In recent years pulmonary function teste have had a wide application in clinical pulmonary diseases. By combining a number of different pulmonary function tests, abnormality present in a particular pa tient can be defined. This narrows the list of possible diagnosis and allows to determine accurately the degree of impairment and assess the pesponse to therapy. To assess the pulmonary function in a patient and label as abnormal, it becomes important to define the range of expected values for a normal population. These normal'predicted values'vary according to sex and prowth, i.e., age, height, and weight, particularly in children. In addition, race and geography have been consistently shown to bc an important determinant of lung function. In order to obtain normal perdicted values of pulmonary function tests in Korean school-aged children, we performed spirometry-based pulmonary function tests on the normal healthy 2022 children, age from 6 through 15, and analyzed the data, with the parameters such as sex, age, height, weight, and body surface area. We calculated each of their simple and complex linear and logarithmic regression equations setting the predicted values. The results are as follows: 1) Predicted values of pulmonary function test items were generally higher in boys than those of girls. 2) A correlation coefficient to the parameters examined was the highest in FEV1, then those of FVC, FEF25,PEFR, FEF50, MMEF, AND FEF75 follow in order. 3) Of the parameters examined, height had the highest correlation coefficient consistently in all pulmonary function test items. 4) As compared with the inland and overseas data, some differences were observed.
Body Surface Area ; Child* ; Continental Population Groups ; Diagnosis ; Female ; Geography ; Humans ; Lung ; Lung Diseases ; Respiratory Function Tests*

No abstract available.
alpha-Fetoproteins* ; Infant, Newborn ; Jaundice, Neonatal* ; Plasma*

No abstract available.
Ameloblastoma* ; Biopsy, Fine-Needle*

BACKGROUND: Pseudo-Kaposi sarcoma mimicks Kaposi sarcoma, both clinically and histopathologically. These conditions are due to congenital (Stewart-Bluefarb syndrome) or acquired (Mali) vascular malformations. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of pseudo-Kaposi sarcoma and finding differential diagnostic tools from Kaposi sarcoma. METHODS: Clinical information of 7 patients with pseudo-Kaposi sarcoma diagnosed in Asan Medical Center from 1989 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them and immunohistochemical studies for cutaneous lymphocyte antigen (CLA), CD34, vimentin, and factor VIII were performed with the standard streptavidin-biotin method using paraffin-embedded tissue specimens of 7 pseudo-Kaposi sarcomas and 3 Kaposi sarcomas. In addition, we examined whether human herpesvirus 8 (HHV8) was detected in 3 patients by polymerase chain reaction (PCR). RESULTS: Six male and one female patients were included. Mean age was 36.3 years. Three patients were classified into Mali type and the other four patients were into Stewart-Bludfarb type. Histopathological examinations revealed capillary proliferation in the upper dermis, perivascular infiltrate of inflammatory cells, extravasated red blood cells, and fibrosis of dermis. Anti-factor VIII and CD34 stained endothelial cells only. CLA was expressed in lymphocytic infiltrate in the epidermis and dermis of pseudo-Kaposi sarcoma, whereas it was negative in Kaposi sarcoma. PCR for HHV 8 showed negative results. CONCLUSIONS: Pseudo-Kaposi sarcoma is an uncommon entity with characteristic clinical and histopathological features. Differential diagnosis between Pseudo-Kaopsi sarcoma and Kaposi sarcoma is important. We suggest that detection of HHV 8 by PCR and imunohistochemical study for CLA may be effective tools in the differential diagnosis between them.
Biopsy ; Capillaries ; Chungcheongnam-do ; Dermis ; Diagnosis* ; Diagnosis, Differential ; Endothelial Cells ; Epidermis ; Erythrocytes ; Factor VIII ; Female ; Fibrosis ; Follow-Up Studies ; Herpesvirus 8, Human ; Humans ; Lymphocytes ; Male ; Mali ; Medical Records ; Polymerase Chain Reaction ; Sarcoma ; Sarcoma, Kaposi* ; Vascular Malformations ; Vimentin

