House dust mites, Dermatophagoides farinae and Dermatophagoides pteronyssius have been identified as the main sources of house dust allergen and are considersed the most important causative allergen in the ethology of allergic respiaratory disease and allergic rhinitis. To evaluate the incidence of positive skin reactivity to house dust mites and relationship between total serum IgE levels and specific IgE antibody to house dust mites, we performed allergic skin test (scratch) in 182 children with allergic respiatory disease and atopic dermatitis. We also checked serum total IgE by PRIST method and specific IgE antibody to D. farinae and D. pteronyssinus by ELISA. Our results showed that positive skin reaction was observed in 79% of patients in D. farinae, 71% in D. pternyssinus. There was a significant correlation between serum total IgE and IgE antibody specific to D. farinae (r=0.55, p<0.001). Serum total IgE and specific IgE antibody to D. petronyssinus had no significant correlation (r=0.39, p<0.001). D. farinae and D. pteronyssinus had close correlation in the skin test (r=0.82, p<0.0001) and relative concentration of specific IgE antibody (r=0.73, p<0.0001). The agreement between skin reaction and relative concentration of specific IgE to House dust mites was 68% in D. farinae and 63% in D.pteronyssinus.
Child* ; Dermatitis, Atopic ; Dermatophagoides farinae ; Dust* ; Enzyme-Linked Immunosorbent Assay* ; Ethology ; Humans ; Immunoglobulin E* ; Incidence ; Pyroglyphidae* ; Rhinitis ; Skin Tests ; Skin*

BACKGROUND: The abnormal barrier function in atopic dermatitis(AD) is caused by a reduction in the amounts of ceramides in the intercellular lipids in the stratum corneum(SC). Replenishing the SC via the topical application of ceramides and pseudoceramides leads to effective recovery of the barrier function of skin. OBJECTIVES: An open clinical crossover evaluation was conducted to investigate the effects in AD of a multi-lamellar emulsion(MLE) that contained pseudoceramide(PC-9s). METHODS: The study group included 30 AD patiendaverage age: 4.4 yr, range: 1-8 yr), who applied MLE or a commercial moisturizing cream(CMC, 5% urea) alternately for four weeks each. We divided the subjects into two subgroups and started with different treatments in each subgroup. Treatment efficacy was evaluated using the average subjective satisfaction scores for each symptom and the global clinical response. In addition, the SCORAD(Scoring AD) index was adopted to evaluate the severity of AD as objectively as possible. The patients were evaluated using this index every other week. RESULTS: Although the SCORAD improved in both subgroups, the patients had better results (p<0.05) when applying MLE(31-35% decrease) than CMC(13% increase to 14% decrease). The subjective satisfaction scores of the symptoms and signs of patients, including itching, erythema, and dry skin, were higher in the MLE group than in the CMC group, and the global response to treatment was also better in the MLE group. During the follow-up period, AD improved in all patients. MLE was more effective than CMC in our patients. CONCLUSIONS: The topical application of a multi-lamellar emulsion containing pseudoceramide is an effective regimen for improving symptoms of AD.
Ceramides ; Cross-Over Studies* ; Dermatitis, Atopic* ; Erythema ; Follow-Up Studies ; Humans ; Pruritus ; Skin ; Treatment Outcome

No abstract available.
Humans ; T-Lymphocytes*

Massive fetomaternal hemorrhage is major cause of neonatal anemia. And neonatal anemia is fatal disease of high mortality rate. Massive fetomaternal hemorrhage is defined as hemorrhage of fetal blood above 150 mL in the maternal circulation. Massive fetomaternal hemorrhage is infrequent but represents a fatal cause of perinatal death. To identify fetal blood in the maternal circulation, Kleihauer-Betke test or flow cytometry has been usually used. But recently HPLC (high performance liquid chromatography) is used in the detection and quantification of fetomaternal transfusion. In fetomaternal transfusion, anemic newborn must be treated when circulatory failure is present. Circulatory failure often necessitates blood transfusion. We report two cases of severe anemia due to massive fetomaternal hemorrhage in full term baby. Each case was diagnosed by high performance lipuid chromatography and treated with exchange transfusion in order to avoid fluid overload and subsequent heart failure.
Anemia ; Anemia, Neonatal ; Blood Transfusion ; Chromatography ; Chromatography, High Pressure Liquid ; Female ; Fetal Blood ; Fetomaternal Transfusion ; Flow Cytometry ; Heart Failure ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Shock

