BACKGROUND AND OBJECTIVE: Auro Dex(R) Visual ENS(TM) allergy screening test is a simplified and newly developed method for the detection of allergen-specific IgE in human serum. This system has advantages in several ways compared to the Pharmacia CAP system, such as the need for relatively small amounts of serum, no expensive equipment and rapid detection. The purpose of this study is to evaluate the efficiency of Auro Dex(R) Visual ENS(TM) screening test for the detection of specific IgE compared to the Pharmacia CAP system in atopic patients. METHOD: In 27 atopic patients (M:F = 11:16, age:13-51 years, average 27.9+/-10.2 years) who had positive response on skin prick test, the Pharmacia CAP system for the sensitized allergen and Auro Dex(R) Visual ENS(TM) screening test were performed. For comparison, 5 normal subjects who had negative response on skin prick test were tested for 5 allergens(Dermatophagoides(D) farinae, D. pteronyssinus, cockroach, dog epithelium, cat epithelium) by the Pharmacia CAP system and Auro Dex(R) Visual ENS(TM) screening test. RESULTS: Using skin prick test results as the reference standards, the sensitivity of the Pharmacia CAP system and Auro Dex(R) Visual ENS(TM) screening test was 87.5%, 57.1%, respectively. The specificity of Pharmacia CAP system and Auro Dex(R) Visual ENS(TM) screening test were 100%. There was a significant correlation between the Auro Dex(R) Visual ENS(TM) and CAP system (D.f. r=0.755, D.p. r=0.856) for D. farinae and D.pteronyssinus. CONCLUSION: Auro Dex(R) Visual ENS(TM) screening test showed high specificity for detection of allergen-specific IgE and good correlation with the Pharmacia CAP system. This system may be useful in general practice. However, due to relatively low sensitivity to some antigens compared to skin prick test, further development may be necessary.
Animals ; Cats ; Cockroaches ; Dogs ; Epithelium ; General Practice ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Mass Screening* ; Sensitivity and Specificity ; Skin

The complications of the treatment of penile lesion are wide ranging, urethrocutaneous fistula being one of the less common. This complication affects the ventral aspect of the penis. We present a rare case of urethrocutaneous fistula after vaporization of penile lesion by CO2 Laser. One fistula was at ventral aspect of the penis. A 43-year-old male presented with passage of urine from one opening. He had undergone a vaporization by CO2 laser, 2 times. Urethrocutaneous fistula repairs was performed with biopsy of the edge of fistula site. Squamous cell carcinoma was confirmed. He subsequently underwent a partial penectomy. It is very important that biopsy was performed before vaporization of even small size skin lesion. This case is reported along with a brief review of the literature.
Adult ; Biopsy ; Carcinoma, Squamous Cell ; Cutaneous Fistula ; Fistula ; Humans ; Lasers, Gas ; Male ; Penile Diseases ; Penis ; Skin ; Volatilization

BACKGROUND: Asthma is a chronic inflammatory disease of the bronchial mucosa and is associated with excess production of Th2 cytokines (IL-4, IL-5) relative to Th1 cytokine (IFN-V). The NK cell and TNK cell are supposed to be involved in the pathogenesis of allergic inflammation by cytokine regulation. OBJECTIVES: The aim of this study was to investigate the effect of allergen (Der p 2) on the production of IFN-V by CD3+T cell, CD56+NK cell and CD3+CD56+TNK cells in patients with mild persistent asthma. METHOD: Peripheral blood mononuclear cells (PBMCs) from patients with mild persistent asthma (n=12) who were sensitive to dust mite, were cultured with or without Der p 2 for 3 days, and phorbol ester plus calcium ionophore and intracellular protein transport inhibitor were added 4 hours before staining. A three-color flow cytometric analysis was done to detect intracytoplasmic IFN-V, surface DC3 and CD56 antigen simultaneously. RESULTS: When PBMCs were cultured only in media, there were no significant differences in the percentage of IFN-V positive CD3+T cell, CD56+NK cell and CD3+CD56+TNK cells between asthmatic patients and normal subjects. However, there were significant decreases in the percent change of IFN-V positive CD3+T cell, CD56+NK cell and CD3+CD56+TNK cell in asthmatic patients comparde to normal subjects after stimulation of PBMCs with Der p 2. CONCLUSION: This study suggests that NK cell and TNK cell may participate in allergic reaction by IFN-V regulation.
Antigens, CD56 ; Asthma* ; Calcium ; Cytokines ; Dust ; Humans ; Hypersensitivity ; Inflammation ; Interferons* ; Killer Cells, Natural ; Mites ; Mucous Membrane ; Protein Transport

BACKGROUND: Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy. Some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. METHODS: We reviewed the patients' charts retrospectively and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. RESULTS: Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). CONCLUSION: Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.
Diagnosis, Differential ; Pneumoconiosis

