No abstract available.
Korea* ; Prevalence*

Several techniques are now avallable for the treatment of fractuers of the shaft of the femur. We must be aware of the advantages, disadvantages and Ilmitation of each if we are to select the proper treatment for each patient. During last decades treatment had been varied markedly from time to time and from place to place. Before Word War II, most fractures of the femoral shaft were treated conservatively either by skeletal traction or by manipulation and immobilization in a spica cast. After medullary fixation was Introduced during that war, it became popular, and until 1960 many surgeons considered it as the treatment of choice for most of these fractures. If the case is properly selected the medullary fixation is almost perfect, provlded no complications develop; convalescence can be shortened and resldual disability can be decreased. We had experienced 14 complications among the 78 cases of Kuntscher nailing from may, 1974, to May, 1980. The results are as follows: 1. We operated 78 cases with Kuntscher nail among the 121 femoral shaft fractures. 2. 14 (17.95%) complications developed among the 78 cases of the Kuntscher nailing. 3. Technical errors were incarcerated nailing with thick nail, too long nail and thin nailing. 4. Early postoperative complications within a year were infection, bendlng, bursitis, angulation and rotation. 5. Late complications after one year were proximal or distal migration and refracture.
Bursitis ; Convalescence ; Femur ; Humans ; Immobilization ; Postoperative Complications ; Surgeons ; Traction

No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Korea* ; Prevalence*

No abstract available.
Hepatitis E virus* ; Hepatitis E* ; Hepatitis* ; Korea* ; Prevalence*

A paragonimiasis infestation is caused by the paragonimus species. It is commonly found in the lung but has also been found to exist extrapulmonary infestations including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, and gynecologic infestation. On the other hand, a cutaneous infestation is extremely rare. Human infestation is caused by ingesting raw or undercooked intermediate hosts. Because paragonimus westermani larva mature to an adult worm in the lung, the possibility of identifying the adult worm of paragonimus westermani at extrapulmonary region is very rare. CASE: After ingesting a fresh-water crab 1 month prior to the hospital visit, a 45-year old female patient was suffering from right pleuritic chest pain during that 1 month. The patient also complained of a palpable mass that was movable and migrating, and it was localized at the right upper quadrant of the abdomen. The eosinophil fraction of the white blood cell of peripheral blood and pleural fluid was elevated to 55.1% and 90%, respectively. Parasite eggs were not found in her sputum and stool examination. By using the enzyme-linked immunosorbent assay (ELISA), the paragonimus-specific IgG antibody titer was elevated to 0.28. During incisional biopsy, we were able to find the young adult worm of paragonimus westermani. We experienced the rare case of ectopic paragonimiasis with pleural effusion that was confirmed by identifying the adult worm of paragonimus westermani within the abdominal subcutaneous tissue. We report a case with brief literature reviews.
Abdomen ; Adult ; Biopsy ; Chest Pain ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Female ; Hand ; Humans ; Immunoglobulin G ; Larva ; Leukocytes ; Lung ; Middle Aged ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasites ; Pleural Effusion* ; Sputum ; Subcutaneous Tissue* ; Young Adult

