PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To analyze CT and follow-up chest radiographic findings in patients with necrotizing pneumonia and to evaluate clinical significance of the extent of necrosis. MATERIALS AND METHODS: We reviewed medical records and retrospectively analysed CT scans and follow-up chest radiographs of 22 patients with necrotizing pneumonia, confirmed by biopsy(n=7) and culture (n=15). Inclusion criteria for necrotizing pneumonia was necrotic low attenuation, with or without cavitation on postcontrast enhanced CT scan. The study group included 15 men and seven women, aged 11-66 years (average: 47years). RESULTS: The pathogens of necrotizing pneumonia were Klebsiella spp(n=7), Enterobacter spp(n=5), Actinomyces spp(n=4), Pseudomonas spp(n=4), Nocardia spp(n=4), and others(n=5). Average duration of pneumonia was 4.1 months. On CT scan, pneumonic consolidations were well-marginated in 14 patients and there were cavities on initial CT scan in 16 cases. Margins of the necrotic portion on CT scan were well-demarcated in majority of the patients(16/22). Low attenuation areas on initial CT scan resulted in cavitation, fibrosis and volume loss as shown on follow-up chest radiographs. The larger the necrotic areas on CT, the more the volume loss was. CONCLUSION: CT findings of necrotizing pneumonia were well-marginated air-space consolidation with low attenuation area, with or without cavity. The extent of necrotic area was closely related with the degree of fibrotic change later on. CT is important tool for diagnosis and prediction of parenchymal damage in necrotizing pneumonia.
Actinomyces ; Diagnosis ; Enterobacter ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Klebsiella ; Male ; Medical Records ; Necrosis ; Nocardia ; Pneumonia* ; Pseudomonas ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Anemia, Hypoplastic, Congenital*

No abstract available.
Asthma* ; Theophylline*

The clinical manifestations in filarial infection were examined during 1965-1966 from the known endemic areas: Yongju, a mountainous inland area and Cheju-Do, an island. All the microfilaria which were found during the survey were Brugia malayi. The principal symptom was cuticular hypertrophy (elephantiasis). It was found in 4 cases from Yongju among 707 villagers, 84 cases from Cheju-Do among 2,376 villagers. Four microfilaremia cases (4.5%) were found among a total of 88 cases of elephantiasis. In Cheju-Do, the higher incidence of elephantiasis was observed among people over 20 years old and the females showed much higher incidence than males (30 males and 54 females). The cuticular hypertrophic changes (elephantiasis) appeared more often in the lower extremities(77%) than in the upper part of the body, and in the right side than in the left.
parasitology-helminth-nematoda ; Brugia malayi ; filariasis ; hypertrophy

Significant traumatic disruption of the ligaments about the knee can occur in a child. Recently several reports have described knee ligament, injuries with open growth plates. And these reports contradict the notion that complete tears of knee ligaments occur only after growth plates have closed. The youngest patient with medial collateral ligament injury reported before was a 4-year-old boy by Joseph and Pogrund in 1978. But authors experienced a case of ruptured medial collateral ligament of the knee in a 2-year and 1-month old boy, who seemed to be youngest with the ligament injury.
Child ; Child, Preschool ; Collateral Ligaments ; Growth Plate ; Humans ; Infant, Newborn ; Knee ; Ligaments ; Male ; Rupture ; Tears

PURPOSE: To elucidate high-resolution CT(HRCT) findings and their pathologic basis in pulmonary oil embolism induced by LipiodoI-Adriamycin emulsion. MATERIALS AND METHODS: Pulmonary oil embolism was induced by infusing LipiodoI-Adriamycin emulsion through a peripheral vein in twelve Yorkshire pigs. Serial HRCT scans were performed on 2rid, 4th, 7th, 14th, and 28th day after the procedure. The pigs were sacrificed immediately after HRCT and histologic specimens were prepared in the same plane and level with HRCT. RESULTS: The basic pathology was reversible hemorrhagic edema of the lung. On HRCT, intraalveolar hemorrhage and edema in the acute stage manifested as ground-glass opacity or air-space consolidation of the whole secondary Iobule. The lesions were predominantly distributed over the dependent posterior lung fields because the specific gravity of Lipiodol is 1.28. Interlobular septal thickening due to edematous fluid collection was also associated. With the elapse of time, the extent and severity of the acute lesions resolved and, sometimes, changed into small nodular opacities. Pulmonary opacity was most severe on the post-embolization 2nd day and completely resolved within 2 weeks. CONCLUSION: Pulmonary embolization of LipiodoI-Adriamycin emulsion causes reversible hemorrhagic edema of the lung and Lipiodol toxicity seems to play a major role. HRCT findings of pulmonary oil embolism are quite different from those of pneumonia and pulmonary metastasis, which suggests the possibility of clincal application.
Edema ; Embolism* ; Ethiodized Oil ; Hemorrhage ; Lung ; Neoplasm Metastasis ; Pathology ; Pneumonia ; Specific Gravity ; Swine ; Veins

