Objective : The aim of this study was to evaluate cross - reactivity between pollens in patients with strong skin reactivity to multiple pollens. METHODS: A pool of sera from 20 patients who showed strong skin responses( > or = 3+ ) to all three kinds of pollens ( tree, grass, and weed ) was used. Oak, ryegrass, mugwort, ragweed and hop Japanese pollens were chosen for the subject of study. The level and pattern of bound IgE to each pollen and cross - reactivity between pollens were investigated by ELISA and immunoblot experiments. RESULTS: In ELISA, the IgE of a pool of sera reacted to ryegrass and ragweed in 100%, to mugwort in 95%, to oak in 75%, and to hop Japanese in 65%, respectively. In inhibitory ELI - SA, more than 50% of bound IgE was mutually inhibited in oak vs ryegrass, oak vs mugwort, mugwort vs ryegrass and mugwort vs hop Japanese. In immunoblot, the IgE binding rate to major allergens of each pollen was 95% for hop Japanese, 75% for ragweed, 50% for ryegrass, 35% for mugwort, and 30% for oak, respectively. In inhibitory immunoblot, the mutually inhibited bound IgE could not be observed between major allergens of each pollen, but some minor allergens of oak pollen were mutually inhibited by ryegrass. CONCLUSION: Cross - reactivity between major allergens of oak, ryegrass, mugwort, ragweed and hop Japanese pollens was not observed at all, but some minor allergens of oak pollen cross-reacted with ryegrass and mugwort, and so did those of mugwort pollen with ryegrass and hop Japanese.
Allergens ; Ambrosia ; Artemisia ; Asian Continental Ancestry Group ; Enzyme-Linked Immunosorbent Assay ; Humans ; Humulus ; Immunoglobulin E ; Lolium ; Poaceae ; Pollen* ; Skin

Central hypoventilation syndrome (CHS) can be caused by any lesions to the medullary respiratory centers, cerebral cortex, corticospinal pathways, and their connections. We report 5 patients with central hypoventilation syndrome and analyzed 26 patients who experienced central hypoventilation syndrome during sleep and waking states. We compared initial clinical symptoms and signs, maximal neurologic deficits, brain MRI and pathologic findings, and associated autonomic dysfunctions. The patients with respiratory failure during waking states showed quadriplegia, a rapidly progressing respiratory failure. The patients who had automatic respiratory failure showed mild hemiparesis, bulbar dysfunction, dysautonomia, and subacute to chronic recurrent respiratory failures. These results support the concept of two separate respiratory systems: a voluntary system and an automatic system. The respiratory management of these patients with central hypoventilation syndrome should be considered critical to their survival.
Brain ; Cerebral Cortex ; Humans ; Hypoventilation* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Paresis ; Primary Dysautonomias ; Pyramidal Tracts ; Quadriplegia ; Respiratory Center ; Respiratory Insufficiency ; Respiratory System

BACKGROUND: Although good clinical effects have been reported, immunotherapy with house dust mite ( HDM ) antigen - autologous specific antibody complex ( IC - IT ) is not yet accepted as an effective immunomodulating tool in HDM allergic diseases. We aimed to prove the clinical effect of IC - IT in HDM sensitized respiratory allergic subjects. Method : Six HDM sensitized respiratory allergic subjects were enrolled. Autologous D. farinae specific IgG was purified with DEAE ion exchange and affinity chromatography. After one year of IC - IT treatment the clinical effects were analyzed with symptom scores, methacholine PC20, ELISA assay of D. farinae specific antibodies and intradermal skin reactivity. Result : The rhinitis symptom score significantly improved after a one - year administration of IC - IT ( 1.23 +/- 0.30 vs. 0.37 +/- 0.15, p< 0.05), but no significant differences were found in asthma symptom score, intradermal skin reactivity to D. farinae and ELISA optic absorbances of D. farinae specific IgE, IgG, and IgG subclasses. Methacholine PC20 values improved in all 6 patients who were administered with IC - IT ( 0.35 vs. 1.66 mg/ml, p< 0.05 ). CONCLUSION: IC - IT may be efficient for management of HDM atopic asthma. Further studies are needed before clinical application of IC - IT in house dust mite atopic subjects.
Antibodies ; Asthma ; Chromatography, Affinity ; Dermatophagoides farinae* ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy* ; Ion Exchange ; Methacholine Chloride ; Pyroglyphidae* ; Rhinitis ; Skin

