PURPOSE: Atopy and specific immunogloguline (Ig) E to individual aeroallergen are considered a hallmark of allergic diseases, including asthma. However, the association between these parameters and lung function or bronchial hyperresponsiveness (BHR) is still controversial in previous studies. METHODS: A total of 234 atopic asthmatic children was recruited in this study. The amounts of total IgE and specific IgE were determined by employing the CAP system FEIA (Pharmacia Diagnostics, Uppsala, Sweden). Specific IgE was focused on two major inhalant allergens in Korea, Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To evaluate BHR, methacholine and exercise challenge tests were performed. RESULTS: In the atopic asthmatic group, total IgE correlated negatively with methacholine PC20 and positively with a maximum percentage fall in FEV1 after exercise. Specific IgE to Der f strongly correlated with a maximum percentage fall in FEV1 after exercise in atopic asthmatics, particularly exercise-induced asthma (EIA) (r=0.176, P=0.007 and r=0.199, P=0.011, respectively) and specific IgE to Der p weakly correlated with a maximum percentage fall in FEV1 after exercise only in EIA-positive children with atopic asthma (r=0.140, P=0.073), while neither of them correlated with methacholine PC20 (P> 0.05). However FEV1, FVC, and FEF25-75% were not associated with total IgE and specific IgE to Der p or Der f regardless of positivity of EIA in atopic asthmatic children. CONCLUSION: The severity of atopy and sensitization to house dust mites are significantly correlated with BHR, especially challenged by exercise but not pulmonary function in atopic asthmatic children.
Allergens ; Asthma ; Asthma, Exercise-Induced ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin E ; Korea ; Lung ; Methacholine Chloride ; Pyroglyphidae

We present a case of ileal stenosis with delayed presentation 3 months after car accident. Ileal stenosis after blunt abdominal trauma is a rare clinical entity. We present CT and small bowel series 3 months after trauma. Image showed segmental thickening of intestinal wall and proximal bowel dilation. At surgery, a stenotic bowel loop was adjacent to a fibrotic mesentery. Histological examination showed ulcers, inflammatory cells and fibroblasts infiltrated to the muscularis mucosae, submucosa, and mesentery. The most likely cause, supported by most authors, implicates an injury to the mesentery. Post-traumatic ischemic bowel stenosis may result from even small tears and contusions of mesentery. Posttraumatic intestinal stenosis should be included in the differential diagnosis in a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.

OBJECTIVES: Hemophagocytic syndrome (HS) is a fatal complication of nasal angiocentric lymphoma (AL) and difficult to distinguish from malignant histiocyosis. Epstein-Barr virus (EBV)-associated HS is frequently observed in lymphoma of T-cell lineage and EBV is highly associated with nasal AL. Clinicopathologic features of 10 nasal ALs with HS were reviewed to determine the clinical significance and the pathogenetic association with EBV. METHODS: Ten patients of HS were identified from a retrospective analysis of 42 nasal ALs diagnosed from 1987 to 1996. Immunohistochemical study and in situ hybridization were performed on the paraffin-embedded tumor specimens obtained from 10 patients. Serologic study of EBV-Ab was performed in 3 available patients. RESULTS: Five patients had HS as initial manifestation, 3 at the time of relapse and 2 during the clinical remission of AL. Four patients were treated by combination chemotherapy (CHOP) and others had only supportive care. The median survival of all patients with HS was 4.1 months (range 2 days-36.5 months) and all had fatal outcome regardless of the treatment-modality. All cases were positive for UCHL1 (CD45RO) and EBV by EBER in situ hybridization. The data of serologic tests indicated the active EBV infection. CONCLUSIONS: HS is a fatal complication of nasal AL and has a high association with EBV. Reactivation of EBV may contribute to HS and further investigation of predictive factors and effective treatment of HS should be pursued in the future.
Adult ; Epstein-Barr Virus Infections/complications ; Female ; Histiocytosis, Non-Langerhans-Cell/pathology ; Histiocytosis, Non-Langerhans-Cell/complications* ; Human ; Lymphoma/pathology ; Lymphoma/complications* ; Male ; Middle Age ; Nose Neoplasms/pathology ; Nose Neoplasms/complications* ; Syndrome

Most of neuroendocrine tumors are usually found in the gastrointestinal tract. Recently, the incidence of gastrointestinal neuroendocrine tumors seems to have increased. However, only a few cases of neuroendocrine tumor arising from the minor duodenal papilla have been reported. Currently, several options are available to treat the tumors of the minor duodenal papilla. Endoscopic papillectomy is increasingly performed as a minimally invasive alternative treatment to conventional surgical resection. We present two cases of neuroendocrine tumor arising from minor duodenal papilla, which were successfully resected by endoscopic papillectomy. Although surgical resection is considered to be a standard treatment for gastrointestinal neuroendocrine tumors, our experience suggests that endoscopic papillectomy can be a minimally invasive alternative treatment for neuroendocrine tumors arising from the minor duodenal papilla.
Gastrointestinal Tract ; Incidence ; Neuroendocrine Tumors* ; Pancreatic Ducts

