A Study of Serum Total and House Dust Mite-Specific IgE, and ECP Levels in Healthy Korean Children Under 7 Years of Age / 소아알레르기및호흡기학회지

PURPUSE: Serum IgE have been shown to be related to allergic disease and used for an initial diagnosis of allergic diseases. House dust mite such as Dermatophagoides pteronyssinus(Dp) and D. farinae(Df) is very important for inhalant allergens, which may be a cause and/or triggering factor of atopic diseases. On the other hand, eosinophil cationic protein (ECP) causes epithelial damages of the airway, and bronchial hyperresponsiveness has been used as a useful indication of allergic inflammation. To date, there are few studies on the longitudinal patterns of total and inhalant allergen-specific IgE, and ECP in normal children in Korea. The present study was performed to determine the reference levels of serum total and Dp- and Df-specific IgE and ECP in healthy children under 7 years of age by the groups of different age and gender. METHODS: Total, and Dp- and Df-specific IgE and ECP concentrations were measured by fluoroimmunoassay(UniCAP, Pharmacia-UpJohn, Sweden) in serum from 449 healthy children under 7 years of age by using a population-based cohort followed from 1996 through 1997. All subjects were enrolled from eight large health organizations in geographically defined area such as Seoul and four local cities. RESULTS: Serum total IgE concentration showed steady increase with age from birth to 4 years, and a plateau. In contrast, Dp- and Df-IgE levels showed apparently continuous increments after 4 years of age. ECP showed variable increase until 4 years of age and slow decrease afterwards. There were no statistically significant differences in those results by gender and/or the living area, but much higher increments of Dp- and Df-IgE of boys from 3 years of age through 6 years were found. CONCLUSION: We found feasible results of total, Dp- and Df-specific IgE, and ECP in serum from healthy children under seven years of age, which may be useful for a reference.

Expression of Insulin-like Growth Factor I (IGF-I) and Its Binding Proteins in Rat Tissues / 대한소아내분비학회지

covered with liguid nitrozen and pulverized with a pestle. To the powered tissue 5ml of 3.3M formic acid/0.5% Tween 20 was added and centrifuged at 40,000*g for 10 min. An aliquot of supernate was put into C18 sepak minicolumn to eliminates IGF-BPs. Measurement of IGF-I in rat tissues was done by RIA with anti-hIGF-I antibody and hIGF-I(PSIII) standard which was prepared by Drs. L. E. Underwood and J. J. Van Wyk UNC at Chapel Hill, NC, USA and distributed through the National Hormone and Pituitary Distribution Program. Distribution of IGF-I in rat tissue was seen by SDS-PAGE and ligand blotting method. A cDNA library in lambda gt11 of rat liver was used to isolate the cDNA of IGF-I. Phage containing inserts encoding rat IGF-I were identified by hybridization with biotin labeled synthesized oligomer which was the sequence from 1 to 8 aminoacids of known rat IGF-I. The EcoRI inserts were subcloned into PBluescript SK. The nucleotide sequence of both strands was determined by the dideoxy chain termination method. RESULTS: 1)IGF-BPs in tissue extract which could compete with antibody for IGF-I in measureing the IGF-I were eluted at 50Kdalton molecular weight marker using Protein-pak 300SW column. Using C18-sepak minicolumn, IGF-BPs were completely eliminated from tissue extract as much as possible, using Protein-pak 300SW column. 2)The amount of IGF-I in tissues was as folows: liver 575+/-41.6ng/g, lung 552.0+/-40.8ng/g. kidney 503+/-30.8ng/g, heart 449.0+/-30.4ng/g, testis 225+/-18.8ng/g, spleen 146+/-26.4ng/g, muscle 92+/-7.6ng/g and brain 49.0+/-5.8ng/g. The amount of IGF-I in blood was 1403+/-60.8ng/ml. 3)Banding patterns of IGF-BPs in rat tissues extract were obtained using ligand blotting. IGF-BP3 bands at 50 Kdalton molecular weight marker were strongly shown in testis, heart, and lung extracts but not in brain and muscle. IGF-BP1 and 2 band at 30Kdalton molecular weight marker was strongly shown in liver, kidney, spleen, testis, heart and lung. IGF-BP4 band at 21 Kdalton molecular weight marker was weakly shown only in spleen and muscle. 4) The nucleotide sequence of cloned cDNA of rat IGF-I is as follows. 5 10 15 5'----- CC CTT TGC GGG GCT GAG CTG GTG GAC GCT CTT CAG TTC GTG TGT 20 25 30 -GGA CCA AGG GGC TTT TAC TTC AAC AAG CCC ACA GGC TAT GGC- 35 40 45 -TCC AGC ATT CGG AGG GCA CCA CAG ACG GGC ATT GTG GAT GAG------3 CONCLUSION: This study suggests that tissue extraction method for IGF-I from tissues and elimination of IGF-BPs using C18 sepak minicolumn is suitable for measuring in large numbers of samples. Expression of IGF-I and IGF-BPs in multiple tissues suggests some phsiologic function at each tissue level. Subcloning of cDNA of exon 3 and 4 of IGF-I was useful for studying regulation of IGF-IA and IB mRNA in rat tissue.

