No abstract available.
Prognosis*

PURPOSE: This study was aimed to investigate the relationship between changes in intrapulmonary right to left shunt(QSP/QT) and improvements in oxygenation during the 2-hr study period after Surfactant-TA(S-TA) administration. METHODS: Umbilical arterial blood gases and corresponding respiratory indexes of 27 preterm neonates with respiratory distress syndrome were studied. The neonates were separated into group A(n=20) and group B(n=7) according to whether their initial QSP/QT was above or below 30 %, respectively. And the patients were studied immediately before and after endotracheal single- dose S-TA administration within 6 hours after birth. RESULTS: In the case of P(a/A)O2, group A showed a significant increase throughout the study period(P<0.01, P<0.001), whereas group B showed an initial significant increase at 2 hr(P<0.05). Significant correlations between changes in QSP/QT and improvements in P(a/A)O2 were seen in both groups(P<0.001, P<0.05). Moreover in the case of PaO2/FIO2, group A showed a significant increase throughout the study period(P<0.01, P<0.001), whereas group B showed an initial significant increase at 30 min(P<0.05). Significant correlations between changes in QSP/QT and improvements in PaO2/FIO2 were also seen in both groups(P<0.01, P<0.05). And at 2 hr, VEI and VA showed a significant increase in both groups(P<0.05, P<0.01), whereas PaCO2 showed a significant decrease in both groups(P<0.001, P<0.05). CONCLUSION: Irrespective of initial QSP/QT, immediate improvements in oxygenation following surfactant replacement were accomplished by recruiting atelectatic alveoli and stablizing underventilated alveoli(namely by decreasing QSP/QT). Moreover, the patients with more severe respiratory failure had a more rapid and sustained improvement in oxygenation.
Gases ; Humans ; Infant, Newborn ; Oxygen* ; Parturition ; Respiratory Insufficiency

No abstract available.
Ferritins* ; Humans

Although basic mechanisms of atopic dermatitis remain largely speculative, many studies on pathogenesis suggest the importance of food and inhalent allergens. To evaluate the frequency of food and house dust mite hypersensitivity and differences in this frequency according to ages, we measured the levels of specific IgE antibodies to egg white, egg yolk, milk, soy, and house dust mites in 119 children with atopic dermatitis. The results showed that 53% of patients had positive RAST to any one kind of allergens. The frequency of food and house dust mite hypersensitivity were 34.5%, 30.3 %, respectively. Among allergens, house dust mites and egg white are the most prevalent allergens in all atopic dermatitis patients. The Prevalence of egg white is most common under the age of 2 years, but those of house dust mites are the dust mites are the highest in the ages of 5-12 years. In conclusion, we recommend an egg restriction diet in atopic dermatitis patients who are less than 2 years old when their symptoms do not improve with general skin care.
Allergens ; Antibodies ; Antigens, Dermatophagoides ; Child* ; Child, Preschool ; Dermatitis, Atopic* ; Diet ; Dust* ; Egg White ; Egg Yolk ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mites ; Ovum ; Prevalence ; Pyroglyphidae* ; Skin Care ; Soy Milk

No abstract available.
Factor X*

Chronic dermatophyte infection rarely fails to respond to topical or systemic antifungal therapy. Such refractory condition relates to many factors and one of them is the decreased response of delayed type hypersensitivity. A plausible mechanism by which the delayed hypersensitivity response may cause dermatophyte inhibition has been proposed already. Our patient had skin rashes for 6 years. It was diagnosed as tinea corporis and treated with various systemic antifungal agents, such as griseofulvin, itraconazole, fluconazole, terbinafine and topical forms of econazole and terbinafine. But the skin lesions did not resolve completely and reaggravated frequently. Numerous verrucae planar were found on face, neck and both extremities. Trichophyton rubrum was identified by fungus culture study. Laboratory examination showed no response against multi-CMI test, DPCP sensitization and prick test for trichophytons. We challenged the therapy with the combined antifungal agents and immune stimulatory drugs. This case is thought to be a chronic dermatophyte infection due to the defects in the both cell mediated immunity and immediate type hypersensitivity which is crucial for the host defence mechanisms against fungal infection.
Antifungal Agents* ; Arthrodermataceae* ; Econazole ; Exanthema ; Extremities ; Fluconazole ; Fungi ; Griseofulvin ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Immunity, Cellular ; Itraconazole ; Neck ; Skin ; Tinea ; Trichophyton ; Warts

