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Study on the Anti-cancer, Anti-metastasis and Immune response improvement Effects of Aqua-acupuncture with Rubi Fructus infusion solution (항암(抗癌) 및 면역효과(免疫效果)에 복분자약침(覆盆子藥鍼)이 미치는 영향(影響))

  • Lee, Seon-Hee;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.189-219
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    • 2000
  • To study the effects of anti-cancer, anti-metastasis and immune response improvement effects of aqua-acupuncture with Rubi Fructus infusion solution, we used Rubi Fructus infusion solution(taken by water-alcohol method) put into Chung-wan (CV12) and Chok-Samni(ST36) of BALB/c or C57BL/6 which are corresponding to humanbody. We observed the cytotoxicity, the effect on the expression of MMP-9 gene, the ability to control cancer cell proliferation, change of body weight, surviving number, median surviving time, increase of life span, changes in amount of leukocyte, erythrocyte, platelet, total protein, creatinine, glucose and LDH, weight of spleen, number of pulmonary colony, histological analysis on tissue metastasis of lung and liver, splenic cell proliferation, the expression of cytokine gene, the number of $CD4^+$, $CD8^+$, $CD19^+$ and NK cell, and concluded like this. The results were obtained as follows : 1. Effects of Anti-cancer 1) The cytotoxicity about B16-F10 cell line of $2^0$, $2^{-1}$, $2^{-2}$, $2^{-3}$, $2^{-5}$, $2^{-6}$, $2^{-7}$, $2^{-8}$ diluent groups in Rubi Fructus infusion solution treatment was inhibited significantly, compared with control group. 2) The cytotoxicity about HT1080 cell line of $2^0{\sim}2^{-8}$ diluent groups in Rubi Fructus infusion solution treatment was inhibited significantly, compared with control group. 3) The effect on expression of MMP-9 gene was inhibited significantly in all the sample groups, compared with control group. 4) The effect on the control-ability on the cancer cell proliferation showed cytotoxicity significantly in $2^0$, $2^{-1}$, $2^{-2}$, $2^{-3}$, $2^{-4}$, $2^{-5}$, $2^{-6}$, $2^{-7}$, diluent groups. 2. Effects of Anti-metastasis 1) S-180 cancer cell line transplants in BALB/c mice were inhibited significantly in weight increase in all the sample groups, compared with control group. The surviving number increased in almost sample groups, except one group put into Chok-Samni(ST36) with 20% Rubi Fructus infusion solution treatment group that showed same number of the control group. 2) S-180 cancer cell line transplants in BALB/c mice showed high MST significantly in almost sample groups, compared with control group. But one group put into Chok-Samni(ST36) with 20% Rubi Fructus infusion solution showed low MST than control group. 3) The group injected in vein with B16-F10 cancer cell line in C57BL/6 mice showed increased ILS than control group significantly in anti-metastasis test. 3. Effects of Immune response improvement 1) The group injected in vein with B16-F10 cancer cell line in C57BL/6 mice were increased significantly in the number of leukocyte and glucose, and decreased significantly in the amount of platelet and LDH, compared with control group. However, there's no significant increase or decrease in number of erythrocyte, total protein and creatinine. 2) We couldn't find any significant relation in spleen weight of the sample group. 3) In pulmonary colony, sample group was decreased significantly, compared with control group. 4) Histological analysis of sample group inhivited compared with that of control group in both of lung and liver. 5) In immune system, all the sample groups showed having more relevancy to the effect on splenic cell proliferation than normal group. 6) Cytokine gene increased in almost sample groups, except one group treated with $50{\mu}g/m{\ell}$ Rubi Fructus infusion solution on IL-12. 7) In flow cytometry there's no significant relation in number of $CD8^+$ cell, however, the number of $CD4^+$, $CD19^+$ cell and NK cell in sample group had more relation than in control group. Above the results showed that aqua-acupuncture of Rubi Fructus solution has effects of anti-cancer, and-metastasis and immune response improvement.

