The Relationship between BCG Vaccination and Allergic Diseases / 소아알레르기및호흡기학회지

PURPOSE: An increase in the prevalence of allergic diseases in our country as well as countries with a western life style may be due to a decrease in exposure to infectious agents in the early life. The aim of this study is to identify the relationship between BCG vaccination and allergic diseases in school-aged children. METHODS: A questionnaire survey was conducted on 8,378 elementary school children, in Seoul, Korea. Multiple logistic regression analysis was performed to investigate the independent relationship between BCG vaccination and allergic diseases. RESULTS: The significant associations between BCG vaccination and diagnosis of asthma or current wheeze (adjusted OR: 0.49 [95% CI: 0.29-0.82], 0.51 [0.28-0.93], respectively), all being adjusted by confounding factors. However, there was no association between BCG vaccination and diagnosis of allergic rhinitis or atopic dermatitis, or current symptoms of allergic rhinitis or atopic dermatitis. CONCLUSION: These findings suggest that BCG vaccination in early childhood may prevent the development of asthma in school-aged children in Seoul, Korea.

Clinical Significance of Immature Reticulocyte Fraction and Reticulocyte Cellular Indices in Pediatric Anemia Patients / 소아과

PURPOSE: Flow cytometric automated reticulocyte analysis is a superior method to manual reticulocyte counting, with respect to precision and sensitivity. Furthermore, flow cytometric analysis is able to measure immature reticulocyte fraction(IRF) and reticulocyte cellular indices(RCI:cell hemoglobin content: CHr, mean cell volume:MCVr, cell hemoglobin concentration mean:CHCMr, distribytion width:RDWr, HDWr, CHDWr). In this study, we investigated the mean values and clinical significances of IRF and RCI in healthy children and pediatric anemia patients. METHODS: IRF and RCI were measured with an automated blood cell analyzer, ADVIA 120(Bayer, USA) using oxazine 750 dye, in 57 healthy children and 61 children with anemia. The anemia group consisted of 27 iron deficiency anemia(IDA) patients and 34 patients with anemia associated with acute infection(AAI). We compared the mean values of IRF and RCI in the control group classified according to age, between anemia groups and the control group, and between the IDA group and the AAI group. RESULTS: For the normal control group, the mean values of IRF, CHr, MCVr and HDWr were higher in neonates when compared to older children. The mean values of IRF and RDWr were significantly higher, and the mean values of CHr and CHCMr were significantly lower in the IDA group when compared to the control group. The mean value of IRF was significantly higher, and the mean value of CHDWr was significantly lower in the AAI group when compared to the control group. The mean values of IRF, CHr and CHCMr were significantly lower in the IDA group when compared to the AAI group. CONCLUSION: We could determine the normal mean values of IRF and RCI in healthy children classified according to age for understanding of hematopoietic response differences according to age. The evaluation of IRF and RCI by automated reticulocyte analyzer seemed to be accurate and clinically useful for the early diagnosis of anemia and the differentiation of IDA from AAI.

Hydroxyurea Therapy in Hemoglobin Madrid Patients / 대한혈액학회지

Unstable hemoglobins (Hb) are variants of adult Hb that tend to precipitate and form insoluble inclusions (Heinz bodies) within red blood cells (RBC) and RBC precursors. More than 100 structurally different unstable Hb variants showing broad spectrum of manifestations from asymptomatic to severe hemolytic anemia and dyserythropoiesis have been discovered. Hydroxyurea is a potent ribonucleotide reductase inhibitor and have been proposed as a new therapy for beta chain hemoglobinopathies through activation of gamma chain synthesis. We treated two patients (A : son, B : father) with highly unstable Hb diagnosed as Hb Madrid [Beta 115(G17)Ala->Pro] by direct DNA sequencing and restriction enzyme analysis. Our patients received hydroxyurea in dosages varying from 0.75g to 1.3g daily for 89 weeks. We could not show the clinical and hematological improvements after hydroxyurea therapy in thses patients. Optimization of dosage and long term side effects of hydroxyurea should be studied further.

Association of the proliferation of CD4(+)/Vbeta17(+) cells and peripheral blood mononuclear cells in response to staphylococcal enterotoxin B(SEB) in atopic dermatitis / 천식및알레르기

