Prevalence of SARS-CoV-2 Antibody in 2,935 Healthcare Workers at 6 Major Hospitals, Daegu, Korea

Background@#In Korea, the first community outbreak of coronavirus disease 2019 (COVID-19) occurred in Daegu on February 18, 2020. This study was performed to investigate the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies in healthcare workers (HCWs) at 6 major hospitals in Daegu. @*Methods@#Blood specimens of 2,935 HCWs at 6 major hospitals in Daegu from January 2021 to February 2021 were collected. Every specimen was tested for antibody against SARS-CoV-2 using both Elecsys Anti-SARS-CoV-2 electrochemiluminescence immunoassay (Roche Diagnostics, Rotkreuz, Switzerland) and R-FIND COVID-19 IgG/M/A enzyme-linked immunosorbent assay kit (SG medical Inc., Seoul, Korea) as screening tests. If 1 or more of these screening test results was positive, 2 additional antibody tests were performed using Abbott Anti-SARS-CoV-2 IgG assay (Abbott, Abbott Park, IL, USA) and cPass SARS-CoV-2 Neutralization Antibody Detection Kit (GenScript USA Inc., Piscataway, NJ, USA). If 2 or more of the total 4 test results were positive, it was determined as positive for the antibody against SARS-CoV-2. @*Results@#According to the criteria of SARS-CoV-2 antibody positivity determination, 12 subjects were determined as positive. The overall positive rate of the SARS-CoV-2 antibody was 0.41% (12/2,935). Of the 12 subjects determined as positive, 7 were diagnosed with COVID-19, and the remaining 5 were nondiagnosed cases of COVID-19. @*Conclusion@#In early 2021, the overall seroprevalence of SARS-CoV-2 antibody among HCW located in Daegu was 0.41%, and 0.17% excluding COVID-19 confirmed subjects. These results were not particularly high compared with the general public and were much lower than HCWs in other countries.

MCR1 and KPC2 Co-producing Klebsiella pneumoniae Bacteremia: First Case in Korea

Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) has been disseminating nationwide due to clonal spread and is taking a serious action at the national level in Korea. The mobilized colistin resistance (MCR1) gene confers plasmid-mediated resistance to colistin and is known to be capable of horizontal transfer between different strains of a bacterial species. We have experienced a fatal case of the patient who developed MCR1-possessing, ST307/Tn4401a[blaKPC2] K. pneumonia bacteremia in the community of non-capital region after being diagnosed as pancreatic cancer with multiple liver metastases and treated in the capital region. The ST307/Tn4401a[blaKPC2] K. pneumonia was the most commonly disseminated clone in Korea. Our strain is the first MCR1 and KPC2 co-producing K. pneumonia in Korea and our case is the critical example that the multi-drug resistant clone can cause inter-regional spread and the community-onset fatal infections. Fortunately, our patient was admitted to the intensive care unit on the day of visit, and the contact precaution was well maintained throughout and KPC-KP was not spread to other patients. The high risk patients for KPC-KP need to be screened actively, detected rapidly and preemptively isolated to prevent outbreak of KPC-KP. Inter-facility communications are essential and the nationwide epidemiologic data of KPC-KP should be analyzed and reported regularly to prevent spread of KPC-KP. The prompt identification of species and antimicrobial susceptibilities for successful treatment against KPC-KP should be emphasized as well.

Third-generation cephalosporin resistance of community-onset Escherichia coli and Klebsiella pneumoniae bacteremia in a secondary hospital

