A 25-year-old male with asthma suffered from generalized urticaria, angioedema and syncope associated with exercise after ingestion of food made with wheat flour. Skin prick test with bread showed strong positive reaction(++++), but with wheat flour, a weak positive(+). Challenge test with wheat flour, and food made with wheat flour, without or with exercise, were done several times. Exercise such as 25 min of running on treadmill following 30 min after 50 grams of bread or 50 grams of hot pepper-stuffed rice cake only showed positive reaction such as generalized urticaria, angioedema and hypotension, but not with 15 grams of bread or 15 grams of hot pepper-stuffed rice cake. Ingestion of bread in such high amounts as 15 grams alone did not trigger reaction, not even with is min of exercise. This is the first clear case of food dependent exercise induced anaphylaxis (FDEIA) in which the allergic reaction depended on both the amount of food ingested and the amount of exercise was clarified.
Adult ; Anaphylaxis* ; Angioedema ; Asthma ; Bread ; Eating ; Flour* ; Humans ; Hypersensitivity ; Hypotension ; Male ; Running ; Skin ; Syncope ; Triticum* ; Urticaria

Occupational asthma induced by the inhalation of the spore of Ganoderma lucidum was demonstrated in a 43-year-old woman who had cultivated it indoors for 6 years. She had suffered from paroxysmal cough and rarely wheezing dyspnea for two years. Recently she also had chest tightness and paroxysmal and repeated cough immediately after the exposure to Ganoderma lucidum spores. Her pulmonary function was normal. But, her PC20 was 6.4mg/ml in MBPT (methacholine bronchial provocation test). She showed not only positive reaction to skin prick test but also dual asthmatic reaction to the bronchial challenge test with antigenic extract of Ganoderma lucidum spores.
Adult ; Asthma, Occupational* ; Bronchial Provocation Tests ; Cough ; Dyspnea ; Female ; Ganoderma* ; Humans ; Inhalation ; Reishi ; Respiratory Sounds ; Skin ; Spores* ; Thorax

BACKGROUND: Oriental medicine is a part of medical service in Korea. However, there are no information about the status of infection control program in oriental medical hospitals. The purpose of this study was to investigate the current status of infection control activities in oriental medical hospitals and to provide a data to establish infection control policy in oriental medical hospitals. METHODS: This study was based on the survey questionnaires about infection control program and activities with total 13 oriental medical university hospitals in Korea. Questionnaires were collected from February 1 to March 31, 2011. RESULTS: Nine hospitals (69.2%) had infection control practitioner (ICP). Only 4 hospitals (30.8%) had full-time ICP and infection control office. The 6 hospitals (46.2%) had a position for infection control doctor and half of them were oriental medical doctors. Eight hospitals (61.5%) had an infection control committee and they had a meeting for average 2.5 times a year. Six hospitals (46.2%) performed surveillance and most of them were monitoring site directed infections. Only 4 hospitals have microbiology laboratory. All hospitals were using disposable acupuncture needles. Six hospitals were only using disposable wet cupping. Two hospitals (15.4%) were reusing wet cupping after disinfection. CONCLUSION: Through this study it was able to find out the status of infection control activities in oriental hospitals. There were also many limits on infection control activities in oriental medical hospitals. Based on this study it is needed to develop the infection control guideline and education for associates in oriental hospitals.
Acupuncture ; Hospitals, University ; Humans ; Infection Control ; Infection Control Practitioners ; Korea ; Medicine, East Asian Traditional ; Needles ; Surveys and Questionnaires

BACKGROUND: Allergen-specific immunotherapy ( IT ) can be an important adjunctive therapy in the treatment of allergic disorders. Although a number of studies have shown that cytokine production by T cells may be modified by IT, IT-induced chsnges at the single cell level in allergen -specific Th ( T helper ) and Tc ( cytotoxic T ) responses have not been reported. Objective : The objectives of the present study were ( 1 ) to demonstrate differences in the house dust mite(HDM)-induced cytokine production patterns of Th and Tc cells between untreated and treated HDM allergic patients and ( 2 ) to determine whether there are differences between child and adult patients in Th and Tc cell responses to HDM. METHOD: This study included twenty Dermatophagoides farinae (Df)-sensitive asthmatics ( ten children and ten adults ), of which five children and five adults received immunotherapy to Df over a 1.5- to 3-year period. Peripheral blood mononuclear cells ( PBMC ) were isolated from peripheral blood of each patient and cultured in the presence of IL-2 ( 10ng/ml ) and Df extract (100ug/ml) for 6 days. After harvesting cultured cells, Th and Tc cell frequencies were determined by a multiparameter cytokine flow cytometric assay that allows simultaneous determination of intracellular IFN-r and IL-4 in CD4+ or CD8+ cells. RESULTS: Predominant Th2 responses to Df were observed in all untreated child patients, three untreated adult patients, and two treated adult patients. On the other hand, predominant Thl responses to Df were observed in all treated child patients, two of untreated adult patients, and three of treated adult patients. Predominant Tcl responses to Df were observed in all groups of patients. However, Tcl responses were more prominent in adults than in children and in treated adult patients than in untreated adult patients. In children, there were no differences in predominant Tcl responses except in one treated child, in whom more prominent Tcl response was observed.
Adult ; Cells, Cultured ; Child ; Dermatophagoides farinae ; Dust ; Hand ; Humans ; Immunotherapy* ; Interleukin-2 ; Interleukin-4 ; T-Lymphocytes

