Aspirin(ASA) and NSAIDs can induce bronchoconstriction in 10~20% of adult asthmatics patients. Inhalation of lysine-ASA(L-ASA) has been described as an alternative method for diagnosis of ASA-sensitive asthma. To further understand the characterlstics of ASA-sensitive asthmas. we studied 38 asthmatic patients with ASA -sensitivity (36 intrinsic and 2 extrinsic asthma) proven by L-ASA bronchoprovocation test (BPT). Most were female (male to female ratio was 27:73). Twenty (53%) of them had no previous history of adverse reactions when exposed to ASA. Twenty nine (79%) had rhino-sinusitis symptoms. Early asthmatic response was observed in 16 (42%) patients, late only response in 16(42%), and dual response in 6(16%) patients. The threshold of L-ASA to provoke a positive response ranged from 11.2 to 180 mg/ml and most (68.3%) had a positive response after the inhalation of 180 mg/ml. Concurrent sensitivity to sulfite was noted in 14 (36%) patients, followed by sensitivity to tartrazine in one (3%) patient. None showed a positive response to sodium benzoate. After the avoidance from ASA/ NSAIDs with administration of anti-asthmatic medications, symptom and medication scores reduced in 26(87%) patients among 30 followed patients. They were classified into the improved group: four (13%) patients belonged to the not-improved group. There were no significant differences in clinical characteristics between the improved and not- improved group (p>0.05). In conclusion, L-ASA BPT could be considered as a useful method to diagnose ASA -sensitive asthma and be used to screen the causative agent for asthmatic patients with intrinsic type, especially in female patients with rhino-sinusitis and/or nasal polyp, even though they do not have arty history of adverse reactions. Cessation of exposure and proper treatment may allow to reduce symptom and medication scores.
Adult ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Bronchoconstriction ; Diagnosis ; Female ; Humans ; Inhalation ; Nasal Polyps ; Sodium Benzoate ; Tartrazine

No abstract available.
Asthma*

BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.
Arteriosclerosis ; Blood Glucose ; Diabetes Complications ; Diabetes Mellitus* ; Diabetic Foot ; Edema ; Female ; Fingers ; Hospitals, General ; Humans ; Korea ; Male ; Onychomycosis ; Outpatients ; Skin

No abstract available.
Child* ; Humans

No abstract available.
Peptic Ulcer*

No abstract available.
DNA, Recombinant* ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Yeasts*

PURPOSE: School-age children spend more than half of the day at school and teachers or school nurses are responsible for managing students with asthma during school hours. Thus, the teachers' knowledge about asthma is very important for the care of asthmatic school children. METHODS: Total 159 teachers were asked to fill out questionnaire on their knowledge about asthma and their personal profiles. The survey was administered by mail. The questionnaire includes 17 items about pathophysiology, symptoms, precipitating factors, treatment, care and prognosis, which were to be answered by either 'true' or 'false'. The correct or incorrect answers were examined data was statistically analyzed by SPSS. RESULTS: Most teachers were in their thirties (54.7%) and years of teaching experience were from six to fifteen years (50.4%). The teachers who experienced asthma students were 23.6%, and 12.6% were either asthma patients or had asthma patients in their family. They had knowledge about precipitating factors of asthma, but, the knowledge was not correct in detail. Only 34% teachers knew what to do and where to contact in case of asthma attack among the students. Teachers' demographic and professional factors did not affect the knowledge about asthma, except their working experience as school nurses and/or with school nursing asthmatic students. CONCLUSION: The survey results demonstrated that their teachers' knowledge about asthma was not sufficient enough to take good care of the asthmatic students at school including emergency management. Asthma education for the school teachers is required and efficient educational programs for the teachers should be developed.
Asthma ; Child ; Education ; Emergencies ; Humans ; Postal Service ; Precipitating Factors ; Prognosis ; Surveys and Questionnaires ; School Nursing

PURPOSE: Airway inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: Twenty one ashtmatic children and age matched control subjects without history of allergy were enrolled in this study. Their age was from 21 months to 15 years old. The study was performed from January to April of 2001. Ultrasonically nebulized hypertonic saline was used to induce sputum from children. The children were pre-treated with bronchodilator and peak expiratory flow rate (PEFR) was monitored thought-out the procedure. Sample were analysed for total cell count, differential cell count and for concentrations of eosinophil cationic protein (ECP). RESULTS: Asthmatic subjects had a significantly higher proportion of blood eosinophils than the control subjects (279.8+/-187.7/mm3 and 26.5+/-18.5/mm3, P<0.01). Correspondingly, percentages of eosinophil and concentration of ECP were 5.10+/-8.79% and 99.85+/-70.10 microL/L in asthmatic and 0.20+/-0.42% and 1.02+/-2.54 microL/L in control subjects (P<0.01 and P<0.01). Serum eosinophils have no correlation with sputum eosinophils or sputum ECP. There was no correlation between sputum eosinophils and ECP either. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with serum eosinophils or serum ECP are to be studied further.
Adolescent ; Asthma* ; Cell Count ; Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Hypersensitivity ; Inflammation ; Peak Expiratory Flow Rate ; Sputum*

No abstract available.
Child* ; Humans

When the tumor is advanced with distant metastasis or unresectable initially, preoperative chemotherapy could be applied in the treatment of Wilms' tumor We experienced 6 cases of favorable type of Wilms' tumor, 1 case of clear cell sarcoma and 1 case of renal cell carcinoma. They were treated with preoperative chemotherapy and underwent CT Scans before and after the therapy. Pathologic changes after chemotherapy in Wilms' tumor were known from previous reports as subtotal hemorrhagic necrosis, cystic change, clusters of foamy histiocytes, granulation tissue formation, primitive nephrogenic tissues and peripherally remained focal areas of blastemal infiltration. Changes of CT findings after chemotherapy were internal necrosis(6/6), decrease in size(5/6), decrease and absence of regional lymph node enlargement(4/6) and improved or disappeared metastatic lesions(3/3). Although our study had some limitations such as small numbers of cases and all cases were favorable types, we thought that there were good correlations between change of CT findings and subtotal hemorrhagic necrosis after preoperative chemotherapy in Wilms' tumor.
Carcinoma, Renal Cell ; Drug Therapy* ; Granulation Tissue ; Histiocytes ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; Sarcoma, Clear Cell ; Tomography, X-Ray Computed ; Wilms Tumor