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

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

No abstract available.
Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome*

A clinico-pathologic study with an immunohistochemical examination for c-erbB-2 expression in 54 cases of ductal carcinoma in situ and 16 cases of Paget's disease of the breast was performed. c-erbB-2 oncoprotein overexpression was observed in 45% (24/54) and 88% (14/16) of ductal carcinoma in situ and Paget's disease, respectively. The overexpression of c-erbB-2 oncoprotein was significantly correlated with the nuclear grade of tumors and inversely with the status of the estrogen receptor. c-erbB-2 was positive in 4 out of 5 patients with metastasis to axillary lymph nodes and 3 out of 4 patients who died of the disease. Prognostic significance of c-erbB-2 oncoprotein in ductal carcinoma in situ was highly suggested. The expression of c-erbB-2 oncoprotein in Paget's disease was well correlated with coexisting infiltrating or in situ ductal carcinoma. The high positive rate of c-erbB-2 oncoprotein in ductal carcinoma with Paget's disease could be understood with a recent hypothesis that c-erbB-2 oncoprotein is involved in promotion of cell motility and the spread of carcinoma cells.
Neoplasm Metastasis

Neurofibromatosis, first clearly described by von Recklinghausen in 1882, is a dominantly inherited mesodermal and ectodermal dysplasia with a broad spectrum of clinical findings. Most common is the classical neurofibromatosis, which has three major features: (1) multiple neural tumors dispersed anywhere on or in the body; (2) numerous pigmented skin lesions, some of which are "cafe au lait" spots; and (3) pigmented iris hamartomas also called Lisch nodules. Other lesions sometimes seen in patients with von Recklinghausen's disease include congenital malformations of various types, vascular lesions, neurilemoma meningioma and other intracranial neoplasms, pheochromocytoma, medullary carcinoma of thyroid gland, neuroblastoma, ganglioneuroma and Wilms' tumor. Approximately 10% of the patients with neurofibromatosis have the gastrointestinal tract tumors as neurofibroma, ganglioneuroma and leiomyoma. Some of them show evidence of malignancy. Increased activity of the protein "nerve growth factor" in the sera of the patients with disseminated neurofibromatosis has been reported. We would like to report here two cases of von Recklinghausen's neurofibromatosis with involvement of the gastrointestinal tract.
Hamartoma ; Meningioma

PURPOSE: Low-dose dopamine (0.5-3 microgram/kg/min) increases renal blood flow, glomerular filtration rate and natriuresis and has protective and therapeutic effects on oliguric renal failures. Asphyxia is the most common cause of acute renal failure in neonates. But the protective effects of dopamine have never been reported in asphyxiated neonates. So we reported the effects of low-dose dopamine on the renal function of asphyxiated neonates. METHODS: Twenty-seven asphyxiated neonates who were admitted to the neonatal intensive care unit of Ewha Womans University hospital, from September, 1995 to June, 1997, were randomized to dopamine group (N=14, dopamine 0.5-3 microgram/kg/min) and control group (N=13). Serum creatinine (Pcr) and Na (PNa), urine creatinine (Ucr) and Na (UNa), urine output, creatinine clearance rate (Ccr), fractional excretion of Na (FENa) of two groups were compared on postnatal day 1, 3, 5. Incidences of acute renal failure and neonatal complications were also checked. RESULTS: The postnatal changes of Pcr (mg/dL), Ccr (mL/min/1.73m2) and FENa (%), on lst, 3rd & 5th days were not significnatly diffrent between dopamine group and control group. The postnatal changes of UNa (mmol/day) and urine output (ml/kg/hr) in dopamine group on 1st, 3rd & 5th days were significantly higher than those of control group (P<0.05). The incidence of acute renal failure, intraventricular hemorrhage, bronchopulmonary dysplasia, patient ductus arteriosus, sepsis and necrotizing enterocolitis were not significantly different between two groups. CONCLUSION: Low-dose dopamine, which was prophylactically given after birth in asphyxiated neonates, showed natriuretic and diuretic effects without significant increase of glomerular function.
Acute Kidney Injury ; Asphyxia ; Bronchopulmonary Dysplasia ; Creatinine ; Diuretics ; Dopamine* ; Ductus Arteriosus ; Enterocolitis, Necrotizing ; Female ; Glomerular Filtration Rate ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn* ; Intensive Care, Neonatal ; Natriuresis ; Parturition ; Polymerase Chain Reaction ; Renal Circulation ; Renal Insufficiency ; Sepsis

