PURPOSE: We studied the accuracy of high resolution computed tomography in staging chest wall/fissural invasion of peripheral lung cancer. MATERIALS AND METHODS: HRCT findings in 27 patients with suspected chest wall (n=18) or fissural (n=16) invasion of peripheral lung cancer were correlated with surgical and pathologic findings. The HRCT images were restrospectively evaluated for pleural thickenings adjacent to mass, maximal contact length (cm) between mass and chest wall/fissure, angle between the mass and chest wall/fissure, ratio of maximal contact to mass diameter, abnormality of extrapleural fat layer, mass extension across the fissure and fissural irregularity adjacent to mass. Various CT findings and the presence or absence of chest pain were correlated with surgical and pathologic findings. RESULTS: For the evaluation of chest wall invasion, abnormality of extraphleural fat layer was the most useful finding (sensitivity 100 %, specificity 36 %, accuracy 61 %). The remaining HRCT findings proved to have high sensitivity but low specificity, and a high false positive rate. For chest pain, sensitivity was 43 % and specificity, 82 %. In cases without chest pain, the positive predictive value of extraphleural fat abnormality was 44 % ; in the absence of chest pain and extrapleural fat abnormality,positive predictive value was zero. The evaluation of transfissural tumor invasion using variable HRCT findings proved to be accurate, especially when the criteria of mass extension across the fissure and fissural irregularity adjacent to the mass were used (accuracy 81 % and 75 %, respectively). CONCLUSION: Using the finding of 'extrapleural fat abnormeality', HRCT was accurate in the staging of chest wall invasion and its predictability was betten than that of other results obtained with conventional CT. Chest pain had high specificity but low prevalence, and extrapleural fat abnormality was more valuable in cases without chest pain. HRCT proved to be accurate in the evaluation of transfissural invasion of lung cancer using the findings 'fissural cross' and 'fissural irregularity'.
Chest Pain ; Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Thoracic Wall* ; Thorax*

BACKGROUND: Dermatological diseases affecting the feet, e.g. fungal infections and nail infections, are often not fully perceived as real medical problems even when they experience great discomfort, including pain. These misperception often prevents from seeking timely treatment, which can result in very severe conditions. This survey, so called "ACILLES PROJECT" was a "foot screening" project that would be focused on all parts of the body below the Achilles heel: foot, toe and toenails. OBJECTIVE: This study was undertaken for both medical doctors and patients to raise the awareness of foot diseases and additional insights into disease that could affect foot. And also, in seasonal variation, we tried to compare the epidemiological data and to look over the relationship of dermatophytosis in other parts with fungal infections in foot and to analyze the compliance and efficacy of antifungal agents in the treatment of patients who were diagnosed as dermatophytosis in their feet in the treatment of antifungal agents. METHODS: Achilles survey was conducted for one week from 7th July to 13th July, 1997 and 16th March to 17th April, 1998 co-worked by the Korean Society for Medical Mycology and Janssen Korea. In 1997, 19,298 patients, who visited dermatology and urology, and 353 investigators participated in this survey. And Achilles 98, in 1998, was composed of two parts, Unit I and Unit II. Unit I survey was a foot disease consult program and Unit II was a patient compliance survey 29,922 patients, 391 investigators and 16,383 patients, 350 investigators were involved in Unit I and Unit II respectively. RESULTS: Among total 29,922 patients who responded to the survey, 57.7% of them had more than one foot disease. There was no big difference comparing with the number (67%) in the survey of last summer. And it was observed that fungal infection was the most dominant disease (79.8%) regardless of seasons (83.7% in July, 1997). Furthermore, there were no significant differences in the prevalence of other foot diseases for each season (eczema 11.1%, corns 5.1%, warts 2.7%, psoriasis 2.1%). Oral antifungal agents were prescribed to the patients who were diagnosed as having fungal infections in their feet in order to survey drug compliance by filling out the patients diary. In compliance, only 24% of patients in itraconazole pulse therapy for 28 days and 16% of patients in itraconazole continuous therapy for 28 days compiled with their dosage guideline exactly. It is observed that the longer the duration of drug therapy is, the worse the patients compliance is. CONCLUSION: According to the epidemiological survey in 1997 and 1998, the prevalence of foot disease was not significantly different seasonally, and it was reported that the awareness of and the intention for the treatment of foot diseases were not high enough based on the compliance data of patients.
Antifungal Agents ; Callosities ; Compliance ; Dermatology ; Drug Therapy ; Epidemiology* ; Foot Diseases* ; Foot* ; Heel ; Humans ; Incidence* ; Intention ; Itraconazole ; Korea ; Mycology ; Nails ; Patient Compliance* ; Prevalence ; Psoriasis ; Research Personnel ; Seasons* ; Tinea ; Toes ; Urology ; Warts ; Zea mays

