OBJECTIVES: There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS: Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS: Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION: Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.
Breast Feeding ; Cesarean Section ; Child ; Cohort Studies ; Delivery, Obstetric ; Female ; Humans ; Odds Ratio ; Pregnancy ; Prevalence ; Rhinitis ; Rhinitis, Allergic

BACKGROUND AND OBJECTIVES: The skin prick test is a widely used test that uses three methods (allergen/histamine ratio method, erythema size method, and wheal size method) to interpret the results. However, there has been no comparison of these methods. The aim of this study is to compare the three different interpretation methods and define the relationship among them. SUBJECTS AND METHOD: A total of 139 patients who visited our allergy clinic complaining of nasal symptoms were enrolled. Three interpretation methods were used for defining positivity in the skin prick test, and their results were compared. The validity of each interpretation method was evaluated by total nasal symptom score. RESULTS: Positivity in the skin prick test was reported in 48.2% of patients according to the allergen/histamine ratio method and in 64.0% of patients according to the wheal size method and erythema size method. The proportion of subjects who showed a negative result with the allergen/histamine ratio method but positive results with the wheal size method or erythema size method was 15.8%. This group had a significantly higher total nasal symptom score, especially rhinorrhea and nasal obstruction, than subjects who showed negative results on all three methods. CONCLUSION: When diagnosing allergic rhinitis patients using the skin prick test, the wheal size method and erythema size method should be considered rather than the allergen/histamine ratio method.
Diagnosis ; Erythema ; Humans ; Hypersensitivity ; Methods* ; Nasal Obstruction ; Rhinitis, Allergic ; Skin Tests* ; Skin*

The incidence of human immunodeficiency virus (HIV) infections continue to increase throughout the world. Although neurologic complications are frequent in individuals with HIV infection or acquired immunodeficiency syndrome (AIDS), vestibulocochlear neuritis is still a relatively rare manifestation. We report the first case of vestibulocochlear neuritis occurring in an AIDS patient in Korea.
Acquired Immunodeficiency Syndrome* ; Hearing Loss ; HIV ; HIV Infections ; Humans ; Incidence ; Korea* ; Neuritis* ; Vestibulocochlear Nerve Diseases

BACKGROUND AND PURPOSE: The coexistence of carotid atherosclerosis in ischemic stroke patients with small-vessel disease (SVD) or intracranial large-vessel disease (ICLVD) was investigated using carotid duplex ultrasonography, and whether its coexistence affected the clinical prognosis was determined. METHODS: Ischemic stroke patients with SVD or ICLVD were enrolled (n=103). Risk factors, demographic data, and National Institutes of Health Stroke Scale (NIHSS) scores were obtained for all of the subjects. Early neurological progression was defined by an increase in NIHSS score during the first 7 days. Carotid ultrasonography was performed to measure the intima-media thickness (IMT) and carotid plaques. RESULTS: Among the 103 patients who were retrospectively enrolled in this study (56 with SVD and 47 with ICLVD), 66 (64.1%) had an atherosclerotic plaque and 23 (22.3%) had increased IMT. Increased IMT was observed more frequently in ICLVD than in SVD [15/47 (31.9%) vs. 8/56 (14.3%), p=0.032]. An atherosclerotic plaque was observed on subsequent carotid ultrasonographic examination in 28 (50%) of the 56 patients whose computed tomography angiography scans of the neck vessels were interpreted as normal. There was no association between presence of atherosclerotic change and early neurologic progression (p=0.94). CONCLUSIONS: A coexisting atherosclerotic plaque or increased IMT was observed in 71.8% of patients with SVD or ICLVD. Whether the coexistence of carotid atherosclerotic change with either of these conditions affects the clinical prognosis remains to be elucidated.
Angiography ; Atherosclerosis ; Carotid Artery Diseases ; Humans ; National Institutes of Health (U.S.) ; Neck ; Plaque, Atherosclerotic ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke

Systemic sclerosis is an autoimmune disease characterized by progressive fibrosis of the skin and visceral organs. Myasthenia gravis is also an autoimmune disease characterized by weakness and fatigue of skeletal muscles. The symptoms of systemic sclerosis and myasthenia gravis overlap clinically, so the recognition of disease co-occurrence may be delayed. Co-occurrence of myasthenia gravis and systemic sclerosis is very uncommon and usually diagnosed after use of D-penicillamine for treating the systemic sclerosis. We report a case of a 49-year-old female patient who complained of general weakness and was diagnosed with myasthenia gravis. Four months earlier she was diagnosed with systemic sclerosis with Sjogren's syndrome and her medications did not include D-penicillamine.
Autoimmune Diseases ; Fatigue ; Female ; Fibrosis ; Humans ; Middle Aged ; Muscle, Skeletal ; Myasthenia Gravis ; Penicillamine ; Scleroderma, Systemic ; Sjogren's Syndrome ; Skin

PURPOSE: Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. METHODS: Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. RESULTS: The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). CONCLUSION: Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.
Asthma ; Caregivers ; Child ; Consensus ; Fathers ; Humans ; Korea ; Mothers ; Motor Activity

BACKGROUND AND OBJECTIVES: Postnasal drip is a common presentation to the medical practitioner. It is a result of disturbance to the normal drainage or an increase in secretion of the paranasal sinuses. However, sometimes no underlying cause can be found and the patient has to be reassured, and that they may just have to live with it. The aim of this study is to evaluate the clinical manifestations of patients with postnasal drip. MATERIAL AND METHOD: There were 90 patients complaining with postnasal drip. We performed a prospective study about accompanying symptoms and physical and psychiatric evaluation. CONCLUSION: Postnasal drip is more common in females over 30 years and the duration of symptoms is usually long. Anatomical nasal abnormality and sinusitis are common. There is no correlation with postnasal drip and psychiatric problems. But several items are concerned with postnasal drip. So we need detailed history taking and physical examination on patients who complained of postnasal drip.
Drainage ; Female ; Humans ; Paranasal Sinuses ; Physical Examination ; Prospective Studies ; Sinusitis

