Controversies in the pathogenesis of CSU: chronic infection/infestation

최미라 ( Mira Choi ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

The pathogenesis of chronic urticaria is multifactorial and still represents a challenge to dermatologist. The association of between urticaria and infection diseases has been discussed for a long time, however, a causal relationship with underlying or precipitating infection is difficult to establish. There are many reports showing a causal relationship with infections in acute urticaria. But in chronic cases, the role of infections is controversial, although it is well known that concurrent infections exacerbated the condition. Recently there has been renewed interest in the role of infections on the chronic urticaria. In patients with chronic urticaria, the prevalence of infections is not increased but in susceptible patients the immune response may lead to the development of chronic urticaria. 1) Viruses According to recent systemic review, no viral cause has ever been clearly documented in chronic urticaria and that the screening of viral markers (hepatitis B and C, HIV) does not yield significant result, compared with the general population. 2) Bacteria Several bacterial pathogens have been described in chronic urticaria, such as Helicobacter pylori, Streptococcus, Staphylococcus, Mycoplasma pneumonia, Samonella, Chlamydia pneumonia, and Yersinia enterocolitica. The most reported bacterial infection associated with urticaria is a Helicobacter pylori infection, but the role of pathogenesis of chronic urticaria is still controversial. 3) Parasites Some epidemiologic studies suggest that internal parasite infections can cause chronic urticaria. Chronic urticaria patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and Anisakis simplex sensitization compared to general controls. Concurrent gastrointestinal symptoms, a history of previous parasite infections, travel abroad, and unexplained eosinophila may suggest parasite infection in chronic urticaria patients. Until now, there is no consensus that infections are potential pathogenesis of chronic urticaria. Although only a weak association with urticaria and infections, however, physicians should consider these pathogens in the workup of patients with recalcitrant chronic urticaria.

Health effect of artificial light

최미라 ( Mira Choi ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Emerging treatment and promising treatment targets for skin photoaging

최미라 ( Mira Choi ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

단일 2차 의료기관에서 약물 유해반응 보고 시스템을 통해 수집된 약물 피부 유해반응 양상 분석

우청하 ( Cheong Ha Woo ),최미라 ( Mira Choi ),윤한정 ( Han Jeong Yun ),박혜진 ( Hai-jin Park ) 대한피부과학회 2018 大韓皮膚科學會誌 Vol.56 No.4

Background: Adverse cutaneous drug reactions (ACDRs) are common and are responsible for increased morbidity, mortality, and socioeconomic costs. Objective: The purpose of our study was to investigate the common drugs and clinical patterns related to ACDRs using an electronic drug adverse reaction reporting system at a single secondary referral center. Methods: We conducted a retrospective analysis of the ACDR database between January 2014 and April 2016 at the Ilsan Paik Hospital. Results: The study analyzed 320 patients with ACDRs (male:female ratio=93:227; mean age 50.8±17.8 years). Using a Korean causality evaluation algorithm, the percentage of drugs with a possible relationship with ACDRs was calculated to be 50.6%, while the percentage with a probable relationship was 44.7%. Antibiotics (44.0%), radiocontrast media (15.1%), and non-steroidal anti-inflammatory drugs (NSAIDs) (14.3%) were the most commonly implicated drugs. Antibiotics, including cephalosporins (30.6%) and quinolones (10.2%), were responsible for the majority of the ACDRs. Acetic acid (5.9%) and propionic acid (5.9%) derivatives of NSAIDs were also common causative agents. The most common clinical presentations were maculopapular exanthema (33.4%), pruritus (30.9%), and urticaria (25.7%). Severe ACDRs were significantly associated with older age, eosinophilia, and underlying heart and renal diseases (p<0.05). Conclusion: Antibiotics, radiocontrast media, and NSAIDs were identified as common causes of ACDRs. Older age, eosinophilia, heart disease, and renal disease were associated with severe ACDRs. (Korean J Dermatol 2018;56(4): 251∼258)

아토피피부염에 대한 올바른 교육의 중요성에 대한 설문조사

도은진 ( Eun Jin Doh ),최미라 ( Mira Choi ),임지수 ( Ji Soo Lim ),윤현선 ( Hyun-sun Yoon ),이동훈 ( Dong Hun Lee ),김규한 ( Kyu Han Kim ) 대한피부과학회 2017 大韓皮膚科學會誌 Vol.55 No.6

