Changes of allergenecity of salted and fermented shrimp / 천식및알레르기

BACKGROUND AND OBJECTIVE: Shrimp is one of the most common food allergens. The salted and fermented shrimp (S/F shrimp) is a traditional food and ingested frequently in the daily life of many Korean people. But few studies have been investigated on the allergenicity of S/F shrimp. The aim of our study is to observe the allergenicity of S/F shrimp and to compare it with the allergenicity of shrimp. MATERIAL AND METHODS: Crude extracts were made from three kinds of S/F shrimps and four kinds of shrimps after boiling. The extracts were used for SDS-PAGE, ELISA, ELISA inhibition test, immunoblotting, and immunoblotting inhibition test with sera from 10 subjects who have shrimp specific IgE by radioallergosorbent (RAST) (3+ or 4+). RESULTS: The protein concentrations of S/F shrimp extracts were less than half of the extracts of shrimps (1.9 mg/ml, 1.2 mg/ml, 1.1 mg/ml vs 4mg/ml, 3.83 mg/ml, 6.8 mg/ml, 6.6 mg/ml). The extracts of S/F shrimp showed weaker and more diffusely distributed protein bands in SDS-PAGE and showed less than half of the O.D. value in IgE-ELISA compared to those of shrimp extracts. The specific IgE immunoblotting of S/F shrimp extracts showed 9 bands (36, 33, 30, 29, 28, 26, 23, 20, 19 kDa). Dose dependent inhibition was observed between shrimps and S/F shrimp in ELISA-inhibition and immnunoblotting inhibition test. The allergen concentration of S/F shrimp needed to inhibit 50% of shrimp-lgE ELISA was five times higher than that of shrimp. CONCLUSION: The crude extracts of S/F shrimps showed less than half the amount of protein compared to crude extracts of shrimps have and also showed reduced allergenicity by salting and fermentation.

18F-Fluorodeoxyglucose-Positron Emission Tomography in the Staging of Malignant Lymphoma Compared with CT and 67Ga Scan

The accurate staging of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) is an important aspect of treatment. In this study, the authors undertook to prospectively evaluate the clinical value of 2- (fluorine-18) fluoro-2-deoxy-D-glucose position emission tomography (FDG-PET) for the staging of malignant lymphoma as compared with computed tomography and 67Ga scan. Thirty consecutive cases with biopsy-proven lymphoma (4 HD, 26 NHL) were examined by FDG-PET for the initial staging and the restaging work-up between September 2000 and April 2001. The FDG-PET and conventional study, including a CT of the neck, chest, abdomen, and of the pelvis, a bone scan, a 67Ga scan, and a bone marrow study were undertaken to investigate nodal/extranodal manifestations and bone marrow infiltration. In terms of the detection of nodal lymphoma manifestation, the sensitivities and specificities of the PET, CT, and 67Ga scan were determined to be 93.3%, 98.9%, and 25.8%, and 100%, 99.1%, and 99.8%, respectively. In terms of the detection of extranodal lymphoma manifestation, the sensitivities and specificities of the PET, CT, and 67Ga scan were 87.5%, 87.5%, and 37.5%, and 100%, 100%, and 100%, respectively. The FDG-PET proved to be very accurate for the staging of malignant lymphoma and superior to Ga-67 scan. Although the results of PET and CT were substantially comparable, both imaging studies were found to complement each other in some cases with respect to the evaluation of lymphomatous involvement.

A case of Churg-Strauss syndrome in association with leukotriene modifier therapy when oral corticosteroids were withdrawn in an asthmatic patient / 천식및알레르기

Churg-Strauss syndrome is one of idiopathic, systemic necrotizing vasculitis characterized by a history of asthma or allergic rhinitis, eosinophilia of peripheral blood and variable symptoms of systemic vasculitis. There have been several recent case reports of Churg-Strauss syndrome in association with leukotriene modifier therapy when oral corticosteroids were withdrawn in asthmatic patients. We report a case of a 31-year-old man with steroid-dependent asthma who developed Churg-Strauss syndrome after 9 months of steroid withdrawal period, while he was receiving leukotriene modifier (Pranlukast).

