BACKGROUND: Tuberculous pleurisy treatment improve symptoms such as fever, chest pain, cough, and prevents the progression to active pulmonary tuberculosis and the development of residual pleural thickening that decrease diaphragm and rib cage movement. This study investigated how the degree of residual pleural thidkening affects the pulmonary function. METHODS: Fifty seven patients who were initially diagnosed as having tuberculous pleurisy, were treated with anti-tuberculous medication for 6 months and had residual pleural thickening between May 1998 and January 2000 at the Eulji university hospital were reviewed. A chest X-ray and pulmonary function test(PFT, Sensormedics 2200) were perfored. The predicted value (%) of the forced vital capacity(FVC), forced inspiratory vital capacity(FIVC) and total lung capacity(TLC) were measured. The residual pleural thickening was defined the average of the summation in the lateral chest at the level of the imaginary line intersecting from the cardiophrenic angle to the diaphragmatic dome and the lowest part of the costophrenic angle between them. The results were sorted into three grades according to pleural thickness; <2mm(grade I), 2~10mm(grade II), 10mm(grade III). RESULTS: 1. FVC(% pred) and FIVC(% pred) were statistically different between grade I and III, and II and III. However, there was no difference between the TLC(% pred) between each of the groups. 2. The pleural thickness that cause restrictive dysfunction(FVC<80%) and a statisticall difference, is 3 mm. CONCLUSION: The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3 mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.
Chest Pain ; Cough ; Diaphragm ; Fever ; Humans ; Lung ; Respiratory Function Tests ; Ribs ; Thorax ; Tuberculosis, Pleural* ; Tuberculosis, Pulmonary

BACKGROUND: Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). The purpose of this study was to investigate the HAV vaccination status and related factors among college students. METHODS: The study subjects were 503 students conveniently sampled from C university located in one district of Jeollanamdo. General characteristics and HAV vaccination related factors were collected by a self-reported questionnaire in October 2013. Chi-square tests and multiple logistic regression analyses were used to evaluate related factors with HAV vaccination. RESULTS: Of the 503 subjects without a history of HAV infection, 65 subjects (12.9%) reported that they were vaccinated. In multiple analyses, subjects who have had health screening (adjusted odds ratio, aOR=2.44 and 95% confidence interval, 95% CI=1.26-4.73) and those who were aware of HAV infection (aOR=6.00, 95% CI=1.81-19.91) or who perceived the benefits of HAV vaccine (aOR=2.05, 95% CI=1.07-3.93) were more likely to be vaccinated than those not involved in these factors. With regard to intention for HAV vaccine, 314 subjects (71.9%) reported that they have the intention to be vaccinated against HAV. In multiple analyses, higher grade level, high monthly allowance, awareness of HAV vaccine, perceived susceptibility of HAV, perceived seriousness of HAV and perceived benefits of HAV vaccine were significantly associated with the intention for HAV vaccination. CONCLUSIONS: The vaccination rate for HAV was found to be low in our sample of college students. To reduce health risks related with HAV, prevention efforts should consider these results.
Communicable Diseases ; Hepatitis A ; Hepatitis A virus* ; Humans ; Intention ; Jeollanam-do ; Liver ; Logistic Models ; Mass Screening ; Odds Ratio ; Risk Factors ; Vaccination* ; Surveys and Questionnaires

Fever is a common and serious problem in patients in the intensive care unit (ICU), but its cause is sometimes difficult to determine. Such fevers may be infectious or noninfectious. Infectious causes include ventilator-associated pneumonia, intravascular catheter-related infection, surgical site infection, catheter-related urinary tract infection, and Clostridium difficile infection. Noninfectious causes include transfusion reaction, drug fever, acute pancreatitis, deep vein thrombosis, pulmonary embolism, adrenal insufficiency, and hyperthyroidism. The medical history should be reviewed carefully and a physical examination performed whenever fever occurs in patients in the ICU.
Adrenal Insufficiency ; Anti-Bacterial Agents ; Blood Group Incompatibility ; Catheter-Related Infections ; Clostridium difficile ; Fever* ; Humans ; Hyperthyroidism ; Intensive Care Units* ; Pancreatitis ; Physical Examination ; Pneumonia, Ventilator-Associated ; Pulmonary Embolism ; Urinary Tract Infections ; Venous Thrombosis

