BACKGROUND: Although airway hyper-responsiveness is one of the characteristics of asthma. bronchial hyper-responsiveness has also been observed to some degree in patients with chronic obstructive pulmonary disease (COPD). Moreover, several reports have demonstrated that a number of patients have both COPD and asthma. The methacholine bronchial challenge test (MCT) is a widely used method for the detecting and quantifying the airway hyper-responsiveness, and is one of the diagnostic tools in asthma. However, the significance of MCT in differentiating asthma or COPD combined with asthma from pure COPD has not been defined. The aim of this study was to determine the role of MCT in differentiating asthma from pure COPD. METHOD: This study was performed prospectively and was composed of one hundred eleven patients who had undergone MCT at Chonbuk National University Hospital. Sixty-five asthma patients and 23 COPD patients were enrolled and their MCT data were analyzed and compared with the results of a control group. RESULT: The positive rates of MCT were 65%, 30%, and 9% in the asthma, COPD, and control groups, respectively. The mean PC20 values of the asthma, COPD, and control groups were 8.1+/-1.16 mg/mL, 16.9+/-2.21 mg/mL, and 22.0+/-1.47 mg/mL, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT for diagnosing asthma were 65%, 84%, 81%, and 69%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT (ed note: please check this as I believe that these values correspond to the one PC20 value. Please check my changes.) at the new cut-off points of PC20 < or = 16 mg/ml, were 80%, 75%, 78%, and 78%, respectively. CONCLUSION: MCT using the new cut-off point can be used as a more precise and useful diagnostic tool for distinguishing asthma from pure COPD.
Asthma* ; Bronchial Provocation Tests* ; Humans ; Jeollabuk-do ; Methacholine Chloride* ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive*

BACKGROUND/AIMS: Non-resolving or slow-resolving pneumonia refers to the persistence of pulmonary infiltrates for >30 days after an initial pneumonia-like illness. Organizing pneumonia (OP) can be found on a lung biopsy in association with a number of diseases. The object of this study was to elucidate the clinical characteristics of the non-resolving pneumonia with the pathology of an OP and suggest the proper diagnostic and therapeutic approaches for the reduction of unnecessary procedures. METHODS: We retrospectively analyzed 70 patients diagnosed with an OP by percutaneous transthoracic needle biopsy and that met the inclusion criteria. Their pulmonary lesions were reviewed for disease resolution. Patients were divided into either a radiologically benign group (group I, n=57) or a malignancy group (group II, n=13) based on the computed tomography (CT) findings. RESULTS: All patients in group I and 8 patients in group II improved and had a complete resolution by 81.70+/-45.36 days. The microbiology findings showed that many infectious pathogens can lead to an OP despite antibiotic therapy. Three cases in group II were ultimately diagnosed as malignancies. CONCLUSIONS: Our data suggest that non-resolving or slow-resolving lesions were strongly suspicious for a malignancy on the CT scans, despite appearing to be benign OP pathologically; such cases should be considered for re-biopsy. In cased with pathology consistent with OP and benign CT findings, careful observation for 3 months is recommended to allow for the complete radiological resolution of the benign OP associated with infection.
Biopsy ; Biopsy, Needle ; Humans ; Lung ; Pneumonia ; Retrospective Studies ; Tomography, Spiral Computed

PURPOSE: Development of a standardized guideline and assessment tool is necessary. Therefore, the aim is to investigate the current state of enteral feeding management and to develop a basis for a standardized guideline. METHODS: From July 1, 2010 through June 30, 2011, this study was conducted retrospectively for 100 patients who had enteral feeding more than once only in the Intensive Care Unit, after General Surgery at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. The analysis was based on the following factors; age, diagnosis, name of the operation, period of start and the end of enteral feeding, method of injection, flushing method, residual volumes of the stomach, location and the size of the tube, medication through tubing, and complications related to enteral feeding. RESULTS: The mean age of the patients was 60.5, 65 men and 35 women. There were 30 malignant tumors of the hepatobiliary system and pancreas, 8 gastric and duodenal cancer, 4 colon and rectal cancer, 11 peritonitis, hemoperitoneum, and bowel obstruction, and 47 others. The average period of performing enteral feeding was 11.7 days and the locations of enteral feeding tube were stomach 56%, jejunum 39%, duodenum 3%, and undescribed 2%. The methods of enteral feeding were as follows; continuous feeding 19%, cyclic feeding 75%, intermittent and bolus feeding 3%, respectively. Only 1% of patients were on flushing and 16% on stomach residual. The most common complication of enteral feeding was clogging of the tube (5%). CONCLUSION: Due to the lack of detailed charting related to enteral feeding, we were unable to analyze the statistics on the relevance of complication which was the primary endpoint. As a result, development of a standardized protocol on charting enteral feeding is suggested for optimal enteral nutritional support.
Colon ; Diagnosis ; Duodenal Neoplasms ; Duodenum ; Enteral Nutrition* ; Female ; Flushing ; Hemoperitoneum ; Humans ; Intensive Care Units ; Jejunum ; Korea ; Male ; Nutritional Support ; Pancreas ; Peritonitis ; Rectal Neoplasms ; Residual Volume ; Retrospective Studies ; Seoul ; Stomach