BACKGROUND: The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of the radioallergosorbent test(RAST). The CLA permits quick, siultaneous detection of total and specific IgE in human serum up to 35 different allergens, as well as their semiquantitative concentrations into classes from 0(negative) to 4(very high). The CLA has shown sensitivity, specificity, and a good correlation with the RAST and also with skin pick testing. OBJECTIVE: The purpose of this study was to find the causatix llergens and to evaluate the clinical significance of CLA comparing the results of tbe CLA wi! h hose of the prick test in patients with chronic urticaria. METHODS: We performed the CLA with 35 allergens(MAST immunosunosystems, Inc., California, America) and the prick test with 51 allergens(Bencard Ltd., Bricantord, England) in 70 patients with chronic urticaria. The CLA detects the allergen-IgE reactic say the use of an enzyme-labeled anti-IgE and a coupled photoreagent mixture. lhe amount of the luminescent energy is measured by exposing a polarcid film and then semiquantitation is a sessed by using a densitometer. RESULTS: Except for those over the age of 60, all age-groups ealed a similar positive reaction to the CLA and prick test, but the positive reaction rate o the prick test(91.4%) was higher than that of the CLA(38.6%). The positive reaction rate oringle allergen and compound allergens was 10.0% and 28.6% in the CLA, but 10.0% and 81.4% in the prick test, respectively. In the CLA, the rate of positive reaction was 17(24.3%) in Dermatophagoides(D.) farinae, 15(21.4% ) in D. pteronyssinus, 5(7.1% ) in house dust, an 13(4.3%) in shrimp in that order. In the prick test, the rate of positive reaction was 39(55.7%) in house dust, 35(50.0%) in D. farinae, 29(41.4%) in D. pteronyssinus, and 21(30.0%) in haydrst(30.0%) in that order. The results of the CLA to 3 comrnon allergens showed a concordance rare of 67.6%, sensitivity of 34.3%, and specificity of 97.3% compared with those of the prick case. The levels of total IgE and eosinophils were elevated in 59(n=70, 843%) and in 5(n=56, 84.3%), respectively. CONCLUSION: The results of this study suggest that the CLA may be used as an alternative method for the diagnosis of chronic urticaria because it is and coiomic, safe, simple procedure with very high specificity and trelative low sensitivity, and is sirnilt. neously capable of testing to multiple allergens.
Allergens ; California ; Diagnosis ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Luminescent Measurements* ; Sensitivity and Specificity ; Skin ; Urticaria*

We report a case of amelanotic melanoma(AMM) in a 53-year-old man who presented a single, 1.5×1.5cm sized, well-demarcated, bright red nodule with erosion on the right heel for 9 months. Histopathologic findings showed irregular junctional activity in the epidermal-dermal junction and alveolar formation in the dermis. The majority of the tumor cells were seen as bizarre and giant cell of epithelioid type with atypical mitotic figure. We could not find melanin pigment in H & E stain.
Dermis ; Giant Cells ; Heel ; Humans ; Melanins ; Melanoma, Amelanotic* ; Middle Aged

BACKGROUND: Atopic dermatitis(AD) exibit multiple immune akno malities including elevated serum IgE levels and impaired cell mediated immunity, but basic immunology defect is largely unknown. OBJECTIVE: The purpose of this study was to evaluate the immnologic changes after treatment with Cyclosporin A(CsA) in AD patients. MEHTODS: Eight patients of severe AD were treated with CsA(4mg/kg body weight per day) for 5 weeks, and evaluated clinical and immunological parameters before aid after treatment. RESULTS: Peripheral blood eosinophil counts were significantly decreased after treatment(P<0.05), and serum IgE level was decressed but not significantly. In immediate hypersensitivity reaction by pinprick test, antigen score was.significantly decreased, and in the evaiuation of cell mediated immunity to recall antigens, total induration score was significantly increased(p<0.05). The number of helper T cell and helper/suppressor 7 cell ratio in peripheral blood, and the niimber of helper T and suppressor T cell in skin lesion were both significantly decreased after treatment(P<0.05). Clinical state after treatrnent was good in all of patients. CONCLUSION: The results indicate that CsA act on peripheral blood osinophil and immediate and delayed hypersensitivity reaction as well as helper T-cells in peripheral blood and skin lesion, and it may by useful in the treatrnent of severe AD.
Allergy and Immunology ; Body Weight ; Cyclosporine* ; Dermatitis, Atopic* ; Eosinophils ; Humans ; Hypersensitivity, Delayed ; Hypersensitivity, Immediate ; Immunity, Cellular ; Immunoglobulin E ; Skin ; T-Lymphocytes, Helper-Inducer

