Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

We analyzed the peripheral blood of patients with gastrointestinal tract cancer at different stages to assess the presence of carcinoembryonic antigen (CEA) mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR), which we used as an indicator for micrometastatic malignant cells. A total of 35 gastric, 24 colorectal, 4 esophageal and 4 biliary tract cancer patients and nine normal healthy subjects were studied. No CEA mRNA was detected in the nine normal healthy volunteers. CEA mRNA was detected in 100% (10/10) of metastatic, 33.3% (3/9) of early gastric cancer (EGC), and 18.8% (3/16) resectable gastric cancer patients, respectively. In colorectal cancer, 55.6% (5/9) of metastatic cancers were positive for CEA mRNA, and 26.7% (4/15) Duke stage B/C showed positive. One patient with stage III gastric cancer who was negative CEA mRNA initially and turned positive during follow-up, developed multiple bone metastasis one month later. Another stage III patient, who was positive for CEA mRNA, preoperatively revealed early relapse in two months. These results suggest that the identification of circulating tumor cells using RT-PCR for the detection of CEA mRNA is feasible and this analysis may be a promising tool for early detection of micrometastatic circulating malignant cells in patients with gastrointestinal tract cancer.
Adult ; Aged ; Carcinoembryonic Antigen/blood* ; Colorectal Neoplasms/pathology ; Esophageal Neoplasms/pathology ; Female ; Gastrointestinal Neoplasms/pathology* ; Gastrointestinal Neoplasms/blood ; Human ; Male ; Middle Age ; Neoplasm Circulating Cells* ; Neoplasm Metastasis/diagnosis ; RNA, Messenger/blood ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms/pathology ; Tumor Markers, Biological/blood*

PURPOSE: The purpose of this study was to survey the health behaviors related to reproductive health, reproductive health history, and sexual behaviors of college students in local areas. METHOD: With a survey design, 792 college students from C and D areas were recruited to assess health behaviors such as smoking and alcohol drinking, as well as history of reproductive health and sexual behaviors. The data were collected by a self-administered questionnaire from November to December, 2007. RESULT: Mean age of the students was 20.8(SD=1.96) and gender distribution was 29.2% for male and 70.8% for female. Unhealthy behaviors were alcohol drinking, smoking, excessive weight loss, and irregular exercise; unsafe sex practices were experience of sexual intercourse with multiple sex partners and history of sexually transmitted disease (STD). Male students had more alcohol drinking (p=.04), smoking(p<.001), excessive weight loss(p=.01), experience of sexual intercourse with multiple sex partners(p<.001), history of STD(p=.025) compared to females. On the other hands, female students participated in regular exercise less than males(p<.001). CONCLUSION: College students seem to perform unhealthy behaviors related to reproductive health and less effective way of safe sex practices. Therefore, a planned education program for reproductive health promotion operated by college level is needed to assess and improve the level of reproductive health in college students.
Alcohol Drinking ; Coitus ; Female ; Hand ; Health Behavior ; Humans ; Male ; Surveys and Questionnaires ; Reproductive Health ; Safe Sex ; Sexual Behavior ; Sexually Transmitted Diseases ; Smoke ; Smoking ; Unsafe Sex ; Weight Loss

It has been well known that dilated cardiomyopathy (D-CMP) has characterized by systolic dysfunction of left ventricle (LV). But there are few studies about LV diastolic and right ventricular (RV) dysfunction in D-CMP. The purpose of this study is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The purpose of this tudy is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The gated blood pool scan (GBPS) was undertaken in 14 patients with D-CMP and 14 normal controls. The results are as follows : 1) Compared to normal controls, the global and regional ejection fraction of LV were significantly reduced (P<0.001) in D-CMP. But, there was no significant difference in LV ejection time between the two groups. 2) Peak filling rate and peak filling time were significantly reduced (P<0.001, P<0.05) in D-CMP 3) Global ejection fraction of RV was also significantly reduced in D-CMP compared to normal controls (P<0.001) But there was no significant difference in ejection rate of right ventricle between the two groups. 4) There was close correlation (R=0.802) between ejection fraction and filling rate of LV : filling rate was also reduced as ejection fraction decreased. And LV filling rate was also reduced with reduction of ejection rate. It is concluded that D-CMP shows diastolic impairment as well as systolic pumping failure and this systolic dysfunction is accounted for the diastolic impairment in D-CMP. And D-CMP shows also right ventricular dysfunction in almost all cases, as well as left ventricular dysfunction.
Cardiomyopathy, Dilated* ; Heart Ventricles ; Humans ; Ventricular Dysfunction, Left ; Ventricular Dysfunction, Right