PURPOSE: There are some disagreements about the optimal dosages of intravenous gammaglobulin(IVGG) and oral aspirin(ASA) in the treatment of Kawasaki disease. So authors performed a prospective clinical study to evaluate the efficacy of IVGG 1g/kg plus ASA 50mg/kg/day. METHODS: We treated 29 patients who were admitted to Inha University Hospital from June 1993 through May 1994 with IVGG 1g/kg plus ASA 50mg/kg/d. We compared the outcomes of above patients with those of two other groups of patients, group A and B in authors' previous study. Group A(20 patients) had been treated with IVGG 2g/kg plus ASA 50mg/kg/d and group B(19 patients) with IVGG 2g/kg plus ASA 100mg/kg/d. The outcomes had been similar in group A and B, which was published on this journal in 1995 (vol. 38:378-385). RESULTS: 1) Twenty five patients(86.2%; group C) were given only one dose of IVGG 1g/kg, and remaining 4 patients(13.8%; group D) were given two doses of IVGG 1g/kg because of persistent high fever. 2) The age and sex distributions, durations of fever before treatment, and durations of ASA therapy in group C were not significantly different from those in group A and B (p>0.05). 3) Laboratory findings on admission in group C were not significantly different from those in group A and B, except that the mean ESR was lower in group C than in group A and B (35.1+/-19.8 vs 55.5+/-5.95 & 50.2+/-11.4mm/hr; p<0.01, respectively). 4) The durations of fever after treatment in group C were not significantly different from those in group A and B (1.32+/-1.07 vs 2.65+/-3.28 & 1.74+/-1.52 days; p>0.05, respectively). 5) In group C, the mean hemoglobin concentration at the 3rd week of illness was higher than in group A (11.1+/-0.98 vs 10.1+/-1.24g/dl; p<0.05), the mean platelet count at the 2nd week of illness was lower than in group A (59.4+/-18.0x10(4) vs 73.6+/-19.0x10(4)/ l; p<0.05), and the mean ESRs at the 2nd and 3rd week of illness were lower than in group A (43.3+/-14.7 vs 54.0+/-9.16, 31.9+/-19.0 vs 47.7+/-13.0mm/hr; p<0.05, respectively). Other follow-up laboratory findings in group C were not significantly different from those in group A and B. 6) Echocardiography was done 2 and 4 weeks after onset of illness. Coronary arterial dilation was observed in four(4/25; 16%) and two(2/23; 8.7%) patients respectively in group C, and the proportions were not significantly different from those in group A(40% & 25%) and B(31.6% & 10.5%) (p>0.05, respectively). In follow-up examinations, coronary aneurysm was observed in only one(1/23; 4.3%) in group C, which was similar to group A(1/18; 5.5%) and B(1/19; 5.2%) (p>0.05, respectively). Giant aneurysm was not observed in any patients. 7) Four patients(group D) were given one more dose of IVGG 1g/kg because high fever persisted 48 hours after injection of the first dose of IVGG. Afterthen fever subsided within 1 to 7 days. Echocardiography revealed mild coronary arterial dilation in two patients initially, but follow-up examinations revealed no coronary aneurysm. CONCLUSIONS: The medium-dose combined regimen with IVGG 1g/kg plus ASA 50mg/kg/d seems to be more cost-effective than the high-dose regimen with IVGG 2g/kg plus ASA 50-100mg/kg/d. If high fever persists 48 hours or more after the first dose of IVGG 1g/kg, it is desirable to give one more dose of IVGG 1g/kg.
Aneurysm ; Aspirin* ; Coronary Aneurysm ; Echocardiography ; Fever ; Follow-Up Studies ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Platelet Count ; Prospective Studies ; Sex Distribution

