The sheaths of tendons are an uncommon site of tuberculous invclvement as compared to other parts of the body. But tuberculou, tenosynovitis occurs often enough to varrant particular attention and study. We report a case of tuberculous tenosynovitis occuring in a 49-year-old woman who had multiple yellowish palpable nodules and swellings distributed along the tencon of flexor digitorum superficialis on the left palm for 3 month. Histopathologic findings showed multip e tuberculoid granulomas in the mid-and deep-dermis. Eosinophilic homogenous trabeculated structure(remnants of tendon sheath resistant to necrosis) was present within the area of caseation. Acid-fast stain showed a crowd of acid-fast bacilli in the deep dermis. The cultures from the skin biopsy spec mens on Ogawa media(3% KH PO4) at 24C, 32C and 37C were all negative. She was treated with surgical excision of granulation tissue and involved tendon sheath followed by systemic administration of INH, RIF and ethambutol for 1 year. The lesions were markedly improved and showed no relaps, during last 5 months of follow up period.
Biopsy ; Dermis ; Eosinophils ; Ethambutol ; Female ; Follow-Up Studies ; Granulation Tissue ; Granuloma ; Humans ; Male ; Middle Aged ; Skin ; Tendons ; Tenosynovitis

PURPOSE: To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy. MATERIALS AND METHODS: We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique. RESULTS: Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose > or =70 Gy (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose > or =70 Gy was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963). CONCLUSION: NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.
Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Prostatic Neoplasms* ; Radiotherapy* ; Radiotherapy, Intensity-Modulated ; Retrospective Studies

BACKGROUND: It is one of anesthesiologist's important tasks to know the accurate recovery state of a patient after general anesthesia. Postanesthetic recovery score (PARS) has been widely used as a measure of evaluating recovery state because it is simple, easy to apply and applicapable to all situations. In this study, we investigated whether there were correlations between PARS and PAR-stay time, and examined factors influencing PAR-stay time. METHODS: Two hundreds and five patients were selected randomly. PARS was measured in each patient immediately after he or she arrived at PAR. Correlations between PARS and PAR-stay time were studied. And other variables such as age, sex, physical status, operation site and anesthetic time were studied as influencing factors on PAR-stay time. RESULTS: There were no significant correlations between PARS and PAR-stay time. PARS was influenced by the operation site only. And PAR-stay time was influenced by the patient's age only. CONCLUSIONS: In evaluating the postanesthetic recovery state, it seems to be important to consider not only PARS but also other factors such as patient's age.
Anesthesia, General ; Humans ; Recovery Room*

No abstract available.
Constriction, Pathologic*

Small cell carcinoma of ovary is extremely rare. This neoplasms compose predominantly or exclusively of small round cells with scant cytoplasm. There are two types of primary small cell carcinoma of ovary described in the literature : the hypercalcemic type and the pulmonary type. The first 11 patients with a primary ovarian small cell carcinoma of the pulmonary type were described by Eichorn et al. in 1992. The prognosis of this tumor is very poor and only limited data on the treatment of this tumor type are available. In the present case report, we describe a patient with the pulmonary type of small cell carcinoma associated with huge mucinous cystadenocarcinoma with a brief review of the concerned literatures.
Carcinoma, Small Cell ; Cystadenocarcinoma, Mucinous ; Cytoplasm ; Female ; Humans ; Mucins ; Ovary ; Prognosis

Since amyloidosis is usually diagnosed later in the disease process, a high index of suspicion is therefore necessary for earlier diagnosis. Confirmative diagnosis rests on a biopsy of the involved organ. Gastrointestinal amyloidosis causes a variety of symptoms including intestinal obstruction, ulcers, malabsorption, hemorrhaging, protein loss, diarrhea, anorexia, nausea, vomiting, and dysphagia. We confirmed amyloid deposits in the stomach in three patients with epigastric pain through a biopsy of erosive gastritis documented on a gastrofiberscopy. One patient with primary amyloidosis which had invaded his kidney, stomach, and heart, expired, although aggressive treatment with a pacemaker insertion, peritoneal dialysis, and ventilator care was performed. Another patient with multiple myeloma died on the 38th day, after having started systemic chemotherapy. The other patient with secondary amyloidosis due to rheumatoid arthritis, is currently receiving colchicine at our out patient clinic.
Amyloidosis* ; Anorexia ; Arthritis, Rheumatoid ; Biopsy* ; Colchicine ; Deglutition Disorders ; Diagnosis ; Diarrhea ; Drug Therapy ; Gastritis ; Heart ; Humans ; Intestinal Obstruction ; Kidney ; Multiple Myeloma ; Nausea ; Peritoneal Dialysis ; Plaque, Amyloid ; Stomach* ; Ulcer ; Ventilators, Mechanical ; Vomiting

