A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria

No abstract available.
Thioctic Acid*

The most important prognostic factor of breast cancer is the status of lymph node or distant metastasis, which is resisted by basement membrane and stromal matrix. MMP (matrix metalloproteinase)-2 is a 72-kilodalton type IV collagenase/ gelatinase and degrades the type IV collagen which is a main component of the basement membrane. Therefore, MMP-2 is believed to be one of the key molecule for cancer invasion and metastasis. Enzymatic activity of MMP is inhibited by TIMPs (tissue inhibitors of metalloproteinase). TIMP-2 forms a complex with latent pro-MMP-2 and inhibits the active forms of MMP-2. The balance of MMPs and TIMPs is suspected as the important factor of invasion and metastasis of the tumor cells. We studied the association between the expression of MMP-2/TIMP-2 and growth pattern of tumor border, lymph node metastasis, and estrogen receptor expression in the 57 cases of invasive ductal carcinoma of the breast using immunohistochemical staining methods. The results revealed increased expression of MMP-2 in the infiltrating tumor border and tumors with positive lymph node metastasis and negative estrogen receptor with no statistical significance (p>0.05). But the expression of TIMP-2 was increased in expanding tumor border and tumors with positive lymph node metastasis and negative estrogen receptor without statistical significance (p>0.05).
Basement Membrane ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Collagen Type IV ; Estrogens* ; Gelatinases ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Tissue Inhibitor of Metalloproteinase-2*

BACKGROUND: During pediatric general anesthesia with Mapleson D-circuit, we used large amount of FGF(fresh gas flow) for avoidance of rebreathing of expired gas but low FGF are employed, the amount of anesthetic consumption and air contamination can be reduced. The aim of this study was to evaluate the fact that FGF of 220 ml/kg/min is clinically acceptable. METHODS: We selected sixty children weighing < or =20 kg who were scheduled for inguinal hernia repair under general anesthesia. The study was performed by 2 steps; In the step 1, the patients were divided into two groups according to weight(less than or greater than 8 kg) and end-tidal Pco2 were compared with simultaneous arterial Pco2 measurements. In the step 2, the patients were divided into two groups according to FGF(2MV or 220 ml/kg) and arterial Pco2, end tidal Pco2 and PminCO2(minimum inspired Pco2) were measured. RESULTS: In the step 1 study, arterial Pco2 was significantly higher than end-tidal Pco2 in the group 1 and there was slight difference in arterial Pco2 and end-tidal Pco2 in the group 2. In the step 2 study, PaCO2, PetCO2, PminCO2 were significantly increased in the group 3 than group 2 but there were no clinical hypoxemia in all patients. CONCLUSIONS: We consider that FGF of 220 ml/kg/min is appropriate during controlled ventilation with Mapleson D circuit in children weighing > or =8 kg because of economic and ecological advantages. Also, we consider FGF can be reduced in children weighing <8 kg under accurate respiratory gas monitoring.
Anesthesia, General* ; Anesthetics ; Anoxia ; Blood Pressure ; Child ; Heart Rate ; Hernia, Inguinal ; Humans ; Lidocaine ; Ventilation

Despite the substantial amount of asthma-related information available on the internet, little is known about the quality of such information. We assessed asthma-related information on the Korean internet intended as an educational material for asthma patients. By entering the key word, 'asthma', into 4 popular search engines, 32 web sites were identified and categorized with respect to authorship. The core asthma educational concepts and Health On the Net Code of Conduct principles were used to evaluate informational value and justifiability of unreliable information. Eight of 32 web sites were categorized as western physician, seventeen as oriental physician, four as commercial, and three as others. The mean number of core asthma educational concepts on the whole web sites was 2.7 out of 8. By type of authorship, 1.7 on the commercial sites, 2.1 on the oriental physician sites, 3.5 on the western physician sites, and 5.0 on the others sites in decreasing order. One of the western physician sites, two of the commercial sites, and all of the oriental physician and others sites contained unreliable information. However all of them except one site failed to satisfy our criteria of justifiability. Asthma-related information currently available on the Korean internet is highly variable in quality and lacks core asthma educational concepts and justifiability.
Asthma/*diagnosis/*therapy ; Health Education ; Human ; Internet ; Korea ; Medical Informatics ; Patient Education/*methods ; Quality Control