PURPOSE: There are many methods to interpret the skin prick test which has been commonly used to find out the causative allergen in allergic disease. Among them two are most frequently used. One is to measure the absolute size of wheal which is caused by the allergen and the other is to compare the size of wheal for allergen with that of positive control. However the wheal is smaller than erythema at the same dosage of allergen and changes less with according to the allergen dosage. So we investigated the feasibility of the size of erythema as one of the index in the interpretation of skin prick test. METHODS: We carried out skin prick tests on various allergens, including Dermatophagoides pteronyssinus (Dp), Dermatophgoides farinae (Df), and house dust (HD) in 220 patients who visited the pediatric allergy clinic at Inha Hospital from January 1990 to January 1996. RESULTS: Among the 220 patients studied, 120 children (55%) showed positive skin test. There was significant correlation between wheal and erythema (P<0.0001 for Dp, P<0.0001 for Df, and P<0.0001 for HD). There was a significant statistical correlation (P<0.0001) between the allergen/histamine wheal ratio (A/HW ratio) and the size of erythema for Dp, P<0.0001 for Df, and P<0.0001 for HD. There was a significant statistical difference in the wheal size, A/HW ratio, and erythema size, allergen/histamine erythema ratio (A/HE ratio) for Dp, Df, HD between positve and negative group of RAST. As the RAST class increases, the erythema size and A/HE ratio for Dp, Df, and HD showed a tendency to increase. Sensitivity and specificity of skin test with cut off value of 20mm for erythema were 87.9%, 58.3% in Dp, 85.2%, 66.6% in Df, 61.4%, 71.9% in HD and 25mm were 75.9%, 83.3% in Dp, 67.6%, 91.6% in Df and 40.9%, 100% in HD. CONCLUSION: We conclude that erythema size can be used as one of the interpreting index of skin prick test. We also recommand more than 25mm as a cut off value for positive reaction for Dp, Df and more than 20mm for HD in bronchial asthma.
Allergens ; Asthma ; Child ; Dermatophagoides pteronyssinus ; Dust ; Erythema* ; Humans ; Hypersensitivity ; Sensitivity and Specificity ; Skin Tests ; Skin*

PURPOSE: There are many methods to interpret the skin prick test which has been commonly used to find out the causative allergen in allergic disease. Among them two are most frequently used. One is to measure the absolute size of wheal which is caused by the allergen and the other is to compare the size of wheal for allergen with that of positive control. However the wheal is smaller than erythema at the same dosage of allergen and changes less with according to the allergen dosage. So we investigated the feasibility of the size of erythema as one of the index in the interpretation of skin prick test. METHODS: We carried out skin prick tests on various allergens, including Dermatophagoides pteronyssinus (Dp), Dermatophgoides farinae (Df), and house dust (HD) in 220 patients who visited the pediatric allergy clinic at Inha Hospital from January 1990 to January 1996. RESULTS: Among the 220 patients studied, 120 children (55%) showed positive skin test. There was significant correlation between wheal and erythema (P<0.0001 for Dp, P<0.0001 for Df, and P<0.0001 for HD). There was a significant statistical correlation (P<0.0001) between the allergen/histamine wheal ratio (A/HW ratio) and the size of erythema for Dp, P<0.0001 for Df, and P<0.0001 for HD. There was a significant statistical difference in the wheal size, A/HW ratio, and erythema size, allergen/histamine erythema ratio (A/HE ratio) for Dp, Df, HD between positve and negative group of RAST. As the RAST class increases, the erythema size and A/HE ratio for Dp, Df, and HD showed a tendency to increase. Sensitivity and specificity of skin test with cut off value of 20mm for erythema were 87.9%, 58.3% in Dp, 85.2%, 66.6% in Df, 61.4%, 71.9% in HD and 25mm were 75.9%, 83.3% in Dp, 67.6%, 91.6% in Df and 40.9%, 100% in HD. CONCLUSION: We conclude that erythema size can be used as one of the interpreting index of skin prick test. We also recommand more than 25mm as a cut off value for positive reaction for Dp, Df and more than 20mm for HD in bronchial asthma.
Allergens ; Asthma ; Child ; Dermatophagoides pteronyssinus ; Dust ; Erythema* ; Humans ; Hypersensitivity ; Sensitivity and Specificity ; Skin Tests ; Skin*

Idiopathic pulmonary hemosiderosis (IPH), a rare disease of unknown etiology, is characterized by iron deficiency anemia and chronic recurrent pulmonary symptoms such as cough, hemoptysis, and dyspnea. Recurrent intra-alveolar hemorrhage resulting in hemosiderin accumulation and progressive fibrosis often leads to death. We experienced a case of IPH in a two-year-old male who was presented with cough, dyspnea, hemoptysis and anemia. The diagnosis was confirmed by hemosiderin-laden macrophages in a gastric aspirate. He was initially treated with oral iron and prednisolone for one year. But pulmonary symptoms such as cough and hemoptysis recurred five times while he was on oral prednisolone and the side effects of moon face and truncal obesity developed. So inhaled steroid (budesonide) was administered for 18 months, with improvement of pulmonary symptoms. This suggests that early treatment with inhaled steroids may work in IPH without the serious side effects of systemic steroid. The effect of inhaled steroid should be evaluated as the initial treatment of IPH.
Anemia ; Anemia, Iron-Deficiency ; Child ; Cough ; Diagnosis ; Dyspnea ; Fibrosis ; Hemoptysis ; Hemorrhage ; Hemosiderin ; Hemosiderosis* ; Humans ; Inhalation* ; Iron ; Macrophages ; Male ; Obesity ; Prednisolone ; Rare Diseases ; Steroids