The fungus aspergillus can cause a variety of pulmonary disorders. Aspergilloma is a noninvasive aspergillus colonization of virtually any type of preexisting pulmonary cavity or Cystic space. Invasive pulmonary aspergillosis is serious, usually fatal infection in patients being treated with immunosuppressants or who have chronic debilitating disease. Allergic bronchopulmonary aspergillosis is charaterized clinically by asthma, blood and sputum eosinophilia and positive immunologic reaction to aspergillus antigen. Awareness of the radio-graphic and CT findings of pulmonary aspergillosis is important in making the diagnosis of aspergillus-caused pulmonary disorders. In this pictorial essay, we illustrated various radiological findings of pulmonary aspergillosis focused on CT findings correlated with gross pathologic specimens.
Aspergillosis, Allergic Bronchopulmonary ; Aspergillus ; Asthma ; Colon ; Diagnosis ; Eosinophilia ; Fungi ; Humans ; Immunosuppressive Agents ; Invasive Pulmonary Aspergillosis ; Pulmonary Aspergillosis* ; Sputum

The fungus aspergillus can cause a variety of pulmonary disorders. Aspergilloma is a noninvasive aspergillus colonization of virtually any type of preexisting pulmonary cavity or Cystic space. Invasive pulmonary aspergillosis is serious, usually fatal infection in patients being treated with immunosuppressants or who have chronic debilitating disease. Allergic bronchopulmonary aspergillosis is charaterized clinically by asthma, blood and sputum eosinophilia and positive immunologic reaction to aspergillus antigen. Awareness of the radio-graphic and CT findings of pulmonary aspergillosis is important in making the diagnosis of aspergillus-caused pulmonary disorders. In this pictorial essay, we illustrated various radiological findings of pulmonary aspergillosis focused on CT findings correlated with gross pathologic specimens.
Aspergillosis, Allergic Bronchopulmonary ; Aspergillus ; Asthma ; Colon ; Diagnosis ; Eosinophilia ; Fungi ; Humans ; Immunosuppressive Agents ; Invasive Pulmonary Aspergillosis ; Pulmonary Aspergillosis* ; Sputum

The various biomechanical responses such as stress distribution, facet contact force and nucleus pressure change in the lumbar spine under vertical static and dynamic loading conditions were. Investigated with a nonlinear three dimensional finite element model. Finite element model of one motion segment, consisted of two vertebral bodies(L3-4) with one disc, was developed from 1 mm thick transverse CT cross-sections. Geometrical nonlinearity was also considered for the large deformation on the disc. ABACUS package was used for calculation and its results were verified comparing with the existing in-vitro experimental data. Clinically useful results could be obtained with this analysis. Stress was concentrated on the endplate under static and dynamic loading condition, especially posterior and anterior aspect and central portion along midsagittal plane. The facet contact force showed some discontinuity when Δt/2=0.03 sec. This discontinuity was considered to de due to the vibration of upper vertebra. Relatively smooth contact force profile was detected when t/2=0.1342 sec. Intradiscal pressure and stress pattern changes on the vertebra were also analyzed.
Spine ; Vibration

OBJECTIVE: Appropriate antituberculosis chemotherapy may not prevent occurrence or progression of tracheobronchial stenosis and obstruction in the patients with endobronchial tuberculosis. The effect of corticosteroid treatment combined with antituberculosis chemotherapy was inconclusive. We evaluated prospectively the effect of corticosteroid treatment. METHODS: We diagnosed endobronchial tuberculosis by bronchoscopic examination and bronchial biopsy in the patients of tuberculosis within one month of antituberculosis chemotherapy. After randomization, we prescribed isoniazid, rifampin, ethambutol, and pyrazinamide with or without prednisolone 40 mg for 4 weeks. We carried out bronchoscopy in second month and ninth month of treatment. RESULTS: Edematous endobronchial tuberculosis showed significant improvement of bronchial stenosis after corticosteroid treatment(p<0.05). Corticosteroid treatment did not have advantage of improvement of bronchial stenosis in the patients with infiltrative endobronchial tuberculosis. CONCLUSION: Corticosteroid is effective in the treatment of bronchial stenosis when endobronchial tuberculosis is edematous type, in the early period of antituberculosis chemotherapy.
Biopsy ; Bronchoscopy ; Constriction, Pathologic ; Drug Therapy ; Ethambutol ; Humans ; Isoniazid ; Prednisolone ; Prospective Studies ; Pyrazinamide ; Random Allocation ; Rifampin ; Tuberculosis*

