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즉시형 우유 알레르기 환자에서 카제인 특이 IgE와 IgG의 유용성
임자현 ( Ja Hyun Lim ),정경욱 ( Kyung Uk Jeong ),이정민 ( Jeong Min Lee ),이경은 ( Kyung Eun Lee ),이수영 ( Soo Young Lee ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2
Purpose: Cow`s milk-specific IgE (CM-IgE) has been proposed as one of the valuable markers for diagnosis of clinical cow`s milk (CM) allergy. In this study, we evaluated the additional usefulness of casein-specific IgE (casein-IgE) and IgG (casein-IgG) for the diagnosis of clinical CM allergy. Methods: Fifty-eight subjects, aged from 3 months to 154 months, were enrolled. Thirty-four patients showed immediate-type of clinical CM allergy, and 24 patients were atopic controls. The serum levels of CM-IgE, casein-IgE, and casein-IgG were measured. Pa¬tients were divided into 2 groups: those aged under 12 months and those aged 12 months or over. The diagnostic values of each antibody were analyzed and compared using the Mann-Whitney U-test and receiver operating characteristic curves. Results: CM allergy had significantly higher levels of CM-IgE and casein-IgE, and lower levels of casein-IgG/IgE ratio when compared to atopic controls in both age groups (P<0.05). CM-IgE and casein-IgE were shown to be better predictive markers for immediate-type CM allergy in patients under 12 months, while casein-IgG/IgE ratio was a more useful marker in those aged 12 months or over. Considering 100% positive predictive values, cutoff points were 1.04 kU/L for CM-IgE, 0.11 kU/L for casein-IgE, 19.5 for casein-IgG/IgE ratio in patients aged under 12 months, and 7.1 kU/L for CM-IgE, 1.41 kU/L for casein-IgE, 12.51 for casein-IgG/IgE ratio in those aged 12 months or over. Conclusion: CM-IgE, casein-IgE, and casein-IgG/IgE ratio are useful markers for predicting immediate-type CM allergy. Further stud¬ies are needed on diagnostic decision points for CM allergy using combination of cutoff values of these 3 markers.(Allergy Asthma Respir Dis 2015;3:139-144)
Various Renal Manifestations in Children with Tuberous Sclerosis Complex
임자현,박문성,배기수,김성환,신재일,박세진,Lim, Ja Hyun,Park, Moon Sung,Pai, Ki Soo,Kim, Sung Hwan,Shin, Jae Il,Park, Se Jin Korean Society of Pediatric Nephrology 2014 Childhood kidney diseases Vol.18 No.2
결절성 경화증은 과오종의 발생을 특징으로 하는 유전질환으로, 피부, 뇌, 심장, 눈, 폐, 구강, 신장 등의 다양한 장기들을 침범한다. 신장에서 관찰 가능한 다양한 병변들은 발생 빈도와 사망률이 높기 때문에 주의를 필요로 하며, 신장 증상의 이른 발생 시기를 고려하여 소아 연령에서부터 적절한 진단과 관리가 중요하다. 저자들은 소아 연령에서 발생한 거대 혈관근육지방종, 신세포암, 신경색, 신낭종, 그리고 신결석증 등이 동반된 결절성 경화증 4례를 경험하였기에 보고하는 바이다. Tuberous sclerosis complex (TSC) is a genetic disorder that affects multiple organ systems and causes tumors. It is important that physicians are aware of the manifestations of TSC, and that they follow the recommendations for screening and evaluation. Several types of renal abnormalities may develop in individuals with TSC. Individuals with TSC may require ongoing treatment that can be adapted for each arising manifestation of renal disease. Herein, we report 4 patients with TSC who presented with a range of different renal manifestations, including angiomyolipoma, renal cell carcinoma, renal infarction, renal cyst, and nephrolithiasis.