BACKGROUND AND OBJECTIVE: The outcome of asthma treatment has traditionally been assessed by measuring the conventional clinical parameters such as symptoms, expiratory flow rates and needs for medications. But none of them tells us whether the patients are actually able to function properly in their lives. Only assessment of the quality of life (QOL) can reflect the parts of patients lives affected by the disease. However, there is no measure to assess the quality of life of patients with any chronic diseases in Korea yet. We developed the QOL Questionnaire for Korean Asthmatics and evaluated its measurement properties. METHOD: The questionnaire was composed of 18 items in four domains : i.e. activity limitation (6 items), symptoms (5 items), emotional function (3 items) and environmental stimuli (4 items). At our out-patient clinic, 32 adults with moderate to severe persistent bronchial asthma were enrolled. The study design consisted of 4 week unblinded single cohort with visits at 0 and 4 weeks, and the patients were asked to answer the questionnaire by self administration method at the two separate visits. Forced expiratory volume for 1 second (FEV1) and peak expiratory flow rate (PEFR) were recorded at each visit. According to the patients and physicians global assessment, the patients were divided into two groups, i.e. stable and changed (improved). The responsiveness, reproducibility and validity of the questionnaire were evaluated. RESULTS: The total QOL scores at the second visit in the changed group were significantly higher than those at the first visit. The score differences between the two visits in the changed group were higher than in the stable group. In the stable group, the responses to the questionnaire were reproducible. The QOL scores showed good longitudinal correlation with the expiratory flow rates, whereas FEV1 did not correlate with the QOL in cross-sectional analysis. CONCLUSION: The questionnaire proved to be reproducible, responsive and valid in the subjects. It could be recommended for the outcome evaluation of Korean asthmatics.
Adult ; Asthma ; Chronic Disease ; Cohort Studies ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Korea ; Outpatients ; Peak Expiratory Flow Rate ; Quality of Life* ; Self Administration ; Surveys and Questionnaires

BACKGROUND: Oral allergy syndrome(OAS) is composed of it,ching sense and edema in oral cavity, lips, throat, pharynx, and larynx following eating some fresh fruits or vegetables. It has been known that most of patients with OAS are allergic to pollens. Common epitopes were found among pollens, fruits and vegetables. Although OAS is a common farm of food allergy in adults, this is the first epidemiologic study of OAS in Korea. MATERIAL AND METHOD: One hundred and fifty one patients who showed positive skin reaction to pollens were telephone-interviewed. Investigation of the prevalence and clinical manifestations of OAS was possible in 81 patients. RESULT: The prevalence of OAS among these patients was 34.6% (28/81). OAS was found in 24(48%) out of 50 patients sensitized to tree pollens, whereas 4(13%) of 31 grass or weed pollen-sensitized paients had OAS. Most common causative food was apple and all of 17 apple- OAS patients were sensitized to tree pollens. Peach was the second common food and 14 of 15 peach-OAS patients were sensitized to tree pollens. Besides oral symptoms, rhinitis, asthma, diarrhea, nausea, vomiting or generalized urticaria were accompanied in half of the OAS patients (14/28). Some patients showed OAS to some unique Korean foods such as dropwort, taro and Aster. CONCLUSION: OAS was very common in pollen-sensitized patients. Larger epidemiologic studies are needed to find unique Korean foods and their antigensm causing OAS.
Adult ; Asthma ; Colocasia ; Diarrhea ; Eating ; Edema ; Epidemiologic Studies ; Epitopes ; Filipendula ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity* ; Korea ; Larynx ; Lip ; Mouth ; Nausea ; Pharynx ; Poaceae ; Pollen* ; Prevalence ; Prunus persica ; Rhinitis ; Skin ; Urticaria ; Vegetables ; Vomiting

Newborn gastrointestinal tract emergency diseases include various disorders that occur anywhere along the digestive tract. Most of them are congenital malformations, not acquired diseases. Many of them cannot be confirmed on prenatal examination, and consequently, postnatal evaluation is required. Unlike adults, in newborn babies, detailed evaluations with computed tomography (CT) and magnetic resonance imaging (MRI) are often limited, so making the diagnosis based on early abdominal radiography is most important. Therefore, it is necessary to be familiar with the radiologic findings that may be seen on imaging studies. In addition, it is important to understand abdominal ultrasound and fluoroscopy findings, which can be used in addition to simple radiography and indications that can be used for further diagnosis and appropriate treatment. Therefore, this study describes and organizes the various imaging findings that may occur in neonatal gastrointestinal emergencies.

We report a case of pulmonary edema developed in a 33-year-old female who underwent two-stage bilateral carotid body tumor excision. About 1 month ago, she had undergone a left carotid body tumor excision. After the operation, her tongue was deviated to left side. Bilateral hypoglossal nerve injury was suspected. These injuries should be carefully monitored in patients who will undergo a similar procedure on both sides because a bilateral deficit of the hypoglossal nerve is poorly tolerated, resulting potentially serious pulmonary edema. In recovery room, she became pale and SpO2 was fall down. We reintubated her immediately and the pulmonary edema was treated using a supportive management. She was discharged without any signs of dyspnea or airway obstruction, but hypoglossal nerve injury remained. We discuss the possible etiology of the upper airway obstruction after the neck surgery and review the literatures associated with the pulmonary edema following upper airway obstruction.
Adult ; Airway Obstruction ; Carotid Body Tumor* ; Carotid Body* ; Dyspnea ; Female ; Humans ; Hypoglossal Nerve ; Hypoglossal Nerve Diseases ; Hypoglossal Nerve Injuries ; Neck ; Pulmonary Edema* ; Recovery Room ; Tongue

