Pulmonary tuberculomas show variable responses to treatment, with some even increasing in size after treatment. To date, however, no data have been reported on the response of tumorous type of endobronchial tuberculosis (EBTB-T) to treatment observed both bronchoscopically and histologically. We report a case of bacteriologically- and biopsy-proven EBTB-T that showed delayed response to anti-tuberculosis treatment. Even after EBTB-T was treated with antituberculosis drugs for 15 months, the bronchoscopic findings and the histologic findings of chronic granulomatous inflammation with caseation necrosis still remained. However, in fourteen months after the completion of treatment, the lesioneventually disappeared without further treatment.
Inflammation ; Necrosis ; Tuberculoma ; Tuberculosis*

This is a cross-sectional study to evaluate the serum lipid levels of children living in Pusan in 1996. The distribution of age is from 2 years old to 12 years old. In female children mean total cholesterol is 171.4+/-26.2mg/dl, triglyceride is 104.7+/-50.6mg/dl, HDL-cholesterol is 54.4+/-14.8mg/dl, and LDL-cholesterol is 95.4+/-32.9mg/dl. In male children mean total cholesterol is 167.9+/-25.2mg/dl, triglyceride is 90.6+/-45.5mg/dl, HDL-cholesterol is 55.4+/-11.7mg/dll, and LDL-cholesterol is 94.4+/-23.6mg/dl. The percentile of serum lipid levels is measured in children. The 95th percentile of serum total cholesterol is 210mg/dl in male children, and 214mg/dl in female children. And, the 95th percentile of serum triglyceride is 184mg/dl in male children, and 191mg/dl in female children. And, the 95th percentile of LDL-cholesterol is 133mg/dl in male children, and 135mg/dl in female children. Serum total cholesterol is positively related to age(r=0.18), height(r=0.08), weight(r=0.17), obesity index(r=0.12), and negatively related to father's education level(r=-0.13), mother's education level(r=-0.13). Serum triglyceride is positively related to weight(r=0.23), age(r=0.31) and negatively related to father's education level(r=-0.12), mother's education level(r=-0.18). Serum HDL-C was positively related to mother's education level(r=0.07) and negatively related to height(r=-0.12), weight(r=-0.09). Conclusively, the serum lipid levels of children living in Pusan is generally so high that the family and school must try to control the serum lipid levels.
Busan* ; Child* ; Child, Preschool ; Cholesterol ; Cross-Sectional Studies ; Education ; Female ; Humans ; Male ; Obesity ; Triglycerides

BACKGROUND: Validated simple calcium questionnaires are available to assess the intake of calcium and vitamin D in western countries, but they are not appropriate for Koreans since dairy products are not the major source of calcium and vitamin D in Korea. Thus, the objective of the present study was to develop and validate a simple and easy food frequency questionnaire (FFQ) of calcium and vitamin D for Korean. METHODS: Two hundred and fifty-six women were asked to complete the validated FFQ used by the Korean National Health and Nutrition Examination Survey (KNHANES) and a newly developed FFQ, the Korean Calcium Assessment Tool (KCAT), which contain the 7 food groups with 24 categories of 45 food items that are consumed frequently by Koreans. RESULTS: Calcium intake was not significantly different between the two methods; Pearson's correlation coefficient of 0.98 indicated a positive correlation, and Cohen's kappa coefficient of 0.78 indicated the subjects were correctly classified. Bland-Altman plot also showed that the mean differences of the calcium intake as assessed by the two methods were in high agreement. However, the vitamin D intake assessed by KCAT was significantly higher than that assessed by the FFQ used in KNHANES. The vitamin D intakes as assessed by the two methods were positively correlated but the two methods were in moderate agreement. CONCLUSIONS: The results suggested that the newly developed KCAT was a valid tool for assessing the calcium intake in Korean women, but it might overestimate the vitamin D intake.
Calcium* ; Dairy Products ; Diet Surveys ; Female ; Humans ; Korea ; Methods ; Nutrition Surveys ; Vitamin D* ; Vitamins* ; Surveys and Questionnaires

