The incidence of allergic disease in pediatric outpatient department of a hospital, where primary care is undertaking, was studied from Apr. 1, 1989 to Mar. 32, 1990. The results were as follows, 1) The incidence of respiratory tract disease was the highest with the value of 57.2% of the total patients, followed by gastrointestinal tract disease(13.9%), infectious disease (6.7%), visit for preventive medicine (6.7%), allergic disease (3.0%), neurologic disease (2.9%), cardiovascular disease (2.8%) etc. 2) The allergic patients were 3.0% of total patient and sex ratio was M:F=1.4:1. 3) The allergic patients were most prevalent in1~3 years of age group (46.6%)followed by under 1 year old group (22.4%), and 4~6 years of group (21.3%). 4) The allergic disease was most prevalent in fall (42.8%), followed by spring (20.4%), and winter(19.0%). 5) Among the allergic disease, asthma was most frequent (67.4%), followed by allergic rhinitis(11.8%), atopic dermatitis (10.6%), urticaria (9.3%). 6) Bronchial asthma was most prevalent among 1~3 years of age group (51.9%) and in fall (50.0%) 7) Allergic rhinitis was most frequent among 1~3 years of age group (40.9%) and in fall (34.8%). 8) Atopic dermatitis was most frequent among under 1 year of age group(64.4%)and in spring and winter(28.8%). 9) Urticaria was most frequent among 1~3 years of age group (36.5%) and in summer (32.7%). 10) The percentage of each allergic disease to the total outpatient was as follows; asthma (2.0%), allergic rhinitis(0.40%), atopic dermatitis(0.3%), urticaria (0.3%). 11) Sex ratio of each allergic disease was as follows; asthma (1.5:1), allergic rhinitis(1.6:1), atopic dermatitis (1.1:1), urticaria (1.4:1). With these findings, we ovserved that allergic disease is the fifth most common disease group among the pediatric out patients, covering 3.0% of total patients. Recently, we have had the idea that the prevalence of allergic disease is increasing remarkably. The findings of this study can be used as one of basic data for the study of prvalence and increase of allergic disease with further similar trials afterward.
Asthma ; Cardiovascular Diseases ; Communicable Diseases ; Dermatitis, Atopic ; Gastrointestinal Tract ; Humans ; Incidence* ; Mortuary Practice ; Outpatients* ; Prevalence ; Preventive Medicine ; Primary Health Care ; Respiratory Tract Diseases ; Rhinitis ; Sex Ratio ; Urticaria

BACKGROUND: To assess the clinical utility of new DNA extraction method, the authors attempted PCR using mycobacterial DNA extracted by Chelex 100 ion exchange resin method for 63 clinical samples in patients with pulmonary tuberculosis and compared with proteinase K method, simultaneously. METHODS: We used Chelex 100 ion exchange resin for preparation of DNA. Decontaminated sputums were mixed with resin and incubated at 56degrees C and 100degrees C without opening tube. After centrifugation, supernatants were used directly as template for PCR. 245 bps in primary PCR and 188 bps in nested PCR were amplified and analysed by agarose gel electrophoresis EtBr staining. RESULTS: Chelex 100 ion exchange resin method is more simple, rapid and reliable than proteinase K method, and during sample preparation, carry-over contamination loss of amplificated DNA, influence of organic solvents and cross-contamination are diminished. The results of PCR products are interpreted more distinctively in Chelex 100 ion exchange resin method than proteinase K method. CONCLUSIONS: In the basis of the results, it could be suggested that extraction of mycobacterial DNA by Chelex 100 ion exchange resin is more simple, rapid reliable method than that of conventional method for detection of mycobacterial DNA in patients with tuberculosis by polymerase chain reaction.
Centrifugation ; Diagnosis* ; DNA* ; Electrophoresis, Agar Gel ; Endopeptidase K ; Humans ; Ion Exchange ; Polymerase Chain Reaction* ; Solvents ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

Pulmonary function test is one of the most important tools in the management of patients with respiratory tract diseases and allergic diseases. As with the difficulties in performing the test, it has been seldom used in pediatric field. But with the advent of simple, computerized tools, pediatric pulmonologist and allergist try to manage the patients using PFT. Still the normal predicted values are variable among the reports. So it is important to have normal predicted value in Korean children. From April to July 1992, pulmonary function test was performed in 965(male: 490, female: 475) primary school-aged children except <3 or >97 percentile of Korean-children Physical developemental standards with history of allergic diseases and respiratory tract diseases ay SungNam, KyongKiDo. We evaluated the predicted normal values of the FEV1.0, FVC and PEFR and logarithmic regression equation setting the predicted values by using the microspirometer of Micromedical Ltd. England that could that could be easily applied to children. 1) Predicted values of pulmonary function test items were generally higher in boys than those of girls. 2) Correlation coefficient to the parameters examined was the highest in height 0.78, then age 0.75, weight 0.70 and chest circumference 0.61.
Child* ; England ; Female ; Gyeonggi-do ; Humans ; Peak Expiratory Flow Rate ; Reference Values ; Respiratory Function Tests* ; Respiratory Tract Diseases ; Thorax

As the use of muscle relaxants routinize in the clinical general anesthesia, the proper estimation of neuromuscular blockade and recovery is needed for the more safe anesthetic management. Three recording methods of measurement in recovery are available; measurement of the evoked mechanical responses (mechanography), measurement of the evoked electrical responses (electromyography), and measurement of the acceleration of the muscle responses, The purpose of this study was to evaluate the correlations among mechanomyographic, electromyographic and accelerographic responses during recovery from vecuronium induced neuromuscular blockade. 15 ASA class 1 adult patients were studied. Measurements were as follows: 1) Recovery time of T(1)/Tc, of 25%, 50%, 75%, 90% and 100% in each device. 2) Recovery index in each device 3) The values of T(1)>Tc, in EMG and ACC corresponding ta that of MMG. 4) The values of TOF ratio in EMG and ACC corresponding to that of MMG. The results were as follows: 1) Recovery time of T(1).
Acceleration ; Adult ; Anesthesia, General ; Electromyography ; Humans ; Neuromuscular Blockade* ; Vecuronium Bromide*

Idiopathic myelofibrosis (IMF), which is characterized by marrow fibrosis, leukoerythroblastic anemia, teardrop poikilocytosis and splenomegaly due to extrumedullary hematopoiesis, has known to have no form of therapy. On the ground of the possibility of reversing collagen deposion in IMF using 1, 25dihydroxycholecalciferol [1, 25(OH)2D3], we report here our observations of 5 patients (M:F=1:4) with IMF before and after treatment with 0.5 microgram/day of alfacalcidol, precursor of 1, 25(OH)2D3. In 3 fo 5 patients the hemoglobin rose and in 4 of 5 the platelet count increased. Follow-up marrow examination revealed that marrow trephine reticulin fibrosis decreased according as the amelioration of clinical and laboratory findings. But these did not persist except one patient in spite of the sustained use of alfacalcidol. Our results suggest that alfacalcidol may have a therapeutic role in some patients with IMF. More extensive studies will be clarify the action of alfacalcidol in IMF.
Anemia, Myelophthisic ; Bone Marrow ; Child* ; Collagen ; Fibrosis ; Follow-Up Studies ; Hematopoiesis ; Humans ; Platelet Count ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

Background: To analyze the trends in laboratory and imaging test use 1 week before death among decedents who died in Korean hospitals, tests used per decedents from 2006 to 2015 were examined by using the National Health Insurance Service-Elderly Sample Cohort (NHISESC) dataset. Methods: The study population consisted of decedents aged ≥ 60 years old with a history of admission and death at a hospital, and tests recorded in the payment claims for laboratory and imaging tests according to the Healthcare Common Procedure Coding System codes were examined. Twenty-eight laboratory and 6 imaging tests were selected. For each year, crude rates of test use per decedents in each age and sex stratum were calculated. Regression analysis was used to examine the temporal changes in the test use. Results: During the follow-up period, 6,638 subjects included in the sample cohort died.The number of total laboratory and imaging tests performed on the deceased increased steadily throughout the study year from 10.3 tests/deceased in 2006 to 16.6 tests/deceased in 2015. The use of tests increased significantly in general hospitals, however, not in nursing hospitals. Laboratory tests showed yearly increase, from 9.46/deceased in 2006 to 15.57/ deceased in 2015, an annual increase of 7.39%. On the other hand, the use of imaging increased from 0.86/deceased in 2006 to 1.01/deceased in 2015, which was not statistically significant. Conclusion The use of tests, especially laboratory tests, increased steadily over the years even among those elderly patients at imminent death. Reducing acute healthcare at the end of life would be one target not only to support the sustainability of the health care budget but also to improve the quality of dying and death.

PURPOSE: The prevalence of allergic diseases, including bronchial asthma, increases markedly to make those disease as one of the most important and common disease in pediatric field. As the basic data for managing patients with allergic diseases, we tried to get prevalence of allergic disease and comparison the normal children with the ones related with allergic diseases in primary school-aged children. RESULTS: 1) 1637(57.4%) children among total 2850 children had the history of allergic disease. 2) The most frequent allergic disease was atopic dermatitis(38.9%) followed by urticaria (26.4%), bronchial asthma(10.3%), and allergic rhinitis(8.8%). 3) Among family members of children with allergic disease, mother had allergic disease most frequently(31.1%) followed by father(25.1%), siblings(24.4%), and grandparents(13.9%). 4) 1528(53.6%) children had the symptoms suggesting bronchial asthma. Among them frequent upper respiratory infection was the most frequent complaints(75.6%), followed by history of some weak bronchi(45.4%), having sinusitis(24.2%), and reluctant to do sports(11.7%). 5) 76% of children had the smoker in the house. Father was the most frequent smoker(94.1%), followed by grandparents(13.9%), and mother was only 1.6%. 6) The total number of cigarettes smoked in the house was less than 20 in 89%. 7) The crowdedness of the house, got by the number of family members divided by the number of rooms, was less than 3 in 85.9% of the children. It was more than 5 in 28 children's house. 8) Non of the items of pulmonary function test was consistent in any asthma related conditions when we compare with normal children. Only crowdedness shows statistically significant difference in FVC, FEV(1), and PEFR.
Asthma* ; Child* ; Fathers ; Humans ; Mothers ; Peak Expiratory Flow Rate ; Prevalence* ; Respiratory Function Tests* ; Smoke ; Tobacco Products ; Urticaria

The severe bradycardia and asystole are uncommon complications of epidural anesthesia but can be life threatening if not managed properly. A 73-year-old, ASA class 3, male patient was admitted for a total knee replacement under epidural anesthesia. Approximately 10 minutes after epidural anesthesia, the heart rate decreased significantly to 20 beats/min with asystole. The heart rate returned to 80 beats/min after administering atropine, ephedrine, and external cardiac compression. Severe bradycardia and asystole may be induced by vagal activation as a result of the low venous return and sympathetic blockade.
Aged ; Anesthesia, Epidural ; Arthroplasty, Replacement, Knee ; Atropine ; Bradycardia ; Ephedrine ; Heart Arrest ; Heart Rate ; Humans ; Male

Idiopathic pulmonary hemosiderosis (IPH), a rare disease of unknown etiology, is characterized by iron deficiency anemia and chronic recurrent pulmonary symptoms such as cough, hemoptysis, and dyspnea. Recurrent intra-alveolar hemorrhage resulting in hemosiderin accumulation and progressive fibrosis often leads to death. We experienced a case of IPH in a two-year-old male who was presented with cough, dyspnea, hemoptysis and anemia. The diagnosis was confirmed by hemosiderin-laden macrophages in a gastric aspirate. He was initially treated with oral iron and prednisolone for one year. But pulmonary symptoms such as cough and hemoptysis recurred five times while he was on oral prednisolone and the side effects of moon face and truncal obesity developed. So inhaled steroid (budesonide) was administered for 18 months, with improvement of pulmonary symptoms. This suggests that early treatment with inhaled steroids may work in IPH without the serious side effects of systemic steroid. The effect of inhaled steroid should be evaluated as the initial treatment of IPH.
Anemia ; Anemia, Iron-Deficiency ; Child ; Cough ; Diagnosis ; Dyspnea ; Fibrosis ; Hemoptysis ; Hemorrhage ; Hemosiderin ; Hemosiderosis* ; Humans ; Inhalation* ; Iron ; Macrophages ; Male ; Obesity ; Prednisolone ; Rare Diseases ; Steroids