The authors analysed retrospectively, 69 cases of chronic subdural hematoma admitted to the Department of Neurological Surgery, from January 1992 to February 1995. All hematomas were operated on by one burr hole trephination and continuous closed-system cather drainage system. The results were as follows: 1) Male was more frequently involved than female with ratio of 5.3:1 and the incidence was prredominent in the patients whose ages were over 50. 2) History of head trauma was found in 52 cases(75.4%), among which habitual alcoholism was found in 6 cases(8.7%). 3) The major symptoms and signs at admission were headache(55.1%), hemiparesis(44.9%), and mental changes(30.4%). 4) On the brain CT scan, hematoma showed low, iso, mixed, and high in density, and the shapes of hematoma were crescenteric, biconvex, planoconvex, and concave in order of frequency. 5) We have found a significant relationship between the neurological grade at admission and the prognosis, and noted full recovery in 45 cases(65.2%) and no d eath as a result of 1-burr hole trephination.
Alcoholism ; Brain ; Craniocerebral Trauma ; Drainage ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Male ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Trephining

Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.
Abdominal Pain ; Cardiomyopathies ; Catecholamines ; Female ; Hemodynamics ; Hemoptysis ; Hemorrhage ; Humans ; Hypertension ; Pheochromocytoma ; Pneumonia ; Pulmonary Edema

A 54-year-old man presented with a cough, sputum, and fever. His chest X-ray showed atelectasis in the right middle lobe. Computed tomography revealed obstruction of the bronchus intermedius by an endobronchial tumor. The first bronchoscopic biopsy specimens suggested lipoma. We resected the tumor via rigid bronchoscopy under general anesthesia and the final pathology report revealed a cartilaginous hamartoma. Subsequently, he has been followed for more than 1 year without recurrence.
Anesthesia, General ; Biopsy ; Bronchi ; Bronchoscopy ; Cough ; Fever ; Hamartoma ; Humans ; Lipoma ; Middle Aged ; Pulmonary Atelectasis ; Recurrence ; Sputum ; Thorax

PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation of the airways and progressive destruction of lung parenchyma. Apoptosis is critical for the maintenance of normal tissue homeostasis and is in equilibrium with proliferation and differentiation. This study was undertaken to investigate relationship between apoptosis of peripheral blood lymphocytes during exacerbation of COPD and inflammatory response that characterizes this condition. MATERIALS AND METHODS: Seventeen patients with COPD exacerbation, 21 stable COPD, and 12 control subjects were included. T lymphocytes were isolated from peripheral blood using MACS. Apoptosis of T lymphocytes was assessed with FACS using annexin V and 7-aminoactinomycin. Serum levels of interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF)-alpha were determined by an immunoassay technique. RESULTS: There was significantly increased percentage of apoptotic lymphocytes, CD 4+, and CD 8+ T cells in the peripheral blood of patients with exacerbation of COPD compared with stable COPD. Serum levels of IL-6, IL-8, and TNF-alpha were significantly increased in patients with exacerbation of COPD compared with stable COPD. Only TNF-alpha presented a positive correlation with apoptotic lymphocytes in patients with exacerbation of COPD. CONCLUSION: Increased apoptotic lymphocytes may be associated with upregulation of TNF-alpha in the peripheral blood of patients with acute exacerbation of COPD.
*Apoptosis ; CD4-Positive T-Lymphocytes/pathology ; CD8-Positive T-Lymphocytes/pathology ; Flow Cytometry ; Humans ; Interleukin-6/blood ; Interleukin-8/blood ; Pulmonary Disease, Chronic Obstructive/blood/*pathology ; T-Lymphocytes/*pathology ; Tumor Necrosis Factor-alpha/blood

No abstract available.
Camptothecin ; Recurrence ; Small Cell Lung Carcinoma

Factitious hemoptysis is the bleeding type of Munchausen's syndrome, and this describes a group of patients who intentionally produce symptoms. Because factitious hemoptysis is a very rare manifestation of hemoptysis, it generally passes unnoticed. We report here on a case of factitious hemoptysis in a 15-year-old boy who presented with hemoptysis. During his three hospitalizations, we conducted many diagnostic procedures, including chest CT, laryngoscopy, bronchoscopy and bronchial arteriography, yet we failed to find the definitive cause of the patient's hemoptysis. He kept on complaining of repetitive hemoptysis and seizure-like activity. His father discovered that he had collected his blood into the specimen cup via an intravenous line. After we removed the intravenous line, he did not show blood to us again. We suggest that factitious hemoptysis should be considered in the differential diagnosis of hemoptysis of an unclear bleeding focus, and especially when the patient has a bizarre hospital course or unusual behavior. We also include a review of the relevant literature.
Adolescent ; Angiography ; Bronchoscopy ; Diagnosis, Differential ; Fathers ; Hemoptysis ; Hemorrhage ; Hospitalization ; Humans ; Intention ; Laryngoscopy ; Thorax

A sarcoidosis is a multisystemic granulomatous disorder that has a predilection for pulmonary involvement, and the common radiological findings for the disease are bilateral nodular or reticulonodular patterns. Pseudoalveolar sarcoidosis is a rare presentation of sarcoidosis. The radiological finding is an alveolar pattern that involves or compresses the alveoli by clustered interstitial granuloma. A 58-year-old man was admitted due to incidental findings of a unilateral consolidative lesion as seen on chest radiography. A chest computed tomography (CT) examination showed multiple bronchoalveolar consolidations that were suspicious of a malignancy. However, a percutaneous needle biopsy revealed non-caseating granuloma with an asteroid body that was compatible with sarcoidosis. After one month, the consolidative lesions improved without any treatment.
Biopsy, Needle ; Granuloma ; Humans ; Incidental Findings ; Middle Aged ; Sarcoidosis ; Thorax