The Effect of Parenting Stress and Acculturative Stress on Parenting Efficacy in Vietnamese Married Immigrant Women

PURPOSE: The purpose of this study was to investigate the effect of parenting stress and acculturative stress on the parenting efficacy of Vietnamese married migrant women. METHODS: A total of 130 Vietnamese married immigrant women were recruited from the Multicultural Family Support Center in U-city. Data were collected using self-report questionnaires and analyzed using descriptive statistics of a t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression analysis with the SPSS 21.0 program. RESULTS: The scores of parenting and acculturative stress level were 2.62 and 2.87, parenting efficacy level was 2.98. The Aculturative stress experience was positively correlated with parenting stress (r=0.547, p < 0.001), Parenting stress experience was negatively correlated with parenting efficacy (r=-0.486, p < 0.001), and, acculturative stress experience was negatively correlated with parenting efficacy (r=-0.460, p < 0.001). The multiple regression analysis of acculturative (t=-2.891, p=0.005) and parenting stress (t=-3.818, p < 0.001) showed a significant number of factors that explain parenting efficacy. The model included the two independent variables of acculturation stress and parenting stress which were statistically significant (F=24.966, p < 0.001), and had a descriptive result of 28.5%. CONCLUSION: The results of this study suggest the need for development and implementation of mediation measures such as substantial, cooperative, and systematic parenting programs for women in Vietnam to promote regional community support.

Acute generalized exanthematous pustulosis presumed to be caused by acetaminophen

Acute generalized exanthematous pustulosis (AGEP) is a severe and rare disease usually related to drug eruption. AGEP is induced by drugs in over 90% of cases with antibiotics being the most common. It is characterized by a fever and a pustular eruption on erythematous skin with acute onset and without follicular localization. Acetaminophen is commonly used as an antipyretic and analgesic. Acetaminophen has been reported to be an uncommon cause of AGEP. We report a 79-year-old woman presenting with fever and erythematous maculopapular eruptions on the trunk with sterile pustules arising upon the use of acetaminophen for back pain. Leukocytosis and elevated C-reactive protein levels were noted on the laboratory examination. The histopathological examination of the skin biopsy specimen showed intraepidermal pustule formation with superficial perivascular lymphocytic infiltration, including eosinophils, and extensive red blood cell extravasation. The lesions were resolved with discontinuation of acetaminophen and use of systemic corticosteroid. We report a case of AGEP probably caused by acetaminophen.

A Case of Pulmonary Cryptococcosis in an Immunocompetent Male Patient Diagnosed by a Percutaneous Supraclavicular Lymph Node Biopsy / 결핵및호흡기질환

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.

Liver dysfunction induced by systemic hypersensitivity reaction to lamotrigine: case report

Lamotrigine is an anticonvulsant drug used to treat partial and generalized seizure disorders. Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs. However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission. This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.

Hypersensitivity reactions to radiocontrast media

No abstract available.

Potential Masking of Airway Eosinophilic Inflammation by Combination Therapy in Asthma

PURPOSE: Long-acting beta2 agonists (LABA) may mask ongoing bronchial inflammation, leaving asthmatic patients at greater risk of severe complications. The aim of this study was to compare the effect of combination therapy using low-dose inhaled corticosteroids (ICS) plus LABA on airway inflammation in asthma to the effect of medium-dose ICS alone. METHODS: Twenty-four patients with asthma not controlled by low-dose (400 microg per day) budesonide alone were enrolled in this prospective crossover study. Patients were randomized into 2 treatment phases: one receiving medium-dose (800 microg per day) budesonide (ICS phase), and the other receiving a combination therapy of low-dose budesonide/formoterol (360 microg/9 microg per day) delivered by a single inhaler (LABA phase). Each treatment phase lasted for 6 week, after which patients were crossed over. Asthma symptoms, lung function, and airway inflammation were compared between the 2 phases. RESULTS: Twenty-three patients completed the study; adequate sputum samples were collected from 17 patients. Asthma symptoms and lung function remained similar between the 2 phases. However, the mean sputum eosinophil percentage was higher in the LABA phase than in the ICS phase (5.07+/-3.82% vs. 1.02+/-1.70%; P or =3%) was more frequently observed in the LABA phase than in the ICS phase (six vs. two). CONCLUSION: Addition of LABA may mask airway eosinophilic inflammation in asthmatic patients whose symptoms are not controlled with low-dose ICS.

