PURPOSE: We compared the outcomes of percutaneous transthoracic needle aspiration biopsy (PCNA) of lung masses in cases with and without prior positron emission tomography/computed tomography (PET/CT) information, and investigated the factors associated with false-negative pathological results. MATERIALS AND METHODS: From a total of 291 patients, 161 underwent PCNA without prior PET/CT imaging, while 130 underwent PET/CT before PCNA. Clinical characteristics, procedural variables, pathological results, and diagnostic success rates were compared between the 2 groups. Among patients with initial negative (non-specific benign) PCNA results, the radiological findings of these groups were compared to evaluate the predictors of false-negative lesions. RESULTS: No significant difference was found in the clinical characteristics, procedural characteristics, and pathological results of the 2 groups, nor was the diagnostic rate significantly different between them (p = 0.818). Among patients with initial negative PCNA results, radiological characteristics were similar in both the groups. In multivariate analysis, the presence of necrosis (p = 0.005) and ground-glass opacity (GGO) (p = 0.011) were the significant characteristics that indicated an increased probability of initial false-negative results in PCNA. CONCLUSION Routine PET/CT did not have any additional benefit in patients undergoing PCNA of lung masses. The presence of necrosis or GGO could indicate an increased probability of false-negative pathological results.

Sweet syndrome is an unusual disease characterized by the sudden onset of fever, leukocytosis, and painful erythematous plaques, and the dermal infiltration of neutrophils at the site of skin lesions. Although Sweet syndrome can also present with extra-cutaneous manifestations, involvement of the central nervous system (CNS) is rarely reported. We describe a case of Sweet syndrome involving the CNS in a 46-year-old male with a disturbance of consciousness following fever and erythematous skin plaques in the extremities. Cerebrospinal fluid examination disclosed neutrophilic pleocytosis without decreased glucose and protein levels. HLA typing showed B54, which is frequently seen in Sweet syndrome. Brain magnetic resonance imaging showed abnormal signal intensity lesions in the left temporal lobe. Skin biopsy revealed a dense dermal infiltration of neutrophils, which is compatible with Sweet syndrome. The confused mentality, fever, and erythematous skin plaques resolved after the administration of systemic corticosteroids.
Biopsy ; Brain ; Central Nervous System ; Consciousness ; Extremities ; Fever ; Glucose ; Histocompatibility Testing ; Humans ; Leukocytosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neutrophils ; Skin ; Sweet Syndrome ; Temporal Lobe

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo

Cryptococcus albidus, a non-neoformans species of the genus Cryptococcus, is generally regarded as a rare cause of disease. There have been only 14 previously reported cases in which this organism has been isolated as a pathogen, none of which occurred in a renal transplant recipient. A 23-year-old renal transplant recipient taking medication consisting of cyclosporine and prednisolone was admitted with a 10-day history of dry cough, fever and progressive dyspnea. The next day, his respiratory status deteriorated dramatically, and he developed acute respiratory distress syndrome (ARDS) and fulminant septic shock. On the eighth hospital day, tender macules on both his shins coalesced to form erythematous patches. Cryptococcus albidus was isolated by skin biopsy and tissue culture. We report here the first case of disseminated cryptococcosis caused by C. albidus in a renal transplant recipient who had been successfully treated with fluconazole monotherapy.
Adult ; Antifungal Agents/*therapeutic use ; Cryptococcosis/diagnosis/drug therapy/*microbiology ; Cyclosporine/adverse effects ; Diagnosis, Differential ; Fluconazole/*therapeutic use ; Graft Rejection/prevention & control ; Human ; Immunocompromised Host ; Immunosuppressive Agents/adverse effects ; *Kidney Transplantation ; Lung Diseases, Fungal/diagnosis/drug therapy/*microbiology ; Male ; Opportunistic Infections/diagnosis/*microbiology ; Tomography, X-Ray Computed

Turcot's syndrome is a rare hereditary disease marked by the association of central nervous system neuroepithelial tumor with colonic polyposis. Authors report herein a case of a 15-year-old girl diagnosed as having Turcot's syndrome, otherwise known as brain tumor-polyposis syndrome, combined with sigmoid colon cancer. The patient was carried out craniostomy and brain tumor removal. The tumor was confirmed histologically to be oligodendroglioma. The patient visited the department of internal medicine for bloody diarrhea during 6 months. Colonoscopy and biopsy was done. The patient was diagnosed as having Turcot's syndrome combined with sigmoid colon cancer, and was then transferred to the department of surgery for treatment of sigmoid colon cancer. Total proctocolectomy and IPAA (ileal pouch-anal anastomosis) was carried out. Multiple polyps were found in the colon, two large masses were confirmed histologically to be adenocarcinoma. The remaining polyps were adenomas. This case report describes the characteristic features of Turcot's syndrome presented by this patient.
Adenocarcinoma ; Adenoma ; Adolescent* ; Biopsy ; Brain ; Brain Neoplasms ; Central Nervous System ; Colon* ; Colonic Neoplasms* ; Colonoscopy ; Diarrhea ; Female* ; Genetic Diseases, Inborn ; Humans ; Internal Medicine ; Neoplasms, Neuroepithelial ; Oligodendroglioma ; Polyps ; Sigmoid Neoplasms

