• Childhood Kidney Diseases
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• v.9 no.2
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• pp.143-148
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• 2005

Purpose : Hypogammaglobulinemia has been observed in nephrotic syndrome, but its pathophysiology remains unknown. We evaluated serum immunoglobulins, IgG subclasses, and vaccine-induced viral antibodies(anti-hepatitis B surface IgG and anti-measles IgG) in children with minimal change nephrotic syndrome(MCNS). Methods : Using the stored sera, the levels of immunoglobulin(IgC, IgM, IgA, and IgC) and IgG subclasses(IgG 1, 2, ,3, and 4), anti-HBs Ab and anti-measles IgG of 21 children with MCNS were analyzed and compared to those of 25 age-matched healthy children. Results : The mean values of IgG and IgG1 were $390{\pm}187\;mg/dL$ and $287{\pm}120\;mg/dL$ in nephrotic children, and $1,025{\pm}284\;mg/dL$ and $785{\pm}19\;mg/dL$ in control children, respectively. The values of the total IgG and the 4 IgG subclasses in nephrotic children were all significantly depressed(P<0.001), but the IgM($251{\pm}183\;mg/dL\;vs. 153{\pm}55\;mg/dL$, P=0.02) and IgE values(P=0.01) were elevated, and the IgA values were not changed. The seropositivity of anti-HBs IgG was 42.9$\%$(9 of 21 cases) in the MCNS group and 52$\%$(13/25) in the control group, and that of anti-measles IgG was 75$\%$(16/21) and 92$\%$(23/25), respectively, but there was no statistical difference between the two groups. Conclusion : IgG and IgG subclass levels in MCNS children are all depressed without significant seronegativity of the vaccine-induced viral antibodies. Further studies are needed to resolve the cause of hypogammaglobulinemia in MCNS. (J Korean Soc Pediatr Nephrol 2005;9:143-148)

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.481-487
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• 2010

Purpose: Recently many studies show early exposure during childhood growth to endotoxin (lipopolysaccharides, LPS) and/or early exposure to allergens exhibit important role in development of allergy including bronchial asthma. The aim of this study was to evaluate the role of endotoxin and allergen exposure in early life via the airways in the pathogenesis of allergic airways inflammation and airway hyperresposiveness (AHR) in mouse model of asthma. Methods: Less than one week-old Balb/c mice was used. Groups of mice were received either a single intranasal instillation of sterile physiologic saline, 1% ovalbumin (OVA), LPS or $1.0{\mu}g$ LPS in 1% OVA. On 35th day, these animals were sensitized with 1% OVA for 10 consecutive days via the airways. Animals were challenged with ovalbumin for 3 days on 55th days, and airway inflammation, hyperresponsiveness, and cytokine expression were assessed. Measurements of airway function were obtained in unrestrained animals, using whole-body plethysmography. Airway responsiveness was expressed in terms of % enhanced pause (Penh) increase from baseline to aerosolized methacholine. Lung eosinophilia, serum OVA-IgE and bronchoalveolar lavage (BAL) fluid cytokine levels were also assessed. ANOVA was used to determine the levels of difference between all groups. Comparisons for all pairs were performed by Tukey-Kramer honest significant difference test; $P$ values for significance were set to 0.05. Results: Sensitized and challenged mice with OVA showed significant airway eosinophilia and heightened responsiveness to methacholine. Early life exposure of OVA and/or LPS via the airway prevented both development of AHR as well as bronchoalveolar lavage fluid eosinophilia. Exposure with OVA or LPS also resulted in suppression of interleukin (IL)-4, 5 production in BAL fluid and OVA specific IgE in blood. Conclusion: These results indicate that antigen and/or LPS exposure in the early life results in inhibition of allergic responses to OVA in this mouse model of astham. Our data show that early life exposure with OVA and/or LPS may have a protective role in the development of allergic airway inflammation and development of allergen-induced airway responses in mouse model of asthma.

• Journal of Acupuncture Research
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• v.22 no.3
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• pp.227-241
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• 2005

Objective & Methods : The purpose of this study is to observe the effects of Asari Herba Cum Radice herbal-acupuncture solution(AHCR-HAS) on arthritis of mice induced by Collagen II at Joksamni(ST36). The author performed several experimental items. First, it is the cell survival rate of mice lung fibroblasts and expression of TNF-${\alpha}$ in synovial cells. Second, it is the incidence rate of arthritis and the weight of spleen. Third, it is the levels of IL-6, TNF-${\alpha}$, INF-${\gamma}$, IgG, IgM and anti-collagen II in serum Fourth, it is histological analysis of the mice joint. Fifth, it is expression ratio of CD3e+ to CDl9+ cell, CD4+ to CD8+ cell, CD69+/CD3e+ cells, CD11+/CD19+ cells and CD11b+/Gr-1+ cells. Result : 1. The highest survival rate of mice lung fibroblasts were measured in the 1% AHCR-HAS, and the expression of TNF-${\alpha}$ in synovial cells were significantly decreased in the 1% AHCR-HAS. 2. In the AHCR-HA I & AHCR-HAII groups, the incidence of arthritis and the weight of spleen were significantly decreased. 3. In AHCR-HAI & AHCR-HAII groups, the levels of IL-6, INF-${\gamma}$, TNF-${\alpha}$, IgG, IgM and anti-collagen II in serum of CIA mice were significantly decreased. 4. In histology, the cartilage destruction and synovial cell proliferation were decreased in the AHCR-HA I & AHCR-HAII groups, and the collagen fiber expressions in the AHCR-HA I & AHCR-HAII groups were similar with that of the Normal group. 5. In the AHCR-HA I & AHCR-HA II groups, the expression ratio of CD3e+ to CD19+ cell and CD4+ to CD8+ cell were similarly maintained as Normal group in lymph nodes, and CD69+/CD3e+ cells and CD11a+/CD19+ cells were decreased in Iymph nodes, and CD11b+/Gr-1+ cells were decreased in synovium. Conclusion : Taking all these observations into account, AHCR-HA is considered to be effective in prophylaxis and treatment of rheumatoid arthritis, and then more effective in prophylaxis than treatment, so put to practical use in future rheumatoid arthritis clinic.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1241-1248
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• 2009

