BACKGROUND: The measurement of nonspecific bronchial hyperreactivity is valuable for diagnosis and management of bronchial asthma. Methacholine or histamine is used for the pharmacologic provocation test. Usually a methacholine bronchial provocation test is performed by a dosing technique with counted number of breaths. A dosimeter is indispensable in the dosing technique. Recently a timed tidal breathing technique which dose not need an expensive dosimeter was introduced. We measured the degree of nonspecific bronchial hyperreactivity to histamine using a simple timed tidal breathing technique. METHOD: Forty two healthy volunteers, 12 patients with bronchial asthma(BA), 10 patients with rhinitis(RH) and 10 patients with upper respiratory infection(URI) participated in the study. The subject's nose was clipped and inhalation continued during tidal breathing for 2 minutes via a face mask. FEV1 was measured at 30 seconds, 90 seconds after inhalation and inhalation of next solution was continued until there was a fall in FEV1 of 20%. Histamine PC20 was defined as the concentration at 20% fall of FEV1 and it was obtained from the log dose-response curve by linear interpolation. RESULTS: Inhalation of serial dilution of histamine could be performed in all patients without significant side of effects. The geometric mean±standard deviation of histamine PC20 in healthy volunteers is 8.27±2.22mg/ml, BA group 0.33±3.02mg/ml, RH group 0.85 ±3.24mg/ml, and URI group 1.47±1.98mg/ml. CONCLUSION: Histamine bronchial provocation test using timed tidal breath method is a simple and suitable tool for management of patients with bronchial hyperreactivity.
Asthma ; Bronchial Hyperreactivity ; Bronchial Provocation Tests* ; Diagnosis ; Healthy Volunteers ; Histamine* ; Humans ; Inhalation ; Masks ; Methacholine Chloride ; Nose ; Respiration*

Methicillin-resistant Staphylococcus aureus colony variants (SCVs) are frequently auxotrophic for hemin, menadione, thiamine, and CO2 involved in biosynthesis of the electron transport chain element. This phenotype grows slowly, and forms very small, nonhemolytic colonies in routine culture, so it may be led to the misidentification of this organism. We isolated an organism with catalase-positive, gram-positive cocci in cluster from the urine of a 55-years-old woman with persistent and relapsing bladder stone, who had undergone the antibiotic treatment with cefotaxime, ceftizoxime, amikacin, and/or micronomicin, intermittently for three years. The possibility of SCVs should have been ruled out because this organism didn't grow on Mueller-Hinton agar (MHA) for the susceptibility test. It formed small colonies on blood agar plate overnight, and grew only on MHA with supplement of hemin, or with 5% CO2. This organism was coagulase-positive, DNase-positive, manitol-salt positive, and identified as S. aureus with VITEK GPI card. The susceptibility test could be performed after adding hemin(1mg/mL) into bacterial suspension and showed susceptibility against vancomycin, teicoplanin, and rifampin. Because these phenotypes can be misidentifide as other non-pathogenic organisms due to their atypical characteristics, we should consider SCVs in case of small, nonhemolytic colonies with catalase-positive, gram-positive cocci in cluster, showing no growth on MHA. In addition, infections caused by SCVs are recently recognized in relation to persistent and relapsing infection, so they could be isolated from the patients with long-term antibiotic therapy.
Agar ; Amikacin ; Cefotaxime ; Ceftizoxime ; Electron Transport ; Female ; Gram-Positive Cocci ; Hemin ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Phenotype ; Rifampin ; Teicoplanin ; Thiamine ; Urinary Bladder Calculi* ; Urinary Bladder* ; Vancomycin ; Vitamin K 3

Heat disorders are not uncommon in the military society due to supposedly hard training to overcome the environmental conditions. Twenty-two soldiers with heat disorders were admitted to Chin Hae Naval Hospital June 1969 through July 1970. Hoping that our clinical studies on them contribute to a renewed understanding, the results are reported in summary as follows: 1) Heat disorders occurred with an overall incidence of 3.1 per cent during running in early summer. 2) Of the twenty-two patients, eight (37 per cent) had heat cramps, six (27 per cent) heat exhaustion, five(23 per cent) heat stroke, and three(13 per cent) had undetermined disorder. 3) Ten patients(45 per cent) were comatous, and this occurred most frequently(80 per cent) among those with heat stroke. 4) All patients were grouped into four according to their physical status on admission. Those with heat exhaustion mostly belonged to group I (good) or group II (fair). Those with heat stroke and heat cramps eomprised most of group III (poor) and group IV (grave). 5) Group I and II patients recovered within 12 hours; group III, within 12~24 hours; and group IV, required more than 24 hours of care. 6) One patient with heat stroke, graded V, expired with sudden hypothermia 15 hours following admission. Overall mortality of heat disorders was 4.5 per cent, and that of heat stroke 20 per cent. 7) The rest recovered uneventfully within 19 hours of average.
Chin ; Emergencies* ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hope ; Hot Temperature* ; Humans ; Hypothermia ; Incidence ; Military Personnel ; Mortality ; Running