To assess whether the free-to-total prostate specific antigen (PSA) ratio (F/T PSA ratio) would enhance prostate cancer detection in Korean men with serum total PSA levels between 4 and 20 ng/ml. Methods: A total of 240 consecutive patients whose serum PSA levels were between 4 and 20 ng/ml were enrolled in this two-year study. All patients underwent ultrasound-guided transrectal biopsies of the prostate gland. The F/T PSA ratio was measured using the Roche immunoassay. Results: Of the 240 patients, 202 (84%) had benign histologies, while 38 (16%) had prostate cancer. The two patient groups were well matched for age. The mean F/T PSA ratio showed a statistically significant difference between the two groups: in the benign histology group it was 0.14 (0.04 - 0.37), and 0.10 (0.08 - 0.20) in the prostate cancer group (p< 0.05). Out of the 183 patients with a PSA level between 4-10ng/ml, the mean F/T PSA ratios were 0.14 and 0.11 in the benign histology (n=158) and prostate cancer groups (n=25), respectively (p< 0.05). From the 57 patients with a PSA level between 10 - 20 ng/ml, the mean F/T PSA ratios were 0.14 and 0.10 in the benign histology (n=44) and prostate cancer groups (n=13), respectively (p< 0.05). Overall, when the cut-off value of the F/T PSA ratio was 0.10, the sensitivity and specificity were 75.0% and 76.5%, while for the cut-off value of 0.15 they were 83.3% and 39.7% respectively. Conclusion: Our data demonstrated the usefulness of the free to total PSA ratio in distinguishing benign prostate disease and cancer disease, hence eliminating unnecessary biopsies. It is recommended that a cut-off value for the F/T PSA ratio of 0.10 be applied to Korean men which this is lower than the value used in Western countries.
Biopsy ; Humans ; Male ; Middle Aged ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis ; ROC Curve

The intraoperative rupture of an intracranial aneurysm can dramatically interrupt the fine operative procedure and jeopardize the patient's chance for meaningful survival. A sudden increase of the arterial pressure and intracranial pressure during laryngoscopy and intubation is potentially dangerous and may lead to fresh bleeding from an aneurysm in patient with recent subarachnoidal hemorrhage due to aneurysmal rupture. But aneurysmal rupture during induction occurs rarely. Recently we experienced rebleeding due to sudden increased arterial blood pressure during laryngoscopy and intubation in 39 years old female patient who was scheduled for clipping of ruptured intracranial aneurysm on 11th day after ictus. And she died of cerebral death on 6th postoperative day. Here we discuss the incidence, prognosis, diagnosis, management and prophylaxis of the aneurysmal rupture during induction with a brief review of the literature.
Adult ; Anesthesia* ; Aneurysm ; Arterial Pressure ; Diagnosis ; Female ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm* ; Intracranial Pressure ; Intubation ; Laryngoscopy ; Prognosis ; Rupture ; Surgical Procedures, Operative

BACKGROUND: When patients return to the emergency department shortly after being seen, it is generally assumed that their initial evaluation or treatment was inadequate. But in other aspects many short term revisits may be unnecessary in the aspect of emergency care because it is known that substantial numbers of patients use emergency department for nonemergency problems. So we analysed the tendency and the cause of short term revisit patients, determined the rates and the associated demographic, clinical, disease variables as a tool of quality assurance. METHODS: We carried out a chart review of patients seen in the emergency department, who revisited within 72 hours, of Young Dong Severance Hospital retrospectively between January 1, 1998 and September 30, 1999 (period 2), and compared with result between April 1, 1990 and March 31, 1991 (period 1) respectively. RESULTS: In the period 1, the total revisits patients were 204/21,025(0.97%), in that period scheduled revisits were 15.2%, the unscheduled were 84.8%, and the frequent revisits (more than 3 times) were 6.4%. In the period 2, the total revisit patients were 4,722/72,802 (6.49%), in that period scheduled revisits were 86.3%, the unscheduled were 13.7%, and the frequent revisits were 24.8%. The most common cause of revisit during the period 2 is a drug addictor (31.2%) that frequently used the emergency room for seeking drug. CONCLUSIONS : The scheduled revisit patients for dressing, medication, re-evaluation were increased enormously, so the medical care of these patients might be a part of job that performed in emergency department. And if the health care system could support the adequate nursing care facility, the portion of avoidable revisits of emergency department can be decreased. We also found that the emergency department is an important points for the early identification and referral for the treatment of patients who revisited emergency room for seeking drug, and the analysis of physician related factor in revisits patients may be used as a tool of quality assurance in the emergency department.
Bandages ; Delivery of Health Care ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Humans ; Nursing Care ; Referral and Consultation ; Retrospective Studies