• 한국임상약학회지
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• 제22권3호
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• pp.268-273
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• 2012

The definition of anaphylaxis is 'a serious, life-threatening generalized or systemic hypersensitivity reaction' and is considered as the life threatening adverse drug reaction. We experienced a case of cefotetan induced anaphylaxis with negative pre-skin test, used for surgical prophylaxis. A 82-year-old female was scheduled for total knee replacement therapy. She had no previous history of allergy and her skin test results were also negative. On her right knee surgery, she underwent cefotetan therapy as a surgical prophylaxis for a week with no problems identified. Next left knee surgery, she also received the prophylaxis of intravenous cefotetan. However, a few minutes later, anaphylactic reaction developed with vomiting, severe hypotension, bronchospasm, and dyspnea. After immediate intensive care treatment, she recovered without significant complications. Though commonly used laboratory data in case reports, such as the specific IgE, tryptase, histamine, or allergic skin prick test were limited, we successfully confirmed anaphylaxis based on clinical criteria for diagnosing anaphylaxis based on WAO 2011 guideline with through concurrent patient°Øs medical history review and the process of identifying the causes.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.493-496
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• 2007

Dapsone은 나병과 여러 수포성 피부 질환의 치료에 널리 사용되고 있다. 일반적인 투여 용량의 dapsone은 부작용이 드물지만, 피부, 신경계, 위장관, 간, 신장과 혈액학적 합병증을 일으킬 수 있다. 이들 부작용 중 하나인 dapsone 증후군은 약물 투여 수주 후에 발생하여, 예측 불가능하게 진행하며 치명적인 경과를 취할 수 있는 중증 약물 과민 반응이다. 저자들은 dapsone 투여 4주 후에 열, 박탈성 피부염, 황달, 용혈성 빈혈, 늑막 삼출 등의 특징적인 임상 소견을 보인 dapsone 증후군 1례를 경험하였기에 보고하는 바이다.

• Parasites, Hosts and Diseases
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• 제52권6호
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• pp.581-593
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• 2014

Toxoplasmosis is an opportunistic infection caused by the protozoan parasite Toxoplasma gondii. T. gondii is widespread globally and causes severe diseases in individuals with impaired immune defences as well as congenitally infected infants. The high prevalence rate in some parts of the world such as South America and Africa, coupled with the current drug treatments that trigger hypersensitivity reactions, makes the development of immunotherapeutics intervention a highly important research priority. Immunotherapeutics strategies could either be a vaccine which would confer a pre-emptive immunity to infection, or passive immunization in cases of disease recrudescence or recurrent clinical diseases. As the severity of clinical manifestations is often greater in developing nations, the development of well-tolerated and safe immunotherapeutics becomes not only a scientific pursuit, but a humanitarian enterprise. In the last few years, much progress has been made in vaccine research with new antigens, novel adjuvants, and innovative vaccine delivery such as nanoparticles and antigen encapsulations. A literature search over the past 5 years showed that most experimental studies were focused on DNA vaccination at 52%, followed by protein vaccination which formed 36% of the studies, live attenuated vaccinations at 9%, and heterologous vaccination at 3%; while there were few on passive immunization. Recent progress in studies on vaccination, passive immunization, as well as insights gained from these immunotherapeutics is highlighted in this review.

• 한국임상수의학회지
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• 제40권4호
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• pp.288-293
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• 2023