Erratum: Reference Correction. Updates on desensitization for hypersensitivity reactions related to chemotherapy

There was reference error in references section (p.302, reference #45).

Updates on desensitization for hypersensitivity reactions related to chemotherapy

As the use of chemotherapeutic agents increased rapidly in recent years, more patients are under the potential risk of chemotherapy related adverse reactions. Multiple regular exposures to the same drug by chemotherapy protocol may increase the risk of sensitization to a chemotherapeutic agent, which can result in hypersensitivity reactions. Once severe hypersensitivity reactions occur, causative drugs should be avoided. However, a substitute with equal efficacy is not always available. When there is no effective alternative, desensitization is a safe tool for maintenance of chemotherapeutic agents causing hypersensitivity reaction. In this review, we introduce the latest knowledge about desensitization protocol for chemotherapeutic agents which are frequently used recently.

A Case of Toxocariasis with Visceral Larva Migrans Combined with Ocular Larva Migrans / 대한내과학회지

Toxocariasis is an infection in a human host caused by Toxocara canis or Toxocara cati larvae. Clinical manifestations are classified according to the organs affected, such as visceral larva migrans (VLM) and ocular larva migrans (OLM). Epidemiological evidence suggests that OLM tends to occur in the absence of systemic involvement and vice versa, which has led to two manifestations of this infection being reclassified as VLM and OLM. No case of a patient with VLM combined with OLM has been reported in Korea. Here, we report a case of VLM combined with OLM in a 51-year-old female caused by massive ingestion of raw cow meat, manyplies, and liver.

Comparison of the Causes and Clinical Features of Drug Rash With Eosinophilia and Systemic Symptoms and Stevens-Johnson Syndrome

PURPOSE: Drug rash with eosinophilia and systemic symptoms (DRESS) and the Stevens-Johnson syndrome (SJS) are both severe drug reactions. Their pathogenesis and clinical features differ. This study compared the causes and clinical features of SJS and DRESS. METHODS: We enrolled 31 patients who were diagnosed with DRESS (number=11) and SJS (number=20). We retrospectively compared the clinical and laboratory data of patients with the two disorders. RESULTS: In both syndromes, the most common prodromal symptoms were itching, fever, and malaise. The liver was commonly involved in DRESS. The mucosal membrane of the oral cavity and eyes was often affected in SJS. The most common causative agents in both diseases were antibiotics (DRESS 4/11 (37%), SJS 8/20 (40%)), followed by anticonvulsants (DRESS 3/11 (27%), SJS 7/20 (35%)). In addition, dapsone, allopurinol, clopidogrel, sulfasalazine and non-steroidal anti-inflammatory drugs (NSAIDs) were sporadic causes. CONCLUSIONS: The most common causes of DRESS and SJS were antibiotics, followed by anticonvulsants, NSAIDs and sulfonamides. The increase in the use of antibiotics in Korea might explain this finding.

Comparison of the Causes and Clinical Features of Drug Rash With Eosinophilia and Systemic Symptoms and Stevens-Johnson Syndrome

PURPOSE: Drug rash with eosinophilia and systemic symptoms (DRESS) and the Stevens-Johnson syndrome (SJS) are both severe drug reactions. Their pathogenesis and clinical features differ. This study compared the causes and clinical features of SJS and DRESS. METHODS: We enrolled 31 patients who were diagnosed with DRESS (number=11) and SJS (number=20). We retrospectively compared the clinical and laboratory data of patients with the two disorders. RESULTS: In both syndromes, the most common prodromal symptoms were itching, fever, and malaise. The liver was commonly involved in DRESS. The mucosal membrane of the oral cavity and eyes was often affected in SJS. The most common causative agents in both diseases were antibiotics (DRESS 4/11 (37%), SJS 8/20 (40%)), followed by anticonvulsants (DRESS 3/11 (27%), SJS 7/20 (35%)). In addition, dapsone, allopurinol, clopidogrel, sulfasalazine and non-steroidal anti-inflammatory drugs (NSAIDs) were sporadic causes. CONCLUSIONS: The most common causes of DRESS and SJS were antibiotics, followed by anticonvulsants, NSAIDs and sulfonamides. The increase in the use of antibiotics in Korea might explain this finding.

