• IMMUNE NETWORK
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• 제3권2호
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• pp.89-95
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• 2003

Background: Unusually high amounts of N region addition and CDR3 length diversity were found in immunoglobulin (Ig) light chain Vk and Jk joins in patients with rheumatoid arthritis (RA). We sought to determine whether this finding is due to excessive activity of the enzyme responsible for N region addition (terminal deoxynucleotidyl transferase [TdT]) in B lineage cells in bone marrow or from positive antigenic selection of B cells with long CDR3 lengths. Methods: We used FACS to isolate $IgM^+/IgD^+$ B cells (predominantly naive) and $IgM^-/IgD^-$ B cells (predominantly class-switched) B cells from peripheral blood of a patient with RA known to have enrichment for long Vk CDR3s and from that of two normal controls. RT-PCR of VkIII transcripts was performed, followed by sequencing of individual cDNA clones. We analyzed the CDR3 lengths and N region additions in 97 clones. Results: There was enrichment for long CDR3 lengths (11 or 12 amino acids) in both $IgM^+/IgD^+$ and $IgM^-/IgD^-$ B cells in RA compared to B cell subsets in the normal controls. The $IgM^+/IgD^+$ B cell subset in RA was markedly enriched for N region addition and was similar to that seen in the $IgM^-/IgD^-$ subset. Conclusion: These data suggest that enrichment for N region addition and long CDR3 lengths in RA may result from unusually high or prolonged activity of TdT in bone marrow.

• 한국임상약학회지
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• 제27권3호
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• pp.127-135
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• 2017

Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications. Methods: We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ${\geq}1$0 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group. Results: In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with high-dose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate). Conclusion: We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

• Advances in pediatric surgery
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• 제2권2호
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• pp.151-155
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• 1996

Hyperimmunoglobulin E syndrome is a relatively rare primary immunodeficiency syndrome characterized by recurrent infection, abscess formation and marked elevation of serum IgE level. The common infectious organism is Staphylococcus aureus and recurrent infection indicates some defects in the immunologic system. Although the infection can affect various organs, gastrointestinal tract involvement is rare and only one case of colon perforation has been previously reproted. Herein we report another one case of colon perforation which ocurred in an 8-year-old girl with hyper immunoglobulin E syndrome. The patient was admitted to the hospital due to an abscess on right neck. The diagnosis of hyper immunoglobulin E syndrome was made because she had eczematoid dermatitis on the face, pneumatocele on left upper lung field and markedly elevated serum IgE level(>15,000 IU/ml) with a past histories of frequent scalp abscesses and otitis media. Abdominal pain developed on the 13th day of admission and abdominal plain X-ray revealed free air. An exploratory laparatomy was performed and two free perforations of the transverse colon were noted. Segmental resection and double barrel colostomy were performed. Colostomy closure was done 4 month later and she had no gastrointestinal problem during a follow up period of 15 months.

• Clinical and Experimental Pediatrics
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• 제49권3호
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• pp.332-336
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• 2006

독성 표피괴사 증후군(Toxic epidermal necrosis)은 매우 드문 수포성 피부 질환으로 표피 전층의 괴사와 박리를 특징으로 하는 질환이며, 적절한 치료에도 불구하고 높은 사망률을 보이는 질환이다. 대부분의 독성 표피괴사 증후군의 약물과 연관이 있으며, 대표적인 약물로는 설폰아마이드(Sulfonamide), 항경련제(Phenytoin, Phenobarbital), 페니실린계 항생제, 비스테로이드성 소염제 등이며, 드물게 부신 피질 호르몬제에 의한 발병도 보고되고 있다. 최근 독성 표피괴사 증후군에서 각질 세포의 세포고사(cell apoptosis)에 Fas 수용체가 중요한 역할을 한다고 알려진 후 치료에 면역 글로불린 사용이 점차 늘어나고 있으며, 생존율의 증가와 치료기간의 단축이 보고되고 있다. 국내에서는 아직 독성 표피괴사 증후군에서 면역 글로불린정주가 치료방법으로 확립되지 않았지만 몇몇의 경우에서 면역 글로불린 정주로 치료한 경험들이 보고되고 있다. 저자들은 막성 신염 환아에서 부신 피질 호르몬제와 안지오텐신 수용체 길항제 사용 후 발생한 독성 표피괴사 증후군에서 면역 글로불린을 사용하여 치료한 1례를 경험하였기에 문헌 고찰과 함께 보고하자 한다.

• Clinical and Experimental Pediatrics
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• 제59권2호
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• pp.80-90
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• 2016

Purpose: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. Methods: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. Results: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. Conclusion: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

• Clinical and Experimental Pediatrics
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• 제59권2호
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• pp.54-58
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• 2016

