Barley is not a rare dietary content in Asian food but very few cases of anaphylactic reactions to barley have been reported. Furthermore, most reports are in adult patients with allergic reactions to beer containing barley components or occupational asthmatics known as 'baker's asthma'. We present a case of 11-month old boy who experienced an episode of anaphylaxis with generalized urticaria, periorbital swelling, wheeze and dyspnea after eating baby food containing barley, chestnut, glutinous rice, nonglutinous rice, within 30 minutes. Laboratory tests demonstrated high total serum IgE (531 kU/L) and revealed high level of IgE sensitizations to wheat (64.3 kU/L), barley (35.2 kU/L), rice (1.39 kU/L). Using the IgE-immunoblot assay, 7, 14, 25, and 26 kDa of IgE binding bands were identified and high degree of IgE cross-reactivity between barley and wheat extracts were revealed using IgE-immunoblot inhibition and ELISA-inhibition tests in this case.
Adult ; Anaphylaxis ; Asian Continental Ancestry Group ; Beer ; Dyspnea ; Eating ; Hordeum ; Humans ; Hypersensitivity ; Immunoglobulin E ; Triticum ; Urticaria ; Weaning

PURPOSE: Acute optic neuritis is an inflammatory optic neuropathy, and rarely occurs in children. Childhood-onset optic neuritis is different from adult-onset optic neuritis in terms of clinical and prognostic aspects. We investigated the clinical characteristics and visual prognosis related to the steroid therapy in children with acute optic neuritis. In addition, we evaluated the recurrence rate of acute optic neuritis and subsequent evolution into multiple sclerosis. METHODS: The medical records of ten children, who were previously admitted for acute optic neuritis at the Department of Pediatrics of Ajou University Medical Center from January 1995 to April 2004, were retrospectively reviewed. Nine patients were treated with intravenous methylprednisone pulse therapy, 0.5-1.0 g/day, for 3-5 days followed by an oral prednisone therapy. To 30 months after discharge, we followed up a long-term visual prognosis, recurrence rate and subsequent evolution into multiple sclerosis. RESULTS: There were 4 boys and 6 girls and the mean age of onset was 10 years. Bilateral optic neuritis was noticed in 8 children and 9 children presented with papillitis. Etiology of acute optic neuritis was idiopathic in 50% of patients. Of the remaining cases, it was related with acute disseminated encephalomyelitis(30%), sinusitis(10%), and neuromyelitis optica(10%). Orbital MRI showed optic nerve enhancement and/or enlargement and optic disc protrusion in 15 of the 18 examined eyes. Visual evoked potential (VEP) was abnormal in 12 of the 16 examined eyes; P100 response was totally attenu ated in 6 eyes, and in the others the amplitude of P100 response was normal but the latency was delayed. On follow-up VEP at 1 month after steroid pulse therapy, the amplitude of P100 response was normalized in all, but the latency was still delayed in 60% of the patients. A short-term visual acuity after treatment with steroid was normally recovered in 14 of 15 involved eyes. Acute optic neuritis recurred in one of the nine patients who were treated with high dose methylprednisone pulse therapy, but there was no subsequent development of multiple sclerosis during the follow up. CONCLUSION: The most common cause of acute optic neuritis in children is idiopathic, and presents as bilateral papillitis. On this study, a short-term visual prognosis after high dose methylprednisone pulse therapy is extremely good, but there was no significant difference in long-term visual prognosis at 6 months after treatment with steroid. Acute optic neuritis in children does not usually recur, and does not evolve into multiple sclerosis.
Academic Medical Centers ; Age of Onset ; Child* ; Evoked Potentials, Visual ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Multiple Sclerosis* ; Optic Nerve ; Optic Nerve Diseases ; Optic Neuritis* ; Orbit ; Papilledema ; Pediatrics ; Prednisone ; Prognosis ; Recurrence* ; Retrospective Studies ; Visual Acuity

