PURPOSE: The aim of our study was to identify the CT features helpful in the differential diagnosis of Iobar consolidation. MATERIALS AND METHODS: We evaluated the CT findings in 52 consecutive patients with Iobar consolidation which were proved to be pulmonary tuberculosis(n=24), malignant obstructive pneumonitis due to bronchogenic carcinoma(n=21), and lung abscess(n=7). We retrospectively reviewed CT scans with respect to 1) number of cavities or low attenuation area suggesting necrosis(we described these as cavity), 2) the contour of cavity, 3) enhancement of the cavity wall, 4) enhancement of pleura, 5) small nodules adjacent to the consolidation, 6) similar lesion in other location in lung, 7) air-bronchogram 8) mediastinal lymph node enlargement, and 9) extrapleural change. RESULTS: The helpful CT fingings in the patients with pulmonary tuberculosis were multiple cavities(more than three;79.2%), small nodules adjacent to the Iobar consolidation(75.0%), similar lesion in another lobe or lung(91.7%), air-bronchogram(91.7%), and mediastinal lymph node enlargement(58.3%). Although extrapleural change had low sensitivity it was highly specific for pulmonary tuberculosis(sensitivity, 43.5%;specificity, 91. 7%). Multiple cavities(61.9%) and mediastinal lymph node enlargement(52.4%) were common findings of malignant obstructive pneumonitis. In the patients with lung abscess, the common findings were small number of cavities(one or two, 85.7%) and air-bronchogram(85.7%). However, other findings of pulmonary tuberculosis were rarely seen in the patients with malignant obstructive pneumonitis or lung abscess. CONCLUSION: The CT findings of Iobar consolidation may be used as useful adjuncts in the differential diagnosis of Iobar consolidation.
Diagnosis, Differential ; Humans ; Lung Abscess* ; Lung* ; Lymph Nodes ; Pleura ; Pneumonia* ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary

When tracheal invasion of a malignant tumor or tracheal stenosis of a benign origin exists at the lower or anterior part of the trachea, tracheal intubation or conventional tracheostomy may be difficult, and in these cases a modified tracheostomy through the lower or lateral part of the trachea would be necessary. We present 6 cases of modified tracheostomy performed with satisfactory results in severe tracheal stenosis that developed in the lower or anterior part of the trachea.
Intubation ; Trachea ; Tracheal Stenosis* ; Tracheostomy*

Authors analyzed the results of treatment in 49 cases of medulloblastoma who had been operated upon at the Seoul National University Hospital from January 1972 to June 1987. There were 2 cases(4%) of postoperative mortality(death within postoperative one month) and 13 cases of late moratlity. The 3-year overall survival rate was 49.3% and 3-year disease-free survival rate was 48.5%. The risk period of recurrence was about 2 years after surgery. The 3-year survival rate was significantly better in "grow total resection" group, "radiation dose more than 50 Gy" group, and group II(23 cases operated after July 1982) (p<0.05). The rate of posterior fossa recurrence was lower in "gross total resection" group for the patients who received posterior fossa irradiation of more than 50 Gy.
Disease-Free Survival ; Humans ; Medulloblastoma ; Prognosis* ; Recurrence ; Seoul ; Survival Rate

Tuberculosis is one of the main infectious health problems in Korea, and a combination of antibiotics is required to treat this illness. The combination therapy with rifampicin, isoniazid, ethambutol and pyrazinamide has many adverse reactions and there have been several case reports about pseudomembranous colitis (PMC) after anti- tuberculosis treatment. Rifampicin is regarded as a main cause of anti-tuberculosis induced PMC because of its bacteriocidal effect, and interruption of the offending drug, such as rifampicin, is usually necessary to treat the PMC. However, in patents with uncompensated tuberculosis, the discontinuance of anti-tuberculosis medication accentuates the disease severity, and continuance of the anti-tuberculosis medication is necessary to overcome the tuberculosis. We report here on a case in which the anti- tuberculosis agents induced PMC in 32 year old female who was diagnosed with active pulmonary tuberculosis. She was treated with maintenance of the anti-tuberculosis medication and also the addition of both oral metronidazole and probiotics.
Anti-Bacterial Agents ; Enterocolitis, Pseudomembranous ; Ethambutol ; Female ; Humans ; Isoniazid ; Korea ; Metronidazole ; Probiotics ; Pyrazinamide ; Rifampin ; Tuberculosis ; Tuberculosis, Pulmonary

