Lee, Sang-Il The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.4

고 IgE 증후군은 만성 습진성 피부병변, 반복적인 호흡기 감염과 고 IgE 혈증이 특징인 드문 면역결핍질환이다. 환아는 객혈을 주소로 내원한 16세 여아로, 과거력상 신생아시기서부터 시작된 반복적인 피부발진, 잦은 상기도 감염 및 폐렴으로 외부병원에서 지속적인 치료를 받은 바 있었다. 가족력 상에는 특별한 이상이 없었다. 신체검진상 전신의 만성 습진성 피부병변, 크고 뭉특한 코, 아구창 등을 관찰할 수 있었고, 청진상의 양폐야의 부잡음 및 우측 하엽의 호흡음이 감소되었다. 전신 흉부방사선 촬영상 양측 폐야의 기관지확장성 변화를 동반한 우하엽의 흉수 및 경화가 관찰되었으며, 말초혈액검사상 호산구수치($750/{\mu}L$) 및 면역글로불린 E 수치(5,001 U/mL)가 증가되었다. 환아는 임상적으로 고 IgE 증후군이 의심되었으며, 유전자 검사를 통해 확진하였다(Arg382Trp). 최근의 연구에 따르면, 고 IgE 증후군의 주된 원인으로 STAT3 유전자의 이상이 알려져 있으며, 이를 유발하는 여러 돌연변이가 보고되어 있다. 저자들은 STAT3 유전자의 돌연변이 중 잘 알려진 Arg382Trp 돌연변이를 우리나라에서 최초로 유전자 검사를 통해 본 환아에게서 확진하였기에 문헌고찰과 함께 보고하는 바이다. 고 IgE 증후군은 만성 습진성 피부병변, 반복적인 호흡기 감염 등 특징적인 병력이 있는 환자에서 고 IgE 혈증이 동반될 때 임상적으로 의심할 수 있으며, 유전학 검사로 확진이 가능하다. Hyperimmunoglobulin E syndrome (HIES) is a rare immunodeficiency disease which is characterized by high serum IgE levels, eczema, and recurrent infections. Herein we present the case of a patient with HIES associated with STAT3 gene ($stat3$) mutation. A 16 year-old girl was admitted to our hospital due to hemoptysis caused by pneumonia with bronchiectasis. She had a history of recurrent skin and respiratory tract infections, such as pneumonia caused by MRSA (methicillin-resistant $Staphylococcus$ $aureus$) and $Pseudomonas$ $aeruginosa$. On physical examination, a broad round shaped nose, oral thrush, and chronic eczematous skin rash over her whole body were found. Laboratory data showed an elevated eosinophil count ($750/{\mu}L$) and total IgE level (5,001 U/mL). The patient's National Institutes of Health (NIH) score for HIES was 44. Direct sequencing of the STAT3 gene revealed that the patient was heterozygous for a missense mutation in the DNA binding domain of the STAT3 protein (c.1144C>T, p. Arg382Trp). HIES should be suspected in patients with recurrent infections and can be confirmed by clinical scoring and genetic analysis.

COVID-19 among solid organ transplant recipients in Korea: surveillance data of the Korean Transplantation Society, January 2020 to March 2022

강지만,김윤정,허경민,김종만,박완범,안형준,양재석,이상오,정수진,김명수,김상일 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.2

Successful Sirolimus Treatment for Korean Patients with Activated Phosphoinositide 3-kinase δ Syndrome 1: the First Case Series in Korea

강지만,김수경,김동섭,최새롬,임연정,김순기,박병규,박원서,강은숙,고영혜,최연호,이지원,김예진 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.6