PURPOSE: The purpose of this study was to compare the clinical outcome of femoral shaft fracture treatment with intramedullary nailing performed using a greater trochanter and a piriformis entry nail. MATERIALS AND METHODS: A total of 57 patients treated by antegrade nailing for a femoral shaft fracture between January 2008 and April 2013 were included in this study. We evaluated postoperative radiographs of 57 femoral shaft fractures stabilized with femoral intramedullary nailing at a single institutional center. The cases included 25 piriformis fossa entry nails and 32 greater trochanter entry nails. Outcome measures included the alignment, union rate and duration of union, complications, operation time, intra-operative bleeding, and a pain rating scale. RESULTS: The alignment, union rate, and duration of union did not differ significantly between the groups with piriformis fossa and trochanteric nailing. In addition, no significant differences regarding complications and operation time were observed between the two groups. Less intra-operative bleeding was observed in the trochanteric nailing group. This difference was statistically significant (p=0.044). CONCLUSION: Use of a femoral nail specially designed for the trochanteric insertion resulted in equally high union rates, duration of union, and low complication rates. Thus, greater trochanter entry nails were similar to conventional antegrade femoral nailing through the piriformis fossa.
Femur* ; Fracture Fixation, Intramedullary ; Hemorrhage ; Humans ; Outcome Assessment (Health Care)

PURPOSE: Lithium-pilocarpine induced status epilepticus (LPSE) causes selective and age-dependent neuronal death, although the mechanism of maturation-related injury has not yet been clarified. The activating transcription factor-2 (ATF-2) protein is essential for the normal development of mammalian brain and is activated by c-Jun N-terminal kinase (JNK). It induces the expression of the c-jun gene and modulates the function of the c-Jun protein, a mediator of neuronal death and survival. Therefore, we investigated the expression of c-Jun and ATF-2 protein in the immature and adult rat hippocampus to understand their roles in LPSE-induced neuronal death. MATERIALS AND METHODS: Lithium chloride was administrated to P10 and adult rats followed by pilocarpine. Neuronal injury was assessed by silver and cresyl violet staining, performed 72 hours after status epilepticus. For evaluation of the expression of ATF-2 and c-Jun by immunohistochemical method and Western blot, animals were sacrificed at 0, 4, 24, and 72 hours after the initiation of seizure. RESULTS: Neuronal injury and expression of c-Jun were maturation-dependently increased by LPSE, whereas ATF-2 immunoreactivity decreased in the mature brain. Since both c-Jun and ATF-2 are activated by JNK, and targets and competitors in the same signal transduction cascade, we could speculate that ATF-2 may compete with c-Jun for JNK phosphorylation. CONCLUSION: The results suggested a neuroprotective role of ATF-2 in this maturation-related evolution of neuronal cell death from status epilepticus.
Activating Transcription Factor 2/*metabolism ; Animals ; Antimanic Agents/pharmacology ; Blotting, Western ; Hippocampus/drug effects/*metabolism ; Immunohistochemistry ; Lithium/pharmacology ; Miotics/pharmacology ; Pilocarpine/pharmacology ; Proto-Oncogene Proteins c-jun/*metabolism ; Rats ; Status Epilepticus/*chemically induced

No abstract available.
Kidney Transplantation* ; Urinary Tract Infections* ; Urinary Tract*

OBJECTIVE: To evaluate the clinical efficacy of a new air cleaning device (LG Electronics, Korea) equipped with electrostatic precipitator (EP) and photocatalytic plasma filter (PCP) in 24 respiratory allergic subjects. MATERIAL AND METHOD: Air cleaning conditioner and air cleaner were placed in living room and bedroom. Both EP and PCP (EP/PCP) filters were used for the first 4 weeks and for another 4 weeks, PCP without EP filter (PCP) was used. We measured symptom scores of asthma and rhinitis, peak expiratory flow rate (PEFR), serum eosinophil cataionic prote in? in ECP, Dermatophagoides farinae (DF) specific IgE and IgG in sera, concentrations of major allergens of DF in floor dust of living room, bedroom and in airborne dust. RESULTS: Both asthma and rhinitis symptom scores were significantly improved not only with EP/PCP filters but also with PCP filter. The morning PEFR was significantly improved with EP/PCP filters, but not with PCP filter. Frequency of salbutamol inhalation by air cleaner with EP/PCP filter tended to de crease(p=0.051), with no significant difference in serum ECP concentration. DF specific IgE significantly decreased at the 8th week with no differences in specific IgG. However, the mean Der f I levels in floor dust of bedroom (1, 128 vs. 374 ng/gm dust, p<0.01) and living room (1,516 vs 812 ng/gm dust, p<0.01) decreased, Der f1 in airborne dust measured only in 8 out of 22 subjects, and they decreased significantly with the trial of EP/PCP filter (172.2 pg/4.5m vs. 62.1 pg/4.5m, p<0.01). CONCLUSION: These results suggest that the EP/PCP air cleaner may be an effective tool for environmental control in respiratory allergic subjects.
Albuterol ; Allergens ; Asthma ; Dermatophagoides farinae ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Inhalation ; Peak Expiratory Flow Rate ; Plasma* ; Rhinitis

As the use of the antibiotics, antitumor substances, steroid hormone and immunosuppressive agent have been increased remarkably, the incidence of the fungal infection has also been increased. Aspergillus is a fungus belonged to ascomycetes family and distributed world-widely. Aspergillus infection of the spine is very rare. Mode of vertebral Aspergillosis is direct extension of primary lesion of lung in children, on the other hand, hematogenous metastasis in adults. We report a adult woman who suffered from thoracolumbar pain without any neurological deficit for 6 months prior to admission. Imaging studies revealed irregular bony destruction on the adajacent end plates of T12 and L1 vertebras with kyphotic change. We underwent operation via anterolateral approach using Z-plate fixation. followed by amphotericin-B administration.
Adult ; Anti-Bacterial Agents ; Ascomycota ; Aspergillosis* ; Aspergillus ; Child ; Female ; Fungi ; Hand ; Humans ; Incidence ; Lung ; Neoplasm Metastasis ; Spine*

Central nervous system toxicity is the most commonly recognized problem during treatment with carbamazepine (CBZ). The most common side effects of CBZ are drowsiness, incoordination, and vertigo. However, unusual conditions such as movement disorders, seizure aggravation, and encephalopathy have also been attributed to CBZ therapy. In case 1, cognitive dysfunction and exacerbation of preexisting gait disturbance were observed in a 63-year-old female who had frontal lobe epilepsy, schizencephaly, and lissencephaly treated with CBZ. The neurological symptoms were resolved 24 hours after the withdrawal of CBZ and induced with the reintroduction of CBZ. In case 2, myoclonic jerks occurred in a 37-year-old female when CBZ was readministered after a 4-day-withdrawal period of CBZ. The myoclonic jerks disappeared 12 days after CBZ was discontinued. In both cases, plasma CBZ levels were within the therapeutic range. We report two cases with encephalopathy and myoclonic jerks as unusual side effects of CBZ, with the plasma levels of CBZ being within the therapeutic range.
Adult ; Ataxia ; Carbamazepine ; Central Nervous System ; Epilepsy, Frontal Lobe ; Female ; Gait ; Humans ; Lissencephaly ; Malformations of Cortical Development ; Middle Aged ; Movement Disorders ; Myoclonus* ; Plasma ; Seizures ; Sleep Stages ; Vertigo

Hennekam syndrome is a rare autosomal recessive disorder resulting from malformation of the lymphatic system. The characteristic signs of Hennekam syndrome are lymphangiectasia, lymph edema, facial anomalies, and mental retardation. This is a case in which a patient presented with left-arm lymphedema, facial-feature anomalies, and multiple organ lymphangiectasia consistent with symptoms of Hennekam syndrome. There is no curative therapy at this time, but rehabilitative treatments including complete decongestive therapy for edema control appeared to be beneficial.
Edema ; Humans ; Intellectual Disability ; Lymphatic System ; Lymphedema