BACKGROUND: Superficial fungal disease is one of the most common human infectious diseases. A recent clinical survey reported that more than half of patients with superficial fungal diseases might be infected at home. OBJECTIVE: The aim of this study is to investigate the correlation of the fungal infection between the patients and their family members. METHODS: Dermatologists of 71 general hospitals were involved and evaluated 7,323 patients and 1,037 their family members who were confirmed microscopically to have superficial fungal diseases. RESULTS: According to the survey results, 46.1% of the patients answered they might have been infected at home and 33.6% of the patients remembered there were other fungus-infected patients among their family members at the same time. The isolated organisms were Trichophyton rubrum (1686 cases, 80.9%), Trichophyton mentagrophytes (269 cases, 12.9%), Candida albicans (112 cases, 5.4%), Microsporum canis (12 cases, 0.6%), Trichophyton tonsurans (3 cases, 0.1%), Epidermophyton floccosum (2 cases, 0.1%). On the basis of the fungus culture, it was proven that 85.4% of the patients and their family members had the same kind of microorganism. CONCLUSION: As a result, we could conclude that there is a high possibility of transmitting the fungal infection from one family member to another.
Candida albicans ; Communicable Diseases ; Epidemiology* ; Epidermophyton ; Fungi ; Hospitals, General ; Humans ; Korea* ; Microsporum ; Trichophyton

In order to analyze the occlusion of TMD patient, 73 casts and post eroanterior cephalometric X-rays of patients showing TMD symptoms at first interview were measured and compared that of 30 non-patients. Horizontal overjet, vertical overbite, openbite, crossbite, depth of curve of Spee, midline deviation, facial asymmetry, attrition, and TPI were measured and processed statistically. The results could be summarized as follows, 1. TMD group showed the highest prevalence in twenties, teens, and before 9 years old group in order, and more prevalent in female than male. 2. There were no statistically significance between two groups of overjet and overbite measurements, but showed significance of 6 classification of anterior tooth relationship between two groups TMD groups. 3. TMD group had more anterior openbite than normal group but there were no statistically significance between two groups. 4. Anterior crossbite was more prevalent in normal group but posterior crossbite was more prevalent in TMD group. 5. TMD group showed deeper curve of Spee and there were statistically significance between two groups. 6. TMD group had more attrition than normal group and there were statistically significance beween two groups. 7. TMD group showed more facial asymmetry than normal group. 8. TPI did not showed statistical significance between two groups. According to the above results, TMD group showed severe and complex mode of malocclusion and this should be carefully regarded when treatment planning and during the treatment of malocclusion.
Adolescent ; Child ; Classification ; Dentition* ; Facial Asymmetry ; Female ; Humans ; Male ; Malocclusion* ; Open Bite ; Overbite ; Prevalence ; Tooth