Activated phosphoinositide 3-kinase δ syndrome (APDS)1 is caused by gain-of-function mutations in PIK3CD, which encodes the catalytic p110δ subunit of phosphoinositide 3 kinase. We describe three patients with APDS1, the first thereof in Korea. Therein, we investigated clinical manifestations of APDS1 and collected data on the efficacy and safety profile of sirolimus, a mammalian target of rapamycin inhibitor and pathway-specific targeted medicine. The same heterozygous PIK3CD mutation was detected in all three patients (E1021K). After genetic diagnosis, all patients received sirolimus and experienced an excellent response, including amelioration of lymphoproliferation and improvement of nodular mucosal lymphoid hyperplasia in the gastrointestinal tract. The median trough level of sirolimus was 5.5 ng/mL (range, 2.8–7.5) at a dose of 2.6–3.6 mg/m2. Two patients who needed highdose, short-interval, immunoglobulin-replacement treatment (IGRT) had a reduced requirement for IGRT after initiating sirolimus, and the dosing interval was extended from 2 and 3 weeks to 4 weeks. The IgG trough level after sirolimus treatment (median, 594 mg/dL; range, 332–799 mg/dL) was significantly higher than that before sirolimus treatment (median, 290 mg/dL; range, 163–346 mg/dL) (p<0.001). One episode of elevated serum creatinine with a surge of sirolimus (Patient 2) and episodes of neutropenia and oral stomatitis (Patient 1) were observed. We diagnosed the first three patients with APDS1 in Korea. Low-dose sirolimus may alleviate clinical manifestations thereof, including hypogammaglobulinemia.

Aetiology and Prognosis of Encephalitis in Korean Children: A Retrospective Single-Centre Study, 2005–2020

강지만,김세희,김아라,김민영,백지연,이지영,안종균,강훈철 연세대학교의과대학 2024 Yonsei medical journal Vol.65 No.2

Purpose: Encephalitis is a heterogeneous syndrome that occurs in childhood and is not rare. However, epidemiological studies of encephalitis based on the International Encephalitis Consortium (ICS) and expert recommendations are lacking. We investigated the aetiology and prognosis of encephalitis in Korean children. Materials and Methods: This retrospective study included children aged <19 years hospitalised for encephalitis at Severance Children’s Hospital between 2005 and 2020. The 2013 ICS criteria were used to diagnose encephalitis, and causality was classified according to the site from which the specimen was obtained. Neurological sequelae were categorised using the modified Rankin Scale (mRS) score. Results: In total, 551 children were included, with 7% classified as possible, 77% as probable, and 15% as proven cases. A cause was identified in 42% of the cases (n=222), with viruses being the most common (42%), followed by bacteria (38%) and autoimmune encephalitis (12%). In cases of proven/probable encephalitis (n=65), bacteria accounted for 52%, followed by viruses (25%) and au toimmune encephalitis (22%). In cases with a single pathogen, the anti-N-methyl-D-aspartate receptor autoantibody (n=14) was the most common, followed by Group B streptococcus (n=13), herpes simplex virus (n=11), enterovirus (n=4), and others. Approxi mately 37% of patients had severe sequelae (mRS score ≥3) at discharge, which decreased to 31% 6 months after discharge. Conclusion: This large-scale study showed that autoimmune and infectious causes accounted for a significant proportion of en cephalitis in Korean children. Further studies are needed to determine whether early targeted treatment following early diagnosis leads to a favourable prognosis in these populations.

스포츠,레저 산업용 소재 스포츠, 레저용 고부가가치 섬유복합소재

강지만 ( Ji Man Kang ) 한국공업화학회 2014 공업화학전망 Vol.17 No.6

스포츠·레저 분야의 섬유제품은 일부 선진국의 독점 품목으로 부가가치가 매우 높으며, 가격적인 면에서 기존의 의류용, 생활용과 같은 범용섬유 제품(약 $2∼5/kg)에 비해, $50/kg의 고부가가치 산업이라 할 수 있다. 스포츠·레저 제품에서 섬유복합소재를 적용하는 용도분야 중 Bulky성의 저신장 섬유복합로프, 스크린바디직물, 충격흡수공간직물 그리고 스키/스노우보드 등의 Sliding제품과 같은 분야는 수입의존도가 매우 높고, 향후에도 지속적인 시장증가가 예상되므로 국내 기술개발로 시장진입을 시도할 시점이다. 본고에서는 상기에서 언급한 용도분야를 중심으로 관련 기술현황 및 향후 기술개발 방향 제시에 초점을 두고 기술하였다.