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The Influence of Food Habits on Body Stature of Children (어린이의 식습관(食習慣)이 체위(體位)에 미치는 영향(影響)에 관한 연구(硏究))

  • Lee, Mi-Suk;Mo, Su-Mi
    • Journal of Nutrition and Health
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    • v.9 no.1
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    • pp.7-15
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    • 1976
  • The Purpose of this study was to determine every possible correlation between food habits and body statures of primary school children, aged ten years old. This study was conducted from July to October of 1975. In July, prepared questionaires concerning life style, anthropometry, food preference, and food behavior were distributed through school teachers to 425 children; 219 boys and 206 girls, in the 5th grade of three elementary schools in the city of Seoul. Then, in October, when subjects had been classified into underweight/obese by statistical analysis, mothers of obese or underweight children were interviewed by the authors to determine weaning history, daily food consumption of their children, and opinions of various snacks for children. Analysis of results in terms of correlation coefficient, chisquare test and percentage calculations, are as follows: 1. Physical growth and development Boys Girls Height (cm) $134.8{\pm}5.74\;134.4{\pm}5.97$ Weight (kg) $30.0{\pm}4.27\;29.5{\pm}5.16$ Chestgirth (cm) $64.1{\pm}3.59\;63.3{\pm}3.81$ Arm circumference (cm) $18.3{\pm}1.61\;18.2{\pm}1.70$ Triceps skinfold thickness (mm) $10.9{\pm}5.13\;12.7{\pm}4.86$ Various indices of nutrition such as relative weight, relative chestgirth, $R{\ddot{o}}hrer's$ index, Kaup index, Vervaeck index were determined. 2. Food habits 1) Food $preference{\cdots}{\cdots}A$ varying number of foods were selected from 60 items were accepted. It was found that the food which children liked best was fruit and snacks were popular one. Lowest ranking among LIKED foods were from strongly flavored vegetables and organ meat. In general, girls had more food dislikes than did boys. Selected as liked foods were fruits, rice noodle soup, biscuits, and peanuts. Disliked foods were liver, green onions, onions, green pepper, mushrooms, oysters, shellfish, and pork. Items which children never ate before were liver, mushrooms, fish cake, boiled rice mixed with sorghum, mayonnaise, and fresh water firsh. Reasons which children gave for dislike were undesirable flavor and odor. 2) Food $behavior{\cdots}{\cdots}It$ was found that boys liked sweet and salty flavors more than did the girls who more often liked sour flavor. The majority of children enjoyed evening meals more than lunch and breakfast. A number of children skipped breakfast because of lack of appetite or lack of time before going to school. Snacks were the most popular food, especially among girls. Their snacking habits were formed by the encouragement of the mother, and the relieve boredom. Educational backgrounds of mothers and family economical levels of children were remarkable correlated with mothers' attitudes toward feeding of children. There were several interesting findings relating body stature to some other responses; such as that the obese child has a small number of brothers, higher birth order, higher educated mothers and higher family cultural background. It was also discovered that food perference, except for fat and oil group foods was not related to body stature. Sweet taste was liked best and pepperly taste was mostly disliked. Sour taste was popular in the group of underweight. Underweight children were more finicky, disliked snacking, and didn't get much attention from their mothers. 3) Correlation between body stature and nutrition during their infancy. The majority of children, both from obese and underweight, were breast fed as infant. Twenty five per cent of obese children and 17.4 per cent of underwight children started weaning at $1{\sim}6$ months old. The most popular supplemental food of weaning was cereal gruel for the obese group, while boiled white rice and cereal gruel were most common for the underweight group. Highly significant relationships were found between stature of parents and their children. In the obese group 47.8 per cent of fathers and 45.9 per cent of mothers were overweight; however, none of the fathers and only one mother was found to be underweight. In daily food consumption patterns, meals consisting of bread or noodle were popular in the obese group but disliked by the underweight group. The study found clear contrast in that the obese group liked meat and fish while the underweight group liked fruits and vegetables, especially kimchee. The obese children desired to eat cereal foods, milk and milk products, and fat foods while the underweight group desired to eat fruits and vegetables. Frequency of snacks per day was much greater in the obese group. Foods which mothers believed to be good for the health were carrots, cucumbers, fruits, milk, potatoes, sweet potatoes, and breads, while sweet foods such as candies, drinks. chocolate were considered not good for the teeth. Watching television was not significantly related to statures of children. Most significant relationships were found beween frequencies of family guest meals/and eating-out, and children's statures. Nutritional problems which have been considered for the malnourished children in addition to those of children who have a tendency toward obesity, must be taken into consideration in the development of proper nutrition education through the channels of regular school teaching and teaching by parents in the homes. Korean standards of anthropometric measurements for children should be revised, current measurements show much higher figures than present Korean standards.