Acute suppurative thyroiditis(AST) and thyroid abscess are uncommon in children. The remaining pyriform sinus tract with fistula is well known underlying abnormality of AST in pediatric patients. AST or thyroid abscess in children can be caused by infection through pyriform sinus fistulae which usually originate from the tip of the left pyriform sinus. The left-sided predominance of involvement and frequent recurrence are characteristic findings. We present a case history that include a left sided thyroid lesion of a 5-year-old girl and radiologic evidence of pyriform sinus fistula. The pus culture revealed the bacterial etiology as Staphylococcus epidermidis. Our discussion focused on the etiology and the management of AST and thyroid abscess in children.
Abscess ; Child ; Child, Preschool ; Female ; Fistula ; Humans ; Pyriform Sinus ; Recurrence ; Staphylococcus epidermidis ; Suppuration ; Thyroid Gland ; Thyroiditis, Suppurative*

No abstract available.
Hypersensitivity* ; Phenobarbital*

BACKGROUND: Bronchial asthma is a complex genetic disorder. Although serum IgE level and bronchial hyperresponsiveness are well known to be under genetic control, the influence of genetic factors on basophil releasability has been seldom studied. OBJECTIVE: The present study was carried out to investigate whether genetic factors may influence the basophil histamine releasability. MATERIALS AND METHODS: We studied 50 children, 32 with atopic asthma (AA) and 18 normal control (NC), and their parents. Suspensions of leukocytes were isolated and stimulated with Ca ionophore and anti-IgE antibody. Then, histamine in the supernatant was as-sayed by an automated fluorometric analyzer. RESULTS: Among the probands, AA children had a significantly higher anti-IgE induced histamine release than NC children. In contrast, Ca ionophore-induced histamine release was similar between the two groups. Ca ionophore-induced or anti-IgE-induced histamine release was not significantly different between parents of AA children and those of NC children. However, the maximal histamine release by Ca ionophore in parents had a significant correlation with that of probands, whereas the values by anti-IgE were not correlated between probands and their parents. CONCLUSION: We confirmed that basophils from patients with atopic asthma are characterized by a specific increase in IgE-mediated histamine release. The significant correlation of Ca ionophore-induced maximal histamine release between children and their parents suggests that genetic factors may play an important role in the control of non-IgE-mediated relessability from basophils.
Asthma ; Basophils* ; Child ; Genetics ; Histamine Release ; Histamine* ; Humans ; Immunoglobulin E ; Leukocytes ; Parents ; Suspensions

BACKGROUND: Although occupational asthma is defined as a reversible airway obstruction causally related to exposure in the working environment, many occupational asthmatics complain of asthmatic symptoms despite avoidance of the causative agent. Subjects and methods. Twenty-nine patients with occupational asthma who had been confirmed by specific bronchial challenge with reactive dye or isocyanates and had avoided the causative agent for at least 6 months were included in this study. A questionnaire about asthmatic symptoms and medication requirements, a lung functiontest, and a methacholine bronchial provocation test were performed. RESULTS: Asthmatic symptoms at follow-up were remitted in seven (41.2%) isocyanate-induced asthmatics, but none with reactive dye-induced asthma were remitted. At follow-up, the symptom-medication score and FEV1 were significantly improved in isocyanate-induced asthmatics than in those with reactive dye-induced asthma, but the geometric mean of PC20-methacholine was not different between the two groups. Among 17 isocyanate-induced asthmatics, a duration from symptom onset to avoidance was significantly shorter in the remission group than in the nonremission group, although the symptom-medication scores, FEV1 (% predictive value) and logPC20-methacholine at an initial diagnosis, and follow-up period defined as duration from avoidance to follow-up, showed no difference between the two groups. CONCLUSION: The outcome of occupational asthma may be determined by the causative agents and the duration from onset of asthmatic symptoms to avoidance.
Airway Obstruction ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Diagnosis ; Follow-Up Studies ; Humans ; Isocyanates ; Lung ; Methacholine Chloride ; Prognosis ; Surveys and Questionnaires