Prevalence of serum allergen-specific immunoglobulin E for canine atopic dermatitis in Korea / 동물의과학연구지

Canine atopic dermatitis (CAD) is an allergic skin disease with characteristic clinical features associated with immunoglobulin E (IgE) antibodies. Identification of the causative allergens is the diagnostic goal, which is essential to treat and manage CAD patients. CAD is commonly associated with environmental allergens surrounding the patients. For this reason, it is important for diagnostic tests to select allergens that are related to the environment of each country and each province. There are two main allergen-specific tests, serological IgE test (SAT) and intradermal skin test (IDT). SAT did not show direct cutaneous reaction but did show serological reaction against allergens. However, SAT is simpler and more convenient than IDT in small animal practice. In this study, we selected domestically prevalent allergens for SAT, including 60 food allergens and 60 inhalant allergens, and tested eight dogs tentatively diagnosed with CAD based on Favrot's criteria. Furthermore, IDT was performed on four dogs from the SAT group for comparison of SAT and IDT, and the results were very similar. In SAT, four types of mites (Bloomia tropicalis, Glycophagus domesticus, Euroglyphus maynei, and mite mixture 1 Korea; house dust mites), four types of molds (Botrytis cinerea, Alternaria alternata, mold fungi mixture 11, mold fungi mixture), and one type of pollen (tree pollen mix 3 Korea) induced a reaction in more than half of dogs tested. In IDT, all four dogs reacted positively to Dermatophagoides farinae, and three reacted positively to Dermatophagoides pteronyssinus and house dust. The mean agreement rate between SAT and IDT in this study was 76.3%. This is the first trial to apply local allergens for SAT in Korean veterinary medicine, and it might play an important role for diagnoses and management of animal allergic diseases.

Anaphylaxis with angioedema by rocuronium during induction of general anesthesia: A case report / 대한마취과학회지

Perioperative anaphylaxis is characterized by severe respiratory and cardiovascular manifestations. Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anesthesiologist. A 34-year-old woman was scheduled to undergo endo venous laser therapy of varicose veins. She had no history of allergies and had never undergone general anesthesia. General anesthesia was induced with propofol and rocuronium bromide. Approximately three minutes after rocuronium administration, hypotension and tachycardia developed and angioedema around the eyelids and skin rashes and urticaria appeared. The patient received ephedrine and hydrocortisone with hydration. After achieving stable vital signs and symptom relief, surgery was performed without complications. A postoperative skin dermal test performed to identify the agent responsible revealed a positive skin test for rocuronium.

Anesthetic Experience in a Patient with Positive Intradermal Skin Test to Muscle Relaxants: A case report / 대한마취과학회지

Muscle relaxants are the most common cause of anaphylaxis during anesthesia. An intradermal skin test is commonly used to investigate the cause of anaphylaxis. A 46-year-old man was scheduled for percutaneous nephrolithotripsy. He had a history of a positive intradermal skin test to muscle relaxants for general anesthesia. After injection of thiopental sodium, anesthesia was induced, which gradually deepened with increments of sevoflurane in 100% oxygen. Tracheal intubation was performed smoothly, without adjunct muscle relaxant. After stabilization, a small dose of vecuronium was administered, but the blood pressure transiently decreased, and the oxygen saturation was decreased from 98 to 92% for 30 minutes. No muscle relaxant was used thereafter, and the anesthesia was maintained with sevoflurane, nitrous oxide and oxygen with intermittent propofol administration. Surgery was completed uneventfully, and the patient recovered without any adverse reaction. To prevent anaphylaxis, the use of a suspicious causative agent should be avoided.

Allergens Causing Atopic Diseases in Canine

Canine atopic skin disease is seasonal or sometimes non-seasonal immune-mediated skin disease which occurs commonly in Korea. The definite clinical sign is systemic pruritus, especially on periocular parts, external ear, interdigit spaces and lateral flank. For diagnosis of this dermatitis, complete history taking followed by intradermal skin test and serum in vitro IgE test needs to be performed. Allergen selection for the diagnosis and treatment of atopic dermatitis should be varied geographically. In this study, with intradermal skin test(IDST) the prevalence of atopic disease and what allergens are involved in are researched. Allergens used for IDST included 26 allergen extracts from six allergen groups: grasses, trees, weeds, molds, epidermal allergens and environmental allergens. The number of allergens was 42 in which the positive and negative controls are included. The most common positive allergen reaction was the house dust mites on IDST(22/35, 63%). The other positive allergen reactions were to flea(3/35, 9%), molds(1/35, 3%), house dusts(2/35, 6%), feathers (1/35, 3%), cedar/juniper(1/35, 3%), timothy grass(1/35, 3%) and dandelion(1/35, 3%). In this study, the most prevalent allergen causing atopic dermatitis in dogs in Korea was the house dust mites followed by the flea.

A Study on the Intradermal Skin Test of Antibiotics / 기본간호학회지

This study was done to identify the reality in doing the intradermal skin test of injectional antibiotics and to serve a basis to the clinical and educational situations. For the study, the survey was done to the staff nurses who are working at one of the selected 39 hospitals in the capital area, from January 6 to Feburary 8 in 1997. The data analysis was done by mean, standard deviation, Fisher's exact test, t-test, ANOVA through running SAS computer program. The results of the study were as follows : 1.The dilution ratio of the antibiotics was mostly 1 : 10 regardless of what kind of antibitics. Making the contrast was done only for the suspended to the antibiotics. Mostly the reaction was detected after 15 to 20 minutes from its diameter of redness and wheals. Most of the respondents answered they do the intradermal skin test only once for the same antibiotics. 2. In the education on the skin test the 66.7% from the respondents had exposed to the education mostly through the new nurses orientation. The 85.4% from them answered the need of the continuous education which had a significant difference in the number of beds(p=.046). The had experiences of detecting positive reactions(98.3%), and of anaphyaxis(49.5%) which had a significant difference in experience(p=.002) and in their age groups(p=.000). 3. The average score of the confidence on the intradermal skin test was 3.32 form 4-point scale. Also it had a significant difference from the number of beds(p=.010), the year of experiences(p=.016), and their age groups(p=.046). 4. From the general characteristics of respondents, the infection methods had a significant difference in the amounts of injection, whether adopting the contrast pairing, and the repeatable skin tests for the same antibiotics. 5. Only 15 from 39 hospitals had their protocol about the intradermal skin test provided by nursing department which differs in its contents from that provided by the medical information center. From the results of the study, it is suggested that the continuous education on the intradermal skin test and its unified protocol should be provided. Also it is recommended that the drug manufacturer should notice about its anaphylactic cautions and pack its extra skin test use.

A case of mycobacterium fortuitum infection at the site for antibiotics susceptibility test / 대한피부과학회지

Cutaneous mycobacterial infection can occur with Mycobacterium tube culosis or other mycobacterial agents. The commonest of the group IV rapidly growing mycobacteia Mycobacterium fortuitum, has widespread distribution in natur, and is an uncommon causative agent of human mycobacterial infection. We report herein a case of Mycobacterium fortuitum infection follcwiiig an antibiotics susceptibility test. This 24-year-old man suffered fram ulcerative itchy nodules on the left forearm where the antibiotics susceptibility test was don. The skin biopsy specimen revealedly. iphohistiocytic granulomatous infiltration in the dermis. Culture of the tissue specimen revealed rapicly growing yellowish colonies, which was isolated to Mycobacoterium fortuitum. Among 3 biovariants of M. fortuitum, our case was revealed to he biovariant fortuiiam: Surgical excision was performed followed by the administration of antiliiiitics, and no sign of relapse was noted until now, 1 year since.