No abstract available.
Mortality* ; Tuberculosis*

PURPOSE: We analysed the role of modified Gianturco self-expandable stents in the treatment of tracheobronchial stenosis in 13 patients. MATERIALS AND METHODS: We inserted modified Gianturco self-expandable stents under the fluoroscopic and bronchoscopic guidance. There were stenosis in the trachea(n--2), the right main bronchus(n=2), and the left main bronchus(n=9). The causes of the stenosis were endobronchial tuberculosis(n=10), intubation granuloma (n=l), restenosis after surgical reconstruction(n=2). RESULTS: Dyspnea or wheezing was improved within 1 or 2 days following the procedure. There were 32% and 22% respective increase in average FEV1 and FVC. Lung perfusion scan showed 9.6% increase of perfusion in the involved lung. No complications related to the procedure were encountered. During follow-up period of up to 31 months, 2 patients showed tracheal or bronchial restenosis, at 3 and 6 months, retrospectively. There was a distal migration of the stents in one case. CONCLUSION: During the follow up period after stent insertion, improvement of the obstructive changes and dyspnea persisted in 10 out of 13 patients. The modified Gianturco self-expandable metallic stents may be a good choice for the treatment of tracheobronchial stenosis, either as a primary treatment, or when the reconstruction failed.
Constriction, Pathologic* ; Dyspnea ; Follow-Up Studies ; Granuloma ; Humans ; Intubation ; Lung ; Perfusion ; Respiratory Sounds ; Retrospective Studies ; Stents*

PURPOSE: The purpose of this study was to determine the following:the safety of fine needle aspiration biopsy in immunocompromized children with radiographic features of Pneumocystis car/nil pneumonia, its diagnostic rate in those groups and the appropriate radiographic stage for fine needle aspiration biopsy to prove the etiologic agent. METHODS AND MATERIALS: We retrospectively reviewed the patient records of 16 children with immune compromizing diseases who had undergone fine needle aspiration biopsy of the lung. They showed the infectious sign of the lung along with the radiographic pattern of diffuse pulmonary disease, suggesting Pneumocystis carlnil pneumonia. All patients had underlying lymphoreticular malignancies including 14 acute lymphocytic leukemia and 2 non Hodgkin's lymphoma. According to the radiographic pattern of biopsy site, parenchymal disease was categorized as fine reticulonodular density(n=4), ground-glass opacity(n=9) and compact consolidation(n=3). We assessed the diagnostic rate of Pneumocystis carinii pneumonia and complications in each of the three groups. RESULTS: A diagnosis of Pneumocystis carinii pneumonia was established by fine needle aspiration biopsy in 9 patients(56%) including 2 of 4 patients with fine reticulonodular density, 4 of 9 patients with ground-glass opacity, and all 3 patients with compact consolidation. Four patients(25%) developed pneumothorax, and three of them required tube insertion. There was no patient who developed hemoptysis. CONCLUSION: Fine needle aspiration biopsy is a safe and easy method that can yield Pneumocystis carinii organism at a relatively high rate in immunocompromized children with diffuse pulmonary lesions suopicions of Pneumocystis carinii pneumonia. We recommend performing fine needle aspiration biopsy regardlesss of radiographic patterns when Pneumocystis carinii pneumonia is suggested.
Biopsy* ; Biopsy, Fine-Needle* ; Child* ; Diagnosis ; Hemoptysis ; Humans ; Lung Diseases ; Lung* ; Lymphoma, Non-Hodgkin ; Pneumocystis ; Pneumocystis carinii ; Pneumonia* ; Pneumonia, Pneumocystis ; Pneumothorax ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies

No abstract available.
Hypophysectomy*

PURPOSE: The acute or subacute patellar dislocation is frequently neglected. Arthoscopy has provided a new method of both diagnosis and treatment of the patellofemoral instability. In our series, we performed proximal realignment including lateral retinacular release and medial capsular imbrication under arthroscopic alone on the patients who had normal skeletal alignment with Q angle less than 20 degree. The clinical and radiographic results of the procedure was assessed. MATERIAL AND METHODS: 21 knees in 20 patients were evaluated at an average 36 months following arthroscopic procedures alone. The average patient's age was 25 years old and the mean follow-up period was 18 months. The patients had been treated surgically after conservative management for mean three weeks from initial trauma. Medial patellar osteochondral fractures and loose bodies in 7 knees of 6 patients and osteochondral defect of lateral femoral condyle in 1 knee of 1 patient were confirmed radialologically and intraoperatively. We performed additional treatments for the associated disease. The radiologic results of Insall-Salvati index, congruence angle for subluxation and lateral patellofemoral angle (LPFA) for tilt on preoperative, postoperative and last follow-up and clinical outcome were assessed, according to Crosby and Insall's criteria. RESULTS: Congruence angle(+10.8 to -0.5), LPFA(+7.2 to -7.3) and Insall-Salvati index(0.82 to 1.05) were radiologically normalized. Clinically, results were excellent to good results in 19 knees(90.5%). CONCLUSION: The arthroscopic proximal realignment was done by minimal surgical exposure and was effective on relief of the patellofemoral pain after acute or subacute dislocation, it also proved the less pain, rapid rehabilitation and ability to diagnose the other intraarticular disorders.
Adult ; Arthroscopy ; Diagnosis ; Dislocations ; Follow-Up Studies ; Humans ; Knee ; Patellar Dislocation* ; Rehabilitation

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Pleural Effusion*

No abstract available.
Diagnosis* ; Tuberculosis*

No abstract available.
Acute Lung Injury* ; Animals ; Hydroxyl Radical* ; Rats*

BACKGROUND: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant causes of cirrhosis. It is uncertain that tie same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia. METHOD: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. RESULTS: The hypoxemia of PaO2 less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). Hut there was no patient with significant hypoxemia of PaO2 less than 60 mmHg. PaO2 was significantly decreased in the patients with spider angioma than the patients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of 11.4+/-4.1% than normoxemic group of 4.1+/-2.0% (p<0.05). CONCLUSIONS: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to play a major role in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.
Alcoholics ; Anoxia* ; Ascites ; Blood Gas Analysis ; Dilatation ; Esophageal and Gastric Varices ; Fibrosis ; Hemangioma ; Hepatic Encephalopathy ; Humans ; Incidence ; Korea ; Liver Cirrhosis* ; Liver Cirrhosis, Biliary ; Liver Function Tests ; Liver* ; Lung Diseases ; Renal Circulation ; Respiratory Function Tests ; Skin ; Spiders ; Technetium Tc 99m Aggregated Albumin* ; Whole Body Imaging*

No abstract available.
Macrophages, Alveolar* ; Mycobacterium tuberculosis* ; Mycobacterium*