IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria

Isometric tension was recorded in uterine arterial ring preparation contracted by potassium (60 mM) and norepinephrine(1.8 X 10(-7) M). With pretreatment of various concentrations of nifedipine(2.9 x 10(-9) ~2.9 X10(-7) M) and verapamil(2.2 X 10(-7) -2.2 X 10(-5) M), the relaxation was dose-dependent and inhibitory effects of both agents were more marked on the potassium than norepinephrine-evoked contraction. After immersion of the arterial preparation in calcium-free solution, the potassium-evoked contraction was decreased to 21+/-4.1%(mean+/-SEM) of the response in normal Krebs solution and norepinephrine-evoked contraction to 26+/-3.8%. The responses to both agents were completely restored when the calcium concentration was increased to 4.0 mM. Pretreated nifedipine(2.9 x 10(-7) M) in calcium-free solution depressed the potassium-evoked contraction to 7.3+/-1.6% and norepinephrine-evoked contraction to 12+/-3.7%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 30+/-4.6% and that by norepinephrine to 45+/-5.4%. Pretreated verapamil(2.2 X 10(-5) M) in calcium-free solution depressed the potassium-evoked contraction to 14+/-3.6% and norepinephrine-evoked contraction to 18+/-3.3%. In addition of calcium(0-4.0mM), the potassium-evoked contraction increased to 41+/-4.2% and that by norepinephrine to 57+/-4.7%. It was concluded that nifedipine and verapamil relaxed KC1 contracted ring in the presence of external calcium and relaxed norepinephrine contracted ring in both the presence and absence of external calcium. These findings suggest that calcium antagonists interfere with the release of calcium from intracellular sites as well as with the slow inward current of calcium.
Calcium ; Humans* ; Immersion ; Nifedipine* ; Norepinephrine ; Potassium ; Relaxation ; Uterine Artery* ; Verapamil*

No Abstract available.
Adolescent* ; Adult* ; Delivery of Health Care* ; Heart Defects, Congenital* ; Humans

Intravenous anesthesia of propofol was compared with ketamine on 20 gynecological patients undergoing dilatation and currettage. The patients were randomly assigned to study in two treatment groups so that l0 patients was administered ketamine anesthesia and 10 patients was administered propofol anesthesia. The hemodynamic responses and recovery characteristics of the two group were compared with control group. Arterial blood pressure(systolie, .mean, diastolic) and heart rate after induction were significantly increased in ketamine group, but showed significantly decrease in propofol group(table 5). Time to full recovery(mean+/-SD) was significantly less in the propofol group(14.3+/-2.9 min vs 40.2+/-4.l min, p<0.01)(table 4). The authors conclude that intravenos anesthesia of propofol is a pratical alternative technique for gynecological patients undergoing dilatation and currettage and may be preferable to ketamine because of the significantly shorter recovery time.
Anesthesia ; Anesthesia, Intravenous* ; Dilatation* ; Heart Rate ; Hemodynamics ; Humans ; Ketamine* ; Propofol*

A 70-year-old woman developed sick sinus syndrome associated with thyrotoxicosis. Initial T3 was above 800ng/dl and TSH was below 0.05IU/ml. But sinus node dysfunction was resolved upon achieving a euthyroid state. This clinical course suggest that transient reversible sinus node dysfunction could be developed due to thyrotoxicosis.
Aged ; Female ; Humans ; Sick Sinus Syndrome* ; Thyrotoxicosis*

