No abstract available.
Female* ; Humans ; Urinary Incontinence*

No abstract available.
Emergencies* ; Emergency Medical Services*

It is difficult to distinguish benign from malignant, pulmonary nodule by conventional roentgenologic examination. But CT makes it easier to evaluate adjacent parencymal invasion, pleural or mediastinal extenstion,or early metastasis to intra- or extrathoracic lymph node as well as distant organs, although only a solitaryperipheral pulmonary nodule is seen on plain radiograph. Authors reviewed CT of 22 cases of histopathologically confirmed primary lung cancer seen as a solitary peripheral pulmonary mass from May 1980 to Sep. 1984 at DongsanMedical Center, Keimyung University. The results are as follows: 1.The incidence was most common in the 6thdecade(36%). Male to female ratio was 10:1 and 2 females all had bronchioloalveolar cell carcinoma. 2. Thedistributions of histologic cell type were as follows: squamous cell carcinoma 40%, adenocarcinoma, small cellcarcinoma, bronchioloalveolar cell carcinoma and unclassified carcinoma 14% in each cases, and adenoid cysticcarcinoma 4% . 3. The CT findings were as follows: a) Superior and posterior basal segments of both lower lobeswere most frequently involved(68%). b) The mean diameter of the mass was 48mm, and most common in the range of30-49 mm in the greatest dimension(46%). c) The mean CT atttenuation value was 57 H.U., and most common in thegroup of 41-70 H.U. (64%). d) Lymph node metastasis was found in 13 (59%) of 22 cases, and the involved nodes wereas follows: hilar nodes 10 cases, paratracheal nodes 8 cases, subcarinal nodes 7 cases and extrathoracic nodes 3cases. In 2 of 3 cases with small cell carcinoma, diffuse multiple lymph nodes were involved. e) Distantmetastasis was seen relatively early in 3 cases; cerebral metastasis in 1 case of squamous cell carcinoma, rightaderenal metastasis without intrathoracic lymph node metastasis or invasion of adjacent structures in 1 case ofbronchioloalveolar cell carcinoma, and liver and bone metastases in 1 case of unclassified carcinoma. f) Adjacentpleural or mediastinal invasion was found in 7 cases(32%): pleural invasion along chest wall in 4 cases, andinvasion of adjacent mediastinal pleura in 3 cases of 2 squamous cell carcinoma and 1 unclassifed carcinoma. g)Calcifications witihin the mass were found in 5 cases (23%), and most common in squamous cell carcinoma(3 cases).In all cases, a few granular calcification were seen along the peripheral margin of the mass. h) Tumor necrosiswas seen in 4 cases(18%), and 3 cases were squamous cell carcinoma, and one of them showed irregular centralcavitation. i) The margins of tumor were irregularly lobulated with radiating spiculations in all except one ofadenoid cystic carcinoma, which revealed oval shaped, smooth clear margin. j) In 9(41%) of 22 cases, someenlargement of pulmonary vessels with perivascular linear infiltrations were found in the adjacent lungparenchymes of the mass, which were thought to be retrograde perivascular lymphangitic spread along pulmonaryvessels.
Adenocarcinoma ; Adenoids ; Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Female ; Humans ; Incidence ; Liver ; Lung Neoplasms ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pleura ; Thoracic Wall

PURPOSE: This study was performed for the evaluation of the feasibility and toxicity of hypofractionated radiation therapy for early glottic cancer METHODS AND MATERIALS: From February 1999 to February 2000, 20 patients with histologically confirmed Stage I, II glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as follows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy (2.5 Gy per fraction, 24 fractions, total 60 Gy). Median duration of treatment was 36 days (range 31-45 days). RESULTS: Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia (5%), six cases of grade 3 hoarseness (30%). Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy CONCLUSION: This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer. But longer follow up time would be required to assess the long-term disease control and the late complication by shortening radiation therapy duration.
Appointments and Schedules ; Biopsy ; Female ; Follow-Up Studies ; Hoarseness ; Humans ; Male ; Neoplasm Metastasis ; Recurrence ; Treatment Failure

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

Diffuse aspiration bronchiolitis is defined as a clinical entity characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. Clinical symptoms are bronchorrhea, bronchospasm, and dyspnea, and chest radiographs show the presence of regional or disseminated srnall nodular shadows and hyperlucency. Chest CT should help in detecting diffuse nodular shadows of bronchiolitis. Pathologic findings of diffuse aspiration bronchiolitis are characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play an important role in the pathogenesis of diffuse aspiration bronchiolitis. We report a case of diffuse aspiration bronchiolitis in a 4-month- old female infant who had recurrent aspiration due to dysphagia and presented with recurrent fever, dyspnea and wheezing. She showed typical radiologic and histologic findings compatible to diffuse aspiration bronchiolitis. She was improved with treatment of nasogastric tube feeding. We emphasize the importance of recognizing this disease entity and differentiating it from pulmonary diseases associated with bronchospasm. (J Korean Pediatr Soc 2000;43:842-845)
Bronchial Spasm ; Bronchioles ; Bronchiolitis* ; Deglutition Disorders ; Dyspnea ; Enteral Nutrition ; Female ; Fever ; Foreign-Body Reaction ; Humans ; Infant* ; Inflammation ; Lung Diseases ; Radiography, Thoracic ; Recurrence ; Respiratory Sounds ; Tomography, X-Ray Computed

No abstract available.
Humans ; Incidence* ; Infant* ; Resuscitation*

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

No abstract available.
Coronary Sinus*

BACKGROUND: Atopic asthma is characterized by activation of Th2-type T cells in the bronchial mucosa. Several reports have suggested an important role for costimulation through the CD28/CTLA4 (cytotoxic T lymphocyte-associated antigen 4)-B7 (CD80/CD86) pathway in allergen activation of T cells in animal models of allergen-induced asthma, because B7-CD28/ CTLA4 interaction can promote the differentiation and development of the Th2 lymphocyte subset. OBJECTIVE: In the present study, we intended to investigate a potential role of humanized CTLA4-Ig on the inhibition of T and B cell activation by blocking B7/CD28 interactions. METHOD: For this purpose we produced humanized CTLA4-Ig fusion protein by transfection to CHO cell and examined its inhibitory effects for activated T and B cell responses. We evaluated the inhibitory effect of MLR (mixed lymphocyte reaction) and con A-stimulated T cell proliferation. And we assayed wheather B cell was inhibited by stimulation of costimulatory signal in LPS-induced B cell response and PFC assay. RESULT: In vitro assay, humanized CTLA4-Ig fusion protein inhibited T cell-specific immune response in dose-dependent manner: CTLA4-Ig inhibited allogeneic stimulation in murine MLR, and the proliferation of T cell by the stimulation of Con A. But CTLA4-Ig did not inhibit directly the proliferative response of B cell by the stimulation of LPS. In addition, in vivo assay, CTLA4-Ig inhibited the production of antibody from B cell, which was presented by plaque-forming cell (PFC) assay. CONCLUSION: These findings suggest that humanized CTLA4-Ig is effective to inhibit the proliferation of activated T cell directly by blocking B7/CD28 costimulation. And humanized CTLA4-Ig influences antibody-producing capacity of B cell indirectly by regulating T cell.
Abatacept ; Animals ; Antibody Formation* ; Asthma ; Cell Proliferation ; CHO Cells ; Cricetinae ; Humans ; Lymphocyte Subsets ; Lymphocytes ; Models, Animal ; Mucous Membrane ; T-Lymphocytes ; Transfection