Exercise-induced anaphylaxis can be associated with ingestion of a specific food. We experienced a case of exercise-induced anaphylaxis followed by ingestion of parsely. A 22- year old female patient was presented with angioedema of the face and chest tightness induced by running after ingestion of parsley within 15 minutes. She had suffered from allergic rhinitis. She had positive reactions to mugwort pollen and parsely extract on skin prick test in a dose dependent manner. Although the oral provocation test with parsely could not induce bronchoconstriction, we could diagnosed as parsely dependent exercise induced anaphylaxis based upon skin prick test and history.
Anaphylaxis ; Angioedema ; Artemisia ; Bronchoconstriction ; Eating ; Female ; Humans ; Petroselinum ; Pollen ; Rhinitis ; Running ; Skin ; Thorax

PURPOSE: Some studies report a role of leukotrienes in the pathogenesis of atopic dermatitis and suggest a rationale for the use of leukotriene receptor antagonist (LTRA) in the treatment of atopic dermatitis. This study aimed to evaluate the treatment effectiveness of montelukast in children with atopic dermatitis. METHODS: Fifty-four children between the ages of 2 and 6 years with moderate to severe atopic dermatitis were enrolled. Group A received montelukast for 8 weeks, followed by a crossover to 8 weeks of placebo after a 2-week washout period. Group B reversed the administration according to a randomized, double-blind, placebo-controlled, crossover design. The SCORing atopic dermatitis (SCORAD) index, urinary leukotriene E4 (LTE4), and eosinophil-derived neurotoxin (EDN) were assessed at every visit. RESULTS: Forty-three patients (21 males) completed the study. Although the SCORAD index was decreased in both groups, there was no statistically significant difference between montelukast and placebo (-3.0±11.2 vs -5.7±11.3, P=0.43). The level of urinary LTE4 was decreased after taking montelukast when compared to placebo, but there was no statistically significant difference (-65.9±556.2 vs 87.7±618.3, P=0.26). The changes in urinary EDN after taking montelukast and placebo had no significant difference (37.0±1,008.6 vs -195.8±916.7, P=0.10). When analyzing SCORAD indices, urinary LTE4, and EDN, we could not prove the effectiveness of montelukast in the atopic, non-atopic or high ECP (ECP ≥15 µg/L) subgroups. CONCLUSIONS: There was no statistically significant difference in clinical improvement or biomarkers between montelukast and placebo treatment. Therefore, conventional treatments with skin care and infection control might be more important strategies in the treatment of atopic dermatitis.
Biological Markers ; Child* ; Cross-Over Studies* ; Dermatitis, Atopic* ; Eosinophil-Derived Neurotoxin ; Humans ; Infection Control ; Leukotriene E4 ; Leukotrienes ; Receptors, Leukotriene ; Skin Care ; Treatment Outcome

OBJECTIVES: A stratified cross-over study was conducted to evaluate the effects of familiarity with computer on the performance of computerized neurobehavioral tests. Effects of keyboard type on the relationship between familiarity with computer and performance of computerized neurobehavioral tests were also examined. METHODS: We tested 70 persons classified into three groups according to degree of familiarity with computer: Group 1 was people with no computer competency, Group 2 had slight working experience on the computer, and Group 3 were highly competent and efficient on the computer. For each group, we executed 4 tests of the Korean version of the Swedish Performance Evaluation System (Simple Reaction Time, Addition, Symbol Digit, and Finger Tapping Speed). Three types of keyboard were applied for all three groups. Type 1 keyboard was a conventional layout with 106 keys. We removed the unused keys except for the 17 which were used in the test and remodeled the normal keyboard into Type 2 keyboard with 17 keys (10 numeric keys, 4 arrow keys, space bar, and both Ctrl keys). Type 3 keyboard with 11 keys consisted of 10 numeric keys and the space bar was newly developed for the computerized neurobehavioral performance test. RESULTS: It was found that Simple Reaction Time, Addition, and Finger Tapping Speed were not affected by familiarity with computer and type of keyboard. The mean reaction time of Symbol Digit adjusted by age and educational level with Type 1 keyboard was found to have significant difference among the three groups (F=3.347, p=0.041). The performance of Symbol Digit in Group 1 was found to be significantly lower than that in Group 2. The performances of Symbol Digit measured with Types 2 and 3 keyboards were not found to have significant differences among the three groups. In Groups 1 and 3, the performances of Symbol Digit measured with Type 1 keyboard were found to be significantly lower than those of other keyboards. CONCLUSIONS: According to the above results, Simple Reaction Time, Addition, and Finger Tapping Speed have high priority over other neurobehavioral tests for the workers having varying degrees of computer familiarity. It is also suggested that familiarity with computer and keyboard type needs to be considered in interpretation of the performance of Symbol Digit. We recommended executing the computerized neurobehavioral test with keyboards 2 or 3 to reduce the effect of computer familiarity.
Cross-Over Studies ; Fingers ; Humans ; Reaction Time ; Recognition (Psychology)*

