BACKGROUND: Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treatment treatment of hemoptysis. METHODS: We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. RESULTS: The mean age at diagnosis was 49.3 years and male to female ratio was 2.1:1. The main causes were active pulmonay pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronicbronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial artery embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases (43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. CONCLUSION: The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.
Bronchial Arteries ; Bronchiectasis ; Bronchoscopy ; Diagnosis ; Female ; Hemoptysis* ; Hemorrhage ; Humans ; Incidence ; Korea ; Lung Diseases* ; Lung Neoplasms ; Lung* ; Male ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey. METHODS: Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2. RESULTS: Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group. CONCLUSION: Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.
Adult ; Aged ; Alcohol Drinking ; Asian Continental Ancestry Group ; Body Mass Index ; Cholesterol/blood ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*epidemiology/pathology ; Exercise ; Female ; Humans ; Hypertension/epidemiology ; Life Style ; Male ; Middle Aged ; Nutrition Surveys ; Prevalence ; Republic of Korea ; Risk Factors ; Smoking ; Socioeconomic Factors ; Stress, Psychological ; Triglycerides/blood ; Unemployment

We conducted a retrospective study of 20 penetrating keratoplasty (19patients) for corneal opacity due to herpes simplex keratitis from January 1992 to February 1997 at National Medical Center. We exaniined f requeuey of graft rejection and recurrence of herpetic keratitis after penetrating keratoplasty. The patients were grouped into control & treatinent, group according to the use of antivirial drug after penetrating keratoplasty and we examined the difference in rate of recurrence between two groups. The follow-up period was from 8 months to 68 months, mean follow-up period being 29.6 months. Graft rejection was seen in 3 eyes out of 20 eyes (15.0%) and recurrence was developed 3 eyes out of 20 eyes (15.0%). Recurrent herpetic keratitis developed in 15.4%(2 of 13) of the eyes in control group and 14.3% (1 of 7) of the eyes in treatment group. There was no statistically significant difference in recurrence rate between two groups (p)0.05). Postoperative prophylactic antiviral treatment is not associated with decreased rate of herpes simplex keratitis recurrence.
Corneal Opacity ; Follow-Up Studies ; Graft Rejection ; Herpes Simplex* ; Humans ; Keratitis, Herpetic* ; Keratoplasty, Penetrating* ; Recurrence ; Retrospective Studies

The authors have evaluated the effect of topically applied 1% cyclosporine A for four weeks after limbal allograft transplantation for ocular surface stability in severely ocular surface damaged rabbits. A total eleven severely damaged rabbits were subdivided into three groups of four limbal autograft (AUTO), three limbal allograft (ALLO), four limbal allograft with topical application of 1% cyclosporine A five times daily for four weeks (ALLO-C). We examined ocular surface smoothness, clarity, corneal vascularization before surgery and three months after surgery, and classified three grade (success, partial success, failure) according to result. In AUTO, three eyes were success, one eye was failure. In ALLO, one eye showed inferior graft detachment and one eye was success, two eyes were failire. In ALLO-C, no graft detachment detected and one eye was success, two eyes were partial success, one eye was failure. We knew that. ALLO-C show more effective ocular surface stability than ALLO. These result suggest ALLO-C can be used as alternative treatment of AUTO in ocular surface reconstruction. But, rnore study for duration and concentration of cyclosporin A will be need.
Allografts ; Autografts ; Cornea* ; Cyclosporine* ; Rabbits ; Transplants

We have reported general principles of low vision aid prescription. But, we have not reported near vision aid prescription only. So, we analyse prescriptions of near low vision aid(diagnosis, type, magnification, etc) and present new near low vision aids that patients feels comfortable. We reviewed the clinical records of 100 patients who visited our low vision clinic more than twice and was prescribed near low vision aid for low vision. According to the data analysed, optic nerve atrophy was the most common etiology for low vision. Illuminated hand held magnifier(31.3%), telemicroscope with plus cap(27.7%), aspheric doublet sens(Clear Image II)(24.1%) were low vision aids most commonly used for near vision, but we knew new trend that newly prescribed aids(telemicroscope with plus cap, aspheric doublet lens) were prescribed more than illuminated hand held magnifier. After prescription of the low vision aid, visual acuity improved significantly (p<0.05). We examined contrast sensitivity test to measure the functional acuity and predict the visual prognosis after prescription of low visio aid.In addition,we studied the relationship between reading speed and the degree of contrast sensitivity and we knew that the relationship between degree of contrast sensitivity and reading speed was associated(p<0.05). Majority of patients(89%) were benefited from prescribed low vision aids.
Atrophy ; Audiovisual Aids ; Contrast Sensitivity ; Hand ; Humans ; Optic Nerve ; Prescriptions* ; Prognosis ; Vision, Low*

