BACKGROUND: The skin prick test and in vitro allergen-specific IgE assays are commonly used to diagnose atopic diseases. However, there is still a need for comparison of their diagnostic efficiency. Objective and METHOD: To evaluate their clinical efficiency, the results of UniCAP and multiple antigen simultaneous test (MAST) were compared with skin prick test results. After 51 allergic patients completed skin prick test (SPT), serum sample was collected and UniCAP and MAST were performed to determine specific IgE to house dust mite (Dermatophagoides pteronyssinus : Dp and D. farinae. Df). Result : When SPT was used as a reference standard, UniCAP depicted higher sensitivity of 88.8% to Dp IgE and 91.4% to Df - IgE, but lower specificity of 73.3% to Dp IgE and 75.0% to Df - IgE. However, MAST had lower sensitivity of 75.1% to Dp-IgE and 71.4% to Df - IgE, higher specificity of 93.3% to Dp-IgE and 93.7% to Df - IgE. The values of UniCAP and MAST were significantly correlated with the reactivity grade of skin prick test, respectively. Additionally, the response of SPT was not apparently associated with ECP levels. CONCLUSION: These study results may suggest that both UniCAP and MAST are generally feasible for measuring house dust mite - specific IgE and that they are both replicable.
Dust* ; Humans ; Immunoglobulin E* ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin*

The eye is a common target organ of the allergy, and allergic conjunctivitis is the most common of eye diseases. Clinical manifestations of allergic conjunctivitis are acute bilateral red, itchy, and watery eyes. The presence of conjuncitival eosinophilia may be consided to be a diagnostic indicator of allergic conjunctivitis. ECP is a quantifiable toxic product secreted by activated cosinc phils. VCAM-1 promotes adhesion of leukocytes to endothelium in vitro and may promote imflammation in vivo. The objective of this study is to measure eosinophil count, ECP and sVCAM-1 levels of tears and sera in patients with acute allergic conjunctivitis and normal subjects and to assess the correlation of these mediators with the severity of the disease and the clinical usefulness. Seventeen subjects were selected on the basis of clinical manifestations, history, skin prick test, total IgE. A microcapillary tube was used to collect the tears from the inner canthus, conjunctival epithelia were obtained for eosinophil count by scraping the upper tarsal conjunctiva. The level of ECP was measured by CAP system (Kabi-Pharmacia, Sweden), sVCAM-1 was measured by ELISA (R&D, USA). Serum IgE and eosinophil count were in creased in 10 patients, allergic skin prick test were positive in 11 subjects (D.p: 9, D.f: 8), eosinophilia in conjunctival epithelium were present in 11 subjects (4 patients: > 3/HPF, 7 patients: 1-3/HPF). ECP in tears were increased in patients significantly (12.0+8.0 vs 3.9+3.8 ng/ml, p=0.01), but not in serum (52.5+43.1 vs 28.3+25.9 ng/ml). There is no significant correlation between eosinophil count and ECP in serum and tears (p>0.05, r-=0.19). Serum sVCA-M-1 level is significant different between patients and controls (1916.5+756.0 vs 1147.2+146.1 micro gram/ml, p=0.01), sVCAM-1 is significantly correlated to eosinophil count (p=0.01, r=0.56) and ECP (p<0.05, r=0.65). In conclusion, eosinophil and ECP in tears may be very important role in allergic conjunctivitis and are useful indicators of the disease. The elevation of sVCAM-1 in serum may be interpreted simply as marker of the presence of non-specific inflammation.
Cell Adhesion* ; Child* ; Conjunctiva ; Conjunctivitis, Allergic* ; Endothelium ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils* ; Epithelium ; Eye Diseases ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Leukocytes ; Skin ; Tears* ; Vascular Cell Adhesion Molecule-1

BACKGROUND: Infection with respiratory virus has been shown to exacerbate asthma in humans. However, the role of a respiratory virus in the pathogenesis of chronic asthma and/or wheezing in young children has not been clearly defined. The objective of this study was to determine whether respiratory virus infections such as RSV, and influenza A virus are related to the productions of IL-11, IFN-gamma, and ECP levels in nasopharyngeal secretions. METHOD: We compared IL-11, IFN-gamma, and ECP levels in nasopharyngeal secretions from 38 non-asthmatic wheezing children with viral infections (RSV in 21 children, influenza A virus in 17 children), and 16 non-asthmatic healthy children who were included as the controls. IL-11, and IFN-gamma levels were analysed by ELISA. ECP concentrations were measured by monoclonal antibody-based fluorometric assay. RESULT: RSV infection in children induced a greater release of IL-11 in nasopharyngeal secretions than in influenza A virus infection, and in the controls. The release of IFN-gamma levels in nasopharyngeal secretions from children with influenza A virus infection was significantly higher than in nasopharyngeal secretions from children with RSV. ECP levels of subjects with viral infection were significantly higher than in control children. CONCLUSION: This study demonstrated that RSV is a potent inducer of IL-11 elaboration in nasal epithelium and that IL-11 is an important mediator in the pathogenesis of RSV infection. Increased IFN-gamma production in response to the influenza A virus infection may be related to effective Th1 responses.
Asthma ; Child* ; Enzyme-Linked Immunosorbent Assay ; Eosinophil Cationic Protein ; Humans ; Influenza A virus* ; Influenza, Human* ; Interferon-gamma ; Interleukin-11* ; Nasal Mucosa ; Respiratory Sounds* ; Respiratory Syncytial Viruses*

