Immunizing children aged 9 to 15 months with live attenuated SA14-14-2 Japanese encephalitis vaccine in Thailand.

The authors aimed to evaluate the safety and immunogenicity of a live attenuated SA14-14-2 Japanese Encephalitis (JE) vaccine in healthy Thai infants. One hundred and fifty subjects aged 9-15 months were vaccinated with one dose of this vaccine. Regarding the vaccine safety, during the 28-day post-vaccination follow-up, no vaccine-related serious adverse events were reported. In terms of immunogenicity, the sero-conversion rate of a single dose vaccination was 95% (95% CI, 90.0-97.6%) within 90 days after vaccination and the geometric mean titer (GMT) was 66.1. Eight subjects with JE seronegative on days 28-35 post-vaccination became sero-positive on day 90. Seven subjects who remained sero-negative during days 28-35 and day 90 post-vaccination were successfully sero-converted after receiving a second dose 3 months later. Thus, two doses of this JE vaccine resulted in a 100% (95% CI, 97.3-100%) sero-conversion rate with the GMT of 260.8. Eight children with GMTs lower than protective level after a single vaccination demonstrated a booster response with GMT of 1237 after the second dose of JE vaccination. In conclusion, the live attenuated SA14-14-2 vaccine was safe, well tolerated and highly immunogenic with 95% and 100% sero-conversion rate after one and two doses, respectively. Nevertheless, its long-term immune response and possible influences from natural dengue infection requires further evaluatiope

Immunogenicity and Safety of a 20 ㎍ Dose of the Green Cross Recombinant Hepatitis B Vaccine ( HG -Ⅱ ) in Healthy Adults

Background/Aims . The introduction of Hansenula polymorpha for recombinant hepatitis B vaccine production allowed high product yield with plasmid stability and less glycosylation than conventional Saccharomyces cerevisiae system. A Green Cross HG-II vaccine formulated from HBsAg produced by a recombinant strain of the yeast H. polymorpha was evaluated for immunogenicity and safety in an open label triaL Method ' A 20 ug dose of Green Cross HG-II vaccine was administered intramuscularly at 0, 1 and 6 months at the deltoid region in 118 healthy adults seronegative for HBV markers. The anti-HBs titers were determined at one month after administration of the third dose of vaccine by radioimmunoassay. Results .' The seroconversion rate was 96.8% (90 out of 93), with seroprotective rate of 95.7% (89 out of 93). The geometric mean titers(GMT) of the anti-HBs response was 153.1mIU/ml in seroconverters. An age-dependent effect was observed in the anti-HBs response. But sex-dependent effect was not prominent. Reactogenecity was in incidence and general reactions were short-lasting and a mainly mild in severity. Conclusions .' The results of this study have shown that the Green Cross HG-II vaccine is safe and clinically well tolerated, a nd that it may provide protection against HBV infection.ope

Idiopathic thrombocytopenic purpura in childhood-predicting clinical prognosis and evaluation of treatment

의학과/석사[한글] 소아에서 발생하는 특발성 혈소판 감소성 자반증(Idiopathic thrombocytopenic purpura,이하 I T P라 약함)의 임상 경과는 환자를 계속 관찰하여야 알 수 있다. Doan등 (1967), Walker와 Walker (1961),Simon등(1975),및 McClure(1975)등은 소아 I T P의 70∼80%는 급성형이고, 나머지 20∼30%는 만성의 경과를 처하는 성인형 자가면역 성 혈소판 감소증 (Karpatkin, 1980)과 유사하다고 하였다. 소아 I T P의 급성형과 만성형은 여러가지 차이점이 있다. 또한 급성형의 연속이 만성형으로 이행되는 것인지 아니면 처음부터 만성형의 I T P로 시작되는 것인지 확실치 않다. 저자는 112예의 소아 I T P환아에 대한 임상적 연구결과와 스테로이드요법을 시행한 81예및 감마글로부린요법을 시행한 13예에 대한 치료 효과를 보고하는 바이다. 외국의 문헌과 비교하여 연령, 성별 및 임상증상에서는 의의있는 차이가 없었으며 임상형은 급성형이 73예로 69%였고 만성형이 21예 (18%), 재발형이 12예 (13군)였다. 73예의 급성형에서는 선행된 바이러스 질환의 빈도가 높았고( P<0.05) 출혈증상의 기간이 2주이 하였다 (p<0.05). 급성형에서의 스테로이드 치료효과는 스테로이드 투여군과 투여치 않은 군간에 차이가 없었으나, 초기 혈소판수가 20.001/㎣이상 이었던 환아 29예에서는 스테로이드를 투여한 경우가 투여치 않은 경우보다 혈소판의 회복이 2배정도 빨랐다(P<0.01). 감마글로부린의 치료 효과는 13예중 8예에서 급속한 혈소판수의증가를 관찰 하였으며 1 예에서 완전회복을 유지하였다. 만성형 I T P에서는 스테로이드, vincristine, 감마글로부린등에 따른 치료 효과에는 차이가 없었으나 스테로이드 단독 투여보다는 감마글로부린과의 병행요법이 더 좋은 결과를 기대해 볼수 있을 것으로 생각된다. 재발형 l T P 12예에서는 첫 스테로이드 치료에 혈소판수의 증가를 보인 7예중 4예에서 추후 완전 회복이 관찰되었다. 이는 재발형 I T P의 경우 첫스테로이드 치료에 반응을 보이면 추후 완전회복의 가능성이 높음을 시사하는 것으로 생각된다. [영문] A clinical study was conducted to predict acute vs chronic childhood idiopathic thrombocytopenic purpura. Also this study valuated the effect of steroid treatment in acute ITP and the effect of gammaglobulin treatment in recurrent or chronic ITP. Author observed the clinica1 features on 112 cases of the period of 10 years form January, 1975 to March, 1985. The following results were obtained. 1. Acute ITP was the most frequent clinical form(69%) and age group less than 7 was 79%, male to female ratio was 1.4:1. 2. Antecedent viral illness was noted in 52% at acute form, but in 20% at chronic form ITP. 3. Eighty six percent of patients in acute in had a short duration of hemorrhagic symptom, less than 2 weeks, before presentation. 4. Eighty five percent of patients with a short duration of hemorrhagic symptom were recovered. 5. Clinical symptoms were petechiae or bruise(99.1%), epistaxis(34.0%) gastrointestinal bleeding(27.7%), hematuria(8.9%), and gum or oral mucosal bleeding(5.4%). Splenomegaly was observed in 8% of patients. There was no intracranial bleeding. 6. There was no prognostic predictability in initial platelet count or anti-paltelet antibody. 7. Thirty one patients. Who had initial platelet count 20,000/㎣ and were treated with steroid, increased their platelet count by at least 100,000/㎣, required the about 31 days. But 8 patients who had same range of initial platelet count, and had been observed, required about 15 days. Sixteen patients, initials, platelet count more than 20,000/㎣, treated steroid required about 16 days and 13 observated patients with same initial platelet count range required about 29 days. 8. There was no definite difference of outcome between gammaglobulin and steroid treatment in chronic and recurrent form of ITP. But initial platelet response to steroid may be a good prognostic sign of following sustained remission.restrictio