BACKGROUND/AIMS: To enable appropriate antimicrobial treatment for community-onset infections in emergency departments (EDs), data are needed on the resistance profiles of Escherichia coli and Klebsiella pneumoniae, which are the main pathogens of community-onset bacteremia. METHODS: Records were reviewed of 734 patients with E. coli and K. pneumoniae bacteremia who visited the Daegu Fatima Hospital ED, Daegu, Korea between 2003 and 2009. We investigated the demographic data, clinical findings, and antimicrobial susceptibility patterns of the organisms. RESULTS: Of 1,208 cases of community-onset bacteremia, 62.8% were caused by E. coli or K. pneumoniae in an ED of a secondary care hospital. Five hundred and forty-eight cases of E. coli (75%) and 183 cases of K. pneumoniae (25%) were analyzed. Urinary tract infection (43.1%) was most common, followed by intra-abdominal infection (39%) and pneumonia (7.2%). Trimethoprim/sulfamethoxazole, fluoroquinolone, third-generation cephalosporin (3GC) and amikacin resistance rates among E. coli and K. pneumoniae were 22.8%, 19.6%, 6.2%, and 1.3%, respectively. In 2009, the rate of 3GC resistance (10.6%) was significantly higher, compared to the annual averages of 2003 to 2008 (6.1%; p = 0.03). Previous exposure to antibiotics was an independent risk factor for 3GC resistance in multivariate logistic regression analysis. CONCLUSIONS: The rate of 3GC resistance increased in community-onset infections, and previous exposure to antibiotics was an independent risk factor. Despite the increased 3GC resistance in community-onset infections, an amikacin combination therapy could provide an option for treatment of bacteremic patients with previous antibiotic exposure in an ED.

Tigecycline Treatment for Infections Caused by Multidrug-Resistant Pathogens / 영남의대학술지

BACKGROUND: Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. METHODS: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. RESULTS: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant Acinetobacter baumannii (76.2%), methicillin-resistant Staphylococcus aureus (61.9%), extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (38.1%), and penicillin-resistant Enterococcus species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%). CONCLUSION: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea. Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital / 결핵및호흡기질환

BACKGROUND: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. METHODS: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. RESULTS: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. CONCLUSION: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.

Fatal melioidosis in a tourist returning from Cambodia / 대한내과학회지

Melioidosis, which is infection with the Gram-negative bacterium Burkholderia pseudomallei, is an important cause of sepsis in Southeast Asia and northern Australia and mainly affects diabetics who come into direct contact with wet soil. It presents as a febrile illness, ranging from an acute fulminant septicemia to a chronic debilitating localized infection. Only two cases of chronic infection have been reported in Korea. Both patients had lived in Southeast Asia for more than 1 year. We report a case of melioidosis presenting as acute fulminant septicemia and pneumonia in a 47-year-old diabetic male who had visited Cambodia for 4 days, 1 month before admission. He died of refractory septic shock and multi-organ failure within 10 hours of admission. Melioidosis should be suspected in any severely ill febrile patient with an underlying predisposing condition who lives in, or has travelled from, an endemic area.

Changes of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sputum from Moderate to Severe Acute Asthma after Corticosteroid Therapy / 소아알레르기및호흡기학회지

PURPOSE: Bronchial asthma is an inflammatory respiratory disease characterized by the activation of inflammatory cells and its infiltration. It has been recently reported that MMP- 9 dose an importance role in the movement of inflammatory cells through basal membrane, that the function may be suppressed by TIMP-1. We studied to know the change of MMP-9 and TIMP-1 in sputum before and after corticosteroid (CS) therapy, and the relation with MMP-9/TIMP-1 ratio and improvement of FEV1. METHODS: Seventeen acute moderate to severe asthmatics were selected as was a control group of 17 healthy children. MMP-9 and TIMP-1 in sputum were measured on the 0 day, 7 days and 3 months later and observed as to the flow of time. FEV1 was measured before the CS therapy and 3 months later, and the change of FEV1 & FEV1 at 3 months were compared with the relation of MMP-9/TIMP-1 ratio. RESULTS: Sputum MMP-9 was lowered more at 7 days and 3 months compared with 0 day (P< 0.05). Sputum TIMP-1 was significantly high on 7 days (P< 0.05) and then had a tendency to decrease until 3 months (P< 0.05). MMP-9/TIMP-1 ratio decreased according to the flow of time (P< 0.05). MMP-9/TIMP-1 ratio at 3 months closely correlated with the change of FEV1 (r=0.65, P< 0.05). CONCLUSION: These data suggest that the overproduction of MMP-9 after asthma exacerbation correlates with airway inflammation and TIMP-1 production might contribute to airway fibrosis. MMP-9/TIMP-1 ratio at 3 months correlates with improvement of pulmonary function after CS therapy.

