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

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A onegroup pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z = -4.89, p < .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t = -3.19, p = .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p < .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes ( ± 1 hour 52 minutes) to 3 hours 1 minute ( ± 1 hour 41 minutes) (t = 2.51, p = .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% ( χ 2 = 6.90, p = .009). Conclusion The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

PURPOSE: To obtain the findings of normal variant types of lower cervical body configuration for the purpose of differention from compression fracture. MATERIALS AND METHODS: We retrospectively analysed simple true lateral radiographs of cervical spine from C3 to C7 in 157 pediatric patients who did not have definitive clinical symptoms of cervical spinal injury. We classified the variations of normal cervical spine into 5 types by their configuration. In case of rounded upper corner or anteriorly wedged type, we measured the height and the width of vertebral body to classify these types, and undertook ANOVA test and multiple range test to determine the correlation between the gross configuration and the measured values. RESULTS: Type 1 was similarly observed at each of C3 to C7 in age of 1-4 group but the frequency was markedly decreased in age of 5-8 group. Type 2a was frequently observed at both age groups, and its incidence increased considerally at C3 and C4 with advancing age. Type 2b was more frequently observed at C3 body and Type 3 was observed only at C3 body in age group 1-4. Type 4 was markedly increased at 5-8 age group. Type 2b and 3 were seen mostly at C3, but sometimes at C4 body. Height of body was statistically more significant than width of body in classification of type 2a, 2b and 3. CONCLUSION: The configuration of lower cervical spine in infants and children changes from immature oval type(type 1) to mature rectagular type(type 4) with increasing age. Among the 4 types, the rounded upper corner type or anterior wedging type of lower cervical spine should be differentiated from compresson fracture. We concluded that the height of cervical body is more significant than the width of body in simple radiographic classification of types 2a, 2b and 3.
Child* ; Classification ; Fractures, Compression ; Humans ; Incidence ; Infant* ; Retrospective Studies ; Spinal Injuries ; Spine

Hemolytic Uremic Syndrome (HUS) is the most common cause of acute renal failure in children and is comprised of the combination of hemolytic anemia, thrombocytopenia, and acute renal failure. Atypical HUS, rare in childhood, has worse prognosis than that of typical HUS and is associated with chemotherapy drug, other bacterial (especially Streptococcus pneumoniae) or viral infections, and so on. We report a case of HUS caused by pneumococcal infection in 4-year-old boy. While he was admitted with pneumonia and pleural effusion, pneumococcal infection could be revealed. Although HUS progressed rapidly, he immediately received 3-time hemodialysis and recovered completely after two weeks.
Acute Kidney Injury ; Anemia, Hemolytic ; Child ; Child, Preschool ; Drug Therapy ; Hemolytic-Uremic Syndrome* ; Humans ; Male ; Pleural Effusion ; Pneumococcal Infections* ; Pneumonia ; Prognosis ; Renal Dialysis ; Streptococcus ; Thrombocytopenia

Hydroxychloroquine, an 4-amino-quinoline, has been used widely for the treatment of lupus erythematosus due to its anti-inflammatory and immuno-modulatory activities, as well as for the treatment of malaria. A 37-year-old woman who was suspected as lupus erythematosus and treated with hydroxychloroquine for 3 weeks was seen with exfoliated annular patches and pustules on the trunk, neck, and extremities. Histological examination showed subcorneal and spongiform neutrophilic pustules with perivascular lymphocytes, eosinophils and neutrophils infiltrations. The patient had been treated with systemic steroid and antihistamine. The pustular lesions had improved 2 weeks later without recurrence. The causative drug was confirmed by a positive patch test.
Acute Generalized Exanthematous Pustulosis ; Adult ; Eosinophils ; Extremities ; Female ; Humans ; Hydroxychloroquine ; Lymphocytes ; Malaria ; Neck ; Neutrophils ; Patch Tests ; Recurrence

Purpose: This study aimed to identify the effects of hospital ethical climate and communication self-efficacy on nursing care left undone. Methods: The participants were 142 nurses working in a general hospital. Data were collected from July 18 to August 30, 2021. Data were analyzed by t-test, ANOVA, Pearson correlation, and multiple regression analysis using the SPSS/WIN 25.0 program. Results: (a) The mean value of hospital ethical climate was 3.54±0.41, communication self-efficacy was 5.03±0.81, and the sum of nursing cares left undone was 3.68±3.14.(b) Nursing cares left undone had a negative correlation with hospital ethical climate(r=-.25, p=.003) but not with communication self-efficacy (r=-.13,p=.116). (c) Factors that affected nursing cares left undone included education (≥master) (β=.23, p=.005), marital status (single) (β=-.19, p=.018), age (26~27) (β=-.18, p=.022), and hospital ethical climate (β=-.18, p=.029); the explanation power was 18.0% (F=8.66, p<.001). Conclusion Our study shows that hospital ethical climate plays a significant role in nursing cares left undone of nurses. It is important to strengthen hospital ethical climate to lower the incidence of nursing cares left undone. These results may serve as basic data to help develop strategies for reducing the incidence of nursing cares left undone.

