The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.
Pulmonary Artery* ; Takayasu Arteritis*

Brain size is a useful parameter describing ontogenic character and function. Despite its potential contribution to functional study and diagnosis of disease, it has been hampered by poor assessment tools in vivo and postmortem changes. Recent development of medical imaging techniques such as MRI and CT enable us to understand brain structures in vivo. Many morphometirc studies of the brain has given us new insights in the field of functional neuroanatomy and neuropsychiatric diseases. In spite of these advances, volumetric data of normal Korean brain is not available yet. As an initial approach to Korean standard brain size, we measured the cerebellar volume between 20 and 80 years old Koreans. The MRI films free from lesions in brain was analyzed and measured by NIH image program. The Korean cerebellar volume were ranged between 86.2cm(3) and 141.3 cm(3) and average male cerebellum volume was significantly larger than that of female[male : 118.2+/-11.2cm(3)] > female : 108.0+/-9.6cm(3), P=0.1021E-07<0.05]. And we could not find volume change according to aging process. This is the first report on normal Korean cerebellar volume and the presence of gender difference in the Korean cerebellar volume. These data will be used for the standard useful in studying cerebellar function and cerebellum associated disorders in the future.
Aged, 80 and over ; Aging ; Brain ; Cerebellum ; Diagnosis ; Diagnostic Imaging ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Neuroanatomy ; Postmortem Changes

MR imaging was performed in 40 patients of aortic disease from March 1988 to February 1990. Transverse, coronal and oblique sagital views were obtained with ECG gating and even echo technique using 0.5 T and 2.0 T MR systems. In 12 patients of aortic aneurysm, the location, the size and the extent of aneurysm could be assessed in all cases. In the cases of six abdominal aortic aneurysm, the relation of aneurysm to renal arteries was evaluated. In 18 cases of aortic dissection, the extent of involvement as well as associated abnormalities was well evaluated in all cases. In the 8 cases of congenital aortic anomalies, the vascular anatomy was well demonstrated. However, the abnormalities of major branches could not be assessed with MR imaging especially in 2 cases of Takayasu's arteritis. With our experiences, MR imaging is regarded as a primary diagnostic modality for aortic disease and expected to be developed as the alternative measure to the angiography in the future.
Aneurysm ; Angiography ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Aortic Diseases* ; Electrocardiography ; Humans ; Magnetic Resonance Imaging* ; Renal Artery ; Takayasu Arteritis

Recently, informations that clinicians should know to perform the daily practice increase so rapidly thatappropriate use of computer system is needed to handle the large amount of informations efficiently. But little isknown about which system is appropriate to use or how much can we do with personal computer. Authors describe theexperience in developing computer management and data storage system for cardiovascular radiology section in seoulNational University Hospital with APPLE II personal computer and report the experience which we got during recentone year. The results are as follows; 1. Authors describe the data input format for carciovascular radiologysection in Seoul National University Hospital. 2. Authors can get various sums, average and count of datacollected during one month's clinical trial (202 cases) in an hour using our system. 3. Authors suggest that wecan computerize the unite as large as 3,000 to 10,000 examinations per year using personal computer with two 51/4" floppy disk system if length of record is adequately modified. 4. But for more efficient use of accumulateddata(Database), authors recommend the use of large external memory device, such as hard disk.
Computer Systems ; Humans ; Information Storage and Retrieval ; Memory ; Microcomputers ; Seoul

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Hospitals, Teaching* ; Korea* ; Medical Records*

PURPOSE: The objectives of this study were: 1) to analyze Clinical Performance Examination(CPX) items using item response theory(IRT) and classical test theory(CTT) and 2) to discuss how to apply and interpret these results in order to improve the quality of CPX items. In addition, we intended to explore statistical procedures in order to merge examination data from several different medical schools. METHODS: The subject of the study was the 2005 CPX examination data from 10 medical schools located in Seoul and the Kyunggi province. For merging data from ten different medical schools, Levene's test for homogeneity of variances was used. Homogeneous group selection was conducted based on ANOVA or Kruskal-Wallis' test and Tukey's multiple comparisons appropriately. The generalized partial credit model was applied to analyze polytomous items and the 2-parameter logistic model was used to analyze dichotomous items. RESULTS: Data from 8 medical schools were incorporated into the analysis. The result of the discrimination index by IRT was different from that of CTT in both polytomous and dichotomous items. Discrimination index from IRT tended to be lower than that of CTT. Difficulty index of dichotomous items of two models was correlated well with each other. However, for polytomous items, IRT model provided more information than CCT. CONCLUSION: We discovered that the CPX items were mostly easy in terms of difficulty index, and the result from IRT and CCT model did not correlated well in the discrimination index. IRT may provide more detailed information for polytomous items, but the checklist and criteria of scoring system should be cautiously reviewed.
Checklist ; Discrimination (Psychology) ; Gyeonggi-do ; Logistic Models ; Schools, Medical ; Seoul

PURPOSE: To compare the CT findings of mycobacterial infection other than tuberculosis (MOTT) with those of tuberculosis (TB). MATERIALS AND METHODS: The chest CT scans of 30 immunocompetent patients with culture-proven pulmonary MOTT (M:F=11:19; mean age, 51.2 yrs.) and of 24 patients with active tuberculosis (M:F=12:12; mean age, 42.5 yrs.) were analyzed by two radiologists; decisions were reached by consensus. RESULTS: Common findings for both MOTT and TB included bronchogenicaly-spread bronchogenic spread nodular lesion (93.3% for MOTT, 100 % for TB), bronchiectasis (90%, 83.3%), bronchial wall thickening (66.7%, 54.2%), granuloma (63.3%, 75%), parenchymal scarring (53.3%, 54.2), and mediastinal lym-phadenopathy (50%, 37.5 %). Less commonly observed findings were emphysema (46.7%, 29.7%), atelectasis (36.7%, 29.2%), narrowing of a major airway (23.3%, 25%), consolidation (23.3 %, 29.2 %), and pleural disease (16.7%, 29.2%). Except for cavity (30%, 53.3%; p< .05), the frequencies of each finding were not right middle lobe (40%, 16.7%), right lower lobe (63.3%, 33.3%) and lingula division (53.3 %, 25%) was sig-nificantly more common in MOTT than in TB (p < .05). The number of lobes in which bronchiectasis and bronchial wall thickening were involved was greater in MOTT(3.20) than in TB(2.04) (p=.011). CONCLUSION: Although the CT findings of MOTT and TB overlap considerably, cavities are more common in TB, while in MOTT, bronchiectasis in the lower lung zone is more common and bronchiectasis tends to be more extensive.
Bronchiectasis ; Cicatrix ; Consensus ; Emphysema ; Granuloma ; Humans ; Lung ; Pleural Diseases ; Pulmonary Atelectasis ; Tomography, X-Ray Computed ; Tuberculosis*

PURPOSE: To tabulate underlying disease and to assess the clinical significance of CT-diagnosed spontaneouspneumonediastinum. MATERIALS AND METHODS: We retrospectively reviewed CT scans and medical records of 11consecutive patients with spontaneous pneumomediastinum, and analyzed their clinical history and course, and infive cases, pulmonary function. CT scans of 126 patients with idiopathic pulmonary fibrosis (IPF) collected whilethe 11 consecutive patients were being treated were analyzed for the prevalence of pneumomediastinum. We analyzedCT findings with respect to the amount and distribution of air in the mediastinum, and the presence or absence ofair outside the mediastinum. RESULTS: In the 11 patients, underlying diseases were IPF (n=4), bronchiolitisobliterans organizing pneumonia (BOOP)(n=2), bronchiectasis (n=2), tuberculous tracheal stenosis (n=1), andpulmonary tuberculosis with bullous emphysema (n=1); there was one without associated disease. Of the 126 patientswith IPF, four (3.2%) showed spontaneous pneumomediastinum. All ten with underlying diseases had severe dyspnea.In five patients, a pulmonary function test showed marked impairment. Two of four patients with IPF and both withBOOP died within 2 months of CT scanning, whereas the remaining six showed clinical improvement. The detectionrate of pneumomediastinum on plain chest radiograph was 82% (9/11). CT showed that mediastinal air was mostfrequently found in the retrosternal space. There were four cases of pneumothorax and two of subcutaneousemphysema. CONCLUSION: Spontaneous pneumomediastinum might be associated with idiopathic pulmonary fibrosis andmight be a poor prognostic factor in patients with IPF or BOOP.
Bronchiectasis ; Cryptogenic Organizing Pneumonia ; Emphysema ; Humans ; Idiopathic Pulmonary Fibrosis ; Mediastinal Emphysema* ; Mediastinum ; Medical Records ; Pneumonia ; Pneumothorax ; Prevalence ; Radiography, Thoracic ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Tracheal Stenosis ; Tuberculosis