Diabetes mellitus is a major risk factor for fungal infections, and mortality increases when diagnosis and treatment of fungal infections are delayed in diabetic patients. Common fungal infections in diabetic patients are candidiasis, mucormycosis, and aspergillosis. These fungal infections show various clinical manifestations and are treated with various antifungal agents such as fluconazole, echinocandin, amphotericin B, and voriconazole. Early diagnosis and proper treatment are very important when fungal infection is suspected in diabetic patients.
Amphotericin B ; Antifungal Agents ; Aspergillosis ; Candidiasis ; Diabetes Mellitus* ; Diagnosis ; Early Diagnosis ; Fluconazole ; Fungi ; Humans ; Mortality ; Mucormycosis ; Risk Factors ; Voriconazole

Vibrio vulnificus is a gram-negative bacterium that can cause serious, potentially fatal infections. V. vulnificus causes three distinct syndromes: an overwhelming primary septicemia caused by consuming contaminated seafood, wound infections acquired when an open wound is exposed to contaminated warm seawater, and gastrointestinal tract-limited infections. Case-fatality rates are higher than 50% for primary septicemia, and death typically occurs within 72 hours of hospitalization. Risk factors for V. vulnificus infection include chronic liver disease, alcoholism, and hematological disorders. When V. vulnificus infection is suspected, appropriate antibiotic treatment and surgical interventions should be performed immediately. Third-generation cephalosporin with doxycycline, or quinolone with or without third-generation cephalosporin, may be potential treatment options for patients with V. vulnificus infection.
Alcoholism ; Diagnosis ; Doxycycline ; Hospitalization ; Humans ; Liver Diseases ; Prognosis ; Public Health* ; Risk Factors ; Seafood ; Seawater ; Sepsis ; Vibrio vulnificus* ; Vibrio* ; Wound Infection ; Wounds and Injuries

A culture of the Leptospira species and the microscopic agglutination test (MAT) are considered as the reference standard for the diagnosis of leptospirosis, but both tests are imperfect for early diagnosis. We describe 4 patients diagnosed with leptospirosis using nested polymerase chain reaction (N-PCR) that targeted the 16S rRNA gene and the passive hemagglutination assay (PHA). In our 4 cases, Leptospira DNA in the urine, plasma, or cerebrospinal fluid (CSF), was detected by N-PCR in the early phase of leptospirosis, except in the sample from the buffy coat. Especially, case 3 showed that N-PCR with the urine and CSF was positive 8 days after symptom onset, but not for the plasma or buffy coat. We report 4 cases of leptospirosis that were diagnosed by N-PCR that targeted the 16S rRNA gene with urine, plasma, or CSF, but not the buffy coat. Three were cured by doxycycline but the case 4 was fatal. Detection of Leptospira DNA by PCR from the urine and CSF, in addition to plasma, may be helpful to confirm the diagnosis.

We present herein an unusual case of multilocular thymic cyst, with prominent lymphoid follicular hyperplasia, in a 64-year-old man. It was incidentally founded as a mediastinal mass on chest radiography, during a routine health check-up. Computed tomography revealed a cystic lesion, which contains thick septa involving the thymus. The resected mass, 8x4 cm in diameter, involved the thymus and there is no adhesion or invasion into the adjacent tissue. The cut surface showed cystic spaces with thick white-tan firm wall, which cysts contained gelatinous material. Microscopically, the lesion was characterized by multiple cysts, lined by flattened cuboidal epithelium that was separated by thick walls, having a dense lymphoid tissue with lymphoid follicles. The patient was discharged without any complication and is well without evidence of recurrence for sixteen months.
Epithelium ; Gelatin ; Humans ; Hyperplasia ; Lymphoid Tissue ; Mediastinal Cyst ; Mediastinal Diseases ; Middle Aged ; Recurrence ; Thorax ; Thymus Gland

