BACKGROUND AND OBJECTIVE: It is generally accepted that one third of children with food allergy lose their clinical activity if the responsible food allergen can be identified and completely eliminated from their diet. But buckwheat allergy rarely lose clinical activity. So, we have produced hypoallergenic buckwheat(HBW) according to Ikezawa's method, and characterized the allergenicity by immunoblot method using monoclonal antibodies to raw buckwheat. MATERIAL AND METHODS: HBW was prepared from raw buckwheat by salting with 0.5 M NaCl. 18 monoclonal antibodies to raw buckwheat were made according to standard polyehtylene glycol method. We performed SDS-PAGE of HBW and transferrd to nitrocellulose membranes, which were immunoblotted by selected 3 monoclonal antibodies to raw buckwheat. RESULTS: The protein concentration of HBW was 47.3 microgram/microliter. As the result of SDS-PAGE of HBW the protein bands of 50, 36, 13 kD of raw buckwheat disappeared. 3 monoclonal antibodies were selected due to their higher specificities in ELISA. Immunoblot study showed that 2 among 3 monoclonal antibodies bind to HBW. CONCLUSION: The SDS-PAGE of HBW showed less protein bands in comparison to raw buckwheat. But the allergic component of HBW still remained. So further studies are required to eliminate the residual allergenicity of hypoallergenic food.
Antibodies, Monoclonal* ; Child ; Collodion ; Diet ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Fagopyrum* ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Membranes

PURPOSE: This study is intended to investigate results of skin prick tests, family history, and diet pattern in patients under 2 years of age diagnosed with atopic dermatitis (AD). METHODS: A total of 82 AD patients and 53 controls participated in this study. They visited outpatient department of Pediatrics in Pundang Cha hospital from July 2002 to May 2003. Questionnaire survey about family allergy history, duration of breast feeding, time of first weaning, kinds of foods eaten from birth was performed. Skin prick tests were performed with food allergens that consisted of egg, milk, mixed bean, beef, pork, cod, mixed flour and D. f. as aeroallergen, histamine as positive control, normal saline as negative control. RESULTS: Egg (19.5%), milk (11.0%), D. f. (9.8%), cod (8.5%) were the common allergens in AD patients. Erythema and wheal size was 14.6 mm, 2.7 mm in AD patients and 8.5 mm, 1.6 mm in controls (P< 0.05). There was no significant effect of age on the skin reactivity to histamine. Odd ratio of atopy was 31.6 (95% CI: 4.2-240.3) and that of family history was 2.6 (95% CI: 1.3-5.2). The mean age of the start of weaning was 5.6 months in AD patients and 4.5 months in controls (P< 0.05). There were no significant differences in duration of breast feeding and the number of foods eaten from birth between AD patients and controls. CONCLUSION: Egg, milk, D. f., and cod were the common allergens in AD patients under 2 years of age. This means that it is necessary for AD patients to have proper guide for weaning diet and regulation of environment. Allergy history of parents has high relative risk and therefore the high risk infants require positive prophylactic counterplans for AD.
Allergens ; Breast Feeding ; Dermatitis, Atopic* ; Diet* ; Erythema ; Flour ; Food Hypersensitivity ; Histamine ; Humans ; Hypersensitivity ; Infant ; Milk ; Outpatients ; Ovum ; Parents ; Parturition ; Pediatrics ; Surveys and Questionnaires ; Skin ; Weaning

PURPOSE: Cat is the pet which many of us quite frequently contact without any specific precautions. According to the allergy skin tests conducted in children, cat antigen shows a comparatively high positive reaction, and past history also shows that there are many patients who suffer allergies from cat contacts. Therefore, once it is diagnosed as an allergy caused by cat, it is important that patients be isolated in order to restrict their contact with cat. In this context, this study was conducted for the purpose of finding out how serious and how frequent the allergies by cat contacts are. METHODS: Forty five children patients who visited to the Allergy Clinic for Children, Severance Hospital annexed to the Medical College, Yonsei University were enrolled in this study. Some of patients had shown a positive reaction against cat antigen in the allergy skin test, and others had a past history of developing symtoms when contacted by cat. The patients were isolated from cat for seven days, and then contacted with cats for 30 minutes and observed the provocated symptoms. RESULTS: 1) Among the tested patients, the number of cases who were provocated by the symptoms after cat contact were 18 (40%). 2) Among those patients who were shown to be positive only in allergy skin test, only 24.2% proved to be provocated by the symptoms, while 90.0% of those who had a past history in addition to allergy skin test proved to be provocated by the symptoms. 3) Symptoms provocated after cat contact showed allergic rhinitis patients 88.2% which was the highest ratio, bronchical asthma, 35.3%, urticaria, 29.4%, and allergic conjunctivitis, 23.5%, respectively. 4) The onset and duration of symptoms provcated were under 10 minutes and from 30 to 60 minutes, which included most cases in the test. 5) Total IgE and eosinophil count of patients did not show any meaningful differences between the group which was provocated and that which was not provocated. CONCLUSION: It was shown that 40% patients who were suspected of cat allergy had a positive reaction to the cat contact provocation test. Ninety percents of patients who showed both positive allergy skin test and past history were provocated after cat contact.
Animals ; Asthma ; Cats* ; Child ; Conjunctivitis, Allergic ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Rhinitis ; Skin Tests ; Urticaria

