Food allergy is an immune-mediated adverse reaction that occurs mainly by food ingestion. Some children with food allergies manifest fatal symptoms like anaphylaxis. Oral immunotherapy (OIT) may offer an effective therapeutic modality for persistent and severe forms of food allergies. We report our experience with OIT in 3 patients with IgE-mediated hen’s egg allergy. Our treatment strategy consists of 1–3 days of initial escalation, 47 to 65 weeks of build-up phase, and 1 year of maintenance phase. Lactobacillus plantarum CJLP133, 1×1010 colony-forming unit/day was taken during OIT. As a result, 1 patient achieved successful desensitization, and 1 patient reached maintenance therapy, but did not obtain desensitization. In addition, 1 patient withdrew from treatment due to anxiety symptoms. Despite the limited number of patients, we experienced and herein presented 3 cases of OIT in egg allergy. More trials of OIT need to be performed as a treatment option in Korean children with food allergies.

BACKGROUND: This study investigated the effect of fine dust concentrations in the air on the incidence of viral respiratory infections in the Republic of Korea.METHODS: A time series analysis using R statistics was performed to determine the relationship between weekly concentrations of fine dust in the air and the incidences of acute respiratory tract infections caused by the respiratory syncytial virus (RSV), adenovirus (HAdV), rhinovirus (HRV), human metapneumovirus (HMPV), human coronavirus (HCoV), human bocavirus (HBoV), human parainfluenza virus (HPIV), and influenza virus (IFV), from the beginning of 2016 to the end of 2017. Correlations between various meteorological factors and the amount of fine dust were analyzed using the Spearman's rank correlation coefficient. To analyze the relationship between viral infections and fine dust, a quasi-poisson analysis was performed.RESULTS: The incidence of the HAdV was proportional to fine dust and air temperature. The IFV was proportional to fine dust and relative humidity and was inversely proportional to temperature. The HMPV was proportional to fine dust, wind speed, and inversely proportional to relative humidity. The HCoV was proportional to micro dust, relative humidity, and inversely proportional to temperature. Both the HBoV and HPIV were directly proportional to fine dust, temperature, wind speed, and inversely proportional to relative humidity. The RSV was inversely proportional to fine dust, temperature, wind speed. A lag effect was observed for the influenza virus, in that its incidence increased 2–3 weeks later on the cumulative lag model.CONCLUSION: As the weekly average concentration of fine dust increases, the incidence of HAdV, HMPV, HCoV, HBoV, HPIV, and influenza increase.
Adenoviridae ; Air Pollution ; Coronavirus ; Dust ; Human bocavirus ; Humans ; Humidity ; Incidence ; Influenza, Human ; Metapneumovirus ; Meteorological Concepts ; Orthomyxoviridae ; Paramyxoviridae Infections ; Particulate Matter ; Republic of Korea ; Respiration Disorders ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Rhinovirus ; Wind

PURPOSE: Because the main drawback of bilateral adrenalectomy is permanent adrenal insufficiency and the subsequent risks of life-long steroid use, adrenal preserving partial adrenalectomy is being accepted as its alternative. The aim of this study is to investigate the indications for bilateral adrenalectomy and to assess the postoperative outcomes and steroid replacement according to operative methods. METHODS: From May 1996 through July 2013, a total of 25 patients who underwent bilateral adrenalectomy in our institution were reviewed retrospectively. Surgical outcomes were compared between total and partial adrenalectomy, and postoperative steroid hormone replacement were examined according to the volume of remnant adrenal gland. RESULTS: The median follow-up duration of 25 patients was 55.8 months. The most common indication for bilateral adrenalectomy was bilateral pheochromocytoma (n=16), which was associated with genetic mutation of RET or VHL gene in 11 cases. Cushing's syndrome (n=8) and hyperaldosteronism (n=1) were another indications of bilateral adrenalectomy. Total adrenalectomy was performed in 8 patients and adrenal preserving partial adrenalectomy in 17 patients. Among the 17 patients, only 5 patients needed adrenal hormone replacement and 2 patients had a recurrence at remnant adrenal tissue. CONCLUSION: Adrenal preserving partial adrenalectomy might be a better option for bilateral adrenal tumor than total adrenalectomy because it can reduce complications associated with adrenal insufficiency and recurrence of the disease is not common.
Adrenal Glands ; Adrenal Insufficiency ; Adrenalectomy* ; Cushing Syndrome ; Follow-Up Studies ; Humans ; Hyperaldosteronism ; Pheochromocytoma ; Recurrence ; Retrospective Studies

