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>

호산구성 간농양 54예의 임상상

강혜련,권혁수,송우정,이상민,김태범,박혜경,장윤석,김윤근,조상헌,민경업,김유영 대한알레르기학회 2004 천식 및 알레르기 Vol.24 No.2

미국 Medicare 투석환자 치료의 질 지표 개발 : 4가지 주요 치료영역을 바탕으로

강혜영 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.2

Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality in-dicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ≥ 1.2: (b) hematocrit level ≥ 30%: (c) serum albumin concentration ≥3.8g/di : and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2.179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of 'ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

복수암 Sarcoma 180을 생쥐의 B 임파구 분화에 미치는 Ascorbate의 영향

강영준,노정혜,강사욱,정가진 大韓免疫學會 1993 大韓免疫學會誌 Vol.15 No.-

Ascorbate is one of the important radical scavengers. Its roles in biological system including anti-cancer effects have been broadly studied. Ascorbate recovered the function of B lymphocytes which was suppressed by Sarcoma 180-derived immunosuppressive factor(s). Production of anti-SRBC antidody was increased by the adminisration of ascorbate in the Sarcoma 180 culture supernatant-treated mice. Ascorbate enhanced the suppressed immune function of tumor-bearing hosts. Treatment of 1 mg of ascorbate increased the function of B lymphocytes, however, 10ug of ascorbate treatment decreased. In vitro treatment of ascorbate increased the immunoglobulin production ac-cording to the increasement of ascorbate concentration. These results also imply that ascorbate may be a immunoreeulatory molecule.

국내·외 관련 제도 및 실태분석을 통한 한국형 장애인 자립생활센터의 계획방향에 관한 연구

강지혜,윤영삼,김상운,성기창,박광재,강병근 한국의료복지시설학회 2006 의료·복지 건축 Vol.12 No.2

The wealth of Korean disability people’s paradigm has developed by the meaning of whole rehabilitation of the small society for acception and protection. Today, that meaning has been changed to make and choose disability people’s future plans by themselves. The CENTER FOR INDEPENDENT LIVING in Korea has been accepted through the American and Japanese’s activity systems with no objection. Following result of the real reserching, because the CENTER FOR INDEPENDENT LIVING in Korea have no legal basement, so there are little support for these centers and no proper rules and check systems. Therefore, we have to make the legal basement of CENTER FOR INDEPENDENT LIVING and separate by each parts of system and to specialize about them. That means, each parts of system have to mark role mode for doing well, and each systems have to develop new programs and services, and to specialize for in Korea. To add, we should have more small CENTER FOR INDEPENDENT LIVING in each area, and the CENTER FOR INDEPENDENT LIVING which are already started should make network system to contact with other centers in society for giving support of proper information.

남자대학생의 흡연태도와 행동에 관한 연구

강경진,김정미,민혜영,안소진,오경숙,은경희,이현,이희선,홍주미,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

There have been so many researches about problems of cigarettes and relation of smoking and heath since 1950's and generally known that smoking is one of the worst factor of increasing disease and mortality. No matter what such many proofs about various problems of smoking have been researched, smoking rate of current male collage students has not been decreased. Besides, most of the researches about cigarette use and its addiction have been focused on the adolescent or adult women smokers or adult male, not male collage student. Therefore, the subject of this study is about smoking attitude and smoking behavior of male collage students by general features. Smoking attitude was analyzed by modifying 'Guidelines for the content of tobacco smoking surveys of the general population'(WHO, 1982). Two hundred of male collage students participated to the distributed questionnaire for one week in May. The smoking attitude was categorized into duration of smoking and number of cigarette per day(CPD), and nicotine dependency, investigated by Fagerstrom Tolerance Questionnaire(FTQ) (Fagerstorm & Schneider, 1989). All statistics were performed by procedure of SAS according to number, percentage, mean, standard deviation, and ANOVA. The results are as follows: 1. Smoking attitude level was mean 25.73±5.15 marks, ranging from 13 to 39 marks of the total 40 marks. 2. Duration of cigarettes, number of cigarette per day, and nicotine dependency were mean 5.14±2.84 years, 12.88±6.85 pieces, and 4.78±1.69, respectively. 3. Smoking attitude showed significance according to general features such as marital state and allowance, but the significance according to marital state is not valuable because the numerical difference is so big between married one and single that they cannot be compared with each other. 4. Duration of smoking was significant according to general features such as age and allowance. 5. Smoking amount showed significance the factors of age only. 6. ll1ere was no significance in nicotine dependency according to general features. As a result, smoking attitude of male collage student in this study shows moderate level. Smoking attitude and duration is significant according to allowance, and smoking amount is significant according to age. Nicotine dependency according to general features is not significant but comparing with the preceding study about adult male, male collage students in this study are respectively more nicotine-dependent than adult male smokers. In conclusion, the right allowance usage strategies and effective heath education focused on the young are needed. In addition, helpful programs and information spreading strategies are necessary for establishing higher level of smoking attitude. At last, systemic regulations in daily living for ""anti-nico-dependent"" and perspective reforming of male university student are needed for reducing nicotine dependency.