BACKGROUND AND OBJECTIVE: Atopic dermatitis(AD) is a chronic inflammatory skin disease with a high incidence in early childhood. Staphylococcus aureus(SA) is found at high concentrations in over 90% of AD skin lesions compared with 5-37% of age-matched controls. SA isolates from AD subjects have a high prevalence(37-57%) of superantigen-producing strains. And staphylococcal enterotoxin B(SEB) has been shown to induce inflammatory reactions following application to intact skin of normal and atopic subjects. These findings suggest that SA toxin produced by SA may be linked with initiation or aggravation of AD, but the role of satphylococcal enterotoxin to the T cell in the pathogenesis of AD has not been determined clearly. This study was conducted to determine whether staphylococcal enterotoxin might have a role as a superantigen in the pathogenesis of AD. Materials and Method: We investigated the proliferative responses of peripheral blood mononuclear cell(PBMC) from 8 patients with AD and 10 age-matched normal controls. We also assessed T cell markers and T cell receptor(TCR) Vbeta chain expression by flow cytometry with and without SEB stimulation. RESULTS: PBMC from AD patients showed increased proliferation to SEB 100 pg/ml and 1000 pg/ml compared to controls. There were no differences of CD3(+), CD4(+), and CD8(+) cells after SEB stimulation between the two groups. And there were also no differences of TCR Vbeta2(+) and TCR Vbeta8(+) cells with and without SEB stimulation, but TCR Vbeta17(+) cells were increased after SEB stimulation not only in AD patients but also in controls compared to culture without SEB. The expressions of TCR Vbeta17 chain of CD3(+) and CD4(+) cells after SEB stimulation were increased in AD patients compared to controls. Furthermore, there was positive correlation between the enhanced PBMC proliferative responses to SEB and increased expressions of SEB reactive TCR Vbeta17(+)/CD4(+) cells in AD patients and controls. CONCLUSION: These findings suggest that SEB is important in the pathogenesis of atopic dermatitis and also provide evidence that the increased use of certain TCR Vbeta families is of functional significance.

A Case of Renal Angiomyolipoma with Lymph Node Involvement / 대한비뇨기과학회지

No abstract available.

An Analysis of MCV, RDW, HDW and EPO Concentration in Anemia of Acute Infection / 대한소아혈액종양학회지

PURPOSE: The purpose of this study was to assess the usefulness of mean corpuscular volume (MCV), red cell distribution width (RDW) and hemoglobin distribution width (HDW), which can be measured easily with automatic blood cell counter, in differentiating anemia of acute infection from iron deficiency anemia (IDA) in the early phase of infection. We also wanted to determine whether decreased erythropoietin (EPO) production contribute to the pathogenesis of anemia of acute infection. METHODS: 39 anemic children who were admitted to Kangbuk Samsung Hospital due to acute infectious disease between June 1997 and September 1998 were studied. We measured serum ferritin level by radioimmunoassay and divided the patients into two groups according to the serum ferritin level. The children with serum ferritin level above 30 ng/mL were included in anemia of infection group, and the children with serum ferritin level under 10 ng/mL were included in IDA group. Anemic children whose ferritin level were between 10 ng/mL and 30 ng/mL were excluded. We measured MCV, RDW and HDW by automatic blood cell counter and compared them between two groups. We also measured EPO concentration in anemia of acute infection group and compared with that of the control group. RESULTS: 1) Most common acute infectious disease accompanied by anemia of acute infection were acute gastroenteritis, acute pharyngitis, and pneumonia. 2) Complete blood count (CBC) revealed normocytic normochromia in anemia of acute infection and microcytic hypochromia in IDA. MCV of IDA group was significantly lower than that of anemia of acute infection group (65.2+/-8.7 fL vs 82.4+/-5.5 fL, P<0.005). RDW in IDA group was significantly higher than that of anemia of acute infection group (17.1+/-2.5% vs 15.0+/-1.0%, P<0.005). HDW in IDA group was significantly higher than that of anemia of acute infection group (3.2+/-0.5 g/dL vs 2.4+/-0.2 g/dL, P<0.005). 3) The mean EPO concentration in anemia of acute infection group was significantly higher than that of control group (27.1+/-14.5 mU/mL vs 18.4+/-8.7 mU/mL, P<0.05). CONCLUSION: 1) We concluded that MCV, RDW and HDW are effective parameters to differentiate anemia of acute infection from IDA. 2) Decreased EPO production may have less significant role in the pathogenesis of anemia of acute infection compared to anemia of chronic disease. 3) Our results suggested that other factors such as accelerated erythrocyte destruction or hypoferremia may contribute to the development of anemia of acute infection. Further studies will be required to identify the pathophysiology of anemia of acute infection.

