• The Journal of Korean Medicine
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• v.21 no.2
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• pp.37-42
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• 2000

Objectives and Methods : Unlike respiratory anaphylaxis responses, mediators responsible for cardiovascular responses are not clearly elucidated. Main characteristics of cardiovascular anaphylaxis include hypotension and cardiac failure (anhythmia and cardiac contraction failure). In this experiment, the fractionations of Sophorae Radix (SR) were tested for its preventive effects against cardiovascular anaphylaxis in pithed rats. Results : Of the SR fractionations, water fractions, at the concentration of 20 and 60mg/kg, was significantly effective on all the cardiovascular changes in pithed rats. Also, of the cardiovascular changes, depressor response was significantly attenuated by the ethyl acetate (EA) fraction, at the concentration of 60mg/kg. Conclusions : These results suggest that water and EA fractions of the SR fractionations possess anti. anaphylactic effects in pithed rats. Additional research is needed to identify active principles for the observed pharmacological effects.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.351-354
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• 2008

Anaphylaxis is an acute systemic reaction caused by IgE-mediated immunological release of mediators from mast cells and basophils to allergenic triggers, such as food, insect venoms, and medications. An alternative definition was recently proposed as follows: anaphylaxis is a "condition caused by an IgE mediated reaction" that is "often life threatening and almost always unanticipated." The reaction can be severe enough to lead to the rapid onset of symptoms, including dizziness, upper airway occlusion, bronchial constriction, hypotension, urticaria, cardiovascular arrhythmias and possible cardiac arrest. The incidence or prevalence of anaphylaxis in Korean pediatrics has not known. Thus, Epidemiology of Anaphylaxis in Pediatrics based on the data from Korean Health Insurance Review and Assessment Service (KHIRA) from 2001 to 2007 and questionnaire to the member of Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD) who are working at the training hospitals was studied. The incidence of anaphylaxis under age 19 is 0.7-1.0 per 100,000 year-person. The causes of anaphylaxis based on data from KHIRA were unknown (61.7%), food (24.9%), medications (12.4%), and serum (1.0%).

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.24-30
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• 2017

Purpose: This study was conducted to investigate the frequency and clinical characteristics of anaphylaxis patients who are registered inaccurately with other disease codes. Methods: Study subjects presenting at the emergency department (ED) were retrospectively collected using disease codes to search for anaphylaxis patients in a previous studies. The study group was divided into an accurate and inaccurate group according to whether disease codes were accurately registered as anaphylaxis codes. Results: Among 266 anaphylaxis patients, 144 patients (54%) received inaccurate codes. Cancer was the most common comorbidity, and the radio-contrast media was the most common cause of anaphylaxis in the accurate group. Cutaneous and respiratory symptoms manifested more frequently in the inaccurate group, while cardiovascular and neurological symptoms were more frequent in the accurate group. Blood pressure was lower, and shock and non-alert consciousness were more common in the accurate group. Administration of intravenous fluid and epinephrine use were more frequent in the accurate group. Anaphylaxis patients with a history of cancer, shock, and epinephrine use were more likely to be registered as anaphylaxis codes accurately, but patients with respiratory symptoms were more likely to be registered with other disease codes. Conclusion: In cases of anaphylaxis, the frequency of inaccurately registered disease codes was higher than that of accurately registered codes. Anaphylaxis patients who were not treated with epinephrine at the ED who did not have a history of cancer, but had respiratory symptoms were at increased risk of being registered with disease codes other than anaphylaxis codes.

• Biomolecules & Therapeutics
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• v.16 no.4
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• pp.299-305
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• 2008

Active cardiovascular anaphylactic response was induced in ovalbumin-sensitized, pithed Sprague-Dawley and Wistar rats. On intravenous administration of the antigen, ovalbumin, marked tachycardia and pressor responses were immediately elicited. Thereafter, a delayed long-lasting severe hypotensive response was observed. These anaphylactic cardiovascular responses were maximal 2-3 weeks after the sensitization, and the response was slightly diminished 6 weeks after sensitization. The immediate pressor response was blocked by a non-selective serotonin antagonist methysergide at a dose-dependent manner, but not by histamine receptor antagonists mepyramine (pyrilamine) or cimetidine. The delayed hypotension was reduced either by histamine $H_1$ receptor antagonist mepyramine or $H_2$ receptor antagonist cimetidine, both in a dose-dependent manner. The tachycardic response was not influenced by serotonin or histamine receptor antagonists examined in this study. Differently from the cardiovascular responses, there was no observable bronchial contraction in Sprague-Dawley rat trachea in contrast to Wistar rat where the trachea contracted to in vitro antigen challenge. The cardiovascular anaphylactic model seems to be useful for studying cardiovascular events that occur exclusively in peripheral heart-blood vessel systems. The involvement of two major anaphylactic mediators, serotonin and histamine, is partially demonstrated.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.5
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• pp.1309-1316
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• 2004