Severe Acute Respiratory Syndrome, SARS / 대한임상미생물학회지

An international outbreak of severe acute respiratory syndrome (SARS), a recently recognized syndrome caused by the newly identified severe acute respiratory syndrome-associated coronavirus (SARS-CoV), began in November 2002 and ended in July 2003. Coronavirus is a family of enveloped, single stranded-RNA viruses causing disease in humans and animals, but the other known coronaviruses that affect humans cause only the common cold. The number of SARS cases in 2003 was approximately 8000 across the world. Many recent studies have reinforced initial impressions that SARS-CoV is primarily transported via contact and/or droplets and that the combination of standard, contact, and droplet precautions is generally effective for its control. Active surveillance for clusters of cases of severe respiratory disease must be a first priority, especially among health care workers. Such surveillance should include the rapid diagnosis and prevention of other respiratory viruses that cause outbreaks of febrile respiratory disease-notably, influenza. Surveillance on the part of clinicians is the key to the early detection of any reemergence before it regains a foothold in the community. During the outbreak of SARS, ribavirin, steroids, interferon, convalescent plasma, and lopinavir/itonavir were used in varying doses and combinations in different regions of the world. At present no definitive conclusions regarding the efficacy of any of these treatments can be drawn. New findings regarding SARS are continuing to be discovered at an unprecedented pace, permitting a better understanding of the disease and enabling better preparation for its possible returns.

Feasibility of Reflecting Improvement of Tumor Hypoxia by Mild Hyperthermia in Experimental Mouse Tumors with 18F-Fluoromisonidazole / 대한방사선종양학회지

PURPOSE: The aims of this study were to evaluate the change of [18F]fluoromisonidazole ([18F]FMISO) uptake in C3H mouse squamous cell carcinoma-VII (SCC-VII) treated with mild hyperthermia (42oC) and nicotinamide and to assess the biodistribution of the markers in normal tissues under similar conditions. METHODS AND MATERIALS: [18F]FMISO was producedby our hospital. Female C3H mice with a C3H SCC-VII tumor grown on their extremities were used. Tumors were size matched. Non-anaesthetized, tumor-bearing mice underwent control or mild hyperthermia at 42oC for 60 min with nicotinamide (50 mg/kg i.p. injected) and were examined by gamma counter, autoradiography and animal PET scan 3 hours after tracer i.v. injected with breathing room air. The biodistribution of these agents were obtained at 3 h after [18F]FMISO injection. Blood, tumor, muscle, heart, lung, liver, kidney, brain, bone, spleen, and intestine were removed, counted for radioactivity and weighed. The tumor and liver were frozen and cut with a cryomicrotome into 10-micrometer sections. The spatial distribution of radioactivity from the tissue sections was determined with digital autoradiography. RESULTS: The mild hyperthermia with nicotinamide treatment had only slight effects on the biodistribution of either marker in normal tissues. We observed that the whole tumor radioactivity uptake ratios were higher in the control mice than in the mild hyperthermia with nicotinamide treated mice for [18F]FMISO (1.56+/-1.03 vs. 0.67+/-0.30; p=0.063). In addition, autoradiography and animal PET scan demonstrated that the area and intensity of [18F]FMISO uptake was significantly decreased. CONCLUSION: Mild hyperthermia and nicotinamide significantly improved tumor hypoxia using [18F]FMISO and this uptake reflected tumor hypoxic status.

Effect of Coexistence of Allergic Rhinitis in Mild Persistent Asthma on Lower Airway Eosinophilic Inflammation / 소아알레르기및호흡기학회지

PURPOSE: Epidemiologic studies have demonstrated that rhinitis and asthma commonly coexist in the same patients and that a temporary relationship exists between the onset of rhinitis and asthma, with rhinitis frequently preceeding the development of asthma. Despite the compelling evidence that rhinitis has a remarkable impact on asthma, it has been controversial how the presence of rhinitis causes asthma to be worsen. We studied to know the effect of coexistence of allergic rhinitis on lower airway eosinophilic inflammation in mild persistent bronchial asthma. METHODS: A total of 129 mild persistent asthmatics were enrolled and divided into three different groups as follows: 37 cases with asthma only; 40 cases with mild allergic rhinitis; and 52 cases with moderate to severe allergic rhinitis. Methacholine challage test and sputum induction were performed and sputum ECP, sputum eosinophils and bronchial hyperresponsiveness (BHR) were compared in each group. RESULTS: In mild asthmatics with moderate to severe allergic rhinitis, the BHR to methacholine increased compared to those with mild or no allergic rhinitis. Eosinophils and ECP in induced sputum were significantly higher in more severe allergic rhinitis groups. We also found a significant correlation between BR index and sputum eosinophils. (gamma=0.578, P< 0.05) CONCLUSION: Our results demonstrated that the severity of allergic rhinitis was related to lower airway eosinophilic inflammation and bronchial hyperresponsiveness in mild persistent asthmatics with allergic rhinitis.