Garlic and mugwort have long been used in traditional medicine to prevent various diseases. Several in vitro studies have reported protective efficacies of garlic and mugwort in cases of gastric cancer. In the present study, we investigated the cancer preventive effects of garlic and mugwort mixture extract (GME) in a Helicobacter (H.) pylori-associated gastric carcinogenesis mouse model. To induce gastric cancer, C57BL/6 mice were treated with N-methyl-N-nitrosourea and H. pylori. Various concentrations of GME (0, 100, 500, and 1,000 ppm) were then fed to the mice for 38 weeks, after which the tumor tissues were examined for histopathology, mucin histochemistry and beta-catenin. The incidence of gastric tumors was significantly lower in the highest dose GME-treated mice (46.7%) than control mice (85.7%) (p < 0.05). The multiplicity and size of tumors were also significantly reduced by GME feeding in a dose-dependent manner (p < 0.01). Furthermore, GME suppressed the H. pylori-associated chronic inflammation measured by histologic grading of H. pylori density, chronic gastritis, glandular atrophy and intestinal metaplasia in non-tumorous gastric mucosae. Our data suggest that GME suppresses gastric tumorigenesis via suppression of H. pylori-associated chronic inflammation.
Animals ; Artemisia* ; Atrophy ; beta Catenin ; Carcinogenesis* ; Garlic* ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Helicobacter* ; Incidence ; Inflammation ; Medicine, Traditional ; Metaplasia ; Methylnitrosourea ; Mice* ; Mucins ; Stomach Neoplasms

Garlic and mugwort have long been used in traditional medicine to prevent various diseases. Several in vitro studies have reported protective efficacies of garlic and mugwort in cases of gastric cancer. In the present study, we investigated the cancer preventive effects of garlic and mugwort mixture extract (GME) in a Helicobacter (H.) pylori-associated gastric carcinogenesis mouse model. To induce gastric cancer, C57BL/6 mice were treated with N-methyl-N-nitrosourea and H. pylori. Various concentrations of GME (0, 100, 500, and 1,000 ppm) were then fed to the mice for 38 weeks, after which the tumor tissues were examined for histopathology, mucin histochemistry and beta-catenin. The incidence of gastric tumors was significantly lower in the highest dose GME-treated mice (46.7%) than control mice (85.7%) (p < 0.05). The multiplicity and size of tumors were also significantly reduced by GME feeding in a dose-dependent manner (p < 0.01). Furthermore, GME suppressed the H. pylori-associated chronic inflammation measured by histologic grading of H. pylori density, chronic gastritis, glandular atrophy and intestinal metaplasia in non-tumorous gastric mucosae. Our data suggest that GME suppresses gastric tumorigenesis via suppression of H. pylori-associated chronic inflammation.
Animals ; Artemisia* ; Atrophy ; beta Catenin ; Carcinogenesis* ; Garlic* ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Helicobacter* ; Incidence ; Inflammation ; Medicine, Traditional ; Metaplasia ; Methylnitrosourea ; Mice* ; Mucins ; Stomach Neoplasms

In order to determine the survival rate and prognostic factors of patients with intracranial oligodendroglioma as predictors of survival, a retrospective analysis of a total of 68 cases treated between 1982 and 1992 at our institute was performed. The 5-year and 10-year survival rates were 84.5% and 55.1% respectively while the median survival time was 116+/-5.3 months. The significant factors identified by the univariate analysis included the presence of preoperative seizure, the pre- and postoperative status, the presence of signs of increased intracranial pressure before operation and pathologic grade of the tumors. Factors such as age, types of chief complaints, blood types, the preoperative neurologic deficit, the size of tumor, the enhancement of tumor, cysts in tumor, the extent of removal and the postoperative seizure had no correlations with survival rates. The only significant prognostic factor determined by the multivariate analysis was the pathological grade(p=0.04).
Humans ; Intracranial Pressure ; Multivariate Analysis* ; Neurologic Manifestations ; Oligodendroglioma* ; Retrospective Studies* ; Seizures ; Survival Rate*