PURPOSE: Whereas allergic disease has the high morbidity during preschool age, there have not been sufficient surveys among the children in that age group. Thus we evaluated the prevalence of allergic disease among pre-school age children and risk factors which could cause or aggravate the disease. METHODS: A questionnaire survey was conducted among 593 kindergarten children, from 5 different kindergartens in Seoul between May and June, 2004. The standard for prevalence was whether one had been treated for allergic disease in past 12 months. Parents or guardians were surveyed to answer for each risk factor. RESULTS: For a question, "Have you been treated for allergic disease during past 12 months?", asthma showed 3.9% prevalence. For allergic rhinitis and atopic dermatitis were 11.1% and 20.1% respectively. Children with at least one of three diseases were 29.7%. Among children with asthma, risk factors were past history of bronchiolitis and paternal history of allergic disease. For allergic rhinitis, they were past history of bronchiolitis, mother's high education, and maternal history of allergic disease. For atopic dermatitis, risk factors were history of allergic disease of mother and father only. Other possible risk factors were statistically insignificant. CONCLUSION: Compared to the prevalence of primary school children (1995, 2000), asthma showed no difference but allergic rhinitis was lower and atopic dermatitis was higher. Among pre-school children, risk for allergic disease was higher with parental history of allergic disease. Especially the risk for respiratory allergy was even higher for those children with history of bronchiolitis.
Asthma ; Bronchiolitis ; Child* ; Dermatitis, Atopic ; Education ; Fathers ; Humans ; Hypersensitivity ; Korea* ; Mothers ; Parents ; Prevalence* ; Surveys and Questionnaires ; Rhinitis ; Risk Factors ; Seoul

BACKGROUND: Immediate operative management has been applied to infants and children with an attacks of adhesive small-bowel obstruction (ASBO), but this treatment has been controversial. We retrospectively reviewed 30 patients who were admitted from 1992 to 1996 because of adhesive small-bowel obstructions. METHODS: Immediate operation was reserved for the 7 patients that presented with fever and leukocytosis and /or localized abdominal tenderness or complete obstruction. The remaining 23 patients initially underwent conservative treatment. RESULTS: Although 20 episodes were cured with conservative treatment, 3 cases subsequently required surgical intervention. No adverse occurrences were observed during or after the delayed operations. Recurrence occurred in 3 cases after surgery and in 2 cases after conservative treatment. In the study, we found that the age at the recent laparotomy, the time elapsed between the recent laparotomy and the obstructive episode, and the primary condition necessitating the laparotomy correlated significantly with the success of conservative treatment. CONCLUSIONS: We conclude that in the treatment of ASBO in children, conservative treatment through the use of abdominal decompression, antibiotics, fluid-electrolytes, physical therapy, etc. has to be applied first for patients without significant evidence of strangulation and complete obstruction.
Adhesives* ; Anti-Bacterial Agents ; Child* ; Fever ; Humans ; Infant ; Laparotomy ; Leukocytosis ; Lower Body Negative Pressure ; Recurrence ; Retrospective Studies

The Sturge Weber syndrome is an uncommon disorder characterized by port-wine nevus of the face with angiomatosis of the ipsilateral cerebral leptomeninges and extensive calcification in the underlying cerebral cortex. Associated with this syndrome are mental retardation, choroidal angioma, buphthalmus or glaucoma, seizure and hemiplegia. We studied a case of incomplete form of Sturage Weber syndrome in a 12 year-old boy, who had generalized seizure, a homonymous hemianopsia, intracranial calcification and leptomeningeal angiomatosis. There are no characteristic facial nevus, mental retardation, occular changes and hemiplegia.

The laparoscopic cholecystectomy has been rapidly accepted as the standard treatment for gallbladder stones because its minimally invasive nature offers a significant advantage over an open cholecystectomy in terms of postoperative morbidity & recovery. The endoscopic sphinterotomy has become the primary treatment for common bile duct stones, yielding a duct clearance rate of approximately 90%. The laparoscopic cholecystectomy combined with the preoperative endoscopic sphinterotomy is becoming more widely employed as a therapeutic option for the management of gallbladder stones & common bile-duct stones. The authors retrospectively analyzed 71 patients who had been treated by an open cholecystectomy and a common bile-duct exploration (group A) and 35 patients who had been treated by a laparoscopic cholecystectomy plus endoscopic sphinterotomy (group B) at the Department of Surgery, Jungang Gil Hospital, from March 1993 to January 1996. The diagnotic procedures performed were ultrasonography ERC and DISIDA scan, and abdominal computed tomography. Intraoperative cholangiograms were successfully performed in 59 cases from group A and in 5 cases from group B. Successful duct clearance was achieved in 87.3% of the group A cases and in 87.5% of the group B cases. The operation time, the postoperative hospital stay, and postoperative complications were significantly lower for group B than for group A. The major postoperative complication was wound pain & infection for both groups. We conclude that in comparison with group A, group B appeared to have a similar clearance rate, a much lower morbidity, a shorter hospital stay, an earlier return to working fitness, and a better cosmetic result.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Choledocholithiasis* ; Cholelithiasis* ; Common Bile Duct ; Gallbladder ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Return to Work ; Ultrasonography ; Wounds and Injuries