Chikungunya infection is caused by an arbovirus transmitted by the Aedes mosquito. A 19-year-old man who had traveled to the Republic of Surinam to perform volunteer work complained of a fever, arthralgia, articular stiffness, and a skin rash on both the arm and trunk. Chikungunya fever was diagnosed using a Chikungunya virus specific IgM antibody in an enzyme-linked immunosorbent assay (ELISA) using blood samples obtained during follow-up visits. In this report, we describe a case of imported Chikungunya fever that presented with arthralgia and a skin rash, with islands of normal skin, that occurred following travel to Surinam, South America.
Aedes ; Arboviruses ; Arm ; Arthralgia ; Chikungunya virus* ; Culicidae ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Islands ; Skin ; South America* ; Suriname* ; Volunteers ; Young Adult

This study inquired the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and left ventricular (LV) dysfunction and extracellular water in continuous ambulatory peritoneal dialysis (CAPD) patients. We conducted a cross-sectional study of 30 CAPD patients. Each patient was admitted to the department of internal medicine, Chosun University Hospital between February and October, 2006. Echocardiography was performed using HDI 5000, allowing M-mode, two-dimensional measurement. A multifrequency bioimpedance analyzer was used; extracellular water was calculated as a percentage of total body water and was understood as the index of volume load of CAPD patients. The mean age was 47+/-12 years. Underlying causes of renal failure were 14 with diabetes mellitus, 7 with hypertension, and 9 with chronic glomerulonephritis. The mean serum NT-proBNP level was 14236.56 (83-35,000) pg/mL. LV mass index and LV ejection fraction were 151.67+/-42.5 g/m2 and 57.48+/-12.9%, respectively. The mean extracellular water was 35.97+/-1.04%. Serum NT-proBNP levels correlated positively with LV mass index (r=0.768, p=0.01) and extracellular water (r=0.866, p=0.01) and negatively with LV ejection fraction (r= -0.808, p=0.01). Serum NT-proBNP levels significantly correlated with LV mass index, LV ejection fraction, and extracellular water. Therefore, serum NT-proBNP levels can be a clinical predictive marker for LV hypertrophy, LV dysfunction, and volume status in CAPD patients.
Body Water ; Cross-Sectional Studies ; Diabetes Mellitus ; Echocardiography ; Extracellular Fluid ; Glomerulonephritis ; Humans ; Hypertension ; Hypertrophy ; Internal Medicine ; Natriuretic Peptide, Brain ; Peptide Fragments ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Insufficiency ; Ventricular Dysfunction, Left

BACKGROUND: We recently encountered a case of typhoid fever in a patient who visited us after travelling India. The patient received ciprofloxacin therapy, but developed typhoid pneumonia and typhoid hepatitis, and nalidixic acid resistance Salmonella Typhi (NARST) was identified. The aim of this study was to assess the in vitro efficacy of several antimicrobial combinations, which are commonly used in clinical practice. MATERIALS AND METHODS: Time-kill studies were performed for a clinical NARST strain to evaluate synergy. Synergy was defined as a > or = 2 log10 decrease (100-fold drop) in CFU per mL at 24 hours by a drug combination compared to the most active constituent. RESULTS: The combination regimen of cefotaxime plus ciprofloxacin significantly reduced the bacterial counts (> 3 log CFU) at 3/4 MIC and at 24 hours compared to the ciprofloxacin or cefotaxime alone and showed synergistic effect against a NARST strain. CONCLUSION: In conclusion, our time-kill studies showed that ciprofloxacin plus cefotaxime was the best in vitro combination against a NARST. This combination may improve efficacy compared to fluoroquinolone alone in typhoid fever patient with NARST. Time kill studies with more NARST strains and clinical studies are required to test the relevance of our findings
Anti-Bacterial Agents ; Bacterial Load ; Cefotaxime ; Ciprofloxacin ; Hepatitis ; Humans ; India ; Nalidixic Acid ; Pneumonia ; Salmonella ; Salmonella enterica ; Salmonella typhi ; Sprains and Strains ; Typhoid Fever