BACKGROUND AND OBJECTIVES: A history of poor weight gain can often be elicited in young children with chronic upper airway obstruction resulting from adenotonsillar hypertrophy. The purpose of this study was to determine the incidence of growth disturbance and what effect, if any tonsillectomy and/or adenoidectomy has on subsequent growth in a group of children. MATERIALS AND METHODS: The subjects consisted of 78 patients with adenotonsillar hypertrophy who had been treated between March 1997 and September 1997 at the department of otolaryngology, Saint Benedict Hospital. Available preoperative data were collected including sex, age at surgery, tonsillar hypertrophy grade, presence of snoring and sleep apnea, preoperative weight, preoperative eating disorder, and URI frequency. RESULT: Many had improvements in growth after adenotonsil-lectomy. The improvement in growth appears to be obvious in chidren with eating disorder, snoring, and sleep apnea resulting from adenotonsillar hypertrophy. CONCLUSION: We can conclude that there exists a relationship beween adenotonsillar hypertrophy children and preoperative eating disorder, growth delay and snoring.
Adenoidectomy ; Airway Obstruction ; Child* ; Feeding and Eating Disorders ; Humans ; Hypertrophy ; Incidence ; Otolaryngology ; Saints ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy ; Weight Gain

PURPOSE: Chromosomal aberration has an effect on the lives of both patients and families. Peripheral blood chromosomal analysis is useful to make a diagnosis and counsel the patient with chromosomal abnormality. We studied the cases with peripheral blood chromosomal analyses and investigated the positivity of peripheral blood chromosomal analysis. METHODS: We analyzed 650 patients with chromosomal analyses in Ajou University Hospital during the past 10 years. We used a high-resolution banding technique to diagnose the chromosomal aberrations. RESULTS: The male to female ratio of the patients was 1.1 : 1. Among 650 patients, 108 patients had chromosomal aberrations(16.6%). Fifty seven out of 313 patients with the congenital anomalies or dysmorphologies had chromosomal aberrations. twenty six out of 166 patients with hematologic disorders had chromosomal aberrations. Fifteen out of 109 patients with developmental delay had chromosomal aberrations. Four out of 24 patients with seizures had chromosomal aberrations. Six out of 39 patients with the aberrant perinatal histories had chromosomal aberrations. CONCLUSION: Peripheral blood chromosomal analysis is an important diagnostic method in managing patients with chromosomal aberrations. Further advanced chromosomal staining and molecular genetic methods will raise the detection rate of chromosomal aberration and be useful in managing patients with chromosomal abnormalities.
Chromosome Aberrations ; Diagnosis ; Female ; Humans ; Male ; Molecular Biology ; Seizures

Oligmeganephronia is congenital hypoplasia of kidney with renal pathology showing very small number of nephrons with compensatory hypertrophy of the remaining glomeruli. A 7- year-old girl was referred to our nephrology clinic due to hematuria detected on school screening urinalysis and diagnosed as chronic renal failure and oligomeganephronia on renal biopsy. We are reporting the clinical and histomorphometric changes for the four years follow-up with review of literatures.
Biopsy ; Female ; Follow-Up Studies* ; Hematuria ; Humans ; Hypertrophy ; Kidney ; Kidney Failure, Chronic ; Mass Screening* ; Nephrology ; Nephrons ; Pathology ; Urinalysis*

OBJECTIVES: The aim of this study was to estimate musculo-skeletal symtoms of municipal sanitation workers and to evaluate working conditions of municipal sanitation workers to search for the factors related to musculo-skeletal symptoms. METHODS: We conducted a descriptive cross-sectional survey. The study subjects were comprised of 543 municipal sanitation workers in some divisions of Seoul and the Gyeonggi province. Musculo-skeletal analysis was done by using the modified criteria of NIOSH musuclo-skeletal symptoms, RULA and, REBA. Statistical analysis was done by using the chi-square test, multiple logistic regression analysis. RESULTS: 72.2% of the subjects complained musculo-skeletal symptoms (39.6% on the upperlimbs, 30.0% on the lumbar region, 27.4% on the legs). For the musculo-skeletal symptoms criteria (1~3), street cleaners complained of more musculo-skeletal symptoms than the solid waste collectors, after classifying the jobs of sanitation workers. On logistic regression analysis of the musculo-skeletal "symptoms criteria1" positive groups, age was related to the criteria positive (prevalence odds ratio=1.018, 95% CI: 0.993-1.046). The worktime was significantly related to 'criteria positive 1 and, 2' (prevalence odds ratio=2.165 (95% CI: 1.156-4.131), 2.187 times (95% CI: 1.071-4.651)). The RULA score, the subtotal A score of RULA, the REBA score and , the total A REBA score of the upperlimbs of solid waste collectors were higher than those of the street cleaners. CONCLUSIONS: In spite of the lower ergonomic evaluation score of the street cleaner, the street cleaners complained of more musculo-skeletal symptoms than did the solid waste collectors due to more frequent repetitive motions, a longer work time (over 10 hours) etc. It is suggested that the sanitation workers need to use the proper methods to avoid musculo-skeletal disease.
Cross-Sectional Studies ; Human Engineering ; Humans ; Logistic Models ; Lumbosacral Region ; National Institute for Occupational Safety and Health (U.S.) ; Sanitation ; Solid Waste ; Task Performance and Analysis ; Upper Extremity