BACKGROUND: The present study was aimed (1) to assess the effects of nitric oxide (NO) synthesis inhibitor on regional myocardial function and systemic and pulmonary hemodynamics; (2) to determine whether the blockade of the cyclo-oxygenase (COX) pathway modifies these effects on the variables, and (3) to investigate the mechanism of cardiac depression following NO synthesis inhibition in an open-chest canine model. METHODS: Twenty-five dogs of either sex were acutely instrumented under 1.6% ethrane anesthesia to measure aortic, pulmonary arterial and left ventricular pressure, pulmonary (cardiac output) and left circumflex coronary flow, and subendocardial segment length. NG-nitro-L-arginine methyl ester (L- NAME) at doses of 0.3, 1.0, 3.0, or 10.0 mg/kg i.v. was administered alone (control dogs, n = 10) or in the presence of COX inhibitor, indomethacin (10 mg/kg i.v., n = 10). Seven dogs (n = 7) received phenylephrine at doses of 0.1, 0.3, 1.0, or 3.0 microgram/kg/min i.v. to compare its hemodynamic effects with those of L-NAME. The preload recruitable stroke work slope (Mw) and percent systolic shortening (%SS) as an index of regional myocardial contractility, and the maximum segment lengthening rate (dL/dt max) and percent post-systolic shortening (%PSS) as an index of regional diastolic function, were evaluated. RESULTS: L-NAME dose-dependantly attenuated both regional systolic (Mw and %SS) and diastolic functions (dL/dt max and %PSS), whereas it caused an increase of coronary flow. L-NAME dose- dependently increased systemic blood pressure and vascular resistance as well as pulmonary arterial pressure and vascular resistance. L-NAME also reduced cardiac and stroke volume indices. Pretreatment with indomethacin did not affect the regional myocardial and systemic hemodynamic responses to L-NAME, but did blunt the coronary flow and pulmonary pressure responses. The magnitude of decreases in cardiac and stroke volume indices and Mw was greater with L-NAME than with phenylephrine (P <0.05), despite the comparable blood pressure increases. CONCLUSIONS:These results suggest (1) that NO plays a significant role in cardiac function as well as in systemic and pulmonary but not coronary, vasomotor activities, and (2) that COX products are involved in pulmonary hemodynamic responses to NO synthesis inhibition. It is also suggested that the decline in cardiac output following the NO synthesis inhibition results from a direct myocardial depressant effect of the drug.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Depression ; Dogs* ; Enflurane ; Hemodynamics* ; Indomethacin ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Stroke ; Stroke Volume ; Vascular Resistance ; Ventricular Pressure

