Up to 5% of young children suffer from food allergy. Children with food allergy may present with a variety of symptoms that parents have attributed to constituents of the diet. The diagnosis and management of adverse food reactions is a challenge for physicians. Diagnostic approaches are composed of a detailed history, in vitro tests and in vivo tests. Improved diagnostic methods include more precise in vitro and in vivo tests for immunoglobulin E-mediated food allergies, in vitro assays for predicting development of oral tolerance, and novel non-invasive tests for cell-mediated food allergies such as patch testing, cytokine assays, and detection of eosinophil activation markers. The conventional diet therapy, pharmacotherapy and new immunomodulatory approaches to food allergy are also discussed. Rapidly evolving findings might provide hope for a cure of food allergy in the near future.
Child ; Diagnosis* ; Diet ; Diet Therapy ; Drug Therapy ; Eosinophils ; Food Hypersensitivity* ; Hope ; Humans ; Immunoglobulins ; Parents ; Patch Tests

PURPOSE: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. We studied the changes of antibiotic sensitivity to the causative organisms of urinary tract infection(UTI) for recent 5 years in order to give some useful informations about the choice of adequate drug in the treatment of UTI. MATERIALS AND METHODS: We analysed 1191 uropathogens and their antibiotic sensitivities of the 1132 patients who admitted or visited the National Police Hospital and had more than 105cfu/ml on urine culture from January 1994 to December 1998 retrospectively. RESULTS: The common pathogenic organisms were E. coli(51.5%), staphylococcus(15.7%), pseudomonas(9.1%), klebsiella(7.5%) and enterobacter(4.0%), enterococcus(3.4%), proteus(3.1%) in order. The incidence of E. coli decreased from 50.8% in 1994 to 41.3% in 1998 but the incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter increased from 24.8% in 1994 to 42.6% in 1998. In E. coli isolates(the majority of positive cultures), resistance to six antibiotics changed significantly: ampicillin(19.4% to 15.5%), piperacillin(44.1% to 32.0%), cephalothin(70.6% to 58.6%), gentamicin(62.8% to 60.2%), tobramycin(95.0% to 88.1%), and ciprofloxacin(87.6% to 76.3%). The sensitivity rates of the gram negative organisms including E. coli were very low in 1998 (ampicillin 11.6%, piperacillin 36.6%, and trimethoprim/sulfamethoxazole 49.3%). CONCLUSIONS: We think that E. coli is still the most important organism in the UTI but we shoud be concerned about the increasing incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter. And prior to receiving the bacteriological report, using ampicillin, trimethoprim/sulfamethoxazole as the first choice in the treatment of UTI shoud be reconsidered.
Acinetobacter ; Ampicillin ; Anti-Bacterial Agents ; Anti-Infective Agents ; Enterobacter ; Humans ; Incidence ; Klebsiella ; Piperacillin ; Police ; Proteus ; Pseudomonas ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

OBJECTIVE: Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >10° at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. METHODS: A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study. All enrolled cases included at least 4 or more levels from L5 or the sacral level. The patients were divided into two groups based on the presence of PJK during follow-up, and these two groups were compared to identify factors related to PJK. RESULTS: PJK was observed in 16 of the 49 cases. Age, sex and mean follow-up duration were not statistically different between two groups. However, mean bone marrow density (BMD) and mean back muscle volume at the T10 to L2 level was significantly lower in the PJK group. Preoperatively, the distance between the C7 plumb line and uppermost instrumented vertebra (UIV) were no different in the two groups, but at final follow-up a significant intergroup difference was observed. Interestingly, spinal instrumentation factors, such as, receipt of a revision operation, the use of a cross-link, and screw fracture were no different in the two groups at final follow-up. CONCLUSION: Preoperative BMD, sagittal imbalance at UIV, and thoracolumbar muscle volume were found to be strongly associated with the presence of PJK.
Adult ; Back Muscles ; Bone Marrow ; Congenital Abnormalities ; Follow-Up Studies* ; Hospitals, University ; Humans ; Kyphosis* ; Osteoporosis ; Risk Factors* ; Sarcopenia ; Spine

