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1.  Varicella and Varicella Vaccination in South Korea 
With continuing occurrence of varicella despite increasing vaccine coverage for the past 20 years, a case-based study, a case-control study, and an immunogenicity and safety study were conducted to address the impact of varicella vaccination in South Korea. Varicella patients under the age of 16 years were enrolled for the case-based study. For the case-control study, varicella patients between 12 months and 15 years of age were enrolled with one control matched for each patient. For the immunogenicity and safety study, otherwise healthy children from 12 to 24 months old were immunized with Suduvax (Green Cross, South Korea). Fluorescent antibody to membrane antigen (FAMA) varicella-zoster virus (VZV) antibody was measured before and 6 weeks after immunization. In the case-based study, the median age of the patients was 4 years. Among 152 patients between 1 and 15 years of age, 139 children received varicella vaccine and all had breakthrough infections. Clinical courses were not ameliorated in vaccinated patients, but more vaccinated patients received outpatient rather than inpatient care. In the case-control study, the adjusted overall effectiveness of varicella vaccination was 54%. In the immunogenicity and safety study, the seroconversion rate and geometric mean titer for FAMA antibody were 76.67% and 5.31. Even with increasing varicella vaccine uptake, we illustrate no upward age shift in the peak incidence, a high proportion of breakthrough disease, almost no amelioration in disease presentation by vaccination, and insufficient immunogenicity of domestic varicella vaccine. There is need to improve the varicella vaccine used in South Korea.
doi:10.1128/CVI.00645-13
PMCID: PMC4018876  PMID: 24671555
2.  Vaccine allergies 
Currently, the increasing numbers of vaccine administrations are associated with increased reports of adverse vaccine reactions. Whilst the general adverse reactions including allergic reactions caused by the vaccine itself or the vaccine components, are rare, they can in some circumstances be serious and even fatal. In accordance with many IgE-mediated reactions and immediate-type allergic reactions, the primary allergens are proteins. The proteins most often implicated in vaccine allergies are egg and gelatin, with perhaps rare reactions to yeast or latex. Numerous studies have demonstrated that the injectable influenza vaccine can be safely administered, although with appropriate precautions, to patients with severe egg allergy, as the current influenza vaccines contain small trace amounts of egg protein. If an allergy is suspected, an accurate examination followed by algorithms is vital for correct diagnosis, treatment and decision regarding re-vaccination in patients with immediate-type reactions to vaccines. Facilities and health care professionals should be available to treat immediate hypersensitivity reactions (anaphylaxis) in all settings where vaccines are administered.
doi:10.7774/cevr.2014.3.1.50
PMCID: PMC3890451  PMID: 24427763
Vaccine; Allergy; Influenza; Egg; Anaphylaxis
3.  A Case of Hypersensitivity to Mosquito Bite Associated with Epstein-Barr Viral Infection and Natural Killer Cell Lymphocytosis 
Journal of Korean Medical Science  2010;25(2):321-323.
Hypersensitivity to mosquito bites (HMB) is a disorder characterized by a necrotic skin reaction and generalized symptoms subsequent to mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer cell leukemia/lymphoma. We describe here a Korean child who had HMB associated with chronic EBV infection and natural killer cell lymphocytosis. A 5-yr-old boy was suffered from necrotic skin lesions on the right ear lobe. Type A EB virus was detected from hlood cells and bone marrow biospy recognized hemophagocyrosis.
doi:10.3346/jkms.2010.25.2.321
PMCID: PMC2811306  PMID: 20119592
Hypersensitivity; Culicidae; Epstein-Barr Virus Infections; Killer Cells, Natural; Lymphocytosis
4.  Clinicians and laypeople assessment of facial attractiveness in patients with cleft lip and palate treated with LeFort I surgery or late maxillary protraction 
Objective
To assess the changes in the Facial Attractiveness (FA) in two groups of cleft lip and palate patients with Class III malocclusions treated using LeFort I surgery or late maxillary protraction.
Materials and Methods
Standardized pre- and post-treatment photographs were taken of 32 patients (17 corrected by orthognathic surgery and 17 by late maxillary protraction). The photographs were randomized and 42 clinicians and 121 laypeople rated them on a 10-point FA scale via a web-based survey.
Results
Clinicians’ mean FA values increased from 4.45 to 5.16 [95% CI of Mean Difference (MD), 0.59–0.82, p<0.001] in surgical cases and 4.84 to 5.30 (95% CI of MD, 0.35–0.56, p<0.001) in protraction cases. The laypeople mean FA values increased from 5.07 to 5.54 (95% CI of MD, 0.40–0.53, p<0.001) in surgical cases and 5.51 to 5.68 (95% CI of MD, 0.11–0.23, p<0.001) in protraction cases. When patients combined, laypeople rated FA 0.64 points higher (95% CI, 0.54–0.74, p<0.001) in pre-treatment and 0.38 points higher (95% CI, 0.27–0.48, p<0.05) in post-treatment relative to clinicians.