OBJECTIVE: To assess the reliability of triple marker screening test in midtrimester pregnancy for fetal Down syndrome. METHODS: From October 1, 1996 to May 31, 1998 at Nowon Eulji Hospital, 3700 Pregnant women underwent serum tiple marker screening for Down syndrome during 15-20weeks of gestational age. The results of serum triple marker screenig tests for Down syndrome and the outcomes of pregnancies were retrospectively assesed. RESULTS: Sixty seven of 3700 cases(1.81%) were positive in screening test, and 3633(98.18%) cases were negative. Among 67 cases of positive screening test, 1 case(1.49%) was diagnosed as Down syndrome. Among 3633 cases of negative screening test, 4 cases(0.1%) were diagnosed as chromosomal abnormalies postnatally. Two of these 4 cases of chromosomal abnormalies were Down syndrome. CONCLUSION: With this results, sensitivity of triple marker screeing test for Down syndrome is very low as 33.3%. In order to increase the sensitivity, some compensatory adjustment is required in triple marker screening test.
Down Syndrome* ; Equidae ; Female ; Gestational Age ; Humans ; Mass Screening* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Retrospective Studies

No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

OBJECTIVE: To compare the clinical outcomes of day 2 embryo tranfer with those of day 3 embryo transfer after In Vitro Fertilization (IVF). METHODS: Medical records of 192 patients (217 cases) undergoing IVF-ET at Chonnam National University Hospital from February 1995 to July 2001 were reviewed. The number of cases of the day 2 transfer (D-2) group and the day 3 transfer (D-3) group was 152 and 65, respectively. Clinical characteristics, mean number of fertilized oocytes, frequency of embyo qualities, mean number of embyo transferred, cumulative embryo score (CES) per transfer, pregnancy rate per cycle, clinical pregnancy rate per cycle and implantation rate per transferred embyo were compared between the two groups. RESULTS: In embyo quality, grade I in D-2 group (69.5%) was much more than in D-3 group (52.3%) in number, and grade III and IV in D-3 group (9.7% and 6.2%) was much more than in D-2 group (1.0% and 0.2%). CES was significantly higher in D-3 group than in D-2 group (62.4+/-40.0 versus 49.1+/-34.2). However, there were no statistically significant differences between the two groups in number of fertilized oocytes, number of embryo transferred, pregnancy rate, implantation rate and pregnancy outcome. There were also no significant differences between the two groups in implantation and pregnancy rates according to age, under 35 vs over 35 and the presence or absence of previous IVF-ET failure. CONCLUSION: There were no difference in the pregnancy rate and implantation rate between the two groups. The CES which indicates the quality of embryo was higer in D-3 group than in D-2 group. Since this study did not show the direct effect of better quality of D-3 embryo on implantation rate and pregnancy rate, further investigation should be needed. In addition, further studies about improving culture media for embryonic development and selecting better quality embryos for delayed embryo transfer should be continued.
Culture Media ; Embryo Transfer* ; Embryonic Development ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Humans ; Jeollanam-do ; Medical Records ; Oocytes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

No abstract available.
Female ; Humans ; Marriage*

BACKGROUND: Chronic cough is a common clinical problem to which various etiologies are attributable; postnasal drip, asthma, gastroesophageal reflux (GER) and chronic bronchitis, However, in some cases, no particular etiology can be confirmed. OBJECTIVE: This study was aimed to evaluate cough sensitivity and the clinical manifestations of patients with idiopathic chronic cough. MATERIALS AND METHODS: We recruited 70 non-smoking patients who had been coughing for more than 3 weeks without any history, symptoms or signs of rhinitis, sinusitis, typical asthma, GER or recent upper respiratory infection episodes. Nineteen healthy controls were also enrolled. Bronchial provocation tests with methacholine, capsaicin and distilled water (DW) were performed. RESULTS: Thirteen patients were positive to rnethacholine test (PC20 < 25mg/ml) and defined as cough variant asthma. The others are classified into idiopathic chronic cough. By capsaicin and DW challenge tests, idiopathic cough patients could be divided into two groups, i.e., increased cough sensitivity (ICS) and normal cough sensitivity (NCS) groups. DW- induced cough counts were negatively correlated with C7 (lowest capsaicin concentration inducing continuous 7 or more coughs) (r=-0.739, p<0.001). No difference was found in clinical features such as age, sex, atopy, or peripheral eosinophil counts between these two groups but cough counts per cough burst were significantly higher in the ICS group. CONCLUSION: The heterogeneity in cough sensitivity of idiopathic chronic cough patients may refiect different pathophysiologic mechanisms. It is unclear whether patients with NCS merely have habitual or psychogenic cough or not. These suggest that different therapentic strategies should be established on idiopathic chronic cough patients according to cough sensitivity.
Asthma ; Bronchial Provocation Tests ; Bronchitis, Chronic ; Capsaicin ; Cough* ; Eosinophils ; Gastroesophageal Reflux ; Humans ; Methacholine Chloride ; Population Characteristics ; Rhinitis ; Sinusitis ; Water

A 21-month-old girl with cri-du-chat syndrome in conjunction with developmental delay underwent brain magnetic resonance imaging (MRI). The MRI showed hypoplasia of the brain stem, a normal cerebellum, thinning of the corpus callosum, and a lack of myelination in both anterior limbs of the internal capsule. She also had neonatal bilateral subependymal cysts. We believe that the symmetrical lack of myelination in both anterior limbs of the internal capsule could be a diagnostic clue of cri-du-chat syndrome.
Brain ; Brain Stem ; Cerebellum ; Corpus Callosum ; Cri-du-Chat Syndrome* ; Extremities* ; Female ; Humans ; Infant ; Internal Capsule* ; Magnetic Resonance Imaging ; Myelin Sheath*