Clinical criteria have been established for idiopathic hypereosinophilic syndrome (HES): persistent eosinophilia of 1500 eosinophils/mm3 for at least 6 months or death even within 6 months with signs and symptoms of HES; no evidence for parasitic, allergic, or other recognized causes of eosinophilia despite careful evaluation; and signs and symptoms of organ system involvement or dysfunction, such as congestive heart failure, hepatosplenomegaly, central nerveous system disease. Because cerebral hemorrhage in HES has not been reported yet in Korea, we report a case of hypereosinophilic syndrome with peripheral blood eosinophilia, with biopsies of skin and duodenum showing diffuse eosinophilic infiltration, and multiple organ dysfunction in a 49 year old man died of cerebral hemorrhage three months after the occurrence of the disease.
Biopsy ; Cerebral Hemorrhage ; Duodenum ; Eosinophilia ; Eosinophils ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Intracranial Hemorrhages* ; Korea ; Middle Aged ; Polyradiculoneuropathy* ; Skin

The authors report on 17 patients having primary central nervous system(CNS) lymphomas between January, 1981 and August, 1992. All patients were treated at Seoul National University Hospital. Only three cases underwent surgery only and fourteen cases underwent surgery and radiation theraphy with or without chemotherapy. There were no immunosuppressive patients. Sixteen patients were analyzed for survival studies, because one case was lost during follow-up. The median survival time(MST) was 26 months and one- and two-year survival rates for the 16 patients were 87.5% and 65.6% respectively. The rate of survival was analyzed according to possible prognostic factors factors;age and sex, multiplicity and location of tumors, preoperative Karnofsky performance score(KPS), pathological subclassification, type of surgery, preoperative steroid therapy, postoperative adjuvant therapy, extent of radiation, chemotherapy and the degree of response to treatment at three months follow-up. Postoperative adjuvant therapy and the degree of response to the treatment correlated with survival. Fourteen patients who underwent postoperative adjuvant therapy had a median survival time of 63 months. The one- and two-year survival rates were 100% and 75% respectively compared to the MST of 1.5 months with survival rates of 0% and 0% retrospectively for the two patients who did not. A higher long term survival rate was observed in the group with better immediate responses. In nine of 16 patients with complete responses, the MST, one-, and two-year survival rates were 63 months, 100%, and 83% respectively. The authors suggest that preoperative application of steroids may be considered in case of clinically suspected primary CNS lymphomas. It is concluded that after obtaining the tissue diagnosis of primary CNS lymphomas, radiotherapy with or without chemotherapy should be performed until the complete response.
Brain Neoplasms ; Central Nervous System* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymphoma ; Radiotherapy ; Retrospective Studies ; Seoul ; Steroids ; Survival Rate*

We present a series of 42 patients with the lateral ventricular mass lesions who underwent operative removal between 1979 and 1992 at the Seoul National University Hospital. These lesions included 29 tumors, 10 benign cysts and 3 arteriovenous malformations. There were 20 lesions in the trigone, 14 in the frontal horn, 6 in the body, and 2 in the temporal horn. Together with the age of the patient, the location in the lateral ventricle and the CT or MR patterns, the range of the differential diagnosis of the lesions can be narrowed. The mass were removed by various surgical approaches;11 by the middle frontal gyrus, 10 by the superior parieto-occipital, 13 by the middle temporal gyrus, 4 by the anterior transcallosal, 2 by the posterior transcallosal and 3 by the combined approaches. The superior parieto-occipital approach left postoperative morbidities in 64% and other approaches in 20 to 25% of the cases. These morbidities included hemiparesis, hemianopsia, aphasia, memory distubance and seizure. Most hydrocephalus disappeared without the shunting procedure after removal of the lateral ventricular mass. The high frequency of postoperative complications in the superior parieto-occpital approach require meticulous consideration in the selection of this approach.
Animals ; Aphasia ; Arteriovenous Malformations ; Diagnosis, Differential* ; Hemianopsia ; Horns ; Humans ; Hydrocephalus ; Lateral Ventricles ; Memory ; Paresis ; Postoperative Complications ; Seizures ; Seoul