This study examined the reproducibility of nutrient intakes estimated by the 24-hour recall method in a prospective cohort study (Longitudinal study of aging and health monitoring of Korean elderly) of middle-aged volunteer subjects (42 males and 49 females) in the Seoul area. The three-day 24-hour recall was administered twice at an interval of approximately 6 months. The first data were collected and a corrective procedure was performed by interviewing of the subjects and a trained dietitian. The second data were collected by mail from the subjects without the performance of any corrective procedure. The mean age of the subjects was 53.5+/-9.6 for the males and 52.2+/-8.9 for the females. The subjects who had above college education were 95% in the case of the males and 60% in the case of the females. The characteristics of the male subjects in this study were that they were highly educated and held professional jobs and were from the middle or upper class. Comparing the first and second 24-hour recall data, the second data showed relatively lower intakes of all nutrients, except vitamin A, vitamin Bi and cholesterol. There was no difference in the nutrients of the first and the second data with respect to vitamin A, vitamin B1 and cholesterol in the males and calcium, iron, sodium, vitamin A, vitamin B1, vitamin B2 and cholesterol in the females. This data may indicate that the 24 hour retail method without a dietitian's help may result in lower reporting of the subject's intakes. The men had a tendency to remember less than the women. Pearson's correlation coefficients with unadjusted nutrient intakes values were ranged from 0.24 to 0.66. When energy intake was adjusted, there was a slight increase (from 0.26 to 0.71). Intra-class correlation coefficients with nutrient-unadjusted values ranged from 0.22 to 0.66, and the energy-adjusted values were ranged from 0.23 to 0.69. The weighted Kappa statistical values ranged from 0.10 to 0.40. On the average,46.3% of the subjects who were found in the lowest quartile of the nutrient intake levels based on the first 24-hour recall, were in the lowest quartile based on the second 24-hour recall. Therefore, there was a low reproducibility between the first and the second 24-hour recall. We should examine the factors influencing low reproducibility. Also, strategies should be developed to maximize the reliability of the assessment, with regard to portion-size training and telephone validation.
Aging ; Calcium ; Cholesterol ; Cohort Studies ; Education ; Energy Intake ; Female ; Humans ; Iron ; Male ; Nutritionists ; Postal Service ; Prospective Studies ; Riboflavin ; Seoul ; Sodium ; Telephone ; Thiamine ; Vitamin A ; Vitamins ; Volunteers

In Korea, the clinical manifestation of scrub typhus in humans appears to be severe in the northern regions of the country and mild in the southern areas. Studies on the geographic distribution of the serotype of Orientia tsutsugamushi revealed that the Boryong serotype is predominant in the southern Korean peninsula, whereas the Gilliam, Karp, and Gilliam-Karp serotypes prevail in the northern or central peninsula. We report a case of severe scrub typhus caused by the Japanese Gilliam type of Orientia tsutsugamushi in a 66-year-old woman from Tongyeong, a city located in the southern part of Korean peninsula. The patient was admitted to the hospital with fever on August 29th, 2001. Scrub typhus complicated by shock, pneumonitis, and encephalitis was diagnosed. Additionally, markedly elevated alkaline phosphatase levels was observed, which necessitated an ultrasonographic examination, which showed an ill-defined hyperechogenic mass on the right hepatic lobe. Liver biopsy showed cholestatic hepatitis and blood culture showed growth of O. tsutsugamushi. Gene sequencing of the amplicons of a polymerase chain reaction using primers for the amplification of the gene encoding the 56-kDa protein of O. tsutsugamushi revealed a nucleotide sequence that matched Yonchon strain of O. tsutsugamushi.
Aged ; Alkaline Phosphatase ; Asian Continental Ancestry Group ; Base Sequence ; Biopsy ; Encephalitis ; Female ; Fever ; Genotype ; Hepatitis ; Humans ; Korea ; Liver ; Orientia tsutsugamushi ; Pneumonia ; Polymerase Chain Reaction ; Scrub Typhus ; Shock ; Sprains and Strains

In Korea, the clinical manifestation of scrub typhus in humans appears to be severe in the northern regions of the country and mild in the southern areas. Studies on the geographic distribution of the serotype of Orientia tsutsugamushi revealed that the Boryong serotype is predominant in the southern Korean peninsula, whereas the Gilliam, Karp, and Gilliam-Karp serotypes prevail in the northern or central peninsula. We report a case of severe scrub typhus caused by the Japanese Gilliam type of Orientia tsutsugamushi in a 66-year-old woman from Tongyeong, a city located in the southern part of Korean peninsula. The patient was admitted to the hospital with fever on August 29th, 2001. Scrub typhus complicated by shock, pneumonitis, and encephalitis was diagnosed. Additionally, markedly elevated alkaline phosphatase levels was observed, which necessitated an ultrasonographic examination, which showed an ill-defined hyperechogenic mass on the right hepatic lobe. Liver biopsy showed cholestatic hepatitis and blood culture showed growth of O. tsutsugamushi. Gene sequencing of the amplicons of a polymerase chain reaction using primers for the amplification of the gene encoding the 56-kDa protein of O. tsutsugamushi revealed a nucleotide sequence that matched Yonchon strain of O. tsutsugamushi.
Aged ; Alkaline Phosphatase ; Asian Continental Ancestry Group ; Base Sequence ; Biopsy ; Encephalitis ; Female ; Fever ; Genotype ; Hepatitis ; Humans ; Korea ; Liver ; Orientia tsutsugamushi ; Pneumonia ; Polymerase Chain Reaction ; Scrub Typhus ; Shock ; Sprains and Strains