Conclusion
Both clinicians and laypeople perceived an improvement of FA after both treatments. Laypeople rated FA higher compared to clinicians.
doi:10.1016/j.ijporl.2013.05.042
PMCID: PMC3943337  PMID: 23871270
Facial attractiveness; Cleft lip and palate; Class III malocclusion
5.  Prevalence of Primary Immunodeficiency in Korea 
Journal of Korean Medical Science  2012;27(7):788-793.
This study represents the first epidemiological study based on the national registry of primary immunodeficiencies (PID) in Korea. Patient data were collected from 23 major hospitals. A total of 152 patients with PID (under 19 yr of age), who were observed from 2001 to 2005, have been entered in this registry. The period prevalence of PID in Korea in 2005 is 11.25 per million children. The following frequencies were found: antibody deficiencies, 53.3% (n = 81), phagocytic disorders, 28.9% (n = 44); combined immunodeficiencies, 13.2% (n = 20); and T cell deficiencies, 4.6% (n = 7). Congenital agammaglobulinemia (n = 21) and selective IgA deficiency (n = 21) were the most frequently reported antibody deficiency. Other reported deficiencies were common variable immunodeficiencies (n = 16), X-linked agammaglobulinemia (n = 15), IgG subclass deficiency (n = 4). Phagocytic disorder was mostly chronic granulomatous disease. A small number of patients with Wiskott-Aldrich syndrome, hyper-IgE syndrome, and severe combined immunodeficiency were also registered. Overall, the most common first manifestation was pneumonia. This study provides data that permit a more accurate estimation PID patients in Korea.
doi:10.3346/jkms.2012.27.7.788
PMCID: PMC3390729  PMID: 22787376
Primary Immunodeficiencies; Registry; Korea
6.  332 Project for Prevention & Control of Asthma and Allergic Diseases in Korea 
Background
The prevalence rate of allergic disease, one of chronic diseases, has been recently increased due to changes of life style and numerous environmental factors. In May 2007, the Ministry of Health and Welfare of Korea established the comprehensive countermeasures to prevent and control asthma and allergic disease in Korea and has pushed ahead with this project related associations and academic experts together.
Methods
To improve the quality of life, reduce social and economic burden through getting over allergic diseases, the evidence based healthcare policy should be established about prevention and control of allergic diseases ; 1) Campaign & education 2) Proper treatment & control 3) Construction of environment friendly living 4) Construction of investigation, monitoring and alert systems 5) Support the disadvantaged patients.
Results
This project has moved ahead according to each 5 major program ; 1) Establish and provide guideline for prevention & control, promote prevention & control measures by cooperating with the private sector, operate an education & information center for asthma and allergic disease, 2) Provide & educate standard treatment guidelines, program development for a patient's self-treatment & control, 3) Create asthma and allergic disease friendly school, improve the living environment to control the trigger of asthma and allergic disease, 4) Establish an surveillance and monitoring system for asthma and allergic disease, study on asthma & allergic diseases; cohort study, develop and forecast an asthma index, 5) Support the patients of the disadvantaged with treatment, improve the living environment of the disadvantaged patients
Conclusions
We expect that evidence based healthcare policy about prevention and control of allergic diseases would improve the quality of life by reduction inducing factor for allergic diseases, and minimize the recurrence and aggravation by realization of the proper treatment and control the trigger for asthma and allergic diseases.
doi:10.1097/01.WOX.0000412095.11096.bc
PMCID: PMC3513037
7.  Etiology of Invasive Bacterial Infections in Immunocompetent Children in Korea (1996-2005): A Retrospective Multicenter Study 
Journal of Korean Medical Science  2011;26(2):174-183.
The purpose of this study was to identify the major etiological agents responsible for invasive bacterial infections in immunocompetent Korean children. We retrospectively surveyed invasive bacterial infections in immunocompetent children caused by eight major pediatric bacteria, namely Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Listeria monocytogenes, and Salmonella species that were diagnosed at 18 university hospitals from 1996 to 2005. A total of 768 cases were identified. S. agalactiae (48.1%) and S. aureus (37.2%) were the most common pathogens in infants younger than 3 months. S. agalactiae was a common cause of meningitis (73.0%), bacteremia without localization (34.0%), and arthritis (50%) in this age group. S. pneumoniae (45.3%) and H. influenzae (20.4%) were common in children aged 3 months to 5 yr. S. pneumoniae was a common cause of meningitis (41.6%), bacteremia without localization (40.0%), and bacteremic pneumonia (74.1%) in this age group. S. aureus (50.6%), Salmonella species (16.9%), and S. pneumoniae (16.3%) were common in older children. A significant decline in H. influenzae infections over the last 10 yr was noted. S. agalactiae, S. pneumoniae, and S. aureus are important pathogens responsible for invasive bacterial infections in Korean children.
doi:10.3346/jkms.2011.26.2.174
PMCID: PMC3030999  PMID: 21286006
Bacterial Infections; Epidemiology; Bacteremia; Meningitis; Streptococcus agalactiae; Streptococcus pneumonia; Staphylococcus aureus
8.  The Causative Organisms of Bacterial Meningitis in Korean Children in 1996-2005 
Journal of Korean Medical Science  2010;25(6):895-899.
