Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.
Male ; Humans ; Cysts ; Biopsy

Adenomyosis is a common disease of middle-aged women and adenomyoma is a variety of adenomyosis that formed localized tumor. Cystic degeneration of an adenomyoma is a rare clinical manifestation. A 30-year-old parous woman suffered from severe dysmenorrhea and menorrhagia for about 5 months, was operated under the impression of endometriosis of the pelvis. Following the operation, cystic degeneration of an adenomyoma was found incidentally. The authors experienced a case of adenomyosis that formed cystic tumor of uterus and presented with a pertinent literatures.
Adenomyoma ; Adenomyosis* ; Adult ; Dysmenorrhea ; Endometriosis ; Female ; Humans ; Menorrhagia ; Pelvis ; Uterus

No abstract available.
Pregnancy* ; Uterine Hemorrhage*

The purpose of this study was to assess the energy value of breakfast and its relation to total daily nutrient intake and serum lipid. Dietary intakes were evaluated through the 3-day dietary recalls(interview for 1day and self-report for 2 days) from 333 Korean urban adults aged 20-49 year. Serum lipids in fasting blood samples were measured form 98 of those 333 adults. Low energy breakfast(<15% of daily energy intake) was consumed by 22.6% of males and 18.5% of females. 59.4 of males and 43.3% of females consumed a breakfast of average energy intake(15-25% daily energy intake) ; and 18.1 of males and 38.2% of females consumed a significant contribution to a total daily nutrient intake. The daily nutrient intake except crude fiber and vitamin A, B, B, and C in males and except vitamin C in females significantly increased as the energy value of breakfast increased. The differences in energy and nutrient intakes at breakfast were not made up for by other meals. To make matters worse, the satisfactory-energy breakfast group took more energy at dinner compared with the low-energy and average-energy breakfast group took more energy at dinner compared with the low-energy and average-energy breakfast groups in females. Among serum lipid parameters, TG was negatively correlated with energy provided at breakfast, and total cholesterol and LDL-cholesterol had a negative correlation with energy and carbohydrates provided at breakfast in males. For females TG was positively correlated with the ratio of carbohydrates to energy at breakfast but negatively correlated with the ratio of fat to energy at breakfast. These results suggest that satisfactory energy intakes at breakfast have positive effects on the adequacy of daily nutrient intake and may positively affect the serum lipid status.
Adult* ; Ascorbic Acid ; Breakfast* ; Carbohydrates ; Cholesterol ; Fasting ; Female ; Humans ; Male ; Meals ; Vitamin A

No abstract available.
Carcinoma, Renal Cell* ; Prognosis*

No abstract available.
Carcinoma, Renal Cell* ; Prognosis*

A new microemulsion formulation of cycloporine(CsA) has been recently used in Korean renal transplants. We compared the clinical effect and the trough levels of microemulsion cyclosporine(M-CsA) as opposed to conventional CsA in soft gelatine capsule(C-CsA). In the study for hospitalized post-operative patients, 58 patients were divided into two groups; the C-CsA(control) group(n=23) received C-CsA, and the M-CsA group(n=28) received M-CsA after transplantation. In the study for stable OPD patients, 32 patients were divided into two groups. The C-CsA(control) group(n=16) did not change the type of CsA and continued C-CsA medication after Sep. 1994, M-CsA group(n=16) switched from C-CsA to M-CsA in Sep. 1995. In postoperative hospitialized patients, mean trough levels were not different between the two groups with CsA dosage (9mg/kg - 5mg/kg), although the M-CsA group had higher trough levels with 10mg/Kg CsA dosage than the control group. In OPD patients, there was no significant change in CsA dosage in both groups during the 6 month period. Mean trough levels, 6 months after conversion, were lower in the M-CsA group than in the control group. In the M-CsA group who received the same dose as a preconversion dose, mean trough levels at 2, 3, 4, 5, 6 months were lower than the preconversion level, although control groups had lower trough levels only at 5 months. Serum creatinine levles were significantly decreased in the M-CsA OPD patients. From these results, we couldn't find a dose saving effect of M-CsA in our patients, it is much desirable to study the pharmacokinetics of M-CsA and C-CsA in Korean renal transplants.
Creatinine ; Cyclosporine* ; Gelatin* ; Humans ; Kidney Transplantation ; Pharmacokinetics ; Transplantation*

