PURPOSE: This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluate the usefulness of HRCT by compareson with chest radiographs. MATERIAL AND METHODS: High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. RESULTS: On HRCT, characteristic 1--2mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n=5), pleural effusion(n=4), mediastinal lymphadenopathy(n=6) and ARDS(n=I) were also associated. CONCLUSION: HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs.
Diagnosis ; Humans ; Lung ; Lymphatic Diseases ; Medical Records ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

PURPOSE: We performed this study to define the characteristic mammographic and ultrasonographic findings in lower risk lesions of fibrocystic change and also tried to evaluate the role of both modalities in planning the treatment of these lesions. MATERIALS AND METHODS: We retrospectively reviewed 38 cases of mammography and 46 cases of ultrasonography in biopsy proven 55 cases of fibrocystic change, histologically showing the nonproliferative pattern or proliferative pattern without atypia. We analyzed the mammographic and ultrasonographic findings, final assessments, and compared the effectiveness of each modality. RESULTS: On mammography, there were no abnormalities in 20 cases(53%), nodules or masses in 9 cases(24%), microcalcifications in 6 cases(16%) and asymmetric density in 5 cases(14%). On ultrasonography, there were 40 cases(87%) of focalsonographic abnormality and no abnormality in 6 cases(13%). Most focal sonographic abnormalities were smooth(40cases, 93%), well-defined(21 cases, 49%) or ill-defined(22 cases, 51%) round or oval(36 cases, 84%) shaped, homogeneous(31 cases, 67%), hypoechoic(30 cases, 65%) lesions. Final assessment revealed that only 7 cases(18%) of mammography and 8 cases(18%) of ultrasound examinations were included into the category of indeterminate and malignancy groups which were recomended biopsy. Mammography was excellent to demonstrate the microcalcifications and ultrasonography was effective in depiction of the focal lesions. CONCLUSION: The mammography and ultrasonography findings were not specific in diagnosing lower risk group of fibrocystic change. But complementary study of both modalities in conjunction with clinical findings will be helpful in making decinion amary biopsy, fine needle aspiration, and simple close follow up of the lesions.
Biopsy ; Breast* ; Mammography ; Needles ; Retrospective Studies ; Ultrasonography

No abstract available.
Gastric Stump*

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.
Animals ; Animals, Wild ; Bites and Stings ; Child ; Child Health ; Health Personnel ; Humans ; Isothiocyanates ; Medical Records ; Post-Exposure Prophylaxis ; Rabies ; Vaccination

Esophageal duplication is the congenital developmental anomaly manifestated as cystic or tubular type. The tubular esophageal duplication found at adult is extremely rare. A patient with tubular esophageal duplication is reported. A 37 years old male developed epigastric pain aggravated at hunger state from 2 monthes before administration. Gastrofiberscopy was done, and we could found the tubular esophageal duplication at 25 cm from incisiors. Esophagogram exposed the tunnel communicated with right anterior side of normal esophagus at upper and lower part of the tubular pathway with the length of 6 cm at T4-5 level. The microscopic finding of the tubular lumen revealed normal esophageal wall structure involving the outer part of muscle layer. Surgical resection was not done for the lesion was small and no symptom due to esophageal duplication was present. And so, the authors report this case as a tubular esophageal duplication with a literature review.
Adult ; Esophagus ; Humans ; Hunger ; Male

No abstract available.
Vesico-Ureteral Reflux*

PURPOSE: The placement of a ureteral stent following a ureteroscopy (URS) with a stone extraction is routine. However, many patients complain of stent pain and urinary symptoms in the postoperative period. Reducing the frequency of stenting would decrease the need for re-instrumentation, reduce costs, and increase patient satisfaction provided that the efficacy and safety are not compromised. In order to evaluate the necessity of stenting, a comparison of patients with and without stenting after URS for ureteral calculi is reported. MATERIALS AND METHODS: 45 patients with ureteral calculi amenable to ureteroscopic management were prospectively randomized into stented (23 patients) and unstented (22 patients) groups. Standard ureteroscopic basketing and lithotripsy were performed with a ureteroscope (8.5Fr) with or without ureteral dilatation. Postoperative symptom questionnaires were obtained from each patient. Radiographic follow-up to assess the stone-free rate and evidence of obstruction was performed in all patients. RESULTS: There was no statistically significant difference in the age, stone size, operation time, and hospital stay, between the unstented and stented groups (p>0.05). In addition, there was no statistically significant difference in the flank pain and urinary symptoms (p>0.05), except for hematuria between the 2 groups. Hematuria was more severe and long standing in the stent group (p=0.001). CONCLUSIONS: Uncomplicated ureteroscopy for calculus retrieval can safely be performed without the placement of a postoperative stent. Considering its complications and side effects, we do not believe that a routine placement of a ureteral stent following an uncomplicated ureteroscopy for a stone is necessary.
Calculi ; Dilatation ; Flank Pain ; Follow-Up Studies ; Hematuria ; Humans ; Length of Stay ; Lithotripsy ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Surveys and Questionnaires ; Stents* ; Ureter* ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy*

To assess the change of nitric oxide(NO) concentration according to photorefractive keratectomy(PRK) depth and the role of NO in cataractohenesis after excimer laser PRK. The treated 36 rabbits were divided into 12 groups according to PRK depth(-3.0, -7.0, -11.0 diopter [0]), the dates of sampling(the 1st day and the 7th day after PRK), and reatment of NOS inhibitor (NG-nitro-L-arginine methylester, L-NAME). NO concentration and superoxide dismutase(SOD) activity in the aqueous humor and malondialdehyde(MDA) concentration in the lens were measured. Changes of lens epithelium were examined by eletron microscopy on the 3rd day and the 6th day after -11.0D of PRK. The NO and MDA concentration in the group without L-NAME treatment on the 1st day after -11.0D of PRK were significantly higher than those in the L-NAME treated group and control group. The activity of SOD increased in all of the PRK treated group on the 1st day and was even higher on the 7th day. The histopathological changes of lens epithelium on the 3rd day after PRK were compatible with cellular necrosis and those of the 6th day after PRK were compatible with cellular reparing. The results suggested that the toxicity of NO after PRK correcting over -11.0D may a role in cataractogenesis, but the progress could be suppressed by treatment of NOS inhibitor.
Aqueous Humor ; Epithelium ; Lasers, Excimer ; Malondialdehyde ; Microscopy ; Necrosis ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Photorefractive Keratectomy* ; Rabbits ; Superoxide Dismutase ; Superoxides

OBJECTIVE: Despite the good prognosis of borderline ovarian tumors (BOTs), a few BOT patients experience the relapse of disease, either borderline or malignant. However, the risk of recurrence of BOTs is somewhat controversial. We intended to find out the specific characteristics and prognosis of the recurrence of BOTs. METHODS: Between 1995 and 2012, 130 women were diagnosed with BOTs at a single institution. Eleven patients diagnosed and treated for the recurrence of BOTs including seven cancerous and four borderline relapses were included for the analysis in this retrospective study. Clinicopathological characteristics and surgical procedures as well as follow-up data with overall survival were assessed. Statistical analyses was performed using the chi2 test, t-test and log-rank test with Cox regression. RESULTS: One hundred and thirty patients with mean follow-up of 65.8 months were evaluated, of whom half were below 40 years old at their first diagnosis of BOTs. Among 11 recurrent cases (8.5%), 7 cancerous transformations (5.4%) and 4 borderline recurrences (3.1%) were detected with median time of 6 and 71 months after the primary surgery, respectively. Nine out of 11 recurrences were happened at their equal or below 40-years-old age at the primary diagnosis (P=0.027). Also, all 7 cancerous relapses arose from premenopausal women of median age of 35 years old. Twenty (15%) patients had laparoscopic surgery and they were all treated conservatively. Among those 20, 5 were suffered from relapse of BOTs and laparoscopic approach was proved to be a significant risk factor for disease relapse in our study (P=0.013). Although laparoscopic surgery was revealed had meaningful influence on disease free survival (P=0.024), it was not significant on overall survival (P=0.226). CONCLUSION: Laparoscopic conservative surgery for BOTs can be accepted under close follow-ups. And younger patients should be followed for long period to evaluate recurrence.
Diagnosis ; Disease-Free Survival ; Epithelial-Mesenchymal Transition ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Ovarian Neoplasms ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors

Macrodystrophia lipomatosa is a congenital macrodactyly characterized by progressive overgrowth of all the mesenchymal elements of a digit or digits with a disproportionate increase in the fibroadipose tissue. We reported a case of macrodystrophia lipomatosa of the foot, which is a rare case, and reviewed the literatures.
Fingers ; Foot ; Limb Deformities, Congenital