Although the measurement of tear film break-up time (BUT) is the most frequently used diagnostic test for dry eye syndrome, there have been no reports for the relationship between clinical manifestations of dry eye patients and the degree of their BUTs. To investigate the relationship, we analyzed retrospectively clinical manifestations of 466 dry eye patients and categorized them into two groups in terms of BUT, the group of BUT <5 seconds and BUT >or=5 seconds, in various clinical manifestations. The two groups were compared by X2-test and the results were as follows. The two groups did not show statistically significant difference in sex, age, duration of symptoms, degree of corneal erosion, and time from the beginning of management to symptom improvement. Therefore we thought that there was no statistically significant correlation beteween the above-mentioned clinical manifestations of this study patients and their BUT's. There were more patients whose BUT were below 5 seconds than those having BUT above 5 seconds in group complaining foreign body sensation as a main symptom and in group having associated chronic conjunctivitis. (BUT, dry eye)
Conjunctivitis ; Diagnostic Tests, Routine ; Dry Eye Syndromes ; Foreign Bodies ; Humans ; Retrospective Studies ; Sensation ; Tears

Mucinous cholangiocarcinoma, characterized by large quantities of mucin production, is a rare subtype of peripheral cholangiocarcinoma and usually shows rapid progression and a fatal outcome. We report here a case of mucinous cholangiocarcinoma in a 69 year-old man, who was infected with Clonorchis sinensis. Histologically, the tumor was an adenocarcinoma with extensive intracellular and extracellular mucin production, up to 70% of the tumor mass and there was frequent lymphovascular invasion of the tumor cells. The liver adjacent to the mass contained eggs of Clonorchis sinensis in the bile duct lumen and showed ductal epithelial hyperplasia, mucinous metaplasia and adenomatous proliferation of intramural glands. The patient was treated with a right hepatectomy. Four months after the surgery, the tumor recurred in the soft tissue of the right flank.
Aged ; Bile Duct Neoplasms/*complications/secretion ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*complications/secretion ; Clonorchiasis/*complications ; English Abstract ; Humans ; Male ; Mucins/secretion

In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients(89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A(95.7%), type B (89.%). There was significantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bed >45° and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors, Stenosis severity, thrombus, lesion location at a bend >45°, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.
American Heart Association ; Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Male ; Myocardial Infarction ; Phenobarbital ; Thrombosis

The development of back pain following epidural analgesia is one reason for patient refusal of neuraxial analgesia. The primary endpoint of this study was to compare the incidence and severity of back pain following midline and paramedian epidural technique. The secondary endpoint was to identify the risk factors associated with the occurrence of back pain. Methods: This prospective randomized study included 114 patients receiving thoracic epidural catheterization for pain management following upper abdominal or thoracic surgery. Patients were allocated to either the midline or the paramedian group by computer-generated randomization. An investigator who was blinded to the patient group interviewed patients at 24, and 48 h, and 3–5 days after surgery about the existence of back pain and its severity. Results: The total incidence of back pain following epidural anesthesia was 23.8% in the midline group and 7.8% in the paramedian group. The numerical rating scale of back pain was not different between the two groups at 24 h and 4 days after surgery. The paramdian technique was associated with a lower incidence of back pain than the midline technique (95% confidence interval 0.05–0.74, odds ratio 0.2, P < 0.01). However, the number of attempts, surgical position, body mass index, and duration of surgery were not associated with back pain. Conclusions: This study showed that the midline group of thoracic epidural analgesia demonstrated higher incidence of back pain than the paramedian group. However, the pain was mild in intensity and decreased with time in both groups.

BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Endoscopy ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyloric Antrum ; Reaction Time ; Sensitivity and Specificity ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia-disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.
Abdomen ; Adult ; Chest Pain ; Deglutition Disorders ; Diagnosis ; Endoscopy, Digestive System ; Esophageal Fistula* ; Fistula ; Follow-Up Studies ; Gastroscopy ; Humans ; Korea ; Mediastinum ; Methods ; Pancreatic Diseases ; Pancreatic Pseudocyst* ; Pancreatitis ; Pancreatitis, Chronic ; Pleural Effusion ; Pneumonia ; Thorax

There are many ways to evaluate the learning achievement of medical students. We are familiar with the problems related to the traditional laboratory course practical examinations of pathology and histology courses, which deal with morphology heavily. In order to overcome the limitations inherent to the traditional evaluation methods, we used Internet for the written and practical examinations for the pathology course. Two tests were conducted on the internet with thirty medical students. Each student used his/her personal computer, which was connected to Local Area Network(LAN), in the computer laboratory. The examinee entered the Pathology Department home page(address: http://ajoupath. ajou.ac.kr) and took their tests made up of descriptive and multiple choice questions including related gross and microscopic images. Common Gateway Interface(CGI) program of Perl language was used for automatic scoring and analysis of the multiple choice questions. The server computer in the Pathology Department scored the results instantaneously upon the answer selection and push down of the "send" button by the examinee. Furthermore, the computer program was capable of providing data regarding how many students got the correct answer and the degree of difficulty for each item. The students were requested to provide hand-written descriptions for the questions requiring descriptive answers, because of the technical limitation. We believe that the tests on the internet were performed successfully. The "dreadful" old fashioned examination using timer were no longer needed because high quality gross and microscopic images on the monitor were available for the examinee. We believe that the internet is very useful for the comprehensive evaluation of the medical students' learning achievement.
Education, Medical ; Humans ; Internet* ; Learning* ; Microcomputers ; Pathology ; Students, Medical

BACKGROUND: To prevent and control legionellosis outbreaks, it is important to monitor cooling towers for Legionella and establish epidemiological markers. We determined level of contamination with Legionella of cooling tower in Seoul city, analyzed the distribution of Legionella subtypes, and evaluated molecular typing methods for discrimination power and feasibility. METHODS: Water samples from 120 cooling towers in 25 areas(Gu) of Seoul city were collected during June, 1997. Culture and duplex-PCR(polymerase chain reaction) with Southern hybridization probed with Legionella-specific genes were performed with filtered samples. Twenty-two Legionella isolates were analyzed comparatively by pulsed-field gel electrophoresis(PFGE) and arbitrarily primed(AP)-PCR using a M13 reverse primer. RESULTS: Culture and duplex-PCR with Southern hybridization were positive for Legionella in 22(18.3%) and 106(88.3%) of 120 samples, respectively, resulting in 90.8%(109/120) of contamination level. Out of 22 Legionella isolates, 17 were identified as Legionella pneumophila serogroup 1, 4 as L. pneumophila serogroup 6 and 1 as an unknown. Molecular analysis of 17 isolates of L. pneumophila serogroup 1 showed 7 subtypes by PFGE(A0 in 9 isolates; A1, 2; A2, 1; A3, 2; B, 1; C, 1; D, 1) and 5 subtypes by AP-PCR(Ia in 11 isolates; Ib, 2; Ic, 2; II, 1; III, 1). The agreement of results of both methods was 76.5%(13/17) of L. pneumophila serogroup 1 and 81.8%(18/22) of all isolates, respectively. CONCLUSION: Most of cooling towers in Seoul city were already contaminated with Legionella just before summer, requiring decontamination measures and continuous surveillance. L. pneumophila serogroup 1 was the predominant isolate with variable subtypes. The AP-PCR can be used as a rapid and reproducible screening tool in tracking legionellosis outbreak.
Decontamination ; Discrimination (Psychology) ; Disease Outbreaks ; Legionella pneumophila ; Legionella* ; Legionellosis ; Mass Screening ; Molecular Typing ; Seoul* ; Water*