A Case of Septic Pulmonary Embolism Associated with MRSA Infective Endocarditis / 결핵및호흡기질환

Septic pulmonary embolism is the process in which an infected thrombus becomes detached from its site of origin and lodges in a pulmonary artery, and is usually associated with infective endocarditis, especially right-sided, or infection-associated with indwelling catheters, peripheral septic thrombophlebitis, and periodontal diseases, etc. Here, we report a case of septic pulmonary embolism associated with tricuspid valve infective endocarditis. A 23-year-old female was admitted to our hospital, due to fever, sore throat, and myalgia. In her past medical history, she had undergone a surgical operation for closure of a ventricular septal defect, but was informed that the operation resulted in an incomplete closure. The initial chest radiograph demonstrated multiple rounded, parenchymal nodules in various sizes; several nodules had central lucency suggesting cavitations. Echocardiography demonstrated a large vegetation attached to the septal tricuspid valve leaflet, extending from right ventricular inflow tract to outflow tract. Computed tomography of thorax revealed bilateral peripheral nodules and wedge-shaped consolidation at various sizes, mostly accompanied by cavitations.

A Case of Escherichia Coli Empyema Preceded by Acute Pyelonephritis / 감염과화학요법

We experienced a case of acute pyelonephritis which progressed to Escherichia coli bacteremia and later complicated by empyema in a 65-year-old female. She was successfully treated with intravenous antibiotic therapy and percutaneous drainage of empyema.

A Case of Escherichia Coli Empyema Preceded by Acute Pyelonephritis / 감염과화학요법

We experienced a case of acute pyelonephritis which progressed to Escherichia coli bacteremia and later complicated by empyema in a 65-year-old female. She was successfully treated with intravenous antibiotic therapy and percutaneous drainage of empyema.

Toxocariasis Might be an Important Cause of Atopic Myelitis in Korea

Atopic myelitis is defined as myelitis with atopic diasthesis but the cause is still unknown. Toxocariasis is one of the common causes of hyperIgEaemia that may lead to neurologic manifestations. The purpose of this study was to evaluate the sero-prevalence of Toxocara specific IgG Ab among the atopic myelitis patients. We evaluated the medical records of 37 patients with atopic myelitis whose conditions were diagnosed between March 2001 and August 2007. Among them, the 33 sera were analyzed for specific serum IgG Ab to Toxocara excretory-secretory antigens (TES). All of 37 patients had hyperIgEaemia. Specific IgE to D. pteronyssinus and D. farinae was detected in 22 (64.7%) and 34 (100%) patients, respectively, of the 34 patients. Thirty-one of 33 patients (93.9%) were found to be positive by TES IgG enzyme-linked immunosorbent assay (ELISA). Based on the image findings of eosinophilic infiltrations in the lung and liver, 8 patients had positive results. These results inferred that the prevalence of toxocariasis was high in patients with atopic myelitis. Our results suggest that toxocariasis might be an important cause of atopic myelitis and Toxocara ELISA is essential for evaluating the causes of atopic myelitis.

A Case of Pulmonary Sparganosis in a Patient with a History of Recurrent Sparganum Infections / 결핵및호흡기질환

Sparganosis is a zoonosis caused by the migrating larvae of cestode genus Spirometra. We report a rare form of sparganosis that invades the lung. A 44-year-old man presented with newly appeared pulmonary nodules that were found accidentally on regular medical checkup, and on sequential chest CT, which we checked at an interval of every 2 months, revealed that the pulmonary lesion had migrated. The patient had a medical history of having undergone surgical excisions for sparganosis in muscles and in subcutaneous tissues of the lower abdomen, perianus, thigh, right axilla, and scapula area, several times over 7 years. A right middle lobectomy was performed and the lesion was diagnosed as sparganosis based on the characteristic histological findings.

A Case of Posttraumatic Pleural Effusion with Peripheral Eosinophilia / 결핵및호흡기질환

Eosinophilic pleural effusions (EPE) are defined as those effusions that contain at least 10% eosinophils, and EPE can be associated with peripheral blood eosinophilia in a variety of systemic diseases. There have been a few cases that have addressed the association of peripheral blood eosinophilia and posttraumatic EPE, and this condition can be misdiagnosed as being the result of other causes due to the delayed presentation. We report here on a case of 47-year-old male who presented with eosinophilic pleural effusion associated with peripheral blood eosinophilia at 2 months after minor chest trauma. We excluded the other possible causes such as consumption of drugs, parasite infection, malignancy, diseases of pulmonary eosinophilic infiltration, autoimmune diseases and pulmonary thromboembolism. We observed his clinical course without specific treatment. Three months later, the pleural effusion completely disappeared and the number of peripheral eosinophils returned to normal.

