Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

This study was conducted to evaluate the health hazards and to develop diagnostic methods of glass fiber workers. We examined 40 male glass fiber workers (exposure group) and 57 male non-glass fiber workers (reference group) with a questionnaire, physical examination, chest x-ray and pathological examination in Mar, 1997. Also we examined 65 male glass fiber workers (exposure group) and 42 male non-glass fiber workers (reference group) with the same methods also we did some energy-dispersive x-ray analyses with a scanning electron microscopic examination in Sep. 1997. Most of the clinical symptoms were significantly more frequent among the exposure group than the reference group. Coughing (32.5%), itching of the nose (30.0%), irritation of eyes (27.5%), irritation of the nose (25.0%) and sputum (22.5%) were the major symptoms among the exposure group in Mar. 1997. Only itching of the nose was significantly more frequent in Sep. 1997. No cases of pneumoconiosis were observed among the groups and there were no differences in chest abnormalities between the exposure group with the reference group on both examinations. The prevalence of dermatosis among the exposure group was 20.0% (8 cases) and the cumulative prevalence was 72.5% (29 cases) in Mar. 1997. The prevalence of dermatosis among the exposure group was 23.1% (15 cases) and the cumulative prevalence was 58.5% (38 cases) in Sep. 1997. Onset of dermatosis among the exposure group was most frequent within one month after handling. The frequent sites of skin lesions were the hands and arms on both examinations. Glass fiber induced skin lesions can be diagnosed by the scotch tape method or KOH mount and then can be examined under the light, polarizing and phase-contrast microcopies. Glass fibers can be identified by some energy-dispersive x-ray analyses with a scanning electron microscopic examination.
Arm ; Cough ; Glass* ; Hand ; Humans ; Male ; Nose ; Physical Examination ; Pneumoconiosis ; Prevalence ; Pruritus ; Questionnaires ; Skin ; Skin Diseases ; Sputum ; Thorax

BACKGROUND: Oropharyngeal manipulation is problematic when patients have a gag reflex. Sedation can suppress gag reflex, but can cause serious airway problems. We compared remifentanil (Group R) and propofol (Group P) in terms of cooperation and loss of gag reflex, while drugs were administered incrementally using target controlled infusion (TCI). METHODS: Fifty seven patients who required awake fiberoptic intubation were randomized to Group R or Group P. After measurement of baseline gag trigger point index (GTPI), TCI was set to effect-site concentration (Ce) of 1 ng/ml (Group R) or 1 microg/ml (Group P), then titrated by 0.5 increment until GTPI score reached 0. The incidence of drop-out and decreased cooperation, Ramsay sedation scale (RSS) and Ce at loss of GR, and complications were assessed. RESULTS: Seven patients were dropped out in Group P due to deep sedation and disobedient behavior, but none in Group R (P = 0.015). Gag reflex suppressed as RSS increased in both groups (P < 0.001), however, the incidence of elimination of gag reflex clustered at RSS 2 in Group R (P < 0.001), whereas it was evenly distributed in Group P (P = 0.20). The incidence of patients who were spontaneously roused (gag reflex elimination at RSS 1 and 2) were higher in Group R than in Group P (P = 0.002). CONCLUSIONS: Deep sedation and impaired cooperation were observed only in Group P and spontaneously roused patients were higher in Group R, suggesting that remifentanil is more suitable for cooperative elimination of GR.
Conscious Sedation ; Deep Sedation ; Humans ; Incidence ; Intubation ; Piperidines ; Propofol ; Reflex ; Trigger Points