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

Small cell carcinoma is derived from APUDcells of any parts of the body. Usually the cases are discovered in the lungs and have poor prognosis. Small cell carcinoma has been increasingly reported in various organ outside the lungs, such as the larynx, thymus, esophagus, stomach, pancreas, uterine cervix, and prostate. Primary small cell carcinoma of the stomach is extremly rare. The histology of the tumor was similar to that of ordinary small cell carcinoma of the lung, and the secretory granules were identified by electron microscopy. We report a patient with gastric pure small cell carcinoma who treated by a radical total gastrectomy and chemotherapy.
Carcinoma, Small Cell* ; Cervix Uteri ; Drug Therapy ; Esophagus ; Female ; Gastrectomy ; Humans ; Larynx ; Lung ; Microscopy, Electron ; Pancreas ; Prognosis ; Prostate ; Secretory Vesicles ; Stomach ; Thymus Gland

We report a case of male infertility secondary to pituitary apoplexy, which occurred as a sequela of korean hemorrhagic fever. A 32 years old male patient with past history of korean hemorrhagic fever was studied because of infertility and erectile impotence. The size of his testicles were about 8ml in Rt. and Lt. Semen analysis, endocrinologic studies, and brain MRI demonstrated hypogonadotrophic hypogonadism due to panhypopituitarism. The patient was treated with HCG (2,000 IU) administered intramuscularly three times per week for 6 months. After the treatment, improvement of male secondary sex characteristics such as hair growth and testicle size was noted. Promotion of sexual potency and improvement of semen quality were also noted. Following the treatment, his wife conceived after 6 months.
Adult ; Brain ; Erectile Dysfunction ; Hair ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypogonadism ; Infertility ; Infertility, Male* ; Magnetic Resonance Imaging ; Male ; Male* ; Pituitary Apoplexy* ; Semen Analysis ; Sex Characteristics ; Spouses ; Testis

Von Recklinghausen`s neurofibromatosis is an unusual disorder with a wide variety Of manifestations. The initial findings may at times involve the female genitalia. When the phallus is affected, the urologist has an opportunity for the establishment of an accurate diagnosis as well as for cosmetic correction. We report a case of neurofibromatosis with an involvement of clitoris in 1l-year-old girl.
Clitoris ; Diagnosis ; Female ; Genitalia, Female ; Humans ; Neurofibromatoses* ; Neurofibromatosis 1

BACKGROUND : Prophylactic nasogastric decompression is used routinely after elective gastric surgery in spite of many disadvantages and complications - discomfort, pain, especially postoperative atelectasis. The aim of this study was to determine whether routine nasogastric decompression benefitted patients undergoing elective stomach operations. METHODS : Two hundreds forty patients were studied prospectively. All patients underwent elective gastric surgery from January 1994 to March 1996 by one surgeon at Gospel Hospital. In the intubated group, 120 consecutive patients were treated with a nasogastric tube (silastic, 16 French) just before or during the operation, it being removed on the 1st or the 2nd postoperative day. In the tubeless group, a nasogastric tube was not inserted at all in 120 consecutive patients. We compared the differences between two groups with respect to the mean duration of flatus passing, the incidence of postoperative pulmonary complication, leakage, reoperation, wound dehiscence, and operation mortality. RESULTS : The two groups showed no significant differences in age, sex and operation methods. Flatus passed earlier in the tubeless group, but the difference was statistically insignificant. The patients suffering from atelectasis were much larger in number in the intubated group (p<0.03). There were no significant differences in the incidence of anastomotic leakage, wound dehiscence, reoperation and operation mortality. CONCLUSIONS : The routine omission of nasogastric intubation was not associated with increased risks, such as leakage, wound dehiscence, reoperation, postoperative pulmonary complication, delayed flatus passing or diet intake, operative morbidity and motality. Conversely, the incidence of postoperative atelectasis was twice as high in the intubated group. We conclud that routine nasogastric intubation should be used only in specific cases and routine use of nasogastric intubation is not justified.
Anastomotic Leak ; Decompression* ; Diet ; Flatulence ; Humans ; Incidence ; Intubation, Gastrointestinal ; Mortality ; Prospective Studies ; Pulmonary Atelectasis ; Reoperation ; Stomach ; Wounds and Injuries

No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Ifosfamide* ; Paclitaxel*