No abstract available.
Adult* ; Humans

No abstract available.
Adult* ; Humans

The pubic louse, Pthirus pubis is a blood-sucking ectoparasite adapted to hold onto pubic, axillary and body hairs. It is usually confined to the pubic and inguinal region. However, it may also rarely involve the scalp and eyelashes. We report two cases of phthiriasis occurring on unusual sites, the first case occurring on the scalp of a 5 month-old male infant, and the second case on the eyelashes of a 49-year-old fe-male.
Eyelashes ; Hair ; Humans ; Infant ; Male ; Middle Aged ; Phthiraptera ; Scalp

We report a case of ruptured mycotic aneurysm involving innominate artery requiring an urgent surgical treatment. A 62-yr-old woman presented with fever and dyspnea. Previously, she was diagnosed with colon cancer and received right hemicolectomy and one cycle of adjuvant chemotherapy. On echocardiogram, pericardial effusion was noted and emergency pericardiocentesis was performed. CT scan revealed aortic aneurysm involving ascending aorta and innominate artery, and thrombi surrounding those structures. Patch repair of the defect in the ascending aorta and ringed Goretex graft to bypass the innominate and ascending aorta were performed. We believe that this is the first case of ruptured mycotic aneurysm involving innominate artery.
Aneurysm, Infected/*surgery ; Aorta/pathology ; Aortic Aneurysm/surgery ; Brachiocephalic Trunk/pathology ; Colonic Neoplasms/drug therapy/surgery ; Female ; Human ; Middle Aged ; Tomography, X-Ray Computed ; Transplants

BACKGROUND: Pulmonary infiltrate in immunocompromised hosts has many infectious and non- infectios etiologies. To evaluate the diagnostic yield and therapeutic implication of two invasive diagnostic methods, such as bronchoscopy and surgical lung biopsy, we performed retrospective analysis of these patients. METHODS: All immunocompromised patients admitted to Samsung Medical Center from October 1995 to August 1998 who underwent bronchoscopy and/or surgical lung biopsy for the diagnosis of pulmonary infiltrates were included in this study. Confirmative diagnostic yield, the rate of changed therapeutic plan and patients' survival were investigated. RESULTS: Seventy-five episodes of pulmonary infiltrates developed in 70 patients(M : F = 46 : 24, median age 51). Underlying diseases of patients were hematologic malignancy(n=30), organ transplantatio n(n=11), solid tumor(n=12), connective tissue disease(n=6) and others. Confirmative diagnosis was made in total 53 cases (70.7%), of which 70.2% had infectious etiology. Diagnostic yields of bronchoscopy, bronchoalveolar lavage(BAL), transbronchial lung biopsy(TBLB) and surgical lung biopsy were 35.0%(21/60), 31.4%(16/51), 25.0%(9/36) and 80.0%(20/25). Therapeutic plan was changed in 40%(24/60) of patients after bronchoscopy and in 36%(9/25) of patients after surgical lung biopsy. More patients survived (84.4% vs 60.5%, p=0.024) when therapeutic plan was changed after invasive diagnostic study. CONCLUSION: Bronchoscopy and surgical lung biopsy are helpful for the therapeutic implication of pulmonary infiltrates in immunocompromised hosts. Large-scale prospective case-control study may further clarify their limitation and usefulness.
Biopsy* ; Bronchoscopy* ; Case-Control Studies ; Connective Tissue ; Diagnosis* ; Humans ; Immunocompromised Host* ; Lung* ; Retrospective Studies

Tracheal tumors are very rare disease, which may cause dyspnea, obstructive pneumonia and life-threatening hypoxemia, depending on the site of the lesion and the severity of the narrowing. Such patients frequently die within hours or days due to suffocation. Patients who expressed upper airway stenosis, should be secured the airways prior to the diagnosis and treatment commonly. Then, treatment plan should be determined. For the relief of such stenosis, various modalities of therapy including surgery, laser photoresection, balloon dilatation and sometimes stent insertion have been used. Tracheobronchial stent insertion has been a good therapeutic option in these patients in point of avoiding morbidities associated with surgery. We report a case of repeated tracheobronchial stenosis by infiltrating tumor mass after metallic stent insertion in a 48-year-old man. The patient was treated successfully by Natural stent insertion with rigid bronchoscopy after removal of previous inserted metallic stent.
Anoxia ; Asphyxia ; Bronchoscopy ; Constriction, Pathologic ; Dilatation ; Dyspnea ; Humans ; Laser Therapy ; Middle Aged ; Pneumonia ; Rare Diseases ; Stents

