• KSBB Journal
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• v.24 no.4
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• pp.383-392
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• 2009

Xanthii fructus which is well known as "Chang-ihjah" in Korea is the dried fruit of Xanthium strumarium L. (or Xanthium sibiricum PATR. Ex WIDD., Asteraceae. XS). Water extract of this fruit has been used for treatment of various inflammatory diseases such as tympanitis, allergic rhinitis, or ozena as alternative therapy material usually by oral administration in far Eastern countries including Korea. In this study, the effect of XS extract (XS-E) or XS-30% acetone fraction layer (XS-30% AFL) on the differentiation of $CD4^+$ T cells isolated from NC/Nga mouse and the production of IL-17 was investigated. The experimental results showed that $100\;{\mu}g$/mL of XS-E could decrease the production of IL-17 by $CD4^+$ Th17 cells by 2 fold and only $20\;{\mu}g$/mL of XS-30% AFL could inhibit 3.5 fold. The amount of IL-17A and IL-22 mRNA determined by real-time PCR was decreased remarkably when XS-E or XS-30% AFL was treated on $CD4^+$ Th17 cells(p<0.01, p<0.001). The amount of IL-17A protein determined by ELISA was also decreased remarkably(p<0.05, p<0.001). To study the effect of XS-E or XS-30% AFL on the proliferation of Th17 cells, $CD4^+$ T cells of a NC/Nga mouse was firstly differentiated by rIL-6/TGF-$\beta$ and then stimulated by rIL-23. The control group of Th17 cells were doubled every each day, while those of XS-E or XS-30% AFL treated group were shown to be delayed remarkably by these extracts. In conclusion, XS can inhibit the differentiation of Th17 cells of NC/Nga mouse and the production of IL-17 successfully, which may be a beneficial result for the treatment of atopic skin dermatitis.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.94-99
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• 2008

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.868-873
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• 2008

Purpose : Immunotherapy is accepted as the only treatment of allergic disease that can modify the natural course of the disease and ameliorate symptoms. This study aimed to evaluate the safety and efficacy of ultra-rush therapy using Dermatophagoides extracts in children. Methods : Of children older than four years who had visited Bundang CHA Pediatric Allergy Clinic, those showing positive reactions only to Dermatophagoides in the skin prick test and to the nasal provocation test were included. In all, 11 and 12 patients respectively preferred conventional and ultra-rush immunotherapy. We elevated allergen concentrations diluted to 1,000:1 of the end strength by 2-3 times with 30-minute intervals and checked oxygen saturation, pulse rate, blood pressure, and systemic reactions every 15 minutes. Immunotherapy effectiveness was valued by changes in nasal provocation test scores before and after immunotherapy. Results : The average ages of patients in the conventional and ultra-rush immunotherapy groups were $8.3{\pm}2.3$ and $9.2{\pm}2.8years$, respectively. Systemic reactions were observed in six in the ultra-rush group (50%) without anaphylaxis and one (9%) in the conventional group. The average scores in the nasal provocation test before and after treatment in the conventional group were $8.2{\pm}1.5$ and $4.6{\pm}2.1$, respectively (P=0.043). In the ultra-rush immunotherapy group, the scores changed from $6.2{\pm}2.2$ to $3.7{\pm}2.5$ (P=0.017). Conclusion : Ultra-rush immunotherapy using Dermatophagoides in children is effective for treating allergic disease but can induce systemic effects rather than conventional immunotherapy.