1.Changes in skin reactivity and associated factors in patients sensitized to house dust mites after 1 year of allergen-specific immunotherapy
Jeong Yeop SON ; Mann Hong JUNG ; Kwang Wook KOH ; Eun Kee PARK ; Jeong Hoon HEO ; Gil Soon CHOI ; Hee Kyoo KIM
Asia Pacific Allergy 2017;7(2):82-91
BACKGROUND: Allergen-specific immunotherapy (SIT) can significantly improve symptoms and reduce the need for symptomatic medication. OBJECTIVE: The aim of this study was to investigate changes in skin reactivity to house dust mites (HDMs) as an immunologic response and associated factors after 1 year of immunotherapy. METHODS: A total of 80 patients with allergic airway diseases who received subcutaneous SIT with HDMs from 2009 to 2014 were evaluated. The investigated parameters were basic demographic characteristics, skin reactivity and specific IgE for HDM, serum total IgE level, blood eosinophil counts, and medication score. RESULTS: The mean levels of skin reactivity to HDMs, blood eosinophil counts, and medication scores after 1 year were significantly reduced from baseline. In univariate comparison of the changes in skin reactivity to HDMs, age ≤30 years, HDMs only as target of immunotherapy, and high initial skin reactivity (≥2) to HDMs were significantly associated with the reduction in skin test reactivity. In multivariate analysis, high initial skin reactivity and HDMs only as target allergens were significantly associated with changes in skin reactivity to HDMs. In the receiver operating characteristic curve of the initial mean skin reactivity to HDMs for more than 50% reduction, the optimal cutoff value was 2.14. CONCLUSION: This study showed significant reductions in allergen skin reactivity to HDMs after 1 year of immunotherapy in patients sensitized to HDMs. The extent of initial allergen skin reactivity and only HDMs as target allergen were important predictive factors for changes in skin reactivity.
Allergens
;
Desensitization, Immunologic
;
Dust
;
Eosinophils
;
Humans
;
Immunoglobulin E
;
Immunotherapy
;
Multivariate Analysis
;
Pyroglyphidae
;
ROC Curve
;
Skin Tests
;
Skin
2.Effect of Oliguria Within 2 Months Postoperative Period on Graft Outcome in Renal Transplantation.
Oh Sang KWON ; Young Joo KWON ; Young Gee LEE ; Gil Mann JUNG ; Nan Hee KIM ; Mi Kyoung JANG ; Yong Sub KIM ; Ja Ryong KU ; Dae Ryong CHA ; Won Yong CHO ; Heui Jung PYO ; Hyoung Kyu KIM
Korean Journal of Medicine 1998;54(1):83-89
OBJECTIVE: Graft survival rate has been improved due to newly developed immunosuppressive agents, care of recipient and operative method. However, since many risk factors are still threatening the graft survival, many studies have been underway to identify such factors, one of which has been on delayed graft function(DGF). Extending the definition of DGF to oliguria within 2 months postoperative period(POP), we began this study in order to evaluate what effects oliguria within 2 months POP have on graft survival and what are the risk factors involved. METHODS: 103 patients who have had renal transplantation performed were divided into two groups (oliguric group and non-oliguric group), based on the presence or absence of oliguria within 2 months POP. Risk factors such as the recipient factors(age, gender), donor factors(age, gender), operative factors(warm ischemia time, intraoperative urine volume), HLA typing, postoperative hypotension, postoperative hypovolemia were compared between the two groups and the impact of oliguria on graft outcome was also analysed. RESULTS: 1) 14 were Oliguric patients and 89 were nonoliguric patients. 2) One-year graft survival rate was 40% in the oliguric group and 98% in the non-oliguric group(P<0.05). 3) As the result of analyzing the risk factors, non living related donor(living non-related donor and cadaver donor) were 7(50%) in the oliguric group and 16(18%) in the non-oliguric group(P<0.05). The mean intraoperative urine volume was 442m1 in the oliguric group and 774m1 in the non-oliguric group(P<0.05). The occurrence of postoperative hypotension were 5(36%) in the oliguric group and 1(1%) in the non-oliguric group(P<0.05). Other risk factors such as the recipient fractors, donor factors, warm ischemia time, HLA typing and postoperative hypovolemia were not significantly different between the two groups. CONCLUSION: Graft survival rate in the oliguric group was lower than in the non-oliguric group. The risk factors for oliguria were non living related donor, intraoperative urine volume lower than 500m1 and postoperative hypotension. In conclusion, renal transplantation from non living related donor needs to be proceeded with caution; the maintenance of intraoperative urine volume and the prevention of postoperative hypotension are essential for better graft outcome.
Cadaver
;
Graft Survival
;
Histocompatibility Testing
;
Humans
;
Hypotension
;
Hypovolemia
;
Immunosuppressive Agents
;
Ischemia
;
Kidney Transplantation*
;
Oliguria*
;
Postoperative Period*
;
Risk Factors
;
Tissue Donors
;
Transplants*
;
Warm Ischemia