No abstract available.
Neck*

PURPOSE: Atopic dermatitis is a chronic, inflammatory relapsing skin disease fre- quently seen in children with a history of food allergy. Recently, acute allergic reaction to egg in patients with atopic dermatitis who have never been exposed to egg white protein has been reported. The pattern of antigen-antibody reaction by means of IgE and IgG western blotting was analysed to evaluate the possibility of non- dietary sensitization. METHODS: Total 16 children(<3 years old) with egg allergy were enrolled. Eight patients of them had never ingested egg before(Non-dietary sensitization, NDS) and the other 8 patients had a history of previous egg ingestion without significant clinical symptoms(Dietary sensitization, DS). Egg proteins were analysed by SOS-PAGE and antigen-antibody reaction by means of IgE and IgG was deteded by Western-Blotting. RESULTS: The pattern of IgE antibodies to egg white protein were similar in the two groups. IgG Western blotting to egg white in the two groups, the ovotran sferrine and ovalbumin were significantly bound by 100% of sera, respectively. In DS patients, specific IgG antibodies to ovomucoid was significantly bound by 87% (7/8) of sera whereas only 38%(3/8) of sera had detectable specific IgG antibodies against ovomucoid in NDS patients. CONCLUSION: Theses results suggest that specific IgE to egg white related to exposure of egg white protein regar specific IgG to ovomucoid is related to dietary ingestion of egg. Specific IgG to ovalbumin and ovotrans-ferrine show good clinical correlation, further study might be essential to clarify to this hypothesis.
Allergens* ; Antibodies ; Antigen-Antibody Reactions ; Blotting, Western ; Child ; Dermatitis, Atopic ; Eating ; Egg Hypersensitivity ; Egg Proteins ; Egg White ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulin G* ; Ovalbumin ; Ovomucin ; Ovum* ; Skin Diseases

PURPOSE: Kiwi fruit allergy in children has scarcely been reported. This study focused on the clinical characteristics of kiwi fruit allergy and value of kiwi specific Immunoglobulin E (IgE) antibodies in Korean children. METHODS: The study was based on a data analysis of 18 patients, who were diagnosed with clinical kiwi fruit allergy at Ajou University Hospital from June 2005 to June 2012. Clinical details were collected by medical history and telephone survey. Sera from all children were analyzed for kiwi specific IgE (ImmunoCAP) and patients with negative result were further evaluated by an enzyme linked immunosorbentassay test (ELISA) using our own made kiwi fruit extracts. RESULTS: The subjects were 10 male and 8 female with a median aged 25 months. Twelve out of 18 (66.7%) were diagnosed with angioedema or urticaria, 4 (22.2%) were diagnosed with oral allergy syndrome, 1 was presented with dyspnea, and 1 was diagnosed with anaphylaxis. Oral route of exposure (88.9%) was most common and majority of patients (88.9%) experienced clinical symptoms at the first exposure to kiwi fruit. Six out of 12 patients with urticaria showed negative result in specific IgE by ImmunoCAP, but specific IgE were detected in 2 of 6 by ELISA with our own made kiwi extract. CONCLUSION: Systemic reactions to kiwi fruit were common in Korean children, and the symptoms were frequently developed at the first time of exposure. Additional diagnostic methods would be needed for evaluation of IgE sensitization in kiwi allergic patients with negative result by ImmunoCAP.
Aged ; Anaphylaxis ; Angioedema ; Antibodies ; Child ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Female ; Fruit ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Male ; Statistics as Topic ; Telephone ; Urticaria

RO Kishun was born on February 2, 1893 in Ongjin County, Hwanghae Province of Joseon Korea. He graduated from the Medical Training Center, a campus associated with the Joseon Government-General Hospital, in 1915, and from Kyushu Imperial University School of Medicine in 1917. He continued his medical study at the university in 1929, majoring in biochemistry, and earned a doctorate in medicine in 1932. Dr. RO, one of the earliest pioneers in Korean biochemistry, was active in his research, publishing four studies in the Japanese Journal of Biochemistry between 1931 and 1932. After returning from Japan in 1932, Dr. RO opened a medical practice in Mokpo and Busan, port cities situated on the southern tip of Korea. Later in 1936, he moved north to Manchuria (northeast China) to practice medicine at the International Hospital in Mukden (present-day Shenyang). He also served as president of Tumen Public Hospital between 1942 and 1946. When Japan signed unconditional surrender bringing World War II to an end, Dr. RO relocated to Yanbian and began providing medical training to ethnic Koreans. In October 1946, he was appointed dean of the First Branch School of China Medical University in Longjing, and in October 1948 the first dean of Yanbian Medical School, the predecessor of Yanbian University College of Medicine. Dr. RO dedicated his life to medical practice, teaching and training students, and mentoring younger faculty. A brilliant clinician, he also inspired and helped his colleagues with his outstanding ability to diagnose and treat patients. He was one of the founding members of Yanbian University College of Medicine. RO Kishun died on June 7, 1957 at age 64. Ethnic Koreans hailed him as Sinui (literally, the physician of God), and a bronze statue of himself was erected in front of the medical college in 1988. Dr. RO's life brings modern historians' attention to the issue of determining geographical territories and nationality, in that his life unfolded at the borderlands or frontiers of Joseon Korea, China, and Japan, where the history of the three nations met and intermingled with one another. He was a biochemist and researcher, practicing physician and medical professor of the era under Japanese Rule and the one following it. In modern Korean medicine, his life is viewed as a history of the borders, or a transnational legacy going beyond individual history of Korea, China, and Japan.
Biochemistry/*history ; Clinical Medicine/history ; Education, Medical/*history ; History, 20th Century ; Hospitals, Public/history ; Humans ; Korea ; Universities/history

