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

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

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

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*

PURPOSE: Pneumonia is one of the most common respiratory diseases in hospitalized children, and often recurs. It has been reported that asthma is one of the significant contributing factors to recurrent pneumonia. On the basis of similarities between asthma and recurrent pneumonia, we intended to evaluate the influence of allergy on recurrent pneumonia. METHODS: Seventy one children with recurrent pneumonia were defined as recurrent group(RG) and twenty one children with first episodes of pneumonia were defined as control group(CG). WBC, total eosinophil count, Eosinophilic Cationic Protein(ECP), serum total IgE and specific IgE for eleven common allergens using the CAP system were measured and compared. Recurrent pneumonia was defined as at least two pneumonia episodes in a year, or at least three episodes from birth to the time of our study. Children with previous allergic disorders were excluded. RESULTS: There were no statistical differences in WBC, total IgE, and ECP between the two groups. Total eosinophil count in RG was significantly higher than CG(P=0.021), significantly correlating with ECP(r=0.755, P<0.05) and total IgE(r=0.354, P<0.05). When the cut-off value was 0.35 kU/L in CAP test, positive prevalence of CAP in RG was significantly higher than CG(P=0.009). Also, the positive prevalence of house dust mites group, especially Dermatophagoides farinae(D.f.), was significantly higher in RG(P=0.019, 0.025, respectively). When the cut-off value was 0.7 kU/L in CAP test, only a positive prevalence of house dust mites group was significantly higher in RG than CG (P=0.042). The quantitative levels of specific IgE for Dermatophagoides pteronyssinus(D.p.) and D.f. were very high in RG(P=0.018, 0.028, respectively), significantly correlating with each other(r=0.639, P<0.05). CONCLUSION: Allergic sensitization, especially to house dust mites, is one important contributable factor in recurrent pneumonia in children. Further study, such as bronchial hyperresponsiveness, is needed in children who were sensitized by D.p. or D.f..
Allergens ; Asthma ; Child* ; Child, Hospitalized ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Eosinophils ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Parturition ; Pneumonia* ; Prevalence ; Pyroglyphidae

Chestnut as a Food Allergen: Identification of Major Allergens To evaluate the clinical significance of chestnut as a food allergen in Korea, skin prick test and ELISA were done in 1,738 patients with respiratory allergies. To identify the IgE binding components, IgE-immunoblotting, 2D IgE-immunoblotting and MALDITOF were performed. To observe the effects of digestive enzymes and a boiling treatment, simulated gastric fluid (SGF) and simulated intestinal fluids (SIF) were incubated with chestnut extracts, and IgE-immunoblotting were then repeated. Skin prick test revealed that 56 (3.2%) patients showed more than 2+ of allergen to histamine ratio to chestnut. Among the 21 IgE binding components, 9 bands were found in more than 50% of the sera tested and the 24 kDa protein had the highest binding intensity. The amino acid sequence of the 24 kDa protein (pI 6.3) had homology with legume protein of oak tree. SGF, SIF and boiling treatment were able to suppress the IgE binding components. In conclusion, chestnut ingestion was shown to induce IgE mediated responses with a 3.2% sensitization rate. Twenty one IgE binding components and one new allergen (the 24 kDa protein) were identified. Digestive enzymes and boiling treatment were able to decrease the allergenic potency.
Allergens/analysis/immunology ; Amino Acid Sequence ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay/methods ; Fagaceae/chemistry/*immunology ; Food Hypersensitivity/blood/*immunology ; Humans ; Immunoblotting ; Immunoglobulin E/blood/immunology ; Plant Extracts/chemistry/immunology ; Protein Binding/immunology ; Research Support, Non-U.S. Gov't ; Sequence Analysis, Protein ; Skin Tests/methods

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.
Checklist ; Delivery of Health Care ; Humans ; Infant ; Infant Care ; Infection Control* ; Postnatal Care* ; Postpartum Period* ; Social Control, Formal