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점박이응애 ( Tetranychus urticae )알레르겐 성분 규명 및 집먼지진드기와의 교차항원성 연구
이수걸(Soo Keol Lee),지영구(Young Koo Jee),김윤근(Yoon Keun Kim),서정희(Jung Hee Suh),이명현(Myung Hyun Lee),박해심(Hae Sim Park) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.6
N/A Background: The Tetranychus urticae (TU) is commonly found on fruit trees and green house flowers. A recent investigation demonstrated that the sensitization rate to TU was as high as that of HDM in respiratory allergy patients in middle part of South Korea. Material and methods : To identify IgE binding components within TU, sera from 8 TU-sen- sitive asthmatic patients and sera from unexposed controls showing negative response to TU on skin prick test were enrolled. SD5-PAGE and immunoblot analysis were applied. To evaluate cross-allergenieity with house dust mite (HDM) two kinds of serum pool were used: one (A) showing isolated positive response to TU and the other (B) showing positive responses to both TU and HDM. ELISA inhibition tests using sera A and B were were used. Results : TU-ELISA inhibition test using serum pool A showed significant inhibition with TU and CRM and minimal inhibition with HDM, while ELISA inhibition test using serum pool B showed significant inhibition with addition of TU and CRM and partial inhibition with HDM. Immunoblot analysis using individual sera showed six IgE binding components (75, 56, 41, 37, 28, 14 kDa) and three (75, 41, 14 kDa) were bound to IgE in more than 50% of sera tested. Conclusions : Six IgE binding components were identified within TU and three (75, 41, 14 kDa) could be considered major allergens. Extensive cross-allergenicity was noted between TU and CRM TU-derived extracts contain TU-specific addition to common sharing allergens with HDM. Further investigations will be needed to identify species-specific, or common allergenic components within TU. (J Asthma Allergy Clin Immunol 20: 879-86, 2000)
이수걸(Soo Keol Lee),이선민(Sun Min Lee),함기백(Ki Baik Hahm),임현이(Hyun Ee Yim),김선신(Sun Sin Kim),남동호(Dong Ho Nahm),박해심(Hae Sim Park) 대한내과학회 2001 대한내과학회지 Vol.61 No.6
N/A Background: The underlying mechanism to explain the poor prognosis of TDI-induced asthma is unknown. We performed this study to evaluate the role of TGFβ1 and its receptor, TFGβ receptor II (RII) in TDI-induced asthma. Methods : We applied immunohistochemistry with monoclonal antibodies to TGFβ1 and RII in bronchial mucosa from 22 subjects with TDI-induced asthma (group I: 10 newly diagnosed, group II: 12 subjects with persistent asthma symptoms for more than 4 years after diagnosis) and 8 non-asthmatics undergoing pneumonectomy from lung tumor. The expression was analyzed in 4 areas of bronchial tissue-epithelium (EP), vascular endothelium (VE), smooth muscle (SM), mucous gland (MG). The grade of intensity was presented from 0 to 3. Subepithelial basement memberane (SBM) and submucosal extracellular matrix (SECM) thickness were measured using an image analyzer. Serum specific IgE and IgG antibody levels to TDI- human serum albumin (HSA) conjugate were detected by ELISA. Results : Grade of TGFβ1 expression was significantly higher in EP, VE and SM in group II than those of group I of TDI-induced asthma (p<0.05 respectively), with significant difference in SM only inRII expression. SBM and SECM thickness of TDI-induced asthma were significantly higher than those of non-asthmatics (p<0.05, respectively), while there was no significant difference between group I and II (p>0.05). Significant correlations were noted between asthma duration after diagonsis and intensity of TGFβ1 expression in EP, VE and SM (p<0.05, respectively), with no significant correlations with RII expression (p>0.05). TGF 1 expression was significantly higher in EP, VE and SM in subjects with specific IgG antibody to TDI-HSA than those without it (p<0.05). Conclusion : These findings suggest that TGFβ1 may contribute to develop persistent asthma symptoms in TDI-induced asthma.(Korean J Med 61:623-633, 2001)
의료인에서 발생한 췌장 추출물 흡입에 의한 직업성 천식
이수진(Soo Jin Lee),김희연(Hee Yeon Kim),서유진(Yu Jin Suh),김선신(Sun Sin Kim),이수걸(Soo Keol Lee),남동호(Dong Ho Nahm),박해심(Hae Sim Park) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.2
