Complications of mitomycin C soaking method during pterygium surgery and its effect on recurrence rate were compared with postoperative use of topical mitomycin C. Sixty three patients(seventy three eyes) with primary pterygium received surgery with the bared sclera method. Thirty nine eyes randomly chosen were treated with cotton applicator soaked with 0.2mg/ml mitomycin C for 5 minutes after the excision of pterygium(soaking group). Thirty four eyes underwent the same surgical procedure and received topical 0.2mg/ml mitomycin C postoperatively, twice a day for five days(eye drop group). During the mean follow-up period of 13 months, recurrence rate was 15.4%(6 eyes) in soaking group and 20.6%(7 eyes) in eye drop group respectively. This difference was not statistically significant(p>0.5). There were no specific complications related to mitomycin C treatment in both groups during the follow-up periods. The soaking method of 0.2mg/ml mitomycin C was found as effective and safe as postoperative use of topical 0.2mg/ml mitomycin C for prevention of the recurrence of primary pterygium.
Follow-Up Studies ; Mitomycin* ; Pterygium* ; Recurrence ; Sclera

It has been reported that 2.5% povidone-iodine solution was an effective antimicrobial agent on the conjunctivae of newborns and caused less toxicity than silver nitrate eye drops. The effectiveness and the safety of 1% povidoneiodine solution, a lower concentration solution, were evaluated on ophthalmia neonatorum prophylaxis. A bacterial culture was taken from each conjunctiva of 70 neonates within 30 minutes after birth. A drop of each of the two agents, which were randomly chosen among 1% povidone-iodine solution, 2.5% povidone-iodine solution. and 1% silver nitrate eye drops, was placed on each conjunctiva. Conjunctival bacterial cultures were again taken two to four hours after birth. Before the first culture and at 24 hours after birth, the eyes were examined for toxic changes. To evaluate the effectiveness of the medications, the numbers of bacterial species and colonyforming units from each culture were compared. All three agents significantly reduced the numbers of species and colonyforming units(p<0.02). Two povidone-iodine solutions did not show significant ocular toxicity(p>0.7) but silver nitrate eye drop did(p<0.02). Therefore, it was found that 1% povidone-iodine solution as well as 2.5% povidone-iodine solution are effective antibacterial agents on the conjunctivae of newborns and cause less toxicity than silver nitrate eye drops.
Anti-Bacterial Agents ; Conjunctiva ; Endophthalmitis* ; Humans ; Infant, Newborn ; Ophthalmia Neonatorum* ; Ophthalmic Solutions ; Parturition ; Povidone-Iodine* ; Silver Nitrate

Conjunctival bacterial cultures for 113 neonates who were delivered by cesarean section or vaginal delivery were performed within 30 minutes after birth. These neonates were in the condition of no eye drops applied. The 43 newborns were delivered by cesarean section(CS group) and the 70 newborns were delivered vaginally(VD group). The 10 newborns(P1) (14 eyes(P2)) in the CS group and the 29 newborns(41 eyes) in the VD group showed culture positivity. These differences between two groups were statistically significant(p1, p2<0.05). The CS group had significantly fewer species and colony forming units cultured per subject (0.395 +/- 0.821(p3), 5.116 +/- 27.095(p4) than the VD group(0.971 +/- 1.393, 25.843 +/- 62.285) (p3,p4<0.05). Coagulase negative staphylococci were predominantly isolated in the CS group and coagulase negative staphylococci, gram positive bacilli, E. coli, nonfermenting bacilli, and S. aureus in the VD group. Therefore it was found that the conjunctiva of the newborns delivered by cesarean section bore significantly fewer bacteria and need less prophylactic measures than that of newborns delivered vaginally.
Bacteria ; Cesarean Section* ; Coagulase ; Conjunctiva ; Female ; Humans ; Infant, Newborn ; Ophthalmic Solutions ; Parturition* ; Pregnancy ; Stem Cells

