Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: The perfect preanesthetic medication and its ideal route of administration are still debated. Transmucosal administration of midazolam has been of interest because of the rapid, reliable onset of action, predictable effects and avoidance of injections. Because many medications are well absorbed from the mucosa, we conducted a randomized, prospective, blinded study to compare acceptance and efficacy of intranasal and sublingual administration of midazolam as a preanesthetic medication in children. METHODS: One hundred twenty eight patients aged 0.5-12year were stratified by age: 38 infants and toddlers, 0.5-3yr; 48 preschoolers, 3.1-7yr; and 42 school age, 7.1-12yr. They were randomized to received 0.2 mg/kg of midazolam in the nose or under the tongue. Hemoglobin oxygen saturation by pulse oximetry and sedation score were recorded before drug administration, at 2.5min intervals for 15min, at separation from parents and during induction with enflurane in O2. Retention time of sublingual drug and duration of crying were recorded. RESULTS: The incidence of crying at the time of administration of midazolam was greater following intranasal compared with sublingual administration(60% vs 17%, p<0.05). Within age groups, only infants and toddlers showed a significant difference in the incidence of crying between treatment groups. Significant changes in sedation occured in both groups from 2.5min after administration. CONCLUSIONS: Sublingual midazolam is better accepted than intranasal midazolam as a preanesthetic sedative in children.
Administration, Mucosal ; Administration, Sublingual ; Child ; Crying ; Enflurane ; Humans ; Hypnotics and Sedatives ; Incidence ; Infant ; Midazolam* ; Mucous Membrane ; Nose ; Oximetry ; Oxygen ; Parents ; Preanesthetic Medication* ; Premedication ; Prospective Studies ; Tongue

PURPOSE: Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances, abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. we experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. MATERIALS AND METHODS: We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had mdical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. RESULTS: Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. CONCLUSION: The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment.
Abscess ; Cesarean Section ; Diagnosis ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Laparotomy ; Male ; Pregnancy ; Retrospective Studies ; Surgical Sponges ; Tomography, X-Ray Computed

No abstract available.
Pregnancy* ; Pyelonephritis*

PURPOSE: Tuberculosis is a chronic infection caused by mycobacteria species. M. tuberculosis causes disease predominantly in the lung, although every organ in the body may be involved. Retinal tuberculosis is very rare and usually unilateral. Possible hypotheses on the pathogenesis of tuberculosis-related retinal vasculitis are an infectious process and a hypersensitivity mechanism. In Korea, no case has been reported. METHOD: We experienced a case of bilateral retinal vasculitis who was suffering from tuberculous meningitis. RESULT: His vasculitis was successfully treated with anti-tuberculosis medications. We report a case of tuberculosis-related retinal vasculitis with the review of literature.
Hypersensitivity ; Korea ; Lung ; Retinal Vasculitis* ; Retinaldehyde* ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

No abstract available.
Child* ; Humans ; Nephrotic Syndrome* ; Peritonitis*

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

The layout problem involves finding the best arrangement of physical components of the service system possible within the time, cost, and technology constraints of the situation. And the layout problem can be a very complex system design problem requiring the most sophisticated lay system analysis and design tools in order to develope satisfactory layout solutions. The objective of this layout study is to reorganize service rooms for minimizing overall patient's moving distance. In solving the service room layout problem, there exist a number of constraints on the building facilities in current location. All other service rooms can be moved if layout analysis indicates it would be beneficial. The first step is to analyze records in order to determine the number of trips made by patients between departments in two months. And a number of layout cases developed as methods to a good service room layout. The result is shortened total patient's layout distance of 252,880 meters.
Humans

PURPOSE: The present study proposes to examine the change of IOP in response to the rise of abdominal pressure and in response to position change during laparoscopic surgery. METHODS: The subjects of the present study included 28 patients who had laparoscopic appendectomy and 20 patients who had laparoscopic cholecystectomy. In both groups, the IOP was measured before surgery, after general anesthesia, after the occurrence of pneumoperitoneum, after position change according to operative method, after the removal of pneumoperitoneum and under general anesthesia. RESULTS: When comparing the IOP before and after the occurrence of pneumoperitoneum, the IOP after the occurrence increased by 3.70 +/- 0.96 mm Hg in the appendectomy group and by 3.15 +/- 0.5 mm Hg in the cholecystectomy group. After the occurrence of pneumoperitoneum, the IOP measured in the head-low position was 3.25 +/- 0.16 mm Hg higher than measured in the level position in the appendectomy group, and the IOP measured in the head-high position was 2 +/- 0.12 mm Hg lower than measured in the level position in the cholecystectomy group. Between the 2 groups, there was a significant difference of 6.5 mm Hg in IOP according to the change of head position. CONCLUSIONS: In the present study, the occurrence of pneumoperitoneum in laparoscopic surgery increased IOP, and position change according to operative method also changed IOP. In addition, IOP was significantly different between the 2 groups. In order to prevent the patient from being exposed to high IOP for a long period during laparoscopic surgery, keeping the duration of pneumoperitoneum and a head-low position to a minimum may be helpful.
Anesthesia, General ; Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Head ; Humans ; Intraocular Pressure ; Laparoscopy ; Pneumoperitoneum