지속성 외래 복막투석환자에서 발생한 장간막경색증 1예

강동구,이준상,윤재호,장원철,조영일,송종호,전혜정 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

The mesenteric infarction, as a abdominal disease which show acute abdominal pain and almost need to emergency operation, has very high mortality. This mesenteric infarction has been reported very rarely. Also specific clinical manifestations are not clear, therefore initial diagnosis can be missed easily so that patients usually miss their opportunities for adequate treatment. Especially CAPD patients have high mortality because of their rareness and having similar symptoms like CAPD peritonitis. The authors report that the mesenteric infarction was miss-diagnosed to the CAF'D peritonitis with unspecific symptoms.

영어·미술 통합수업을 통한 내용중심교육 프로그램 모형 개발 및 적용

강후동,강혜영 晋州敎育大學校 初等敎育硏究所 2009 初等敎育硏究 Vol.19 No.-

PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adentis) 증후군 1예

강혜련,김신우,배기범,박지현,강영모,이종명,김능수 대한감염학회 2001 감염 Vol.33 No.3

PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis) syndrome has characteristic features of an early onset, periodicity (interval <4 weeks), and a brisk rising high fever (>39℃) of 3 to 6 days' duration without signs of infection. An 18-year-old male was admitted for high fever, sore throat, headache, and abdominal pain. He had suffered from periodic fevers associated with pharyngitis and cervical adenitis for 14 years without any evidence of infection. The fever recurred approximately every 4 weeks lasting 4 to 7 days with intervening asymptomatic periods. Physical examination was unremarkable except for slightly injected tonsils. Most laboratory tests including CBC were normal except for elevation of Creactive protein level (3.47 mg/dL). Bacteriologic and radiologic studies were negative. The fever was spontaneously subsided in 6 days. To our knowledge, this is the first case report of PFAPA syndrome in Korea. (Korean J Infect Dis 33:219∼222, 2001)

중금속이 코스모스와 해바라기의 초기 생육반응에 미치는 영향 : the Potential for Phytoremediation

강민혜,이영현,이종화 韓國植物ㆍ人間ㆍ環境學會 2003 인간식물환경학회지 Vol.6 No.2

This research used cosmos(Cosmos bipinnatus Cav.) and sunflower(Helianthus annuus L.) to test the possibility of phytoremediation, an environment-friendly heavy metal removing method. I examined the emergence, growth rate and physiological responses and confirmed heavy metal accumulation of Cd and Cu treatment and pH treatment-affected plants at early growing period. The emergence and growth rate was shown the most low in the Cu 2000uM. Chlorophyll and soluble protein content according to pH concentration were a little bad in their treatment plot compared with the control and were a little bad as pH concentration was low. But total nitrogen content was shown the highest in the Cu 2000μM than other treatments and was increased as pH was low. Heavy metal accumulation of roots in two plants was higher than the content of shoot part. Heavy metal accumulation concentration was measured Cu 369.79μg/g, Cd 114.99μg/g in roots of cosmos, and Cu 318.94μg/g, Cd 81.20μg/g in roots of sunflower.