A Case of Hypersensitivity Pneumonitis by Alternaria as a Suspected Etiology / 결핵

A 65-year-old man was admitted due to low grade fever, dry coughing, and dyspnea on exertion. The chest radiograph and CT scan showed diffuse ground glass opacities and small nodules in the both lung fields resulting in a diagnosis of severe interstitial pneumonia. Conservative treatment with antibiotics and bronchodilators decreased the symptoms, but the dyspnea and cough reappeared when he returned home. An inspection of his house revealed the presence of fungi under the wallpaper. His symptoms disappeared completely after these were removed. His clinical course raised the suspicion of hypersensitivity pneumonitis and these fungi believed to be the cause of hypersensitivity pneumonitis. The histological findings of a lung specimen by video-assisted thorachoscopy were compatible with hypersensitivity pneumonitis. The fungi were identified as Alternaria.

The Effect of Atopy and Airway Eosinophilic Inflammation on Exercise-Induced Bronchospasm in Asthmatics / 소아알레르기및호흡기학회지

PURPOSE: Exercise-induced bronchospasm (EIB) is widely prevalent in asthmatic patients. Recently, eosinophilic airway inflammation and atopy (defined as skin sensitivity to common aeroallergens) are considered to be a important factors in the pathogenesis of asthma. Thus we studied to find out the effect of atopy and airway eosinophilic inflammation on exercise- induced bronchospasm. METHODS: We followed up the cases of 132 mild asthmatics for 2 years. On their first visit, skin prick tests, with 29 common allergens including dust mites antigen, and sputum induction were performed. And 3 days later, methacholine challenge was done. 24 hours after methacholine challenge, treadmill test was performed and the positive EIB was defined as a 15% reduction or more in FEV1 from baseline after exercise. RESULTS: EIB was observed in 54 (40.9%) of 132 asthmatic subjects. There was no significant difference in atopy between EIB positive and EIB negative asthmatics. Eosinophil and eosinophil cationic protein in induced sputum were significantly higher in EIB positive asthmatics. We also found the significant correlation between bronchial responsiveness (BR) index and maximal % fall in FEV1. CONCLUSION: The severity of bronchospasm evoked by exercise was more closely related to eosinophilic airway inflammation and airway hyperresponsiveness to methacholine than atopy.

Clinical Effectiveness of Diagnosis Using Immunohistochemistry and New Grade in Gastrointestinal Stromal Tumors (GISTs)

PURPOSE: Paraffin-embedded tissue samples from the gastrointestinal tract, which had been diagnosed as tumors of a mesenchymal origin, were reviewed by an immunohistochemical staining method. The prognostic significances of the immunohistochemical subtypes and anatomical locations were also investigated. GIST, as a new grading system, was compared with the pre-existing system for its useful prognostic significance. METHODS: 122 cases were evaluated and classified by immunohistochemical staining for KIT, CD34, actin, desmin, vimentin, S-100 protein and NSE. RESULTS: Positivity for both KIT and CD34 of 92.6 and 73.8%, respectively, indicated that KIT was more effective for the diagnosis of GISTs. The stomach (62.3%) and small bowel (23.7%) were most common organs of GIST. There was no difference in the prognosis between these two organs. Immunophenotypically, the uncommitted, myoid, combined and neural types were 37.7, 23.7, 20.2 and 7%, respectively. There was no significant difference in the prognosis between these types. The old grading system showed no difference between the borderline and malignant groups (P=0.14), whereas, the new grading system showed a significant difference between the intermediate and high risk groups (P=0.01). CONCLUSION: KIT is more useful for the diagnosis of GOSTs. The immunophenotypical classification and anatomical location showed no prognostic significance in GISTs. Therefore, the new grading system might be more useful than older system.

