• Title/Summary/Keyword: Provocation tests

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Allergy tests in clinical practice (알레르기 검사의 실제)

  • Lee, Jaechun
    • Journal of Medicine and Life Science
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    • v.15 no.1
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    • pp.1-5
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    • 2018
  • Allergy is conditions when a hypersensitivity reaction happens with a certain element, called as an allergen, which is commonly not reactive to ordinary individuals. Allergic diseases involve various organs or systems in the body. The purpose of allergy tests is to make a diagnosis of allergic diseases and to identify the affecting allergens. In vivo tests, more relevant in clinical situation, include skin test, patch test and provocation test. In in vitro tests, there are specific IgE test, histamine releasing assay, and lymphocyte activation test, safer and more objective than in vivo tests. In the view point of clinical practice, skin test, provocation test, total IgE test and specific IgE test were reviewed in depth.

Biomechanics of Sacroiliac Joint Dysfunction and Clinical Disease (엉치엉덩관절 통증과 임상 질환에 대한 생체역학)

  • Jeong, Seong-Gwan;Lee, Woo-Hyung;Kim, Kyung-Hwan
    • PNF and Movement
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    • v.8 no.1
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    • pp.41-50
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    • 2010
  • Pain originating from the sacroiliac joint(SIJ) has been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction(SID) has been difficult to achieve. Clinical presentation of SID appears that pain and poor performance is responsive to local analgesia of periarticular structures with poorly defined pathology, and poor performance with bony pathological changes present as a result of chronic instability. Previous research indicates that physical examination cannot diagnose SIJ pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. Tests based on mechanics as manual provocation for SIJ pain have formed the basis of tests used to diagnose SIJ dysfunction. In this review summary, the purpose of this study was to describe the sacroiliac tests with a model of examination, diagnosis, and management of SID. Further research is warranted to determine whether SIJ tests is reliable means of evaluating innominate impairments.

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Technetium-99m hand perfusion scintigraphy (Raynaud's scan) as a method of verification in hand arm vibration syndrome: a review

  • Taewoong Ha;Hyeoncheol Oh;Jungwon Kim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.26.1-26.13
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    • 2022
  • It is important to assess the blood flow of fingers in the verification of hand-arm vibration syndrome. In the Republic of Korea, most assessments of the blood flow in the fingers are performed using a cold provocation test with finger skin color change. However, this test is a non-objective method with a relatively low sensitivity, leading to possible social and legal problems. Thus, we reviewed the characteristics of several tests that assess the blood flow in the fingers. Among these tests, using the radioactive isotope method, Raynaud's scan has a relatively higher sensitivity and specificity than other tests, provides objective results, and is approachable in many hospitals. So we suggest using Raynaud's scan as an alternative test when cold provocation test with finger skin color change is negative in vibration exposed worker.

Usefulness of drug provocation tests in children with a history of adverse drug reaction

  • Na, Hye-Ran;Lee, Jeong-Min;Jung, Jo-Won;Lee, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.54 no.7
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    • pp.304-309
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    • 2011
  • Purpose: There are very few reports of adverse drug reactions (ADR) and almost no study of drug provocation test (DPT) in Korean children. We aimed to assess the role of DPT in children with unpredictable ADRs, and compare the causative drugs and clinical characteristics between detailed history of ADRs and result of DPTs. Methods: We included 16 children who were experienced ADRs referred to pediatric allergy clinic at Ajou University Hospital (January 2006 to December 2009). With various suspected drugs, 71 DPTs were done in 16 patients using our own protocol, and skin tests to antibiotics were combined in ADRs to antibiotics in medical history. Results: There were 17 (23.9%) positive DPTs results out of 71 individual DPTs, and 11 patients (68.8%) from 16 patients were positive to at least one drug. Drugs causing positive reactions were acetaminophen in 5 (31%), Non-steroidal anti-inflammatory drugs in 4 (25%), penicillin in 3 (19%), cephalosporin in 2 (13%), and cotrimoxazole, macrolide and lactose in 1 each. Conclusion: DPT seems a safe and useful procedure to confirm causative drug and identify safely administering alternative drugs in children with ADR.

Drug eruption by antihistamine mistaken for chronic urticaria in a child

  • Lee, Gun Moo;Chu, Shou-Yu;Kang, Sung Yeon;Kim, Hyo-Bin;Park, Jin-Sung;Kim, Ja Kyoung
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.75-78
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    • 2019
  • Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

A study on measure of North Korea's nuclear terror threat; Focusing on the guarantee of 'anticipatory self-defense' (북한 핵테러 위협 대비방안 연구; '선제적 자위권' 보장을 중심으로)

  • Kim, Yeon Jun
    • Convergence Security Journal
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    • v.16 no.3_2
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    • pp.13-23
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    • 2016
  • North Korea had recently conducted the fourth nuclear test and ICBM tests, dared nuclear provocation targeting the Korea and the international community. It is determined based on experiments of nuclear and missile in progress in North Korea that the technical level of nuclear force reached the completion stage of standardization, lightweight, and variation. It is expected to become reality that North Korea executes the nuclear provocation targeting the Korea and the international community in the near future. Nuclear bomb is an absolute weapon that the logic of counterattack after allowing the first strike of the other party cannot be applied due to its tremendous destructive power. Therefore, as the opponent to North Korea that it decided to hold the nuclear, the exercise of anticipatory self-defense in order to guarantee a minimum of right to life is not a choice, but the only essential correspondence concept. At the moment that the North Korean nuclear provocation is expected in the near future, it shall be provided with competence to strike the origin region of provocation by forming a national consensus of preemptive strike enforcement. Also, in preparation for the fifth nuclear test of North Korea, which is anticipated, the national competence must be mobilize to be able to ensure the 'Nuclear Option' from the international community.