OBJECTIVES: The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). METHODS: Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). RESULTS: 70 individuals with ASD (63 males, 87.94+/-37.8months), 53 SIB (27 males, 85.40+/-48.06 months), and 32 TC (19 males, 104.19+/-23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age (chi2=15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination (chi2=10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. CONCLUSION: These results do not support the previous controversies regarding the relationship between prenatal/perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.
Aged ; Appointments and Schedules ; Autistic Disorder ; Caregivers ; Child ; Autism Spectrum Disorder ; Fertilization ; Gestational Age ; Humans ; Male ; Parturition ; Siblings ; Vaccination

PURPOSE: Squamous cell carcinoma(SCC) of the lower lip is the most common malignant tumor comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is of an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. Depending on the location and size of the tumor, different types of flaps are used. We used new method ? 'both buccal mucosa transposition flap' for the reconstruction of the near total mucosal defect of the lower lip. METHODS: This 67-year-old men presented with the crusted 1x1cm sized ulceration of the lower lip that was arised 30 years ago. There were no size or color change, except the bleeding and ulceration. At first, We diagnosed the SCC through the incisional biopsy. Then We performed the wide excision of the tumor and reconstruction of the lower lip. After the excision of the whole tumor, the defect was measured at 8x3.5cm. We designed the buccal mucosa transposition flap taking care to avoid the parotid duct. The flap was made in a triangular shape for the reconstruction of defected lower lip. The donor site defect can be sutured primarily. RESULTS: A patient in this study had no postoperative complications such as necrosis, dehiscence, infection of the flap or donor site. Reconstructed lower lip is relatively close to that of the natural lip; More satisfactory aesthetic and functional results can be obtained by using this technique rather than other techniques. CONCLUSION: 'Both buccal mucosa transposition flap' is reliable method for the reconstruction of the large lower lip mucosal defect. The operation is simple and performed in one stage, with no postoperative complications. This technique can offer consistently good functional and esthetic outcomes after reconstruction of lower lip mucosal defect.
Aged ; Biopsy ; Hemorrhage ; Humans ; Lip ; Male ; Mouth Mucosa ; Necrosis ; Postoperative Complications ; Tissue Donors ; Ulcer

OBJECTIVE: The objective of this study was to identify patterns of brain activation elicited by erotic visual stimuli in patients treated with either Selective Serotonin Reuptake Inhibitors (SSRIs) or mirtazipine. METHODS: Nine middle-aged men with major depressive disorder treated with an SSRI and ten middle-aged men with major depressive disorder treated with mirtazapine completed the trial. Ten subjects with no psychiatric illness were included as a control group. We conducted functional brain magnetic resonance imaging (fMRI) while a film alternatively played erotic and non-erotic contents for 14 minutes and 9 seconds. RESULTS: The control group showed activation in the occipitotemporal area, anterior cingulate gyrus, insula, orbitofrontal cortex, and caudate nucleus. For subjects treated with SSRIs, the intensity of activity in these regions was much lower compared to the control group. Intensity of activation in the group treated with mirtazapine was less than the control group but grea-ter than those treated with SSRIs. Using subtraction analysis, the SSRI group showed significantly lower activation than the mirtazapine group in the anterior cingulate gyrus and the caudate nucleus. CONCLUSION: Our study suggests that the different rates of sexual side effects between the patients in the SSRI-treated group and the mirtazapine-treated group may be due to different effects on brain activation.
Brain ; Caudate Nucleus ; Depressive Disorder, Major ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male ; Mianserin ; Serotonin Uptake Inhibitors

