Lung flukes Paragonimus heterotremus is a parasitic disease in which transmit by food, occur in 8 Northern mountainous provinces . The incidence of disease is from 0.3 to 15% on human, from 3.3 to 75% on dogs, from 8.7 to 98.1% on mountain scrab and from 1.4 to 3.6 % on snail. Clinical diagnosis based on mainly symptom such as haemoptysis or fluid pleurisy. Diagnosis definetely that have eggs of lung fluke in sputum, in fluid or in feces. Specific treatment medicine is praziquantel. Prevention of its disease by education communication for people and detective patients ealry then use specific treatment medicine
Lung ; Parasitic Diseases ; Pleurisy

PURPOSE: To describe radiologic differences between tuberculous pleural effusion and empyema on the basis of computed tomography(CT). MATERIALS AND METHODS: We reviewed retrosepectively CT findings of 50 patients with pathologically and grossly proved empyema. Twenty-two patients had empyema, and 28 patients had tuberculous pleurisy. RESULTS: CT findings known to be useful in differentiating tuberculous pleural effusion from empyema (1) contour and extent of pleural thickening, (2) mediastinal pleural involvement, (3)accumulation of extrapleural tissue and (4) change of ipsilateral thoraic volume of empyema. However, none of the above findings were helpful in the differential diagnosis of empyema. CONCLUSION: The differentation of tubrculous pleurisy from pyogenic empyema may be not possible with CT findings only.
Diagnosis, Differential ; Empyema* ; Humans ; Pleural Effusion* ; Pleurisy ; Tuberculosis, Pleural

BACKGROUND: pH measurement is an important test in assessing the etiology of pleurisy and in identifying complicated parapneumonic effusion. Although the blood gas analyzer is the' gold standard method' for pleural pH measurement, pH meter & pH strip methods are also used for this purpose interchangably. However, the correlation among the pH data measured by the three different methods needs to be evaluated. In this study, we measured the pH of pleural fluid with the three different methods respectively and evaluated the correlation among the measured data. METHODS: From August 1999 to March 2000, were measured the pleural fluid pH in 34 clinical samples with three methods-blood gas analyzer, pH meter, and pH strip. In the blood gas analyzer and pH meter methods, the temperature of plerual fluid was maintained around 0℃ in air-tight condition before analysis and measurement was performed within 30 minutes after collection. As for the pH strip method, the pleural fluid pH was checked in the ward immediately after tapping and in the clinical laboratory of our hospital. This part is unclear. RESULTS: The causes of pleural effusion were tuberculosis pleurisy in 16 cases, malignant pleural effusion 5 cases, parapneumonic effusion 9 cases, empyema 3 cases, and congestive heart failure 1 case. The pH of pleural fluid (mean±SD) was 7.34±0.12 with blood gas analyser, 7.52±0.25 with pH meter, 7.37±0.16 with pH strip of immediate measurement and 6.93±0.201 with pH strip of delayed measurement. The pH measured by delayed pH strip measurement was lower than those of other methods(p<0.05). The correlation of the results between the blood gas analyzer and pH meter(p=0.002, r=0.518) and the blood gas analyzer and pH strip of immediate measurement(p<0.001, r=0.607). CONCLUSION: In the determination of pH of pleural fluid, pH strip method could be a simple and reliable method under immediate measurement conditions after fluid tapping.
Empyema ; Heart Failure ; Hydrogen-Ion Concentration* ; Methods* ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy ; Tuberculosis

In this study, we investigated interleukin (IL)-18 and IL-12 following in vitro stimulation with either the 30-kDa or purified protein derivative (PPD) antigens (Ag) of pleural mononuclear cells from 12 cases of tubercular pleurisy (TB-PMC) and 8 cases of malignant pleurisy (MG-PMC). Ag-stimulated TB-PMC produced significantly more IL-12 than did MG-PMC and the levels correlated with those of IFN - gamma. Although elevated IL-18 levels were found in freshly isolated pleural fluids, in vitro IL-18 production in response to either Ag was dramatically decreased in TB-PMC. Pro-IL-18 mRNA was detected before and after Ag stimulation in TB patients. Supernatants from the Ag-stimulated TB-PMC significantly suppressed IL-18 production in normal peripheral blood mononuclear cells (PBMC) and primary malignant cells over an 18 h incubation period. In addition, this suppressive activity was not inactivated by either heat or trypsin. Our findings imply that modulation of IL-12 and IL-18 levels may contribute to the Th1 elevation induced in human TB-P VIC by the 30-kDa and PPD antigens.
Hot Temperature ; Humans ; Interleukin-12* ; Interleukin-18* ; Interleukins ; Mycobacterium tuberculosis ; Pleurisy ; RNA, Messenger ; Trypsin ; Tuberculosis, Pleural