PURPOSE: Adverse reactions to mosquito bites have been recognized for some time, and these usually consist of large swellings, generalized urticaria, angioedema, and less frequently asthma. There have been some efforts to define immunologic characteristics of mosquito allergens throughout the world. But, in Korea, the immunologic analysis of mosquito allergen have not been made. METHODS: Extracts of locally distributed female mosquito Culex pipiens, were prepared from their heads and thoraxes. By sodium dodecylsulfate-polyacrylamide gel electrophoresis, proteins of two extracts were isolated. Then their proein bands were transferred to nitrocellulose membrane. Immunoblotting was performed with sera of allergic patients to mosquito bites, then completed by antibodies to human IgE. RESULTS: Immunoblotting showed IgE binding proteins weighing 70 kD, 60 kD, 34 kD in Culex pipiens. CONCLUSION: We found that mosquito antigens induced IgE response, and it suggested that species-specific antigens exist. Further investigation using salivary gland extracts from Culex genus are needed in identifying specific allergens.
Allergens* ; Angioedema ; Antibodies ; Asthma ; Collodion ; Culex* ; Culicidae* ; Electrophoresis ; Female ; Galectin 3 ; Head ; Humans ; Immunoblotting ; Immunoglobulin E ; Korea ; Membranes ; Salivary Glands ; Sodium ; Thorax ; Urticaria

Gemcitabine is an effective newly developed chemotherapeutic agent, which is increasingly being used to treat non-small cell lung, ovarian and breast cancers. Pulmonary toxicity is usually self-limiting mild dyspnea, bronchospasm, but severe pulmonary toxicity is rarely reported. Herein, we report drug induced interstitial lung disease associated with gemcitabine treatment. High resolution computerized tomogram (HRCT) showed an increased ground glass opacity and thickened septal lines. The patient showed a rapid good response with prednisolone treatment.
Breast ; Bronchial Spasm ; Capillary Leak Syndrome ; Dyspnea ; Glass ; Humans ; Lung ; Lung Diseases, Interstitial* ; Prednisolone

A 14-year-old girl presented with recurrent, progressive lower leg weakness and decrease in sensation. When the symptoms first appeared, she was misdiagnosed as transverse myelitis and was treated with methylprednisolone. Eleven months later, when she had the same symptoms, spine magnetic resonance images showed the characteristic findings of spinal cord cavernoma and she underwent surgical intervention. Spinal cord cavernomas are rare lesions. Because of their highly bleeding tendency, acute neurological deterioration occurs secondary to hemorrhage within the spinal cord. In order to prevent intramedullary hemorrhage and to halt the progressive neurological decline, surgical resection is recommended. We experienced a case of spinal cord cavernoma presenting with recurrent transverse myelitis clinically.
Adolescent ; Hemorrhage ; Humans ; Leg ; Magnetic Resonance Spectroscopy ; Methylprednisolone ; Myelitis, Transverse ; Sensation ; Spinal Cord ; Spine

Sedation is often necessary to optimize care for critically ill children requiring mechanical ventilation. If too light or too deep, however, sedation can cause significant adverse reactions, making it important to assess the degree of sedation and maintain its optimal level. We evaluated the efficacy of the COMFORT scale in assessing optimal sedation in critically ill children requiring mechanical ventilation. We compared 12 month data in 21 patients (intervention group), for whom we used the pediatric intensive care unit (PICU) sedation protocol of Asan Medical Center (Seoul, Korea) and the COMFORT scale to maintain optimal sedation, with the data in 20 patients (control group) assessed before using the sedation protocol and the COMPORT scale. Compared with the control group, the intervention group showed significant decreases in the total usage of sedatives and analgesics, the duration of mechanical ventilation (11.0 days vs. 12.5 days) and PICU stay (15.0 days vs. 19.5 days), and the development of withdrawal symptoms (1 case vs. 7 cases). The total duration of sedation (8.0 days vs. 11.5 days) also tended to decrease. These findings suggest that application of protocol-based sedation with the COMPORT scale may benefit children requiring mechanical ventilation.
Anesthetics, Intravenous/administration & dosage/therapeutic use ; Child, Preschool ; Conscious Sedation/methods/standards ; Critical Care/*methods/standards ; *Critical Illness ; Female ; Fentanyl/administration & dosage/therapeutic use ; Humans ; Hypnotics and Sedatives/administration & dosage/*therapeutic use ; Infant ; Infusions, Intravenous ; Intensive Care Units/statistics & numerical data ; Length of Stay ; Male ; Midazolam/administration & dosage/therapeutic use ; *Respiration, Artificial ; Treatment Outcome