Tricyclic antidepressant (TCA) is a useful drug for treating neuropathic pain. However, tremors are one of the relatively frequent side effects of TCA. A female patient, who was suffering from postherpetic neuralgia, was treated with amitriptyline starting with 10 mg/day. She developed resting tremors on the second day after increasing the dose to 30 mg/day. This case highlights the need for the careful use of amitriptyline in the treatment of neuropathic pain in elderly patients.
Aged ; Amitriptyline ; Female ; Humans ; Neuralgia ; Neuralgia, Postherpetic ; Tremor*

PURPOSE: Egg (egg white) allergies are among the most common food allergies in infants and young children. Serum egg white-specific IgE (sIgE) levels have been shown to be correlated with clinical symptoms, and the predictive decision point of sIgE levels has been proposed and used widely in the clinical setting. However, some patients whose sIgE levels to egg white are higher than the predictive decision point value show no clinical symptoms, and vice versa. This study was conducted to evaluate the clinical usefulness of sIgE antibodies to egg white and its components in the diagnosis of egg allergies. METHODS: Forty-one patients younger than 2 years of age with no experience of egg intake due to concerns regarding allergies or a non-specific clinical response to eggs were enrolled. Total IgE levels and the levels of IgE antibodies specific for egg white and its components (ovomucoid, ovalbumin, and conalbumin) were measured by ImmunoCAP testing. The clinical response of the subjects was confirmed by an open oral food challenge (OFC). RESULTS: Fifteen (71.4%) out of 21 patients in the egg white-sIgE > or =2 kU/L group showed a positive response, while 10 (50.0%) out of 20 patients in the egg white-sIgE <2 kU/L group showed a negative response to the OFC. There were no statistically significant differences in the levels of sIgE antibodies against egg white and its components between the positive and negative open OFC groups. In addition, there were no statistically significant differences in the levels of sIgE antibodies against egg white and its components based on an intra-group analysis. CONCLUSIONS: Our results show that the sensitivity and specificity of the predictive decision point values for egg white-sIgE antibodies by ImmunoCAP were relatively low in Korean children. In addition, no egg white component predicted the clinical reactivity of the subjects. We suggest that the predictive decision point value for a positive egg oral challenge test by ImmunoCAP should be re-evaluated. Moreover, we suggest that careful personal history recording and challenge tests are necessary for the correct diagnosis of an egg allergy.
Antibodies ; Child ; Egg Hypersensitivity ; Egg Proteins ; Egg White ; Eggs ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Ovalbumin ; Ovum

BACKGROUND: Carbapenem-resistant Acinetobacter spp. are being isolated with increasing frequency from clinical sources. This study was designed to determine the resistance mechanism to carbapenems of Acinetobacter spp. isolates from patients of a tertiary care hospital in Busan, Korea. METHODS: Nonduplicated clinical isolates of Acinetobacter spp. resistant to carbapenems were collected during the period of 2000-2001 in Kosin Medical Center, Busan, Korea. Antimicrobial susceptibilities were tested by disk diffusion method. Carbapenem-resistant Acinetobacter spp. isolates were examined for metallo-beta-lactamase-production by modified Hodge and EDTA-disk synergy tests. For the detection of blaIMP-1 and blaVIM-2 genes, polymerase chain reactions (PCR) were performed, and the DNA sequences of amplified products were determined by using dideoxy- chain termination method. RESULTS: Among 21 clinical isolates of Acinetobacter spp. intermediate or resistant to carbapenems, 17 isolates showed positive reactions in modified Hodge and EDTA-disk synergy tests. Nine isolates showed positive reaction in PCR for the detection of blaIMP-1 genes, and 8 isolates showed positive reaction in PCR for the detection of blaVIM-2 genes. Sequencing of amplified products showed that they were blaIMP-1 or blaVIM-2 genes. CONCLUSION: Acinetobacter spp. isolates with carbapenem-resistance are not uncommon in Kosin Medical Center, and most of the carbapenem-resistant isolates acquired resistance by production of IMP-1 or VIM-2 metallo-beta-lactamases. The spread of metallo-beta-lactamase genes could compromise the future usefulness of carbapenem for the treatment of gram-negative bacilli infections.
Acinetobacter* ; Base Sequence ; Busan ; Carbapenems ; Diffusion ; Genotype* ; Humans ; Korea ; Polymerase Chain Reaction ; Tertiary Healthcare