Aggressive fibromatosis is best difined as a group of non-encapsulated, non-metastasizing fibrous tumors that have tendency for local recurrence. This tumor is chariaterized histologically by fibroblastic proliferation and clinically by the potential to infiltrate and to recur after surgical excision, but not metastasize. The most common anatomic location have been the abdominal muscle and the extrimities. The incidence of the head and neck is mentioned as from 9.5% to 50% of all desmoid tumors. Within this area, 40%-to 80% of the tumors are located in the neck, but rare in oral cavity. Histologically the tumor is composed of proliferative fibroblasts with a collagenous component. The degree of cellularity varies from area to area and from tumor to tumor. The cells are usually spindle-shaped and the nuclei present only slightly polymorphism, but mitosis are rare and never atypical. Oral fibromatosis has been described as fibrosarcoma, pseusarcoma, pseudosarcomatous fibrosarcoma, metastasizing fibromatosis, juvenile aggressive fibromatosis, and aggressive fibromatosis, but Wilkin and Waldron suggested that the aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the tumor. The treatment of aggressive fibromatosis is traditionally surgical resection with an area of tumor free tissue. But when the complete surgical excision is not possible, radiation and chemotherapy also can be used. Clinically the tumor reported to be not painful in most cases, but capable of rapid growth. Careful clinical and histological examinations are essential for correct diagnosis. We report a case of aggressive fibromatosis. Occurring of the maxilla in 10 year female patient.
Abdominal Muscles ; Collagen ; Diagnosis ; Drug Therapy ; Female ; Fibroblasts ; Fibroma ; Fibromatosis, Aggressive* ; Fibrosarcoma ; Head ; Humans ; Incidence ; Maxilla* ; Mitosis ; Mouth ; Neck ; Recurrence

Esophageal duplication is a rare congenital disorder. Although infrequent, complications such as infection, bleeding, and perforation have been reported. Surgical resection is the standard treatment for esophageal duplication cysts. We report the case of a 45-year-old female with an esophageal duplication cyst that presented with dysphagia, with a review of the literature.
Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Deglutition Disorders ; Endosonography ; Female ; Hemorrhage ; Humans ; Middle Aged

PURPOSE: Allergic rhinitis (AR) is a common chronic disease. Many factors could affect the development of AR. We investigated early-life factors, such as delivery mode, feeding method, and use of antibiotics during infancy, which could affect the development of AR. In addition, how interactions between these factors and innate gene polymorphisms influence the development of AR was investigated. METHODS: A cross-sectional study of 1,828 children aged 9-12 years was conducted. Three early-life factors and AR were assessed by a questionnaire. Skin prick tests were done. Polymorphisms of TLR4 (rs1927911) and CD14 (rs2569190) were genotyped. RESULTS: Use of antibiotics during infancy increased the risk of AR (aOR [95% CI] 1.511 [1.222-2.037]) and atopic AR (aOR [95% CI], 1.565 [1.078-2.272]). There were synergistic interactions between caesarean delivery, formula feeding, and use of antibiotics in the rate of atopic AR (aOR [95% CI], 3.038 [1.256-7.347]). Additional analyses revealed that the risk for the development of AR or atopic AR subjects with the TLR4 CC genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.127 [1.265-20.780] for AR; 6.078 [1.499-24.649] for atopic AR). In addition, the risk for the development of AR or atopic AR in subjects with the CD14 TT genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.960 [1.421-15.002] for AR; 6.714 [1.440-31.312] for atopic AR). CONCLUSIONS: Delivery mode, feeding method, and use of antibiotics during infancy appeared to have synergistic interactions in the development of AR. Gene-environment interactions between polymorphism of innate genes and early- life risk factors might affect the development of AR.
Anti-Bacterial Agents ; Child ; Chronic Disease ; Cross-Sectional Studies ; Delivery, Obstetric ; Feeding Methods ; Female ; Gene-Environment Interaction ; Genotype ; Humans ; Immunity, Innate* ; Infant Food ; Rhinitis* ; Risk Factors* ; Skin ; Surveys and Questionnaires