PURPOSE: To document the radiologic characteristics of Korean Gaucher disease. MATERIALS AND METHODS: Fifteen bone marrow biopsy and laboratory data confirmed Gaucher disease patients (age 1 -21, mean 10.9 yr) wereundertaken plain X ray and MRI. Number of type I were 10, type II, 2, type III, 3. Seven were splenectomized oninitial evaluation or during follow up. Five enzyme treated patient were undertaken follow-up MR examinationduring 6 -40 month with 6 month interval. Conventional T1 and T2WI of spine and femur was performed and FMPSPGR inand out of phase image was also done. Volume of liver and spleen were measured, and bone marrow infiltration andpresence of infarction were scored according to 6 scale scoring system. Clinical data were also reviewed andcorrelated with the MR findings. RESULTS: Marrow infiltration was noted in 71.4% of all patients in MRI, while itwas in 45.7% with plain radiography. Type I group showed marrow infiltration in all but one cases, which wasparallel with ages, SGPT, and presence of osteopenia, reversely correlated with spleen size. Severe bonecomplications (infarction or fracture) were noted in 7 of 10 type I group, and 6 patients showed severe growthretardation (below 3rd percentile). Follow up MR examination of 5 patient showed decrease in liver and spleen sizefirst without bone change until 6 months. There showed bone regeneration in 2 patient 1 year after, and increasedfat signal in one patient 3.5 years after. In and out of phase images couldn't help in quantifying fatcomposition in bone marrow. CONCLUSION: Korean Gaucher patients revealed as more severe skeletal complicationsthan others reported from Western groups. MR examination is a effective modality to evaluate and monitor ofGaucher patients.
Alanine Transaminase ; Biopsy ; Bone Diseases, Metabolic ; Bone Marrow ; Bone Regeneration ; Femur ; Follow-Up Studies ; Gaucher Disease* ; Humans ; Infarction ; Liver ; Magnetic Resonance Imaging ; Metabolism ; Radiography ; Spine ; Spleen

No abstract available.
Gangwon-do* ; Humans ; Norovirus* ; Sequence Analysis*

Wegener's granulomatosis (WG)is a multisystemic inflammatory disease characterized by necrotizing granulomatous inflammation and vasculitis of unknown etiology which classically affects the upper airway,lung,and kidney.Subglottic stenosis (SGS)is rare and occurs independently of other features of active WG. SGS can be a life-threatening manifestation of disease,and prompt diagnosis is essential.Since the presenting symptoms of SGS can be nonspecific,SGS should be considered in the differential diagnosis of any patient with WG who has increasing dyspnea,voice change,or cough.Although both surgical and medical treatments have been utilized,the optimal therapeutic approach to SGS in patients with WG has not been determined.So far,a case of WG with SGS has not been reported in Korea.Recently,we experienced a case of 59-year-old woman with SGS in WG.She responded to prednisolone and methotrexate therapy and did not require surgical intervention.So we report this case with a review of literatures.
Constriction, Pathologic* ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Inflammation ; Methotrexate ; Middle Aged ; Prednisolone ; Vasculitis ; Wegener Granulomatosis*

Background: Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method: The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 to April 1996. The following results were obtained. Results: 1) Total 201 patienls(19.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146, and the male to female ratio was 1: 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%, cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5%, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous stenosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, branchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB stain positive in 36.4%, granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%, and non diagnostic biopsy finding in 14.1%. Conclusions: Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.
Age Distribution ; Antitussive Agents ; Asthma ; Biopsy ; Bronchoscopy ; Classification ; Constriction, Pathologic ; Cough ; Diagnosis, Differential ; Drug Therapy ; Dyspnea ; Edema ; Erythema ; Female ; Fever ; Granuloma ; Hemoptysis ; Humans ; Inflammation ; Male ; Pleural Effusion ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Medicine ; Respiratory Sounds ; Retrospective Studies* ; Sputum ; Steroids ; Thorax ; Trees ; Tuberculosis* ; Ulcer