BACKGROUND: The aim of this study was to investigate the influence of epidural clonidine on the BIS, and its potential dose-sparing effect on the sevoflurane requirement for maintaining the BIS 50. METHODS: Forty ASA I or II patients aged 20 to 65, undergoing lower abdominal, gynecologic surgery under general anesthesia, were randomly allocated to either a 10 ml epidural normal saline injection group (n = 20) or a 10 ml epidural clonidine 3microgram/kg mixed with normal saline injection group (n = 20). They received 5 mg/kg thiopental sodium and 0.1 mg/kg vecuronium bromide for induction, with no premedication. After surgical incision, the sevoflurane concentration was controlled to maintain the BIS 50. Epidural saline or clonidine was then injected and end-tidal sevoflurane concentration to maintain the BIS 50, the heart rate (HR) and mean arterial pressure (MBP) were measured every 5 min over a 20 minute period. RESULTS: The end-tidal sevoflurane concentration in the clonidine group decreased by 27.5% after the epidural clonidine injection (1.49 +/- 0.23 vol% vs. 1.08 +/- 0.27 vol%; P<0.05) compared with the saline group (1.36 +/- 0.18 vol% vs. 1.33 +/- 0.21 vol%; P>0.05). There were no changes in the heart rate and mean blood pressure in either group. CONCLUSIONS: Epidural clonidine causes a significant decrease in the BIS, and lowers the end-tidal sevoflurane concentration required for maintaining the BIS 50.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Clonidine* ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Humans ; Premedication ; Thiopental ; Vecuronium Bromide

OBJECTIVE: To investigate the group differences in contents of subjective memory problem and objective cognitive functions in late life depression and mild cognitive impairment. METHODS: 40 participants were classified into three groups [normal, amnestic mild cognitive impairment (MCI), and depression]. Differences in subjective memory complaints were examined using the Prospective and Retrospective Memory Questionnaire. And the Consortium to Establish a Registry for Alzheimer's Disease-Korean version neuropsychological assessment battery results were used for evaluating objective cognitive functions. Group differences were analyzed ANCOVA analysis. RESULTS: In post-hoc analysis, the questions "Do you fail to recognize a character in a radio or television show from scene to scene?" and "Do you forget something that you told a few minute before?" were significantly able to discriminate between the MCI and normal groups. In post-hoc analysis, late life depression group showed significantly higher score on the question "Do you intend to take something with you, before leaving a room or going out, but minutes later leave it behind, even though it's there in front of you?". CONCLUSION: The result demonstrates the presence of differences in the contents of subjective memory complaints according to groups. Subjectively reported memory complaints in MCI group are related to deficits in learning new information. In late life depression, memory complaints are more related to difficulty in executive functions.
Depression* ; Executive Function ; Learning ; Memory* ; Mild Cognitive Impairment* ; Neuropsychological Tests ; Prospective Studies ; Surveys and Questionnaires ; Retrospective Studies ; Self Report ; Television

Pulmonary alveolar proteinosis is characterized by the remittent or progressive accumulation of lipid-rich proteinaceous material within the alveolar sacs in the absence of inflammatory response. Whole-lung lavage is the only consistent treatment for pulmonary alveolar proteinosis. We have utilized whole-lung lavage for the successful treatment of a 62 year-old female patient with pulmonary alveolar proteinosis. There was no persistent complication during the procedure and the postanesthetic recovery except temporary fever and hypoxic event. The patient was symptomatically, physiologically, and radiologically improved within days after the procedures.
Female ; Fever ; Humans ; Middle Aged ; Pulmonary Alveolar Proteinosis* ; Therapeutic Irrigation*

PURPOSE: To compare functional MR imaging of the motor cortex during active and passive movement. MATERIALS AND METHODS: Seven healthy, right-handed volunteers (M:F=6:1; age:25-30 years) were included in this study. A 1.5-T whole body scanner and the multislice EPI BOLD method were used. The motor paradigm was flexion-extension of a thumb against rest. In the active motion task, the thumb was flexed voluntarily once a second, while in the passive task, it was tied with a thread and pulled to flex and extend passively at the same interval and with the same intensity as in the active task. For image postprocessing, an SPM 96 program was used. The sites, numbers, and signal intensity of the activated pixels were determined, and the threshold for significance was set at p<0.001 to p<0.01. RESULTS: In the active motion task, strong activation at the contralateral side of the primary sensorimotor cortex and supplementary motor cortex occurred in all 14 examples in all seven volunteers. Additionally, the ipsilateral primary sensorimotor cortex and supplementary motor area were activated in 12/14 and 11/14 such tasks, respectively. During passive motion tasks, on the other hand, weak activation occurred at the contralateral side of the primary sensorimotor cortex in all cases, but in the contralateral supplementary motor cortex in only three. In the ipsilateral primary sensorimotor cortex and supplementary motor area, there was no activation. CONCLUSION: Compared with the active motion task, activation occurring in the contralateral primary sensorimotor cortex and supplementary cortex was weaker and less frequent during the passive task, and during this latter, the ipsilateral motor cortex remained inactive. These results may be useful for the clinical application of functional MR imaging in unconscious patients or in animal studies.
Animals ; Hand ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex* ; Thumb ; Volunteers