Hormonal replacement therapy (HRT) has been proven for treatment of postmenopausal symptoms such as hot flushes, night sweats and urologic symptoms. HRT became very popular in the 1990's, when there were several reports showing that it also helped with other menopausal complications such as osteoporosis and cardiovascular disease. Recent studies report that the incidence of breast cancer, endometrial cancer, cerebral infarction, coronary artery diseases, deep vein thrombosis and pulmonary thrombembolism could rise after HRT. Among these side effects of HRT, the risk of pulmonary thromboembolism increases 2 to 4 fold after HRT, but can vary with the use of different doses and preparations. Here, we summarize the risk factors and clinical courses for 5 patients who developed pulmonary thromboembolism after postmenopausal HRT.
Breast Neoplasms ; Cardiovascular Diseases ; Cerebral Infarction ; Coronary Artery Disease ; Endometrial Neoplasms ; Female ; Humans ; Incidence ; Osteoporosis ; Postmenopause* ; Pulmonary Embolism* ; Risk Factors ; Sweat ; Venous Thrombosis

PURPOSE: The purposes of this study were to determine the normal values of spectral and chaotic indexes and to assess the maturational process of autonomic and chaotic control of fetal heart rate according to gestational age. METHODS: Three hundred and thirty-seven mothers with normal singleton pregnancies, who were 23 weeks or more in gestational age, was randomly chosen. For more than 40 minutes fetal heart rates and fetal movements were recorded and were downloaded to a computer. From each heart rate data, we extracted 25 minutes (3,000 points) worth of time series of dimension were calculated and then 2 weeks' average were compared to find the maturational change of them. RESULTS: LF power and LF/HF ratio which are indexes of cardiac sympathetic tone increased significantly (P=0.0001) with gestational age from 23 to 38 weeks. The HF power did not show significant developmental change. Correlation dimension, an index of chaotic control, tended to decrease with the gestational age (P=0.0001). It was 4.07 +/- 0.13 before 24 weeks and, after it reached the peak of 4.15 +/- 0.14 at 31-32 weeks, it gradually decrease to a slight but significant lower value of 3.67 +/- 0.08 at 41-42 weeks. CONCLUSION: Magnitude of cardiac sympathetic modulation increases until 37-38 weeks. On the average, fetal heart rate is regulated at least by four independent variables throughout the gestation and after 23 weeks of gestation. Complexity of heart rate control system peaks at 31-32 weeks then slightly decreases until term gestation, probably to synchronize the heart rate to other physiologic functions.
Female ; Fetal Movement ; Fetus* ; Gestational Age ; Heart Rate* ; Heart Rate, Fetal ; Heart* ; Humans ; Mothers ; Pregnancy ; Reference Values

Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of prominent intra-alveolar fibrin and organizing pneumonia, with out hyaline membranes or prominent eosinophilia. The clinical manifestations of AFOP resemble those of acute lung injury such as acute interstitial pneumonia (AIP). However, the classic histological patterns of AFOP differ from diffuse alveolar damage (DAD), bronchiolitis obliterans with organizing pneumonia (BOOP) or acute eosinophilic pneumonia (AEP). The characteristic intra-alveolar fibrin ball and lack of classic hyaline membrane are the predominant histological features of AFOP. Although some reports suggest that its clinical course is less catastrophic than DAD, the clinical entity that distinguishes AFOP from DAD has not been established. We present a case of pathologically demonstrated AFOP in a 79-year-old man. The radiological findings of our case were similar to those of DAD, presented with diffuse bilateral lung infiltrations. However, despite the rapid development of respiratory failure, the patient had a better response and outcome to steroid therapy than what would be expected for DAD.
Acute Lung Injury ; Aged ; Bronchiolitis Obliterans ; Eosinophilia ; Fibrin* ; Humans ; Hyalin ; Lung ; Lung Diseases, Interstitial ; Membranes ; Pneumonia* ; Pulmonary Eosinophilia ; Respiratory Insufficiency