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Prevention of thromboembolism with ticlopidine and aspirin after cardiac valve replacement (심장변막치환후 Ticlopidine과 Aspirin의 혈전방지 효과)

  • Kim, Gwang-Taek;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.35-42
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    • 1986
  • Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

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Nutritional Status and Health Risks of Low Income Elderly Women in Gwangju Area (광주지역 저소득층 여자노인의 영양상태와 건강위험요인에 관한 연구)

  • Yang, Eun-Ju;Bang, Hee-Myung
    • Journal of Nutrition and Health
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    • v.41 no.1
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    • pp.65-76
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    • 2008
  • This study was performed to identify association between nutritional status and health risks of the elderly. This was a cross-sectional study involving low income elderly women in Gwangju, Korea (${\geq}$65y, n = 92). Socio-demographics, life style characteristics, health conditions, dietary intakes based on 24h-recall method, anthropometric measures, and clinical biochemistry parameters were examined. Anthropometric and clinical parameters included wt, ht, waist, hip, body protein, body fat, abdominal fat, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, hemoglobin, hematocrit, fasting blood glucose, ferritin, IL-2, IL-6, TNF-${\alpha}$, CRP, TAS, TBARS, systolic blood pressure, and diastolic blood pressure. The subjects were divided into three groups based on age (65-74y, 75-84y, 85y${\leq}$) and were divided into two groups according to the sum of the Nutrition Screening Initiative (NSI) checklist score (adequate nutritional status, NSI score ${\leq}$3; at risk of malnutrition, NSI score >3). Mean and frequency of variables were estimated. Analysis of Variance, Tukey test, Chi-square test, and Multiple linear regression analyses were performed. Mean BMI and body fat were 25.1 $kg/m^2$ and 40.0%, respectively. However, for over 80% of subjects, the intakes of energy, fiber, thiamin, riboflavin, niacin, folate, Ca, K, and Zn were less than the Korean DRI (EAR or AI). The subjects who had lower NSI score tended to have better health status, eat meals frequently, have less depression, and exercise regularly. The subjects who had higher NSI score tended to have tooth problems, to eat alone most of time, and to be physically unable to cook or feed. Serum IL-6 and TNF-${\alpha}$ were significantly related with nutritional status which suggested higher tendency of inflammatory response. Serum IL-2, TAS, and glucose were significantly correlated with body fat (%) or abdominal fat (%). These results suggest that improving the nutritional status, increasing regular exercise, maintaining normal weight are beneficial to health care of low income elderly women.

Evaluation of Fertilization Effect of Slow-Release Complex Fertilizer on Pepper Cultivation (원예용 완효성 복합비료의 고추에 대한 시비효과 평가)

  • Lee, Chang-Hoon;Lee, Hyub;Ha, Byung-Hyun;Kang, Chang-Sun;Lee, Yong-Bok;Kim, Pil-Joo
    • Korean Journal of Environmental Agriculture
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    • v.26 no.3
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    • pp.228-232
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    • 2007
  • Slow-release fertilizers (SRF) have been used to reduce nutrient loss through increasing fertilizer efficiency and to save labor. Several SRFs were developed for rice plant in Korea, but there is few for horticultural crop plants. Two slow-release complex fertilizers, 100T and 150T, which made for controlling nitrogen release time up to 100 and 150 days, respectively, were selected for the incubation test cto evaluate nitrogen (N) release rate in soil. The N of urea selected as the control was completely released within a week after application. Sixty three and 53% of total N were released from 110T and 150T of slow release fertilizers within 8th weeks after application, respectively. For pepper cultivation CF110 and CF150, new slow-release complex fertilizer, were made of mixing 40% of conventional fertilizer and 60% of 110T and 150T, respectively, based on the amount of recommended fertilizer for pepper cultivation $(N-P_2O_5-K_2O=190-112-149\;kg\;ha^{-1})$, and were totally applied before pepper transplanting in the field as the basal fertilizer. Inorganic N $(NH_4^+-N+NO_3^--N)$ concentration in soil was higher in the CF110 treatment than in the control (NPK) at all period of pepper cultivation. In the CF150 treatment concentration of inorganic N in soil was low compared to control up to 8th weeks after transplanting. However, there was no difference in plant height and nutrient content of pepper leave between CF110 treatment and the control. In comparison, plant height was significantly lower in CF150 than the control and CF110 treatments. Around 4% of fresh pepper yield was increased in CF110 compared to the control, but it was decreased to about 2% by CF150 treatment. Conclusively, CF110 form could be recommended as a slow release fertilizer for pepper cultivation.