Background: Therapeutic education is important for successful management of atopic dermatitis (AD). Objective: To provide effective therapeutic education, clear common misunderstandings, and answer questions regarding AD among patients and caregivers. Methods: A questionnaire survey was conducted for patients and caregivers who visited the Department of Dermatology at Seoul National University Hospital, Seoul, Korea, regarding the course, etiology, and management of AD. Results: Among the 327 subjects who participated in the study, only 35.2% were aware of the natural course of AD, which usually improves with age. Many subjects (53.2%) misinterpret AD relapse as resistance to topical steroids. We found that 87.8% of subjects were under the impression that improvement in a patient`s immunity can improve the symptoms of AD. Dietary restriction was considered an essential management strategy, and 59.0% of subjects agreed to delay the initiation of weaning foods. Most subjects did not have accurate information about cleansing methods, and 30.9% of subjects reported that they used only water without any cleanser. We noted that 47.5% of subjects obtained information regarding AD from medical doctors who they considered the most reliable sources (82.5%). Subjects preferred printed materials (41.3%) over seminars or video-clips to obtain educational information. Conclusion: Therapeutic education regarding the course, etiology, and management of AD using printed materials put together by physicians would be a valuable tool for the effective management of AD. Institutional support such as educational programs covered by the National Health Insurance Service is required. (Korean J Dermatol 2017;55(6): 329∼336)

Improved Production Efficiencies of Various Adeno-Associated Virus (AAV) Serotypes and a Novel Universal AAV Titration Method

Young-Hwa Cho(조영화),Yejin Choi(최예진),Jung-Hee Yun(윤정희),Nam Hee Kim(김남희),Mira Choi(최미라),Young-Kook Choi(최영국),Kyung-Hee Kim(김경희),Young-Ill Lee(이영일),Beom Jun Lee(이범준),Keerang Park(박기랑) 한국생명과학회 2012 생명과학회지 Vol.22 No.6

AAV는 매우 안전하고 효율적인 유전자전달방법으로 인정되어 왔다. 그러나, AAV가 가진 생물의약품으로서 단점은 효율적이고 재현성 높은 생산법이 취약하고, 또한 다양한 혈청형을 간단한 한 가지 공통적 방법으로 신뢰성 있게 정량하는 방법이 개발되어야 하는 것이다. 따라서, 본 연구에서는 AAV2와 아데노바이러스를 동시에 감염하는 종래의 생산법에 의한 효율성과 새로운 생산법, 즉 AAV2 감염 후 pHelper 플라스미드를 transfection 하는 방법을 통한 생산효율성을 비교하였고, HEK293과 293T를 생산세포주로 하여 시간에 따른 생산효율성도 분석하였다. 그 결과 AAV2와 pHelper DNA를 포함한 새로운 생산법은 기존의 방법에 비해 10배 이상 높은 생산효율성을 보였고, 293T에서 AAV2를 10 MOI로 감염한 후 5일째에 가장 높은 생산효율성을 보였는데, 생산세포 한개 당 1.61×10? virus genomes (v.g.)을 생산하는 결과였다. 따라서 이 생산조건을 다른 혈청형 생산에 적용한 결과, 모든 혈청형에서 생산세포주 한 개 당 10? v.g. 이상을 생산하는 효율성을 보였다. 한편, 다양한 AAV 혈청형을 한 가지 공통적인 방법으로 정량하기 위해 the universal PCR 프라이머를 제작하였고, 그것을 이용하여 신뢰성 높고 10개 분자까지도 증폭이 가능한 결과를 모든 혈청형에서 얻었다. 그러므로 이 한 쌍의 정량용 the universal 프라이머는 임상시험용 아데노바이러스벡터에 존재하는 AAV오염을 검출하는 것에도 사용 가능하다. Adeno-associated virus (AAV) has been considered to be a very safe and efficient gene delivery system. However, the major obstacles to therapeutic usage of AAV have been to achieve highly efficient and reproducible production processes, and also to develop a reliable quantifying method of various serotypes with a simple protocol. We compared the efficiency of the conventional production protocol of AAV2 and adenovirus (Ad) co-infection to that of a new method containing AAV2 infection followed by pHelper transfection. We tested HEK293 and 293T, and further examined the time-dependent changes of AAV2 production. The new method of AAV2 and pHelper DNA gave about ten times higher production efficiency than that of the conventional protocol. The highest production efficiency in 293T was achieved as 1.61 × 10? virus genomes (v.g.)/cell by the new method of 10 MOI of AAV2 infection and 5 days post-infection. This protocol of the highest efficiency was then applied to produce various AAV serotypes and showed the efficiencies higher than 10? v.g./cell. Next, we designed the universal PCR primers of highly conserved regions for various AAV serotypes to develop a simple and reliable titration method. The universal primers could amplify all the tested AAV serotypes with similar sensitivities by ten molecular copies. Therefore, this pair of universal primers can be further utilized to detect AAV contaminants in therapeutic adenoviral vectors.

