OBJECTIVES: The purpose of this study was to examine the prevalence of allergic rhinitis between urban areas in the adjacent areas to a steel industrial complex and rural areas and the impact of pollutants in the industrialized city on allergic rhinitis. METHODS: From July 28 to August 9 of 2008, 1,043 residents of urban and rural areas in a local community had enrolled in health screening and questionnaire survey. One thousand thirty-three patients also underwent a skin prick test. Prevalence rates of allergic rhinitis were calculated according to residential areas, and the used statistical analysis were Fisher's exact test and chi-square test. RESULTS: In a survey, the fraction of adults, who complained of sneezing, nasal obstruction and rhinorrhea, during a recent 1 year period, showed the significant difference between urban (30.5%) and rural areas (22.4%). The fractions of positive skin prick tests were not different between two areas in each age group. The prevalence of allergic rhinitis was 8.4% in urban areas and 6.9% in rural areas. Considering the age groups, the adults group only showed the significantly higher prevalence of allergic rhinitis in urban areas (8.2% vs. 3.7%). CONCLUSIONS: Unlike the children and adolescents groups, the prevalence of allergic rhinitis in adults group was higher in the industrialized urban areas.
Adolescent ; Adult ; Child ; Humans ; Mass Screening ; Nasal Obstruction ; Prevalence* ; Rhinitis* ; Skin ; Skin Tests ; Sneezing ; Steel

No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

We report a recent case in which ciprofloxacin-resistant Shigella flexneri was isolated from a 23-yr-old female patient with a history of travel to India. Prior to her admission to our internal medicine department, she experienced symptoms of high fever and generalized weakness from continuous watery diarrhea that developed midway during the trip. S. flexneri was isolated from the stool culture. Despite initial treatment with ciprofloxacin, the stool cultures continued to show S. flexneri growth. In the susceptibility test for antibiotics of the quinolone family, the isolate showed resistance to ciprofloxacin (minimum inhibitory concentration [MIC], 8 microg/mL), norfloxacin (MIC, 32 microg/mL), ofloxacin (MIC, 8 microg/mL), nalidixic acid (MIC, 256 microg/mL), and intermediate resistance to levofloxacin (MIC, 4 microg/mL). In molecular studies for quinolone resistance related genes, plasmid borne-quinolone resistance genes such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB were not detected. Two mutations were observed in gyrA (248C-->T, 259G-->A) and 1 mutation in parC (239G-->T). The molecular characteristics of the isolated S. flexneri showed that the isolate was more similar to the strains isolated from the dysentery outbreak in India than those isolated from Korea.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics/metabolism ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/microbiology ; Feces/microbiology ; Female ; Humans ; India ; Mutation ; Quinolones/*pharmacology ; Shigella flexneri/drug effects/*isolation & purification/metabolism ; Travel ; Young Adult

BACKGROUND: induction of analgesia is frequently required during undergoing reduction of fractures or dislocation in the emergency department. METHODto induce analgesia should be easy, convenient, and safe because patients are not always in fasting state. Nitrous oxide inhalation has been known as a good method of analgesia in emergency patients. PURPOSE: This study was aimed to evaluate the efficacy and safety of nitrous oxide analgesia in the emergency department. METHOD: We prospectively studied 34 patients undergone reductions of fractures in the emergency department. Nitrous-oxide was the sole source of analgesia. The Visual Analogue Scale(VAS) was rated by the emergency physician before nitrous oxide inhalation,5 minutes after inhalation and reduction procedures. RESULTS: No complication such as vomiting, respiratory depression, or a change in oxygen saturation resulted from the use of nitrous-oxide. Ninety one percent of patients obtained an analgesic effect. However, 9% of patients did not experience any analgesic effect after inhalation of nitrous oxide. In subgroup analysis for analgesic effect of nitrous-oxide, nitrous oxide provided only partial analgesia for acute pain in open fracture group. VAS was significantly lower after inhalation than before inhalation of nitrous oxide in simple fracture group. However, VAS of simple fracture group was increased during closed reductions, which indicated incomplete relief of pain by nitrous oxide. Nitrous oxide inhalation foiled to relieve pain during reduction in patients with open fracture or dislocation. CONCLUSION: Administration of nitrous-oxide, when used as the sole source of analgesia, is not the ideal method of analgesia during reduction of fractures or dislocations.
Acute Pain ; Analgesia ; Dislocations ; Emergencies* ; Emergency Service, Hospital* ; Fasting ; Fractures, Open ; Humans ; Inhalation ; Nitrous Oxide* ; Oxygen ; Prospective Studies ; Respiratory Insufficiency ; Vomiting