Benign Tracheobroncheal tumor is a rare disease such as 1.9% of all tumor of pulmonary origin. Because clinical manifestation of benign tracheal tumor resembles that of broncheal asthma, these patients are usually treated in a way that used in broncheal asthma. Therefore, the diagnosis is delayed. We experienced a case of tracheal neurilemmoma that awed by bronchoscopic laser therapy. A 23-year-old woman visited ow hospital be cause of progressing dyspnea especially during inspiration. She was treated with aminophylline and 2 agonist under the impression of bronchial asthma at a local clinic. But because the symptoms were not relieved and pulmonary function test revealed variable extrathoracic lesion, we conducted bronclxaopy and biopsy. There were 1.5 x 2cm sized movable mass with stalk attached right anterior wall of bronchus. The biopsy result was neurilemmoma. Therefore we conducted bronchoscopic Laser therapy four times and the lesion disappeared in bronchosccpy and chest CT.
Aminophylline ; Asthma ; Biopsy ; Bronchi ; Diagnosis ; Dyspnea ; Female ; Humans ; Laser Therapy* ; Neurilemmoma* ; Rare Diseases ; Respiratory Function Tests ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: Moxifloxacin is a newly developed drug which is more potent and safe compared to previous fluoroquinolones. This drug effectively eradicates organisms such as beta-lactamase-producing or other resistant bacteria. Moxifloxacin is known to be effective in treating respiratory infections such as Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Chlamydia pneumoniae, Legionella spp. and Mycoplasma pneumoniae. METHODS: In a multicenter, randomized, open, comparative study, the efficacy and safety of oral moxifloxacin taken 400 mg once a day and clarithromycin taken 500 mg twice daily for 7 days were compared for the treatment of Korean patients with acute exacerbations of chronic bronchitis. RESULTS: A total of 170 patients were enrolled, and they were divided into two groups:87 in the moxifloxacin group and 83 in the clarithromycin group. Of those enrolled, 76 (35 for bacteriologic efficacy) in the moxifloxacin group and 77 (31 for bacteriologic efficacy) in the clarithromycin group were included in the efficacy analysis. All were included in the safety analysis. Clinical success was noted in 70 (92.1%) of 76 moxifloxacin-treated patients and 71 (92.2%) of 77 clarithromycin-treated patients. Bacteriologic success rate seemed to be higher in moxifloxacin group (73.5%) than in clarithromycin group (54.8%), but statistically insignificant (p=0.098). Drug susceptibility among organisms initially isolated was higher in moxifloxacin group on Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae(p<0.001). Adverse events were reported by 12.8% of 86 patients receiving moxifloxacin and 21.7% of 83 patients receiveing clarithromycin. Headache (4.7% vs 4.8%, moxiflosacin group vs clarithromycin group, respectively) and indigestion (2.3% vs 6.0%, moxifloxacin group vs clarithromycin group, respectively) were the most frequent side effects in the two groups. CONCLUSION: This study demonstrated that for the treatment of acute exacerbations of chronic bronchitis a 7-days course of moxifloxacin 400 mg od was clinically equivalent and microbiologically superior to clarithromycin 500 mg bid.
Bacteria ; Bronchitis, Chronic* ; Chlamydophila pneumoniae ; Clarithromycin* ; Dyspepsia ; Fluoroquinolones ; Haemophilus influenzae ; Headache ; Humans ; Klebsiella ; Legionella ; Moraxella (Branhamella) catarrhalis ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; Pseudomonas aeruginosa ; Respiratory Tract Infections ; Streptococcus pneumoniae

BACKGROUND: Interleukin-12 (IL-12) can induce antitumor effects in vivo. This antitumor effect is associated with T cell infiltration but the effect of IL-12 on the steps of T cell migration into the tumor tissue has not been fully elucidated. This study focused on the effect of IL-12 on the tumor growth and the metastasis and on the expression of E-selectin, an adhesion molecule which is activated endothelial specific in its expression. In addition, we studied whether the expression of E-selectin is associated with the TNF-alpha, a cytokine that its production is increased by IL-12 and has functions inducing a variety of adhesion molecules. METHODS: Mice of C57BL/6 strain were injected with Lewis lung cancer cells followed by either IL-12, TNF-alpha, or normal saline by intraperitoneal route. Twenty eight days after tumor cell inoculation, metastatic nodules of lung were enumerated and immunohistochemical staining of the subcutaneous tumors were performed with monoclonal antibodies to CD4, CD8, CD16, and E-selectin. RESULTS: In IL-12 treated mice, the subcutaneously implanted Lewis lung tumors were decreased in size and the metastases were also decreased in number compared to control mice. On tumor tissues, increased infiltration of CD4+, CD8+, and CD16+ cells were observed in IL-12 treated mice compared to control mice. In control mice, E-selectin was absent on tumor vessels, but the expression of E-selectin was increased on tumor vessels of IL-12 treated mice. Administration of TNF-alpha increased not only the expression of E-selectin but also infiltrations of CD4+, CD8+, and CD16+ cells on tumor tissues. CONCLUSIONS: These results demonstrate that IL-12 inhibits tumor growth and metastases through infiltrations of inflammatory cells in mouse model of Lewis lung carcinoma and E-selectin may play a role in inflammatory cell recruitment on tumor tissue following IL-12 administration. Also, TNF-alpha may have a role as a mediator responsible for the IL-12 induced expression of E-selectin.
Animals ; Antibodies, Monoclonal ; Carcinoma, Lewis Lung* ; Cell Movement ; E-Selectin* ; Interleukin-12* ; Lung ; Lung Neoplasms ; Mice* ; Neoplasm Metastasis ; Tumor Necrosis Factor-alpha