PURPOSE: Peroxynitrite plays a critical role in vascular pathophysiology by increasing arginase activity and decreasing endothelial nitric oxide synthase (eNOS) activity. Therefore, the aims of this study were to investigate whether arginase inhibition and L-arginine supplement could restore peroxynitrite-induced endothelial dysfunction and determine the involved mechanism. MATERIALS AND METHODS: Human umbilical vein endothelial cells (HUVECs) were treated with SIN-1, a peroxynitrite generator, and arginase activity, nitrite/nitrate production, and expression levels of proteins were measured. eNOS activation was evaluated via Western blot and dimer blot analysis. We also tested nitric oxide (NO) and reactive oxygen species (ROS) production and performed a vascular tension assay. RESULTS: SIN-1 treatment increased arginase activity in a time- and dose-dependent manner and reciprocally decreased nitrite/nitrate production that was prevented by peroxynitrite scavenger in HUVECs. Furthermore, SIN-1 induced an increase in the expression level of arginase I and II, though not in eNOS protein. The decreased eNOS phosphorylation at Ser1177 and the increased at Thr495 by SIN-1 were restored with arginase inhibitor and L-arginine. The changed eNOS phosphorylation was consistent in the stability of eNOS dimers. SIN-1 decreased NO production and increased ROS generation in the aortic endothelium, all of which was reversed by arginase inhibitor or L-arginine. N(G)-Nitro-L-arginine methyl ester (L-NAME) prevented SIN-1-induced ROS generation. In the vascular tension assay, SIN-1 enhanced vasoconstrictor responses to U46619 and attenuated vasorelaxant responses to acetylcholine that were reversed by arginase inhibition. CONCLUSION: These findings may explain the beneficial effect of arginase inhibition and L-arginine supplement on endothelial dysfunction under redox imbalance-dependent pathophysiological conditions.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Acetylcholine ; Arginase* ; Arginine ; Blotting, Western ; Endothelium ; Human Umbilical Vein Endothelial Cells ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase Type III* ; Oxidation-Reduction ; Peroxynitrous Acid ; Phosphorylation* ; Reactive Oxygen Species

The etiology of allergic diseases has been considered multi-factorial, comprising genetic, epigenetic, developmental, and environmental factors, as well as their complex interactions. The rising prevalence of allergic disease in recent decades could be explained by changes in environmental factors rather than genetic factors. Climate change has many significant impacts on aeroallergens such as pollen and mold. Therefore, climate changes are considered to be a key environmental factor affecting not only the prevalence but also the severity of allergic disease. In addition, these environmental factors might be more important for young children than for adults. While the concept that environmental factors including climate change would affect the characteristics of allergic disease is generally accepted, it is not enough to explain the mechanisms of the increase in the prevalence and severity of allergic diseases. Nevertheless, evidence exists that climate change has spurred changes in aeroallergens such as pollen and outdoor fungi, and that these changes are associated with the increased incidence of pediatric allergic disease.
Adult ; Child ; Climate ; Climate Change ; Epigenomics ; Fungi ; Humans ; Incidence ; Pollen ; Prevalence

BACKGROUND: In the last few decades, there has been a substantial increase in the population of aged people. Aging skin is a common concern for many people these days. OBJECTIVE: The purpose of this study was to evaluate the efficacy of cosmetics containing Ascidian tunic in reducing wrinkles. METHODS: Cream containing the Ascidian tunic was applied to right lateral epicanthal areas of 30 subjects for 8 weeks. As control group, a placebo which does not contain the Ascidian tunic was applied to the left lateral epicanthal areas of the subjects. Skin barrier function was evaluated and skin replicas were molded on both epicanthal areas every 4 weeks. The changes of the skin wrinkles were analyzed with skin visiometer. RESULTS: In comparison of the changes between groups treated with placebo and Ascidian tunic, there was statistically significant differences in hydration and sebum secretion. But there were no statistically significant differences in the result of R-value by visiometer. CONCLUSION: The treatment of Ascidian tunic extract seems to be partially effective in improving wrinkles, but further study is required.
Aged ; Aging ; Cosmetics ; Fungi ; Humans ; Sebum ; Skin ; Urochordata

In Korea, careinoma of the cervix is the most common malignancy in women annually affecting 25 per every 100,000 female. The widespread use of the Papanicolaou smear has resulted in earlier detection of the tumor and a reduction in the number of patients with advanced disease, but the incidence of cervix. carcinoma is still the fifth most common malignancy in the world. Cervical carcinoma spreads to the small bowel primarily by direct extension from involved lymph nodes, most commonly from peraaortic or mesenteric nodes to the serosa of the bowel. But, the involvement of small bowel by cervical carcinoma is so rare, and shows a maximum incidence of small bowel involvement of less than 1.5%. We report a patient with squamous cell carcinoma of the cervix metastases to the second portion of the duodenum in whom the diagnosis was made by endoscopic biopsy of the lesion.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Duodenum* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Papanicolaou Test ; Serous Membrane ; Stomach*