Antigenicity of an aphid allergen in respiratory allergic diseases / 천식및알레르기

BACKGROUND: Several inhalant allergens are newly identified from arthropods including insects or arachnids recently. Aphids (Heteroptera: Aphididae) are widespread sucking insects, which are parasitic on numerous host plants such as various crops, trees and weeds. Among aphids, Aphis gossypii is a particularly polyphagous species that has been described on almost 300 host plants from various botanical families. Thus A. gossypii is found throughout the country and is a species anyone can easily contact. It is unknown whether aphids have a role in the pathogenesis of respiratory allergy. OBJECTIVE: We assumed that aphids can act as an inhalant allergen on the hypothesis that numerous allergenic materials are released from aphids and become airborne. Using a representative species, A. gossypii, this study was performed to evaluate the antigenicity of an aphid allergen in patients with respiratory allergic diseases. METHODS: Skin prick test with crude extracts of A. gossypii and 50 common inhalant allergens was performed for 225 subjects with respiratory allergic diseases (bronchial asthma and/or rhinitis). A. gossypii-specific IgE (sIgE) were detected by means of ELISA, and IgE- binding components were identified by SDS-PAGE with immunoblot analysis. RESULTS: Of the 225 enrolled subjects, 37 (16.4%) subjects showed positive skin reactivity to A. gossypii. Of them, 17 (7.6%) subjects had A. gossypii-sIgE by ELISA. The SDS-PAGE of A. gossypii extracts showed various protein bands ranging from 9 to 200 kd. Of them, diverse IgE-binding pattern was noted for individual subject by immunoblot analysis. The inhibitory ELISA results indicated that IgE binding to A. gossypii was partially inhibited by the allergenic extracts of house dust mite (HDM), cockroach, or other aphid (Acyrthosiphon kondoi). Finally, A. gossypii-bronchial challenge test was conducted for one asthmatic farmer with skin reactivity to A. gossypii and strong job-related symptoms, but showed no significant response. CONCLUSION: A. gossypii can elicit IgE response in some patients with respiratory allergic diseases. A. gossypii may have a cross-reactivity with HDM and cockroach. Further study will be needed to evaluate its clinical significance in respiratory allergy patients.

Generic health-related quality of life in patients with bronchial asthma / 천식및알레르기

BACKGROUND AND OBJECTIVE: It is recommend that health-related quality of life (HRQL) should be measured as well as conventional clinical indices in order to obtain a complete picture of a patient's health status. In patients with bronchial asthma, frequent symptoms and management related burdens may result in reduced HRQL. In Korea, asthma-specific quality of life (QOL) questionnaire has been developed and broadly applied in clinical practice. But little is known about the impact of asthma on generic HRQL. In this study, we evaluated the generic HRQL in adult asthmatic patients by using the Nottingham Health Profile (NHP). METHODS: Two-hundred three subjects with age over 40 years were enrolled in this study; 77 hospital out-patients with asthma, 63 with stable ischemic heart disease (IHD), 26 hospitalized patients with unstable IHD such as unstable angina or acute myocardial infarct (MI), and 37 healthy controls. All subjects were asked to answer the NHP by self-administration method. The NHP was composed of two parts. Part I consisted of 38 items in six domains and part II 7 items. Six domains of part I were physical mobility (8 items), pain (8 items), social isolation (5 items), emotional reaction (9 items), energy level (3 items) and sleep (5 items). RESULTS: Although patients with unstable IHD had most significant problems in all area of the NHP part I and II, bronchial asthmatics had similar or more restriction to patients with stable IHD. Patients with asthma also had significantly more problems of generic HRQL than healthy controls. Patients with more severe asthma suffered from more pain and loss of energy than mild asthmatics. In similar severity of asthma, patients with lower economic state had more restriction, especially in pain and emotional reaction. Patients with asthma experienced difficulties with daily activities in the NHP part II in order of holidays, work, home relationships, homework, hobbies, social life, sex life, and had more problems with their home work and home relationships than patients with stable IHD. CONCLUSION: Patients with bronchial asthma had similar or more restriction to patients with stable IHD in generic HRQL. To improve outcome measurement of asthma treatment, generic HRQL should be measured as well as asthma-specific QOL and clinical indices.

A Case of Metastatic Pulmonary Calcification in Primary Hyperparathyroidism / 대한내분비학회지

Metastatic calcification is the deposition of calcium, in previously normal tissue, as a result of elevated plasma calcium and phosphorus product levels and has been reported in patients with parathyroid adenoma, parathyroid carcinoma, hyperparathyroidism due to chronic renal failure, vitamin D intoxication, and osteolytic bone tumors, such as multiple myelomas. The lungs are the most common site of metastatic calcification. We have experienced metastatic pulmonary calcification in a case of primary hyperparathyroidism. A 55-year old woman was admitted due to general weakness. From the laboratory evaluation, hypercalcemia and excess production of parathyroid hormone (PTH) were noted. technetium-99m-labelled sestamibi scintigraphy indicated an intense uptake in the lower pole area of the left thyroid gland, suggestive of a parathyroid adenoma. A technetium-99m phosphate (99mTc-MDP) bone scan showed increased uptakes in both lungs. A parathyroid lobectomy was performed, and primary hyperparathyroidism, due to a parathyroid adenoma, was finally diagnosed. A follow-up 99mTc-MDP bone scan showed the disappearance of the metastatic pulmonary calcification, with the clinical symptoms and biochemical parameters normalizing after 6 months.