Bacterial meningitis remains a serious cause of morbidity and mortality in childhood, despite the availability of effective vaccines against Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae. The purpose of this study was to analyze data on bacterial meningitis cases in Korea from 1996 through 2005. The information of all hospitalized bacteria-proven meningitis cases was obtained from 17 university hospitals nationwide. A total of 402 cases were identified. Of these, 125 (29.9%) cases were neonates. Streptococcus agalactiae was the most common bacteria responsible for 99 (24.6%) of all cases regardless of age, followed by S. pneumoniae for 91 (22.6%) and H. influenzae for 67 (16.7%) patients. The common etiology beyond the neonatal period was S. pneumoniae for 91 (33.0%) followed by H. influenzae for 63 (22.8%) patients. The overall case fatality rate was 9.4%, which was similar with that in 1986-1995. In conclusion, S. agalactiae, S. pneumoniae and H. influenzae were important etiologic agents of bacterial meningitis in children in the last 10 yrs. It is required to establish the preventive strategy of the three bacteria. The nationwide epidemiologic study should be continued to evaluate immunization strategy and efficacy.
doi:10.3346/jkms.2010.25.6.895
PMCID: PMC2877225  PMID: 20514311
Meningitis, Bacterial; Etiology; Epidemiology; Streptococcus pneumoniae; Haemophilus influenzae; Streptococcus agalactiae; Neisseria meningitidis
9.  Immunogenicity and Safety of Two Different Haemophilus influenzae Type b Conjugate Vaccines in Korean Infants 
Journal of Korean Medical Science  2008;23(6):929-936.
The incidence of invasive diseases, including meningitis caused by Haemophilus influenzae type b (Hib) was markedly decreased after routine immunization of Hib vaccine through diverse schedules in many countries. The purpose of this study was to evaluate the immunogenicity and safety of Hib conjugate vaccines in Korean children before the implementation of a national immunization program against Hib in Korea. A multicenter controlled trial was performed on two different Hib vaccines in Korean children. A total of 319 infants were enrolled: 199 infants were immunized with the Hib polysaccharide conjugated to the tetanus toxoid (PRP-T) and 120 infants with the Hib polysaccharide conjugated to the outer-membrane protein of Neisseria meningitides (PRP-OMP). Immunogenicity was evaluated by enzyme-linked immunosorbent assay (ELISA) and serum bactericidal assay. Both vaccines showed good immunologic responses after primary immunization. After 2 doses of PRP-T or PRP-OMP, 78.9% and 91.7% of infants achieved an antibody level of ≥1.0 µg/mL, respectively. Both vaccines were safe and well-tolerated. No serious adverse events were observed. Thus, Hib conjugate vaccines appear to be safe and show good immunogenicity in Korean infants. These results will be important reference data for the implementation of Hib vaccine in the national immunization program of Korea.
doi:10.3346/jkms.2008.23.6.929
PMCID: PMC2610654  PMID: 19119431
Haemophilus; Vaccines; Immunogenicity; Safety
10.  Double high-dose chemotherapy with autologous stem cell transplantation in patients with high-risk neuroblastoma: a pilot study in a single center. 
Journal of Korean Medical Science  2002;17(4):537-543.
Double high-dose chemotherapy (HDCT) was applied to 18 patients with highrisk neuroblastoma including 14 patients who could not achieve complete response (CR) even after the first HDCT. In 12 patients, successive double HDCT was rescued with peripheral blood stem cells collected during a single round of leukaphereses and in 6 patients, second or more rounds of leukaphereses were necessary after the first HDCT to rescue the second HDCT. The median interval between the first and second HDCT (76 days; range, 47-112) in the single harvest group was shorter than that (274.5 days; range, 83-329) in the double harvest group (p<0.01). Hematologic recovery was slow in the second HDCT. Six (33.3%) treatment-related mortalities (TRM) occurred during the second HDCT but were not related to the shorter interval. Disease-free survival rates at 2 years with a median follow-up of 24 months (range, 6-46) in the single and double harvest group were 57.1% and 33.3%, respectively. These results suggest that successive double HDCT using the single harvest approach may improve the survival of high-risk patients, especially who could not achieve CR after the first HDCT despite delayed hematologic recovery and high rate of TRM during the second HDCT.
PMCID: PMC3054907  PMID: 12172052

Results 1-10 (10)