Tuberculous lymphadenitis is easily mistaken for an infection by only mycobacterium tuberculosis. However, many cases reveal atypical mycobacterium. Treatment of atypical mycobacterium differs from that of M. tuberculosis and M. bovis. Usual anti-tuberculous medication is the response to M. tuberculosis and M. bovis, but not to atypical mycobacterium. Excision and antibiotic therapy is the known treatment of choice for atypical mycobacterium. We used the polymerase chain reaction(PCR) for differential diagnosis of tuberculosis from lymphadenitis, and by using PCR we were able to differentiate the infecting organism as typical or atypical mycobacterium. We excised 50 case of cervical lymphadenitis, and PCR was done with Primer I(IS6110), which is specific for M. tuberculosis and M. bovis, and with Primer II(65 KDa Ag), which covers all mycobacterium species. The results obtained by PCR were compared with the pathologic results(control): sensitivity 81.8%, specificity 88.9%, false positive ratio 11.1%, false negative ratio 18.2%, typical mycobacterium 45.5%, and atypical mycobacterium 45.5%. These findings suggest that PCR is a good diagnostic tool for the early detection of tuberculous lymphadenitis and for differentiation of mycobacteria in cervical lymphadenitis.
Diagnosis, Differential ; Lymphadenitis ; Mycobacterium ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Lymph Node*

PURPOSE: This study was performed to find out the natural history of lung cancer in Pusan-Kyungnam area and changing of that in previous report. MATERIALS AND METHOD: We studied retrospectively 508 patients with pathologically proven lung cancer from January 1991 to December 1995. We analysed age and sex distribution, initial symptoms before diagnosis, first method yielding histologic diagnosis, cell types of lung cancer, initial stage of lung cancer, schema of overall patients, survivial of lung cancer patients, and prognostic factors affecting survival of lung cancer patients.. RESULTS: The overall male to female ratio was 4.5: 1 and the age distribution ranged from 20 to 86 years, and the median age of overall patients was 60 years. Histologic classification revealed that the most prevalent type was squamous cell carcinoma (251 cases, 49.4%), followed by adenocarcinoma (141 cases, 27.8%), small cell carcinoma (91 cases, 17.9%), and large cell carcinoma (3 cases, 0.6%). In non-smali cell lung cancer 56.8% were stage IIIb and IV, therefore curative operation was done in 18.7% of all cases, but in small cell lung cancer 65.6% were extended disease. Meidan survival of overall patients was 11.8 months. There was a quite difference in survival among the stages. In non-small cell lung cancer, median survival was 59.7 months, 27.3 months, 18.5 months, 12.7 months, 5.9 months in stage I, II, IIIa, IIIb, IV in each. In small cell lung cancer, median survival of limited disese was 12.2 months and median survival of extended disease was 6.7 months. The stage and the performance status were independent prognostic factors in both small cell and non-small cell lung cancer. CONCLUSION: The prognosis of patients with lung cancer was still grave, but the survival was better than that of a previous report. This may be accorded to increase in early diagnosis and operation and advance in supportive care.
Adenocarcinoma ; Age Distribution ; Busan* ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Early Diagnosis ; Female ; Gyeongsangnam-do* ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Natural History ; Prognosis ; Retrospective Studies ; Sex Distribution ; Small Cell Lung Carcinoma

Primary segmental omental infarction in adults is very rare and occasionally occurs due to impaired perfusion to the greater omentum. Most authors believe that the condition results from an embryologic variant associated with anomalous and fragile blood supply of the right lower portion of the greater omentum, which is consequently susceptible to infarction. Since there are no characteristic clinical findings, the clinical presentation often mimics acute appendicitis or cholecystitis. However, in the proper clinical setting, the correct diagnosis can be established by the radiologist; therefore, unnecessary surgery can be avoided in many cases. Cross-sectional imaging by ultrasound or computed tomography will demonstrate characteristic findings in a location corresponding to the patient's point of maximal tenderness. These findings consist of an ovoid or cake-like mass in the omental fat with surrounding inflammatory changes. We report a case of primary segmental omental infarction in an adults who was treated conservatively after the diagnosis was established with clinical findings.
Abdominal Pain ; Adult ; Appendicitis ; Cholecystitis ; Diagnosis ; Humans ; Infarction* ; Omentum ; Perfusion ; Ultrasonography ; Unnecessary Procedures

