BACKGROUND: Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. METHOD: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both FEV1 and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. RESULTS: There was no significant difference inthe demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the PaCO2 was higher (42.9±4.7 vs 38.8±3.1 mmHg at rest ; 47.9±7.0 vs 41.1±5.9 mmHg after exercise ; p<0.01) and the right ventricular ejection fraction was lower (57.6±6.5 vs 61.4±4.7 % at rest ; 51.1±10.8 vs 59.8±6.6 % after exercise ; p<0.01) both at rest and after exercise. The PaO2 after exercise was also lower (65.7±12.6 vs 80.2%±14.4 mmHg, p<0.01), while the PaO2 at rest tended to be lower(82.9±12.0 vs 87.8±7.5, p>0.05). In both groups, right ventricular ejection fraction correlated with the PaO2 after exercise(PTE r=0.536, PE r=0.557), and the PaCO2 at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). CONCLUSION: Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.
Blood Gas Analysis ; Demography ; Echocardiography ; Emphysema* ; Heart ; Humans ; Lung ; Stroke Volume ; Tuberculosis ; Tuberculosis, Pulmonary ; Ventricular Function, Right*

Left ventficular ejection times were measured by four different methods in 200 healthy males and females from the polygraphic tracings including an apexcardiogram, a phonocardiogram and a carotid pulse tracing. The results obtained by each method were compared and the adequacy of each method was critically reviewed. It was felt that the method measuring the left ventricular ejection time from the carotid pulse tracing was the most reasonable. However, there was a significant correlation between the carotid-derived values and those obtained by other methods, thus, regression equations for the relationship of the latter values to the fromer were obtainable.
Female ; Humans ; Male

No abstract available.
DNA* ; Laryngeal Neoplasms*

Pure red cell aplasia in uncommon disorder characterized by finding of anemia, absence of nucleated red blood cell in the marrow, absence of reticulocytes in the peripheral blood and normal peripheral platelet and leukocytes counts. We experienced one case of pure red cell aplasia associated with hemolytic anemia characterized by hemoglobinuria, reticulocytopenia, and erythroid hypoplasia of the bone marrow. The cause of the illness was not definitely identified, but we concluded that this patient had simultaneous occurrence of PRCA and hemolytic anemia following administration of diphenylhydantoin after craniotomy rather than virus or bacteria induced. The simultaneous occurrence of PRCA and hemolytic anemia in uncommon and the mechanism for diphenylhydantoin induced PRCA and hemolytic anemia is unclear.
Anemia ; Anemia, Hemolytic ; Bacteria ; Blood Platelets ; Bone Marrow ; Craniotomy ; Erythrocytes ; Hemoglobinuria ; Humans ; Leukocytes ; Phenytoin ; Red-Cell Aplasia, Pure* ; Reticulocytes

Clinical study on 62 patients (26 males and 36 females) with neurofibromatosis seen during past ten years at the Department of Dermatology, Pusan National Universitg Hospital, was made the variable clinical manifestations of the disease and Riccardis ciassification were emphasized. The results were as follows . 1) Family history was noted in 32 cases(51.6%) and exhibited autosomal dominant inheritance pattern. 2) Cutaneous neurofibromas were found in 52 cases(83.8%). 3) Cafe-au-lait spots, measuring greater than 1.5cm in its longest diameter, were found in 60 cases(96.8%) and 44 cases(71.0%) had more than 6 in number. 4) Among associated abnormalities were,' mental retardation(20,9%), skeletal abnormalities(11.2%), seizure, severe headache, etc. 5) According to Riccardis classification, 38 cases could be classified as type I, 28 cases(73.7%); type II, 0 case ; type III, 1 case(2.6%); type IV, 3 cases(7, 9%); type V, 1 case(2.6%); type VI, 4 cases(10.5%); type VII, l case(2.6%); and type VIII, 0 case.
Busan ; Cafe-au-Lait Spots ; Classification* ; Dermatology ; Headache ; Humans ; Inheritance Patterns ; Male ; Neurofibroma ; Neurofibromatoses* ; Seizures

No abstract available.
Humans ; Schools, Medical*

No abstract available.
Animals ; Cricetinae* ; Fertilization in Vitro* ; Humans*

PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

Involucrin is a recently recognized structural component of mature squamous epithelial cells and is considered as a marker of normal eratinocyte differentiation and ma.turation. In this study peroxidase-antiperoxidase techniques were used to assess involucrin expression in histologic sections of normal skin and a variety of epidennal tumors including squamous cell carcinomas(25 cases), keratoacanthomas(11 cases), basal cell carcinomas(20 cases), trichoepitheliomas(5 cases), Howens diseases(12 cases), arsenic keratoses(10 cases), actinic keratoses(10 cases) and Pagets diseases(2 cases). The results were as follows : l. In normal skin, the upper third of the viable epidermis showed diffuse cytoplasmic staining for involucrin. In hair follicles, the lower area of inner root sheath and inner area of the outer root sheath stained positively. The sebareous glands did not stain, but the ducts of sebaceous glands were positive. 2. Keratoacanthomas showed a relatively homogeneous staining pattern for inirolucrin ', all cells except basal cells stained with mild to moderate intensity. In contrast, squamous cell carcinomas disclosed a highly irregular involucrin staining pattern with marked variation in staining intensity from cell to cell. 3. Basal cell carcinomas were negative for involucrin except squamous horn cysts, and the epidermis overlying basal cell carcinomas showed the field effect, that is, the epidermis overlying the tumors exhibited diffuse, homogeneous positive staining of cells in all layers of the epidermis. 4. ln trichoepitheliomas, the involucrin reactivity was negative as in basal cell carcinoma.s, but the field effect was not observed. 5. In Elowens disease, actinic keratosis, arsenic keratosis and Pagets disease, the positivit.y for involucrin staining extended deeper into the stratum malpighii than was observed wit,h normal epidermis. And areas showing irregular patchy pattern of involucrin staining were considered to have the potentiality of malignant invasive change much more than the negative or homogeneous areas. Paget's cells were negative for involucrin as the adjoining keratinocytes in the lower portion af epidermis.
Actins ; Animals ; Arsenic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Epidermis ; Epithelial Cells ; Hair Follicle ; Horns ; Keratinocytes ; Keratoacanthoma ; Keratosis ; Keratosis, Actinic ; Sebaceous Glands ; Secobarbital ; Skin

PURPOSE: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. METHODS: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. RESULTS: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (< or =368,000/mm3), (5) total bilirubin (> or =0.4 mg/dL), (6) alkaline phophatase (> or =227 IU/L), (7) lactate dehydrogenase (> or =268 IU/L), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. CONCLUSION: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.
Bilirubin ; Blood Platelets ; C-Reactive Protein ; Child ; Extremities ; Humans ; Immunoglobulins* ; Korea ; L-Lactate Dehydrogenase ; Logistic Models ; Lymphatic Diseases ; Male ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity