More than half of the cryptococcal infections occur in acquired immune deficiency (AIDS) patients, and more than half of the non-AIDS patients with cryptococcosis are immunocompromised. Most immunocompromised patients have meningoencephalitis at the time of diagnosis. Without the appropriate therapy, this from of the infection is invariably fatal. Death can occur any time from 2 weeks to several years after the onset of symptoms. Pulmonary crytococcosis in immunocompromised patients is usually asymptomatic, but coughing, chest pain, fever, or hemoptysis may occur in immunocompetent patients. Pulmonary cryptococcosis symptoms in immunocompetent patients tend to improve without treatment. Here, we describe the various pulmonary manifestations of cryptococcal pneumoniae in three immunocmpetent patients.
Chest Pain ; Cough ; Cryptococcosis ; Diagnosis ; Fever ; Hemoptysis ; Humans ; Immunocompromised Host ; Meningoencephalitis ; Pneumonia*

Mindfulness training is growing in popularity as an adjunctive intervention in disordered eating and weight loss. Lifestyle modification, pharmacologic treatment, and surgical intervention have been widely used for weight reduction in obese persons, but these modifications are sometimes insufficient. In particular, stress-induced eating and binge-eating disorder have been frequently associated with increased risk of regaining weight. Initial research suggests that mindfulness training may be an effective intervention for binge eating. In this article, we reviewed 19 studies that investigated mindfulness training as an intervention for weight change and/or emotional eating. Results suggest that mindfulness training effectively decreases emotional eating in persons with good adherence to the training; evidence for its effect on weight reduction, however, is mixed. Further large-scale studies are warranted to explore the effectiveness of mindfulness training on long-term weight loss and emotional eating in persons with obesity.
Binge-Eating Disorder ; Bulimia ; Cognitive Therapy ; Eating ; Humans ; Life Style ; Mindfulness ; Obesity ; Overweight ; Weight Loss ; Weight Reduction Programs

Mindfulness training is growing in popularity as an adjunctive intervention in disordered eating and weight loss. Lifestyle modification, pharmacologic treatment, and surgical intervention have been widely used for weight reduction in obese persons, but these modifications are sometimes insufficient. In particular, stress-induced eating and binge-eating disorder have been frequently associated with increased risk of regaining weight. Initial research suggests that mindfulness training may be an effective intervention for binge eating. In this article, we reviewed 19 studies that investigated mindfulness training as an intervention for weight change and/or emotional eating. Results suggest that mindfulness training effectively decreases emotional eating in persons with good adherence to the training; evidence for its effect on weight reduction, however, is mixed. Further large-scale studies are warranted to explore the effectiveness of mindfulness training on long-term weight loss and emotional eating in persons with obesity.

No abstract available.
Humans ; T-Lymphocytes*

OBJECTIVE: To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). MATERIALS AND METHODS: The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. RESULTS: Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. CONCLUSION: Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.
Asbestosis ; Biopsy ; Biopsy, Needle ; Diagnosis, Differential* ; Hand ; Humans ; Korea* ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Mesothelioma* ; Neoplasm Metastasis ; Odds Ratio ; Pleura ; Pleural Diseases* ; Pleural Effusion ; Thoracotomy

Pulmonary siderosis is one kind of pneumoconiosis caused by the long term inhalation of iron dust. Iron is deposited in the lungs, usually in the form of iron oxides. Iron oxides are relatively inert particles with a minimal fibrotic response. It occurs in a number of occupations including welding, steel rolling and grinding, casting, iron ore mining and oxyacetylene cutters. We have experienced the first case of pulmonary siderosis in Korea. A 42-year-old woman who had engaged in a metalware manufacturing factory as a manager for 7 years was admitted because of dyspnea on exertion. A pulmonary function test disclosed a mildly obstructive ventilatory defect. Open lung biosy revealed deposition of iron-laden macrophages in most alveolar spaces by which confirmed the diagnosis of pulmonary siderosis. We report a case of pulmonary siderosis with a review of the literature.
Adult ; Diagnosis ; Dust ; Dyspnea ; Female ; Humans ; Inhalation ; Iron ; Korea ; Lung ; Macrophages ; Mining ; Occupations ; Oxides ; Pneumoconiosis ; Respiratory Function Tests ; Siderosis* ; Steel ; Welding

PURPOSE: To compare the neutral, internal, and external rotation positions of the glenohumeral joint during magnetic resonance (MR) arthrography performed to assess changes in the shape of the labroligamentous complex (LLC) and in the labral tear. MATERIALS AND METHODS: MR arthrography of the shoulder was retrospectively evaluated in 36 patients aged 14-66 (mean, 40) years. Fourteen cases were confirmed by arthroscopic surgery (7 SLAP lesions, 2 Bankart lesions, 1 both SLAP and Bankart lesions). Axial fat-suppressed T1-weighted spin-echo images were acquired with each shoulder in the neutral position, and with internal and external rotations. In each position, we measured the angle of rotation between the perpendicular line on the glenoid fossa and the long axis of the humeral head, analyzing the relationship between the rotational angle and changes in the shape of the LLC at each internal and external rotation, relative to the neutral position. In addition, labral tears in 14 arthroscopically confirmed joints were evaluated in each position. RESULTS: Mean angles of rotation relative to the neutral position were 44.1 and 45.3 degrees in internal and external rotation, respectively. Changes in the anterior LLC occurred in 25 and 24 cases of internal and external rotation, respectively. There was a significantly meaningful relationship between rotational angle and change in the shape of the anterior LLC during external rotation, and when this change was noticed, the rotational angle was wider (p<0.05). The posterior LLC changed in shape in 13 and 16 cases of internal and external rotation, respectively, but changes according to the angle of rotation were not statistically significant. In arthroscopically confirmed joints, diagnosis of the eight SLAP lesions at external rotation tended to become more accurate, but no statistically significant differences were noted (p=0.07). Two Bankart lesions were interpreted as a tear in all three positions, and one other such lesion was interpreted as a tear in the neutral position and at external rotation, and a possible tear at internal rotation. CONCLUSION: In shoulder MR arthrography, changes in the shape of the anterior LLC were statistically prominent according to the angle of external rotation, and accuracy of diagnosis in SLAP lesions tended to be significantly higher at external rotation. If a SLAP lesion causes clinical concern, additional axial MR arthrography with the shoulder externally rotated is suggested.
Arthrography* ; Arthroscopy ; Axis, Cervical Vertebra ; Diagnosis* ; Humans ; Humeral Head ; Joints ; Retrospective Studies ; Shoulder Joint ; Shoulder*