Systemic lupus erythematosus (SLE) is a chronic and multisystemic disease. Pleuropulmonary disease in SLE has various clinical manifestations, such as immunologic pneumonia, infectious pneumonia, interstitial lung disease, pulmonary hypertension, pulmonary hemorrhage, pleuritis and pleural effusion. It can manifest as an initial clinical finding of SLE. We experienced two cases; one case of pulmonary hemorrhage and one case of atypical pneumonia as an initial clinical manifestation of SLE.
Hemorrhage ; Hypertension, Pulmonary ; Lung Diseases ; Lung Diseases, Interstitial ; Lupus Erythematosus, Systemic* ; Pleural Effusion ; Pleurisy ; Pneumonia

Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.
Abscess ; Airway Obstruction ; Early Diagnosis ; Humans ; Lung Abscess ; Mediastinitis ; Pericarditis ; Pharynx ; Physical Examination ; Pleurisy ; Pneumonia, Aspiration

BACKGROUND: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. MATERIAL AND METHODS: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. RESULTS: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration(9.70 +/-7.50mm vs. 6.26 +/-7.02mm, p<0.001) as well as the ratio of patients showing an induration > 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). CONCLUSION: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.
Humans ; Incidence ; Mass Screening ; Military Personnel* ; Pleurisy ; Radiography, Thoracic ; Skin Tests ; Tuberculin ; Tuberculosis* ; Tuberculosis, Pulmonary

Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references.
Diagnosis ; Humans ; Korea ; Pleural Cavity ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Radiography ; Rare Diseases ; Thorax ; Ultrasonography

BACKGROUND: Isolation of M. tuberculosis (MTB) is required in cases of Tuberculous pleural effusion (TBPE) for confirming diagnosis and successful therapy based on drug sensitivity test. Several studies have focused on predictors of MTB culture positivity in TBPE. However, the clinical role of loculated TBPE as a predictor of MTB cultivation from TBPE remains unclear. The aim of this study was to examine possible predictors including loculation of TBPE of MTB culture positivity in TBPE. METHODS: We retrospectively examined associations between clinical, radiological, microbiological, and laboratory characteristics and positive MTB culture from TBPE to determine a potent predictor of culture positivity. RESULTS: From January 2011 to August 2015, 232 patients with TBPE were identified. Of these, 219 were finally analyzed. Among them, 69 (31.5%) were culture positive for MTB in TBPE and 86 (39.3%) had loculated TBPE. In multivariate logistic regression analysis, the loculation of TBPE was independently associated with culture positivity for MTB in TBPE (adjusted odds ratio [OR], 40.062; 95% confidence interval [CI], 9.355–171.556; p<0.001). In contrast, the lymphocyte percentage of TBPE (adjusted OR, 0.934; 95% CI, 0.899–0.971; p=0.001) was inversely associated with culture positivity for MTB in TBPE. CONCLUSION: In clinical practice, identification of loculation in TBPE is easy, reliable to measure, not uncommon and may be helpful to predict the possibility of positive mycobacterial culture.
Diagnosis ; Humans ; Logistic Models ; Lymphocytes ; Odds Ratio ; Pleural Effusion* ; Pleurisy ; Retrospective Studies ; Tuberculosis

BACKGROUND: Determining the cause of an exudative pleural effusion is sometimes quite difficult, especially between malignant and tuberculous effusions. Twenty percent of effusions remain undiagnosed even after a complete diagnostic evaluation, including pleural biopsy. The activity of tumor necrosis factor-alpha (TNF-alpha), which is the one of proinflammatory cytokines, is increased in both infectious and malignant effusions. The aim of this study was to investigate the diagnostic efficiency of TNF-alpha activity in distinguishing tuberculous from malignant effusions. METHODS: 46 patients (13 with malignant pleural effusion, 33 with tuberculous pleural effusion) with exudative pleurisy were included. TNF-alpha concentrations were measured in the pleural fluid and serum samples using an enzyme- linked immunosorbent assay (ELISA). In addition, TNF-alpha ratio (pleural fluid TNF-alpha : serum TNF-alpha) was calculated. RESULTS: TNF-alpha concentration and TNF-alpha ratio in the pleural fluid were significantly higher in the tuberculous effusions than in the malignant effusions (p<0.05). However, the serum levels of TNF-alpha in the malignant and tuberculous pleural effusions were similar (p>0.05). The cut off points for the pleural fluid TNF-alpha level and TNF-alpha ratio were found to be 136.4 pg/mL and 6.4, respectively. The sensitivity, specificity and area under the curve were 81%, 80% and 0.82 for the pleural fluid TNF-alpha level (p<0.005) and 76%, 70% and 0.72 for the TNF-alpha ratio (p<0.05). CONCLUSION: We conclude that pleural fluid TNF-alpha level and TNF-alpha ratio can distinguish a malignant pleural effusion from a tuberculous effusion, and can be additional markers in a differential diagnosis of tuberculous and malignant pleural effusion. The level of TNF-alpha in the pleural fluid could be a more efficient marker than the TNF-alpha ratio.
Biopsy ; Cytokines ; Diagnosis, Differential* ; Humans ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy ; Tuberculosis ; Tumor Necrosis Factor-alpha*