We previously reported that the ethtyl acetate(EA) soluble fraction of Sophorae Radix(SR) water extract had the preventive effects against cardiovascular anaphylaxis elicited in experimental animals. In this study, we tested the anti-anaphylatic effects of the nine kinds of EA soluble subfractions in animal models such as Langendorff heart and anesthetized rats. These results were obtained as followed ; Among nine kinds of SR EA soluble subfractions, N10-16-2 and N10-16-9 fractions have an effects improving cardiovascular anaphylaxis in guinea pig Langendorff hearts. In passively anesthetized rats, N10-16-2 and N1 0-16-9 fractions of SR EA soluble subfractions have an effects improving cardiovascular anaphylaxis. N10-16-2 and N1 0-16-9 fractions of SR EA soluble subfractions inhibited the decrease of histamine release induced by compound 48180 and A-23187 in rat peritoneal mast cells. These results suggest that N10-16-2 and N10-16-9 fractions of SR EA soluble subfractions involve anti-anaphylactic molecules in cardiovascular system.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.1
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• pp.160-164
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• 2002

The water extract of Sophorae radix was tested for its preventive effects against cardiovascular anaphylaxis elicited in experimental animals. H₂O and ethyl acetate fractionation of Sophorae radix water extract improved anaphylactic cardiac dysfunction in passively sensitized isolated guinea hearts: improvement was noted in the maximal contractile force, post-challenge contractile force, post-challenge coronary flow and creatine kinase change elevation. These results suggest that H₂O and ethyl acute fractionation of Sophorae radix water extract possesses anti-anaphylactic effect in cardiovascular system.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.1
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• pp.30-36
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• 2010

Purpose: The purpose of this study is to analyze the clinical characteristics of anaphylaxis and anaphylactic shock caused by bee venom. Methods: We retrospectively collected the data of the patients who experienced anaphylaxis caused by natural bee sting or acupuncture using bee venom from January 1999 to December 2008. Seventy subjects were divided into the shock and non-shock groups. The clinical characteristics, sources of bee venom, treatments and outcomes were compared between the two groups. Results: The mean age of the subjects was $45.5{\pm}16.3$ years old and the number of males was 44 (62.9%). There were 25 patients in the shock group and 45 in the non-shock group. The age was older (p=0.001) and females (p=0.003) were more frequent in the shock group. Transportation to the hospital via ambulance was more frequent in the shock group (p<0.001). No difference was found in species of bee between the two groups. The cephalic area, including the face, was the most common area of bee venom in both groups. Anaphylaxis caused by bee sting commonly occurred between July and October. Cutaneous and respiratory symptoms were the most frequent symptoms related to anaphylaxis. Cardiovascular and neurologic symptoms were more frequent in the shock group. The amount of intravenously administered fluid and subcutaneous injection of epinephrine were much more in the shock group than that in the non-shock group. Conclusion: Older age was the factors related to anaphylactic shock caused by bee venom. Further validation is needed to evaluate the gender factor associated with shock.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.140-144
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• 2009

The majority of flexible bronchoscopies are performed under topical anesthesia with lidocaine being the most commonly used agent. Anaphylaxis rarely occurs after local administration of lidocaine, but can be a fatal complication. We experienced a case of unexpected anaphylaxis. A 66-year-old woman was scheduled for flexible bronchoscopy to evaluate a tracheal mass and stenosis. The oral and nasal mucosa were pretreated with lidocaine. About 2~3 minutes later, the patient developed hypotension and we treated for anaphylaxis in the emergency room. Then, we decided to perform rigid bronchoscopy in this patient, under conditions of general anesthesia. A rigid bronchoscopy was performed in this patient, safely and successfully. The tracheal mass was determined to be squamous cell carcinoma.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.2 s.11
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• pp.121-126
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• 2006

Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction. Most fatalities from anaphylaxis occur within the first 30 minutes postantigenic exposure. The mechanism of generalized anaphylaxis is the reaction of IgE antibodies to an allergen that causes the release of histamine, bradykinin, and others. These chemical mediators cause the contraction of smooth muscles of the respiratory and intestinal tracts, as well as increased vascular permeability. Four major clinical symptoms are recognized: skin reactions, smooth muscle spasm (gastrointestinal and genitourinary tracts and respiratory smooth muscle), respiratory distress, and cardiovascular collapse. Epinephrine is the drug of choice for the management. Its syrnpathomimetic effects directly counteract most aspects of the attack. Respiration must be immediately supported by the establishment of a patent airway along with artificial ventilation. The circulation should be supported and the existing hypotension overcome by placing the victim in a position to allow gravity to aid venous return and by administering intravenous fluids, vasopressors, and corticosteroids. When an imperceptible pulse is evident, external cardiac compression must also be instituted. This is a case report of anaphylactic shock care during general anesthesia, possibly due to penicillin, pancuronium and others.

• Kosin Medical Journal
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• v.33 no.2
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• pp.245-251
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• 2018

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.