BACKGROUND AND OBJECTIVE: The selection of allergen panels is a prerequisite to effectively test for innumerable allergens scattered throughout the environment. However, the selection of the pre-existing panel has been vague and contains some allergens that have not been verified as being common in Korea. This study was aimed to produce allergen panels in Korea. METHODS: For 12 months in 1996, sera were tested by the chemiluminescent assay of Multiple allergen simultaneous test (MAST-CLA: Immunosystems, Mountain view, U.S.A.). A total of 2, 467 specimens that either tested positive or were negative but had high total IgE level were pooled together. The pooled ser a were assayed for 60 allergens supplied by Dexall Acti Tip System (Dexall biomedical Labs. Inc., Gaithersburg, U.S.A.), a recently developed enzyme immunoassay. According to the Allerg Ens Unit (Allergen Unit:AU), 12 of the most frequently encountered and 6 of the leaot frequent allergens with reactions between classes 3 and trace were selected. RESULTS: The 12 most frequently encountered allergens were : Dermatophagoides pteronyssinus, Dermatophagoides farinae, house dust, timothy grass, perennial rye, mugwort, birch, oak, hazel nut, common ragweed, alder and dog dander. The 6 least frequently encountered were : wheat, egg-white, cat epithelium, milk, cockroach and shrimp. CONCLUSION: The 12 allergens we chose proposed to be the minimally required panel of frequently encountered allergens in allergy testing. We conclude that the 12 most frequent allergens should be tested with the total IgE level as a major panel (panel-M) and that the 6 least frequently encountered allergens may be tested separately when needed, as a minor panel (panel-m).
Allergens ; Alnus ; Ambrosia ; Animals ; Artemisia ; Betula ; Cats ; Cockroaches ; Dander ; Dermatophagoides pteronyssinus ; Dogs ; Dust ; Epithelium ; Hypersensitivity ; Immunoenzyme Techniques ; Immunoglobulin E ; Korea ; Luminescent Measurements ; Milk ; Nuts ; Phleum ; Secale ; Triticum

No abstract available.
Interleukin-2* ; Interleukins* ; Mucocutaneous Lymph Node Syndrome* ; Receptors, Interleukin-2*

BACKGROUND: Chlamydia pneumoniae causes pneumonia and upper respiratory tract infection and has been recently reported to be associated with coronary atherosclerosis. The difference between C. pneumoniae and other Chlamydia spp. has been demonstrated by serologic study, DNA analysis and ultrastructural observation. However, studies concerning the developmental cycle of C. pneumoniae are relatively short. This study was conducted to investigate the morphological changes and developmental characteristics of C pneumoniae in the HeLa cell. METHODS: To observe the intracellular inclusion of C. pneumoniae, the cultured HeLa cell monolayer was stained with Jones' iodine and Giemsa. The ultrastructures were examined with an electron microscope at 6, 24, 48, 72 and 96 hr after inoculation of elementary bodies. RESULTS: The C. pneumoniae organisms which formed intracytoplasmic inclusion bodies in HeLa cells were negative on iodine stain. In Giemsa-stained preparation, the inclusion bodies of variable sizes with a bluish purple color were identified in the cytoplasm of infected HeLa cells. After 6 hrs of infection, the elementary bodies with electron-dense spicule shaped substance of C. pneumoniae were enclosed by the HeLa cell membrane and were taken the host cell by endocytosis. After 24 hrs of infection, the electron-dense material in the elementary bodies were disappearing and the elementary bodies were transforming into reticulate bodies. After 48 hrs of infection, the reticulate bodies of C. pneumoniae were seen dividing by binary fission. Small electron-dense round bodies(miniature bodies) appeared near completion of division. After 72 hrs of infection. about half of the reticulate bodies were transformed into elementary bodies. Newly formed elementary bodies had a pear-shaped structure and large periplasmic space. After 96 hrs of infection. mature elementary bodies with condensed electron-dense material and a rigid outer membrane were observed. Miniature bodies were located in the cytoplasm of the elementary bodies. CONCLUSIONS: These unique morphological changes in HeLa cell culture show the developmental characteristics of C. pneumoniae.
Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Artery Disease ; Cytoplasm ; DNA ; Endocytosis ; HeLa Cells ; Humans ; Inclusion Bodies ; Iodine ; Membranes ; Periplasm ; Pneumonia ; Respiratory Tract Infections

