Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

BACKGROUND: Recurrent recalcitrant warts are likely to increase gradually, and require more aggressive and effective treatment for remedy. According to recent foreign research materials and literature, aminolevulinic acid photodynamic therapy (ALA-PDT) is reported to prove to show high curative performances, but there has been little relevant research in Korea to date. OBJECTIVE: This study will evaluate the efficiency and side effects of ALA-PDL and PDL in treating recalcitrant viral warts. METHODS: 120 warts from 44 people were selected and sorted by their locations such as hand, foot, and periungual area, and then randomly divided into 2 groups: ALA-PDL group and PDL group. The ALA-PDL group used 20% 5-ALA as a photosensitizer, and PDL for the light-source, the other group used PDL. The setting of PDL being used in both groups is as follows: wavelength of 585 nm, spot size of 7 mm, and energy density of 7.0~10 J/cm2. RESULTS: After 3 treatment sessions, the complete clearance of ALA-PDL and PDL groups was 44/59 (74.6%), 18/61 (29.5%), partial clearance-good was 8/59 (13.6%), 20/61 (32.8%), partial clearance-poor was 7/59 (11.9%), 21/61 (34.4%) and no response was 0/59 (0%), 2/61 (3.3%). The average treatment sessions were 2.32 and 2.97 times. ALA-PDL group showed pain in 27/59 (45.8%) for the first and second treatment sessions, and postinflammatory hyperpigmentation (PIH) in 11/59 (18.6%). The PDL group showed only PIH in 3/61 (4.9%). CONCLUSION: PDT is an efficient treatment modality in recalcitrant viral warts. Especially in the case of periungual warts, it is very safe and cosmetically satisfactory without serious side effects such as nail deformity.
Aminolevulinic Acid ; Congenital Abnormalities ; Foot ; Hand ; Hyperpigmentation ; Korea ; Lasers, Dye ; Nails ; Photochemotherapy ; Triazenes ; Warts

No abstract available.
Musculocutaneous Nerve ; Paralysis

Diabetes mellitus (DM) can accompany many musculoskeletal (MSK) diseases. It is difficult to distinguish the DM-related MSK diseases based on clinical symptoms alone. Sonography is frequently used as a first imaging study for these MSK symptoms and is helpful to differentiate the various DM-related MSK diseases. This pictorial essay focuses on sonographic findings of various MSK diseases that can occur in diabetic patients.
Adult ; Cellulitis/ultrasonography ; Diabetes Mellitus, Type 2/*complications ; Diabetic Neuropathies/ultrasonography ; Female ; Humans ; Male ; Musculoskeletal Diseases/complications/*diagnosis/ultrasonography ; Pyomyositis/microbiology/ultrasonography ; Tenosynovitis/microbiology/ultrasonography ; Vascular Diseases/ultrasonography

C677T mutation in the gene encoding 5,10-methylenetetrahydrofolate reductase (MTHFR) predisposes to hyperhomocysteinemia in vivo and is known to be one of the causes of perinatal ischemic stroke. As MTHFR plays a role in the metabolism of homocysteine, C677T mutation may account for reduced enzymatic activity resulting in hyperhomocysteinemia. This may be prevented by introducing activity-enhancing coenzymes such as folic acid, vitamin B6, and B12. Though C677T mutation is known as a significant risk factor for cerebral infarction, reported cases of cerebral infarction among affected neonates are scarce. This report describes a case of a neonate homozygous for C677T mutation who had a perinatal ischemic stroke, born in a mother whose folic acid and nutritional consumption had been reduced during pregnancy.
Cerebral Infarction* ; Coenzymes ; Folic Acid ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Infant, Newborn ; Metabolism ; Mothers ; Oxidoreductases ; Pregnancy ; Risk Factors ; Stroke ; Vitamin B 6

Pseudoaneurysm of the abdominal wall is a possible but very rare clinical entity. It is a known complication of surgery, trauma, or arterial puncture, but it is rarely spontaneous. Even though it can usually present with a wide range of local symptoms, it can cause referred pain via spinal cord, which is cross-excited with afferent sympathetic nervous system. We report a case of right arm pain which was referred from a small abdominal pseudoaneurysm like a referred pain from gall bladder. This rare entity should be considered in the differential for pain management in case that the pain does not resolve with medication or interventional pain management.
Abdominal Wall ; Aneurysm, False ; Arm ; Pain Management ; Pain, Referred ; Punctures ; Spinal Cord ; Sympathetic Nervous System ; Urinary Bladder

BACKGROUND:One of effective treatment methods for back pain and radiculopathy is epidural steroid injection (ESI). However, its effectiveness is hard to judge.So, it is strongly urged to develop a method to evaluate the proper injection of ESI. Photoplethysmogram (PPG) is known as a technique to measure blood oxygen saturation. We were intended to study the PPG for the evaluation of the ESI instantaneously. METHODS:All patients were explained for the study protocol to get informed consent.Twenty volunteers were recruited for this study and four of them were allocated in one of 5 ESI levels; L2-3, L3-4, L4-5, L5-S1 and caudal.They were in the lateral position with 4 PPG probes in their both 2nd fingers and 2nd toes.The PPG signals were collected to a device and converted digitally.PPG signal has two components, total absorbance (TA) and oscillating pulse component (OPC).We compared the both toe PPG signals before and after ESI based on the finger PPG. RESULTS:TA changed in 60% of ESI volunteers and L4-L5 and L5-S1 groups had high change rate compared to L2-L3 group.Also, the symptom relief rate of TA and OPC change volunteers of L4-L5 and L5-S1 were 100% but other level had variable relief rate. CONCLUSIONS:It is possible to use the PPG signal to predict ESI success based appropriate signal change.It is also needed to develop other level signal detection method and to modify appropriate guideline for the decision of change of PPG.
Back Pain ; Fingers ; Humans ; Oxygen ; Radiculopathy ; Toes

