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

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

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

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

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

PURPOSE: Typical absence seizures are characterized by the daily presentation of frequent staring and typical 3Hz spike and wave discharges in otherwise healthy children. Typical absence seizures can present in childhood absence epilepsy and related syndromes. Lamotrigine (LTG) has been anecdotally used as a monotherapy for this seizure type; however, the efficacy and tolerability has remained unknown. The aim of this study was to evaluate the efficacy, tolerability, and long-term outcome of LTG in patients with newly diagnosed typical absence seizures. METHODS: Medical records of 36 patients having newly diagnosed typical absence seizures were analyzed. Patients were included based on the history of typical absence seizures and 3 Hz spike and wave discharges in interictal EEG. LTG was administered at a starting dose of 10 mg/day and increased by 10 mg/week until seizure freedom or reaching a dose of 10 mg/kg/day. RESULTS: Thirty-one patients had childhood absence epilepsy (CAE) and five had juvenile absence epilepsy (JAE). Thirty patients (83.3%) experienced more than 50% reduction of seizure frequency after 4 weeks of initial titration. Twenty-three patients (63.9%) achieved seizure freedom for 4 weeks after a mean duration of 8.3 weeks of treatment, and the cumulative numbers of patients with seizure freedom were 6 (16.7%), 18 (50.0%), and 23 (63.9%) within 4, 8, and 12 weeks, respectively. After 12 months of treatment, 12 patients (33.3%) showed normalized EEG findings, and their symptoms also disappeared. Four patients had uncontrolled seizures despite of dose increment and consequently needed additional treatment with valproic acid or ethosuximide. Most adverse effects, including skin rash (n=4), headache (n=1), and dizziness (n=1), were transient and tolerable. CONCLUSION: Lamotrigine, as a first-line monotherapy in newly diagnosed patients with typical absence seizures, could be safely used with good efficacy in seizure control.
Child ; Dizziness ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Ethosuximide ; Exanthema ; Freedom ; Headache ; Humans ; Medical Records ; Seizures ; Triazines ; Valproic Acid

PURPOSE: In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004. METHODS: Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea. RESULTS: One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels (10.4+/-1.6 g/dL) and increased leukocyte counts (16,234.3+/-10,601.8/microliter). Pleural fluid obtained from patients showed high leukocyte counts (30,365.8+/-64,073.0/microliter), high protein levels (522.3+/-1582.3 g/dL), and low glucose levels (88.1+/-523.5 mg/dL). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was 28.6+/-15.3 days. CONCLUSION: We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.
Anti-Bacterial Agents ; Chest Pain ; Child ; Cough ; Drainage ; Empyema* ; Female ; Fever ; Glucose ; Hospitalization ; Humans ; Korea* ; Lethargy ; Leukocyte Count ; Male ; Medical Records ; Pneumonia ; Retrospective Studies ; Sex Ratio ; Streptococcus ; Streptococcus pneumoniae ; Tertiary Care Centers ; Vaccination

BACKGROUND: The 'hygiene hypothesis', the apparent inverse relationship between certain childhood infections and the subsequent development of asthma and atopy, has been gaining attention and is currently now considered one of the most plausible explanations for the cause of asthma and atopy currently. OBJECTIVE: We tried to evaluate the relationship between Epstein Barr virus infection in infancy and early childhood with total IgE, the hallmark of atopy. with these results, we observed the changing pattern of total IgE levels according to the ages that EBV infection occured. METHODS: The study population, a total of 75 patients were divided by age: under 2 years of age, under 3 years of age, under 4 years of age and then they were divided into the two groups : EBNA negative and EBNA positive groups. EBNA and IgE were measured by ELISA and CLA respectively. We analyzed the relationships between age, sex, family history, atopic predisposition, total eosinophils, log IgE, and positivity of EBNA stastically. RESULTS: Prevalence of EBNA positivity was 26% in children 1-3 years of age. Among the six variables, log IgE showed statistically significant difference in the two groups under 2 years of age and under 3 years of age. In the group of under 2 years of age, mean log IgE in EBNA positive group was 0.7 IU/mL and EBNA negative group was 1.3 IU/mL, these differences were significant statistically (p<0.05). In the group of under 3 years of age , mean log IgE in EBNA positive group was 0.8 IU/mL and EBNA negative group was 1.5 IU/mL, these differences were statistically significant(p<0.05). CONCLUSION: This study showed that Ebstein Barr virus infection before 3 years of age is associated with lower log IgE. This means that there is a possibility of a negative influence in the prevalence of allergic disease by EBV infection in children before 3 years of age.
Asthma ; Child ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human* ; Humans ; Hygiene Hypothesis ; Immunoglobulin E* ; Prevalence