A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

No abstract available.
Arthrogryposis*

No abstract available.
Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Appendicitis* ; Pregnancy*

No abstract available.
Abscess* ; Thyroid Gland*

BACKGROUND: Cardiac tamponade is associated with the expiratory increase and the expira-tory decrease in left ventricular filling flow. With Doppler echocardiography, we analyzed the respiratory variations of mitral and tricuspid inflows, and pulmonary and hepatic venous flows in patients with cardiac tamponade. METHODS: Respiratory hemodynamic changes in mitral and tricuspid inflows and pulmonary and hepatic venous flows were evaluated using Doppler echocardiography in 13 patients (6 men and 7 women; mean age 51+/-13 years) with large pericardial effusion and clinical cardiac tamponade, and compared the results with those of 11 control subjects (3 men and 8 women, mean age 53+/-13 years). Doppler examination was repeated after pericardiocentesis in 6 patients. RESULTS: Peak velocity of early diastolic mitral inflow (E velocity) decreased during inspiration compared with expiratory increase; the mean percentage change was 40%. Peak velocity of late diastolic mitral inflow (A velocity) decreased 13% during inspiration. E/A ratio decreased 31% during inspiration. Deceleration time (DT) and isovolumic relaxation time (IVRT) increased by 26% and 44%, respectively, during inspiration. But respiratory variations of tricuspid inflow were opposite to those of mitral inflow. Tricuspid E velocity increased during inspiration and decre-ased during expiration. The mean percentage change was 123%, which was larger than thte 40% of mitral inflow. The most characteristic findings of pulmonary venous flow during respiration were the expiratory increases of peak diastolic velocity (DV) and diastolic time-velocity integral (D-TVI). The mean percentage changes of peak systolic velocity (SV), DV and D-TVI during respiration were 27%, 45% and 53% respectively. In contrast, the SV and DV of hepatic venous flow increased during inspiration and decreased during expiration. The respiratory variations of peak systolic reverse flow velocity (SR) and peak diastolic reverse flow velocity (DR) were opposite to those of SV and DV. DR notably increased during expiration, and the mean percentage change was 61%. The ratio of RFI (Inspiratory reverse flow integral) to FFI (forward flow integral) of the tamponade group was 270%. The mean percentage changes of each parameters decreased after pericardiocentesis. CONCLUSION: Patients with cardiac tamponade showed inspiratory increases of diastolic tri-cuspid filling flow and hepatic forward flow. Expiratory increases included diastolic mitral filling flow, pulmonary venous systolic and diastolic flow, and hepatic venous reverse flow. Such res-piratory variations decreased after pericardiocentesis.
Cardiac Tamponade* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Female ; Hemodynamics ; Humans ; Male ; Pericardial Effusion ; Pericardiocentesis ; Relaxation ; Respiration

PURPOSE: To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significancy. MATERIAL AND METHOD: We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. RESULTS: On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 --2ram in 6 cases, and 3mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). CONCLUSION: HRCT findings of miliary tuberculosis are diffusely distributed micronodules of variable size, less than 5mm in diameter. The ground-glass opacity can be combined.
Glass ; Humans ; Lymphatic Diseases ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Miliary*

No abstract available.
Diagnosis* ; Exanthema* ; Lymphadenitis* ; Scrub Typhus*

BACKGROUND: Policy-makers are required to know the current patterns of resource use and the costs of stroke. However, the scientific evidence, on which health policy-making can be based, is not sufficient. Our study aimed to investigate resource utilization and costs during the one year after stroke. METHODS: Among patients with acute ischemic stroke (7 days from onset) who were admitted from July of 2001 to July of 2002, 223 were interviewed one year after the onset of stroke through a home visit by an experienced research nurse. Resource utilization and related costs were investigated. RESULTS: The average length of stay was 25 days. The average first inpatients costs was won 2, 230, 000. After discharge, the average outpatient visit was 22 days. The average expenditure per patient during the one year from onset of stroke was won 5, 235, 000. The hospital charge was 59% of the total cost, the cost for hiring a care-giver was 14%, and the fee for the outpatient clinic was 13%. Thirty-nine percent (won 2, 051, 000) of the total expenditure was consumed in the first month, 12% was in the second, 8% was in the third, and around 5% monthly was after 3 months. CONCLUSIONS: Our study is the first one to investigate the resource utilization and the related costs in stroke patients in Korea. The results of this study should not be generalized to all Korean stroke patients, but this study may serve as a reference for inferring the real status in Korea and may be a starting point for further nationwide resource utilization and costs studies.
Ambulatory Care Facilities ; Delivery of Health Care* ; Fees and Charges ; Health Expenditures ; Hospital Charges ; House Calls ; Humans ; Inpatients ; Korea ; Length of Stay ; Outpatients ; Stroke*

The purpose of this study is to present the importance of work-related cerebrovascular and heart disease from the viewpoint of expenses. Using the insurance benefit paid for the 4,300 cases, this study estimated the burden of insurance benefits spent on work-related cerebrovascular and heart disease. The number of cases with work-related cerebrovascular and heart disease per 100,000 insured workers were 3.36 in 1995; they were increased to 13.16 in 2000. By the days of occurrence, the estimated number of cases were 1,336 in 2001 (95% CI: 1,211-1,460 cases) and 1,769 in 2005 (CI: 1,610-1,931 cases). The estimated average insurance benefits paid per person with work-related cerebrovascular and heart disease was 75-19 million won for medical care benefit and 56 million won for other benefits except medical care. By considering the increase in insurance payment and average pay, the predicted insurance benefits for work-related cerebrovascular and heart disease was 107.9 billion won for the 2001 cohort and 192.4 billion won for the 2005 cohort. From an economic perspective, the results will be used as important evidence for the prevention and management of work-related cerebrovascular and heart disease.
*Accidents ; *Accidents, Occupational ; Brain Diseases/epidemiology ; Cohort Studies ; Compensation and Redress ; Costs and Cost Analysis ; Heart Diseases/epidemiology ; Human ; *Insurance Benefits ; Insurance Coverage ; Korea ; Linear Models ; Models, Statistical ; *Occupational Health ; Sensitivity and Specificity ; Time Factors ; *Workers' Compensation