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

Osteoblastoma is a rare tumor which forms osteoid and bone with highly vascular stroma, account for less than 1 percent of all bone tumors. The lesion had been though to be controlled with curettage and local excision. In recent years, osteoblastomas have been described as aggressive osteoblastoma or malignant osteoblastoma, separated from the innocuous behavior of usual osteoblastoma. It represents the histologic characteristics of the presence of epithelioid osteoblasts, trabecular rather than lace-like osteoid, low mitotic rate with no atypical form with prominent giant cells of osteoclastic type. The differential diagnosis between aggressibe osteoblastoma and osteogenic sarcoma is extremely difficult, but its peculiar histologic pattern and its different clinical and radiologic features and better prognosis are helpful. We report here a case of aggressive osteoblastoma of 17 years old female patient with 3 years and 4 months follow-up period and review the literature.
Curettage ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Giant Cells ; Humans ; Osteoblastoma ; Osteoblasts ; Osteoclasts ; Osteosarcoma ; Prognosis

Neuroblastoma occurs most frequently in children. It, however, may occur in adults. The peripheral neuroblastoma in adult is a primitive neuroectodermal tumor arising from peripheral tumor arising from peripheral nerve. It is exceedingly rare and estimated less than 1% of all malig-peripheral nerve tumors. We report a case of adult peripheral neuroblastoma arising in left lower extremity, who was treated with local excision and radiation.
Adult ; Child ; Humans ; Lower Extremity ; Neuroblastoma ; Neuroectodermal Tumors, Primitive ; Peripheral Nerves

Fibromuscular dysplasia is the single leading etiology of renovascular hypertension in children. We report an eight-year-old girl who was admitted for generalized tonic seizure with fibromuscular dysplasia of right renal artery. On admission, she presented hypertension and altered mentality. She had suffered from intermittent severe headache for the past year. Renal angiography of right renal artery showed stenosis, beaded pattern and aneurysms. Brain MRI showed multifocal lesions in parietooccipital, periventricular and external capsular area. She was diagnosed as hypertensive encephalopathy due to fibromuscular dysplasia of renal the artery. Renal angioplasty with ballooning catheter was performed. Successful renal angioplasty dropped her blood pressure to normal level and no more headaches has occurred for more than a year after discharge.
Aneurysm ; Angiography ; Angioplasty ; Arteries ; Blood Pressure ; Brain ; Catheters ; Child ; Constriction, Pathologic ; Female ; Fibromuscular Dysplasia* ; Headache ; Humans ; Hypertension ; Hypertension, Renovascular ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging ; Renal Artery ; Seizures

The aim was to investigate the proteolytic activity of plasmin and its long-term complications. Plasmin was injected into the vitreous cavity of rabbits' eyes. Slit lamp biomicroscopy and electroretinography were performed. Rabbits were serially sacrificed at four months, and globes fixated and prepared for light and transmission electron microscopy. In both the plasmin-injected and control eyes, electroretinography showed a transient decrease in the amplitude, but this recovered to the baseline level in a week. Under the light microscope, the plasmin-treated eyes had a smooth retinal surface, implying separation of the vitreous cortex from the retina. In the control eyes, the collagen fibers remained on the retinal surface. By transmission electron microscopy, the plasmin-treated eyes showed a vitreous-free retinal surface, but no vitreoretinal separation was observed in the control eyes. Plasmin induces a cleavage between the vitreous and the internal limiting membrane, with no long-term complications, so may be a useful pharmacologic adjunct to vitrectomy.
Animals ; Electroretinography ; Fibrinolysis/*drug effects ; Fibrinolytic Agents/*pharmacology ; Injections ; Plasmin/*pharmacology ; Rabbits ; Research Support, Non-U.S. Gov't ; Retina/drug effects/physiology ; Vitreous Body/*drug effects ; Vitreous Detachment/*chemically induced/pathology