Transcutaneous cardiac pacing(TCP) is a rapid, safe, noninvasive and easily utilized form of emergency cardiac pacing, with hemodynamically similar to transvenous cardiac pacing. This paper reports the result of transcutaneous pacing in a series of patients in emergency department.32 patients with bradyanhythmia were enrolled during the study period. TCP was successful in 29(91%) patients. No evidence of electrical capture was seen in two patients in asystole and a patient with ventricular escape rhythm. Mean capture threshold was 66 mA. Transvenous pacemaker was inserted in 18(56%) of the 32 patients during transcutaneous cardiac pacing. Twenty(61%) of the 32 patients survived and eventually discharged. Ten patients(31%) were died of uncorrectable underlying disease in spite of successful ECG capture and palpable pulse by TCP. In conclusion, TCP is a reliable, noninvasive method that offers the possibility to initiate pacing within seconds and can be used by any emergency medical staff. In our opinion, it should be considered as the first choice of emergency treatment of hemodynamically unstable bradyarrhythmia.
Bradycardia* ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Heart Arrest ; Humans ; Medical Staff ; United Nations

Fanconi-Bickel syndrome is a rare autosomal recessive disorder of the carbohydrate metabolism recently demonstrated to be caused by mutations in GLUT2, the gene for the glucose transporter protein 2 expressed in the liver, pancreatic beta islet-cells, intestine and kidney. Typical clinical and laboratory findings of Fanconi-Bickel syndrome are hepatomegaly secondary to glycogen accumulation, glucose and galactose intolerance, fasting hypoglycemia, a characteristic proximal tubular nephropathy and severe short stature. Several cases have been reported in other countries after Fanconi and Bickel in Switzerland first reported this syndrome in 1949. We experienced the first Korean case of Fanconi-Bickel syndrome in a neonate presented with hyperglycemia and hypergalactosemia that was initially diagnosed as transient neonatal diabetes mellitus and galactosemia. We also identified a novel mutation(K5X) in the GLUT2 gene.
Carbohydrate Metabolism ; Diabetes Mellitus* ; Fanconi Syndrome* ; Galactose ; Galactosemias* ; Glucose ; Glucose Transport Proteins, Facilitative ; Glycogen ; Hepatomegaly ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant, Newborn ; Intestines ; Kidney ; Liver ; Switzerland

BACKGROUND: Sinus valsalva aneurysm (SVA) is a rare disease, and it is frequently accompanied by ventricular septal defect and aortic valve regurgitaion. For treatment of SVA, several surgical mordalities were applied, but there was no report on the long-term result after surgical repair in Korea. We reviewed our 28 years of experiences and analyzed the long-term results after treatment of sinus valsalva aneurysm with or without rupture. MATERIAL AND METHOD: Between March 1974 and February 2002, 81 patients were operated under the impression of sinus valvsalva aneurysm or sinus valsalva aneurym rupture. Retrospectively we reviewed the patients' record. Mean age of patients was 29.2+/-11.5 and there were 49 males. Accompanyng diseases were as follows: VSD in 50, PDA in 2, Behcet's disease in 2, TOF in 1, RVOTO in 1, AAE in 1. Seventy-seven (95%) patients had sinus valsalva rupture and in 14 patients, subacute bacterial endocarditis was accompanied. Degree of aortic valve regurgitation was as follows: grade I: 8, II: 10, III: 9, IV: 4. Most common rupture site was right coronary sinus (66 patients, 81%) and most common communication site was right ventricle (53 patients). In repair of sinus valsalva rupture, patch was used in 37 patients, and direct suture was done in 38 patients. RESULT: There was one surgical death (1.2%). Follow up was done in 78 patients (97.5%), mean follow up period was 123.3+/-80.9 (3~330 months). During the follow up period, 3 patients died (3.8%). One patient died of heart failure, another patient died of arrhythmia and the other one died of unknown cause. In two patients, complete atrio-ventricular block was developed during follow up period, and there was no operation related event or complication. Kaplan-Meier survival analysis revealed 92.5+/-3.5% survival at 15 and 27 years and it seems to be satisfactory. CONCLUSION: Long-term surgical results and survival is satisfactory after repair of sinus valsalva aneurysm with or without rupture.
Aneurysm* ; Aortic Valve ; Arrhythmias, Cardiac ; Coronary Sinus ; Endocarditis, Subacute Bacterial ; Follow-Up Studies ; Heart Failure ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Korea ; Male ; Rare Diseases ; Retrospective Studies ; Rupture* ; Sinus of Valsalva ; Sutures