Homocystinuria is an autosomal recessive inherited disorder of methionine metabolism. The most common cause of homocystinuria is cystathione-beta-synthase deficiency, which has the characteristic clinical features such as ectopia lentis, Marfanoid skeletal changes, mental retardation, and vascular thromboembolic events such as deep vein thrombosis, cerebral infarction, pulmonary embolism, and myocardial infarction. The thromboembolic vascular events occur in 20-50% of untreated patients with homocystinuria at the age of 15, and could be associated with vasculopathy related mortality in 20% of untreated patients before the age of 30. Therefore, homocystinuria is one of the important cause of stroke in children and young adults. Only 2 cases of homocystinuria were reported in Korea; one without vasculopathy and the other with cerebral infarction. Homocystinuria complicated with systemic deep vein thrombosis is first reported in Korea. We report a 13 year old female with homocystinuria complicated with severe systemic deep vein thrombosis and venous infarction of both thalami due to thrombosis of vein of Galen and internal cerebral vein.
Adolescent ; Cerebral Infarction ; Cerebral Veins ; Child ; Ectopia Lentis ; Female ; Homocystinuria* ; Humans ; Infarction* ; Intellectual Disability ; Korea ; Metabolism ; Methionine ; Mortality ; Myocardial Infarction ; Pulmonary Embolism ; Stroke ; Thalamus* ; Thrombosis ; Venous Thrombosis* ; Young Adult

Plasmacytomas are tumors composed of plasma cells of variable maturity, which are histologically identical to those seen in multiple myeloma. Ankylosing spondylitis is a chronic inflammatory disease, probably resulting from the interaction of a genetic predisposition involving HLA-B27 with an environmental event such as enteric bacterial infection. Multiple myeloma has been intermittently reported in patients with ankylosing spondylitis. It has been proposed that the protracted stimulation of immunocytes by inflammatory lesions on the mucosal surfaces of the gastrointestinal, respiratory tracts may be implicated in the pathogenesis of multiple myeloma in some patients. We observed a 23 year old male patient with a history of plasmacytoma who subsequently developed ankylosing spondylitis. He was diagnosed as plasmacytoma 4 years ago and took a radiation therapy. There was no previous report of ankylosing spondylitis following plasmacytoma. The relationship between two diseases is uncertain until now and further study should be needed.
Bacterial Infections ; Genetic Predisposition to Disease ; HLA-B27 Antigen ; Humans ; Male ; Multiple Myeloma ; Plasma Cells ; Plasmacytoma* ; Respiratory System ; Spondylitis, Ankylosing* ; Young Adult

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

Renal hemangioma is an uncommon benign tumor which usually causes painless or painful gross hematuria. Its preoperative diagnosis is extremely difficult or even impossible. We experienced three cases of renal hemangioma, located mainly at the pelvocalyceal junction or in the inner medulla. US demonstrated variable echogenecity, and CT revealed a lack of significant enhancement. Where there is gross hematuria in a young adult, especially when the renal mass located in the pelvocalyceal junction or inner medulla shows little enhancement on CT, renal heman-gioma should form part of the differential diagnosis.
Adult ; Case Report ; Diagnosis, Differential ; Hemangioma, Capillary/*radiography/*ultrasonography ; Hemangioma, Cavernous/*radiography/*ultrasonography ; Hematuria/etiology ; Human ; Kidney Neoplasms/*radiography/*ultrasonography ; Male ; Tomography, X-Ray Computed