온도 변화에 따른 위치 센서의 동작 특성 연구

강지만(Jiman Kang) 한국자동차공학회 2011 한국자동차공학회 학술대회 및 전시회 Vol.2011 No.11

본 논문은 터보차져 用 액츄에이터의 Rod의 움직임을 감지하는 Position sensor의 온도에 따른 동작 특성에 대한 연구 결과이다. 일반적으로 자동차에 적용되는 hall ic를 그 대상으로 선정하고, 자동차의 performance에 따른 터보 차져 액츄에이터 및 액츄에이터 위치 센서의 온도 변화, 이러한 주변 온도 변화에 따른 hall ic의 동작 특성 변화에 대해서 소개하고 및 온도 별 센서 출력 hysteris를 감소시킬 수 있는 파라미터 결과를 도출한다. 이는 hall ic에 적합한 parameter를 입력하게 되면 엔진 ECU에서는 터보차져의 상태를 좀더 정밀하게 인지하게 되고, 효율적으로 터보과급기를 조절함으로써 배기가스 저감, CO2 저감 및 반응 속도 향상, 연비 성능 개선, 출력의 향상을 도모할 수 있기 때문이다.

터보차저 엑츄에이터 위치 검출 포지션 센서 개발

강지만(Jiman Kang) 한국자동차공학회 2010 한국자동차공학회 학술대회 및 전시회 Vol.2010 No.11

자동차용 터보차저 엑츄에이터 포지션 센서의 개발을 수행한 결과를 요약하면 다음과 같다. 1. 종래 공압식 엑츄에이터에 포지션 센서를 일체형으로 하여 설계 한 것으로 2. 포지션 센서 내부에 엑츄에이터 로드의 움직임과 연동되어 상하 운동 할수 있도록 자석 취부 위치를 채택하고, 자석의 세기 변화를 감지하는 검출 센서를 몰딩 함으로 해서 자동차 ECU가 터보차저의 베인 상태를 보다 정밀하게 알 수 있고 또한 컨트롤을 보다 효율 적으로 할 수 있게 하였다. 3. 포지션 센서 내부 회로 구성은 EMC 등의 장애에 최적화 동작할 수 있도록 실험에 의하여 설계 하였고 4. 엑츄에이터 로드의 상하 운동에 의하여 자석이 연동 운동 할 수 있도록 직관적으로 설계하여 mechanical 적인 error율을 줄이고자 하였다.

열과 발진을 주소로 응급실을 방문한 47일 여아에서 진단된 신생아 루푸스

신윤겸,강지만,안종균 대한소아응급의학회 2021 대한소아응급의학회지 Vol.8 No.1

Neonatal lupus (NL) is a passively acquired autoimmune disease that occurs in infants born from asymptomatic mothers having anti-SSA or anti-SSB antibody. Infants with NL may show symptoms of systemic lupus erythematosus, including skin rash, congenital heart block, hepatic dysfunction, and hematological abnormalities. Mothers of the infants are asymptomatic or diagnosed with autoimmune diseases. When infants born to asymptomatic mothers who have never been diagnosed with the diseases show symptoms of NL, they may be mistaken for having infections. We report an NL case of a 47-day-old girl who presented to the emergency department with fever and skin rash.

래피어 직기 특성이 의류용 모직물 물성에 미치는 영향 (Ⅱ) : 의류용 모직물 물성 변화 Physical Properties of Worsted Fabrics for Garment

김승진,강지만 한국의류산업학회 2004 한국의류산업학회지 Vol.6 No.6

This research surveys the mechanical properties of worsted fabrics for garment according to the loom characteristics and fabric positions with relation to the warp and weaving weft tensions on the 3 types of rapier looms, which is previously surveyed in the 1st paper. For this purpose, the grey fabrics are processed in dyeing and finishing processes. The mechanical properties of the finished fabrics are measured and discussed with relation to the warp and weft weaving tensions of 3 types of rapier looms and the variations of the fabric mechanical properties according to the fabric positions are also surveyed for investigating the homogeneity of the tailorability and fabric hand.