Churg-Strauss Syndrome: The Clinical Features and Long-term Follow-up of 17 Patients

Churg-Strauss syndrome (CSS) is a rare multi-system vasculitis; some cases have been reported in Korea. The aim of this study is to describe the clinical features, treatment outcome, and long-term follow-up of CSS from a single Korean medical center. Between 1995 and 2004, seventeen patients were diagnosed with CSS at the Department of Medicine of the Samsung Medical Center, Sungkyunkwan University School of Medicine. The diagnosis of CSS is based on the classification criteria of the American Collage of Rheumatology. All patients had asthma. As in other case series, the lung, peripheral nervous system, and skin were the most commonly involved organs. During the active stage of the disease, most of the patients exhibited peripheral blood eosinophilia and an elevated serum eosinophil cationic protein level. Ten patients were treated with pulses of methylprednisolone followed by tapering and cyclophosphamide, and the others were treated with corticosteroids alone. The outcomes after long-term follow-up were generally good. One patient who was refractory to initial treatment died of heart failure during the follow-up period. CSS was highly variable in its presentation and course. The manifestations may range from mild symptoms to life-threatening conditions. The outcome after long-term follow-up was as good as that of previous studies.

A case of Stevens-Johnson syndrome caused by oxcarbazepine / 대한내과학회지

Stevens-Johnson syndrome and toxic epidermal necrolysis are acute life-threatening conditions. Aromatic antiepileptic drugs such as carbamazepine, phenytoin and phenobarbital are frequently associated with severe adverse cutaneous reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis. Oxcarbazepine, a 10-keto derivative of carbamazepine has been reported to have a similar range of efficacy and fewer side effects than carbamazepine because it is a prodrug of a monohydroxy derivative. Because there are few clinical records of oxcarbazepine induced erythemamultiforme-like skin eruptsions, we reported a case of Stevens-Johnson syndrome thought to be caused by the use of oxcarbazepine in a 66-year-old male. Diffuse erythematous maculopapular eruptions were developed on his whole body 30 days after beginning with oxcarbazepine. The clinical and histologic findings of the patient were compatible with Stevens-Johnson syndrome. Although it is rare, oxcarbazepine can cause severe adverse cutaneous reactions.

Correlation of Ki-67, nm23-H1 and the VEGF Expression with the Clinicopathological Variables for Distant Recurrence after Curative Surgery for Carcinoma of the Ampulla of Vater

PURPOSE: Not a few patients show early distant recurrence after curative resection for carcinoma of the ampulla of Vater, and this recurrence is not just related to the clinicopathological factors. This study was performed to determine the correlation of the clinicopathological and biological characteristics with early distant recurrence after surgery for carcinoma of the ampulla of Vater. METHODS: Of the 158 patients who underwent curative resection for carcinoma of the ampulla of Vater at the Samsung Medical Center between December 1994 and August 2004, 38 patients (the recurrence group) with distant recurrence within a year after surgery and 32 patients (the non-recurrence group) without recurrence for more than 3 years after surgery were retrospectively analyzed. Evaluation of their clinicopathological characteristics and their immunohistochemical staining for Ki-67 antigen, nm23-H1 protein and vascular endothelial growth factor (VEGF) were carried out. RESULTS: Of the recurrence group, 24 patients (63.2%) had multiple recurrence sites and 10 (26.3%) were TNM stage I after surgery. The TNM stage was significantly advanced in the recurrence group. Both the Ki-67 labeling index (LI) (10.2% vs. 5.8%, respectively) and positive rate (50.0% vs.18.8%, respectively) according to the cut-off value of Ki-67 LI (i.e. 9%) were significantly higher in the recurrence group. The immunoreactivity for nm23-H1 protein and VEGF was not different between the two groups. Only lymph node metastasis was statistically significant on the multivariate analysis for early distant recurrence after surgery. CONCLUSION: The recurrence group showed an advanced TNM stage and increased Ki-67 LI. Lymph node metastasis was the single independent poor indicator for early distant recurrence after curative resection for carcinoma of the ampulla of Vater.