BACKGROUND AND OBJECTIVES: Food restriction increases life span, reduces aging rate and affects a wide variety of biological functions. Neurotransmitter is a substance released from the axon terminal of a presynaptic neuron on excitation, which diffuses across the synaptic cleft to either excite or inhibit the target cell. The nervous system makes use of neurotransmitters for signaling. We investigated the change of immunoreactivity of neuropeptides in olfactory bulb of rat after food restriction. MATERIALS AND METHOD: Of 10-week old Sprague-Dawley rats used in this study. six rats were killed at the beginning of the experiment. Thirty rats which had been restricted to only half of their normal voluntary mean food intake (12 g instead of 24 g per day) were killed at 3 days, 1, 2, 4 and 9 weeks after food restriction (n=6 per time point). Olfactory bulbs of the rats were cut into 40 micrometer-thick coronal sections and immunostained. RESULTS: On the layers of glomerular, outer plexiform, granular cell and subependymal zone of olfactory bulb, immunoreactivities of cholecystokinin (CCK), tyrosine hydrolase (TH), and neuropeptide-Y (NPY) were increased at one week of food restriction. On all layers, immunoreactivities of CCK and TH were increased at 2 weeks of food restriction. However, immunoreactivity of NPY was increased on the only layers of glomerular, and granular cell of olfactory bulb at week 2. After 4th week, the immunoreactivity of NPY was the same as the control group; after 9th week, the mmunoreactivity of CCK and TH were the same as the control group. CONCLUSION: Our results demonstrated that CCK, TH, and NPY could be expressed in different manners on the layers of olfactory bulb of rat after food restriction, and that food restriction may improve olfactory sensitivity owing to the change of neuropeptides.
Aging ; Animals ; Cholecystokinin ; Eating ; Nervous System ; Neurons ; Neuropeptides* ; Neurotransmitter Agents ; Olfactory Bulb* ; Presynaptic Terminals ; Rats* ; Rats, Sprague-Dawley ; Tyrosine

OBJECTIVE: This study was to establish the human embryonic stem (ES) cells derived from frozenthawed blastocyst stage embryo that were destined to be discarded after five years in routine human IVF-ET program. METHODS: Frozen-thawed and survived human blastocysts were treated by immunosurgery, and recovered ICM cells were cultured onto STO feeder cell layer and ICM colony was subcultured by mechanical dissociation into clumps. To identify ES cell, alkaline phosphatase staining and expression of Oct4 in replated ICM colonies were examined. Also, to examine the possibility of ES cell differentiation, retinoic acid (RA), basic fibroblast growth factor (b-FGF), nerve growth factor (NGF) were added in culture medium. In addition, to classify the specific cell type, differentiated cells were stained by indirect immunocytochemistry. RESULTS: One ICM colony recovered from frozen-thawed six blastocysts was subcultured, continuously replated during 40 passage culture duration without differentiation. Subcultured colonies were strong positively stained by alkaline phophatase. When the expression of Oct4 in cultured ES colony was examined, Oct4b type is more clearly indicated than Oct4a one although there was not detected in embryoid body or differentiated cells. In differentiated cardiomyocytes from ES colony, cells were beaten regularly (60 times/min). In differentiated neural cells from ES colony, neurofilament (NF) 200 kDa protein, microtubule associated protein (MAP) 2 and beta-tubulin of specific marker in neurons, glial fibrillary acidic protein (GFAP) of specific marker in astrocytes and galactocelebrocide (GalC) of specific marker in oligodendrocytes were confirmed by indirect immunocytochemistry. Also, muscle cells were detected by indirect immunocytochemistry. In addition, ES colonies can be successfully cryopreserved. CONCLUSION: This study suggested that establishment of human ES cells can be successfully derived from frozen-thawed blastocysts that were destined to be discarded, and obtained specific cell types (cardiomyocytes, neurons and muscle cells) through the in vitro differentiation procedures of ES cells.
Humans

Rhinocerebral mucormycosis, a rare opportunistic invasive fungal infection, is known to be fatal and aggressive. It is characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit, and the brain. This disease is most often associated with diabetic ketosis but can be seen with uremic acidisis, leukemia, malnutrition, AIDS, steroid, antimetabolic or antibiotic therapy, severe burn, septicemia, and treatment with immunosuppressive medications. Early clinical recognition of this potentially fatal disease is essential before irreversible changes occur. We report in this study about a 40-year-old man with poorly controlled diabetes mellitus who developed mucormycosis which involved unilateral paranasal sinus, orbit, and selective cranial nerves (especially, hypoglossal nerve). Despite of treatment he died from an abruptly developed acute respiratory distress syndrome that might be caused by mucormycotic hematogenous dissemination 33 days after admission.
Adult ; Brain ; Burns ; Cranial Nerve Diseases* ; Cranial Nerves* ; Diabetes Mellitus ; Diabetic Ketoacidosis ; Humans ; Hypoglossal Nerve ; Leukemia ; Malnutrition ; Mucormycosis* ; Nose ; Orbit ; Paranasal Sinuses ; Respiratory Distress Syndrome, Adult ; Sepsis