Although embryonal rhabdomyosarcoma has been frequently reported in genitourinary tract, head and neck, embryonal rhabdomyosarcoma of the biliary tree is an extremely rarte. It must be considered in differential diagnosis of jaundice in childhood. About 35 cases have been reported in world literatures, since first description on 1875, by Moxon and Wilks. We present a case of embryonal rhabdomyosarcoma of the biliary tree in a 25 months old boy with brief review of literatures. Since chief complaints of this case were jaundice and loss of appetite, the first clinical diagnosis was infectious hepatitis. On ultrasound examination, there is a space occupying lesion in right lobe of liver and it was diagnosed as hepatoma. Choledochoduodenostomy with biopsy was done. The operation revealed dilated common bile dut and both hepatic ducts which were filled with light brown jelly like materials and diagnosed as embryonal rhabdomyosarcoma on frozen and permanent senions. In gross and histologic characteristics, this tumor resembles embryonal rhabdomyosarcoma(sarcoma botryoides) in other locations. In spite of chemo-and radiotherapy after operation, the boy was died.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

Electron microscopic study of two malignant fibrous histiocytomas confirmed the presence of previously described tumor cells in the literature. In addition, there existed intermediate cells with morphologic features of both myofibroblasts and histiocytes, or both histiocytes and smooth muscle cells. Our result supported the idea that malignant fibrous histiocytoma may be derived from the undifferentiated mesenchymal cells that differentiate primarily along a fibroblastic and histiocytic cells.

Accidental or suicidal fatalities of paraquat (Gramoxon) poisong are occasionally seen in the emergency room or intensive care unit in this country. In most cases, respiratory symptoms and eventual death by respiratory distress occur within several days. The most striking pathologic change is fibrosis of the lung due to widespread proliferation of fibroblastic cell. We experience a 21-year-old woman with huge bulla on left lung and diffuse fibrosis in other site, who ingested paraquat 10 months ago. After thoracoscopic removal of bulla, the patient survive without progression of pulmonary complication till now.
Emergency Service, Hospital ; Female ; Fibroblasts ; Fibrosis ; Humans ; Intensive Care Units ; Lung ; Paraquat ; Pulmonary Fibrosis* ; Strikes, Employee ; Young Adult

Breast carcinoma has been infrequently reported in children. About 25 cases have been reported in world literatures since first description in 1913, by Bryan. We present a case of juvenile breast carcinoma in a 17 months old girl with brief review of literatures. Grossly, the submitted specimen is grayish white and measured by 1.3x1.0x0.8 cm in size. It is not encapsulated and its cut surfaces are homogeneous. Microscopic examination showed a neoplastic proliferation of duct cells forming mainly glandular spaces with focal papillary pattern, solid sheets or cribriform pattern. The glandular spaces were filled with collections of PAS-positive eosinophilic secretory materials. The individual cell varied from columnar to polygonal and showed moderate hyperchromatism and variation of nuclear size. Mitoses and necrosis are not found. Tumor cell invasion into the stroma was found.
Child ; Male ; Female ; Humans

Hypertensive encephalopathy is usually defined as malignant hypertension associated with central nervous system abnormalities such as headache, seizure, hypertension, altered consciousness, increased intracranial pressure, and retinopathy. The pathogenesis of hypertensive encephalopathy is uncompletely understood, although it seems to be related to hypertensive cerebrovascular endothelial dysfunction, disruption of the blood-brain barrier with increased permeability, cerebral edema, and microhemorrhage formation. Magnetic resonance imaging shows a characteristic posterior leukoencephalopathy that predominantly affects the white matter of the parieto-occipital regions. Hypertensive encephalopathy is a rare manifestation of hypertensive emergency that requires proper diagnosis and management to avoid a irreversible brain damage. We report a patient who developed hypertensive encephalopathy after cesarean section without preeclampsia or chronic hypertension and a case presented with a brief review of the literatures.
Blood-Brain Barrier ; Brain ; Brain Edema ; Central Nervous System ; Cesarean Section* ; Consciousness ; Diagnosis ; Emergencies ; Female ; Headache ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertensive Encephalopathy* ; Intracranial Pressure ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Permeability ; Pre-Eclampsia ; Pregnancy ; Seizures