OBJECTIVE: To investigate factors associated with enrollment and participation in cardiac rehabilitation (CR) in Korea. METHODS: Patients admitted to four university hospitals with acute coronary syndrome between June 2014 and May 2016 were enrolled. The Cardiac Rehabilitation Barriers Scale (CRBS) made of 21-item questionnaire and divided in four subdomains was administered during admission. CRBS items used a 5-point Likert scale and ≥2.5 was considered as a barrier. Differences between CR non-attender and CR attender, or CR non-enroller and CR enroller in subscale and each items of CRBS were examined using the chi-square test. RESULTS: The CR participation rate in four hospitals was 31% (170 of the 552). Logistical factors (odds ratio [OR]=7.61; 95% confidence interval [CI], 4.62–12.55) and comorbidities/functional status (OR=6.60; 95% CI, 3.95–11.01) were identified as a barrier to CR enrollment in the subdomain analysis. Among patients who were enrolled (agreed to participate in CR during admission), only work/time conflict was a significant barrier to CR participation (OR=2.17; 95% CI, 1.29–3.66). CONCLUSION: Diverse barriers to CR participation were identified in patients with acute coronary syndrome. Providing the tailored model for CR according to the individual patient's barrier could improve the CR utilization. Further multicenter study with large sample size including other CR indication is required.
Acute Coronary Syndrome ; Exercise Therapy ; Hospitals, University ; Humans ; Korea ; Outpatients ; Patient Participation ; Rehabilitation ; Sample Size ; Secondary Prevention

The second affiliation of the author, Sora Baek, was not added in the article.

Tuberculous involvement of the colon is an uncommon clinical entity. Other colonic disease which should be considered in the differential diagnosis include inflammatory bowel disease such as Crohn's disease, ulcerative colitis and colon cancer. Intestinal tuberculosis most frequently involves the ileocecal area. The common presenting symptoms are abdominal pain, fever, weight loss and malabsorption. Pathologically, tuberculous colitis may present as an ulcerative type, hypertrophic type or in combination. Massive bleeding is said to be very rare even in the ulcerative type because of an obliterative endarteritis. We report a case of colonic tuberculosis presenting with massive bleeding in 52-year-old man with alcoholic liver cirrhosis, which was diagnosed by colonoscopic biopsy and acid-fast stain.
Abdominal Pain ; Biopsy ; Colitis ; Colitis, Ulcerative ; Colon* ; Colonic Diseases ; Colonic Neoplasms ; Crohn Disease ; Diagnosis, Differential ; Endarteritis ; Fever ; Hemorrhage* ; Humans ; Inflammatory Bowel Diseases ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Tuberculosis* ; Ulcer ; Weight Loss