Relationship Between IgE-Mediated Basophil Histamine Releasability and Airway Hyperresponsiveness or Atopy Markers in Atopic Children / 소아알레르기및호흡기학회지

BACKGROUND: Our previous data suggested that IgE-mediated histamine release from basophil was elevated in the atopic asthmatic children. Basophil may play an important role in the development of the IgE-dependent, late phase response in allergen induced airway disease. So the existence of enhanced basophil histamine release in asthma could promote airway reactivity and obstruction. PURPOSE: The purpose of this study is to determine the relationship between IgE-mediated basophil histamine releasability (BHR) and airway hyperresponsiveness or markers of atopy in atopic children. METHODS: Twelve atopic asthmatics and four healthy atopics who were sensitive to D.p and D.f were selected. Their median age was 11.2 years old, their mean serum IgE level was 897+/-276 IU/mL and mean total eosinophil count was 536+/-71/mm3. Total eosinophil counts, total IgE, D.p and D.f-specific IgE, pulmonary function test, and methacholine provocation test were performed. IgE-mediated basophil histamine release by D.f allergen and goat-antihuman IgE antibody were measured by automated fluorometric assay. The relationship between histamine release and airway hyperresponsiveness or atopic markers was investigated. RESULTS: PC20 inversely correlated with anti-IgE antibody-mediated BHR (r=-0.50, P<0.05). Serum total IgE concentration correlated with anti-IgE antibody-mediated BHR (r=0.54, P<0.05). Serum concentrations of specific IgE to D.p correlated with anti-IgE antibody-mediated BHR (r=0.66, P<0.05). PC20 correlated correlated with FEF25-75% (r=0.75, P<0.05) and inversely with the total eosinophil counts (r=-0.69, P< 0.01). CONCLUSION: IgE-mediated basophil histamine releasability is inversely correlated with airway hyperresponsiveness, and correlated with total or specific-IgE in atopic children. These findings suggest that basophil histamine releasability is easy and useful method of diagnosis and monitoring response to treatment in atopic disease.

Prognostic Value of PCNA , c-erbB-2 , c-fos in Patients with Non-small Cell Lung Cancer / 대한암학회지

PURPOSE: Oncogenes, tumor suppressor genes, and growth variables of tumors are important in the assessment of prognosis in lung cancer. The expression of PCNA, c-erbB-2 (HER-2/neu), and c-fos oncoprotein and their prognostic implications in surgically resected patients with non-small cell lung cancer were evaluated. MATERIALS AND METHODS: Seventy patients with non-small cell lung cancer were included and PCNA, c-erbB-2 and c-fos overexpression were evaluated by immunohistochemical stain using paraffin-embedded tissue. RESULTS: The mean proportion of PCNA positive cells was 18.6%, and there was no significant difference according to cell type and stage. The median survival time was significantly shorter in the group with high PCNA expression (>10%) as compared with the group with low PCNA expression (<10%) (37 months vs 16 months). Four (6.3%) of 64 cases demonstrated c-erbB-2 positivity. These were all adenocarcinoma cases. c-fos protein was only rarely overexpressed (1/51). CONCLUSION: PCNA expression was shown to be a useful prognostic parameter in resected non-small cell lung cancer while c-erbB-2 and c-fos oncoprotein were infrequently expressed.

Cytokine production of peripheral blood mononuclear cells from atopic asthmatics / 알레르기

To investigate the imbalance of the cytokine production profile of T cells from atopic asthmatics, we measured concentrations of IL-4, IL-5 and IFN-y by ELISA method in the culture supernatants of peripheral blood mononuclear cells(PBMCs) and Derrnato-phagoides pteronyssinus(Der p) J-stimulated PBMCs from Der p-sensitized atopic asthmatics, Der p-sensitized healthy atopits, non-atopic asthmatics and healthy non-atopics. The suppressive effect of IFN-y on cytokine production of Der p J-stimulated PBMCs was also examined. The PBMCs from atopics showed higher IL-4 and IL-5 production in response to PHA +TPA and higher IFN-gamma production in response to Der p Jq compared with non-atopits. The Der p J-stimulated PBMCs from atopics showed a tendency of increased IL-5 production in response to Der p J and higher IL-4 and IL-5 production in response to PHA+TPA compared with non-atopics. IL-5 production of Der p J-stimulated PBMCs from atopics was suppressed by IFN It is suggested that an imbalance in IL-4, IL-5 and IFN-y production is a feature of the atopic state. The TH2 characteristics of allergen-stimulated PBMCs could be regulated by IFN-y.

Pathologic Characteristics of Colorectal Cancers with DNA Replication Errors

Unstable microsatellite repeat sequences or DNA replication errors(RER) due to defective mismatch repair genes have been reported in a subset of sporadic colorectal tumors and in most tumors of patients of hereditary nonpolyposis colorectal carcinoma(HNPCC). To elucidate the clinicopathological correlation of these RER-positive cancers, we examined 16 cases of colorectal carcinoma of different histologic subtypes(6 cases of carcinoma with no gland formation, 5 cases of mucinous carcinoma and 5 cases of gland forming carcinoma). We detected RER in five cases. The patients with RER-positive cancers had a marked preponderance of carcinoma with no gland formations out of 6 carcinomas with no gland formation were RER-positive cancers) and of cancers proximal to splenic flexure(all of the RER-positive cases were proximal colon carcinomas). We conclude that RER-positive cancers have wiique pathologic features that may be useful for the screening and counselling of patients with hereditary colon cancers.