We studied to assess the relationship between intrauterine growth retardation and theincreased nucleated red blood cell counts (NRBC) in small for gestational age (SGA) and appropriatefor gestational age (AGA) neonates with low birth weight. We also evaluated the nucleated red blood cell counts in low birth weight neonates who had either perinatal asphyzia or hyaline membrane disease (HMD) or died within 7 days after birth. The results were as follows: 1) In low birth weight neonates, the mean value for NRBC counts was 9.02/100 WBCs and the mean absolute value for NRBC counts was 0.9210E9/L. 2) The mean values for NRBC counts were 13.4/100 WBCs in SGA and 6.4/100WBCs in AGA. The mean absolute values for NRBC were 1.32x10E9/L in AGA neonates 3) In SGA neonates with low birth weight, the mean NRBC counts wers 19.6/100WBCs in asphyxiated group and 4.5/100WBCs in control group. The mean absolute NRBC counts were 1.9810E9/L in control group. 4) In AGA neonates with low birth weight, the mean NRBC countswere 9.1/100WBCs in asphyxiated group and 2.4/100WBCs in control group. The meanabsolute NRBC counts were 0.98x10E9/L in asphyxiated group and o.23x10E9/L in controlroup. 5) The mean NRBC counts were 13.8/100WBCs in neonates with HMD and 7.1/100WBCs in control group. The mean absolute NRBC counts were 1.50x10E9/L in neonates withHMD and 0.70x10E9/L in control group. 6) The mean NRBC counts were 19.9/100 WBCs in expired group and 6.8/100WBCs in suvived group. The mean absolute NRBC counts were 2.1810E9/L in expired group and 0.66x10E9/L in survived group. 7) The NRBC counts of SGA neonates were significantly higher than that of AGA neonates with low birth weight. 8) The NRBC counts of asphyxiated neonates were significantly higher than that of the control group. 9) The NABC counts of expired neonates were significantly higher than that of the control group. 10) The NRBC counts of expired neonates were significantly higher than that of the survived neonates.
Birth Weight* ; Erythrocyte Count* ; Erythrocytes* ; Fetal Growth Retardation ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Infant, Low Birth Weight ; Infant, Newborn* ; Parturition*

PURPOSE: This study was conducted to examine the effects of simulation-based education regarding care in a cardio-pulmonary emergency care as related to knowledge, clinical performance ability, and problem solving process in new nurses. METHODS: An equivalent control group pre-post test experimental design was used. Fifty new nurses were recruited, 26 nurses for the experimental group and 24 nurses for the control group. The simulation-based cardio-pulmonary emergency care education included lecture, skill training, team-based practice, and debriefing, and it was implemented with the experimental group for a week in May, 2009. Data were analyzed using frequency, ratio, chi-square, Fisher's exact probability and t-test with the SPSS program. RESULTS: The experimental group who had the simulation-based education showed significantly higher know-ledge (t=5.76, p<.001) and clinical performance ability (t=5.86, p<.001) for cardio-pulmonary emergency care compared with the control group who had traditional education but problem solving process was not included (t=1.11, p=.138). CONCLUSION: The results indicate that a simulation-based education is an effective teaching method to improve knowledge and clinical performance ability in new nurses learning cardio-pulmonary emergency care. Further study is needed to identify the effect of a simulation-based team discussion on cognitive outcome of clinical nurses such as problem solving skills.
Adult ; Cardiopulmonary Resuscitation/*nursing ; *Clinical Competence ; *Competency-Based Education ; Educational Measurement ; Emergency Medical Services ; Female ; Humans ; Male ; *Problem Solving ; Program Evaluation ; Questionnaires ; Young Adult