Familial adenomatous polyposis (FAP) is an autosomal dominant disorder characterized by hundreds of colorectal adenomatous polyps that progress to colorectal cancer. Management of patients with FAP is with a total colectomy. Chemopreventive strategies have been studied in FAP patients in an effort to delay the development of adenomas in the upper and the lower gastrointestinal tract and to prevent recurrence of adenomas in the retained rectum of patients after prophylactic surgery. Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients. However, evidence regarding long-term use of this therapy and its effect on the intact colon has been insufficient. We report a case in which the long-term use of sulindac was effective in reducing the size and the number of colonic polyps in patients with FAP without a prophylactic colectomy and polypectomy; we also present a review of the literature.
Adenoma* ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Chemoprevention ; Colectomy* ; Colon* ; Colonic Polyps ; Colorectal Neoplasms ; Follow-Up Studies* ; Humans ; Lower Gastrointestinal Tract ; Rectum ; Recurrence ; Sulindac*

Endotracheal obstruction may cause serious complications, including cardiovascular instability, pneumothorax, pulmonary edema and even brain death. A 21-year-old man was scheduled to undergo an open reduction for an orbital fracture. The patient had tracheostomy with an 8.0 mm tracheostomy tube 3 weeks ago and was breathing well spontaneously. When the cuff of tracheostomy tube was inflated for assisted manual ventilation and the induction of anesthesia, signs of partial endotracheal obstruction were observed, including high airway pressure, low tidal volume and high ETCO2. Large dried mucous plug was impacted in the tracheostomy tube. After removing this plug with a sterile surgical forcep, effective ventilation was recovered without complications. The case like this nearly fatal obstruction by large dried mucous plug was rarely reported, but it should be considered cautiously when a patient uses tracheostomy tube as an airway before general anesthesia.
Airway Obstruction ; Anesthesia ; Anesthesia, General ; Brain Death ; Humans ; Orbital Fractures ; Pneumothorax ; Pulmonary Edema ; Respiration ; Surgical Instruments ; Tidal Volume ; Tracheostomy ; Ventilation ; Young Adult

BACKGROUND AND OBJECTIVE: Murine system for studying allergic diseases has been popular in the fields of food allergy and development of their therapeutic strategies. However, there has been no information about the age-dependent changes of natural immune responses of naive C3H/HeJ mice. The purpose of this study was to evaluate the age-dependent changes of B and T-cell mediated immunologic parameters in naive C3H/HeJ mice, which can provide information for experimental planning and analysis of research results. SUBJECTS AND METHODS: Eight naive, female, 5-week-old C3H/HeJ mice were grown under the regular mouse chow feeding conditions for 6 weeks. Sera were obtained at week (w) 5, w6, w8 and w10 for measuring total and chow-specific IgE, IgG1 and IgG2a antibodies. Splenocyte proliferation (at w8 and w10) and cytokine production (at w6, w8 and w10) were evaluated with or without Con A stimulation with pooled splenocytes from two mice of each age group. Serum antibodies and cytokines (IL-4, IL-5, IL-12, INF-gamma, TGF-beta1) were measured by ELISA. Using RT-PCR, IL-4 and INF-gamma mRNA expressions were measured in Peyer's patch and spleen tissue at w10. RESULTS: The levels of total IgE and IgG1 were increased by age while the level of IgG2a was decreased. Chow-specific IgE and IgG2a responses were neglectable through out the whole experimental period (20-30 ng/ml or less). Chow-specific IgG1 levels were measured in the significant concentrations (200-300 ng/ml) but there was no age-dependent change through out the experiment. Con A stimulated-splenocyte proliferation indexes were variable according to the culture-durations and ages of mice. The higher proliferation indexes were observed in the wells receiving thymidine pulse at 48-hour culture, especially in the mice at w10. Con A stimulated IL-4 production in the 72-hour splenocyte culture supernatant was significantly increased at w8, and w10 while INF-gamma production increased only at w10. The changes in the production of IL-5, IL-12 and TGF-beta did not provide significant information in the present study. The ratio of IL-4/IFN-gamma mRNA expression was higher in Peyer's patch than in the spleen. CONCLUSION: The changes of B-cell and T-cell mediated immunologic parameters were complex and variable according to the age in naive C3H/HeJ mice under regular chow feeding conditions. For that reason, the information from the present study needs to be considered in the course of planning or analysing research/data using murine systems.
Animals ; Antibodies ; B-Lymphocytes ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Interleukin-12 ; Interleukin-4 ; Interleukin-5 ; Mice* ; RNA, Messenger ; Spleen ; T-Lymphocytes ; Thymidine ; Transforming Growth Factor beta

OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Child, Preschool ; Cost Sharing/*legislation & jurisprudence ; *Health Policy ; Health Services/*utilization ; Hospitalization ; Humans ; Insurance Claim Review ; Korea ; Length of Stay

OBJECTIVE: There is a broad spectrum of compensated hydrocephalus. Various terms such as long-standing overt ventriculomegaly in adult (LOVA) has been coined, however, even such terms leave diverse aspect of this condition out of account. We have experienced compensated hydrocephalus cases which were considered to be activated after a long time period of quiescent state, and tried to compare their clinical characteristics with the relatively well described entity of LOVA. METHODS: We conducted a retrospective review of 206 patients who underwent ventriculoperitoneal shunt (VPS) between February 2001 and May 2012. Of these, 6 patients had chronic compensated hydrocephalus. The clinical and radiological characteristics are evaluated. RESULTS: Definite triventriculomegaly was observed in two patients. Macrocephaly was observed in two cases, one with aqueductal stenosis (AS), the other with unknown status of aqueduct. All of the cases with triventriculomegaly were normocephalic. Spinal causes were thought as aggravating factor in two. Two endoscopic third ventriculostomy and eight VPS were performed in five patients. Four patients responded well but one took a very complicated course. CONCLUSION: The relationships between macrocephaly, triventriculomegaly, and AS suggested in other studies were inconsistent. Blockage or narrowing of cerebrospinal fluid pathways were observed at various sites. Disturbances of spinal arachnoid pathways were related to the activation in some cases. Treatment is to be tailored individually considering various reigniting event. It is suggested that this entity is to be evaluated for better nomenclature reflecting diverse aspects of this condition. Further study is needed to elucidate underlying pathophysiology and effective management.
Adult ; Arachnoid ; Humans ; Hydrocephalus ; Macrocephaly ; Numismatics ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Ventriculostomy

PURPOSE: Currently many studies have confirmed the relationship between serum adiponectin and its influence on insulin resistance in adults. But physiologic insulin resistance due to changes in sex hormones exists during puberty, which prohibits us from knowing the influence of adiponectin to insulin resistance in this population. In this study, we investigated the influence of adiponectin on insulin resistance in children and adolescents. METHODS: 18 obese children, from the OPD were selected. From All subjects, blood was sampled after overnight fasting, adiponectin, lipid profiles, AST, ALT, fasting glucose and insulin levels were measured to evaluate correlations with adiponectin. The group were divided into subgroups by BMI, sex and HOMA-IR values. All variables were compared for differences and relationships. RESULTS: Obese groups showed decrease in adiponectin and showed increased insulin. HOMA-IR values were increased in the obese group. In all study participants, adiponectin showed significant correlation with triglyceride and HDL. But adiponectin showed no significant correlation with HOMA-IR, insulin and glucose. In the obese group adiponectin showed no correlation with HOMA-IR, insulin and glucose. HOMA-IR showed significant correlation with BMI, body weight and age. There were no sexual differences in adiponectin, insulin and HOMA-IR values. Insulin resistant group showed decrease in adiponectin but had no statistical significance. CONCLUSION: Decreased adiponectin levels and increased insulin resistance were observed in obese children but adiponectin showed no correlation with insulin resistance in children and adolescence. Factors other than adiponectin may play a more significant role in insulin resistance in this age group.
Adiponectin* ; Adolescent* ; Adult ; Body Weight ; Child* ; Fasting ; Glucose ; Gonadal Steroid Hormones ; Humans ; Insulin Resistance* ; Insulin* ; Puberty ; Triglycerides