A Gait Analysis of the Women with Unilateral Posterior Rotated Ilium : A Clinical Case Report (편측 장골이 후방 회전된 여성의 보행분석 : 임상 사례보고)

  • Yang, Kyung-Hye
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.20 no.1
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    • pp.27-34
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    • 2014
  • Background: The purpose of this clinical case report is to confirm sacroiliac joint misalignment effects on the gait. Methods: A healthy women volunteered to participate in this case report. Measurement of the subject was performed two categories. One is physical examination of the pelvic by inspection, palpation, movement based tests and pain provocation tests. The other one is gait performance measurement by 3 dimentional motion analysis. Results: Diagnosis by physical examination of the subject was Lt. ilium posterior rotation. Pelvic, hip, knee and ankle in the 3 dimensional kinematic data, the most notable result was the ankle. Conclusion: To confirm the effect of the misalignment of the sacroiliac joint on the gait function, it must be evaluated by integrating the movement to the ankle from the lumbar.

Clinical Value of Physical Examination and Electromyography in Acute and Chronic Lumbosacral Radiculopathy (급, 만성 요천추부 신경근병증 환자의 신체진찰과 근전도의 임상적 의미)

  • Jeoung, Ju Hyong;Jeong, Ha Mok;Kang, Seok;Yoon, Joon Shik
    • Clinical Pain
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    • v.19 no.2
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    • pp.90-96
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    • 2020
  • Objective: To investigate the diagnostic accuracy of two physical examinations (straight leg raise [SLR] and Bragard test) and electromyography (EMG) in patients with lumbosacral monoradiculopathy in acute and chronic state on confirmation of different diagnostic criteria (MRI vs MRI and diagnostic selective nerve root block [DSNRB]). Method: We identified 297 participants retrospectively from the departmental database. MRI evidence of L5 or S1 nerve root compression and a positive result in diagnostic SNRB served as reference standards. They were divided into two groups by the symptom duration: lasting more than 12 weeks in the chronic group and less than 12 weeks in the acute group. The diagnostic value of clinical tests and EMG were compared. Results: The clinical tests (SLR and Bragard test) done in acute stage on detection by MRI and DSNRB had the highest sensitivity (68%) compared to the chronic stage (63%), but sensitivity was low (57%) on confirmation of MRI alone. However, there was no significant difference on sensitivity and specificity of EMG regardless of reference standards and symptom duration. Electromyography was a significant predictor of neuropathic abnormalities on both acute (OR, 6.3; 95% CI, 2.4 to 16.7; p<0.01) and chronic (OR, 6.8; 95% CI, 2.9 to 16.3; p<0.01). Conclusion: In general, individual physical tests are easy to do and a combination of those tests could be a sensitive indicator of L5 or S1 radiculopathy. Furthermore, the use of provocation tests could provide useful information, especially in proceeding therapeutic selective nerve root block.

Overnight Growth Hormone Secretions and Sleep Patterns in Idiopathic Short Stature Children (특발성 저신장 아동의 야간 성장호르몬 분비와 수면양상)

  • Seo, Sang Young;Lee, Kee Hyoung;Eun, Baik Lin;Sohn, Chang Sung;Tockgo, Young Chang;Shin, Chol;Kim, Baek-Hyun
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.363-369
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    • 2003
  • Purpose : Pharmacologic provocation test of growth hormone(GH) is a non-physiologic method and has several limitations for diagnosing growth hormone(GH) deficiency. Spontaneous GH release studies could be important in understanding the pathophysiology of children with poor growth but normal responses to GH provocation tests. Also, the relationship between nocturnal GH secretions and sleep patterns in short stature children is poorly understood. The aim of this study is to determine whether there are differences in sleep patterns and nocturnal GH secretory profiles between idiopathic short stature children and a normal stature group. Methods : Spontaneous nocturnal GH secretions and sleep patterns were evaluated in 12 prepubertal idiopathic short stature children with normal responses to provocation tests and 9 normal stature controls. Blood samples were taken every 30 minutes from 22:00-06:30 and sleep patterns were analyzed by polysomnography. Results : The mean GH level during sleep was significantly lower in short stature children than in controls. The peak GH level after sleep, coincident with the first slow wave sleep, was lower in the short stature group. The slow wave sleep times of short stature children were decreased compared with those of normal subjects. Conclusion : These results suggest that overnight serial GH sampling is helpful to identify short stature children with subnormal GH secretions, and sleep structure differences may be associated with decreased overnight GH secretions in short stature children.

Epicondylitis (상과염)

  • Chung Sun-Gun
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.81-87
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    • 2005
  • Epicondylitis, as a tendinopathy characterized by fibroblast and microvascular hyperplasia, is a common musculoskeletal problem especially related with repetitive hand and wrist motion. It has a prevalence of between 0.2% and 5% in general population depending on the amount of exposure to manual labor jobs. Although it is known that the pathological lesions lie in the flexor or extensor common tendons, there could be collateral ligament lesions and/or reactive synovitis accompanied, which may make a case unresponsive to the treatment aimed only at the tendinopathy. Epicondylitis is easy to diagnose with typical pain, tenderness, and positive provocation tests. However, many conditions can mimic epicondylitis that further imaging or electrodiagnostic studies should be undertaken to exclude other possible problems. Ultrasonography provides information about the existence and extent of tendinopathy with relatively high specificity. Magnetic resonance imaging is often required to rule out other problems and confirm the diagnosis of the cases intractable to long term treatment. Many options of treatment are available for epicondylitis while numerous conflicting evidences have been noted, debating one treatment method is better than the others. Since it was reported that over 80% of epicondylitis improved within a year no matter what was done as treatment, it is a challenge to make accurate diagnosis and combine effective therapeutic regimens for the 20% of intractable cases.