Tracheal stenosis is well known complication of endotracheal intubation. However, severe post intubation tracheal stenosis that requires interventional bronchoscopy or tracheal surgery is un-common. Necrosis induced by cuff pressure-related loss of regional blood flow is the central injury leading to postinubation tracheal stenosis. The large volume, low pressure cuff of endo-tracheal tubes have markedly reduced the occurrence cuff-induced injury. However, in any patient who develops symptoms of airway obstruction, who has been intubated and ventilated in the recent past, possibility of tracheal stenosis should be considered. We report a case of severe tracheal stenosis by tracheal web formation a 52-year-old following ventilator therapy for ARDS.
Airway Obstruction ; Bronchoscopy ; Humans ; Intubation ; Intubation, Intratracheal ; Middle Aged ; Necrosis ; Regional Blood Flow ; Tracheal Stenosis ; Ventilators, Mechanical

To investigate the genetic variation within pspA from 17 clinical isolates of Streptococcus pneumoniae representing 12 capsular serotypes, we used specific PCR primers LSM12 and LSM2 derived from the DNA sequence of pspA of S. pneumoniae Rxl (type 2). We have found that all 17 isolates of S. pneumoniae have a pspA gene whose size ranges from 1.8 to 2.3 kb. RFLP analysis of the PCR-amplified pspA genes of the isolates exhibited distinct restriction patterns. Even within the same capsular type, the individual isolates of S. pneumoniae generally differed in PspA molecular masses and showed variabilities in the pspA gene locus. The nucleotide sequence of the pspA gene of S. pneumonaie KNIH1156 (type 19F) isolated from a blood specimen was determined. The sequence revealed an open reading frame of 1,827 bp nucleotides. Predicted size of the mature PspA was approximately 63 kDa. Deduced amino acid sequence of PspA of S. pneumonaie KNIH1156 revealed 57.0% identity with that of S. pneumonaie Rxl. Comparison of the nucleotide and amino acid sequences of PspA S. pneumoniae KNIH1156 (type 19F) with those of Rxl (type 2) showed considerable differences in the a-helical coiled-coil region of the two PspAs. These results suggest that the PspA of S. pneumoniae KNIH1156 has antigenic variations distinguished from those of Rxl strains.
Amino Acid Sequence ; Base Sequence ; Cloning, Organism ; Genetic Variation ; Korea* ; Nucleotides ; Open Reading Frames ; Pneumonia ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sequence Analysis* ; Staphylococcal Protein A* ; Streptococcus pneumoniae* ; Streptococcus*

Sopungsungi-won has been used as a traditional medicine for diabetes and it has been proved to be a potential remedy for type 2 diabetes mellitus. We previously reported that water extract of Sopungsungi-won exhibits anti-diabetic effects both in vivo and in vitro experiments. In the present study, we have chosen to examined anti-apoptotic effect of Rheum undulatum, which is the main component of Sopungsungi-won, on pancreatic beta-cells, HIT-T15, against hydrogen peroxide (H2O2). oxidative stress. To investigate the anti-apoptotic effect of Rheum undulatum water extract (RUWE) against H2O2-induced apoptosis in pancreatic beta-cell line of hamster, HIT-T15, MTT assay, DAPI staining, TUNEL assay, RT-PCR and caspase-3 enzyme assay were performed. The morphological analysis demonstrated that cells treated with H2O2 exhibited classical apoptotic features, while such changes was reduced in cells pre-treated with RUWE. In addition, RUWE pre-treated cells prior to H2O2 treatment induced increase of levels of bcl-2 expression and decrease of caspase-3 enzyme activity compared to cells treated with H2O2 only. These results provide the possibility of usage of RU in patients with progressively deteriorated diabetes.
Animals ; Apoptosis ; Caspase 3 ; Cricetinae ; Diabetes Mellitus, Type 2 ; Enzyme Assays ; Humans ; Hydrogen Peroxide ; In Situ Nick-End Labeling ; Medicine, Traditional ; Oxidative Stress ; Rheum* ; Water*