PURPOSE: To evaluate the effectiveness of percutaneous catheter drainage in treatment of the lung abscess. MATERIALS AND METHODS: We treated the lung abscesses in 14 patients(12 men, 2 women), who did not respond to medical therapy, by percutaneous catheter drainage under fiuoroscopic or ultrasound guidance. One abscess due to infacted bulla was managed by combination treatment with alcohol sclerosing therapy. Patients were followed by serial chest radiographs every three days and the amount of drained or aspirated pus evaluated. The treatment effect and recurrence were followed by chest PA and lateral chest at one week after removal of drainage catheter. RESULTS: Thirteen patients(93%) recovered clinically and radiologically within 3 days. In 10 patients, drainage catheter could be removed within 2 weeks, and three patients, the catheter was keept longer. Most complications were mild ;vague to moderate chest pain(n=14), mild hemoptysis(n=2), and pneumothorax(n=I). One man who suffered from far advanced pulmonary tuberculosis died of asphyxia caused by massive hemoptysis 16 days after percutaneous drainage. CONCLUSION: Percutaneous catheter drainage is a safe and effective method for treating lung abscess.
Abscess ; Asphyxia ; Catheters* ; Drainage* ; Hemoptysis ; Humans ; Lung Abscess* ; Lung* ; Male ; Radiography, Thoracic ; Recurrence ; Suppuration ; Thorax ; Tuberculosis, Pulmonary ; Ultrasonography

PURPOSE: To evaluate the effectiveness of percutaneous catheter drainage in treatment of the lung abscess. MATERIALS AND METHODS: We treated the lung abscesses in 14 patients(12 men, 2 women), who did not respond to medical therapy, by percutaneous catheter drainage under fiuoroscopic or ultrasound guidance. One abscess due to infacted bulla was managed by combination treatment with alcohol sclerosing therapy. Patients were followed by serial chest radiographs every three days and the amount of drained or aspirated pus evaluated. The treatment effect and recurrence were followed by chest PA and lateral chest at one week after removal of drainage catheter. RESULTS: Thirteen patients(93%) recovered clinically and radiologically within 3 days. In 10 patients, drainage catheter could be removed within 2 weeks, and three patients, the catheter was keept longer. Most complications were mild ;vague to moderate chest pain(n=14), mild hemoptysis(n=2), and pneumothorax(n=I). One man who suffered from far advanced pulmonary tuberculosis died of asphyxia caused by massive hemoptysis 16 days after percutaneous drainage. CONCLUSION: Percutaneous catheter drainage is a safe and effective method for treating lung abscess.
Abscess ; Asphyxia ; Catheters* ; Drainage* ; Hemoptysis ; Humans ; Lung Abscess* ; Lung* ; Male ; Radiography, Thoracic ; Recurrence ; Suppuration ; Thorax ; Tuberculosis, Pulmonary ; Ultrasonography

PURPOSE: Conventional contrast dacryocystography(C-DCG) has been used mainly for anatomical assessment of the lacrimal drainage apparatus, due to its limited information on the dynamics of the lacrimal system, and thus correlation role in epiphora. The purpose of study was to improve the diagnostic value in epiphora by utilizing RI dacryocystography(RI-DCG) with quantitative criteria. MATERIALS AND METHODS: The patient for RI dacryocystography set erect with the head fixed in front of gamma camera fitted with a standard 6 mm pinhole collimater. Both eyes of 85 patients(170 eyes) were scanned with 99rnTc-pertechnetate followed by conventional dacryocystography. The data from gamma camera were recorded simultaneously on a computer system for subsequent quantitative analysis. RESULTS: In 94 of 96 eyes without epiphora, RI-DCG was correlated with normal C-DCG and % of emptying was at least over 50%. In 58 of 74 eyes with epiphora, RI-DCG was correlated with abnormal C-DCG and % of emptying was at most below 50%. In 16 eyes with functional block, quantitative RI-DCG showed abnormal % of emptying. CONCLUSION: Nuclear DCG with quantitation had higher diagnostic yield in functional block and correlated higher with epiphora. Thus nuclear DCG with quantitation would be a valuable functional test after postprocedures such as dacryocystoplasty.
Computer Systems ; Drainage ; Gamma Cameras ; Head ; Humans ; Lacrimal Apparatus Diseases* ; Radionuclide Imaging*