Purpose:The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections. Methods:Nasopharyngeal aspirate samples were obtained from 54 patients diagnosed with KD at the Seoul National University (SNU) Children's Hospital and SNU-Bundang Hospital between October 2003 and September 2006. Viral diagnoses of 11 respiratory viruses were made using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR): respiratory syncytial virus (RSV), adenovirus, rhinovirus (RV), parainfluenza viruses (PIVs) 1 and 3, influenza viruses (IFVs) A and B, human metapneumovirus (HMPV), human bocavirus (HBoV), HCoV OC43/229E, and HCoV-NL63. Clinical data were reviewed retrospectively. Results:The median age was 32 months (6 months-10.4 years). Respiratory symptoms were observed in 37 patients (69%). The following respiratory viruses were identified in 12 patients (22%): RV (n=4), PIV-3 (n=2), HBoV (n=2), and adenovirus, RSV, PIV-1, IFV-A, and HCoV-NL63 (n=1). Co-infection with PIV-3 and RV was observed in one patient. Respiratory symptoms were observed in 7 (58.3%) and 30 (71.4%) patients of the virus-positive and virus-negative groups (P>0.05). Response rate to intravenous immunoglobulin administration was 67% (n=8) and 86% (n=36) in the virus- positive and virus-negative groups (P>0.05). Conclusion:Respiratory symptoms were commonly observed in KD patients but the association between respiratory viruses and KD were not found. Large multicenter-based investigations are required to confirm the association between acute respiratory viral infections and KD.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.489-497
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• 2002

Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.857-863
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• 2006

Purpose : To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. Methods : A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. Results : The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. Conclusion : Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.1-16
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• 2011

Owing to the risk of fetal loss associated with prenatal diagnostic procedures (amniocentesis, chorionic villus sampling), noninvasive prenatal diagnosis (NIPD) is ultimate goal of prenatal diagnosis. The discovery of circulating cell-free fetal DNA (cffDNA) in maternal plasma in 1997 has opened up new probabilities for NIPD by Dr. Lo et al. The last decade has seen great development in NIPD. Fetal sex and fetal RhD status determination by cffDNA analysis is already in clinical use in certain countries. For routine use, this test is limited by the amount of cell-free maternal DNA in blood sample, the lack of universal fetal markers, and appropriate reference materials. To improve the accuracy of detection of fetal specific sequences in maternal plasma, internal positive controls to confirm to presence of fetal DNA should be analyzed. We have developed strategies for noninvasive determination of fetal gender, and fetal RhD genotyping using cffDNA in maternal plasma, using real-time quantitative polymerase chain reaction (RT-PCR) including RASSF1A epigenetic fetal DNA marker (gender-independent) as internal positive controls, which is to be first successful study of this kind in Korea. In our study, accurate detection of fetal gender through gestational age, and fetal RhD genotyping in RhD-negative pregnant women was achieved. In this assay, we show that the assay is sensitive, easy, fast, and reliable. These developments improve the reliability of the applications of circulating fetal DNA when used in clinical practice to manage sex-linked disorders (e.g., hemophilia, Duchenne muscular dystrophy), congenital adrenal hyperplasia (CAH), RhD incompatibility, and the other noninvasive pregnant diagnostic tests on the coming soon. The study was the first successful case in Korea using cffDNA in maternal plasma, which has created a new avenue for clinical applications of NIPD.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.52-61
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• 2005

Background: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. Materials and Methods: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. Results: The male to female ratio was 1.8:1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7 % of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3 %). Intravenous immunoglobulin therapy was performed in 29 cases (64.4 %). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. Conclusion: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.146-152
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• 2009

Purpose : We performed this study to evaluate the incidence and clinical significance of antiphospholipid antibodies (aPL Ab) in Korean children with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods : The medical records of 62 patients (31 boys and 31 girls) aged $46.0{\pm}3.1$ (1-16) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2009, the sera from children with acute HSP were tested for aPL Ab such as LA, anti-cardiolipin antibody and anti-${\beta}_2$ glycoprotein I antibody. Results : LA was positive in 18 (29%) of the 62 patients with HSP and We divided the patients into the two groups LA positive group (N=18) and LA negative group (N=44). There were no significant differences between the two groups with regard to abdominal pain, arthralgia and renal involvement, but LA positive group had significantly higher C-reactive protein ($4.3{\pm}7.2$ mg/dL vs. $1.3{\pm}1.8$ mg/dL, P=0.035), erythrocyte sedimentation rate ($37.5{\pm}26.2$ mm/hr vs. $25.1{\pm}22.6$ mm/hr, P= 0.039), IgM ($148.1{\pm}48.4$ mg/dL vs. $114.9{\pm}41.5$ mg/dL, P=0.024), C3 ($143.1{\pm}21.9$ mg/dL vs. $129.7{\pm}24.5$ mg/dL, P=0.048) and C4 levels ($30.9{\pm}6.3$ mg/dL vs. $24.9{\pm}7.8$ mg/dL, P=0.002) compared with LA negative group. Conclusion : We found that the incidence of positive aPL Ab tests was relatively higher in Korean children with HSP and the presence of aPL Ab was associated with acute inflammatory process of HSP. These results suggest that the aPL Ab are involved in the pathogenesis of HSP in children.