Acetaminophen is a world-wide used analgesic and anti-pyretic drug with less anti-in-flammatory effect, available without prescription in most countries. Allergic-like reactions to this drug, including urticaria, angioedema, and anaphylactic reactions have only rarely been reported. This report describes a systemic reaction to acetaminophen documented by oral provocation test in a 30-year-old female patient with a history of anaphylaxis associated with acetaminophen use, in a subject who tolerated aspirin. After an oral challenge with 108.3 mg of acetaminophen, the subject had itching sensation of tongue. With a dose of 162.5 mg (cumulative dose 270.8 mg) acetaminophen, systemic urticaria and rash developed. Also, hand and facial angioedema and chest tightness were noted. Significant change of FEV1 was not noted. But, this patient has bronchial hyperresponsiveness. A rare acute hypersensitivity reaction to acetaminophen without aspirin sensitivity is described in this study. The results of study suggest an other mechanism rather than inhibition of cyclooxygenase as responsible.
Acetaminophen* ; Adult ; Anaphylaxis* ; Angioedema ; Aspirin* ; Drug Hypersensitivity ; Exanthema ; Female ; Hand ; Humans ; Hypersensitivity ; Prescriptions ; Prostaglandin-Endoperoxide Synthases ; Pruritus ; Sensation ; Thorax ; Tongue ; Urticaria

We describe a case of Streptococcus pyogenes pneumonia in a 63-year-old man presenting with rhabdomyolysis and acute renal failure. The patient completely recovered following treatment with mechanical ventilation, continuous venovenous hemodiafiltration, and intravenous antimicrobial agents.
Acute Kidney Injury ; Anti-Infective Agents ; Hemodiafiltration ; Humans ; Middle Aged ; Pneumonia* ; Respiration, Artificial ; Rhabdomyolysis* ; Streptococcus pyogenes* ; Streptococcus*

BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Acute Kidney Injury ; Chungcheongnam-do ; Doxycycline ; Female ; Fever ; Gangwon-do* ; Humans ; Hypoalbuminemia ; Incidence ; Korea ; Leukocytosis ; Male ; Medical Records ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Scrub Typhus* ; Shock ; Thrombocytopenia ; Ventilators, Mechanical

We describe a case of Streptococcus pyogenes pneumonia in a 63-year-old man presenting with rhabdomyolysis and acute renal failure. The patient completely recovered following treatment with mechanical ventilation, continuous venovenous hemodiafiltration, and intravenous antimicrobial agents.
Acute Kidney Injury ; Anti-Infective Agents ; Hemodiafiltration ; Humans ; Middle Aged ; Pneumonia* ; Respiration, Artificial ; Rhabdomyolysis* ; Streptococcus pyogenes* ; Streptococcus*

BACKGROUND: Although the incidence of tsutsugamushi disease has been increasing in Korea, epidemiological and clinical characteristics of tsutsugamushi disease in Young?dong province have not been reported. METHODS: We retrospectively reviewed the medical records of 46 patients of tsutsugamushi disease who admitted at Gangneung Asan hospital from 1997 to 2001. RESULTS: Incidence of tsutsugamushi disease in Young-dong province had been increasing since 1999. Most patients were infected during agricultural work. The incidence of women was higher than that of men (65.2%). Characteristic laboratory finding was elevation of AST and ALT, hypoalbuminemia and thrombocytopenia. Despite fever, leukocytosis was found only in 20% of patients. Course of disease was relatively good in most patients, but complications such as pneumonia, acute renal failure, and shock developed in 26% of patients. In one case with acute renal failure and another case with pneumonia, the patients' condition aggravated in spite of doxycycline therapy, thus, hemodialysis and mechanical ventilator care were done respectively. Consequently, both patients recovered completely without chronic complication. Old age (>65 years), longer duration from onset of symptoms to admission (>10 days), hypoalbuminemia at admission(<2.6 g/dL) and leukocytosis could be used as a marker for prediction of complications. CONCLUSION: Incidence of tsutsugamushi disease increased in Young?dong region. Old age, delayed admission, hypoalbuminemia and leukocytosis could be used as marker for prediction of complications.
Acute Kidney Injury ; Chungcheongnam-do ; Doxycycline ; Female ; Fever ; Gangwon-do* ; Humans ; Hypoalbuminemia ; Incidence ; Korea ; Leukocytosis ; Male ; Medical Records ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Scrub Typhus* ; Shock ; Thrombocytopenia ; Ventilators, Mechanical

Vitamin C, one of essential micronutrients, has been reported to modulate the humoral immune responses in some mammals. We investigated whether vitamin C might modulate this response in mice by directly affecting B cells. Splenic B cells were isolated and activated by CD40- and B cell receptor-ligation in vitro. The cells were cultured with a pretreatment of vitamin C from 0 to 1 mM of concentrations. Vitamin C slightly increased apoptosis of B cells dose-dependently and behaved as an antioxidant. We found that in vivo administration of vitamin C by intraperitoneal injection affected isotype switching as previously reported: the titer of antigen-specific IgG1 antibody was decreased, while that of IgG2a was unaffected. Somewhat different from those observed in vivo, in vitro exposure to vitamin C slightly decreased isotype switching to IgG1 and increased isotype switching to IgG2a. Pretreatment with vitamin C in the safe range did not affect either proliferation of cultured B cells or the expression of CD80 and CD86 in those cells. Taken together, in vivo results suggest that vitamin C acts to modulate isotype switching in the mouse. However, because of our in vitro results, we suggest that the modulation exerted by vitamin C in vivo is by indirectly affecting B cells, perhaps by directly influencing other immune cells such as dendritic cells.
Animals ; Apoptosis ; Ascorbic Acid ; B-Lymphocytes ; Dendritic Cells ; Immunity, Humoral ; Immunoglobulin Class Switching ; Immunoglobulin G ; Injections, Intraperitoneal ; Mammals ; Mice ; Micronutrients ; Reactive Oxygen Species ; Vitamins