We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.
Anti-Bacterial Agents ; Biopsy, Fine-Needle ; Bronchi ; Bronchogenic Cyst ; Female ; Follow-Up Studies ; Humans ; Needles ; Pneumonia ; Rupture ; Thorax

BACKGROUND: Until the early 1990's in Korea, treatment outcomes of patients with pulmonary tuberculosis in the private sector were reported to be inferior to those of the public health center under the National Tuberculosis Programme. The purpose of this study was to analyze the clinical characteristics and the treatment efficacy of the patients with pulmonary tuberculosis recently diagnosed at a private general hospital. MATERIALS and METHODS: The study included all pulmonary tuberculosis patients diagnosed at Samsung Medical Center and notified to the public health center from August 2000 to January 2001. RESULTS: Of the 232 patients included in the study during a 6-month period, 188 were (81.0%) initial treatment cases and 44 (19.0%) were re-treatment cases. Eighty-three (35.8%) patients had smear-positive sputa, and 27 (11.6%) had smear-negative, culture-positive sputa. Initial sputum examinations were not performed in 47 (20.3%) patients. A six-month, short-course treatment using isoniazid, rifampin, ethambutol and pyrazinamide was prescribed for 31.4% of the patients under the initial treatment. The success rate (cured plus treatment completed) of the initial treatment for the smear-positive patients was 69.1%. Eleven (13.3%) of the 83 patients with smear-positive pulmonary tuberculosis discontinued their treatment without notice. CONCLUSIONS: To improve the treatment efficacy and decrease the default rates of the patients with pulmonary tuberculosis in the private sector, further efforts are required in line with the Korean Academy of Tuberculosis and Respiratory Disease Treatment Guidelines and in the implementation of an appropriate model of public-private mix for tuberculosis control in Korea.
Diagnosis ; Ethambutol ; Hospitals, General* ; Humans ; Isoniazid ; Korea ; Private Practice ; Private Sector ; Public Health ; Pyrazinamide ; Rifampin ; Sputum ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Pulmonary*

PURPOSE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate and minimally invasive technique used routinely for investigation of mediastinal and hilar lymphadenopathy. However, few studies have addressed its role in comparison to the traditional diagnostic approaches of transbronchial lung biopsy (TBLB), endobronchial biopsy (EBB), and bronchoalveolar lavage (BAL) in the diagnosis of sarcoidosis. We evaluated the usefulness of EBUS-TBNA in the diagnosis of sarcoidosis compared to TBLB, EBB, and BAL. MATERIALS AND METHODS: Consecutive patients with suspected sarcoidosis (stage I and II) on chest radiography and chest computed tomography were included. All 33 patients underwent EBUS-TBNA, TBLB, EBB, and BAL during the same session between July 2009 and June 2011. EBUS-TBNA was performed at 71 lymph node stations. RESULTS: Twenty-nine of 33 patients, were diagnosed with histologically proven sarcoidosis; two patients were compatible with a clinical diagnosis of sarcoidosis during follow-up; and two patients were diagnosed with metastatic carcinoma and reactive lymphadenopathy, respectively. Among 29 patients with histologically proven sarcoidosis in combination with EBUS-TBNA, TBLB, and EBB, only EBUS-TBNA and TBLB revealed noncaseating granuloma in 18 patients and one patient, respectively. The overall diagnostic sensitivities of EBUS-TBNA, TBLB, EBB, and BAL (CD4/CD8 > or =3.5) were 90%, 35%, 6%, and 71%, respectively (p<0.001). The combined diagnostic sensitivity of EBUS-TBNA, TBLB, and EBB was 94%. CONCLUSION: EBUS-TBNA was the most sensitive method for diagnosing stage I and II sarcoidosis compared with conventional bronchoscopic procedures. EBUS-TBNA should be considered first for the histopathologic diagnosis of stage I and II sarcoidosis.
Adult ; Aged ; Biopsy, Fine-Needle/*methods ; Bronchoscopy ; Female ; Humans ; Lymph Nodes/pathology ; Male ; Middle Aged ; Sarcoidosis/*diagnosis/*ultrasonography ; Young Adult

BACKGROUND: Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity(FEV1/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictivepulmonary abnormality. METHODS: Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a FEV1/FVC% that was below 70%, were classified as being abnormal. RESULTS: Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal FEV1/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low FEV1/FVC% and a low FVC showed a restrictive defect. CONCLUSION: Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.
Adult ; Diagnosis ; Forced Expiratory Volume ; Humans ; Lung Volume Measurements ; Plethysmography, Whole Body ; Respiratory Function Tests ; Spirometry* ; Total Lung Capacity ; Vital Capacity