PURPOSE: Recent studies have demonstrated that probiotics are effective in the management of allergic diseases, but there have been few reports about their preventive effects in asthma. We examined the effects of Lactobacillus acidophilus (LA) and its mechanism in the primary prevention of asthma. METHODS: Before allergen sensitization, newborn Balb/c mice orally received 1x10(9) colony forming unit (CFU) LA per day every 2 days for consecutive 4 weeks starting from birth. After ovalbumin sensitization and challenge from day 36, airway hyperresponsiveness (AHR) to methacholine, influx of inflammatory cells to the lung, serum total IgE levels, cytokine levels in the supernatant of splenocytes culture, and expression of FoxP3 mRNA in the peribronchial lymph nodes were assessed. RESULTS: The AHR showed a tendency to decrease in LA group, however, there was no statistical significance. The eosinophil counts in bronchoalveolar lavage fluid and serum total IgE were significantly reduced in LA group compared with asthma control group. LA effectively induced IFN-gamma secretion and inhibited IL-4, IL-5 and TGF-beta1 secretion compared with asthma control group. The expression of FoxP3 mRNA in peribronchial lymph nodes did not show any difference between LA and asthma control group. CONCLUSION: Oral LA administration in murine model of asthma attenuated AHR and significantly suppressed eosinophilic inflammation in the airway. These effects of LA were mediated by suppressing Th2 immune response and enhancing Th1 immune response. The results may suggest the possible role of LA in the primary prevention of asthma.
Animals ; Asthma ; Bronchoalveolar Lavage Fluid ; Eosinophils ; Humans ; Immunoglobulin E ; Infant, Newborn ; Inflammation ; Interleukin-4 ; Interleukin-5 ; Lactobacillus ; Lactobacillus acidophilus ; Lung ; Lymph Nodes ; Methacholine Chloride ; Mice ; Ovalbumin ; Parturition ; Primary Prevention ; Probiotics ; RNA, Messenger ; Stem Cells ; Transforming Growth Factor beta1

BACKGROUND: To treat anastomosis site stenosis and occlusion of the artificial vessels used in vascular surgery, tissue-engineered artificial vessels using autologous cells have been constructed. We developed artificial vessels using a polymer scaffold and autologous bone marrow cells and performed an in vivo evaluation. MATERIAL AND METHOD: We manufactured a vascular scaffold using biodegradable PLCL (poly lactide-co-epsilon-caprolactone) and PGA (poly glycolic acid) fibers. Then we seeded autologous bone marrow cells onto the scaffold. After implantation of the artificial vessel into the abdominal aorta, we performed an angiography 3 weeks after surgery. After the dogs were euthanized we retrieved the artificial vessels and performed histological analysis. RESULT: Among the six dogs, 2 dogs died of massive bleeding due to a crack in the vascular scaffold 10 days after the operation. The remaining four dogs lived for 3 weeks after the operation. In these dogs, the angiography revealed no stenosis or occlusion at 3 weeks after the operation. Gross examination revealed small thrombi on the inner surface of the vessels and the histological analysis showed three layers of vessel structure similar to the native vessel. Immunohistochemical analysis demonstrated regeneration of the endothelial and smooth muscle cell layers. CONCLUSION: A tissue engineered vascular graft was manufactured using a polymer scaffold and autologous bone marrow cells that had a structure similar to that of the native artery. Further research is needed to determine how to accommodate the aortic pressure.
Angiography ; Animals ; Aorta, Abdominal ; Arterial Pressure ; Arteries ; Blood Vessel Prosthesis ; Bone Marrow ; Bone Marrow Cells ; Constriction, Pathologic ; Dogs ; Glycosaminoglycans ; Hemorrhage ; Myocytes, Smooth Muscle ; Polymers ; Prostaglandins A ; Regeneration ; Seeds ; Tissue Engineering ; Transplants

The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CABG). We present the case of a 57-year-old man who underwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation. The patient was successfully treated surgically. This report describes a patient who developed potentially fatal dehiscence of SVGs secondary to infection and outlines preventive and management strategies for this complication.
Catheters ; Containment of Biohazards ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Middle Aged ; Pericardium ; Renal Dialysis ; Rupture ; Saphenous Vein ; Sepsis* ; Transplants