A 11-year-old neutered male Maltese dog was vaccinated with a rabies vaccine (Rabisin^®, Boehringer Ingelheim International GmbH, Germany) subcutaneously at a local animal hospital. One hour after vaccination, purpura with edema was observed at the injection site and severe thrombocytopenia (0 K/μL) was noted on a complete blood count (CBC). No specific findings were found in serum chemistry, electrolyte, blood gas analysis, and coagulation tests. The patient was hospitalized and administered antihemorrhagic agents (vitamin K, desmopressin), antihistamines (chlorpheniramine) and corticosteroids (methylprednisolone sodium succinate). On a repeat CBC, mild anemia had developed, thrombocytopenia was still noted, and autoagglutination was observed on a saline agglutination test (SAT). A polymerase chain reaction panel for infectious agents (e.g., Babesia spp.) was negative. The diagnosis was secondary immune-mediated thrombocytopenia (IMT) with immune-mediated hemolytic anemia (IMHA) associated with vaccination. Therefore, the immunosuppressants (prednisolone, and mycophenolate mofetil) were administered. Six days after drug administration, new lesion was not observed, and the previous lesions were significantly improved. It gradually improved and 4 weeks after hematocrit and platelet recovered to normal levels. It was maintained for 6 months without recurrence of related symptoms. Based on patient's history and test results, the patient was diagnosed with Evans' syndrome associated with rabies vaccine.

• 대한미생물학회지
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• 제22권2호
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• pp.175-184
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• 1987

The use of alkylating agent cyclophosphamide(CY), a widely used antitumor drug is well known as a potent immunosuppressant and has been used as a probe for investigating the functional capabilities of lymphocyte subsets of both T and B cells that play an important role in the regulation of the immune response. The present study was undertaken in an effort to assess the effects of CY on immunological memory in murine model. CY, given as a single dose of CY(250mg/kg) before sensitization with sheep red blood cells(SRBC) enhanced the primary response of Arthus and delayed-type hypersensitivity(DTH), as measured by footpad swelling reaction, but suppressed their tertiary DTH response. The similar CY pretreatment enhanced both the primary and tertiary hemagglutinin(HA) responses to SRBC, and the tertiary antibody response against polyvinylpyrroridone(PVP), a thymus-independent antigen but not the primary response against PVP. CY, given as a single dose of 250mg/kg 2 days before the primary immunization and two doses of 100mg/kg 2 days before the secondary and tertiary immunization, markedly suppressed the tertiary DTH and HA responses to SRBC. However, CY, given as small multiple daily doses(10mg/kg) over 4 days before sensitization but not after sensitization, enhanced the secondary HA response to SRBC. Contact sensitivity to dinitrofluorobenzene(DNFB) was suppressed by the drug, given either as a single large dose(300mg/kg) or as multiple dose(10mg/kg) administered 2 days before, together with or after DNFB sensitization. This suppression was more pronounced and more significant when CY was given as multiple dose. However, the enhancement of the secondary contact sensitivity to DNFB by CY was not clear-cut. The splenectomy appears to increase the enhancing effect of CY on contact sensitivity. These results suggest that CY selectively influences the immune response depending on the time of the drug administration relative to immunization and that the secondary or tertiary immune response involve memory cells with different susceptibilities to CY. Moreover, these results suggest that multiple low doses may sesectivley inhibit suppressor T cell proliferation involving DTH, HA or contact sensitivity without effecting helper T cells, but high doses presumably inhibit helper T cells and suppressor T cells with effecting B cells.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.98-103
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• 2014

Purpose: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. Methods: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter > 3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. Results: There were 36 boys and 31 girls (mean age, $8.5{\pm}4.8years$ [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. Conclusion: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.

• Childhood Kidney Diseases
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• 제22권1호
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• pp.1-6
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• 2018

Rituximab (RTX) is a chimeric monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation. Several studies have examined its use in intractable nephrotic syndrome (NS) with some positive results. However, those studies examined such effects for a short-term period of 1 year, and some patients continued to relapse after a lapse in RTX treatment. Our use of RTX as a maintenance therapy (RTX injection when the CD19 cell count exceeded $100-200/{\mu}L$ before relapse) showed some noticeable efficacy. We used RTX in 19 patients with steroid-dependent NS (SDNS). In 12 patients treated with RTX maintenance therapy, only one relapse occurred. The mean treatment period was $23.4{\pm}12.7months$, and the mean number of RTX administrations was $3.9{\pm}1.6$. The relapse rates were decreased (from 2.68/year to 0.04/year), and the drug-free period also increased (from 22.5 days/year to 357.1 days/year) during maintenance therapy. The other seven patients were treated with one cycle of RTX or additional cycles in case of relapse (non-maintenance therapy). Relapse rates were significantly decreased after RTX treatment (from 1.76/year to 0.96/year, P=0.017). The relapse-free period was $15.55{\pm}7.38$ (range, 5.3-30.7) months. No severe side effects of RTX were found except for a hypersensitivity reaction such as fever and chills during its infusion. In conclusion, RTX is considered an effective and safe option to reduce the relapse rate by a single- or maintenance-interval therapy in SDNS.