BACKGROUND: Exercise is one of the most common precipitants of acute asthma encountered in clinical practice. The development of airflow limitation that occurs several minutes after vigorous exercise, i. g. exercise-induced bronchoconstriction(EIB), has been shown to be closely correlated with the nonspecific bronchial hyperresponsiveness, which is the hallmark of bronchial asthma. All previous reports that assessed the correlation of EIB to nonspecific bronchial hyperresponsiveness have focused on airway sensitivity(PC20) to inhaled bronchoconstrictor such as methacholine or histamine. However, maximal airway narrowing(MAN), reflecting the extent to which the airways can narrow, when being exposed to high dose of inhaled stimuli, has not been studied in relation to the degree of EIB. METHODS: Fifty-six children with mild asthma(41 boys and 15 girls), aged 6 to 15 years(mean +/- SD, 9.9 +/- 2.5 years) completed this study. Subjects attended the laboratory on two consecutive days. Each subject performed the high-dose methacholine inhalation test at 4 p.m. on the first day. The dose-response curves were characterized by their position(PC20) and MAN, which was defined as maximal response plateau(MRP: when two or three data points of the highest concentrations fell within a 5% response range) or the last of the data points(when a plateau could not be measured). On the next day, exercise challenge, free running outdoors for ten minutes, was performed at 9 a.m.. FEV1 was measured at graduated intervals, 3 to 10 minutes apart, until 60 minutes after exercise. Response(the maximal DeltaFEV1 from the pre-exercise value) was classified arbitrarily into three groups; no response ((-) EIB: DeltaFEV1 <10%), equivocal response ((+/-)EIB:10% < DeltaFEV1, <20%) and definite response((+) EIB: DeltaFEV1 >20%). RESULTS: 1) When geometric mean PC20 of the three groups were compared, PC20 of (+) EIB group was significantly lower than that of (-)EIB group. 2) There was a close correlation between PC20 and the severity of EIB in the whole group(r= -0.568, p<0.01). 3) Of the total 56 subjects, MRP could be measured in 36 subjects, and the MRP of these subjects correlated fairly with the severity of EIB(r= 0.355, p<0.05) 4) The MAN of (+) EIB group was significantly higher than that of (-)EIB group(p<0.01). 5) The MAN correlated well with the severity of EIB in the whole group(r=0.546, p<0.01). CONCLUSION: The degree of MAN as well as bronchial sensitivity (PC2o) to methacholine is correlated well with the severity of EIB. The results suggest that the two main components of airway hyperresponsiveness may be equally important determinants of exercise reactivity, although the mechanism may be different from each other. The present study also provides further evidence that EIB is a manifestation of the increased airway reactivity characteristic of bronchial asthma.
Asthma ; Bronchoconstriction* ; Child ; Histamine ; Humans ; Inhalation ; Methacholine Chloride* ; Running

BACKGROUND: Overnight transfusions have been associated with higher transfusion risk than transfusions during the day. The aim of the study was to evaluate the transfusion status at our hospital and to help provide plans for overnight transfusions. METHODS: All blood products, including red blood cell products (RBC), fresh frozen plasmas (FFP), and all platelet products (PLT) issued between January 2013 and December 2014 were included. Night1 (5 pm∼8 am) and Night2 (8 pm∼8 am) were defined as overnight, and all issued bloods (IB) were analyzed in accordance with the issued time, ordered medical departments, and the reason of transfusion. RESULTS: The total unit number of IB at Night1 (Night2) was 53,483 (38,224), and it consisted of 44.4% (31.7%) total IB; 53.2% (39.6%) FFP; 46.8% (33.4%) RBC; and 39.3% (27.6%) PLT. The IB ordered from the departments of trauma & acute care surgery and emergency medicine consisted of 40% IB. The 80.9% RBC, 53.1% FFP and 70.2% PLT could be considered as appropriate for overnight transfusion. CONCLUSION: Due to the characteristics of our hospital with many trauma patients, the percentage of IB during an overnight period in our hospital was higher than those in other countries, and the rate of appropriate reason for RBC transfusion was also higher. However, as inappropriate overnight transfusions may have been still performed, education for medical staffs and appropriate policies for overnight transfusion could be helpful in reducing inappropriate transfusion.
Blood Platelets ; Blood Transfusion ; Education ; Emergency Medicine ; Erythrocytes ; Humans ; Medical Staff ; Plasma ; Tertiary Care Centers*

