Dermatophagoides farinae 자극에 대한 알레르기 천식 환아에서의 Th 및 Tc 림프구 반응

한윤수,박진우,김상태,박종국 충북대학교 의학연구소 2000 忠北醫大學術誌 Vol.10 No.1

연구목적: 본 연구에서는 Dermatophagoided farninae(Df)에 알레르기를 나타내는 소아 천식 환아들의 말초혈액 단핵세포를 여러 농도의 Df 존재 하에서 배향한 후 T helper(Th) 및 T cytotoxic(Tc) 림프구 반응을 관찰하여 Df 농도 변화에 따른 Th 및 Tc 림프구 반응의 변화를 관찰하고 면역요법 시행 유무에 따른 Th alc Tc 림프구 반응의 차이를 단일 세포 수준에서 관찰하고자 하였다. 대상 및 방법: 천식 증상으로 충북대학교 소아과 알레르기 클리닉을 방문하여 피부 단자 검사상 Df에 강양성(4±)을 나타낸 10 명의 소아 알레르기 천식 환자를 대상으로 하였다. 8세에서 11세 사이의 소아만을 연구에 포함시켰으며, 이 중 소아 5명은 최소 2년 동안 면역요법을 시행 받은 환자들이었다. 환아들로부터 말초혈액 단핵세로를 분리하여 각각 0, 0.1, 1, 10 ㎍/㎖의 Df 존재 하에서 5일 동안 배양한 후 유세포 분석을 실시하여 Th 및 Tc 림프구의 빈도를 관찰하였으며, 이를 이용하여 Th2/Th1 및 Tc2/Tcl 비율을 계산하였다. 결과: 모든 환아에서 Df 자극에 의한 우월한 Th2 림프구의 빈도를 관찰하였으며, 이를 이용하여 Th2/Th1 및 Tc2/Tcl 비율의 증가가 관찰되지 않았으나 10㎍/㎖의 Df 농도에서는 Tc2/Tcl 비율 증가에 비해 Df 자극에 의한 Tc2/Tc1 비율의 증가가 상대적으로 적었으며, 모든 환아들에서 0.1 및 1 ㎍/㎖의 Df농도에서는 현저한 Tc2/Tc1 비율의 증가가 관찰되었다. 면역치료를 시행받지 환아들에 비해 면역치료를 시행 받은 환아들에서 Th2/Tc1 비율의 증가가 관찰되지 않았으나 10㎍/㎖의 Df농도에서는 현저한 Tc2/Tc1 비율의 증가가 관찰되었다. 면역치료를 시행받지 환아들에 비해 면역치료를 시행 받지 환아들에 비해 면역치료를 시행 받은 환아들에서 Th2/Th1 비율 및 Tc2/Tc1 비율이 상대적으로 낮았다. 결론: Tc 림프구는 Th 림프구에 비해 IL-4 생성을 유도하는 Df 자극에 저항성을 나타냈으며, 알레르기 면역치료를 시행받지 않은 환아들에 비해 면역치료를 시행 받은 환아들의 Th 및 Tc 림프구는 IL-4 생성을 유도하는 Df 자극에 저항성을 나타낸다. Purpose : The objectives of the present' study were to demonstrate Th and Tc lymphocyte responses to graded doses of house dust mite (HDM) in HDM allergic child patients and to determine differences in the HDM-induced Th and Tc lymphocyte responses between untreated and treated patients. Materials and Methods : This study included ten Dermatophagoides farinae (Df)-sensitive asthmatics of which five children received immunotherapy to Df over a 2-year period. Peripheral blood mononuclear cells ( PBMC) were isolated from peripheral blood of each patient and cultured in the presence of graded doses of Df extract (0, 0.1, 1, 10 ㎍/㎖) 5 days. After harvest of cultured cells, Th and Tc cell frequencies were determined by a multiparameter cytosine flow cytometric assay that allows simultaneous determination of intracellular IFN-γ and IL-4 in CD4+ or CD8+ cells. Results : Predominant Th2 responses to 8f were observed in all of the patients, especially at ㎍/㎖ of .Df Dose-dependent pattern in 8f-induced increases of Th2/Thl ratio was observed in three of untreated and one of treated patients. Increases in Tc2/Tcl ratio were less prominent than those in Th2/Thl ratio. There were no significant increases of Tc2/Tcl ratio at low concentration of Df, which were observed only at 10 ㎍/㎖ of Df. Df-induced increases of Th2/Th1 and Tc2/Tc1 ratios were less remarkable in treated than untreated patients. Conclusion : Tc Iymphocytes were more resistant to Df-induced stimulation to produce IL-4 than Th lymphocytes. Th and Tc lymphocytes of immunotherapy treated patients were more tolerant to the effect of Df to produce IL-4 than untreated patients.