BACKGROUND: Osteoporosis is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). This study examined the prevalence and risk factors associated with osteoporosis in patients with COPD. METHODS: The bone mineral densities (BMDs) of the lumbar spine and femoral bone were measured in 53 patients with clinically stable COPD and 41 age- and gender-matched control subjects showing a normal lung function. Osteoporosis was defined as a T-score < or =-2.5. The subjects' clinical characteristics and laboratory data were reviewed, and multiple logistic regression analysis was used to identify the risk factors associated with osteoporosis in COPD patients. RESULTS: The prevalence of osteoporosis was 47% and 32% in the COPD patients and controls, respectively. In particular, using the femoral neck T-score, the prevalence of osteoporosis in COPD patients was higher than that in the controls (26% vs. 5%; p=0.006). The average T-score of the lumbar spine (p=0.025) and femoral neck of COPD patients were significantly lower than those of the controls (p=0.001). The forced expiratory volume in the 1 second (FEV1) % predicted (p=0.019; odds ratio [OR], 0.955; 95% confidence interval [CI], 0.919-0.993) and age (p=0.024; OR, 1.144; 95% CI, 1.018-1.287) were independently associated with osteoporosis in patients with COPD. CONCLUSION: Using the femoral neck T-score, the prevalence of osteoporosis in patients with COPD was higher than the age-and gender-matched controls. A lower FEV1 and older age further increase the risk of osteoporosis in patients with COPD.
Bone Density ; Comorbidity ; Femur Neck ; Forced Expiratory Volume ; Humans ; Logistic Models ; Lung ; Odds Ratio ; Osteoporosis ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Spine

BACKGROUND/AIMS: In patients with chronic obstructive pulmonary disease (COPD), left ventricular (LV) systolic dysfunction and structural changes are rare, while right ventricular (RV) dysfunction and structural alteration and/or LV diastolic dysfunction are common. We evaluated the cardiac structure and function in patients with COPD using echocardiography. METHODS: Echocardiography examinations were performed in 69 patients with clinically stable COPD and without a history of heart disease; 22 control subjects with normal lung function were enrolled for comparison. Echocardiography parameters of the COPD patients were compared with those of the controls, and assessed according to the COPD stage classified using the Global initiative for chronic Obstructive Lung Disease (GOLD) criteria. RESULTS: Patients with COPD had significantly lower body weight (p=0.001) and higher pack-years of smoking than did the controls (p=0.002). The echocardiogram showed that LV end diastolic diameter (p<0.001), LV end systolic diameter (p=0.020), left atrial (LA) diameter (p=0.026), and LV mass in the COPD patients were significantly decreased compared to the controls (p=0.003). However, there were no differences between the COPD patients and controls in the parameters reflecting LV diastolic function and mean RV systolic pressure (RVSP). According to the COPD stage, body weight (p<0.001), body mass index (BMI) (p<0.001), and LV mass were significantly different (p=0.011). In patients with COPD, LV mass (r=0.432) (p<0.001) and BMI were significantly correlated with FEV1% predicted (r=0.600) (p<0.001). CONCLUSIONS: Patients with COPD had lower LV mass and LA and LV diameters than did the controls, even though both groups had normal LV function. In particular, the LV mass appeared to correlate with the lung function in the patients with COPD.
Blood Pressure ; Body Mass Index ; Body Weight ; Echocardiography ; Heart ; Humans ; Hypertension ; Lung ; Lung Diseases ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Smoking

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. METHODS: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. RESULTS: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator FEV1, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. CONCLUSION: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.
Anxiety* ; Body Mass Index ; Depression* ; Hospitalization ; Humans ; Korea ; Lung ; Lung Diseases ; Mass Screening ; Mortality ; Outpatients* ; Prevalence ; Pulmonary Disease, Chronic Obstructive* ; Serum Albumin ; Smoke ; Smoking