N/A Background and objective : Porcine pancreatic extracts (PPE) are composed of a-amylase, lipase, and protease which are common components of digestives. PPE are known to cause occupational asthma in pharmaceutical workers, but there has been no report of PPE-induced occupational asthma in medical personnel. The aims of this study were to document the rate of sensitization to PPE and the prevalence of PPE-induced occupational asthma in nurses exposed to PPE and to identify possible immunological pathogenic mechanisms. Subjects and method: A clinical questionnaire on bronchial asthma and allergic rhinitis was distributed among 56 nurses working in the medical ward of Ajou University Hospital. Then, allergy skin prick tests were done with PPE and a battery of eight common inhalant allergens. The determination of specific IgE antibodies to PPE, α-amylase, and lipase was performed by ELISA. The nurses with respiratory symptoms and positive skin tests to PPE underwent methacholine inhalation test and bronchial provocation test with PPE. Results. Of the 56 nurses, five (8.9%) had symptoms suggestive of bronchial asthma, and six (10.7%) had nasal symptoms suggestive of allergic rhinitis. Of these nurses, four (7.1%) had positive results on bronchial provocation test with PPE and proved to have PPE-induced occupational asthma. The prevalences of specific IgE to PPE and a-amylase were significantly higher in patients with positive skin tests (p<0.05). The prevalence of specific IgE to lipase was not significantly different between skin test positive and negative groups (p) 0.05). The prevalences of specific IgE to PPE and a-amylase were significantly higher in patients with respiratory symptoms(p<0.05), and four subjects with PPE-induced asthma had high specific IgE antibody to a-amylase, while specific IgE to lipase values were not significantly different between patients with respiratory symptoms and those without symptoms (p>0.05). Conclusion : These results support the view that inhalation of a-amylase within PPE powder may induce occupational asthma by IgE mediated reaction in exposed medical personnel.
스티븐슨-존슨 증후군 및 독성 표피 괴사용해증 환자에서 고용량 면역글로불린 치료
이수미 ( Soo Mi Lee ),엄수정 ( Soo Jung Um ),이수걸 ( Soo Keol Lee ),김기호 ( Ki Ho Kim ),김영훈 ( Young Hoon Kim ),손춘희 ( Choon Hee Son ) 대한천식알레르기학회 2009 천식 및 알레르기 Vol.29 No.4
Background: There have been some uncontrolled studies on clinical efficacy of high-dose intravenous immunoglobulin (IVIG) in patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Objective: This study was conducted to demonstrate the effectiveness of high-dose IVIG therapy in reducing mortality in Korean patients with SJS or TEN. Method: Retrospective data from 2 patients with SJS, 4 patients with SJS/TEN and 3 patients with TEN treated with high-dose IVIG were analyzed. Result: The total dose of IVIG administered was 1.0 gm/kg/day from 2 days to 1.0 gm/kg for 7 days. Of the 8 patients who showed good responses to IVIG, the mean time to objective responses was 2.0±1.4 days (range, 1 to 5 days). The length of stay in hospital was 22.8±9.2 days (range, 11 to 40 days). Two patients had poor outcomes. Based on the SCORTEN system, 3.2 patients (39.9%) were expected to die, but 2.0 patients (25.0%) died. However, there was no statistical significance (P>0.05). Conclusion: Therapy with high-dose IVIG showed a slightly improved mortality in patients with SJS, SJS/TEN overlap and TEN, but there was no statistical significance (P>0.05). Although dramatic clinical improvement was noted in most patients, further nationwide multicenter clinical trials are required to evaluate the effectiveness of high-dose IVIG in the treatment of patients with SJS or TEN. (Korean J Asthma Allergy Clin Immunol 2009;29:256-261)
악성 종양 표지자가 상승된 만성 흉수를 동반한 종격동 기형종
엄수정 ( Soo Jung Um ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee Sook Roh ),김기남 ( Ki Nam Kim ),이기남 ( Ki Nam Lee ),최필조 ( Pil Jo Choi ),방정희 ( Jung Heui Bang ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.2
Most mediastinal teratomas are histologically well-differentiated tumors and benign. The majority of patients with a mediastinal teratoma are asymptomatic and their tumors are usually discovered incidentally on chest radiography. On rare occasions this tumor will rupture spontaneously into the adjacent organs. A 72-year-old female patient was admitted for dyspnea and she had a multiloculated pleural effusion in the left lung field. Although repeated pleural biopsy and pleural fluid cytology did not prove the presence of malignancy, we assumed that this was a malignant effusion because it revealed consistently high levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and the chest CT scan did not show typical fat or bone density in the mass. Secondary infection and an uncontrolled septic condition due to pleural empyema finally compelled the patient to undergo a surgical operation. Mature teratoma was the final diagnosis and she has done well without recurrence for 2 months.
퀴놀론과 비스테로이드소염제 투여 후 발생한 급성 간질성 신염이 동반된 DRESS 증후군
김수진 ( Soo Jin Kim ),남영희 ( Young-hee Nam ),정지영 ( Ji Young Juong ),김은영 ( Eun Young Kim ),이수미 ( Su Mi Lee ),손영기 ( Young Ki Son ),남희주 ( Hee-joo Nam ),김기호 ( Ki-ho Kim ),이수걸 ( Soo-keol Lee ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.1
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.
항 흉선세포 말형청글로불린에 대한 즉시형 과민증의 예측에 있어서 피부반응시험과 특이 IgE 항체검사의 임상적 유용성
이현주(Hyun Joo Lee),임의진(Eui Jin Yim),지서영(Seo Young Ji),강석윤(Seok Yoon Kang),서유진(Yu Jin Suh),조재웅(Jae Woong Cho),김선신(Sun Sin Kim),이수걸(Soo Keol Lee),남동호(Dong Ho Nahm),박해심(Hae Sim Park),김현수(Hyun Soo Kim),남동기 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.6
N/A Background: Horse antithymocyte globulin (ATG) is a useful treatment for aplastic anemia and for bone marrow transplantation from HLA-mismatched donors, Mortality due to anaphylactic reaction to horse ATG has been reported. We evaluated the clinical significance of skin test and specific IgE measurement for the prediction of immediate type hypersensitivity reaction to horse ATG. Subjects and methods : The study subjects consisted of 25 patients who received horse ATG. Underlying diseases of the 25 patients included aplastic anemia (n=20), leukemia (n=3), lymphoma (n=1), and Gaucher's disease (n=1). Skin prick test was done on these patients using undiluted ATG solution (Upjohn, USA) with duplication. Specific IgE to ATG was detected by enzyme-linked immunosorbent assay and immunoblot analysis. Results : Skin prick test was positive in 7 (28%) of 25 patients. None of the patients showing negative skin prick test experienced immediate type hypersensitivity reaction to ATG. All patients showing positive skin prick test received desensitization before the administration of a full dose of ATG. However, 3 of 7 patients showing positive skin prick test experienced immediate type hypersensitivity reaction one of them died of anaphylaxis. Specific IgE measurement using enzyme-linked immunosorbent assay was not useful in predicting immediate type hypersensitivity reaction to ATG because of nonspecific bindings. Specific IRE measurement using immunoblot analysis was only positive in the one patient who died of anaphylaxis. Conclusion : Skin prick test was clinically useful in the prediction of irnmediate type hypersensitivity reaction to horse ATG, but specific IgE measurement was not. Further studies might be needed to develop an in vitro test for the prediction of immediate type hypersensitivity reaction to horse ATG. (J Asthma Allergy Clin Immunol 20: 986-42, 2000)