THE CLINICO-STATISTICAL ANALYSIS OF THE TREATMENT OF THE AMELOBLASTOMA (법랑아세포종의 치료에 관한 임상통계학적 분석)

  • OH, Myoung Chul;Kim, Chin Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.253-268
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    • 1993
  • The author studied on the 109 cases of ameloblastoma which had been diagnosed with biopsy during the period of 1962 to 1992 at the Kyungpook National University Hospital, Kyemyung University Hospital, Youngnam University Hospital, Catholic Medical School Hospital, Pusan National University and Maryknoll Hospital. This study contains the statistical analysis of the treatment method according to the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, size and recurrence. The results were as follows : 1. The incidence rate was 59.7% in male and 40.3% in female. 2. At the time of diagnosis, the age of the patients ranged from 9 to 69 years(average 31.4years). The cases of 72.4% were in the 2nd, 3rd, and 4th decades of life. 3. The majority of cases occurred in the mandible 88.9%, especially in the mandiblar angle area 57.8%. 4. The most prevalent chief complaints was swelling 58.7%. 5. As regards duration, the cases less than 1 year appeared 49.5% and average duration is 31.34months. 6. Unilocular type showed 43.1% and multilocular type appeared 56.9%. 7. Conservative treatment was performed 39.4% and radical treatment was employed 60.6%. 8. There were variations of lesional sizes between 2.0cm and 15cm(average 6.26cm). 9. The recurrence rate is 29.4%. 10. The frequency of treatment was not in association with sexes, locations, chief complaints and sizes. 11. Radical treatment was performed more frequently in cases of older age group(above 20 years old), multilocular cases, above average duration(31.34 months) group and recurrent cases (P<0.05).

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Soil Salinity and Vegetation Distribution at Four Tidal Reclamation Project Areas (4개 간척 지구에 분포하는 식생과 토양 염류농도)

  • Lee, Seung-Heon;Ji, Kwang-Jae;An, Yeoul;Ro, Hee-Myong
    • Korean Journal of Environmental Agriculture
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    • v.22 no.2
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    • pp.79-86
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    • 2003
  • This research was conducted to present reference data to be used as newly reclaimed tidal land management. We investigated vegetation succession at 4 reclaimed/reclaiming project areas and discussed relationship with soil and vegetation trhrough investigation and analysis soil chemical characteristics at 2 areas. 14 families 58 kinds were investigated. Vegetation were variou at Dea-Ho conservation polt and Seok-Mun National Industrial Area which are maintaining naturally. Vegetation were simple at Hong-Bo and Dongjin and MinKyong river areas which effected sea water. Common species that were investigated at 9 sites were Suaeda asparagoides, Aster tripolium, Phragmites australis, Suaeda maritima, Suaeda japonica, Carex scabrifolis. As soil desalinization progressing, soil classified at first saline-soidc soil, the nest saline soil and then normal soil. Chenopodiaceae revealed at about 30 dS/m of soil ECe and existed to 10 dS/m of soil ECe. At about 20 dS/m of soil ECe. Aster tripolium, Calamagrostis epigeios, and Sonchus brachyotus revealed and then non-halophytes and common plants at inland revealed at low soil ECe of about 10 dS/m. However it was not to progress vegetation sucdession and soil desalinization at the same time, owing to input of seeds or plants ect from out-ecosystem. So for promotion of vegetation at newly reclaimed tidal land, we proposed that it was very effective to plant artificially halophytes or suitable species through soil test.