Background: Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method: The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 to April 1996. The following results were obtained. Results: 1) Total 201 patienls(19.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146, and the male to female ratio was 1: 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%, cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5%, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous stenosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, branchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB stain positive in 36.4%, granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%, and non diagnostic biopsy finding in 14.1%. Conclusions: Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.
Age Distribution ; Antitussive Agents ; Asthma ; Biopsy ; Bronchoscopy ; Classification ; Constriction, Pathologic ; Cough ; Diagnosis, Differential ; Drug Therapy ; Dyspnea ; Edema ; Erythema ; Female ; Fever ; Granuloma ; Hemoptysis ; Humans ; Inflammation ; Male ; Pleural Effusion ; Pneumonia ; Pulmonary Atelectasis ; Pulmonary Medicine ; Respiratory Sounds ; Retrospective Studies* ; Sputum ; Steroids ; Thorax ; Trees ; Tuberculosis* ; Ulcer

BACKGROUND: Residual pleural thickening(RPT) develops in about 50% of tuberculous pleurisy(PLTB). Some reports have suggested that elevated TNF-α and impaired fibrinolysis could be the cause of RPT, but until now, the mechanism and predictors of RPT have not been well known. TGF-β has been known to promote fibrogenesis and is increased in tuberculous pleural fluid(PF). PLTB and malignant pleurisy(PLMAL) manifest lymphocyte-dominant exudative pleural effusion, and it has clinical implications in the differentiation of the two diseases, based on the findings of pleural effusion. We performed this study to compare pleural fluid TNF-α, TGF-β, and fibrinolytic parameters between PLTB and PLMAL, and to find the predictors of RPT in PLTB. METHODS: Thirty-five PLTB and 14 PLMAL patients who were admitted to the Asan Medical Center from February 1997 to August 1999 were enrolled. All PLTB patients were prescribed a primary, short-course, anti-tuberculosis regimen. TNF-α, tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), plasminogen, α2-antiplasmin, and D-dimer were measured in both PF and PB, TGF-β was measured only in PF. Clinical characteristics, TNF-α, TGF-β, and fibrinolytic parameters were compared between patients with RPT less than 2 mm and patients with more than 2 mm of the thirty patients who completed the anti-tuberculosis treatment. RESULTS: The levels of TNF-α, tPA, PAI-1, plasminogen, α2-antiplasmin, and D-dimer in PF were higher than those in peripheral blood (PB) in PLTB, whereas only plasminogen, α2-antiplasmin, and D-dimer were higher in PF than in PB in PLMAL. Pleural fluid TNF-α, TGF-β, PAI-1, plasminogen, α2-antiplasmin were increased in PLTB compared with PLMAL, but these factors did not show any further advantages over ADA in differentiation between PLTB and PLMAL. TNF-α, TGF-β, and fibrinolytic parameters did not show any differences between patients with RPT less than 2 mm and patients with RPT more than 2 mm. CONCLUSION: Our data suggest that TNF-α, TGF-β, and fibrinolytic parameters may play some role for the development of RPT in PLTB, but they failed to predict the occurrence of RPT in PLTB. Also these parameters did not seem to have any advantages over ADA in differentiating between two diseases.
Chungcheongnam-do ; Fibrinolysis ; Humans ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Pleural Effusion ; Pleural Effusion, Malignant* ; Tissue Plasminogen Activator ; Transforming Growth Factor beta* ; Tuberculosis, Pleural ; Tumor Necrosis Factor-alpha*

The successful treatment of community-acquired pneumonia requires appropriate, empirical antimicrobial therapy. The etiology and antimicrobial susceptibility of major pneumonia pathogens can differ by country. Therefore, the ideal treatment guidelines for community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia for immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.
Adult ; Anti-Bacterial Agents ; Communicable Diseases ; Humans ; Joints ; Korea ; Pneumonia ; Tuberculosis