The Effect of Antigen Sensitization and Development of Respiratory Allergy Disease on Severity of Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Atopic dermatitis is the most common chronic inflammatory skin disease in children. However, the role of allergy in the pathogenesis of atopic dermatitis is still controversial. The purpose of this study is to investigate the effects of antigen sensitization and development of respiratory allergy disease on severity of atopic dermatitis. METHODS: 211 children with atopic dermatitis were monitored for 2-3 years and classified into three groups: mild, moderate, severe. The severity of atopic dermatitis was compared with antigen sensitization identified by MAST CLA Korea Panel and development of respiratory allergy disease; such as asthma and allergic rhinitis. RESULTS: The frequency of mild, moderate, severe atopic dermatitis was respectively, 38.4%, 33.6%, 28.0%. Food sensitization was significantly higher in patients under 4 years old and aeroallergen sensitization was higher in patients above 5 years old. There was a good correlation between the severity of atopic dermatitis and food sensitization but not in aeroallergen. There was no significant association the severity of atopic dermatitis and development of respiratory allergy disease. CONCLUSION: This result suggests that the sensitization to food allergen is associated with the severity of atopic dermatitis, but sensitization to aeroallergen and development of respiratory allergy disease are not correlated. The restriction of sensitized diets might be helpful in management of atopic dermatitis.

IL-4, IFN-gamma, IL-5, IL-12 Production by Peripheral Blood Mononuclear Cells of Moderate Atopic Asthma and Its Relation with Clinical Findings / 소아알레르기및호흡기학회지

PURPOSE: Activation of T helper(Th) cells and secretion of cytokines play a pivotal role in the pathogenesis of asthma. Th2 cells secrete IL-4 and IL-5. IL-4 stimulates IgE production and IL-5 is related with hematopoiesis, chemotaxis and activation of eosinophils. IFN-gamma produced by Th1 cells and IL-12 produced by antigen presenting cells have an inhibitory action on IgE production. We examined the cytokine production by peripheral blood mononuclear cells(PBMCs) of atopic asthmatic children and its relation with clinical findings. METHODS: We measured IL-4, IFN-gamma, IL-5, IL-12 in serum and supernatants of stimulated PBMCs cultures in 32 children with moderate stable asthma and 17 healthy controls. They were compared with number of skin test positive allergens, serum total IgE, peak expiratory flow rate(PEFR), methacholine PD20, sputum eosinophils and eosinophil cationic protein(ECP). RESULTS: No difference in serum cytokines was found between patients and controls, except IL-5. In supernatants of stimulated PBMCs cultures, the concentration of IL-4, IL-5 was significantly increased and IFN-gamma, IL-12 was significantly decreased in patients compared with controls. IL-4 was related with total serum IgE and numbers of skin test positive allergens. IL-5 was related with sputum eosinophils and ECP. The serum total IgE was inversely and PEFR was directly related with IFN-gamma. CONCLUSION: In atopic asthmatics, Th1 cytokines were increased and Th2 were decreased in stimulated PBMCs cultures. IL-4 was related with atopy, IFN-gamma with lung function and IL-5 with airway inflammation.

Eosionophils in Induced Sputum and Peak Experatory Flow Rate Variability in Children with Allergic Rhinitis / 소아알레르기및호흡기학회지

PURPOSE: A large number of studies have demonstrated that rhinitis and asthma commonly occur together, and that a temporary relationship between the onset of rhinitis and asthma with rhinitis frequently preceding the development of asthma. We studied to know whether there were asthmatic airway inflammations in subjects with allergic rhinitis with bronchial hyperresponsiveness to methacholine who had no asthma symptoms. METHODS: Thirty seven children with an allergic rhinitis who visited the pediatric allergy clinic from January 1998 through June 1999 were enrolled. They were grouped into two groups according to the degree of airway responsiveness to methacholine, and 19 bronchial asthma patients with had no asthma attacks for 2 months were compared as control group.; AR-Mch (+) group (n=19) had a PC20-Methacholine lower than 10 mg/mL: AR-Mch (-) group (n=18) had a PC20-Metacholine greater than 10 mg/mL. The relationship of PEFR variability, sputum eosinophils, and nasal eosinophils with bronchial hyperresponsiveness to methacholine in each groups was compared. RESULTS: 1) The PC20-Methacholine was 5.7+/-3.5 mg/mL in the AR-Mch (+) Group, 1.9+/-2.7 mg/mL in the BA Group. 2) Sputum eosinophil was 14+/-6.9% in the AR-Mch (+) Group, 8.1+/-5.2% in the AR-Mch (-) Group, 29.6+/-16.9% in the BA Group, and sputum eosinophils of the AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 3) PEFR dinural variation was 7.0+/-2.6% in the AR-Mch (+) Group, 5.0+/-2.9% in the AR-Mch (-) Group, 14.0+/-6.0% in the BA Group, and PEFR dinural variation in AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 4) The PC20-Methacholine was not correlated with PEFR dinural variation in both the AR-Mch (+) Group and the BA Group. 5) The PC20-Methacholine was correlated with sputum eosinophils only in the BA Group. 6) Nasal eosinophils were not correlated with sputum eosinophils in the AR-Mch (+) and the BA Group. CONCLUSIONS: This study demonstrated that patients with allergic rhinitis who had bronchial hyperresponsiveness to methacholine might have eosinophilic inflammation in the lower airway and increased dinural PEFR. Further studies are necessary to evaluate whether asthma symptoms will be developed in these allergic rhinitis children.

