Since allergic rhinitis is a disease with a very high prevalence, it is common to find patients with allergic rhinitis among aviation workers. However, they are so afraid that the report of rhinitis will have a negative effect on the evaluation of one's work suitability. Therefore, aviation medical examiners (AMEs) must be able to accurately understand the nature of allergic rhinitis, and confidently explain that appropriate treatment of rhinitis has a positive effect on their performance. In the treatment of allergic rhinitis, there are some medications that may cause drowsiness,which may impair the accuracy and safety of the aviation service. Therefore, AMEs should accurately know safe drugs that do not cause drowsiness and prescribe them to patients. In addition, it is necessary to know exactly whether air workersmay receive the latest treatments for allergic rhinitis, such as surgical treatment andimmunotherapy, and be able to recommend these treatments appropriately. Therefore,in this paper, we first briefly describe the pathophysiology, genetics, causative antigen,symptoms, diagnosis, and treatment of allergic rhinitis. We also aimed to discuss safemedication and other treatment modalities for allergic rhinitis.

Obstructive sleep apnea syndrome (OSAS) can lead to severe complications if left untreated, and therefore should be adequately diagnosed and treated, especially in airline workers. The aviation medical examiner (AME) should induce the patient to cooperate for the diagnosis and treatment of OSAS, by notifying the subject that it does not cause disqualification of the air service and that it is a disease that can be sufficiently controlled and treated by various treatment options. AME should also warn about medical complications and the possibility of serious air accident risks when untreated, and encourage the subject to receive appropriate diagnosis and steady treatment such as continuous positive airway pressure and/or surgical treatment.

Tuberculous cervical lymphadenitis(TCL) has some problems in microbiologic, pathologic, immunologic diagnostic procedures. More accurate diagnostic means has been needed beacuse TCL requires long-term antituberculous chamotherapy as long as 18 months. Recently, polymerase chain reaction (PCR) which amplifies known DNA segments was applied to the diagnosis of tuberculosis. However, the sensitivity of PCR is low with the samples of low-microorganism-burden. Nested PCR (nPCR) was introduced as a good alternative increasing the sensitivity of PCR by repeated amplification of DNA segment with inner primers which exist in the DNA sequence of first PCR products. Fifteen cases which were suspected to TCL were undertaken fine needle aspiration (FNA) and/or excisonal biopsy from enlarged cervical lymph nodes. All samples were examined with pathologic studies, simple PCR using INS-1/INS-2 primers, and nPCR using outer SCL-1/SCL-2 primers and inner SCL-3/SCL-4 primers. Eeight in fifteen patients were pathologically diagnosed to tuberculosis. Aspiration cytology diagnosed 2 cases to tuberculosis and did not confirm but suspect tuberculosis in 3 cases of thier 12 cases. A case of cases compatible with tuberculosis was diagnosed to subacute necrotizing lymphadenitis with tissue...
Base Sequence ; Biopsy ; Biopsy, Fine-Needle ; Diagnosis* ; DNA ; Humans ; Lymph Nodes ; Lymphadenitis* ; Polymerase Chain Reaction* ; Tuberculosis

PURPOSE: Values for hemoglobin, erythrocyte indices and red cell distribution width used in the diagnosis of anemia and iron deficiency are known to vary to some degree according to age. We tried to define age-related changes in red blood cells (RBC) profiles. METHODS: With the eletronic counters routinely used in clinical laboratories we evaluated the RBC profiles of 1,717 samples of blood from children who were considered healthy. Mean, median and percentile curves of hemoglobin, hematocrit, red cell indices and red cell distribution width were calculated in children aged 5 months to 15 yr of age. RESULTS: The median values for hemoglobin and hematocrit were increased substantially during childhood. The values of hemoglobin were increased from 11.6 g/dl at 6-11 months, to 12.0 g/dl at 2 yr of age, 12.7 g/dl at 6-8 yr, reaching a maximum level of 13.7 g/dl at 12-15 yr for males and 13.3 g/dl for females, with an average of 13.5 g/dl for both sexes. The values of hematocrit were also increased from 34.4 % at 6-11 months, 35.5 % at 2 yr of age, 37.4 % at 6-8 yr and achieved 39.3 % for males and 38.6 % for females in adolescence. The MCV at 6-11 months was 76.3 fl; at 2 yr 77.1; and 83.4 fl for males and 84.8 fl for females in adolescence. The increase in MCH parallels the MCV fairly closely from 25.9 pg at 6-11 months of age to 29.0 pg at adolescence. The MCHC remains conatant throughout infancy and childhood. Cut-off values (3 percentile) of hemoglobin were 10.7 g/dl at 6-11 months, 11 g/dl at 1-2 yr and 11.5 after 6 yr. Cut-off values (3 percentile) of MCV were 70 fl at 1-2 yr and 75 fl after 6 yr. Correlation between hemoglobin, MCV, MCH and RDW was relatively significant, but it was much less dependent variables in this reference population than in the children with iron deficiency. CONCLUSIONS: Our findings indicate that there is a developmental change in red blood cell size extending beyond the well-recognized changes seen in the first 6 months of life. Age-related changes in hemoglobin, hematocrit, MCV and MCH must be taken into consideration in order to optimize the identification of individuals with anemia and iron deficiency.
Adolescent ; Anemia ; Child* ; Diagnosis ; Erythrocyte Indices ; Erythrocytes* ; Female ; Hematocrit ; Humans ; Iron ; Male ; Reference Values*