Purpose: We evaluated the characteristics of patients with Kawasaki disease (KD) who presented with only fever and cervical lymphadenopathy on admission, and compared them with the characteristics of those who presented with typical features but no cervical lymphadenopathy. Methods: We enrolled 98 patients diagnosed with KD. Thirteen patients had only fever and cervical lymphadenopathy on the day of admission (group 1), 31 had typical features with cervical lymphadenopathy (group 2), and 54 had typical features without cervical lymphadenopathy (group 3). Results: The mean age ($4.3{\pm}2.1$ years) and duration of fever ($7.5{\pm}3.6$ days) before the first intravenous immunoglobulin (IVIG) administration were highest in group 1 (P=0.001). Moreover, this group showed higher white blood cell and neutrophil counts, and lower lymphocyte counts after the first IVIG administration as compared to the other groups (P =0.001, P =0.001, and P =0.003, respectively). Group 1 also had a longer duration of hospitalization and higher frequency of second-line treatment as compared to groups 2 and 3 (group 1 vs. group 2, P =0.000 and P =0.024; group 1 vs. group 3, P =0.000 and P =0.007). A coronary artery z score of >2.5 was frequently observed in group 1 than in group 3 (P = 0.008). Conclusion: KD should be suspected in children who are unresponsive to antibiotics and have prolonged fever and cervical lymphadenopathy, which indicates that KD is associated with the likelihood of requiring second-line treatment and risk of developing coronary artery dilatation.

• 대한예방한의학회지
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• 제15권3호
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• pp.163-178
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• 2011

Objective : This study is conducted to evaluate the efficiency of ethanol extracts of 4 mixed herbs(CP001 or CP002) on mouse model of atopic dermatitis induced by ovalbumin. Methods : Female BALB/c mice were internally sensitized with ovalbumin($20{\mu}g$) plus aluminum hydroxide hydrate(4mg) once per week. After 3 weeks, they were dermally challenged with patches containing ovalbumin ($100{\mu}g$) plus aluminum hydroxide hydrate(20mg) every other day for 3 weeks. After induction of atopic dermatitis, mice back skin were gently rubbed with CP001 or CP002(200mg/$m{\ell}$, $100{\mu}{\ell}$) for two weeks(every 2 days). Results : In CP001 or CP002 treated group, there was a remarkable reduction in infiltration of eosinophils on the skin areas and diminution of mast cells and total T cells in blood samples as compared with control group. Cutaneous expressions of interleukin-13, 17 were also decreased by CP001 or CP002. Moreover, blood immunoglobulin E level was decreased by drug administration while there was no decrease in OVA sensitization group. Conclusion : In summary, our result shows that herbal extracts(CP001 and CP002) could be potential candidates for the treatment of chronic atopic dermatitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.78-82
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• 2004

보존적인 스테로이드 치료로 호전이 없는 심한 복부증상을 동반한 HSP 환자의 치료에는 아직까지 정설이 없으나, 저자들은 면역글로불린 정맥투여로 증상이 호전된 증례와 소장의 경장괴사를 동반하고 수술적 치료로 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국축산식품학회지
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• 제21권4호
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• pp.358-366
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• 2001

초유의 이용성을 향상시키고, 그 품질을 보존하기 위한 방안의 일환으로 분만 후 12시간 간격으로 착유한 초유를 이용하여 시간의 경과에 따른 초유의 성분 변화를 조사하였다. 그 결과, 초유의 단백질, 지방, SNF, 그리고 총 고형분은 분만 후 12시간부터 48시간까지 급속도로 감소하였다. 그러나, 유당은 분만 12시간 후의 함량이 가장 낮았으며, 회분 함량은 거의 변화하지 않았다. 분만 후 12시간 및 24시간의 IgG함량은 그 이후에 착유한 것보다 높았으며(p<0.05), 12시간 후의 IgG 함량은 큰 차이가 없는 것으로 나타났다. 분만 후 시간의 경과에 따른 초유 중의 지방산 조성은 거의 변화하지 않았으나, lauric acid, myristic acid, 그리고 총 포화 지방산 함량은 경산우에서 감소하는 경향을 나타내었다. 미경산우의 capric acid, lauric acid, myristic aid, 그리고 palmitoleic acid는 경우산의 초유보다 높은 함량을 나타내었다.

• Toxicological Research
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• 제24권4호
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• pp.253-261
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• 2008

Allergic asthma is a worldwide public health problem and a major socioeconomic burden disease. It is a chronic inflammatory disease marked by airway eosinophilia and goblet cell hyperplasia with mucus hypersecretion. Mouse models have proven as a valuable tool for studying human asthma. In the present report we describe a comparison of mouse asthma models. The experiments were designed as follows: Group I was injected with ovalbumin (OVA, i.p.) on day 1 and challenged with 1% OVA (aerosol exposure) on days $14{\sim}21$. Group II was injected on day 1, 14 and aerosol-immunized on days $14{\sim}21$. Group III was injected on day 1, 14 and immunized by 1% OVA aerosol on days $18{\sim}21$. We assessed asthma induction by determining the total number of white blood cells (WBC) and eosinophils as well as by measuring cytokine levels in bronchoalveolar lavage fluid (BALF). In addition, we evaluated the histopathological changes of the lungs and determined the concentration of immunoglobulin E (IgE) in serum. Total WBC, eosinophils, Th2 cytokines (IL-4, IL-13) and IgE were significantly increased in group I relative to the other groups. Moreover, histopathological studies show that group I mice show an increase in the infiltration of inflammatory cell-in peribronchial and perivascular areas as well as an overall increase in the number of mucus-containing goblet cells relative to other groups. These data suggest that group I can be a useful model for the study of human asthma pathobiology and the evaluation of existing and novel therapeutic agents.