Yersinia pseudotuberculosis 감염증 환아 1례

한윤수,박범수,한헌석,김염 충북대학교 의과대학 충북대학교 의학연구소 1997 忠北醫大學術誌 Vol.7 No.1

Yersinia는 장내세균과에 속하는 그람음성간균으로 그 중 사람에게 병원성을 갖는 것은 Y. pestis, Y. enterocolitica, Y. pseudotuberculosis의 세 균종으로 알려져 있으며, 주로 동물의 병원체이지만 감염된 동물과 직접 또는 간접적으로 접촉한 사람에서도 질병을 일으키는 것으로 보고되고있다. 이중 Y. pseudotuberculosis는 소화기 증상 발현뿐 아니라 피부병변등의 다양한 임상증상을 유발하기 때문에 다른 질환과의 감별이 어렵다고 알려져있다. 그 동안 Y. pseudotuberculosis 감염증은 국내에서 다수 보고되었으나, 청주를 중심으로한 인근지역에서의 발생은 보고된 예가 없었다 이에 저자들은 지속적인 고열과 전신피부발진을 주소로 내원하여 복통, 설사 등의 소화기증상과 더불어 피부의 낙설, 경부임파선염, 입술의 홍조 등 가와사끼병과 유사한 임상양상을 보이며 청주근방의 약수터에서 길어온 약수를 섭취한 기왕력이 있는 5세 여아가 혈청학적으로 Y. pseudotuberculosis로 진단된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Yersinia pseudotuberculosis infection is an intestinal infectious disease and its clinical symptoms vary. In this report, we describe the clinical symptoms and laboratory findings of a 6 year old female child who had a history of ingestion of mountain water and was diagnosed on the basis of a 4-fold or greater titer change in agglutinating antibody. She admitted to CNU hospital with major complaints of fever, skin rash, and gastrointestinal symptoms. Litter in the course, periungal desquamation developed, mimicking Kawasaki disease. Treatments with antibiotics improved the conditions and serum examination revealed the Yersinia pseudotuberculosis 4a, 4b infection.

Pathogenesis and clinical manifestations of juvenile rheumatoid arthritis

Hahn, Youn-Soo,Kim, Joong-Gon The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.11

Juvenile rheumatoid arthritis (JRA) is the most common rheumatic childhood disease; its onset is before 16 years of age and it persists for at least 6 weeks. JRA encompasses a heterogeneous group of diseases that is classified according to 3 major presentations: oligoarthritis, polyarthritis, and systemic onset diseases. These presentations may originate from the same or different causes that involve interaction with specific immunogenetic predispositions, and result in heterogeneous clinical manifestations. An arthritic joint exhibits cardinal signs of joint inflammation, such as swelling, pain, heat, and loss of function; any joint can be arthritic, but large joints are more frequently affected. Extra-articular manifestations include high fever, skin rash, serositis, and uveitis. The first 2 types of JRA are regarded as T helper 1 (Th1) cell-mediated inflammatory disorders, mainly based on the abundance of activated Th1 cells in the inflamed synovium and the pathogenetic role of proinflammatory cytokines that are mainly produced by Th1 cell-stimulated monocytes. In contrast, the pathogenesis of systemic onset disease differs from that of other types of JRA in several respects, including the lack of association with human leukocyte antigen type and the absence of autoantibodies or autoreactive T cells. Although the precise mechanism that leads to JRA remains unclear, proinflammatory cytokines are thought to be responsible for at least part of the clinical symptoms in all JRA types. The effectiveness of biologic therapy in blocking the action of these cytokines in JRA patients provides strong evidence that they play a fundamental role in JRA inflammation.

Measurements of fractional exhaled nitric oxide in pediatric asthma

Hahn, Youn-Soo The Korean Pediatric Society 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.10

Exhaled nitric oxide (NO) has been extensively investigated as a noninvasive marker of airway inflammation in asthma. The increased NO expression induced by inflammatory mediators in airways can be monitored easily in exhaled air from asthmatic children. Based on the relationship between the increased NO expression and eosinophilic airway inflammation, fractional exhaled nitric oxide (FeNO) measurements become an important adjunct for the evaluation of asthma. In addition, the availability of portable devices makes it possible to measure FeNO more easily and frequently in the routine pediatric practice. Despite various confounding factors affecting its levels, FeNO can be applicable in diagnosing asthma, monitoring treatment response, evaluating asthma control, and predicting asthma exacerbations. Thus, although pulmonary function tests are the standard tools for objective measurements of asthmatic control, FeNO can broaden the way of asthma monitoring and supplement standard clinical asthma care guidelines.

