Heterogeneity in clinical features and pathogenesis of non-steroidal anti-inflammatory agent (NSAIDs) hypersensitivity have been reported. NSAIDs can cause bronchial constriction in asthmatics or hives and angioedema in patients with chronic urticaria, in which case causative drugs show cross-reactivity with other NSAIDs. Normal subjects without allergic diseases may develop urticaria angioedema or anaphylaxis after ingestion of a specific NSAID. In this type of reaction, cross-reactivity between causative drugs and other NSAIDs does not occur. We experienced a case of acetaminophen anaphylaxis without aspirin sensitivity in a 38-year-old male, which was confirmed by oral provocation test. An oral challenge with 150mg of acetaminophen induced urticaria in lower legs, and erythema, with febrile sensation in ears. With a dose of 600mg acetaminophen, urticaria developed in trunk and extremities with facial angioedema. An oral provocation test with 650mg of aspirin was well tolerated without any adverse reactions. We report acase of acetaminophen anaphylaxis, which occurred in a normal individual at a small dose(150mg) without cross-reactivity with aspirin. This type of reaction supports heterogenei~ty of NSAIDs hypersensitivity and it may be caused by an other mechanism, not by cyclooxygenase inhibition.
Acetaminophen* ; Adult ; Anaphylaxis* ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin* ; Bronchoconstriction ; Ear ; Eating ; Erythema ; Extremities ; Humans ; Hypersensitivity ; Leg ; Male ; Population Characteristics ; Prostaglandin-Endoperoxide Synthases ; Sensation ; Urticaria

PURPOSE: To evaluete the sonographic features of ovarian mass torsion. MATERIALS AND METHODS: We evaluated the sonographic findings in 22 cases of torsioned cystic ovarian mass, benign teratoma(n=21), and normal ovary (n=l) confirmed surgically on pathologically. We classified the ovarian mass into two groups as sonographic ally cystic (n=15) or non-cystic mass(n=6). The patients were 17-72 years old(mean:36.9). We retrospectively reviewed US examination with respect to (1) free fluid in Douglas pouch, (2)pelvic mass & mass wall thickening, (3)dilated uterine tube, (4)prominent follicles, (5) engorged vessels, and (6)beak-like echo in torsion site. The combined conditions of torsion were uterine myoma(n=l) and intrauterine pregnancy(n=3). RESULTS: In sonogram, sonographic cystic mass (n=15) group showed (1)free fluid in Douglas pouch (9/15), (2)mass wall thickening(6/15), (3)dilated uterine tube(2/15), and sonographic non-cystic mass(n=6) group showed (1) free fluid in Douglas pouch (3/6). In sonogram, torsion of the normal ovary(n=1) showed (1) free fluid in Douglas pouch, and (2) prominent follicles. CONCLUSION: If sonogram of reproductive aged women with acute abdomen show free fluid in Douglas pouch and pelvic mass with wall thickening, ovarian mass torsion is suggested. But clinical features of acute abdomen and clinical diagnosis of torsion are more important than sonographic features.
Abdomen, Acute ; Diagnosis ; Douglas' Pouch ; Fallopian Tubes ; Female ; Humans ; Ovary ; Retrospective Studies ; Ultrasonography*

OBJECTIVE: The aim of this study was to investigate the usefulness of serum ECP as a marker of the severity of asthma and extent of airway inflammation. METHOD: We investigated 108 patients suffering from bronchial asthma, who were classified as mild intermittent(n=19), mild persistent(n=27), moderate persistent(n=42), and severe persistent(n=20) and 10 healthy controls. Atopy was defined as those who showed >2+ responses on skin prick test. Serum ECP, peripheral blood eosinophil, sputum eosinophil, and PEFR were measured on the same date and meth~acholine PC20 were determined within 2 weeks. RESULTS: Serum ECP levels were 10.1+- 2.0 ug/L in controls, and 29.1+- 23.6 ug/L in asthmatic patients. According to symptom severity, serum ECP levels were 22.9 +- 15.6 ug/L, 28. 6 +- 24.1 ug/L, 29.5 +- 22.2 ug/L, and 34.6 +- 31.2 ug/L in mild intermittent, mild persistent, moderate persistent and severe persistent asthmatic patients, respectively and there were no significant differences among four groups(p>0.05). Serum ECP levels correlated with peripheral blood eosinophil counts(r=0.48, p<0.01), but not with sputum eosinophil, PEFR, and methacholine PC20 levels. There was no significant difference in serum ECP level between atopic and non-atopic asthma(p>0.05). CONCLUSION: Single measurevment of ECP level at clinic could not represent the severity of asthma.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Skin ; Sputum

No Abstract Available.
Humans

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

PURPOSE: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. METHODS: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. RESULTS: Awareness of health care accreditation correlated negatively with job stress (r=−63, p < .001) and turn over intention (r=−.50, p < .001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p < .001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p < .001). CONCLUSION: These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.
Accreditation ; Certification ; Compensation and Redress ; Delivery of Health Care ; Education ; Intention ; Korea ; Personnel Turnover ; Seoul ; Statistics as Topic ; Tertiary Care Centers

PURPOSE: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. METHODS: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. RESULTS: Awareness of health care accreditation correlated negatively with job stress (r=−63, p < .001) and turn over intention (r=−.50, p < .001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p < .001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p < .001). CONCLUSION These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.

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

Episodic angioedema with eosinophilia was described by Gleich, et al. as a distinct entity characterized by recurrent angioedema, urticaria, leukocytoeis with remarkable eosinophilia, fever and periadically increased body weight. Since then, several cases of this disorder have been reported in the United States, Europe and Japan. We present a Korean patient whose clinical, histopathologic, and laboratory findings are consistent with the syndrome of episodic angioedema with eosinophilia. This case supports the previous study that revealed some differences between Asian and Caucasian patients.
Angioedema* ; Asian Continental Ancestry Group ; Body Weight ; Eosinophilia* ; Europe ; Fever ; Humans ; Japan ; United States ; Urticaria

BACKGROUND AND OBJECTIVE: There has been little clinical data on the treatment outcome of patients with acute asthma attack in Korea. We designed a management protocol of acute asthma, and analyzed clinical p arameters obtained from this protocol. METHOD: A total of 32 cases with acute asthma were treated with oxygen, beta2 agonist, and methylprednisolone. Ipratropium was added in cases of severe attack. After 90 minutes, intravenous aminophylline was given to the patients with poor response. RESULT: Beta2 agonist and methylprednisolone were sufficient for symptom control in 17 cases. Ipratropium and aminophylline were added in 6 and 9 cases, respectively. There was no difference in improvement of PEF, heart rate, respiratory rate, PaO2, PaCO2, and SaO2 at 90 minutes and 8 hours between beta2 agonist inhalation and subcutaneous group. Serum potassium concentration levels significantly decreased in patients treated with ipratropium of aminophylline(n=15, 4.17+/-0.45 vs. 3.99+/-0.35mM/L, p<0.05), compared with patients using only beta2 agonist and methylprednisolone(n=17, 3.89+/-0.30 vs. 4.14+/-0.45mM/L, p>0.05). CONCLUSION: Subcutaneous beta2 agonist may be an alternative to inhalant beta2 agonist for the emergency treatment of acute asthma, and we think a consensus regarding use of aminophylline in the emergency room should be made.
Aminophylline ; Asthma* ; Consensus ; Emergency Service, Hospital ; Emergency Treatment ; Heart Rate ; Humans ; Inhalation ; Ipratropium ; Korea ; Methylprednisolone ; Oxygen ; Potassium ; Respiratory Rate ; Treatment Outcome*