PURPOSE: Adenoid cystic carcinoma (ACC) is a rare malignant epithelial neoplasm derived from the salivary glands. In some cases, ACC may arise in other primary sites, such as skin. We report a case of adenoid cystic carcinoma arising the scalp skin of a 69-year-old woman. METHODS: A 69-year-old woman presented with a tender scalp nodule. A local wide excision was performed. Histopathologic examination revealed the adenoid cystic carcinoma with basaloid cells in a cribriform pattern. The resection margins were free of tumor. Two years later a tumor recurred in the scarred area. The lesion was removed surgically and the histopathological diagnosis of adenoid cystic carcinoma was again established. After two years, tumor recurred again and distant metastasis of the lung was diagnosed. A surgical wide excision was done and the close regular follow-up for recurrence was done. Two years later, third recurrence of the scalp was observed. We also performed the wide local excision with tumor free margin. RESULTS: We experience the recurrent adenoid cystic carcinoma of the scalp with pulmonary metastasis. We have performed the wide local excision for three times. The patient has been followed up for 10 years with regular work-up for recurrence and metastasis CONCLUSION: primary cutaneous adenoid cystic carcinoma is a rare skin neoplasm with a high potential for recurrence after local excision. The standard treatment of ACC is wide local excision with tumor-free margins established by permanent section.
Adenoids ; Aged ; Carcinoma ; Carcinoma, Adenoid Cystic ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Lung ; Neoplasm Metastasis ; Recurrence ; Salivary Glands ; Scalp ; Skin ; Skin Neoplasms

PURPOSE: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. METHODS: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. RESULTS: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. CONCLUSION: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.
Depression ; Displacement (Psychology) ; Facial Asymmetry ; Humans ; Hypesthesia ; Imidazoles ; Malocclusion ; Nitro Compounds ; Operative Time ; Postoperative Complications ; Skeleton ; Zygoma

PURPOSE: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. METHODS: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. RESULTS: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. CONCLUSION: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.
Depression ; Displacement (Psychology) ; Facial Asymmetry ; Humans ; Hypesthesia ; Imidazoles ; Malocclusion ; Nitro Compounds ; Operative Time ; Postoperative Complications ; Skeleton ; Zygoma

BACKGROUND: Malassezia (M.) yeasts are lipophilic fungi which are regarded as normal flora of the skin, and are recovered in 75~98% of healthy adults. Gueho et al reclassified the Malassezia yeasts into 7 species (M. furfur, M. obtusa, M. globosa, M. slooffiae, M. sympodialis, M. pachydermatis, M. restricta) on the basis of molecular biology and by employing an interdisciplinary approach of morphology, microstructurology and physiology. Recently novel species of the genus Malassezia have been discovered as a result of molecular analysis. But there are no additional reports in Korea regarding newly reported Malassezia species because most identification and classification of Malassezia in Korea depend on classical methods and research on molecular biologic application is insufficient. OBJECTIVE: Five clinical isolates of M. dermatis were isolated from the skin of healthy subjects without skin disease or seborrheic dermatitis patients using molecular biology techniques for the first time in Korea. Hence the present study describes mycological and molecular biological characteristics of these five isolates as a novel species of M. dermatis. METHODS: Morphological and biochemical analyses, such as colony morphologies, microscopic morphologies and physiological characteristic were done targeting 5 clinical isolates of M. dermatis. Molecular techniques, namely, 26S rDNA PCR-RFLP, 26S rDNA and internal transcribed spacer region 1 (ITS1) sequencing, were done for identification and phylogenetic systematic analysis. RESULTS: Five clinical isolates of M. dermatis showed positive in the catalase test. No growth is obtained on Sabouraud's dextrose agar (SDA) without lipid supplementation but all grew in 0.5% Tween 60 and 0.1% Tween 80 added 2% glucose/1% peptone culture medium. Round and ellipsoidal yeast cells and budding of the yeast cells were observed under microscope, resembling M. sympodialis, M. furfur, and M. nana. The 26S rDNA PCR-RFLP pattern showed the same pattern as M. dermatis (JCM 11348), the standard strain. 26S rDNA and ITS1 sequencing were performed for exact identification, showing 99% accordance with M. dermatis (AB070361), and M. dermatis (AB070356), confirming the species to be new, the first to be reported in Korea. Phylogenetic trees based on the D1/D2 domains of the 26S rDNA sequences and nucleotide sequences of the ITS 1 region showed that the isolates were conspecific and belonged to the genus Malassezia and crusted with M. sympodialis. CONCLUSION: Taking a molecular biological classification approach, we have successfully isolated 5 cases of M. dermatis-the first in Korea. Although it is not known whether M. dermatis plays a role in Malassezia-related skin disease, this species was part of the microflora in both patients with seborrheic dermatitis and healthy subjects.
Adult ; Agar ; Base Sequence ; Catalase ; Classification ; Dermatitis, Seborrheic ; DNA, Ribosomal ; Fungi ; Glucose ; Humans ; Korea ; Malassezia* ; Molecular Biology ; Peptones ; Physiology ; Polysorbates ; Population Characteristics ; Skin ; Skin Diseases ; Yeasts