PURPOSE: Kimura's disease is an inflammatory condition of unknown etiology which usually occurs in salivary glands and cervical lymph nodes. This study was undertaken to evaluate the radiologic characteristics of Kimura's disease using CT and MRI. MATERIALS & METHODS: We evaluated CT & MR of 10 patients with histologically proved Kimura's disease in the head and neck. Six males and four females between 16 and 58 years old (mean age, 37.6 years) were included. Contrast enhanced CT scan was performed in all, and spin-echo MRI was performed in 2 patients. RESULTS: Both CT and MRI demonstrated the distinctive sites of involvement that were major salivary glands (4 cases) and lacrimal gland (1 case), periglandular soft tissue (8 cases), and cervical lymph nodes (8 cases). Majority of soft tissue lesions were ill-defined with infiltration to adjacent fascial planes, but nodal lesions were relatively well-defined and homogenous. The lesions were iso-intense on Tl-weighted image and hyper-intense on T2-weighted image. All but a few nodal lesions showed variable degree of contrast enhancement on CT and MRI. CONCLUSION: In diagnosis of Kimura's disease, CT & MRI of head & neck, especially salivary glands, are useful. In cases of recurrent periglandular soft tissue mass with contrast-enhancing cervical lymphadenopathy in adult patients, Kimura's disease should be included in the differential diagnosis.
Adult ; Diagnosis ; Diagnosis, Differential ; Female ; Head* ; Humans ; Lacrimal Apparatus ; Lymph Nodes ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck* ; Salivary Glands ; Tomography, X-Ray Computed

PURPOSE: Axillary lymph node metastases are the single most important predictor of overall survival in patients with breast cancer. Micrometastases are defined by the American Joint Committee on Cancer as tumor foci less than or equal to 2 mm in greatest dimension. Recently, up to 30% of breast cancer patients were reported to have micrometastases. In this paper, to assess the rate of micrometastases in patients with stage I breast cancer, we attempted to determine the most useful marker of the micrometastases in node negative cases by routine histopathologic examination of regional lymph nodes and comparison of the results with the influencing factors on prognosis. MATERIALS AND METHODS: We performed immunohisto chemical staining for pancytokeratin, cytokeratin 7, cytokeratin 20 and CEA to identify which protein was the most useful marker for the detection of micrometastases in 86 node negative cases and determined the correlation between histological and clinical data. RESULTS: A total of 5 lymph nodes in 5 separate cases showed micrometastases among the total 1,296 lymph nodes and 86 cases. The rates of micrometastases of lymph nodes and cases were 0.38% and 5.8%, respectively. The tumor type of micrometastasis was infiltrating ductal carcinoma in all cases. None of the microme tastases cases showed any relationship with tumor grade, tumor size, expression of ER and PR, patient survival rate or recurrence rate. The most useful marker to detect micrometastases was pancytokeratin. CONCLUSION: The results of this study indicate that micrometastasis of axillary lymph nodes does not carry any independent prognostic significance.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Humans ; Immunohistochemistry ; Joints ; Keratin-20 ; Keratin-7 ; Keratins* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Prognosis ; Recurrence ; Survival Rate

No abstract available.
Brain* ; Frontotemporal Dementia ; Supranuclear Palsy, Progressive ; Tomography, Emission-Computed, Single-Photon*

The AMBU bag is a useful equipment at the cardiopulmonary resuscitation (CPR) or the respiratory therapy. The AMBU bag eonsists simply of a self-reflating bag, a patient valve and a inlet valve. The patient valve is a non-rebreathing valve and the self-inflating bag is a recoiled rubber bag. The inlet valve on the posterior site of self-inflstion bag is closed during the bag is squeezed, and opened during the bag is released. During reflation of bag, fresh room air through the one-way valve and fresh oxygen through the orifice for oxygen supply will mix. Therefore the inspiratory oxygen concentration is decided by a speed of re- flation of the self-reflating bag. We measured inspiratory oxygen concentration during AMBU bag ventilation under different inspiration : expiration (I:E) ratio, frequency of venti- lation, ventilatory volume and flow rate of oxygen. The results were that factors increase a inspirstory oxygen concentration are 1) decrease of I:E ratio, 2) decrease of frequency of ventilation, 3) decrease of ventilatory volume, 4) inerease of flow rate. We found that haste of physician makes frequent squeezing of AMBU bag and the haste results a decrease of inspiratory oxygen concentration.
Bays ; Cardiopulmonary Resuscitation ; Humans ; Oxygen* ; Respiratory Therapy ; Rubber ; Ventilation*

During the long-term COVID-19 pandemic, wearing a mask is inevitable for protecting individuals from airborne infection. In this case, we found out that mask may exacerbate atopic dermatitis and it can be treated simply and effectively using silicone tape. We suggest that throughout the COVID-19 pandemic, silicone tape can be beneficial in both preventing and treating eczema caused by mask-wearing, especially in patients with atopic dermatitis.

