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

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

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*

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

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

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

PURPOSE: To assess the change in configuration of the diaphragm between scans obtained at end inspiration and end expiration. MATERIALS AND METHODS: Two series of CT scans at end inspiration and at end expiration were obtained in 37 patients. We evaluated the changes in the type of anterior diaphragm, pseudotumor, undulation ofthe diaphragm, and diaphragmatic defect during the respiratory phases. RESULTS: The configuration of the anterior portion of the diaphragm changed between end inspiratory and end expiratory CT scans in 25(67.6%) of 37 patients. Diaphragmatic defect, diaphragmatic pseudotumor, and undulation of the diaphragm were more frequent at end inspiration (13.5%, 18.9%, 37.8%, respectively) than at end expiration (0%, 5.4%, 10.8%, respectively). CONCLUSION: There is a change in the configuration of the anterior portion of the diaphragm and we also observed differences in the visualization of diaphragmatic defects, pseudotumor, and undulation between scans obtained at end inspiration and end expiration.
Diaphragm* ; Humans ; Tomography, X-Ray Computed

PURPOSE: To evalvate whether in patients with diffuse evaluation of a hemidiaphragm on chest radiographs, the apparence of the crura on CT might be helpful in differentiating between traumatic rupture of the diaphragm(TRD) and nontraumatic causes such as diaphragmatic palsy or diffuse diaphragmatic eventration. MATERIALS AND METHODS: Among patients with diffuse elevations of a hemidiaphragm on chest radiograph, 27 who had patients undergone CT scans were retrospectively reviewed. Twelve patients had surgically proven TRD, and 15 had nontraumatic elevation of a hemidiaphragm such as diaphragmatic palsy or diffuse diaphragmatic eventration. Under the hypothesis that the affected crus is markedly thinner than the normal side in nontraumatic elevation but is normal in TRD ("crura sign"), we optically assessed without measurement the thickness of both crura. RESULTS: In all patients with TRD, the thickness of the affected crus was similar to that of the contralateral side. In all patients with nontraumatic causes, however, the crus of the elevated hemidiaphragm was markedly thinner than of the normal side. CONCLUSION: The "crura sign" may be useful additional CT finding of traumatic rupture the diaphragm.
Diaphragm* ; Diaphragmatic Eventration ; Humans ; Paralysis ; Radiography, Thoracic ; Retrospective Studies ; Rupture* ; Tomography, X-Ray Computed