BACKGROUND AND OBJECTIVE: Buckwheat is considered one of the most important food allergens in Korea. Although a very small amount is ingested or inhaled, it can cause serious allergic reactions. However, the major allergens of buckwheat still remain to be elucidated. The aim of our study was to identify and characterize the major allergen of buckwheat seed. MATERIAL AND METHOD: Dialysis membrane with a cut-off MW 1kD was used for the preparation of crude buckwheat seed allergen extract. SDS-PAGE under reducing conditions and IgE immunoblotting were performed using sera from 15 buckwheat sensitive subjects. Isoelectric focusing and lectin blotting assay were done. RESULT: Western blot analysis showed more than 15 IgE-reactive buckwheat proteins. Among them, a 24kD protein was shown to be the most frequently bound to sera from allergic subjects (54%). Isoelectric point of 24kD protein was around 5.9. In lectin blotting assay, 24kD protein did not bind to Con A nor five other lectins. CONCLUSION: A 24kD protein was the most frequently recognized allergenic component in buckwheat seed. Isoelectric point was around 5.9. Glycosylation was not detected in 24kD of buckwheat protein.
Allergens ; Blotting, Western ; Dialysis ; Electrophoresis, Polyacrylamide Gel ; Fagopyrum* ; Glycosylation ; Hypersensitivity ; Immunoblotting ; Immunoglobulin E ; Isoelectric Focusing ; Isoelectric Point ; Korea ; Lectins ; Membranes

Primary cutaneous CD30(Ki-1) positive anaplastic large cell lymphoma(ALCL) is a rare subset of cutaneous lymphoma, with a much better prognosis. ALCL is a heterogeneous process that may have a T-cell, B-cell, or indeterminant(null) phenotype and which may or may not express the anaplastic lymphoma kinase(ALK) oncoprotein. We report a case of ALCL in a 72 year old man. About 4 months ago, multiple erythematous firm ulcerative mass and satellite nodules developed on the right lower leg. The skin lesions rapidly increased in number and size. Some lesions became painful and centrally ulcered. The histologic findings showed a diffuse infiltrate of large lymphocytes with large nuclei, prominent and multiple nucleoli, and ample cytoplasm. Immunohistochemical stainings for CD30, CD5 were positive but stainings for LCA, CD3, CD45RO, CD20, cytokeratin, EMA, and ALK were negative. Therefore, we diagnosed our case as CD 30+/ALK- ALCL.
Aged ; B-Lymphocytes ; Cytoplasm ; Humans ; Keratins ; Leg ; Lymphocytes ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic* ; Phenotype ; Prognosis ; Skin ; T-Lymphocytes ; Ulcer

Subcutaneous panniculitic T-cell lymphoma(SPTCL) is categorized as a rare subtype of peripheral T-cell lymphoma. It is characterized by primary involvement of the subcutaneous fat in a manner mimicking panniculitis with/without hemophagocytic syndrome. They share a generally aggressive course and are highly associated with Epstein-Barr virus infection. EBV infection plays an important role in the tumorigenesis and may be related to cutaneous lymphoma with hemophagocytic manifestations. We have seen a patient, a 67-year-old woman with tender erythematous nodules on both upper extremities and abdomen. With time, the skin lesion showed ulcerative change on her right thigh. She has also suffered from fever, weight loss, arthralgia, and general weakness without hepatosplenomegaly or lymphadenopathy for 4 months. During the admission, she complained of nausea, vomiting and dysarthria. On the MRI examination, we found a multi-focal solid lesion on her brain. The histopathological findings of the biopsy from her abdominal skin lesion showed a septal and lobular, histiocytic panniculitis with bean bag cells and atypical lymphoid cells identified as NK like T-cells and also dense diffuse infiltrates localized in the lower dermis and subcutaneous tissue, with minimal epidermal and upper dermal infiltrates without destructive change of blood vessels. The infiltrating atypical lymphoid cells expressed the phenotype of LCA, CD45RO, CD3, CD8, CD56 and also positive for EBV by in situ hybridization. Our case showed a clonal TCR gamma gene rearrangement by polymerase chain reaction. She was subjected to a course of treatment(cyclophosphamide, vincristine, prednisolone and radiation therapy) under the diagnosis of SPTCL. but died of sepsis due to urinary tract infections after 2 months.
Abdomen ; Aged ; Arthralgia ; Biopsy ; Blood Vessels ; Brain ; Carcinogenesis ; Central Nervous System* ; Dermis ; Diagnosis ; Dysarthria ; Epstein-Barr Virus Infections ; Female ; Fever ; Genes, T-Cell Receptor gamma ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Lymphatic Diseases ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Peripheral ; Magnetic Resonance Imaging ; Nausea ; Panniculitis ; Phenotype ; Polymerase Chain Reaction ; Prednisolone ; Sepsis ; Skin* ; Subcutaneous Fat ; Subcutaneous Tissue ; T-Lymphocytes* ; Thigh ; Ulcer ; Upper Extremity ; Urinary Tract Infections ; Vincristine ; Vomiting ; Weight Loss