No abstract available.
Cervix Uteri* ; Female

Glucocorticoids are usually given according to a standard dosing protocol regardless of individual difference. We evaluated the pharmacokinetic characteristics of methylprednisolone and the degree of interpatient variation in stable Korean renal transplant recipients during the period of 15-21 days after transplantation. This study included 23 renal transplant recipients, 13 males and 10 females, who received kidneys from living donors with stable graft function and without episode of acute rejection. On the study day at 8 A.M., 16.3mg of ethylprednisolone sodium succinate (i.v.) was administered to each patient instead of usual dose (20mg) of prednisolone (p.o.) after sampling of 7cc of baseline blood and additional blood samples were drawn after starting infusion. Plasma was separated and analyzed for methylprednisolone level using high performance liquid chromatography (HPLC) assay, and parameters for pharmacokinetics were calculated. There was significant interpatient variation in the pharmacokinetics of methylprednisolone in our patients group. There was no significant difference in the pharmacokinetic parameters between patients with and without side effects of steroid. Korean renal transplant recipients had higher volume of distribution than black renal transplant recipients; lower clearance than white renal transplant recipients; longer t1/2 than both black and white renal transplant recipients. Even if the number of patients included in this study was too small to reach conclusion, the differences in the pharmacokinetics of glucocorticoids do not seem to be a significant risk factor for side effects of steroid after transplantation. It may be necessary to individualize the dose of a glucocorticoid to achieve an optimal effect and also we need to establish a new steroid regimen protocol for Korean renal transplant recipients.
Chromatography, Liquid ; Female ; Glucocorticoids ; Humans ; Individuality ; Kidney ; Kidney Transplantation ; Living Donors ; Male ; Methylprednisolone* ; Pharmacokinetics ; Plasma ; Prednisolone ; Risk Factors ; Sodium ; Succinic Acid ; Transplantation* ; Transplants

PURPOSE: After the administration of Organ Transplantation Law in Feb. 9. 2000, the number of brain death donation has decreased due to the strictness of donation process, the lack of publicity activities, so the activation of brain death donation issue has arose. Intensive Care Unit (ICU) nurse is the first person that contacts with the brain death donor, the provider of donor care and also the maker of rapport with patient family, accordingly they are considered to be one of the important human resource. The purpose of this study is to analyse the attitude of the brain death donation and the relative factors. METHODS: The subjects were 184 ICU nurses in hospitals, who work in the Neurosurgery and Neurology ICU. RESULTS: (1) The rate of positive attitude about organ donation for the nurses who have the knowledge of enforcement of 'Organ Transplantion Law', the knowledge of first connect point is KONOS (Korean Network for Organ Sharing) and the knowledge of brain death organ donation nursing care, was higher than the others with p=0.050, p=0.029 and p=0.048, respectively. (2) The rate of positive attitude about organ donation for the nurses who experienced the complete process of organ donation, received education on organ donation and transplant, was higher than the others with p=0.007, p=0.043, respectively. The nurses who did not experience brain death organ donation nursing care had higher rate of negative attitude than the others with p=0.022, and for those who have experienced the complete process of organ donation nursing care had a higher negative attitude than others with p=0.006. (3) The positive attitude items were divided 3 groups - the respondants' recognition and will, the benefits of organ donation, the role of organ donation process. The negative attitude items were divided 3 groups - the difficulty of organ donation, the respondants' opposition, the uncoorperation of gaurdians and medical staffs. CONCLUSION: The results of this study is believed to be a useful tool in facilitating organ donation as a groundwork for publicity, education and policy.
Brain Death* ; Brain* ; Critical Care* ; Education ; Humans ; Intensive Care Units* ; Jurisprudence ; Medical Staff ; Neurology ; Neurosurgery ; Nursing Care ; Organ Transplantation ; Tissue and Organ Procurement* ; Tissue Donors ; Transplants