Enthesitis-related Arthritis

( Youn-soo Hahn ) 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.4

Enthesitis-related arthritis (ERA) is a disease predominantly affecting the joints and entheses of the lower extremities and has the potential to eventually affect the sacroiliac joints and spine evolving to juvenile ankylosing spondylitis. ERA is also characterized by rheumatoid factor seronegativity, paucity of antinuclear antibody, and a strong association with the human leukocyte antigen-B27. ERA accounts for a higher proportion of juvenile idiopathic arthritis (JIA) cases in the Asian population compared to other populations. Advances in the understanding of ERA pathogenesis continue to progress and have led to the development of new treatments targeting pro-inflammatory cytokines. In particular, tumor necrosis factor-α inhibitors have become a mainstay of therapy for patients in whom therapy with anti-inflammatory drugs and/or disease-modifying anti-rheumatic drugs are inadequate or contraindicated. Compared to other JIA subtypes, ERA is associated with a poorer quality of life, worse function, and a higher likelihood of ongoing active disease after the initial treatment. Because the current guidelines for the management of ERA is not considered separately from other categories of JIA, there is a need for treatment guidelines specific to ERA to improve the overall disease outcomes. (J Rheum Dis 2018;25:221-230)

소아기 류마티스 관절염에 대한 임상적 고찰 -3. 다수관절형-

한윤수 ( Youn Soo Hahn ),박정숙 ( Jeong Sook Park ),김중곤 ( Joong Gon Kim ) 대한류마티스학회 1997 대한류마티스학회지 Vol.4 No.1

Objective: The purpose of this study was to analyse clinical manifestations and laboratory findings in childhood patients with polyarticular-onset juvenile rheumatoid arthritis (JRA). Methods: Eleven cases of polyarticular JRA who were diagnosed and treated in the Department of Pediatrics, Seoul National University Children`s Hospital from June 1988 to May 1995 were investigated for clinical manifestations and laboratory findings. Results: 1) There were 6 males and 5 females and their ages of onset were 4 years to 15.1 years(mean 10.9 years). 2) Systemic manifestations were not observed, but low-grade fever was noted in 5 patients. 3) The involvement of joints was symmetric in 9 patients and asymmetric in 2 patients. 4) The most commonly affected joints were knees and ankles, followed by proximal interphalangeal joints of hand, shoulder, elbow, temporomandibular joint, and other joints. 5) Roentgenographic changes of joints were detected in 6 patients and bone scan in 7 patients showed increased uptake in the involved joints. 6) The main laboratory findings observed were microcytic and hypochromic anemia (64%), thrombocytosis (82%), elevated eryhtrocyte sedimentation rate (100%), positive or increased C-reactive protein (100 %), positive rheumatoid factor(RF) (18%), positive antinuclear antibody (ANA) (27%). RF was positive in 2 girls with later age of onset and the pattern of immunofluorescent ANA were all homogeneous. 7) Nonsteroid antiinflammatory drugs (NSAIDs) were used most frequently and steroid with or without sulfasalazine was tried in 4 patients unresponsive to NSAIDs. 8) At last follow-up, 6 cases(55%) were classified as functional class I, 4 cases(36%) as class II, and 1 case(9%) as class III. Conclusion: These data showed the clinical manifestations and laboratory findings of polyarticular-onset juvenile rheumatoid arthritis in Korean children.

초자체 대용물에 관한 실험적 연구

한영수 , 윤원식 ( Young Soo Hahn , Won Shik Youn ) 대한안과학회 1973 대한안과학회지 Vol.14 No.4

안구돌출증의 처치

윤동호,김재명,한영수,김산배,박상윤,지제근 大韓眼科學會 1969 大韓眼科學會雜誌 Vol.10 No.3

A New Dehydration Procedure by Ultrasonic Reaction in Homogeneous System

Hahn, Soon-Jong,Kim, Sun-Hwan,Chae, Hee-Ju,Youn, Byung-Hee,Lyu, Hak-Soo Korean Chemical Society 1987 Bulletin of the Korean Chemical Society Vol.8 No.1

Kinetics of the 1,3-dipolar Cycloaddition of p-substituted 3-phenylsydnones with DMAD

Youn, Byoung-Hee,Lyu, Hak-Soo,Han, Jee-Hyun,Hahn, Soon-Jong,Kim, Sun-Hwan Korean Chemical Society 1987 Bulletin of the Korean Chemical Society Vol.8 No.4

The kinetics of the 1,3-dipolar cycloaddition of p-substituted 3-phenylsydnones 1a-d with DMAD have been investigated. The reaction rates over a temperature range $100-140^{\circ}C$ were measured by UV spectrometry. The reactions found to be second-order overall, insensitive to the dielectric constants of the solvents, and characterized by a large entropy of activation. These findings are consistent with the rate-determining step involving the formation of cyclic transition state 1 and the reaction proposed to be concerted.