The aim of this study was to determine the guideline of usage of antibiotics for anonectal suppurative disease. This study was conducted in consecutive 96 patients, who were taken surgical treatments for the anorectal abscess at the department of general surgery of Ewha Womans University Hospital, from January 1990 to December 1994. All subjects were classified in terms of age, gender, duration, history, associated disease, classification, location, and isolation of organism. The incidence of the anorectal abscess was highest in the 3rd and 4th decade of age and male in terms of gender. 80.3% of all patients were admitted within 10 days after onset. The most common past history of anorectal disease was the anorectal abscess(15 cases, 15.6%) and the associated systemic disease was tuberculosis(9 cases, 9.4%). The main type of anoreclal abscess was the perianal abscess(87.5%) and the most frequent location was posterior area(39.6%). In the pus culture and isolation test, 90.6% of all patients had colony formation and the most frequently cultured organism was E.coli(55 cases,57.3%), followed by Klebsiella species(15 cases,15.6%) and anaerobic Bacteroid species(14 cases,14.6%). In antibiotic sensitivity test, the 3rd generation of aminoglycoside was sensitive in 89 cases and resistant in 3 cases, and the 3rd generation of cephalosporin was sensitive in 87 cases and resistant in 5 cases. These results suggest that the 3rd generation of aminoglycoside or the 3rd generation of cephalosporin could be selected to treat the anorectal suppurative disease.
Abscess ; Anti-Bacterial Agents ; Classification ; Female ; Humans ; Incidence ; Klebsiella ; Male ; Suppuration

Perforation of the interventricular septum complicating acute myocardial infarction is uncommon. The condition was first described anatomically by Latham in 1845 and the first antemortem diagnosis was made by Brunn in 1923. In both cases, bedside catheterization utilizing a flow directed catheter detected a step up of O2 saturation at the ventricular level, compatible with ventricular septal defect, and two dimensional echocardiogram allowed direct visualization and localization of the postmyocardial infarction VSD. Finally cineventriculogram confirmed them.
Catheterization ; Catheters ; Diagnosis ; Heart Septal Defects, Ventricular ; Infarction* ; Myocardial Infarction

The purpose of this study was to identify the major health components and measurements to be conducted in National Health Examination Survey(KNHES). The prevalence and severity of disease, acceptability of population and the possibility, of standardization of measurement were considered as guideline for selecting the components. On the base of magnitude and severity of disease, chronic liver disease, hepatic cancer, gastric ulcer, stomach cancer, essential hypertension, cerebrovascular disease, ischemic heart disease, pulmonary tuberculosis, lung cancer, DM, breast cancer, cervical cancer, arthritis and intervertebral disc disorder were selected as the preliminary target diseases. Questionnaire survey for 648 persons in 'K' city and medical specialists in five clinical societies were conducted for evaluating the acceptability of general population for the measurements and the possibility of standardization for the procedures. In conclusion, the major target diseases were chronic liver disease, hypertension and DM and the total cholesterol, high density lipoprotein, triglyceride, total protein, albumin, hemoglobulin, hematocrit, platlet count, anti-HBs, HBsAg, height and weight were selected for basic physical components.
Arthritis ; Breast Neoplasms ; Cholesterol ; Chronic Disease ; Hematocrit ; Hepatitis B Surface Antigens ; Humans ; Hypertension ; Intervertebral Disc ; Korea* ; Lipoproteins ; Liver Diseases ; Liver Neoplasms ; Lung Diseases ; Lung Neoplasms ; Myocardial Ischemia ; Prevalence ; Surveys and Questionnaires ; Specialization ; Stomach Neoplasms ; Stomach Ulcer ; Triglycerides ; Tuberculosis ; Uterine Cervical Neoplasms

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.
Candida albicans ; Candidemia ; Fungemia ; Fungi ; Humans ; Incidence ; Neurosurgery ; Retrospective Studies* ; Trichosporon ; Urinary Tract Infections ; Yeasts