BACKGROUND: The purpose is to determine the efficacy of additional intravenous patient-controlled analgesia (IV-PCA) by comparing the analgesic effects between interscalene block (ISB) combined with IV-PCA and single ISB after arthroscopic shoulder surgery. METHODS: A total of 213 patients who underwent arthroscopic shoulder surgery were divided into two groups based on the type of perioperative anesthesia. The single ISB group included 100 patients, while the IV-PCA group included 113 patients. The visual analogue scale for pain (VAS pain) scores were assessed at 12, 24, and 48 hours postoperatively in accordance with shoulder pathology. Postoperative narcotics-related complications and consumption of additional non-steroidal anti-inflammatory drugs between the two groups were compared. RESULTS: VAS pain showed no significant difference between the two groups at most points of the postoperative timeline, regardless of shoulder pathology, except in patients with rotator cuff repair at postoperative 24 hours. Although the IV-PCA group showed a statistically lower VAS pain score than the ISB group at postoperative 24 hours (p=0.04), the difference in the VAS pain score was only 9.0 mm in patients with rotator cuff repair. Narcotics-related complications were observed more frequently in the IV-PCA group than in the ISB group for patients with rotator cuff repair. CONCLUSIONS: Additional IV-PCA demonstrated no booster effect for immediate pain control in patients undergoing arthroscopic shoulder surgery with preoperative single ISB. Furthermore, patients with IV-PCA experienced greater narcotics-related complications.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Arthroscopy ; Humans ; Pathology ; Prospective Studies* ; Rotator Cuff ; Shoulder*

The malignant fibrous histiocytoma (MFH) was first introduced in 1963 to refer to a group of soft-issue tumors characterized by a storiform or cartwheel-ike growth pattern and predominantly fibroblastic appearance. It was postulated that they were derived from histiocytes that could assume the appearance and function of fibroblasts. MFH has been recognized to be the most common sarcoma in the soft tissue of late adult life which involves the deep fascia or skeletal muscles of the extremities or retroperitoneum. It has been noted in other organs, however, it rarely arises in the liver. We report two cases of primary malignant fibrous histiocytoma of the liver histopathologically confirmed after surgical resection-storiform pleomorphic and myxoid subtypes in the 55 year old male and 49 year old female patients, respectively, and describes the clinical courses, characteristics and pathologic aspects with review of the related literatures.
Adult ; Extremities ; Fascia ; Female ; Fibroblasts ; Histiocytes ; Histiocytoma, Malignant Fibrous* ; Humans ; Liver* ; Male ; Middle Aged ; Muscle, Skeletal ; Sarcoma