PURPOSE: Sensitization to allergens is considered as major mechanism of allergy and related to the development of allergic diseases. The objective of this study was to evaluate overall sensitization rates of inhalant allergens and the relationship between polysensitization and prevalence of allergic diseases in children and adolescents. METHODS: A cross-sectional pilot study of 122 elementary school students, 114 middle school students, and 115 high school students from Incheon and Asan was conducted by using the International Study of Asthma and Allergies in Childhood (ISSAC) questionnaire. The skin prick tests were performed with 14 common inhalant allergens on 339 students. RESULTS: The inhalant allergen that has a significantly different sensitization rate according to age was Dermatophagoides farinae. And the inhalant allergen that has significantly different sensitization rate according to region was Japanese hop. In addition, girls have higher sensitization rate to any mold allergens than boys. In case of having sensitization more than two allergens, the risks of diagnosis of asthma and allergic rhinitis on questionnaire were increased. Asthma is related to sensitization of dog or cat and allergic rhinitis is related to sensitization of house dust mites. However, atopic dermatitis is not related to sensitization of any inhalant allergens. CONCLUSION: The sensitization rates of inhalant allergens may differ among age, gender, and region in children and adolescents of Incheon and Asan area. The polysensitized children and adolescents with inhalant allergens showed higher prevalences of allergic diseases such as asthma and allergic rhinitis on questionnaire than monosensitized group.
Adolescent ; Allergens ; Animals ; Asian Continental Ancestry Group ; Asthma ; Cats ; Child ; Dermatitis, Atopic ; Dermatophagoides farinae ; Dogs ; Fungi ; Humans ; Humulus ; Hypersensitivity ; Pilot Projects ; Prevalence ; Pyroglyphidae ; Rhinitis ; Rhinitis, Allergic, Perennial ; Skin ; Surveys and Questionnaires

The incidence of Mycobacterium kansasii pulmonary diseases are on the increase in Korea with the higher probability of occurrence in middle-aged and older men with underlying lung diseases Among nontuberculosus mycobacterial (NTM) infections, the clinical features of M. kansasii pulmonary infection are most similar to those of tuberculosis (TB). The chest radiographic findings of M. kansasii infection are almost indistinguishable from those of M. tuberculosis (predominance of an upper lobe infiltration and cavitary lesions), even though some suggest that cavities are more commonly thin-walled and have less surrounding infiltration than those of typical TB lesions. Although there are reports on the rare manifestations of M. kansasii infections, such as endobronchial ulcer, arthritis, empyema, cutaneous and mediastinal lymphadenitis, cellulites and osteomyelitis, the association with bronchial anthracofibrosis has not yet been reported. This report describes the first case of M. kansasii infection presenting as a lung mass in the right lower lobe with accompanying bronchial anthracofibrosis.
Arthritis ; Empyema ; Humans ; Incidence ; Korea ; Lung Diseases ; Lung* ; Lymphadenitis ; Male ; Mycobacterium kansasii* ; Mycobacterium* ; Osteomyelitis ; Radiography, Thoracic ; Tuberculosis ; Ulcer

Background: Exercise capacity is associated with lung function decline in chronicobstructive pulmonary disease (COPD) patients, but a discrepancy between exercisecapacity and airflow limitation exists. This study aimed to explore factors contributingto this discrepancy in COPD patients. Methods: Data for this prospective study were obtained from the Korean COPD SubgroupStudy. The exercise capacity and airflow limitation were assessed using the6-minute walk distance (6-MWD; m) and forced expiratory volume in 1 second (FEV1).Participants were divided into four groups: FEV1 >50%+6-MWD >350, FEV1 >50%+6-MWD ≤350, FEV1 ≤50%+6-MWD >350, and FEV1 ≤50%+6-MWD ≤350 and their clinicalcharacteristics were compared. Results: A total of 883 patients (male:female, 822:61; mean age, 68.3±7.97 years) wereenrolled. Among 591 patients with FEV1 >50%, 242 were in the 6-MWD ≤350 group, andamong 292 patients with FEV1 ≤50%, 185 were in the 6-MWD >350 group. The multipleregression analyses revealed that male sex (odds ratio [OR], 8.779; 95% confidence interval[CI], 1.539 to 50.087; p=0.014), current smoking status (OR, 0.355; 95% CI, 0.178to 0.709; p=0.003), and hemoglobin levels (OR, 1.332; 95% CI, 1.077 to 1.648; p=0.008)were significantly associated with discrepancies in exercise capacity and airflow limitationin patients with FEV1 >50%. Meanwhile, in patients with FEV1 ≤50%, diffusioncapacity of carbon monoxide (OR, 0.945; 95% CI, 0.912 to 0.979; p=0.002) was significantlyassociated with discrepancies between exercise capacity and airflow limitation. Conclusion The exercise capacity of COPD patients may be influenced by factors otherthan airflow limitation, so these aspects should be considered when assessing andtreating patients.

BACKGROUND: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. METHODS: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). RESULTS: The study enrolled 144 patients (mean age, 56.7±16.7 years). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from 16.6±4.6 to 20.0±3.9 (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). CONCLUSION: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.
Adult ; Asthma* ; Education* ; Humans ; Nebulizers and Vaporizers ; Pamphlets ; Physicians, Primary Care ; Primary Health Care*