Traumatic anterior dislocation of the hip is rare. Bilateral traumatic anterior dislocation is an even rarer injury; indeed, only 5 cases have been reported in the English literature. We describe a case of a bilateral traumatic anterior dislocation of the hip and a concomitant unstable lumbar burst fracture following a mechanism of injury distinctly different from other reports.
*Accidents, Occupational ; Acetabulum/injuries ; Buttocks/*injuries ; Fractures, Bone/complications/etiology/radiography ; Hip Dislocation/etiology/*radiography ; Humans ; Lumbar Vertebrae/*injuries ; Lumbosacral Region/*injuries ; Male ; Middle Aged ; Spinal Fractures/etiology/*radiography

BACKGROUND: Recurrent pneumonia in adults is not uncommon. However, there is no domestic data about recurrent pneumonia in adults. Therefore, we investigated the associated diseases and clinical findings of recurrent pneumonia in adults. METHODS: Among 5513 patients who were treated in five teaching hospitals of Hallym medical center?over a 5-year period, we retrospectively reviewed the medical records of the 58 who were compatible with diagnostic criteria of recurrent pneumonia. RESULTS: The number of patients with recurrent pneumonia was 58 (1.05%, 58/5513) during the 5 years. Thirty- seven patients were male and 21 were female. Mean age was 66.4 (+/-14.9) years. Median interval between each pneumonic episode was 18.5 months. Associated diseases were 25 cases of respiratory diseases, 13 of heart diseases, 13 of diabetes mellitus, 7 of lung malignancies, 11 of malignancies other than lung, 7 of neurologic disease, and 8 of miscellaneous diseases. Three cases had no underlying illness. Of the 8 cases with 2 or more times of recurrence, 4 were associated with respiratory diseases, 2 with aspiration pneumonia due to neurologic diseases, 1 with heart disease and 1 with no underlying illness. Recurrent pneumonic episodes affecting the same location were 30 of the total recurrent pneumonic episodes (30/67, 47.8%) and common associated diseases were respiratory diseases including lung malignancies. The etiology of recurrent pneumonia was Streptococcus pneumoniae, methicillin- resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, atypical organisms, etc. CONCLUSION: Recurrent pneumonia in adults had a low incidence rate compared with children, but most cases had associated illness. Respiratory diseases including lung cancer were the most common associated illness of recurrent pneumonia.
Academic Medical Centers* ; Adult* ; Child ; Diabetes Mellitus ; Female ; Heart Diseases ; Hospitals, Teaching ; Humans ; Incidence ; Klebsiella pneumoniae ; Lung ; Lung Neoplasms ; Male ; Medical Records ; Pneumonia* ; Pneumonia, Aspiration ; Pseudomonas aeruginosa ; Recurrence ; Retrospective Studies ; Staphylococcus aureus ; Streptococcus pneumoniae

BACKGROUNDS: The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. METHODS: 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. RESULTS: The mean FEV1/FVC in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. CONCLUSIONS: This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.
Asthma* ; Coronavirus ; Humans ; Influenza, Human ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Pulmonary Disease, Chronic Obstructive* ; Respiratory System ; Rhinovirus ; Sputum

BACKGROUND: The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. METHODS: This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. RESULTS: The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. CONCLUSION: The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.
APACHE ; Critical Illness ; Electrocardiography ; Gangwon-do ; Heart ; Humans ; Intensive Care Units* ; Critical Care* ; Length of Stay ; Mortality ; Multiple Organ Failure ; Prognosis* ; Prospective Studies ; Subject Headings ; Survivors