PURPOSE: Asthma has been known as a chronic inflammatory disease to cause airway obstruction by allergens, viral infections and other factors. Nowdays infantile asthma is increasing markedly. However, to date the enough study for predicting its long term prognosis was not performed. This study aimed to estimate the long term prognosis of infantile asthma. METHODS: In pediatric allergy clinic of Hanyang University Hospital, 84 asmatics younger than 24 months of age were included from January 1986 to December 1992, who had no abnormality in the airway. Infantile asthma was diagnosed on the basis of chronic cough, episodic wheezing more than three times and reversibility of clinical symptoms by using inhaled bronchodilators. Forty four asthmatics could have been followed and divided into two groups, symptomatic and resolved by analyzinng their medical records and performing follow- up examination with blood and skin prick tests to common allergens. RESULTS: 1) The two study groups included resolved 28 children (63.6%) and symptomatic 16 children (36.4%) with the ratio of male 3.9 to female 1. 2) There were no significant differences the age of first wheezing episode (9.6+/-5.6 mo. vs. 9.9+/-3.5 mo.) as well as diagnosis (14.3+/-5.7 mo. vs. 16.2+/-5.1 mo.) between two study groups, respectively (P>0.05). 3) For history of atopic dermatitis, there was significant difference between the resolved group 6 of 28 children and the symptomatic group 12 of 16 (P<0.05). 4) For laboratory examination, no significant difference was observed, between the levels of PB eosinophil count (310.4+/-282.2/mm3 vs. 368.1+/-465.9/mm3 at diagnosis; 294.3+/-205.3/mm3 vs. 457.7+/-511.2/mm3 at follow-up) and serum IgE (107.2+/-126.5 IU/ml vs. 157.6+/-246.3IU/ml at diagnosis; 267.3+/-700.5IU/ml vs. 442.6+/-546.0IU/ml at follow-up). 5) The frequency of asthmatic attack per year was 3.3+/-1.6 vs. 3.7+/-1.7; the duration of clinical symptom was 2.6+/-1.4 vs. 5.7+/-2.0 years, respectively. 6) The results of skin prick test showed that more frequent positivity to common inhalants in symptomatic group than in resolved was observed. CONCLUSIONS: In the long term follow-up for infantile asthma, the resolved 28 of 44 asthmatics were observed. The positive history of atopic dermatitis might be one of the important predictors for their persistent clinical symptoms.
Airway Obstruction ; Allergens ; Asthma* ; Bronchodilator Agents ; Child ; Cough ; Dermatitis, Atopic ; Diagnosis ; Eosinophils ; Female ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Male ; Medical Records ; Prognosis ; Respiratory Sounds ; Skin

Purpose: This study aimed to investigate the prevalence of peripheral neuropathy (PNP) and its related serum metabolites in de novo patients with Parkinson’s disease (PD). PNP is a type of frequent comorbidity in PD. Although the administration of levodopa has been described as a presumptive risk factor in its development, few studies have explored its effect on unmedicated PD patients. Materials and Methods: This study included 105 drug-naïve de novo PD patients. A standardized nerve conduction study (NCS) technique was used to evaluate motor or sensory neuropathy. We analyzed serologic tests including metabolic markers of vitamin B12, homocysteine (Hcy), and uric acid (UA). Results: We found abnormal nerve conduction velocity findings in 24 out of 105 total patients. Among them, 20 patients showed a type of combined motor-sensory, while three were a type of pure sensory and one was a pure motor. Nine patients had carpal tunnel syndrome. PD with PNP group demonstrated higher serum levels of Hcy and UA compared to PD without PNP group. Conclusion Our data demonstrated a potential role of Hcy and UA on PNP in de novo patients with PD. These results suggest the contribution of the inherent metabolic pathway in deterioration of the peripheral nervous system in PD.

No abstract available.
Brain* ; Choriocarcinoma* ; Female ; Neoplasm Metastasis* ; Pregnancy

PURPOSE: Asthma is characterized clinically not only by episodic wheeze and reversible airway obstruction but also by excessive airway secretion. Oppenshaw- Warwick found that 77% of asthmatic subjects reported sputum production as a prominent symptom. Invasive assessment for the airway inflammation in children has been frequently limited. Induced sputum by inhalation of hypertonic saline allows monitoring of airway inflammation in children with asthma in a non-invasive way. METHODS: Thirty subjects with asthma were selected by asthma questionares and divided two groups as 14 current symptomatic asthmatics (FEV(1)<85%: PD15) and 16 stable non-symptomatic asthmatics with 4.5% hypertonic saline challenge test, and 14 normal controls were selected. They all inhaled 4.5% hypertonic saline for 10 minutes by ultrasonic nebulizer. The expectorated sputum and saliva were collected from all subjects and collected 3 hours after corticosteroid (Beclomethasone diproprionate 200microgramX2) inhalation for asthmatics and were reduced by dithiotreitol. Total cell counts and differentials were determined. RESULTS: Sputum from current asthmatics contained a significantly higher proportion of eosinophil than stable asthmatics or normal controls (7.9+/-6.0 vs. 3.8+/-4.5% vs. 0.8+/-1.4%, P<0.05). The induced sputum after corticosteroid inhalation showed significant decrease in total cell count, eosinophil proportion in current asthma and stable asthma. CONCLUSION: The cellular analysis of induced sputum was a useful non-invasive and safe study for the diagnosis of childhood asthma and assessment for the direct effects of inhaled corticosteroid on airway inflammation in children with asthma.
Airway Obstruction ; Asthma* ; Cell Count ; Child* ; Diagnosis ; Eosinophils ; Humans ; Inflammation ; Inhalation ; Nebulizers and Vaporizers ; Saliva ; Sputum* ; Ultrasonics

In published article by Li et al., an author's name was misspelled.