No abstract available.
Endosonography* ; Insulinoma*

BACKGROUND: Exercise can aggravate asthmatic symptoms in many patients with bronchial asthma. It is caused by that inhaled air bypasses nasal cavity and goes directly to the lower airways through open mouth dring exercise. Although the pathogenetic mechanisms of exercise-induced asthma(EIA) have not been clarified yet, there is evidence that chemical mediators, released from the inflammatory cells triggered by airway cooling or drying, might be responsible for induction of bronchoconstriction. However, it has been controversial which chemical mediators or cells are involved in such process. Objectiye . The aim of this study was to evaluate the role of activated mast cells in the pathogenesis of EIA and find out whether or not sulfidopeptide leukotrienes (LTC4/d4/E4) are involved in the exercise-induced bronchoconstriction. MATERIAL AND METHOD: Eleven asthmatics with documented exercise-induced bronchoconstriction and 10 control subjects were studied. Before and 6 hours after free running for 6 minutes, forced expiratory volume in 1 second (FEV,) and the concentrations of N- methylhistamine, LTE4, and creatinine in unine collected for 6 hours after exercise were determined. RESULT: Urinary concentrations of N-methylhistamine(mean+SE, ng/mg creatinine) of EIA patients before and after exercise were 159+40 and 450+75, respectively. Those of control subjects were 208+ 54 and 275+ 62, respectively. Uninary N-methylhistamine levels of EIA group increased significantly after exercise, while those of control group did not change. Urinary concentrations of LTE,(mean+SE, pg/mg creatinine) of EIA patients before and after exercise were 15.6 k2.6 and 22.2+5.8, respectively. Those of control subjects were 10.4+ 4.0, 18.2 +7.0, respectively. The concentrations of LTE4 in the urine samples collected before exerise revealed no difference between EIA and control subjects (p=0.07). There was no change after exercise in both groups. Percent fall of FEV, was 29.1+8.0% (mean+SD) in EIA group and 3.4 + 4.0% in control group, respectively. There was no correlation between reduction of FEV, and change in urinary concentrations of N-methyl-histmine after exercise. CONCLUSTION: Chemical mediators of activated mast cells may be involved in exercise-induced bronchoconstriction, but there is little evidence for enhanced sulfidopeptide leukotriene generation as assessed by urinary LTE4.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Creatinine ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Leukotrienes ; Mast Cells ; Mouth ; Nasal Cavity ; Running

Eosinophilic gastroenteritis is an unusual disease characterized by eosinophilic infiltration of gastrointestinal tract, peripheral eosinophilia, and gastrointestinal symptoms. There are mucosal, muscular, and subserosal types, of which the subserosal type is the rarest. We experienced a 32-year old male patient with the subserosal type of eosinophilic gastroe-nteritis, who was presented with abdominal distension. The ascitic fluid revealed increased eosinophil count. With oral prednisolone, diarrhea and ascites rapidly disappeared and eosinophils in peripheral blood returned to normal. We report this case with a review of relevant literature.
Adult ; Ascites* ; Ascitic Fluid ; Diarrhea ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Male ; Prednisolone

BACKGROUND: It is known that HLA molecule can restrict specific IgE responses, but few studies have documented the association between HLA and sensitization to house dust mite(HDM). OBJECTIVE: To evaluate whether a specific HLA type can be a risk or protective factor for the development of HDM sensitivity. METHOD: Total 146 subjects were genotyped for HLA-DRB1 using PCR-SSP technique and HDM sensitivity, determined by skin prick test using two mite allergens, D. pteronyssinus (Dp) and D. farinae (Df). Subjects were grouped according to Dp or Df sensitivity and linkage analysis between HDM sensitivity and HLA-DRB1 genotype was performed. RESULTS: The data revealed higher allele frequencies of DRB1*07 in Dp or Df sensitive groups compared to insensitive groups (11.6% vs. 2.6% in Dp, 11.5% vs. 3.3% in Df group, p<0.05), but the other allele frequencies showed no difference. CONCLUSION: There was a significant association between HLA-DRB1*07 genotype and HDM sensitization. These results indicate that antigen presentation by HLA class II molecule restricts the development of specific IgE response to HDM.
Allergens ; Antigen Presentation ; Dust* ; Gene Frequency ; Genotype* ; HLA-DRB1 Chains* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Skin

Aortoenteric fistula is a rare but potentially fatal condition causing massive gastrointestinal bleeding. In particular, double primary aortoenteric fistulae are vanishingly rare. We encountered a 75-year-old male patient suffering from abdominal pain, hematochezia, hematemesis, and hypotension. His computed tomography images showed abdominal aortic aneurysm and suspected aortoenteric fistulae. During surgery, we found two primary aortoenteric fistulae. The one fistula was detected between the abdominal aorta and the third portion of the duodenum, and the other fistula was detected between the abdominal aorta and the sigmoid colon. We conducted the closure of the fistulae, the exclusion of the aneurysm, and axillo-bifemoral bypass with a polytetrafluoroethylene graft. The patient was discharged with no complications on the 21st postoperative day.
Abdominal Pain ; Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Colon, Sigmoid ; Duodenum ; Fistula ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage ; Humans ; Hypotension ; Male ; Polytetrafluoroethylene ; Stress, Psychological ; Transplants