반려동물 관련 용품 시장의 소비자지향성이 가구 형태별 소비자 만족도에 미치는 영향 분석

이현근(Lee Hyun-Keun),김경호(Kim KyeongHo),최미라(Choi Mira) 한국소비자원 2021 消費者問題硏究 Vol.52 No.2

과수 폐업지원의 성과분석 : 생산성, 규모화, 가격과 소득에 미친 영향

문한필(Hanpil Moon),이현근(Hyun-Keun Lee),최미라(Mira Choi),채상현(Sang-Hyen Chai) 한국농업경제학회 2020 農業經濟硏究 Vol.61 No.3

This study empirically analyzed the effect of the Farm-Closure Assistance(FCA) program on productivity, scale, price, and income of fruit farms for the purpose of objective evaluation of its policy performance.T o this end, panel data for the period of 2000-2018 is constructed for 8 items of fruit, and statistical significance of various proxy variables representing the FCA was tested using the random effect model. As results of the analysis, it is found that the FCA contributed to the improvement of the average productivity and scale of the target item, but the long-term effect on the market price or agricultural income of the item is evaluated to be negligible.I t is because the FCA maintains an institutional framework that induces short-term conversion of crops rather than exit of farming. Although there is an effect on short-term adjustment (reduction) of oversupplied items, it is difficult to expect long-term results such as restructuring, supply and demand stability, and competitiveness improvement.O n the other hand, the balloon effect, which is an indirect ripple effect due to the FCA, is statistically significant in terms of productivity and market price, but not so significant in terms of scale or income increase.

계층분석법(AHP)을 이용한 말 산업 R&D 발전방향 연구

남경수(Kyungsoo Nam),주준형(Joonhyung Joo),최미라(Mira Choi),안병일(Byeong-il Ahn) 한국농식품정책학회 2019 농업경영정책연구 Vol.46 No.4

Domestic horse industry is mostly considered a gambling industry for the negative aspect of horse racing, which is anticipated to serve as a factor that impedes medium to long term industrial development. Thus, for the development of horse industry, support and R&D mostly emphasized on horse racing by now need to be allocated to develpte the plans for shared growth along with many other related areas. And simultaneously with that, perception change on horse industry by promotion of positive aspects of it, such as linkage with rural tourism and rehabilitation treatment is required. To achieve it, this study has develped five strategic goals and four-to-five detailed strategies for an individual target, and implemented a importance and priority assessment with the anlaytic hierarchy process (AHP). The results of the analysis show that the reinforcing of the base of horse industry is considered the most imporatant R&D plan. However, the importance and priority of some objectives and strategies differed by group categorized on characteristics.

신생아 집중치료실 환아에서 유아혈관종의 위험인자 분석

오재홍 ( Jae Hong Oh ),김병윤 ( Byung Yoon Kim ),최미라 ( Mira Choi ) 대한피부과학회 2021 대한피부과학회지 Vol.59 No.5

Background: Infantile hemangioma (IH) is one of the most common tumors in infants. IH occurs more commonly in premature and low birth weight infants, but only a few studies have analyzed the risk factors for IH in neonatal intensive care units (NICUs) in Korea. Objective: We investigated the risk factors for IH in patients admitted to the NICU at a single institution. Methods: A single-center retrospective case-control study was conducted in 37 patients with hemangioma and 185 matched-control babies who were admitted to the NICU between 2013 and 2020. Odds ratios (ORs) and multivariate conditional logistic regression models were used to determine the associations between IH and the potential risk factors. Results: Of the 1,206 neonates admitted to the NICU, 37 had IH, and the prevalence was 3.1%. IH was most commonly found on the trunk (33.3%), followed by the head and neck (29.4%). After adjustment, the risk factors found to be significantly associated with IH were female sex (OR=3.0, 95% confidence interval [CI]=1.4∼6.8), extreme preterm (OR=6.9, 95% CI=1.3∼38.0), very low birth weight (OR=11.9, 95% CI=2.9∼49.3), low 1-minute Apgar scores of <7 (OR=2.3, 95% CI=1.1∼4.9), and multiple gestation (OR=5.0, 95% CI=1.7∼14.9). Conclusion: This matched case-control study revealed that risk factors such as female sex, extremely preterm birth, very low birth weight, low 1-minute Apgar score, and multiple gestations may affect the occurrence of IH. Therefore, if these risk factors are present, they need to be actively managed at an early stage through close physical examination to prevent complications. (Korean J Dermatol 2021;59(5):332∼340)