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.
Abdominal Cavity* ; Catheters* ; Diaphragm*

No abstract available.
Hyperplasia*

Pyelo-caliceal diverticulum refers to a cystic cavity containing urine the renal parenchyme, which is lined by transitional epithelium and communicates with the renal pelvis or a calyx through a narrow channel. Pyelo-caliceal diverticulum is a relatively uncommon entity and are usually quite small in size, averaging 0.5 cm to 5cm. Huge pyelo-caliceal diverticulum is presented with review of literatures.
Diverticulum* ; Epithelium ; Kidney Pelvis

Dermatofibrosarcoma protuberans is an uncommon, locally aggressive fibroblastic tumor, characterized by infrequent metastasis and a marked tendency of local recurrence after excision. Histologically, it shows large uniformed spindle shaped cells arranged in a cartwheel or storiform pattern. We report a case of dermatoribrosarcoma protuberans on the lower abdomen of a man aged of thirty, treated with Mohs micrographic surgery and purse-string suture repair.
Abdomen ; Dermatofibrosarcoma* ; Fibroblasts ; Mohs Surgery* ; Neoplasm Metastasis ; Recurrence ; Sutures*

No abstract available.

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