BACKGROUND: Obesity is not anly one of the risk factors that affects the prevalence and aggravation of chronic diseases, but is also the cause of social unfitness because slimness has become a standard of beauty. We surveyed on the satisfaction about self body image, the factors which are related to it and weight control behavior of the adolescents in a local area of Korea. METHODS: The survey was performed in a high school of Pocheon on August, 1996. Five classes out of 14 classes in 1st and 2nd grade were selected. The body mass index(BMI) was calculated from the measured height and weight. The satisfaction about body image which was estimated by the difference between present body image and wanted body image in 9 graded figures of body image was obtained from the questionnaire. The information about sex, religion, history of being teased about body image, body image of their parents, mean duration of watching TV in a day, body esteem, and binge-eating was obtained from the questiannaire and we evaluated the relationship between all of the above with BMI and body image satisfaction. We also investigated on the interest in education about weight control and efforts made by adolescents from the questionnaire on weight control behavior. RESULTS: Total of 224 students participated in this study and only 14.7% of them were satisfied with their body image. 58.9% wanted weight reduction and 26.4% wanted weight gain. They were more dissatisfied with their body image when they were girls(p<0.01), had the experience of being teased about their body image(p<0.01), had low body esteem(p<0.01), and had high BMl(p<0.01). We could not find statistically significant relationship between body image satisfaction and other factors such as religion, the duration of watching TV in a day, the body image of their parents and binge eating. 64.3% of the subjects tried to control their weight and most(87.5%) tried to lose weight. The selected methods were diet control(65.3%) and exercise(52.1%) and the most preferred method of diet control was skipping meah(45.7%). CONCLUSIONS: Most of adolescents were not satisfied with their body image and this dissatisfaction was related to gender, history of being teased about their body image, BMI, and body esteem. Many of them had tried to lose weight and among the methods of weight reduction, there were behaviors that were injurous to their health and growth
Adolescent* ; Beauty ; Body Image* ; Bulimia ; Chronic Disease ; Diet ; Education ; Humans ; Korea ; Obesity ; Parents ; Prevalence ; Risk Factors ; Weight Gain ; Weight Loss ; Surveys and Questionnaires

BACKGROUND: The yeasts of the genus Malassezia are members of the normal flora on human skin and they are found in 75~80% of healthy adults. Since its association with various skin disorders have been known, there have been a growing number of reports that have implicated Malassezia yeast in atopic dermatitis (AD). OBJECTIVE: The aim of the present study is to isolate the various Malassezia species from AD patients by using 26S rDNA (ribosomal Deoxyribonucleic acid) PCR-RFLP and to investigate the relationship between a positive Malassezia culture and the severity of AD. METHODS: Cultures for Malassezia yeasts were taken from the scalp, cheek, chest, arm and thigh of 60 patients with atopic dermatitis. We used a rapid and accurate molecular biological method 26S rDNA PCR-RFLP, and this method can overcome the limits of the morphological and biochemical methods. RESULTS: Positive Malassezia growth was noted on 51.7% of the patients with atopic dermatitis by 26S rDNA PCR-RFLP analysis. The overall dominant species was M. sympodialis (16.3%). M. restricta was the most common species on the scalp (30.0%) and cheek (16.7%). M. sympodialis (28.3%) was the most common species on the chest. The positive culture rate was the highest for the 11~20 age group (59.0%) and the scalp showed the highest rate at 66.7%. There was no significant relationship between the Malassezia species and SCORing for Atopic Dermatitis (SCORAD). CONCLUSION: The fact that the cultured species was different for the atopic dermatitis lesion skin from that of the normal skin may be due to the disrupted skin barrier function and sensitization of the organism induced by scratching in the AD lesion-skin. But there was no relationship between the Malassezia type and the severity score. The severity score is thought to depend not on the type, but also on the quantity of the yeast.
Adult ; Arm ; Cheek ; Dermatitis, Atopic ; DNA, Ribosomal ; Humans ; Malassezia ; Scalp ; Skin ; Thigh ; Thorax ; Yeasts

BACKGROUND: Recent studies have shown that blood transfusions, and especially red blood cells, are associated with potential adverse outcomes. This study was designed to investigate the effects of red blood cell transfusion according to the hematocrit on the clinical outcomes after cardiac surgery. METHODS: The 433 patients who were undergoing cardiac surgery were randomized to two groups. One group was transfused red blood cells with a hematocrit of 20%, and the other group was transfused red blood cells with a hematocrit of 20~25%. The amounts of intraoperative and postoperative transfusion and various parameters of the clinical outcomes were checked. RESULTS: In the hematocrit <20% group, the amount of infused crystalloid during operation was larger than that of the hematocrit >20% group, and the postoperative hemoglobin and hematocrit were lower than that of the hematocrit >20% group. But there were no differences of the amounts of intraoperative and postoperative transfusion, the use of inotropics, the platelet count, the prothrombin time (PT), the activated partial thromboplastin time (aPTT), the levels of aspartate aminotransferase (AST), the levels of alanine aminotransferase (ALT), blood urea nitrogen (BUN), serum creatinine (Cr), brain natriuretic peptide (BNP) and creatine kinase MB (CK-MB), the extubation time and the ICU stay time between the two groups. CONCLUSION: A hematocrit lower than 20% was tolerated by the cardiac surgical patients and it was not related to the postoperative morbidity and outcomes.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Transfusion ; Blood Urea Nitrogen ; Creatine Kinase ; Creatinine ; Erythrocyte Transfusion ; Erythrocytes ; Hematocrit ; Hemoglobins ; Humans ; Isotonic Solutions ; Natriuretic Peptide, Brain ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Thoracic Surgery