The Relationships of Pretreatment IGF-I SDS, Delay in Bone Age and Response to Recombinant Human Growth Hormone (rhGH) Therapy in Children with Growth Hormone Deficiency

PURPOSE: To assess whether pretreatment IGF-I SDS and pretreatmental bone age are useful indicators in the response of rhGH therapy in children with GH deficiency (GHD), the relationship between pretreatment IGF-I SDS, delay in bone age and the growth response during the first year of rhGH treatment was analyzed. METHODS: This study included 12 children with GHD. We measured IGF-I levels by RIA after acid-ethanol extraction at pretreatment and then calculated IGF-I SDS as follow: SDS = (IGF-I- mean IGF-I for normal subjects of the same age and sex)/SD of IGF-I for normal subjects of the same age and sex. GH levels were measured by immunoradiometric assay. All patients were treated with rhGH, 0.1IU/kg daily, 6 times a week for 1 year. RESULTS: Twelve patients (6 males and 6 females), age distribution from 4 to 16 years, were studed. The data is reported as the mean +/- SD. Height SDS for chronologic age of the group as a whole as -3.6 +/- 1.0 and bone age was 8.2 +/- 3.4 years. Pretreatment height velocity (HV) was 4.0 +/- 1.7cm/yr and the HV during each 3 months of therapy were 10.1 +/- 4.5cm/yr, 9.6 +/- 4.5cm/yr, 8.5 +/- 4.3cm/yr and 7.8 +/- 1.3cm/yr, respectively and therefore the HV during the first year of rhGH therapy increased to 9.3 +/- 2.9cm/yr (P=0.002). Pretreatmental IGF-I SDS was -2.2 +/- 0.9 (-0.4~-3.6). A significant negative correlation between pretreatmental IGF-I SDS and incremental height gain was obtained (r=-0.40, P<0.05). The height velocity of the group whose pretreatmental IGF-I SDS was below -2 (n= 8) as a whole increased significantly from 3.5 +/- 1.8cm/yr to 10.3 +/- 2.9cm/yr (P=0.001). Pretreatmental bone age delay was 3.1 +/- 1.9 (0.5-7.8) years. The height velocity of the group whose pretreatmental bone age delay above 2 years (n=9) increased significantly from 4.1 +/- 1.1cm/yr to 9.7 +/- 2.9cm/yr (P=0.001). CONCLUSION: The height velocity of GH deficient children whose pretreatmental IGF-I SDS below -2 or pretreatmental bone age delay above 2 years increased significantly after rhGH therapy. It suggests that the pretreatmental IGF-I SDS and pretreatmental bone age may be significant indicatiors in the response of GH therapy in children with GHD.

A Study on Prognostic Factors in Children with Encephalopathy

To elucidate the clinical characteristics-especially its clinical pattern and outcome-of children with encephalopathy, we carried out a retrospective review on medical records of 45 patients who were initially diagnosed as encephalopathy except mumps meningitis, Reye's syndome and neonatal hypoxic ischemic encephalopathy at the Department of pediatrics, Hanyang University children's hospital from Jaunary 1986 to February 1994. The results were summarized as follows: 1) Twenty five were male and twenty were female with male to female ratio 1.3:l. 2) There were no association with death rate and conscious level, abnormal liver function test, and sugar level in CSF on admission. 3) Death rate (33.3%) of group with seizure was higher than that (13.3%) of group without seizure on admission, but there was no statistical significance (p=0.28). 4) Death rate (7.5%) of group (l) which initial therapy started before 12hours was lower than that (43.4%) of group (ll) which initial therapy started after 12hours, but there was no statistical significance (p=0.09). However complete recovery rate (66.7%) of the former group was higher than that (26.7%) of the latter group with statistical significance (p<0.05). Therefore, early diagnosis and treatment before 12hours was essential to recovery and good prognosis in childern with acute encephalopathy.

A Case of Rotor Syndrome

We experienced a case of Rotor syndrome in an 8 year 6 month old boy who presented with icteric sclera and icteric skin on whole body. His clinical and laboratory characteristics were as follows; 1) Jaundice appeared from several months ago before admission without any clinical disturbance. 2) Direct bilirubin was more increased than indirect bilirubin. 3) Plasma indocyanine green (ICG) kinetics test revealed hepatic excretory in this patient that after intravenous injection of a standard dose of ICG (0.5mg/kg), its initial plasma disappearance is decreased, resultin in markedly increased retention of the dye 45 to 50 minutes after administration. 4) Oral cholangiography, ultrasonogram, and computed tomogram of abdomen were normal. 5) Liver biopsy specimen showed no dark brown pigmentations in the hepatic cells and any other pathologic abnormalities. 6) Nearly similar clinical and laboratory findings were observed 26 months later.