Spindle cell carcinoma of the esophagus containing both carcinomatous and sarcomatous elements is rare, accounting for approximately 1- 2% of all esophageal neoplasms. Terms used to describe this lesion include carcinosarcoma, pseudosarcoma, polypoid carcinoma, pseudosarcomatous squamous cell carcinoma and spindle cell variant of squamous cell carcinoma. Spindle cell carcinomas were originally classified as carcinosarcomas or pseu- dosarcomas, depending on the morphology and bilologic behavior of the particular lesian. However, pseudosarcoma and carcinosarcoma appear to be the same pathologic entity with varying degrees of anaplastic spindle cell metaplasia of the carcinomatous portion of the tumor. Thus, these lesions have been clsssified together as spindle cell carcinomas. A 59 year-old man who experienced weight loss for 4 months was hospitalized as a result of suffering from dysphagia for 2 months. A diffuse bulky protruding mass with superficial ulceration and easy friability on 25 to 35 cm from the incisors, which invaded the right intermediate bronchus and involved the right paratracheal and subcarnial lymph nodes, were obsetved in esophagogram, endoscopy and chest CT. Pathologic finding, including immunoreactivity to cytokeratin and vimentin, was consistent with spindle cell carcinoma. We report a case of spindle cell carcinoma of the esophagus.
Bronchi ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms ; Esophagus* ; Humans ; Incisor ; Keratins ; Lymph Nodes ; Metaplasia ; Middle Aged ; Tomography, X-Ray Computed ; Ulcer ; Vimentin ; Weight Loss

Esophagea1 achalasia is a disease of unkown etiology characterized by abscenee of peristalsis in the body of the esophagus and failure of the lower esaphageal sphincter to relax in response to swallow. The cause has been suggested by the lack or abscence of ganglion cell in Auerbach's plexus. About 10% of patients with achalasis develop pulmonary complication such as aspiration pnuemonia, pulmonary fibrosis, pulmonary tuberculosis, culosis, bronchiectasis, lung abscess and bronchial asthma. Although aspiration pneumonia is the most common pulmonary complication in patients with achalasia, lung abscess is the extremely rare complication. A 48 years old female, who has experienced dysphagia and regurgitation for several years, is hospitalized because of high fever, cough and sputurn for 2 weeks. Lung abscess in apicoposterior segment of left upper lobe is observed in X-ray and chest CT. The findings of esophagogram, esophagogastroscopy and esophageal manometry are consistent with achalasia. We report a case of lung abscess associated with achalasia.
Asthma ; Bronchiectasis ; Cough ; Deglutition Disorders ; Esophageal Achalasia* ; Esophagus ; Female ; Fever ; Ganglion Cysts ; Humans ; Lung Abscess* ; Lung* ; Manometry ; Middle Aged ; Myenteric Plexus ; Peristalsis ; Pneumonia, Aspiration ; Pulmonary Fibrosis ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

The relationship between occupation and risk of lung cancer was analyzed in hospital based case-control study conducted in Taegu on 168 patients with histologicatly confirmed lung cancer and age group (30-39, 40-49, etc) and sex frequency-matched 168 controls admitted into hospitals for other internal medicine problems. A self administered questionnaire was used to obtain occupation, resident environment, smoking histories and specific agent exposure histoy. The conditional logistic regression was used to estimate odds ratio for age group and sex frequency matched, after controlling for smoking status (non smoker, exsmoker, current smoker) Significant association was observed for farmer[odds ratio(OR), 1.84 , 95% confidence interval(CI), 1.16-2.94], briquette stove users(OR, 3.0 , 95% CI, 1.06-8.25), agricultural chemicals users[0R, 2.14 , 95% CI, 1.35-3.37], and welding/fume exposures[0R, 10.56 ;95% CI, 1.07~103.90]. Although there were elevated risks associated with production, home industry, transportation/storage/communication, lodgement/food worker and construction, none were statistically significant.The effect of smoking was showed significantly increased risk for exsmoker [0R, 4.50 ,95% CI, 1.99-10.16] and current smoker [OR, 3.98 , 95% Cl, 1.88-8.45] As results, although smoking is important risk of lung cancer, occupation and resident environment are showing association of lung cancer. So further evaluation is necessary for occupation risk and take preventive measures.
Agrochemicals ; Case-Control Studies ; Daegu ; Humans ; Internal Medicine ; Logistic Models ; Lung Neoplasms* ; Lung* ; Occupations ; Odds Ratio ; Questionnaires ; Smoke ; Smoking

Peripheral arterial disease(PAD) is a major health problem in the elderly population, so prevalence of PAD is investigated using Edinburgh claudication questionnaire. Subjects were over 65 years old in the kyeongsan county. The prevalence of PAD was 9.0% in total population(8.5% in men, 9.3% in women). definite claudication was 3.9%, atypical claudication was 5.l%. and, grade 1 was 4.4%, grade 2 was 4.6%. The prevalence of PAD was increased with age but not statistically significant. There was no difference of PAD by gender and smoking. PAD was significantly associated with systolic blood pressure positively. But, unexpectedly, PAD was significantly associated with BMl negatively. PAD are important elderly health problem in the our country. so the etiology and preventive methods of PAD will be researched on our country population.
Aged* ; Blood Pressure ; Humans ; Male ; Prevalence* ; Surveys and Questionnaires* ; Rural Population* ; Smoke ; Smoking