BACKGROUND: Few studies have demonstrated an enhanced skin responsiveness to opiates in atopic subjects. OBJECTIVE: To determine whether the skin response to morphine is increased in atopics and to assess the clinical usefulness of morphine skin prick test in diagnosis of allergic diseases. METHOD: Allergy skin prick tests were performed using 55 common allergens, histamine, and morphine in 158 patients with allergic diseases. RESULTS: Wheal and flare sizes for morphine (1mg/mL) were significantly related to and smaller than those for histamine (1mg/mL). Although the proportion of subjects with allergic rhinitis and the level of serum total IgE were not different between responders (wheal >- 2mm) and nonresponders to morphine, the positive response rate to allergens was significantly lower in nonresponders. The flare sizes for morphine were significantly higher in positive allergen test group (A/H ratio >- 0.5). Among positive allergen test group, the subjects with atopy score >- 5 showed a larger flare size for morphine than those with atopy score < 5 while the sizes for histamine were not different. CONCLUSION: Morphine skin prick test is helpful for detecting false negative responses to allergens, and morphine skin test responses are increased in highly atopic patients probably due to enhanced mast cell releasability.
Allergens ; Diagnosis* ; Histamine ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mast Cells ; Morphine* ; Rhinitis ; Skin Tests ; Skin*

Strongyloides stercoralis is a nematodes and is prevalent in the tropical regions. In Korea, 6 cases have been reported in which the parasites were identified in feces. We report a case of hyperinfection syndrome with Strongyloides stercoralis confirmed in the tissue sections. A 52-year-old woman was admitted to the hospital because of generalized edema and weakness. She received steroid therapy for 30 years because of rheumatoid arthritis. One year ago, generalized edema and dyspnea were developed and she was diagnosed as minimal change nephrotic syndrome for which she received cyclosporin. On admission, she complained of generalized weakness and edema, multiple arthralgia and abdominal discomfort with nausea. The white-cell count was 14,600 without eosinophilia. A stool specimen was negative for occult blood, ova or parasites. Right lower quadrant abdominal pain and tenderness were developed, and the exploratory laparotomy was done under the impression of the acute appendicitis. An appendectomy with a biopsy of mesenteric lymph nodes was performed. From the 5th day after operation, the patient began to complain of the abdominal pain and constipation. Under the impression of adhesion bad formation, the laparotomy was done and disclosed that the proximal ileum was markedly dilated. On jejunotomy, a great amount of formed stool and barium was noticed in the proximal portion of small bowel. The jejunal tissue was biopsied. Grossly, the appendix was unremarkable. Microscopically, the inflammatory reaction was nearly absent, but in serosa, minute granulomas were found which contain a part of the parasite. Same feature was noted in the mesenteric lymph node. The biopsied jejunum contains numerous adult female, filariform and rhabdidiform larvae and eggs in the mucosa, submucosa and muscle wall. Their morphology was compatible with Strongyloides stercoralis. The patient died 5 days later in the state of multiple organ failure.
Adult ; Male ; Female ; Humans ; Biopsy

No abstract available.
Asthma, Exercise-Induced* ; Child* ; Humans ; Incidence*

No abstract available.
Child* ; Humans

No abstract available.
Hyperplasia*

No abstract available.
Abdominal Cavity* ; Catheters* ; Diaphragm*

Pinch modification of the linear advancement flap(Peng flap) is a hybrid of the transitional linear advancement flap and two bilateral rotation flaps. The advantages of this technique are a wider and shorter flap and an increase of the skin survival rate. This technique can be applied not only to the dorsum of the nose, but also to large defects of the scalp secondary to the surgical excision of benign or nalignant. lesions, scars, aplasia cutis and cicatricial alopecia. We pres ent, two cases of round defects on the scalp. The first case is an 8-year-old boy suffering from cicatricial alopecia on the right temporal area. The second case is a 12 year-old boy who had had nevus sebaceus on the right temporal area since birth. Pinch modification of the linear advancement flap can be erformed after excision without changing the direction of hairs.
Alopecia ; Child ; Cicatrix ; Hair ; Humans ; Male ; Nevus ; Nose ; Parturition ; Scalp* ; Skin ; Survival Rate

Miescher syndrome comprises congenital acanthosis nigricans, hypertrichosis, failure to thrive and short stature, dysmorphism especially of the jaws and oral cavity, insulin-resistant diabetes mellitus, and a characteristic general appearance. This report concerns a rare case of 12-year-old girl having insulin resistant diabetic mellitus with Miescher syndrome. The relevant literature was reviewed.
Acanthosis Nigricans ; Child ; Diabetes Mellitus* ; Failure to Thrive ; Female ; Humans ; Hypertrichosis ; Insulin ; Jaw ; Mouth

BACKGROUND: Blunted perception of dyspnea, which may be related to the increased mortality, has been demonstrated in patients with a history of near-fatal asthma and in the elderly. OBJECTIVE: The purpose of this study was to evaluate the relationship between the perception of dyspnea and the severity of asthma. METHOD: Baseline spirometry and Borg score change(A Borg score) during breathing through an inspiratory muscle trainer were measured in 27 consecutive asthma patients and 11 normal subjects. RESULTS: The baseline Borg score was negatively related to FEV1 A Borg score was significantly lower in asthmatics than in controls at high level of loads. A Borg score was lower in severe asthma than in mild asthma. A Borg score was positively related to the baseline FEV1. Seventy-five percent of severe asthma, 62.5% of moderate one, and 9.1% of mild one showed impaired dyspnea perception. Dyspnea perception was related to age(r, = -0.49, p<0.001). CONCLUSION: Three quarters of patients with severe asthma showed impaired dyspnea perception to inspiratory resistive load. Dyspnea perception was related to asthma severity and age.
Aged ; Asthma ; Dyspnea* ; Humans ; Mortality ; Respiration ; Spirometry

BACKGROUND: This was concerned with outbreak investigation of the epidemic keratoconjunctivitis (EKC) which occurred from April to May 1996 in the neonatal intensive care unit (NICU) of Seoul National University Hospital in Seoul, Korea. METHOD: We defined the cases by the clinical signs and symptoms and investigated the possible risk factors of this outbreak by case-control analysis. RESULTS: The number of total cases were 17, including neonates (10 cases) and health care workers (7 cases), The index case was thought to be infected by his family, while the other cases may have been transmitted through contact with nurses who cared for or fed the index case. There were no statistically significant differences between case and non-case (control) neonates. However, for nurses, the total amounts of time spent working in the hospital and in the NICU were identified as significant factors. And the incidence of EKC was higher in the nurses who contacted neonates with EKC more frequently. CONCLUSION: According to our contact precautions, we enforced cohort isolation and emphasized strict hand washing and aseptic technique to the health care workers. All of the equipment, especially eye dips used by the cases, was disinfected or sterilized. Fortunately this outbreak ended after about one week when we recognized and started to investigate this outbreak.
Case-Control Studies ; Cohort Studies ; Delivery of Health Care ; Hand Disinfection ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal* ; Keratoconjunctivitis* ; Korea ; Risk Factors ; Seoul