BACKGROUND: Previous studies suggest that systemic administration of agmatine, endogenous ligand for imidazoline receptors has anti-hypernociceptive effects in experimental animal. However the peripheral effects of agmatine on inflammatory pain have not yet been elucidated. Here we examined the effects of intra-articular injection of agmatine in the induction and maintenance phase of arthritic pain. In addition, we sought to determine the potential contribution of imidazoline and alpha(2)-adrenergic receptors to the antinociceptive effects using clonidine which is mixed alpha(2)-adrenoceptor and imidazoline receptor agonist. METHODS: To induce arthritis in rats, 2% lambda-carrageenan (50microliter, in saline) was injected into the joint of the right hind limb under enflurane anesthesia. Either agmatine (10, 50, 100microgram/40microliter) or clonidine (10, 50, 100microgram/40microliter) was injected into the knee joint cavity immediately before or 4 hr after carrageenan injection. Weight load tests were performed to measure pain-related behavior in freely walking rats. RESULTS: The intraarticular injection of agmatine into the knee joint had no effects in the both phase of induction and maintenance of arthritic pain at any dose tested. However, injection of clonidine reversed arthritic pain, when injected 4 h after carrageenan injection. CONCLUSIONS: In rats, agmatine has no peripheral effect on inflammatory pain and imidazoline receptors in the periphery may not contribute to the anti-inflammatory pain.
Agmatine ; Anesthesia ; Animals ; Arthritis ; Carrageenan ; Clonidine ; Enflurane ; Extremities ; Imidazoline Receptors ; Inflammation ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Rats ; Walking

A 56 years old male patient admitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. fingers and weakness on grasping, which were progressively developed recently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We planned staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later. We obligately clamped aorta just below the celiac artery and infused kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative coure was uneventful and patient was discharged without any specific problem.
Aorta ; Aorta, Abdominal* ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis ; Celiac Artery ; Constriction, Pathologic ; Endarterectomy, Carotid* ; Fingers ; Hand Strength ; Humans ; Ischemia ; Kidney* ; Lower Extremity ; Male ; Middle Aged ; Neurology ; Organ Preservation ; Renal Artery ; Sensation ; Transplants*

Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.
Chest Tubes ; Drainage ; Negative-Pressure Wound Therapy ; Subcutaneous Emphysema

BACKGROUND/AIMS: Resection of the esophagus for malignant disease or a benign stenosis, has a choice not only of palliative surgery, but also of replacement of the esophagus with a transposed stomach, jejunum, or colon. The first-line method is replacement with a tubulized stomach. The purpose of this study was to investigate the association of esophageal motor dysfunction and gastric emptying time with symptoms after esophagectomy. METHODS: We performed the esophageal manometry and gastric emptying time after esophagectomy for esophageal cancer in 12 patients and for benign esophageal disease in 2 patients. RESULTS: In manometric studies, a zone of high pressure in the esophago-gastric anastomosis distal to the upper esophageal sphincter was associated with symptoms after esophagectomy. The gastric emptying rate was slowed in 7 out of 14 patients, but not associated with symptoms after esophagectomy. CONCLUSIONS: Our data suggest that a high-pressure zone distal to the upper esophageal sphincter was associated with symptoms after esophagectomy in manometric study. The gastric emptying rate was not associated with postoperative symptoms.
Colon ; Constriction, Pathologic ; Esophageal Diseases ; Esophageal Neoplasms ; Esophageal Sphincter, Upper ; Esophagectomy* ; Esophagus ; Gastric Emptying* ; Humans ; Jejunum ; Manometry* ; Palliative Care ; Stomach

