We experienced a 61-year old man with Pneumocystis carinii pneumonia who had been diagnosed as having relapsed acute myelogenous leukemia(AML). He developed severe dyspnea in the nadir state after reinduction chemotherapy. His chest X-ray showed bilateral interstitial pneumonia in both lung fields. We started ventilator therapy and obtained sputum through the endotracheal tube. Typical P. carinii cysts were found in the sputum by Giemsa stain. No other organisms were found in thelavage sediments. From clinical observation and the presence of typical P. carinii cysts, the patient was diagnosed as having P. carinii pneumonia and was treated with sulfamethoxazole/trimethoprim and glucocorticoid. This was the first reported case of P. carinii pneumonia in an AML patient undergoing chemotherapy in Korea.
Azure Stains ; Drug Therapy ; Dyspnea ; Humans ; Korea ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Lung Diseases, Interstitial ; Middle Aged ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Sputum ; Thorax ; Ventilators, Mechanical

PURPOSE: The purpose of this study is to estimate the accuracy of diagnosing a radio-lucent soft tissue foreign body with using ultrasound according to the different sizes and depth of the foreign bodies in an experimented model. METHODS: In the forefeet of swine, we made 45 incisions (4 in each forefeet) of 2 mm, 5 mm and 10 mm sized toothpicks at depths of 1 cm, 2 cm and 3 cm each. 15 incisions without foreign bodies were cannulated, simulating damage to the soft tissue made by a non captured foreign body. The twelve emergency physicians kept records not only for the presence or absence of a foreign body, but also for the depth of it. We then calculated the sensitivity, specificity, PPV (positive predictive value) and NPV (negative predictive value) according to the sizes of the toothpicks and the depths. RESULTS: The sensitivity, specificity, PPV and NPV of all the depths and sizes were under 80%. The results of the staff and residents were not significantly different. The result of a 3 cm depth was especially poor. CONCLUSION: In our model, ultrasound performed by emergency physicians was neither sensitive nor specific for diagnosing a soft tissue foreign body of various sizes and depths.
Emergencies ; Foreign Bodies ; Sensitivity and Specificity ; Swine

PURPOSE: We aim to analyze the clinical course and the recurrence patterns after surgical treatment in patients with intestinal Behcet's disease and to determine the prognostic factors. METHODS: Thirty-eight patients with intestinal Behcet's disease who had undergone operations between 1979 and 2007 were analyzed. Clinical characteristics between the recurrent group (n=24) and the non-recurrent group (n=14) were compared. The cumulative recurrence rates were calculated by using the Kaplan-Meier method, and the results were compared by using the log-rank test. RESULTS: The median follow-up was 120 months. The median age of the 38 patients was 36.5 years, and the patients included 26 males and 12 females. Recurrences after surgical treatment were observed in 24 patients, and reoperations were performed in 21 patients. The mean age at operation was 35.7 years in the recurrent group and was less than 43.4 years in the non-recurrent group (P=0.030). Clinical subtypes of Behcet's disease (complete or incomplete vs. suspicious) and the cause of operation (presence vs. absence of a perforation or fistula) were different between the recurrent and the non-recurrent groups (P=0.048, P=0.014, respectively). The 5-year cumulative recurrence rate and reoperation rate for all patients with intestinal Behcet's disease who underwent operations were 52.7% and 36.0%, respectively the clinical subtypes and the cause of the operation were significant factors affecting the cumulative recurrence and the reoperation rates. CONCLUSIONS: Intestinal Behcet's disease demonstrates high recurrence and reoperation rates after surgical treatment. More careful follow up is needed to these surgical patients with high risk of recurrence and reoperation.
Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Recurrence ; Reoperation