PURPOSE: To evaluate the clinical efficacy and histopathological tolerance of 2-octyl cyanoacrylate versus conventional suture materials for eyelid wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Eyelid incisions of 15 mm were done 4mm from the upper eyelid margin in both eyes. The eyes of the rabbits were divided into two groups: eyelid incisions of the right eye were closed by a 2-octyl cyanoacrylate adhesive (group A) and eyelid incisions of the left eye were closed by 7-0 nylon sutures (group B). At 1, 2, 4, and 8 weeks after surgery, the rabbits were macroscopically examined and then sacrificed. The specimens of their eyelid tissues were stained by a hematoxylin and eosin stain and Masson-trichrome stain, and were observed under microscope. RESULTS: Both eyelid surgical closure methods were found to be equally efficacious in fixing the eyelids of groups A and B, and their clinical efficacy was similar. Histopathological findings of the hematoxylin and eosin stain of group A showed less inflammatory infiltration than group B at 2 weeks. There were no significant histopathological differences between the two groups at 1, 4, and 8 weeks. The degree of fibrosis of the Masson-trichrome stain was similar between the two groups at 8 weeks. CONCLUSIONS: The 2-octyl cyanoacrylate adhesive proved to be an effective eyelid closure method and was very well tolerated by the skin surface. 2-Octyl cyanoacrylate could be used as an alternative tissue adhesive for eyelid wound closure along with conventional suture materials.
Animals ; Blepharoplasty/*methods ; Cyanoacrylates/*pharmacology ; Disease Models, Animal ; Eyelid Diseases/pathology/*surgery ; Eyelids/*surgery ; Rabbits ; Suture Techniques/*instrumentation ; *Sutures ; Tissue Adhesives/*pharmacology ; Treatment Outcome ; Wound Healing

PURPOSE: The purpose of this study was to evaluate the incidcnce of extrapericardial fat in the left cardiacborder, and with regard to left extrapericardial fat, to correlate chest radiographs with CT scans. MATERIALS AND METHODS: This study involved 132 consecutive patients who underwent chest PA and lateral radiographs, and chestCT scans. According to the results of chest PA radiograph, patients were divided into three groups: those with aclear left cardiac border; those with an indistinct left cardiac border; and those with an indistinct left cardiacborder with increased density; cardiophrenic angle, as seen on lateral radiograph, the presence of increaseddensity in the anterior cardiophrenic angle, as seen on lateral radiograph radiographs was evaluated. On the basisof the results of CT scanning, patients were classified into four groups according to the amount of leftextrapericardial fat: negative, minimum, moderate, and maximum. Left extrapericardial fat, as seen on CT, wascorrelated with the conspicuity of left cardiac border seen on PA radiograph and the presence of increased densityin the anterior cardiophrenic angle, as seen on lateral radiograph. RESULTS: On CT, left extrapericardial fat wasobserved in 51 patients (38.6%). In 38 of these (28.8%), the amount was minimal, in 12 (9.1%), it was moderate,and in one (0.8%), it was maximal. On posteroanterior chest radiograph, clear, indistinct, and indistinct andincreased density of the left cardiac border was seen in 89 (67.4%), 28 (21.2%), and 15 cases (11.4%),respectively. On lateral radiograph, increased density of the anterior cardiophrenic angle was seen in 115 cases(87.1%) but in 17 (12.9%), increase density was not apparent. There was significant correlation between chestradiographs and CT(p<0.001) (sensitivity: 53%; specificity: 100%; positive predictive value: 100%; negativepredictive value: 84%). CONCLUSION: The conspicuousness of the left cardiac border, as seen on PA chestradiograph, correlated with the presence of left extrapericardial fat, as seen on CT, and was related to theamount of left extrapericardial fat. Increased density of the anterior cardiophrenic angle, as seen on lateralradiographs, correlated with the presence of left extrapericardial fat on CT, but the absence of increased densityon lateral radiograph corresponds to the absence or a minimal amount of left extrapericardial fat, as seen on CT.
Humans ; Radiography, Thoracic* ; Sensitivity and Specificity ; Thorax* ; Tomography, X-Ray Computed

Lipoma is a common benign neoplasm, but lipoma arising from the pleura is rare; it is composed of mature adipose tissue and occasionally fibrous stroma. The tumor shows characteristic radiographic and CT features of pleural mass, and the lesion is homogeneous and low density, with CT numbers indicating fat. The mass was removed by surgery and confirmed as a lipoma originating from the parietal pleura.
Adipose Tissue ; Lipoma* ; Pleura