Background and OBJECTIVE: There has been a few case reports of anaphylaxis due to honeybee in Korea. In order to observe the clinical feature of bee sting anaphylaxis. Moderials and methods: Six patients living in Kyunggi province area were referred under history of anaphylaxis after the bee sting. Atopy was defined by skin prick test result to common inhalant allergen. Serum specific IgE antibody to each bee antigen was detected by radioimmunoassay to identify the causative bee. RESULTS: All six cases were female. Three had atopy and four had combined allergic diseases such as allergic rhinitis, asthma, and urticaria. The etiologic bees consisted of yellow jacket (6 cases), paper wasp (4 cases), yellow hornet (3 cases), white faced hornet (1 case) and honey bee (1 case). Four cases had experienced anaphylaxis after ant bite and they showed positive result on specific IgE to imported fire ant. Specific immunotherapy against causative bee venom was begun using bee venom extracts from Bayer (USA) based upon results of specific IgE anti-body to bee venom. CONCLUSION: The yellow jacket is the most common cause of bee venom anaphylaxis in this area. Further studies will be needed to evaluate possible cross-reactivity between bee and ant venom.
Anaphylaxis* ; Ant Venoms ; Ants ; Asthma ; Bee Venoms* ; Bees* ; Bites and Stings ; Female ; Fires ; Gyeonggi-do ; Honey ; Humans ; Immunoglobulin E ; Immunotherapy ; Korea ; Radioimmunoassay ; Rhinitis ; Skin ; Urticaria ; Wasps

BACKGROUND: The aim of this study was to compare the difference in hemodynamic change and in sensory or motor block between hyperbaric tetracaine and bupivacaine in spinal anesthesia. METHODS: The sixty-three patients, belonged to ASA class 1 and 2, were divided into tetracaine group and bupivacaine group. The patients were administered 0.5% hyperbaric tetracaine(Pantocaine ) in tetracaine group and 0.5% hyperbaric bupivacaine(Marcaine ) in bupivacaine group, intrathecally. After intrathecal injection of the agents, we measured the change of sensory block level according to pinprick test, the motor block by the modified Bromage score until fixations was achieved, and the blood pressure and heart rate. RESULTS: The two groups did not differ significantly with loss of sensory level and onset time. Bupivacaine group was revealed a slower fixations of motor block than tetracaine group(p<0.05). Changes of systolic blood pressure and mean arterial blood pressure of bupivacaine group were less than tetracaine group(p<0.05) in 2~25 minutes and 6~15 minutes, respectively. Diastolic blood pressure and heart rate were not different statistically in two groups. CONCLUSION: Spinal anesthesia with hyperbaric bupivacaine was revealed less changes of systolic blood pressure and mean arterial blood pressure than hyperbaric tetracaine, although fixation of motor block was delayed onset. Therefore, we thought that spinal anesthesia with hyperbaric bupivacaine may be used more safe than hyperbaric tetracaine in hemodynamical troublesome case.
Anesthesia, Spinal* ; Arterial Pressure ; Blood Pressure ; Bupivacaine* ; Heart Rate ; Hemodynamics ; Humans ; Injections, Spinal ; Tetracaine*

A multiple primary malignant tumor is a disease mainly encountered in the of the older age groups. Attempts should be made to rule out a second primary malignant neoplasm in the elderly patients with unusual signs and symptoms. We encountered a case of a 67-year-old male with triple primary malignant tumors of the stomach, larynx, and lung. The patient had been treated with a subtotal gastrectomy for early gastric cancer in 1991 and a Laser laryngectomy for the laryngeal squamous cell carcinoma in 2003. In 2005, lung cancer was found with the biopsy revealing an adenosquamous carcinoma. Systemic chemotherapy was performed.
Aged ; Biopsy ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Drug Therapy ; Gastrectomy ; Humans ; Laryngeal Neoplasms ; Laryngectomy ; Larynx* ; Lung Neoplasms ; Lung* ; Male ; Stomach Neoplasms ; Stomach*