No abstract available.
Breast* ; Jaundice* ; Milk, Human*

There have been a few reports suggesting that the imune response to pulmonary tuberculosis provides the appropriate setting for the development of IgA nephropathy (IgAN). To define better the relation between pulmonary tuberculosis and IgAN, we evaluated the prevalence of pulmonary tuberculosis among 386 Korean patients with IgAN. Seventeen cases (4.4%) showed abnormal chest X-ray findings suggestive of pulmonary tuberculosis. Ten patients were male and seven were female. Only one case was a child. Urinary abnormalities were detected during the course of antituberculous medication in 11 patients, and after completion of chemotherapy in 2. Chest abnormalities were noted in the remaining 4 patient after IgAN had been diagnosed. Clinical diagnosis of tuberculosis was made mainly based on the chest X-ray findings, but sputum Acid-Fast Bacilli were detected in one patient and pulmonary granulomo was noted in 2. The patients presented various clinical manifestations such as gross hematuris (5 cases), nephrotic syndrome (5 cases), asymptomatic urinary abnormalities (4 cases) and pyuris (1 case) at time of biopsy. Histologic grading of the glomerular lesions was made with modified Meadow classification (1972): one had grade I lesion, 8 grade II, 5 GRADE III and 3 showed grade IV. Follow-up studies were made in 7 patients. Six showed resolution of urinary abnormalities after completion f antituberculous medication, while one pursued chronic renal failure 20 days after the onset. The above clinical and morphologic features suggest that pulmonary tuberculosis may be partly related to the occurrence of IgAN in some Korean patients.
Child ; Male ; Female ; Humans ; Follow-Up Studies

Omental cyst is benign unilocular or multilocular endothelium-lined cyst that contains either chyle or serous fluid. They are uncommon yet interesting intraabdominal masses that may be difficult to diagnose clinically and often are missed on abdominal palpation. The etiology of this lesion has been subject to much discussion in the literature over the years with the principal debate centering around the question of whether or not this lesion is congenital. It is now recongnized that there is no single etiologic mechanism involved in the development of this lesion. Recently we have experienced an autopsy case of omental cyst occurring in a male fetus. Pregnancy was artificially interrupted at 28 weeks gestation due to suspicious mesenteric cyst or fetal ascites on ultrasonography. Postmortem examination showed hydrops fetalis, hypoplasia of the lungs, ad multifocal calcifications of myocardium. There was an omental cyst in the greater omentum which was 7x3 cm in size, unilocular and containing clear, straw-colored fluid and proteinacious core without evidence of bleeding or calcifications. Microscopic examination of this cyst showed cuboidal or flattened mesothelial lining cells and underlying loose fibrovascular connective tissue with discrete lymphocytic collections. Rarity and interest on the pathogenesis made us redport this case.
Pregnancy ; Female ; Male ; Humans ; Cysts

PURPOSE: The purpose of this study was to identify premorbid personality, depression and disturbing behaviors to provide information for developing nursing interventions for the pre-demented and mild demented elderly living as residents of their community. METHOD: The survey was conducted through direct interviews using a structured questionnaire in J city. Among the subjects contacted, 89 made appropriate replies to the survey. RESULT: The subjects' disturbing behaviors were significantly related to premorbid personality and depression. The predictors to disturbing behaviors of the pre-demented elderly were sex, extroversion, neuroticism and conscientiousness. The predictors to disturbing behaviors of the mild demented elderly were agreeableness, depression, sex, conscientiousness, and extroversion. CONCLUSION: In conclusion, disturbing behaviors of pre-demented elderly and mild demented elderly are affected not only by their premorbid personality but also by their depression. Therefore, it is necessary to encourage and respond to them with understanding their disturbing, behaviors in relation to their premorbid personality. In addition. it is important to maintain positive emotion in order to reduce their disturbing behaviors.
Aged* ; Dementia ; Depression* ; Extraversion (Psychology) ; Humans ; Nursing ; Surveys and Questionnaires

No abstract available.
Brain Neoplasms* ; Brain* ; Humans ; Immunocompetence*

The distinction between cholangiocarcinoma (CC) and metastatic colonic adenocarcinoma of the liver (MCA) is often difficult, particularly in needle biopsy and fine-needle aspiration specimens, if histologic features alone are used. To examine the differences in the expressions of the cytokeratin (CK) 7 and 20 in the CCs and MCAs, we performed immunohistochemical studies on surgically resected 19 CCs and 23 MCAs. We used monoclonal antibodies against CK 7 and CK 20, and applied microwave antigen retrieval technique on formalin-fixed, paraffin-embedded tissue. We interpreted diffuse cytoplasmic reactivity found in > or =5% of tumor cells as positive. CCs showed CK 7+/CK 20- immunophenotype in 63%, CK 7+/CK 20+ in 32%, CK 7-/CK 20+ in 5%, and CK 7-/CK 20- in 0%. MCAs exhibited CK 7-/CK 20+ immunophenotype in 87%, CK 7+/CK 20+ in 9%, CK 7-/CK 20- in 4%, and CK 7+/CK 20- in 0%. CK 20-reactive cells in CCs were frequently columnar in shape (p<0.05). In conclusion, the CK 7/CK 20 immunophenotype was useful in the differentiation of CCs from MCAs: the CK 7+/CK 20- immunophenotype strongly suggested CCs, whereas the CK 7-/CK 20+ immunophenotype strongly suggested MCAs.
Adenocarcinoma* ; Antibodies, Monoclonal ; Biopsy, Fine-Needle ; Biopsy, Needle ; Cholangiocarcinoma* ; Colon* ; Cytoplasm ; Keratin-20 ; Keratin-7 ; Keratins* ; Liver* ; Microwaves