• Pediatric Infection and Vaccine
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• 제23권1호
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• pp.67-71
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• 2016

결절성 홍반은 소아에서 가장 흔한 피하지방층의 염증으로 하지의 압통을 동반한 결절을 특징으로 한다. 이 질환은 다양한 원인에 의해 발생되지만 공통된 조직소견을 보여준다. 저자들은 임상적 소견 및 혈청학적 방법으로 마이코플라즈마 폐렴균에 의한 결절성 홍반을 진단하였고 조직병리적인 접근을 통해 결절성 홍반의 면역병인에 대해 고찰해 보았다. 조직병리소견은 제 4형 면역반응 염증을 보였으며 이는 다양한 원인에 의한 결절성 홍반의 발생 기전을 이해하는데 도움을 줄 것이다.

• Restorative Dentistry and Endodontics
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• 제14권1호
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• pp.135-148
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• 1989

The purpose of this study was to evaluate the periodic effect of desensitizing drug such as potassium oxalate(D.D.S. # I&II), strontium chloride (ZAROSEN)$^{(R)}$, and placebo group. The 193 teeth of 93 patients who had been complained dental hypersensitivity, and were divided into three groups by application agent and desensitizing treatment was completed. The interval of observation and treatment period were immediately, 1 week, 2 week, 3 week, 4 week, before and after treatment. The data was statistically analized and the results were as followed. 1. Group I showed best desensitizing effect to the stimuli, followed by Group II, Group III. 2. There was a significant difference (p < 0.005) in desensitizing effect among the Group I, Group III and Group II, Group III but there was no significant difference (p < 0.005) in Group I, Group II. 3. The cold stimuli was most effective in desensitization and there was a significant difference (p < 0.005) in cold, air-blast, but there was no significant difference (p < 0.005) in other stimuli. 4. There was no significant difference (p < 0.005) in effect of the desensitization of the cause of exposed dentine. 5. Anterior teeth was more effective than posterior teeth in desensitization and there was a significant difference (p < 0.005) between anterior teeth and posterior teeth. 6. In analysis of stimuli on the potassium oxalate, there was a significant difference (p < 0.005) in cold, air-blast but there was no significant difference (p < 0.005) in other stimuli.

• 대한한방종양학회지
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• 제1권1호
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• pp.167-190
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• 1995

Bikiwhan is one of the oriental medicines that have been used for the treatment of tumors since ancient times. However, the mechanism of the drug action is not closely surved. This study was made to investigate the effects of Bikiwhan on the innate immunity were analysed by measuring the functions of phagocytes, and those of specific immunity were analysed by measuring T and B cells activities. The followings are the results obtained from this study : 1. Bikiwhan has direct cytotoxic effects against human lymphoma cell lines (K562) in a dose dependent manner. 2. An administration of Bikiwhan increased allogenic immune response in the mouse. 3. An administration of Bikiwhan increased the antibodies formation against SRBC. 4. An administration of Bikiwhan enhanced the apperance of rosette forming cells in the spleen. 5. An administration of Bikiwhan decreased the delayed-type hypersensitivity against dinitrofluorobenzene. 6. An administration of Bikiwhan has no effect on natural killer cells. 7. Bikiwhan increased the phagocyte activity of peritoneal macrophages in vitro and in in vivo as well. 8. Bikiwhan depressed the formation of reactive oxygen intermediated in vitro and in vivo as well. 9. Bikiwhan has the capacity to make peritoneal macrophages secrete nitric oxide. The above results demonstrate that Bikiwhan has enhancing effects of immune responses against tumors by decreasing tissue demages caused by immune responses.