BACKGROUND: Even though the cause of atopic dermatitis is still unknown, it is considered an allergic reaction whose onset is frequently and strongly associated with both hereditary and environmental factors. The multiple allergosorbent test-chemiluminescent assay(MAST-CLA) is a new assay for serum allergen-specific IgE, and allows up to 35 allergens to be tested simultaneously. Furthermore, the MAST-CLA has shown good sensitivity, specificity, and a correlation with the RAST and skin prick test. OBJECTIVE: The purpose of this study was to find total IgE and allergen-specific IgE and to evaluate the correlations between clinical status and abnormal immunologic findings in MAST-CLA on atopic dermatitis patients. METHODS: Our study was designed by analyzing outpatients with atopic dermatitis via physical examination, questionnaires and the MAST-CLA with a total IgE and 35 allergen-specific IgE in 100 patients. RESULTS: The results were as follows; 1. Among the subjects(mean age=11.6 years, mean age of onset=28.7 months olds), 87% of patients showed elevated serum total IgE levels(more than class level 2) and 72% revealed at least more than one allergen-specific IgE by MAST-CLA. 2. The positive allergens rate, in descending order, were D. farinae 58%, D. pteronyssynus 54%, house dust 43%(aeroallergens), egg white 31%, milk 30%, and crab 22%(food allergens). 3. Good correlation was obtained between total IgE levels and number of positive allergen-specific IgE in MAST-CLA, with 0.497 correlation coefficient(p<0.05). The relationship between the clinical severity(SCORAD scores) and total IgE and allergen-specific IgE did not show statistical significance. 4. While age was significantly increased to positive of total IgE, over 12 year-old group was the highest(100%)(p<0.05). The highest rate of positive allergen-specific IgE was shown in the 7-12 year-old group(9.2+/-9.6), the difference of other groups was statistically significant(p<0.05). The relation of clinical status and result of MAST-CLA did not show statistical significancy but also correlation coefficient was low. 5. The 0-2 year-old group showed only food allergens and no aeroallergens, the positive rate of aeroallergens were 3-6 year-old group 80.2%, 7-12 years group 63.5%, over 12 years old group 73.7%. 6. Both total IgE level and allergen-specific IgE were significantly increased in patient groups with atopic personal history(p<0.05). But, there was not a significant difference in patient groups with or without family history. Also, the relationship among the clinical status, total IgE level, and number of positive allergen-specific IgE in patient groups with or without atopic personal or family history did not show significant difference(p>0.05). CONCLUSION: Our data suggested that MAST-CLA is a sensible and useful method to investigate the causative allergen-specific IgE and to evaluate in patients with atopic dermatitis with additional benefit of a non-isotopic technique and therefore not very expensive
Allergens ; Child ; Dermatitis, Atopic* ; Dust ; Egg White ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Milk ; Outpatients ; Physical Examination ; Sensitivity and Specificity ; Skin ; Surveys and Questionnaires

Using IC cards with powerful information processing capabilities, high level of security, and multi media capabilities to create health IC cards has the following merits: comprehensive management of individual medical information, highly secure access to information that may be stored in separate location and/or institutes, increasing the compatability of difference used by various institutes. In this research ,we have categorized the information stored in the health IC card into the following main categories: basic personal information, emergency medical information, medical informatics, nursing information, welfare information. This was based on international ISO standards and specifics of Japan and south eastern Asia. These main categories are further divided into sub-categories and care was taken to ensure that the format of each sub-category is compatible with international standards while being suitable for Koran conditions of actual use. So, these categories conform to international standards and we will continue our efforts update the international standard to include additional categories needed in Korea and update the Korea standard to conform more closely with the international standards.
Academies and Institutes ; Access to Information ; Automatic Data Processing ; Emergencies ; Far East ; Humans ; Japan ; Korea ; Medical Informatics ; Nursing

Recent developments in computer and communication technology were studied in relation to medical information network systems, using computers and IC cards, to solve problems in community health. Trial use of health IC card systems for personal health data management are already in existence in some countries. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. Emergency medical information card systems that take advantage of advanced information-related technologies such as computers and communication systems, in order to improve their emergency medical care systems may have many advantages. Emergency medical information card can provide a way to protect people during medical emergencies by providing physicians with their vital medical information during the critical seconds of emergency care if being unable to provide your vital medical information. Before introducing these systems, recognition that an important problems such as standardization of the data and code for the medical information systems, defining the access and usage rights by user profiles and the types of data for the security and data protection must be considered. We studied the emergency medical information card systems to clarify their purpose, analyse their present status, standardize the data and codes and define the access and usage rights and present the ideal system, in view of community health care requirements. Here the results of the research are examined, and there is a discussion of what is needed to use the emergency medical card system in the future.
Community Health Services ; Computer Security ; Emergencies* ; Emergency Medical Services ; Human Rights ; Humans ; Information Services ; Information Systems* ; Insurance