No abstract available.
Rho(D) Immune Globulin*

Oral allergy syndrome (OAS) is a subtype of food allergy composing of itching sense and edema in the oral cavity, lips, throat, pharynx, and larynx following ingestion of some fresh fruits or vegetables. Although the major pathogenic mechanism of OAS is known to be IgE-mediated response, here we experienced a case of OAS due to crown daisy (CD) and sesame leaf (SL) mediated by a non-IgE antibody mediated mechanism. A 33-year-old female visited our clinic to evaluate numbness of the tongue and gingiva after eating fresh CD and SL for 2 years. The patient had suffered from allergic rhinitis and atopic dermatitis for 20 years and took medications intermittently. There had been a history of food allergy to crab and shrimp. The serum total IgE level was elevated (404 kU/mL). The skin prick test showed strong positive reactions to tree and weed pollens, but not to CD and SL extracts. Enzyme-linked immunosorbant assay for detecting serum specific IgE to crude extracts of CD and SL showed negative results. The basophil activation test performed with crude extracts of CD or SL showed significant up-regulation of CD63-positive basophils by both CD and SL. In conclusion, we report a case of OAS due to CD and SL, not associated with pollen allergy, which is shown to be mediated by a non-IgE mediated mechanism.
Adult ; Basophils ; Complex Mixtures ; Crowns* ; Dermatitis, Atopic ; Eating ; Edema ; Female ; Food Hypersensitivity ; Fruit ; Gingiva ; Humans ; Hypersensitivity* ; Hypesthesia ; Immunoglobulin E ; Larynx ; Lip ; Mouth ; Pharynx ; Pollen ; Pruritus ; Rhinitis ; Rhinitis, Allergic, Seasonal ; Sesamum* ; Skin ; Tongue ; Up-Regulation ; Vegetables

BACKGROUND: The Tetranychus urticae (TU) is commonly found on fruit trees and green house flowers. A recent investigation demonstrated that the sensitization rate to TU was as high as that of HDM in respiratory allergy patients in middle part of South Korea. MATERIAL AND METHODS: To identify IgE binding components within TU, sera from 8 TU-sen-sitive asthmatic patients and sera from unexposed controls showing negative response to TU on skin prick test were enrolled. SDS-PAGE and immunoblot analysis were applied. To evaluate cross-allergenicity with house dust mite (HDM) two kinds of serum pool were used: one (A) showing isolated positive response to TU and the other (B) showing positive responses to both TU and HDM. ELISA inhibition tests using sera A and B were were used. RESULTS: TU-ELISA inhibition test using serum pool A showed significant inhibition with TU and CRM and minimal inhibition with HDM, while ELISA inhibition test using serum pool B showed significant inhibition with addition of TU and CRM and partial inhibition with HDM. Immunoblot analysis using individual sera showed six IgE binding components (75, 56, 41, 37, 28, 14 kDa) and three (75, 41, 14 kDa) were bound to IgE in more than 50% of sera tested. CONCLUSIONS: Six IgE binding components were identified within TU and three (75, 41, 14 kDa) could be considered major allergens. Extensive cross-allergenicity was noted between TU and CRM TU-derived extracts contain TU-specific addition to common sharing allergens witHDM, Further investigations will be needed to identify species-specific, or common allergenic components within TU.
Allergens* ; Dust* ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Flowers ; Fruit ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Korea ; Pyroglyphidae* ; Skin ; Trees

BACKGROUND: Insulin exerts an effect on cell proliferation and inhibition of apoptosis. However, the actions of insulin on cell cycle progression and signal transduction pathway are not well understood and insulin shows diverse effects on cell proliferation depending on cell types. OBJECTIVE: We attempted to understand the underlying mechanism by which insulin exerts this proliferative effect on 3T3 L1 fibroblasts by various markers of cell proliferation. METHOD: We investigated the effect of insulin on cell proliferation by [3H]thymidine incorporation, analyzing the cell cycle stages by flow cytometric measurement of DNA content per cell, cell counting, analysing cell division as well as the signal transduction pathway of insulin by measuring of phosphatidylinositol 3-kinase(PI3-kinase) and p44/42 mitogen-activated protein kinase (p44/42 MAPK/ERK) activity. RESULTS: The results were as follows: 1. Total accumulated [3H]thymidine incorporation increased approximately two-fold with insulin over the 0.5% serum control at 48 h incubation, and the maximal rate of DNA synthesis was observed during 8-12 h incubation and continuously declined until 48 h without a second increase in DNA synthnesis.. 2. The flow cytometric analysis of cell population distribution showed that insulin increased the cell population in S phase. 3. After insulin treatment for 48 h, cell number was increased approximately 45% in comparison with 0.5% serum control. 4. The cell division analysed after staining 3T3 L1 fibroblasts with carboxyfluorescein diacetate succinimidyl ester (CFSE). Cell division occured only once in 24h after insulin treatment.. 5. Insulin stimulated PI3-kinase and p44/42 MAPK/ERK activity about three- and two-folds, respectively. CONCLUSION: Taken together, this data indicates that insulin stimulated the transit from G0/G1 to S phase, progressed cell cycle through G2/M phase, increased the cell number and PI3-kinase, p44/42 MAPK/ERK stimulate cell proliferation. However, under our experimental conditions, insulin has a limited efficacy for late cell cycle events required for completion of miosis and cell cycle progression into the second round and the increase of the cell number by insulin was much less than the increase of the PI3-kinase and p44/42 MAPK/ERK activity. Therefore, the authors think that another pathways other than PI3-kinase or p44/42 MAPK/ERK might be involved in the effect of insulin on cell proliferation.
Apoptosis ; Cell Count ; Cell Cycle* ; Cell Division ; Cell Proliferation* ; Demography ; DNA ; Fibroblasts* ; Insulin* ; Miosis ; Phosphatidylinositol 3-Kinases ; Phosphatidylinositols ; Protein Kinases ; S Phase ; Signal Transduction