Significance of Eosinophils and Eosinophil Cationic Protein in Induced Sputum in Childhood Asthma / 소아알레르기및호흡기학회지

PURPOSE: Airway eosinophilic inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: A total of 40 asthmatic children over 6 years of age were divided into two groups : Group A of 15 current symptomatic subjects and Group B of 25 stable asymptomatic subjects with history of asthma for 2 weeks. Eosinophils in induced sputum were compared with the severity of asthma symptom, pulmonary function, bronchial hyperresponsiveness by methacholine, sputum ECP, blood eosinophils and serum ECP. RESULTS: 1) Asthmatics had a significantly higher proportion of sputum eosinophils than the control subjects (15.2+/-17.8% VS 3.8+/-4.5%, P<0.01). Group A had a significantly higher proportion of sputum eosinophils than group B (22.9+/-21.7% VS 11.2+/-14.8%, P<0.05). 2) Sputum eosinophils were correlated with symptom scores in asthmatics (r=0.76, P<0.01), inversely correlated with FEV1 in group A (r=-0.65, P<0.01) and with LogPC20 in group B (r=-0.45, P<0.05). 3) Sputum eosinophils were correlated with sputum ECP for group A; r=0.77 (P<0.01) and for group B; r=0.39 (P<0.05) but not correlated with serum ECP. 4) Sputum eosinophils were correlated with blood eosinophils in group A (r=0.67, P<0.05), but not in group B. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with blood eosinophils or serum ECP are to be studied further.

Genotype Frequencies of Platelet Glycoprotein IIIa-Specific Antigens and Granulocyte Antigens In Korean Pregnant Women* / 대한수혈학회지

BACKROUND: Polymorphism of glycoprotein IIIa on human platelets is one of the factors in alloimmunization that causes neonatal alloimmune thrombocytopenia (NATP), and the granulocyte antigens NA1 and NA2 are often targets of granulocytes antibodies causing neonatal alloimmune neutropenia (NANP). Currently, serotyping relies on the properties of the typing sera or antibodies and technique used. Genotyping circumvents the problems associated with serotyping. METHODS: The genomic DNA of 200 unrelated pregnant women admitted to Taegu Fatima Hospital was typed for three platelet glycoprotein IIIa-specific antigens (HPA-1, HPA-4, and HPA-6w) and granulocyte antigens (NA1 and NA2). Allele specific amplification test using primer designed to study HPA-1 and HPA-4, restriction fragment length polymorphism to study HPA-6w, and sequence specific primers for NA1 and NA2 were used for genotyping. RESULTS: The genotype frequencies were HPA-1(a+b-) 100%, HPA-4 (a+b-) 97.5%, HPA-4(a+b+) 2.5%, HPA-6w(a+b-) 97%, and HPA-6w(a+b+) 3%. These frequencies are similar to Japanese but different from Caucasian. The gene frequencies of NA1 and NA2 were 0.56 and 0.44 respectively. There are no cases of alloimmune thrombocytopenia and neutropenia in newborns from the 200 studied women. CONCLUSIONS: The differences in genotype frequencies among platelet glycoprotein IIIa-specific antigens and in the gene frequencies of NA in Koreans are shown as compared with other ethnic groups. Therefore it is needed to find the proper screening target antigens and antibodies for Korean NATP and NANP patients.