BACKGROUND: In acute lung injury, alveolar macrophages play a pivotal role in the inflammatory process during the initiation phase and in the reconstruction and fibrosis process during the later phase. Recently, it is has been proven that alveolar macrophages are constituted by morphologically, biochemically and immunologically heterogenous cell subpopulations. The possibility of alterations to these characteristics of the alveolar macrophage population during lung disease has been raised. To investigate such a possibility a hyperoxic rat lung model was made to check the distributional and morphological changes of rat alveolar macrophage subpopulation in acute hyperoxic lung injury. METHOD: Alveolar macrophage were lavaged from normal and hyperoxic lung injury rats and separated by discontinuous gradients of percoll. After cell counts of each density fraction were accessed the morphomeric analysis of alveolar macrophages was performed on cytocentrifuged preparations by transmission electron micrograph. RESULT: 1. The total alveolar macrophage cell count significantly increased up to 24 hours after hyperoxic challenge (normal control group 171.6+/-24.1x10 5 ,12 hour group 194.8+/-17.9 x10 5 , 24 hour group 207.6+/-27.1x10 5 ,p<0.05). However the 48 hour group (200.0 +/-77.8 x10 5 ) did not show a significant difference. 2. Alveolar septal thickness significantly increased up to 24 hours after hyperoxic challenge (normal control group 0.7+/-0.2mm, 12 hour group 1.5+/-0.4mm, 24 hour group 2.3 +/-0.4mm, p<0.05). However the 48 hour group did not show further change (2.5+/-0.4mm). Number of interstitial macrophage are markedly increased at 24 hour group. 3. Hypodense fraction(fraction 1 and fraction2) of alveolar macrophage showed a significant increase following hyperoxic challenge (b=0.379.b=0.694. p<0.05); however, fraction 3 was rather decreased following the hyperoxic challenge(b=-0.815. p<0.05) (,) and fraction 4 showed an irregular pattern. 4. Electron microscopic observation of alveolar macrophage from each fraction revealed considerable morphologic heterogeneity. Cells of the most dense subfraction(fraction 4) were small, round, and typically highly ruffled with small membrane pseudopods. Cells of the least dense fraction (fraction 1) were large and showed irregular eccentric nucleus and high number of heterogenous inclusions. CONCLUSION: In conclusion, these results suggest that specific hypodense alveolar macrophage subpopulation may play a an important role in the an acute hyperoxic lung injury model. But further study (,)including biochemical and immunological function of these subpopulations(,) is needed.
Acute Lung Injury ; Animals ; Cell Count ; Fibrosis ; Lung Diseases ; Lung Injury* ; Lung* ; Macrophages ; Macrophages, Alveolar* ; Membranes ; Microscopy, Electron ; Population Characteristics ; Rats*

A 34-year-old woman was admitted to the hospital because of recently aggravated right heart failure without angina for 5 months. When she was 25 years old, patch repair with Polytetrafluoroethylene (PTFE) was performed for the secondum type of atrial septal defect (ASD) with moderate pulmonary hypertension. The chest PA, echocardiography and cardiac catheterization at current admission revealed Eisenmenger syndrome without intracardiac shunt. Chest CT scan with contrast revealed markedly dilated pulmonary trunk, both pulmonary arteries and concave disfigurement of the left side of the ascending aorta suggesting extrinsic compression, as well as total occlusion of the ostium of the left main coronary artery that was retrogradly filled with collateral circulation from the right coronary artery. The coronary angiography showed normal right coronary artery and the collaterals that come out from the conus branch to the mid-left anterior descending artery (LAD) and that from distal right coronary artery to the left circumflex artery (LCX) and to the distal LAD, respectively. On aortography, the left main coronary artery was not visualized with no stump, suggestive of total occlusion of the ostium of the left main coronary artery. From our experience, it is possible to say that the occlusion of the ostium of the left main coronary can be induced by the dilated pulmonary artery trunk due to ASD with pulmonary hypertension and that, if the ASD closure was too late, the narrowing or obstruction of the left coronary artery could not be resolved even after operation owing to irreversible pulmonary hypertension.
Adult ; Case Report ; Constriction, Pathologic/etiology/radiography ; Coronary Disease/*etiology/radiography ; Dilatation, Pathologic/etiology ; Eisenmenger Complex/diagnosis ; Female ; Heart Septal Defects, Atrial/*complications ; Human ; Hypertension, Pulmonary/*complications ; *Pulmonary Artery/radiography