BACKGROUND/OBJECTIVES: Chronic or intermittent hyperglycemia is associated with the development of diabetic complications. Oxidative stress and inflammation can be altered by hyperglycemia in diverse tissues, including kidneys and eyes, and play a pivotal role in diabetic complications. Our previous studies showed that the water-insoluble 5,7-dihydroxyflvone chrysin effectively combats diabetic damages incurred in diabetic kidneys and retinas. The current study employed the newly-synthesized 5.7-di-O-acetylchrysin, having higher solubility than chrysin, to compare the effects on diabetes-associated renal fibrosis and abnormal retinal neovascularization.MATERIALS/METHODS: In the in vivo study, db/db mice as animal models of type 2 diabetes were orally administrated 10 mg/kg BW diacetylchrysin, daily for 10 weeks. RESULTS: Unlike chrysin, oral administration of 10 mg/kg diacetylchrysin did not lower the blood glucose level and 24 h urine volume in db/db mice. Nevertheless, the urinary albumin excretion was markedly reduced. The administration of diacetylchrysin also diminished the deposition of collagen fibers in diabetic glomeruli and tubules by suppressing the induction of connective tissue growth factor and collagen IV in diabetic kidneys. Supplying diacetylchrysin enhanced the membrane type-1 matrix metalloproteinase (MMP) expression reduced in diabetic kidneys, while the tissue inhibitor of MMP-2 induction was attenuated in diacetylchrysin-challenged diabetic kidneys. In addition, supplementing diacetylchrysin to diabetic mice ameliorated renal injury due to glomerulosclerosis and tubular interstitial fibrosis. Furthermore, the reduced retinal inductions of Zonula occludens-1 and vascular endothelial cadherin in db/db mice were elevated in the retinal tissues of diacetylchrysintreated animals. Oral administration of diacetylchrysin curtailed the induction of vascular endothelial growth factor (VEGF) and VEGF receptor 2 in db/db mice, ultimately retarding diabetes-associated retinal neovascularization. Additionally, the retinal formation of acellular capillaries with leaky vessels was reduced in diacetylchrysin-treated db/db mice. CONCLUSION Diacetylchrysin may act as a potent pro-health agent for treating renal fibrosisassociated diabetic nephropathy and retinal neovascularization-associated diabetic retinopathy.

BACKGROUND/OBJECTIVES: Dyslipidemia causes metabolic disorders such as atherosclerosis and fatty liver syndrome due to abnormally high blood lipids. Purple perilla frutescens extract (PPE) possesses various bioactive compounds such as α-asarone, chlorogenic acid and rosmarinic acid. This study examined whether PPE and α-asarone improved dyslipidemia-associated inflammation and inhibited atheroma formation in apolipoprotein E (apoE)-deficient mice, an experimental animal model of atherosclerosis.MATERIALS/METHODS: ApoE-deficient mice were fed on high cholesterol-diet (Paigen’s diet) and orally administrated with 10–20 mg/kg PPE and α-asarone for 10 wk. RESULTS: The Paigen’s diet reduced body weight gain in apoE-deficient mice, which was not restored by PPE or α-asarone. PPE or α-asarone improved the plasma lipid profiles in Paigen’s diet-fed apoE-deficient mice, and despite a small increase in high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL)-cholesterol, and very LDL were significantly reduced. Paigen’s diet-induced systemic inflammation was reduced in PPE or α-asarone-treated apoE-deficient mice. Supplying PPE or α-asarone to mice lacking apoE suppressed aorta atherogenesis induced by atherogenic diet. PPE or α-asarone diminished aorta accumulation of CD68- and/or F4/80-positive macrophages induced by atherogenic diet in apoE-deficient mice. Treatment of apoE-deficient mice with PPE and α-asarone resulted in a significant decrease in plasma cholesteryl ester transfer protein level and an increase in lecithin:cholesterol acyltransferase reduced by supply of Paigen’s diet. Supplementation of PPE and α-asarone enhanced the transcription of hepatic apoA1 and SR-B1 reduced by Paigen’s diet in apoE-deficient mice. CONCLUSIONS α-Asarone in PPE inhibited inflammation-associated atheroma formation and promoted hepatic HDL-C trafficking in dyslipidemic mice.

Patients with NIDDM are at increased risk for the development of coronary atherosclerosis and experience more silent myocardial infarction than non-diabetic subjects. The screening tools for early detection of coronary artery disease without significant narrowing has been requested in diabetic patients. Coronary artery calcification (CAC) score, quantified by electron beam computed tomography (EBT), have been reported to correlate with the amount of atherosclerotic plaque and vascular luminal narrowing. We investigated the distribution of CAC score and associated risk factors in asymptomatic NIDDM patients and patients with ischemic heart disease to estimate the usefulness of CAC as a screenig tool for ischemic heart disease in asymptomatic diabetes. METHOD: 136 NIDDM patients without any symptom of coronary artery disease and 37 patients with significant coronary artery stenosis were included. CAC were measured by electron bean tomography (ultrafast CT). Forty contiguous 3-mm thickness transverse two-dimensional sections were obtained through root of aorta and heart. Coronary calcification were defined as the presense of at least two adjacent pixel within the border of visualized coronary artery with CT number of at least 130 HU. Body mass index, waist-hip ratio were measured and body fat components were counted by impedence method. Visceral fat versus subcutaneous fat ratio were calculated by abdominal computed tomography. Plasma lipid profile, fasting insulin, C-peptide level, HbA1c concentration were measured. Correlations between natural log of CAC score and clinical parameters were evaluated and multiple regression analysis with natural log of CAC score as a independent variable was performed. Coronary angiography were performed in 17 asymptomatic NIDDM patients.. RESULT: CAC score was significantly higher in male than female subjects and increased significantly with aging (p<0.01). In patients with hypertension, previous history of cerebrovascular or peripheral vascular disease (p<0.05), CAC score was significantly increased. The CAC score showed significant positive correlations with smoking amount, duration of diabetes and a negative correlation with HDL-cholesterol (p<0.05). There were no association between CAC score and total cholesterol, LDL-cholesterol, waist to hip circumference ratio, or fasting insulin levels. After adjustment of compounding variables (age, sex), duration of diabetes, amount of smoking and previous history of atherosclerotic vascular disease were shown to be associated with CAC score. In multiple logistic regression analysis with natural log of CAC score as dependent variable, age, HDL-cholesterol, duration of diabetes, male gender were found to be significant independent variables. Seventeen diabetic patients with high CAC score, were taken coronary angiography and significant luminal narrowings (more than 50%) of coronary artery were documented in 16 patients. But, In 7 out of 17 patients with coronary one-vessel disease, coronary calcification were not detected by EBT. CONCLUSION: coronary artery calcium score quantified by electron beam computed tomography may be useful for screening of preclinical or asymptomatic coronary artery disease in asymptomatic NIDDM patients.
Adipose Tissue ; Aging ; Aorta ; Body Mass Index ; C-Peptide ; Calcium ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Fasting ; Female ; Heart ; Hip ; Humans ; Hypertension ; Insulin ; Intra-Abdominal Fat ; Logistic Models ; Male ; Mass Screening* ; Myocardial Infarction ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Phenobarbital ; Plaque, Atherosclerotic ; Plasma ; Risk Factors ; Smoke ; Smoking ; Subcutaneous Fat ; Tomography, X-Ray Computed* ; Vascular Diseases ; Waist-Hip Ratio