Ki-1 antigen was found by a monoclonal antibody, made against a Hidgkin' disease-derived cell line (L428) that reacted with Reed-Sternberg cells in Hodgkins disease and a few lymphocytes around lymphoid follicle. In 1985, Stein et al identified a large cell anaplastic lymphoma showing a distinctive pleomorphic appearance, sinus growth pattern, and reactivity to Ki-l. We report a case of Ki-1 positive large cell anaplastic lymphoma, which was presenting as a elevated plaque on the skin of popliteal fossa in a 69-year-old female.
Aged ; Antigens, CD30 ; Cell Line ; Female ; Hodgkin Disease ; Humans ; Lymphocytes ; Lymphoma* ; Reed-Sternberg Cells ; Skin

Type V hyperlipoproteinemia result from the accumulation of trglyceride(TG)-rich lipoproteins, very low density lipoprotein(VLDL), and chylomicrons. A 53-year old woman has showed asmptomatic, yellowish patches on tie palms and eyelids and papules on the knees with various types of xanthoma including xanthelasma palpebraum, xanthoma striatum palmare, anrl nonspecific papular xanthoma. The blood chemistry revealed a marked elevation of cholesterol and TG, and lipoprotein electrophoresis showed fasting chylomicronemia, prep-b and b-band, On histologic studies, typical foam cells were shown.
Chemistry ; Cholesterol ; Chylomicrons ; Electrophoresis ; Eyelids ; Fasting ; Female ; Foam Cells ; Humans ; Hyperlipoproteinemia Type V* ; Knee ; Lipoproteins ; Middle Aged ; Xanthomatosis

Atropine is a commonly used eye drug due to the effect of mydrasis and cycloplegia. The true allergic contact dermatitis to atropine is rarely reported. A case of allergic contact dermatitis due to atropine sulfate in a 35-year-old woman was confirmed by the patch test.
Adult ; Atropine* ; Dermatitis, Allergic Contact* ; Female ; Humans ; Patch Tests

No Abstract Available.
Depression* ; Primary Health Care*

No Abstract Available.
Depression* ; Primary Health Care*

PURPOSE: We performed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1.8~2.0 Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy (56~66 Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclophosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in 2~5 cycles (median 2). RESULTS: Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were 41.5%, 13.7%, and 7%, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, 32.9%, 10.5%, 6% for radiotherapy alone group, and 14 months, 57.8%, 20%, 7.6% for induction chemotherapy group, respectively (p=0.0005). Complete response (CR) to overall treatments was 25% (21/84) in radiotherapy alone and 40.5% (17/42) in induction chemotherapy group (p=0.09). The prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and response to overall treatment(p= 0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). CONCLUSION: Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radio therapy alone. At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.
Carcinoma, Non-Small-Cell Lung* ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Induction Chemotherapy* ; Neoplasm Metastasis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Vinblastine

The paratertiary butylphenol formaldehyde resin(PTBP-FR) is commonly used in neoprene shoe adhesive to provide stability, durability, flexibility, and to stick quickly. We report here a case of allergic contact dermatitis in a 22-year-old female, who had well defined, pruritic, erythematous, and papulovesicular lesions on the lateral side of the left foot and ankle for 3 years. Patch test showed 2+(vesicular) reaction .to PTBP-FR(1% in petrolatum), a piece of leather shoes(as is), and a piece of leather watch strap(as is).
Adhesives ; Ankle ; Dermatitis, Allergic Contact* ; Female ; Foot ; Formaldehyde* ; Humans ; Neoprene ; Patch Tests ; Pliability ; Shoes ; Young Adult