Recently, it is reported that preganglionic oculomotor nerve palsies shows denervational supersensitive pupillary responses to dilute parasympathomimetic agents and this phenomenon is in inverse proportion to consciousness level. We measured pupillary diameters of 10 brain death patients(20 eyes) and 10 comatous patients (20 eyes). After we instilled 0.06% pilocarpine to patients that initial pupillary diameter is over 4.0mm(13 eyes in brain death group, 5 eyes in comatous group), we compared pupillary responses of two groups to evaluate whether this helps diagnosis of brain death. If pupillary diameter was changed over 25%(compared to initial diameter), we considered it positive. In comatous group, no one was positive. But in brain death group, 11 cases were positive(84.6%). It revealed significant difference statistically(P<0.05). Mean change of pupillary diameter to 0.06% pilocarpine was 0.46mm(9.35%) in comatous group, and 2.62mm(47.72%) in brain death group. With above results, we concluded that pupillary response to dilute parasympathomimetic agents is a useful indicator for diagnosis of brain death.
Brain Death* ; Brain* ; Consciousness ; Diagnosis ; Humans ; Oculomotor Nerve Diseases ; Parasympathomimetics ; Pilocarpine*

Despite a sharp decline in the prevalence of iron deficiency anemia (IDA) during the past several decades owing to better nutrition and iron-fortified foods, IDA continues to remain the most common disorder in the world. From about 4 months of age, iron stores are insufficient to maintain the rapidly expanding blood volume associated with normal growth. If there is no steady dietary supply, iron stores become depleted and IDA develops. It is known that iron deficiency (ID) may impair not only physical activity but also mental functions such as learning. Children with ID are found to have more psychomotor deficits and achieve lower scores in aptitude tests than those with normal iron status. Therefore, the detection and treatment, or preferably prevention of ID and IDA is imperative during late infancy, when increased vulnerability to ID coincides with the rapid growth and differentiation of the brain. The diagnosis of IDA is confirmed by the findings of a hemoglobin level <11 g/dL and low iron stores (serum ferritin level <12 microg/L, transferrin saturation <16%). Iron status should be evaluated in children who have risk factors for IDA such as low birth weight, premature baby, exclusive breastfeeding beyond 6 months of life, and weaning to whole milk and complementary foods without iron-fortified foods. With the management of underlying cause, oral iron therapy should be given to replenish iron stores. Parenteral therapy may be used in children who cannot tolerate or absorb oral preparations.
Anemia, Iron-Deficiency ; Aptitude Tests ; Blood Volume ; Brain ; Breast Feeding ; Child ; Ferritins ; Hemoglobins ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Iron ; Learning ; Milk ; Motor Activity ; Prevalence ; Risk Factors ; Transferrin ; Weaning

No abstract available.
Child ; Croup ; Humans ; Korea

No abstract available.
Child ; Egg Hypersensitivity ; Humans ; Ovum

The purpose of the aviation physical examination guideline is not only to determine the physical fitness of the aviation workers but also to treat the underlying diseases of the aviation employees effectively and to carry out the optimal aviation duties. As medical science advances, treatment guidelines for various diseases are rapidly changing, and aviation physical examination guidelines need to be revised accordingly.Therefore, it is necessary to analyze the change trends of the AME guideline around the world and appropriately reflect it according to the situation of Korea. It is also necessary to continue the training of AME who are required to carry out examinations and certificates by these revision guidelines. Therefore, it would be desirable to analyze the education system of the advanced countries including the US and introduce the advantages of these systems into Korean AME education curriculum. Primarily, with the development of the Internet, various online lectures have been developed recently. Therefore, we first aimed to look at the changes in the current AME guideline of the Federal Aviation Administration. Next, we aimed to discuss changes in the course of the AME refresher course. Finally, we would like to suggest some points to be improved by comparing these AME guidelines and educational programs with those of Korea.

As the coronavirus disease 2019 (COVID-19) pandemic continues, doctors face many difficulties in managing patients with respiratory allergies. As research continues, much new knowledge has emerged about the link between COVID-19 infection and respiratory allergies. Studies to date have shown that there is no significant increase in the risk of COVID-19 infection in patients with respiratory allergies. However, in patients undergoing treatment for moderate to severe asthma or allergic rhinitis, more severe clinical manifestations, increased hospitalization period, and increased mortality may occur, so patients need to be managed with more care.In addition to personal efforts, social consideration should be accompanied to prevent deterioration in patients’ quality of life with respiratory allergies due to COVID-19.Lastly, as clinical doctors, we should treat patients with respiratory allergies to protect ourselves appropriately by actively utilizing remote medical treatment and minimizing tests that generate droplets. Also, by appropriately educating patients and continuing drug treatment, efforts should be made to ensure that patients receive the best treatment even in a pandemic situation.