Background: Maintaining optimal blood inventory levels in hospitals is important to prevent blood shortage and wastage. We aimed to provide an efficient blood inventory management strategy for hospital blood banks nation-wide by comparing the current use of 5-day issuable stock (IS) with Lim’s IS as a novel target IS. Methods: The average and CV of daily usage (DU) were calculated from information entered into Korea’s Blood Management System by 194 participating hospitals in 2019 and 2020. Using these data, Lim’s IS was calculated by determining the simulated annual average blood shortage day nearest to 1 for each blood group in each hospital. The 5-day IS (5IS) was estimated by multiplying the average DU in 2018 by five to count the shortage days in 2019. Results: The average DU (0.3–231.3 units) and corresponding CV (0.33–7.14) in the participating hospitals were inversely proportional (r = –0.699 to –0.695). The hypothetical averages of 5IS and Lim’s IS were 27.0 ± 41.2 and 24.7 ± 20.8, respectively (P = 0.006). The shortage days for 5IS and Lim’s IS were 8.9 ± 22.7 and 1.0 ± 1.9, respectively (P < 0.001). Conclusions While 5IS was unacceptable for universal application, Lim’s IS remained near one shortage day and is considered more efficient than 5IS. Hospitals should implement indicators that consider DU and its variations. This is the first study to introduce Lim’s IS as an indicator of optimal blood inventory, and the data are expected to provide guidance for effective blood inventory management nationwide, particularly during blood shortages.

Cast formation of biliary sludge leading to obstruction and cholangitis have been reported in patients who received orthotopic liver transplantation. The pathogenesis of biliary cast after orthotopic liver transplantation appeared to be multifactorial. Cold ischemic damage, immunologic attack to the bile duct and bile stasis may have played a role. On the other hand, only three cases of biliary cast have been reported in non-transplanted patients. We described the successful endoscopic removal of this complication in a 70-year-old man whose biliary sludge aggregated into firm casts occupying the extrahepatic ducts which has been developed after cholecystectomy and segmentectomy for intrahepatic cholangiocarcinoma. We speculated on the hemolysis and prolonged fasing as the initiating events but the exact pathogenesis of biliary cast remains to be clarified.
Aged ; Bile ; Bile Ducts ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Hand ; Hemolysis ; Humans ; Liver Transplantation ; Mastectomy, Segmental ; Cholangiocarcinoma

Cast formation of biliary sludge leading to obstruction and cholangitis have been reported in patients who received orthotopic liver transplantation. The pathogenesis of biliary cast after orthotopic liver transplantation appeared to be multifactorial. Cold ischemic damage, immunologic attack to the bile duct and bile stasis may have played a role. On the other hand, only three cases of biliary cast have been reported in non-transplanted patients. We described the successful endoscopic removal of this complication in a 70-year-old man whose biliary sludge aggregated into firm casts occupying the extrahepatic ducts which has been developed after cholecystectomy and segmentectomy for intrahepatic cholangiocarcinoma. We speculated on the hemolysis and prolonged fasing as the initiating events but the exact pathogenesis of biliary cast remains to be clarified.
Aged ; Bile ; Bile Ducts ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Hand ; Hemolysis ; Humans ; Liver Transplantation ; Mastectomy, Segmental ; Cholangiocarcinoma

We report a case of multicystic mesothelioma in the visceral peritoneum anterior of the ascending colon. A 39-year-old female patient visited hospital with a palpabel tender mass in the right flank. An ultrasonogram showed multiple cystic mass lesions in the right flank and CT scan showed a multicystic rative mass with enhancing wall and septum in front of the ascending colon. The patient underwent explolaparotomy and the mass. which inpathology turned out to be a benign multicystic masothelioma, was removed.
Colon, Ascending ; Female ; Humans ; Mesothelioma* ; Peritoneum* ; Tomography, X-Ray Computed