Kawasaki disease (KD) is an acute vasculitis of undetermined etiology in infancy and early childhood. There is no diagnostic test to confirm this disease and its diagnosis is made on clinical backgrounds. Most patients diagnosed are under 4 years of age. Here, we report a case of KD in an adult presented with clinical features of fever, headache, and skin rash. A 26-year-old male was presented with fever and headache of four days' duration and skin rash of three days' duration. Nausea and vomiting developed and the patient was treated with antibiotics under the impression of aseptic meningitis and became afebrile two days later. Laboratory findings revealed thrombocytosis, atypical lymphocytes, and elevated liver enzymes. Kawasaki disease was diagnosed, and intravenous immunoglobulin and low-dose aspirin (200mg/d) was administered. Echocardiogram did not reveal any coronary artery changes and the skin lesions disappeared. The patient was discharged after near normalization of the liver enzymes and is now being followed at our clinic.
Adult* ; Anti-Bacterial Agents ; Aspirin ; Coronary Vessels ; Diagnosis ; Diagnostic Tests, Routine ; Exanthema ; Fever ; Headache ; Humans ; Immunoglobulins ; Liver ; Lymphocytes ; Male ; Meningitis ; Meningitis, Aseptic ; Mucocutaneous Lymph Node Syndrome* ; Nausea ; Skin ; Thrombocytosis ; Vasculitis ; Vomiting

BACKGROUND: Most studies involving factor analysis on clinical severity of bronchial asthma are short-term and cross-sectional. OBJECTIVES: We evaluated the clinical severity of bronchial asthma according to requirement of systemic corticosteroid therapy, and analyzed the factors associated with long-term systemic corticosteroid therapy. METHODS: The records of 158 asthmatic patients (including 76 patients followed for one year) visiting the clinic of Allergy-Immunology of Ajou University Hospital between June, 1997 and May, 1999 were reviewed retrospectively. RESULTS: Among the 76 asthmatic patients who had been followed-up for one year, asthmatic patients (n=28) treated with systemic corticosteroid for more than 60 days had lower initial FEV1(% predicted) values (p=0.001), lower prevalence of concomitant allergic diseases (p= 0.04), and lower frequency of allergen-specific immunotherapy (p=0.006) than asthmatic patients treated with systemic corticosteroid for less than 60 days (n=48). Among the 158 asthmatic patients, 87 patients (55%) were atopic asthmatics and 71 patients (45%) were nonatopic asthmatics. Nonatopic asthmatics showed older age at initial visit (p<0.001), lower serum total IgE levels (p=0.02), lower prevalence of concomitant allergic diseases (p=0.004), and higher prevalence of aspirin-sensitivity (p<0.001) than atopic asthmatic patients. Among the 76 patients followed for one year, nonatopic asthmatic patients were treated with significantly higher cumulative-doses of systemic steroid than atopic asthmatic patients (p=0.04). CONCLUSION: Initial pulmonary function and nonatopy are significantly associated with clinical severity determined by requirement of systemic corticosteroid therapy in adult asthmatic patients.
Adult* ; Asthma ; Humans ; Immunoglobulin E ; Immunotherapy ; Prevalence ; Retrospective Studies

Objectives: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition.The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach. Methods: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and anti resorptive agents in sequential therapy approaches. Results: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to anti resorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for in dividuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment. Conclusions This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.