PURPOSE: To demonstrate the bystander effect in murine neuroblastoma model which transduced with HSV-TK gene in vitro and in vivo. METHODS: The LNC/TK vector was transfered in vitro into the neuro-2a cells, murine neuroblastoma cell line. Variable mixed populations of neuro-2a cells consisting of HSV-TK+ or HSV-TK- were plated into culture plates and treated with GCV for another 4 days. Surviving cells were counted and cell viability was determinated. For investigating the in vivo bystander effect, variable mixed populations of neuro-2a cells consisting of HSV-TK+ and HSV-TK- were inoculated into A/J mice. The tumor size was measured following injection of GCV for 7 days. RESULTS: The survival rate of the 100% neuro-2a/TK group was 90%, 25%, 5% and 0%, of 50% neuro-2a/TK group was 92%, 30%, 10% and 0%, and of the 10% neuro-2a/TK group was 95%, 40%, 15% and 5%. But, the survival rate of 0% neuro-2a/TK group was 120%, 150%, 180% and 220% on days 1, 2, 3, and 4 respectively. In the 100% and 50% neuro-2a/TK groups, tumor had disappeared following administration of GCV and in 10% neuro-2a/TK group, tumor size was not increased during GCV treatment. In 0% neuro-2a/TK group, tumor size increased during administration of GCV and all mice died after 6 weeks. CONCLUSIONS: We demonstrated the bystander effect in a murine neuroblastoma model which transduced with HSV-TK gene in vitro and in vivo. These results suggest that HSV-TK/GCV gene therapy may be useful for treatment of neuroblastoma.
Animals ; Bystander Effect* ; Cell Line ; Cell Survival ; Genetic Therapy* ; Mice ; Neuroblastoma* ; Survival Rate

PURPOSE: Environmental factors may increase risk for childhood asthma. The objective of this study was to investigate the association of environmental tobacco smoke (ETS) exposure and home environment with the development of wheeze and asthma. METHODS: We conducted a cross-sectional survey of 969 elementary school students. Data included questions about asthma and wheeze symptoms, exposure to tobacco smoke, and home environment including history of moving into a new house within 1 year of age after birth, use of fragrance at home, recent purchase of new furniture. Logistic regression and Pearson chi statistics were used to estimate these associations. RESULTS: ETS exposure was associated with current wheeze and nocturnal sleep disturbance. Paternal smoking over 20 cigarettes per day was associated with 4 or more episodes of wheeze during the past 1 year. However, there were no significant differences in pulmonary function, serum total IgE levels, blood eosinophil counts, and atopy between children with ETS exposure and non-exposure. Moving into a new house within 1 year of birth was associated with current asthma or wheeze. Use of fragrance at home and purchase of new furniture during the past 1 year were associated with current wheeze, current physician-diagnosed asthma, and nocturnal cough. CONCLUSION: Exposure to ETS, moving into a new house after birth, and indoor fragrance are risk factors for wheeze and asthma in schoolchildren.
Asthma ; Child ; Cross-Sectional Studies ; Eosinophils ; Humans ; Immunoglobulin E ; Interior Design and Furnishings ; Logistic Models ; Parturition ; Risk Factors ; Smoke ; Smoking ; Tobacco ; Tobacco Products

PURPOSE: Atopic dermatitis may impair quality of life and lead to attention deficit-hyperactivity disorder (ADHD). Thymus and activation-regulated chemokine (TARC)/CCL17 may serve as a new biomarker for atopic dermatitis. We investigated the relationship between TARC and the severity of atopic dermatitis, quality of life, and ADHD. METHODS: A total of 249 preschool children who had atopic dermatitis were enrolled. Parents of the patients filled out a questionnaire on the past history of allergic diseases, quality of life, and ADHD. In each patient, total immunoglobulin (Ig) E and specific IgE to nine foods and inhalant allergens, total eosinophil counts, and TARC levels were measured. We evaluated the severity of atopic dermatitis by using the scoring atopic dermatitis (SCORAD) score and divided the patients into three groups; mild (<15), moderate (15 to 40), and severe (>40). RESULTS: In a total of 249 children, 222 children (89.2%) had a history of atopic dermatitis. Children with allergic sensitization had a higher SCORAD score, total IgE levels, and total eosinophil counts, but not TARC levels. Three groups by the SCORAD score showed significant differences in quality of life index and TARC levels but not in ADHD index. TARC level was correlated with the SCORAD score, but not with the quality of life index and ADHD index. The SCORAD score was correlated with the quality of life index but not with the ADHD index. CONCLUSION: Serum TARC levels may be associated with the severity of atopic dermatitis but not with the degree of quality of life and ADHD. Disease severity of atopic dermatitis in preschool children may be associated with the degree of quality of life but not with the level of ADHD.
Allergens ; Attention Deficit Disorder with Hyperactivity ; Chemokine CCL17 ; Child ; Child, Preschool ; Dermatitis, Atopic ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulins ; Parents ; Quality of Life ; Surveys and Questionnaires ; Thymus Gland