BACKGROUND: The criteria established by Light et al in 1972 have been used widely for the differential diagnosis of the pleural effusions in transudates and exsudates. However, in recent years, several reports have agreed that these criteria misclassified an important number of effusions. For this reason, different parameters have been proposed for differentiation the transudates from exudates. Nevertheless, all these alternative parameters have not been better than the past criteria of Light et al. In response the usefulness of two parameters for differentiation pleural transudate from exudates were evaluated : pleural fluid cholinesterase level and pleural fluid to serum cholinesterase ratio. METHODS: A total of forty-three patient with know causes of the pleura effusion by diagnostic thoracentesis were studied. The following criteria for differentiating the pleural effusions in transudates and exsudates were analyzed : Light's criteria, the pleural fluid cholesterol level, the pleural fluid to serum cholesterol ratio. the pleural fluid cholinesterase level, and the pleural fluid to serum cholinesterase ratio. RESULTS: The conditions of forty-three patients were diagnosed. Ten were classified as having transudates and thirty-three as exudates. The percentage of effusions misclassified by each parameter was as follows : Light's criteria, 9.3% ; pleural fluid cholesterol, 2.3% ; pleural fluid to serum cholesterol ratio, 2.3% ; pleural fluid cholinesterase, 4.7% ; and pleural fluid to serum cholinesterase ratio, 2.3%. CONCLUSIONS: The pleural fluid to serum cholinesterase ratio is one of the accurate criteria for differentiating pleural transudates from exudates. If further studies confirm these results, the cholinesterase ratio could be used as the first step in the evaluation of pleural effusion and if evaluated together with the other criteria, the differentiation of pleural transudate from exsudates will become more accurate.
Cholesterol ; Cholinesterases* ; Diagnosis, Differential* ; Exudates and Transudates* ; Humans ; Pleura ; Pleural Effusion

PURPOSE: In the treatment of breast cancer, neoadjuvant chemotherapy (NAC) is useful to reduce breast cancer size before surgical intervention. Patients who achieve a pathologic complete response (pCR) to NAC have improved overall survival (OS). However, the relationship between prognosis and partial response is yet unclear. In this study, we evaluated prognostic factors and the tumor response ratio (TRR) method among patients who received NAC. METHODS: Clinicopathologic factors were evaluated to predict OS. The TRR was calculated by dividing pathologic tumor size by clinical tumor size. TRRs were then categorized into four groups, and the survival times for the different TRR groups were compared using statistical evaluation. RESULTS: Clinical N stage (p=0.02), overall stage (p=0.04), pathologic N stage (p=0.03), hormone receptor status (p=0.01), and lymphovascular invasion (p=0.02) were significantly associated with OS. Pathologic overall stage and TRR did not correlate with OS. Patients with a pCR exhibited the best survival rates using the current staging system and the TRR method. CONCLUSION: Clinicopathologic factors can be easily applied to predict OS, and clinicians could use these parameters until an accurate, simple, and highly discriminatory methods is developed to assess breast cancer patients with a partial.

Tuberculous uveitis is a rare manifestation of tuberculosis infection. Although early diagnosis is important to saving the sight of patients, it is difficult. In dialysis patient, the diagnosis of tuberculosis is often delayed because of non-specific symptoms and extrapulmonary involvements. We report a case involving a 37-year-old man receiving hemodialysis who was presented with persistent fever and left- sided blurred vision. At ophthalmic examination, active papillitis, vitritis, and peripapillary retinal detachment were observed. Neck computed tomography showed multiple necrotic lymphadenopathies (LAPs) in right lateral neck, which was proven as tuberculous lymphadenitis on histological examination. After anti-tuberculosis therapy, fever was subsided and LAPs were improved. Visual acuity was also improved.
Adult ; Dialysis ; Early Diagnosis ; Fever ; Humans ; Hyperthermia, Induced ; Neck ; Papilledema ; Renal Dialysis ; Retinal Detachment ; Tuberculosis ; Tuberculosis, Lymph Node ; Uveitis ; Vision, Ocular ; Visual Acuity

PURPOSE: Due to controveries surrounding in the incidence of coarctation of aorta which reports previously stated rare among Orientals, we evaluated clinical characteristics, natural courses of coarctation of aorta and effects of different surgical modalities. METHODS: Medical records of 51 patients with coarctation of aorta, diagnosed by 2-dimensional echocardiography in Kyungpook University Hospital Pediatric Cardiac Laboratory from June 1985 to August 1997, were retrospectively reviewed. RESULTS: This study involved 32 male and 19 female patients(male-female ratio 1.7 : 1) aged 12 days to 11 years and 8 months(13 newborns, 32 infants and 6 children over 1 year of age). The coarctation patients consisted of 1.2% of all congenital heart disease patients diagnosed by cross-sectional echocardiography during study periods. Of the accompanying cardiac defects, patent ductus arteriosus(56.9%) and ventricular septal defect(49.0%) were the most common. Congestive heart failure was encountered in 35.3% of patients, weak or absent femoral pulse 80.4%, and higher upper limb blood pressure than lower limb 75.6%. Among the types of coarctation, juxtaductal types accounted for 30 cases(58.8%) and tubular hypoplasias 21 cases(41.2%). Preoperative Doppler gradients through the coarctation were significantly decreased(14.0+/-14.3 mmHg) after 3.7+/-3.5 years follow up. Ages at operation, follow-up periods, and residual Doppler systolic gradients through the coarctation according to different surgical methods did not show significant differences except during follow-up periods. CONCLUSION: It is of utmost importance to palpate the pulses and check the blood pressures of upper and lower extremities in diagnosing coarctation of aorta, and there were no significant prognostic differences among different surgical methods after midterm follow-up periods.
Aortic Coarctation* ; Blood Pressure ; Child ; Echocardiography ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Heart Defects, Congenital ; Heart Failure ; Humans ; Incidence ; Infant ; Infant, Newborn ; Lower Extremity ; Male ; Medical Records ; Retrospective Studies ; Upper Extremity

No abstract available.
Fibroma* ; Fingers*

PURPOSE: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. METHODS: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. RESULTS: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. CONCLUSION: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.
Congenital Abnormalities ; Cosmetics ; Fractures, Bone ; Humans ; Nasal Bone ; Nasal Cavity ; Nose ; Osteotomy ; Patient Satisfaction ; Splints

No abstract available.
Carcinoma, Basal Cell ; Cicatrix, Hypertrophic

No abstract available.
Carcinoma, Basal Cell ; Cicatrix, Hypertrophic

No abstract available.
Fibroma ; Toes

No abstract available.
Nails*