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*

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

BACKGROUND: Bacteriokiller system(BKS) produces disinfectant which is generated by the mixture of active oxygen and hypochlorous acid with tap water. Previous studies showed that BKS disinfectant is highly bacteridal against clinical isolates in in vitro testings and more effective than general soap and water for the disinfecttion of contaminated handa. This study was performed to evaluate ling-trem effects of BKS as a handwasing agent in clinical settings. METHODS: Five BKS were installed for the 9-month period from June 1995 to February 1996 in 16-bed Neurosurgery Intensive Care Unit. Handwashing was frequency was observed after 1, 6, and 8 month of BKS use. Six-month incidences of nosocomial infecrion before and after BKS installation were compared to evaluate the possible effect of handwashings on nosocomial infection rates. A self-administered questionaire was used to collect data on handwashing frequency and their opinions of the BKS disinfectant at 2 and 8 months after the installation. RESULTS: Handwashing frequency of healthcare workers(HCWs) before and after patient contacts was increased from 34.1%(137/402) to 50.3%(193/384) (p<0.00001). At the same time, the 6-month nosocomial infection rate was down to 10.5%(43/411) from the pre-BKS rate of 13.0%( 51/431) and the patient-day rate was also decreased from 18.3(56/3068) to 15.1(43/2,844). Most (80.5%) of HCWs thought that BKS promote handwashing and "convenience" was the main reason for more frequent handwashing. Ninety three percent of HCWs would recommend the replacement of tne existing sinks and handwashing disinfectants with BKS. NO adverse skin reaction were reported after 8 months. Conclusions: BKS appears to promote handwashing because it is easy to use with no skin irritation and may contribute toward the prevention of nosocomial infections.
Cross Infection ; Delivery of Health Care ; Disinfectants ; Hand Disinfection ; Humans ; Hypochlorous Acid ; Incidence ; Intensive Care Units ; Neurosurgery ; Reactive Oxygen Species ; Skin ; Soaps

BACKGROUND: Patients with liver cirrhosis are regularly examined for the evaluation of esophageal varices. Those with large varices should be treated with beta-blockers. The aim of this study was to determine whether clinical variables were predictive of the presence of esophageal varices or high-grade varices. METHODS: The medical records of 257 patients, diagnosed as having liver cirrhosis and underwent esophagogastro-duodenoscopy (EGD), were reviewed. None had a history of malignancy and variceal hemorrhage before EGD. Clinical findings were analyzed in relation to the presence of esophageal varices and high grade esophageal varices. RESULTS: The multiple logistic regression analysis showed an independent association between the presence of esophageal varices and ascites and low platelet count. Only low platelet count showed association with high grade esophageal varices. The cut-off value of predictive model for high grade esophageal varices was 73,766/microliter and its sensitivity was 75%, specificity 65.7%, negative predictive value 96.2%, and positive predictive value 18.6%. CONCLUSION: Our analysis showed that low platelet count and ascites were independent predictive factors for esophageal varices. For high grade varices, the platelet count was the only predictive factor. Endoscopic screening for detection of high grade varix is highly recommended when the platelet count is lower than 74,000/microliter is observed in patients with liver cirrhosis.
Ascites ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Liver Cirrhosis* ; Liver* ; Logistic Models ; Mass Screening ; Medical Records ; Platelet Count ; Sensitivity and Specificity ; Varicose Veins

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

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

Pericardial cysts are uncommon benign congenital mediastinal lesions and they are most often found in either cardiophrenic angle. We present here one case of atypically located pericardial cyst that was located in the subpulmonary region. The clinicians should take into consideration this entity in the differential diagnosis of cystic lesion of the mediastinum. The diagnostic difficulties that are encountered and the utility of video-assisted thoracoscopy are described.
Diagnosis, Differential ; Mediastinal Cyst* ; Mediastinum ; Pericardium ; Thoracoscopy

BACKGROUND: Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. METHODS: First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. RESULTS: The mean skin thickness was 2.29+/-0.37 mm in the abdomen and 2.00+/-0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15+/-6.54 mm in the abdomen and 5.50+/-2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. CONCLUSION: It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.
Abdomen* ; Adipose Tissue ; Adult ; Arm* ; Body Mass Index ; Diabetes Mellitus ; Humans ; Injections, Intramuscular ; Insulin* ; Linear Models ; Needles* ; Patient Compliance ; Skin* ; Subcutaneous Fat* ; Ultrasonography ; Surveys and Questionnaires

Schwannomas arising from the cranial nerves of the jugular foramen are rare, only 50 cases including 15 glossopharyngeal schwannomas have been reported. They may be confused with the far more common acoustic schwannoma because of the presenting symptom of hearing loss. With the symptoms and signs of the lower cranial nerve involvement, the characteristic radiographic findings of enlarged jugular foramen and normal internal acoustic meatus can make the diagnosis. The authors review the literature and present a unique case of glossopharyngeal schwannoma which had intra-and extracranial growth with intrapetrosal extension.
Acoustics ; Cranial Nerves ; Diagnosis ; Hearing Loss ; Neurilemmoma* ; Neuroma, Acoustic

BACKGROUND: The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. MATERIAL AND METHOD: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37oC (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. RESULT: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. CONCLUSION: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopreserved arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.
Allografts ; Aorta* ; Arteries ; Cryopreservation ; Edema ; In Situ Nick-End Labeling ; Rupture ; Transplants