A 15-year-old male was admitted with right-sided chest pain and cough for one month. On chest computed tomographic scan, a 10 x 15 x 16 cm-sized huge mediastinal mass was occupied in the right hemithorax. Radiologically, it seemed that the tumor was severely adhesive on the heart and the superior vena cava. Therefore we decided on chemotherapy and radiotherapy first instead of surgery. The tumor marker was nearly normalized afterwards, but the tumor size was seemed to be bigger on chest tomographic scan. This suggests the growing teratoma syndrome. After the successful resection, he showed symptomatic improvement and is being followed up without any symptoms in an out patient department up to now.
Adhesives ; Adolescent ; Chest Pain ; Cough ; Drug Therapy ; Heart ; Humans ; Male ; Mediastinal Neoplasms ; Radiotherapy ; Teratoma* ; Thorax ; Vena Cava, Superior

BACKGROUND: It has been reported that the association between blood pressure and cognitive impairment could be modified by factors such as gender, education, and Apo E genotypes. This study was aimed to investigate whether `age' could also be a modifier of the association. METHODS: The study group consisted of 489 participants aged 65 years or over who lived in Namwon, Korea. The presence of hypertension was ascertained by the measurement of their resting blood pressure. A cognitive impairment was considered to be present when a Korean Mini-Mental State Examination score was less than 19 (30th percentile). RESULTS: A higher systolic blood pressure was significantly associated with cognitive impairment, after an adjustment for age, gender, education, and occupation. However, the significance was lost in subjects aged 71 or over. CONCLUSIONS: High systolic blood pressure is a factor strongly associated with cognitive impairment in an aged population. However, in the subjects with far advanced age, the association is not significant. Further studies are required to elucidate whether blood pressure lowering strategies should be differentiated according to age in order to reduce cognitive impairment.
Adult* ; Aged* ; Apolipoproteins E ; Blood Pressure* ; Education ; Genotype ; Humans ; Hypertension ; Jeollabuk-do ; Korea ; Occupations

Lymphocytic hypophysitis, an inflammatory disease of the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse inflammatory cell infiltration of the pituitary gland and some kinds of detectable autoantibodies. We report a case of lymphocytic hypophysitis in a 31-year-old woman presenting with severe hypoglycemia and hyponatremia after delivery. Hormonal study revealed panhypopituitarism and magnetic resonance imaging with enhancement showed the bulging contour of the right side pituitary gland with an ill-defined mass-like lesion and nodular thickening of the stalk. The patient's symptoms and biochemical data improved greatly with replacement of L-thyroxine and glucocorticoid. Partial recovery of panhypopituitarism was also seen. The follow-up tests revealed dramatic resolution of the pituitary lesion.
Adult ; Autoantibodies ; Female ; Follow-Up Studies ; Humans ; Hypoglycemia* ; Hyponatremia ; Hypopituitarism ; Magnetic Resonance Imaging ; Pituitary Gland ; Pregnancy ; Thyroxine

BACKGROUND: Acute renal failure (ARF) due to acute pyelonephritis (APN) in patients in the absence of obstructive uropathy, diabetes, or chronic renal failure was reported rarely (12 cases in the last 25 yrs in Clin Inf Dis, 1992; 243-6 by SR Jones)2). Acute renal failure is a rare complication of acute pyelonephritis in patients who do not have urinary obstruction. Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure, and when clinicians weigh the possible consequences of bacteriuria, renal failure is not considered to be a reasonable possibility. METHODS: We observed 6 patients of acute pyelonephritis associated with acute renal failure as an initial manifestation on admission in the past 6 months. The analysis of clinical features of these 6 patients (APN+) compared to 7 patients of APN without ARF (APN-) revealed following data. RESULTS: All were female in both groups. The mean age was 331.7 years in APN+ and 48+6 years in APN-, respectively (p, ns). All in both APN- and APN+ were caused by E. coli. But, none in both groups except 1 in APN- had bacteremia. The previous history of UTI was present in 5 in APN-, but none in APN+. Duration of clinical symptoms before admission (8.4+/-0.5 vs. 4.4+/-1.0 days, P<0.05) and admission days (24.2+/-1.8 vs. 11.1+/-1.5 days, p=0.000) were significantly longer in APN+. On admission, HUN and serum creatinine was 45+/-2.7mg/dL and 3.5+/-0.2mg/dL in APN+, respectively. No one in APN+ required dialysis, and subsequently recovered renal function with prompt antibiotic therapy resulting in no significant difference compared to that of APN on discharge (serum creatinine, 1.0+/-0.1 vs. 0.9+/-0.1mg/dL). No differences in leukocytosis and serum electrolyte levels on admission were present. However, significant anemia was noted in APN+ (hemoglobin, 9.0+/-0.7 vs. 11.9+/-0.2gm/dL). The days of fever and leukocytosis before disappearance were not different in both groups, but those of flank pain (12.8+/-1.5 vs. 5.7+/-0.7 days, P=0.001) and pyuria (16+/-1.9 vs. 6.4+/-0.6 days, P=0.000) significantly longer in APN+. Upon ultrasonography, all in APN+ showed enhanced echogenicity, but I in APN . (P=P value, NS=not significant) CONCLUSION: Upon these data, we concluded that ARF associated with APN as an initial manifestation was accompanied by several distinct clinical characteristics, which could be used for the early recognition of its unusual occurrence and subsequent appropriate management including antibiotics leading to a favorable outcome.
Acute Kidney Injury* ; Adult ; Anemia ; Anti-Bacterial Agents ; Bacteremia ; Bacteriuria ; Creatinine ; Diagnosis, Differential ; Dialysis ; Female ; Fever ; Flank Pain ; Humans ; Kidney Failure, Chronic ; Leukocytosis ; Pyelonephritis* ; Pyuria ; Renal Insufficiency ; Ultrasonography ; Urinary Tract Infections

BACKGROUND: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. MATERIAL AND METHOD: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS bleb resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mm VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. RESULT: The mean follow-up duration was 20.8+/-16.1 months in 10 mm VATS group, and 13.9+/-8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax (34%) in 10 mm VATS and patient's desire (40%) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, R2 values were lower than 0.1. The postoperative recurrence rate was 2.7% in 10 mm VATS and 2.9% in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. CONCLUSION: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.
Blister ; Chest Tubes ; Drainage ; Follow-Up Studies ; Gyeonggi-do ; Hospitalization ; Korea ; Linear Models ; Pleurodesis ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted* ; Thoracoscopes ; Thoracoscopy*