No abstract available.
Chickens* ; Yolk Sac*

Purpose: Overweight (OW)/obese girls tend to have an earlier pubertal onset than girls with normal weight. However, only a few studies have reported the progression of puberty in these girls. This study aimed to identify risk factors for rapid pubertal progression in OW/obese girls presenting with precocious breast development. Methods: This retrospective cohort study reviewed the medical records of 110 OW (body mass index [BMI] ≥85th percentile for age and sex) and 213 nonoverweight (NW, BMI <85th percentile for age and sex) girls who presented with breast budding before 8 years of age. OW girls were divided into 2 subgroups: girls with central puberty progression before 9 years of age (OW-RP) and those without (OW-SP). Results: Progression to central puberty before the age of 9 was more common in NW girls than in OW girls (83.8 % vs. 65.2 % in NW vs. OW group, p<0.001), and progression-free survival for 1, 2, and 3 years was higher in the OW group (p<0.001). In a subgroup analysis of OW girls, the OW-RP subgroup had more advanced bone age (BA) at the first visit (p=0.047) and higher initial luteinizing hormone (LH, p=0.010) levels than the OW-SP subgroup. Being NW (p=0.001) and having more advanced BA (p=0.023) at the initial workup were the risk factors for pubertal progression before age 9. Conclusion Pubertal progression seems to be slower in OW girls than in NW girls presenting with precocious breast development. However, it can progress rapidly in OW girls with particularly pronounced BA advancement and high LH levels at the initial workup.

OBJECTIVES: Culture of sputum is apt to be contaminated through oral cavity and proximal airway. Therefore, identification of true etiologic agents by sputum culture is not always reliable. In order to differentiate the pulmonary infection from non-infectious disease and to identify the true etiologic agent of acute pulmonary infection, we used PSB(Protected Specimen Brushing) and evaluated the efficacy of PSB. METHODS: In 168 patients with acute febrile illness with pulmonary infiltrations(male 106, female: 61, mean age: 49.5+/-17.6), we performed PSB via a bronchoscope and compared the results along with blood culture and sputum culture. Protected specimen brush was introduced through biopsy channel of bronchoscope and was rotated within the purulent secretions. Tip of the brush was severed with aseptic technique and was immersed in 1cc of Ringer's lactate solution and vigorously mixed for 1 minute. The specimen was submitted for quantitative culture within 15 minutes and was regarded positive culture if colony forming units were above 10(3)/ml. RESULTS: Using PSB for the diagnosis of pulmonary infection, sensitivity was 71.1% and specificity was 84.296. PSB was helpful in identifing true etiologic agent among several potentially pathogenic organisms. Using PSB for the diagnosis of UAP (ventilator associated pneumonia), sensitivity was 72.4% and specificity was 100%. CONCLUSION: Use of PSB can be a helpful method for the diagnosis of pulmonary infection and identification of its etiologic agents.
Biopsy ; Bronchoscopes ; Diagnosis* ; Female ; Humans ; Lactic Acid ; Mouth ; Pneumonia ; Sensitivity and Specificity ; Sputum ; Stem Cells

Immunoglobulin G4 (IgG4)-related disease (RD) is an immune-mediated, systemic fibroinflammatory condition characterized by a lymphoplasmacytic infiltration of IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. IgG4-RD has become recognized with increasing frequency since the turn of the century and may affect almost any organ. IgG4-RD also involves the meninges but, to the best of our knowledge, no case of IgG4-related intracranial pachymeningitis with periaortitis has been reported in Korea to date. Here, we report on a 65 year-old male with IgG4-RD involving the meninges and aorta.
Aorta ; Fibrosis ; Humans ; Immunoglobulins ; Korea ; Male ; Meninges ; Meningitis* ; Phlebitis ; Plasma Cells

Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) characterized by skeletal muscle inflammation and typical skin manifestations. Creatine kinase (CK) has traditionally been considered to be the most useful serum enzyme for the diagnosis and assessment of adult patients with IIM. To our knowledge, there has been no reported case of biopsy-proven DM without CK elevation in Korea, to date. Panniculitis is an uncommon cutaneous manifestation in adult patients with DM. A search of the PubMed database reveals fewer than 30 reported cases of panniculitis in adult patients with DM. Here, we report a case of a 42-year-old female who was diagnosed with biopsy-proven DM with normal serum CK levels and panniculitis.
Adult ; Creatine Kinase* ; Creatine* ; Dermatomyositis* ; Diagnosis ; Female ; Humans ; Inflammation ; Korea ; Muscle, Skeletal ; Myositis ; Panniculitis ; Skin Manifestations