BACKGROUND/AIMS: The treatment strategy for hepatitis C virus (HCV) has been changing rapidly since the introduction of direct-acting antivirals such as daclatasvir (DCV) and asunaprevir (ASV). We evaluated the efficacy and safety of DCV and ASV for HCV in real-life practice. METHODS: Patients were treated with 60 mg of DCV once daily plus 200 mg of ASV twice daily for 24 weeks, and followed for 12 weeks. The primary endpoint was a sustained virological response at 12 weeks after treatment (SVR12) and safety. RESULTS: This retrospective study included eight patients with chronic HCV genotype 1b infection. All of the enrolled patients were diagnosed with liver cirrhosis, and their mean age was 65.75 years. One patient was a nonresponder and two patients relapsed with previous pegylated interferon (PegIFN) and ribavirin (RBV) treatment. None of the patient showed NS5A mutation. An SVR12 was achieved in 88% of cases by the DCV and ASV combination therapy. The serum transaminase level and the aspartate-aminotransferase-to-platelet ratio were improved after the treatment. DCV and ASV were well tolerated in most of the patients, with treatment discontinuation due to adverse events (elevated liver enzyme and decompensation) occurring in two patients. CONCLUSIONS: In this study, combination of DCV and ASV treatment achieved a high sustained virological response with few adverse events even in those with cirrhosis, advanced age, and nonresponse/relapse to previous interferon-based therapy. Close monitoring of safety issues may be necessary when treating chronic HCV patients receiving DCV and ASV, especially in older patient and those with cirrhosis.
Aged ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; Aspartate Aminotransferases/blood ; Drug Administration Schedule ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/*genetics/isolation & purification ; Hepatitis C, Chronic/complications/*drug therapy/virology ; Humans ; Imidazoles/*therapeutic use ; Isoquinolines/*therapeutic use ; Liver/diagnostic imaging ; Liver Cirrhosis/complications ; Male ; Middle Aged ; RNA, Viral/blood ; Retrospective Studies ; Sulfonamides/*therapeutic use ; Treatment Outcome

We found an error in our published article. Figure 2 should be corrected.

Pyogenic sacroiliitis is a rare osteoarticular infection, occurring most frequently in children and young adults. Diagnosis of the disease is challenging because of a general lack of awareness of the disease and its nonspecific signs and symptoms. Staphylococcus aureus is the most common causative bacteria in pyogenic sacroiliitis. Methicillin-resistant S. aureus (MRSA) has typically been considered a hospital-associated pathogen; however, community-acquired (CA)-MRSA infections are becoming increasingly common in Korea. We report the first domestic case of acute pyogenic sacroiliitis with abscess and bacteremia caused by CA-MRSA. The pathogen carried the type IV-A staphylococcal cassette chromosome mec (SCCmec) without the Panton-Valentine leukocidin (PVL) gene, and was identified as sequence type (ST) 72 by multilocus sequence typing.
Abscess ; Bacteremia* ; Bacteria ; Child ; Community-Acquired Infections ; Diagnosis ; Humans ; Korea ; Leukocidins ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Multilocus Sequence Typing ; Sacroiliitis* ; Staphylococcus aureus ; Young Adult