A Clinical Observation in 14 Children with SLE

To elucidate the clinical characteristics of childhood onset systemic lupus erythematosus (SLE), we carried out a retrospective reivew on medical records of fourteen patients who were diagnosed as SLE on the base of "the 1982 revised criteria for the SLE"(by american Rheumatism Association) at the Department of pediatrics, Hanyang University Hospital from January 1980 through August 1992. The results were summerized as follows: 1) Eleven girls and three boys were recruited in our study, The eight of them were early teens at the time of SLE diagnosis. 2) The frequencies of their clinical manifestations on admission were persistent facial rashes, edema, hepatosplenomegaly, renal abnormalities were proteinuria and hematuria. 3) Immunologic abnormalities were noted as follows: Positive ANA 100%. positive LE cell 64%, elevated anti DS-DNA antibody 64%, and decreased only C3 level 28%, decreased both C3 & C4 64% of the patients. 4) Serum anti-DS DNA(>10units) titer was increased in clinical exacerbated three patients and decreased in four resolved. 5) The high ANA titers( >1;80)obtained in eleven and/or homogenous pattern shown in seven strongly suggested SLE. 6) Renal biopsies of the four patients revealed lupus nephritis and three of the four patients had lupus band in their biopsied skin. 7) Three of 14 patients were recoverd spontaneously with supportive care. Other 11 patients were treated: 7 with prednisolone only, 4 combined prednisolone and other agents. After treatment five were clinically improved. But 4 patients were frequently exacerbated over 2 years, and 2 patients were died of their complications. In conclusion, serum anti-DS DNA level and ANA may be useful for the screening of SLE and for predicting clinical course and prognosis of SLE.

Characteristics of Insulin-Like Growth Factor I in Serum; Pattern of Insulin-Like Growth Factor Binding Protein(Large Complex) in Short Stature Patients with Complete Growth Hormone Deficiency

To elucidate the complex of insulin-like growth factor binding proteins (IGF-BPs) in short stature patients, we carried out a prospective study on three patients who were diagnosed as complete GH deficiency at the department of pediatrics from July 1992 to June 1993. The results were summarized as follows: 1) Two circulating IGFs complexed to specific binding protein existed in normal serum. Binding activity was found to be in the 150,000 molecular weight area (the large complex) and 50~60,000 molecular weight area (the small complex). 2) Binding activity for the large complex was seen to be dependent on advancing age, level of large IGF-BP3 complex peacked at the age of 15~16 years. 3) The binding activity for large complex diminished in three GH deficient patients and increased after hGH injection to near or above normal level. 4) Increased growth rate after GH treatment in GH deficient patient was closely related with increasing level of the large IGF-BP3 complex. Therefore we suggest that the large IGF-BP3 complex is regulated by GH. Estimating its serum level is useful for screening of GH deficiency and the monitoring of response to GH therapy.

Study on the frequency of right bundle branch block after surgical closure of ventricular septal defect

The purpose of this study is to evaluate the ventricular conduction abnormalities, especially RBBB, observed electrocardiographically after surgical closure of VSD. The present study population consists of 92 patients with VSD who were surgically corrected at the Hanyang University Hospital during 6 years period from Jan. 1985 to Dec. 1990. We reviewed their clinical records including surgical notes and EKG findings before and after operations. The results of the study were as follows: 1) Male to female ratio was 1.1:1 (48:44) 2) Out of a total of 92 cases of VSD, 65cases(70.7%)were perimembranous type and 27 cases (29.3%)were subarterial type. 3) The normal preoperative EKG findings were seen in 22 patients, LVH in 21 patients, BUH in 47patients, and RVH in 3 patiens. 4) A transatrial approach was performed in 55 cases, right ventriculotomy with or without resection of muscles in right ventricle in 13 cases, and pulmonary arteriotomy alone in 24 cases. 5) The right bundle branch block after operation developed in 33 patients out of the 65 patinets with perimembranous defect and 5 patients out of the 27 patients with subarterial defects. Postoperative RBBB developed more frequently in perimembranous defect than in subarterial defect. 6) Postoperative RBBB occured in 31.8% of the patients with normal preoperative EKG findings, 23.8% with preoperative LVH, 52.1% with BVH and 66.7% with RVH. Postoperative RBBB was more frequently observed in the patients group with preoperative BVH or RVH than the patients with normal or LVH. 7) Postoperative RBBB was observed in 84.6% after right wentriculotomy, in 43.6% after right atriotomy and in 12.5% with pulmonary arteriotomy alone.

A study on clinical pattern and prognosis in children with encephalopathy / 대한소아신경학회지

No abstract available.

A case of video game epilepsy

No abstract available.