PURPOSE: To identify a useful screening test leading to diagnosis of hypertension in the emergency department (ED). METHODS: This was a retrospective medical record review of adult patients (18> or =years of age) admitted to the ED at a tertiary care educational hospital, between January 1, 2010 and February 28, 2010. Only those patients with a triage systolic blood pressure greater than or equal to 140 mmHg, or a diastolic blood pressure greater than or equal to 90 mmHg, were enrolled. Data including baseline characteristics, basic metabolic panel (BMP), urinalysis, electrocardiogram (ECG), chest radiograph, and whether or not they were diagnosed with hypertension, were obtained. Multivariate analysis was performed to determine an appropriate screening test for diagnosis of hypertension. RESULTS: Of the 447 enrolled patients, 81(18.1%) were diagnosed with hypertension. Age above 35 years (Odds ratio [OR]=8.263; 95% Confidence interval (CI), 1.034-66.062; p=0.046), diagnosis of diabetes mellitus (DM) (OR=3.99; 95% CI, 1.582-10.064; p=0.003), left ventricular hypertrophy (LVH) (OR=4.348; 95% CI, 1.968-9.607; p<0.001), and suspected stage II hypertension (OR=2.699; 95% CI, 1.151-6.329; p=0.022) were independently associated with a positive hypertension diagnosis. The area under the Receiver operating characteristic (ROC) curve for a positive diagnosis of hypertension was 0.687(95% CI, 0.642-0.730). CONCLUSION: Age above 35 years, existence of DM or LVH, and suspected stage II hypertension may be useful data points for screening and diagnosis of hypertension in the ED.
Adult ; Blood Pressure ; Diabetes Mellitus ; Electrocardiography ; Emergencies ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Mass Screening ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; ROC Curve ; Tertiary Healthcare ; Thorax ; Triage ; Urinalysis

PURPOSE: To identify a useful screening test leading to diagnosis of hypertension in the emergency department (ED). METHODS: This was a retrospective medical record review of adult patients (18> or =years of age) admitted to the ED at a tertiary care educational hospital, between January 1, 2010 and February 28, 2010. Only those patients with a triage systolic blood pressure greater than or equal to 140 mmHg, or a diastolic blood pressure greater than or equal to 90 mmHg, were enrolled. Data including baseline characteristics, basic metabolic panel (BMP), urinalysis, electrocardiogram (ECG), chest radiograph, and whether or not they were diagnosed with hypertension, were obtained. Multivariate analysis was performed to determine an appropriate screening test for diagnosis of hypertension. RESULTS: Of the 447 enrolled patients, 81(18.1%) were diagnosed with hypertension. Age above 35 years (Odds ratio [OR]=8.263; 95% Confidence interval (CI), 1.034-66.062; p=0.046), diagnosis of diabetes mellitus (DM) (OR=3.99; 95% CI, 1.582-10.064; p=0.003), left ventricular hypertrophy (LVH) (OR=4.348; 95% CI, 1.968-9.607; p<0.001), and suspected stage II hypertension (OR=2.699; 95% CI, 1.151-6.329; p=0.022) were independently associated with a positive hypertension diagnosis. The area under the Receiver operating characteristic (ROC) curve for a positive diagnosis of hypertension was 0.687(95% CI, 0.642-0.730). CONCLUSION: Age above 35 years, existence of DM or LVH, and suspected stage II hypertension may be useful data points for screening and diagnosis of hypertension in the ED.
Adult ; Blood Pressure ; Diabetes Mellitus ; Electrocardiography ; Emergencies ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Mass Screening ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; ROC Curve ; Tertiary Healthcare ; Thorax ; Triage ; Urinalysis

Brachytherapy ; Follow-Up Studies ; Humans ; Medical Staff ; Mouth Neoplasms ; Necrosis ; Tongue Neoplasms ; Tongue