Most of neuroendocrine tumors are usually found in the gastrointestinal tract. Recently, the incidence of gastrointestinal neuroendocrine tumors seems to have increased. However, only a few cases of neuroendocrine tumor arising from the minor duodenal papilla have been reported. Currently, several options are available to treat the tumors of the minor duodenal papilla. Endoscopic papillectomy is increasingly performed as a minimally invasive alternative treatment to conventional surgical resection. We present two cases of neuroendocrine tumor arising from minor duodenal papilla, which were successfully resected by endoscopic papillectomy. Although surgical resection is considered to be a standard treatment for gastrointestinal neuroendocrine tumors, our experience suggests that endoscopic papillectomy can be a minimally invasive alternative treatment for neuroendocrine tumors arising from the minor duodenal papilla.
Gastrointestinal Tract ; Incidence ; Neuroendocrine Tumors* ; Pancreatic Ducts

PURPOSE: To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. METHODS: We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. RESULTS: In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. 6.8 microgram/L). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. CONCLUSION: There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P<0.05).
Anemia ; Anemia, Iron-Deficiency ; Antimicrobial Cationic Peptides ; Blotting, Western ; C-Reactive Protein ; Child ; Ferritins ; Helicobacter ; Helicobacter pylori ; Hemoglobins ; Humans ; Infant ; Inflammation ; Interleukin-6 ; Iron ; Protein Precursors ; Receptors, Transferrin

PURPOSE: To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. METHODS: We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. RESULTS: In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. 6.8 microgram/L). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. CONCLUSION: There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P<0.05).
Anemia ; Anemia, Iron-Deficiency ; Antimicrobial Cationic Peptides ; Blotting, Western ; C-Reactive Protein ; Child ; Ferritins ; Helicobacter ; Helicobacter pylori ; Hemoglobins ; Humans ; Infant ; Inflammation ; Interleukin-6 ; Iron ; Protein Precursors ; Receptors, Transferrin

The incidence of serious cardiac complications associated with esophagogastro-duodenoscopic examination is very rare. An episode of cardiac arrest developed in 49-year-old during endoscopic examination. The patient had no history of pulmonary or ischemic heart disease. After cardiopulmonary resuscitation, he recovered completely. In this patient, we were able to demonstrate a focal spasm by coronary angiography.
Cardiopulmonary Resuscitation ; Coronary Angiography ; Coronary Vasospasm* ; Endoscopy, Digestive System* ; Heart Arrest ; Humans ; Incidence ; Middle Aged ; Myocardial Ischemia ; Spasm

The incidence of serious cardiac complications associated with esophagogastro-duodenoscopic examination is very rare. An episode of cardiac arrest developed in 49-year-old during endoscopic examination. The patient had no history of pulmonary or ischemic heart disease. After cardiopulmonary resuscitation, he recovered completely. In this patient, we were able to demonstrate a focal spasm by coronary angiography.
Cardiopulmonary Resuscitation ; Coronary Angiography ; Coronary Vasospasm* ; Endoscopy, Digestive System* ; Heart Arrest ; Humans ; Incidence ; Middle Aged ; Myocardial Ischemia ; Spasm

PURPOSE: For conservative treatment of shaft fractures, the butterfly fragments that were somewhat larger in the closed intra-medullary (IM) nailing. The results of treatment were monitored using radiography separately for the weight-bearing femur and non-weight-bearing humerus. MATERIALS AND METHODS: 27 from Group I and 31 from Group II. In the two groups, the displacement and angulation changes in the fragments, and the degree of improvement of these two factors, were compared using follow-up radiography. RESULTS: The mean angulation of fragments in Groups I and II were 9.2degrees and 9.6degrees, and the mean degree of displacement of the fragments in Groups I and II were 16.7 mm and 21.2 mm, respectively. Follow-up radiography showed that the above factors improved in both groups. The degree of displacement was significantly lower in the normal cases than in the complicated cases (p=0.001). CONCLUSION: Displacement and angulation gradually improved in both groups. It was found that the degree of displacement after the initial reduction is more important than the influence of anatomical position or weight bearing. This indicates that care should be taken when inserting IM nails to prevent displacement or angulation.
Butterflies ; Displacement (Psychology) ; Extremities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Nails ; Weight-Bearing