반하후박탕(半夏厚朴湯)이 항암(抗癌) 및 면역조절작용(免疫調節作用)에 미치는 영향(影響)

  • Gang, Jae-Man;Gang, Jae-Chun;Ha, Ji-Yong
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.2 no.1
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    • pp.57-73
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    • 1996
  • These studies were consist of two sub-experiment. In order to study the effect of Banhahubaktang on the Cell-cytotoxicity In vitro. We had put through MTT Assay. In order to investigate the effects of Banhahubaktang on the ICR mice which had Abdominal tumor induced by Sarcoma-180 cell line, C57BL/6 mice which had pulmonary melanoma induced by B16 cell line. After Sarcoma-180 cell line and B16 cell line were transplanted, the extract of Banhahubaktang was orally administered to the mice to observe the extension of survival time of the mice, inhibition of solid tumor, inhibition of pulmonary melanoma metastasis. productivity of Interleukin-2, NK-Activity. The results were summarized as follows: 1. On the MTT assay, in case of $100{\mu}g/ml$ and $10{\mu}g/ml$ of Banhahubaktang concentration were inhibited cell viability significantly. But $1{\mu}g/ml$ of Banhahubaktang was tended to inhibit cell viability with no significance. 2. In the effect of life extension, Banhahubaktang treated group appeared to survive longer than the control group, but which were not significant. 3. In the effect of inhibit solid tumor, Banhahubaktang treated group appeared to decrease than the control group, but which were not significant. 4. In the effect of inhibit melanoma pulmonary metastasis. Banhahubaktang treated group appeared to inhibit than the control group significantly. 5. In the productivity of Interleukin-2, on 7 and 14 day, Banhahubaktang treated group increased than control group, which were significant. But on 21 day, test group and control group were much in common. 6. In the NK-Activity, Banhahubaktang treated group and control group were much in common.

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Feasibility Test on Automatic Control of Soil Water Potential Using a Portable Irrigation Controller with an Electrical Resistance-based Watermark Sensor (전기저항식 워터마크센서기반 소형 관수장치의 토양 수분퍼텐셜 자동제어 효용성 평가)

  • Kim, Hak-Jin;Roh, Mi-Young;Lee, Dong-Hoon;Jeon, Sang-Ho;Hur, Seung-Oh;Choi, Jin-Yong;Chung, Sun-Ok;Rhee, Joong-Yong
    • Journal of Bio-Environment Control
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    • v.20 no.2
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    • pp.93-100
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    • 2011
  • Maintenance of adequate soil water potential during the period of crop growth is necessary to support optimum plant growth and yields. A better understanding of soil water movement within and below the rooting zone can facilitate optimal irrigation scheduling aimed at minimizing the adverse effects of water stress on crop growth and development and the leaching of water below the root zone which can have adverse environmental effects. The objective of this study was to evaluate the feasibility of using a portable irrigation controller with an Watermark sensor for the cultivation of drip-irrigated vegetable crops in a greenhouse. The control capability of the irrigation controller for a soil water potential of -20 kPa was evaluated under summer conditions by cultivating 45-day-old tomato plants grown in three differently textured soils (sandy loam, loam, and loamy sands). Water contents through each soil profile were continuously monitored using three Sentek probes, each consisting of three capacitance sensors at 10, 20, and 30 cm depths. Even though a repeatable cycling of soil water potential occurred for the potential treatment, the lower limit of the Watermark (about 0 kPa) obtained in this study presented a limitation of using the Watermark sensor for optimal irrigation of tomato plants where -20 kPa was used as a point for triggering irrigations. This problem might be related to the slow response time and inadequate soil-sensor interface of the Watermark sensor as compared to a porous and ceramic cup-based tensiometer with a sensitive pressure transducer. In addition, the irrigation time of 50 to 60 min at each of the irrigation operation gave a rapid drop of the potential to zero, resulting in over irrigation of tomatoes. There were differences in water content among the three different soil types under the variable rate irrigation, showing a range of water contents of 16 to 24%, 17 to 28%, and 24 to 32% for loamy sand, sandy loam, and loam soils, respectively. The greatest rate increase in water content was observed in the top of 10 cm depth of sandy loam soil within almost 60 min from the start of irrigation.

The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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