OBJECTIVE: Left ventricular hypertrophy is common and major complication in patients with end stage renal disease (ESRD), but pathogenesis is not clear. We have used echocardiography to evaluate influential factors and contractile performance according to the geometry of left ventricle. METHODS: We measured left ventricular mass, the extent of pericardial effusion and systolic function of left ventricle with M-mode and two dimensional echocardiography in 99 cases of ESRD from March 1993 to March 1996. RESULTS: 1) Body surface area and systolic blood pressure was higher in men than those in women. But, there was no difference in LV mass index or systolic function between the sex. 2) Among the 99 patients with ESRD, 89 cases (90%) had increased ventricular mass and 10 cases had normal ventricular mass. In the left ventricular hypertrophy groups, 60 cases had concentric hypertrophy, 29 cases had eccentric hypertrophy. 3) In patients with normal ventricular mass, hypertension and pericardial effusion were less frequent than in those with left ventricular hypertrophy. In patients with concentric hypertrophy, systolic blood pressure and body surface area were increased and serum albumin was decreased as compared to patients with eccentric hypertrophy. In patients with eccentric hypertrophy, duration of dialysis was increased. But, the result of Logistic analysis showed that systolic blood pressure and serum albumin were reliable factors for the geometry of left ventricle. 4) In patients with eccentric hypertrophy, LV mass index was significantly correlated with the concentration of serum alkaline phosphatase and phosphate. But, in patients with concentric hypertrophy, any factors were not correlated with LV mass index. 5) Systolic performances such as ejection fraction and fractional shortening were decreased in patients with eccentric hypertrophy. 6) The pattern of left ventricular hypertrophy was not different among non-dialysis group, hemodialysis group and CAPD group. CONCLUSION: In patients with ESRD, left ventricular hypertrophy is a common complication and most common hypertrophic type is concentric hypertrophy. The geometry of left ventricular hypertrophy may be influenced by various factors such as systolic blood pressure and serum albumin concentration and influence on the systolic performance of left ventricle. Further study for the geometry of left ventricle and the prognosis may be necessary for the improvement of cardiovascular complications in patients with ESRD.
Alkaline Phosphatase ; Blood Pressure ; Body Surface Area ; Dialysis ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic* ; Male ; Pericardial Effusion ; Peritoneal Dialysis, Continuous Ambulatory ; Prognosis ; Renal Dialysis ; Serum Albumin

Double-chambered right ventricle (DCRV) is a rare congenital heart disorder in which the right ventricle is divided by an anomalous muscle bundle into a high pressure inlet portion and a low pressure outlet portion. We report a case of isolated DCRV without symptoms in adulthood, diagnosed through echocardiography, cardiac catheterization and cardiac magnetic resonance imaging.
Bays ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Heart ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Muscles ; Young Adult

PURPOSE: This study was designed to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery with open surgery for right colon cancer. METHODS: Sixteen patients who underwent a hand-assisted laparoscopic right hemicolectomy (HAL-RHC group) and 33 patients who underwent a conventional open right hemicolectomy (open group) during the same period were enrolled in this study with a case-controlled design. RESULTS: The operation time was 217 minutes in the HAL-RHC group and 213 minutes in the open group (P = 0.389). The numbers of retrieved lymph nodes were similar between the two groups (31 in the HAL-RHC group and 36 in the open group, P = 0.737). Also, there were no significant difference in the incidence of immediate postoperative leukocytosis, the administration of additional pain killers, and the postoperative recovery parameters. First flatus was shown on postoperative days 3.5 in the HAL-RHC group and 3.4 in the open group (P = 0.486). Drinking water and soft diet were started on postoperative days 4.8 and 5.9, respectively, in the HAL-RHC group and similarly 4.6 and 5.6 in the open group (P = 0.402 and P = 0.551). The duration of hospital stay was shorter in the HAL-RHC group than in the open group (10.3 days vs. 13.5 days, P = 0.048). No significant difference in the complication rates was shown between the two groups, and no postoperative mortality was encountered in either group. CONCLUSION: The patients with right colon cancer in the HAL-RHC group had similar pathologic and postoperative recovery parameters to those of the patients in the open group. The patients in the HAL-RHC group had shorter hospital stays than those in the open group. Therefore, hand-assisted laparoscopic right hemicolectomy for right-sided colon cancer is feasible.
Case-Control Studies ; Colon ; Colonic Neoplasms ; Diet ; Drinking Water ; Flatulence ; Hand-Assisted Laparoscopy ; Humans ; Incidence ; Length of Stay ; Leukocytosis ; Lymph Nodes

Tubal leiomyoma during pregnancy is rare. Fewer than 100 cases of leiomyoma of the fallopian tube have been described in the literature. Most of them are asymptomatic. The diagnosis is incidentally if there is a primary tubal lesion such as ectopic pregnancy or during the general gynecologic operation. The tube must be entirely sectioned and completely examined whether there is primary tubal adenocarcinoma, if rare. We experienced a case of tubal leiomyoma in woman at 38+5 weeks gestation with previous primary cesarean section diagnosed after repeat cesarean delivery and bilateral tubal ligation with a brief review of literature.
Adenocarcinoma ; Cesarean Section ; Diagnosis ; Fallopian Tubes ; Female ; Humans ; Leiomyoma* ; Pregnancy* ; Pregnancy, Ectopic ; Sterilization, Tubal