BACKGROUND AND OBJECTIVES: We wanted to perform quantitative echocardiographic assessment of myocardial function in the patients with myocardial bridge by measuring 2-dimensional strain with using newly developed software. SUBJECTS AND METHODS: Novel computer software was used for tracking heart tissue on echocardiography, and we conducted an advanced wall-motion analysis for 18 symptomatic patients (mean age: 57.1+/-9.7 years, 10 female) with myocardial bridging of the left anterior descending coronary artery and also 20 age-matched healthy controls. The conventional wall-motion scoring was normal in all the patients, and the software was able to adequately track their heart tissue. RESULTS: The maximal angiographic systolic lumen diameter reduction within the myocardial bridges was 71+/-12.6% at rest, with a persistent diameter reduction of 31.2+/-11.3%. The radial strain and displacement of the anterior segments were more significantly reduced than that of the posterior segments at the level of the papillary muscle (30.9+/-13.8% vs. 51.8+/-17.3% and 4.8+/-0.9 vs. 5.9+/-1.5, respectively, all p<0.05), and this showed a plateau (39% and 33%, respectively) or biphasic (50% and 56%, respectively) pattern. The time from the R wave on electrocardiography to the transition from regional systole to early diastolic lengthening (Tr) was significantly delayed in the patients with myocardial bridge more than that for the controls (497+/-20.4 ms vs. 348+/-12.5 ms, respectively, p<0.05). CONCLUSION: Delayed systolic contraction and diastolic relaxation are important mechanisms that contribute to ischemia in the patients with myocardial bridge. 2-dimensional strain can be used to achieve real-time wall-motion analysis, and it has the potential to improve the identification and functional quantification of myocardial Bridge.
Coronary Vessels ; Echocardiography ; Electrocardiography ; Heart ; Humans ; Ischemia ; Myocardial Bridging ; Papillary Muscles ; Relaxation ; Systole ; Ventricular Function, Left*

Pyogenic liver abscess is a rare but highly lethal disease. The diagnosis and treatment of pyogenic liver abscess has been evolving owing to specific antibiotic therapy, ultrasonography, abdominal computed tomography with improved percutaneous and operative techniques. However, pyogenic liver abscess may present as a rapidly fatal outcome. These unfavorable results are mainly attributed to the increasing numbers of patients with malignant disease and biliary tract disease. Carcinoma of the gallbladder has remained an uniformly fatal neoplasm characterized by early metastasis and rapid fatal course. In early stage, the symptom is nonspecific and often mimics benign biliary tract disease. We experienced a case of the gallbladder carcinoma presenting with pyogenic liver abscess in a 78-year-old female patient. Surgical drainage and cholecystectomy were done. The microscopic finding of resected gallbladder revealed large cell neuroendocrine carcinoma of gallbladder.
Aged ; Biliary Tract Diseases ; Carcinoma, Neuroendocrine* ; Cholecystectomy ; Diagnosis ; Drainage ; Fatal Outcome ; Female ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic* ; Neoplasm Metastasis ; Ultrasonography

Isolated obstruction of the splenic vein leads to segmental portal hypertension, which is mainly originated from pancreatic disease, such as chronic pancreatitis, pancreatic pseudocyst, pancreatic cancer. The clinical manifestation are devoid of ascites and encephalopathy, but presented with gastric variceal bleeding. We experienced 27-year-old male patient who complained of hematochezia and melena. After work-up with CT and angiography, we performed operation with the impression of pancreatic tumor associated with splenic vein occlusion. It resulted nonfunctioning pancreatic endocrine tumor. Often called islet cell tumor, pancreatic endocrine tumor has various names according to secreted hormones, such as insulinoma, Zollinger-Ellison syndrome and glucagonoma. It was classified as nonfunctioning tumor if there were any evidence of hormone secretion by radioimmunoassay and immunohistochemistry. Surgical excision and adjuvant medical therapy is the mainstay of therapy. We performed tumor resection and splenectomy for control of gastric variceal bleeding due to splenic vein occlusion.
Adenoma, Islet Cell ; Adult ; Angiography ; Ascites ; Esophageal and Gastric Varices* ; Gastrointestinal Hemorrhage ; Glucagonoma ; Humans ; Hypertension, Portal ; Immunohistochemistry ; Insulinoma ; Male ; Melena ; Pancreas* ; Pancreatic Diseases ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Radioimmunoassay ; Splenectomy ; Splenic Vein ; Zollinger-Ellison Syndrome