알레르기 질환 환자에서 고양이털 항원에 대한 감작을 및 고양이털의 항원성에 관한 연구

라선영(Sun Young Rha),남동호(Dong Ho Nam),김범수(Bum Soo Kim),안중배(Joong Bae Ahn),원욱희(Wook Hee Won),송현용(Hyun Yong Song),조홍근(Hong Keun Cho),전동운(Dong Woon Jun),홍천수(Chein Soo Hong) 대한내과학회 1995 대한내과학회지 Vol.48 No.3

N/A Objectives: The cat fur allergen used in skin prick test was known to be contaminated with housedust mites. So we intended to evaluate the clinical importance of cat fur as a causative allergen in patients with allergic diseases. Methods: We performed skin prick tests with cat allergen of Torii company(Japan), Bencard company (England) and home made extracts in 387 patients, We detected specific IgE by 3M FAST-plus and ELISA method using home made cat fur allergen, developed at this class. To characterize the allergenic components, cat fur extracts were fractionated by 12 % sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS-PAGE) and then transferred onto nitrocellulose membrane and probed with sera of cat fur sensitive patients Results: 1) Out of 387 patients, 77(19.9%) showed more than 1+results on skin prick test. There were no significant differences in the rates of positive results ac- cording to the allergic diseases, but the age groups were correlated with the positive results(younger than 30: 34.5%, between 30 and 50: 14.4%, older than 50: 6.8%). 2) Cat ELISA showed specific inhibition to cat fur allergen and Cat ELISA inhibition test revealed the linear dose response curve on the added amounts of cat allergn into pooled sera. 67.7% out of Torii cat fur sensitive patients(A/H ratio≥1) showed positive results in Cat ELISA for specific IgE antibody. 3) Cat fur extracts showed 15 protein bands by SDS-PAGE, then they were transferred onto nitrocellulose membrane and probed with sera of 16 cat-fur sensitive patients, one sera pool of patients with RAST class 3, and three negative controls and with biotin-conjugated anti IgE-avidin peroxidase. Six IgE binding protein bands were detected at 94, 73, 56, 44, 28 and 21 kilodalton of molecular weight. Out of six IgE binding bands, MW 21KD concerned as major cat allergen, Fel d 1, were noted in five sera(31.3% ). Conclusion: It is suggested that cat fur can be regarded as an important allergenic fur and that we need further studies to st.andardize cat antigens for in vivo and in vitro tests.

Amanita Virosa에 의한 독버섯 중독증

강진경(Jin Kyung Kang),박인서(In Suh Park),문영명(Young Myung Moon),박찬일(Chan Il Park),송시영(Si Young Song),이기명(Kee Myeong Lee),원욱희(Wook Hee Won),최윤정(Yun Jung Choi) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4

Amanita mushroom contains phallotoxin and amatoxin, which inhibits nucleoplasmic RNA polymerase B and interferes the synthesis of RNA and cause cellular necrosis. Ingestion of Amanita mushroom develops gastrointestinal symtoms after 6-12 hours and hepatic necrosis after 3-4 days, Severe hepatic necrosis by amatoxin can pmgress to chronic liver damage. Repeated histologic evaluation of liver is ususally recommanded 6 months after the acute episode. Even though we can speculate that mushroom poisoning is not uncommon in Korea, there have been only several teports. We report a 30-year-old-man of Amanita virosa intoxication, who show the typical clinieal findings. (Korean J Gastroenterol 1996; 28:576-581)

소화성궤양에 의한 출혈에서 내시경적 Fibrin Glue 및 Hypertonic Saline Epinephrine 국소주의법의 비교

김원호,강진경,박인서,문영명,전재윤,한광협,정재복,송시영,원욱희 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.1

Endoscopic injection therapy using various different agents(ethanol, polidocanol, epinephrine with and without hypertonic saline, etc.) is considered as the least expensive and effective technique to obtain hemostasis in peptic ulcer bleeding, however most of these agents induce tissue necrosis or degeneration. Theoretically the injection of fibrin glue in peptic ulcer bleeding may be safer than that of other agents, however, to date, there have been no data from randomized clinical trials on the comparison of the efficacies between these agents. To compare the hemostatic efficacy between FG(Beriplast P, Behring, Germany] and HSE[3% saline and epinephrine(1 :10,000)], we conducted a prospective, randomized, clinical trial among one hundred twenty-seven patients with peptic ulcer bleeding from March, 1992 to December, 1993 and in whom a visible vessel or active bleeding was identified. The results were as follows: 1) They were randomized into two groups [FG group, 64 cases; HSE group, 63 cases]. 2) The sources of bleeding in FG group were gastric ulcer in 49 cases and duodenal ulcer in 15 cases, and in HSE group gastric ulcer in 45 cases and duodenal ulcer in l8 cases. As the stigma of bleeding in FG and HSE group, spurting were seen in 18 cases and 21 cases, oozing in 10 cases and 8 cases, and non-bleeding visible vessel in 36 cases and 34 cases, respectively. 3) Permanent hemostasis by only endoscopic treatment was achieved in 59 cases (92:2%) in FG group and in 54 cases(85.7%) in HSE group. 4) The rebleedlng was developed in 7 cases(10.9%) in FG group and 14 cases(22.2%) in HE group, the emergent operation was underwent in 4 cases(6.3%) and 7 cases(11.1%), respectively and the death were noticed in 1 case(1.6%) and 4 cases(6.3%), respectively. These results suggest that endoseopic injection of FG is an effective method with better satisfactory bemastatic efficacy than HSE injection in peptic ulcer bleeding.

Buried Bumper Syndrome 1예

이상호,홍성표,박필원,김배영,원욱희,최욱선,임규성 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.5

Percutaneous endoscopic gastrostomy is used for long-term nutritional support and can be performed with relatively few complications. Among the major and minor complications, migration and erosion of the internal bumper into or through the abdominal wall, so called buried bumper syndrome has been described more recently. We describe a patient in whom internal bumper eroded into stomach wall and was completely covered by gastric epithelium 45 days after gastrostomy placement. The gastrostomy tube itself was patent, and the end still protruded into the lumen of the stomach. But, endoscopy was failed to remove the gastrostomy tube and surgical exploration was required in our case. We experienced a case of buried bumper syndrome after percutaneous endoscopic gastrostomy and report with a review of literatures.

상부 위장관 내시경 검사시 전처치로서의 Midazolam 의 효과

임규성,차영수,홍성표,박필원,원욱희 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.2

The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p$lt;0.05), and midazolam group would accept the same sedation for repeated endoscopies(p$lt;0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy.