Background and OBJECTIVE: There has been a few case reports of anaphylaxis due to honeybee in Korea. In order to observe the clinical feature of bee sting anaphylaxis. Moderials and methods: Six patients living in Kyunggi province area were referred under history of anaphylaxis after the bee sting. Atopy was defined by skin prick test result to common inhalant allergen. Serum specific IgE antibody to each bee antigen was detected by radioimmunoassay to identify the causative bee. RESULTS: All six cases were female. Three had atopy and four had combined allergic diseases such as allergic rhinitis, asthma, and urticaria. The etiologic bees consisted of yellow jacket (6 cases), paper wasp (4 cases), yellow hornet (3 cases), white faced hornet (1 case) and honey bee (1 case). Four cases had experienced anaphylaxis after ant bite and they showed positive result on specific IgE to imported fire ant. Specific immunotherapy against causative bee venom was begun using bee venom extracts from Bayer (USA) based upon results of specific IgE anti-body to bee venom. CONCLUSION: The yellow jacket is the most common cause of bee venom anaphylaxis in this area. Further studies will be needed to evaluate possible cross-reactivity between bee and ant venom.
Anaphylaxis* ; Ant Venoms ; Ants ; Asthma ; Bee Venoms* ; Bees* ; Bites and Stings ; Female ; Fires ; Gyeonggi-do ; Honey ; Humans ; Immunoglobulin E ; Immunotherapy ; Korea ; Radioimmunoassay ; Rhinitis ; Skin ; Urticaria ; Wasps

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. The authors experienced a case of sarcoidosis in 22-year-old female who had palpable mass on left eyelid. Ocular examination revealed enlargement of lacrimal gland, anterior uveitis, iris nodule and abnormal fundus findings such as hyperemic disc with blurred margin, perivasculitis, vitreous himorrhage, and choroidal nodule. Systemic investigation yielded bilateral hilar lymphadenopathy and pulmonary infiltration, enlargement of multiple supraclavicular lymphnodes. Histologic findings of lacrimal gland revealed non-caseating epitheloid granuloma. In the course of corticosteroid therpy, above signs are subsided gradually, but exacerbated when she discontinued steroid because of the development of acne on the face. And so, we confirmed the sarcoidosis.
Acne Vulgaris ; Choroid ; Eyelids ; Female ; Granuloma ; Humans ; Iris ; Lacrimal Apparatus ; Lymphatic Diseases ; Sarcoidosis ; Uveitis, Anterior ; Young Adult

BACKGROUND: There have been few reports suggesting involvement of mast cell and neutrophil to induce bronchoconstriction in aspirin-sensitive asthrna. OBJECTIVE: To evaluate mast cell and neutrophil activation in pathogenesis of aspirin-sensitive asthma. MATERIAL AND METHOD: We observed changes of serum NCA and MPO levels during L-ASA bronchoprovocation test in 14 subjects with aspirin-sensitive asthma. RESULTS: Serum NCA was significantly increased at 30 min(p=0.01) after the inhalation of L-ASA and then, no significant changes were noted at 240 min (p=0.14). NCA was significantly higher in subjects with late asthmatic responses than in those without it (p=0.04). Serum MPO level tended to increase at 30 min with no statistical significance (p=0.08), and then it significantly decreased at 240 min (p=0.05). There was no significant correlation between serum NCA and MPO level (r=0.22, p=0.58). CONCLUSION: These results support the view that NCA derived from mast cell may contribute to neutrophil recruitment into the airway in aspirin-sensitive asthmatic patients.
Asthma ; Bronchoconstriction ; Humans ; Inhalation ; Mast Cells ; Neutrophil Activation ; Neutrophil Infiltration ; Neutrophils*

No abstract available.
Humans

The cardiovascular and CNS effects of MIDAZOLAM 0.25 mg/kg were studied in 40 patients, randomised and emergency operations(20 males and 20 females). The effects of the administration of MIDAZOLAM intravenously on the cardiovascular and central nervous system were determined. The results were as follows: 1) It had short duration of action and absence of vascular irritation compared with MIDAZOLAM. 2) Three minutes after injection, mean systolic pressure decreased from 132+/-16 mmHg to 115+/-18 mmHg and diastolic pressure from 87+/-11mmHg to 77+/-13 mmHg. One minute after injection heart rate increased from 89+/-19 beat/min to 95+/-20 beat/min and after three minutes returned to prior level. 3) Our study shows that the intraveous administration of MIDAZOLAM 0.25mg/kg produces. a statistically significant, but clinically unimportant, decrease in blood pressure and an increase in heart rate. 4) The effects of MIDAZOLAM on the central nervous system were determined from the time of onset of injection. Spontaneous eye closure, loss of eyelash reflex and apnes were observed at 113+/-66 sec, 133+/-65 sec, and 147+/-58 sec, after injection of MIDAZOLAM. 5) MIDAZOLAM as an induction agent for anesthesia is not indicated for in out-patient surgery due to the extended duration of drowsiness losting over 3 hours in the recovery room. 6) MIDAZOLAM was sufficient as an induction agent for general anesthesia.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Central Nervous System ; Emergencies ; Heart Rate ; Humans ; Male ; Midazolam ; Outpatients ; Recovery Room ; Reflex ; Sleep Stages

BACKGROUND: During a 1-month period in 2005 , a series of 4 Leclercia adecarboxylata and 8 Pseudomonas aeruginosa bacteremias were reported from patients admitted to the emergency room. METHODS: An outbreak of L. adecarboxylata and P. aeruginosa bacteremia that occurred from February to March 2005 was investigated. The infection control nurse reviewed medical records and observed the procedures of blood cultures at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from alcohol sponge, tray, sink, water of sink, saline cotton, microscope, computer, and telephone. RESULTS: L. adecarboxylata was isolated from 4 patients and P. aeruginosa from 8 patients during a 1-month period. Observation of the culture procedure revealed that saline cotton was used to prevent betadin skin discoloration. The culture of the saline solution yielded a heavy growth of P. aeruginosa, which was not isolated from any other specimens. CONCLUSIONS: This was a pseudoepidemic caused by contaminated saline cotton. The use of the saline cotton was stopped, and during the follow-up period of 3 months, no additional L. adecarboxylata or P. aeruginosa bacteremia were reported.
Bacteremia ; Emergency Service, Hospital ; Enterobacteriaceae* ; Follow-Up Studies ; Humans ; Infection Control ; Medical Records ; Porifera ; Pseudomonas aeruginosa ; Skin ; Sodium Chloride ; Telephone ; Water

Objective and METHOD: In order to identify the aggravating agents for intrinsic asthma, we performed ASA- and food additive-challenge tests on 182 subjects diagnosed as having intrinsic asthma. The following tests were performed: Lysine-aspirin bronchoprovocation test to confirm aspirin-sensitivity, sodium bi-sulfite (40-200mg) oral provocation test for sulfite sensitivity, tartrazine oral provocation test (50mg) for tartrazine sensitivity, and sodium benzoate (400mg) oral provocation test for sodium benzoate sensitivity. Positive reaction was defined as decrease in FEV, by more than 20% from the baseline value after the provocation. RESULT: Seventy-five (41.2%) of 182 subjects showed positive responses to more than one agent among the aspirin and three food additives challenged. The prevalence of aspirin-sensitivity was the highest (22.5%), followed by sulfite-sensitivity (8.8%), and then concurrent sensitivity to both aspirin and sulfite (6.0% ), to both aspirin and tartrazine (1.6% ), to aspirin, sulfite and tartrazine (1.1%) and to aspirin, sulfite and sodium benzoate (0.5%). Rhino-sinusitis was noted in 62.5% of aspirin-sensitive asthmatic subjects, 60% of sulfite-sensitive ones, and 80% of tartrazine-sensitive ones. Urticaria was noted in 21.4% of aspirin-sensitive asthmatic subjects, 16.6% of sulfite-sensitive ones and 6.3% of tartrazine-sensitive ones. Thirty-seven to 83% of positive responders had no adverse reaction history. CONCLUSION: These findings suggest that ASA and food additive challenge tests should be considered as a screening test to evaluate any aggravating factors in subjects with intrinsic asthma, even though they may not have experienced any adverse reactions.
Aspirin* ; Asthma* ; Food Additives* ; Mass Screening ; Prevalence ; Sodium ; Sodium Benzoate ; Tartrazine ; Urticaria

BACKGROUND AND OBJECTIVE: IgG subclass deficiency has been reported in patients with bronchial asthma and is associated with recurrent respiratory tract infections. This study was done to identify prevalence of IgG subclass deficiency and to evaluate the possible difference between atopic and non-atopic asthmatics. Subjects and METHODS: We measured serum levels of IgG and IgG subclass in 35 asthmatic patients and 50 healthy controls using nephelometry. Reference values of each IgG subclass was defined as cumulative percentile between 2.5% to 97.5% of controls. RESULTS: Total IgG, IgG1 and IgG2 of asthmatics were significantly lower than for those of controls(p<0.05, respectively). In atopic asthmatics, compared with non-atopic asthmatics, IgG4 level was significantly higher (p<0.05). The frequency of IgG subclass levels below the reference value was eight (22.9%) of 35 asthmatics. CONCLUSION: IgG, IgG1 and IgG2 were significantly lower in asthmatic patients. Some patients had IgG subclass levels below reference value. Further studies will be needed to evaluate their clinical significance.
Asthma* ; Humans ; Immunoglobulin G* ; Nephelometry and Turbidimetry ; Prevalence ; Reference Values ; Respiratory Tract Infections

Angioedema is a well-demarcated localized edema involving the deeper layers of the skin, including the subcutaneous tissue. Angioedema occurs with Cl esterase inhibitor (Cl INH) deficiency that may be inborn as an autosomal dominant characteristic or may be acquired. Acquired angioedema (AAE) is a rare disorder characterized by adult onset and lack of evidence of inheritance of the disease. Two types of AAE are known today: type I in which there are lowering of functional Cl INH, an underlying disease such as a B-cell disease, and no detectable autoantibodies to Cl INH, type II with anti Cl INH autoantibodies in the circulation without detectable underlying disease and with depressed functional Cl INH levels. We experienced a case of angioedema in a 29-year old man. He had no family history of angioedema and laboratory data showed depressed Cl-INH levels. We diagnosed the case as acquired type of angioedema. Even though we could not measure anti-Cl INH auto-antibodies, we identified the case as type II because there was no evidence of underlying disease.
Adult ; Angioedema* ; Angioedemas, Hereditary* ; Autoantibodies ; B-Lymphocytes ; Complement C1 Inhibitor Protein* ; Complement C1s* ; Edema ; Humans ; Skin ; Subcutaneous Tissue ; Wills

BACKGROUND AND OBJECTIVES: Immunoglobulin G (IgG) subclass deficiency has been reported in patients with bronchial asthma and is associated with recurrent respiratory tract infections. Aspirin-sensitive asthma (ASA) which affects 10% of adult asthmatics, asthma runs a chronic course with frequent asthma exacerbations, often related to respiratory infections. We performed this study to identify the prevalence of IgG subclass deficiency and evaluate the association between recurrent asthma exacerbations and IgG subclass deficiency in ASA. SUBJECTS AND METHODS: We measured serum levels of IgG and IgG subclass in 26 aspirin- sensitive asthmatic patients (15 steroid used and 11 steroid not used) and 55 healthy controls using nephelometry. Reference values of each IgG subclass was defined as cumulative percentile between 2.5% to 97.5% of controls. RESULTS: Total IgG, IgG1, IgG2 and IgG3 of aspirin-sensitvie asthmatics, were significantly lower than for those of controls (p<0.05, respectively). However, there were no significant differences in total IgG and IgG subclass concentrations, between steroid-not-used asthma group and controls (p>0.05, respectively). CONCLUSION: Lowered levels of IgG, IgG1, IgG2 and IgG3 were noted in ASA sensitive asthma patients, which might be associated with use of steroid. Further studies will be needed to evaluate their clinical significance.
Adult ; Asthma* ; Humans ; Immunoglobulin G* ; Nephelometry and Turbidimetry ; Prevalence ; Reference Values ; Respiratory Tract Infections