No abstract available.
Automation, Laboratory/*methods ; Culture Media/*classification ; Female ; Humans ; Male ; Sputum/*microbiology ; Tuberculosis, Pleural/*diagnosis

OBJECTIVES: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. METHODS & RESULTS: 1) Records of a total of 41 patients with preoperative T1-3N0M0 non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative T2, 2 cases were identified postoperatively as T3 with invasion of chest wall and among 6 cases with preoperative T1-3, 1 case was identified postoperatively as T4 with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with T1-2, 5 cases wore N1 and 3 cases were N2 postoperatively. After the operation of 6 cases with T3, 2 cases were N1 and 3 cases were N2 postoperatively Preoperative T3 showed more intrathoracic lymph node metastases and higher N2/N1 involvement ratio than preoperative T1-2. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative N2 tumors. CONCLUSION: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative T3 non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.
Adenocarcinoma ; Aorta ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Magnetic Resonance Imaging ; Mediastinoscopy ; Neoplasm Metastasis ; Pulmonary Artery ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

PURPOSE: A phyllodes tumor is a rare disease of the breast, which shows various clinicopathological aspects. However, there is some controversy over its clinical behavior, pathologic characteristics, and local recurrence rates. Therefore, the clinicopathological characteristics of phyllodes tumor and the risk factor that influence a local recurrence after surgery were analyzed. METHODS: The medical records of 56 patients with a phyllodes tumor who had undergone surgery at the Department of Surgery, Yonsei University, from 1986 to 1998, were analyzed retrospectively. The median follow up period was 57.2 months (12~245 months). The microscopic slides were re-examined and the pathologic criteria analyzed were cellular atypia, stromal cellularity, pleomorphism, necrosis, differentiation, tumor margin, and number of mitoses. The malignancy was reclassified using the histological criteria reported by Pietruszka et al. (benign was 0~4 mitoses/10 high- power fields, borderline 5~9 mitoses, and malignant more than 10 mitoses). The clinical features evaluated included age, preoperative diagnosis, tumor size, surgical methods, and local recurrence. RESULTS: The mean age was 41 years 14~69 years) and the mean tumor size was 4.5 cm (1~12 cm). Only 9 cases (16.1%) were preoperatively diagnosed as having a phyllodes tumor. The most commonly performed surgical procedures were local or wide excision (46 cases, 82.1%), and a mastectomy in 10 cases (17.9%). Out of 56 cases reviewed, 43 (76.8%) were confirmed as being a benign, 7 (12.5%) as being a borderline, and 5 (1.8%) as being a malignant phyllodes tumor. Cellular atypia was minimal in 40 cases (71.4%) and prominent in 14 cases (25.0%). The stromal cellularity was minimal in 32 cases (57.1%) and prominent in 23 cases (41.1%). Pleomorphism and necrosis were represented in only 1 case (1.8%). The tumor margin was infiltrating in 11 cases (19.6%) and pushing in 43 cases (76.8%). A local recurrence developed in 9 cases (16.1%). There were no dependable histopathological features to predict a local recurrence except for cellular atypia, stromal cellularity, and an infiltrating tumor margin. CONCLUSION: From the above results, the strong prognostic factors that can be used to predict a local recurrence appear to be cellular atypia, stromal cellularity, and an infiltrating tumor margin.
Breast ; Diagnosis ; Follow-Up Studies ; Humans ; Mastectomy ; Medical Records ; Mitosis ; Necrosis ; Phyllodes Tumor* ; Rare Diseases ; Recurrence* ; Retrospective Studies ; Risk Factors*

No abstract available.
Oxygen*

A patient treated with venlafaxine for major depression developed an interstitial lung disease (ILD) with the characteristic clinical, radiological and pathological features of chronic hypersensitivity pneumonitis. A high resolution computed tomography scan demonstrated ground glass opacity, mosaic perfusion with air-trapping and traction bronchiectasis in both lungs. The pathological findings were consistent with a nonspecific interstitial pneumonia pattern. Clinical and radiological improvements were noted after the discontinuation of venlafaxine and the administration of a corticosteroid. This report provides further evidence that the anti-depressant venlafaxine can cause ILD.
Alveolitis, Extrinsic Allergic ; Bronchiectasis ; Depression ; Glass ; Humans ; Hypersensitivity ; Lung ; Lung Diseases, Interstitial* ; Perfusion ; Pneumonia ; Traction ; Venlafaxine Hydrochloride

Rosai-Dorfman disease (RDD) can present in any anatomic site, but breast involvement is rarely reported. Recently, a relationship between RDD and IgG4-related sclerosing disease has been suggested. Here we report another case of RDD with overlapping features of IgG4-related sclerosing disease occurring in a right breast of a 62-year-old female. On microscopic examination, the mass demonstrated a characteristic zonal pattern of proliferation of large polygonal histiocytes and lymphoplasma cells with stromal fibrosis. Emperipolesis was observed in histiocytes with abundant cytoplasm, which showed immunoreactivity for S-100 protein and CD68; the diagnosis of RDD was made. Sheets of plasma cells in the fibrotic stroma demonstrated positive reactions for IgG and IgG4. The mean count of IgG4-positive plasma cells was 100.2/high power field, and the ratio of IgG4/IgG was 56.7%. Additional findings of stromal fibrosis and obliteration of preexisting breast lobules suggested overlapping features with IgG4-related sclerosing disease.
Breast ; Cytoplasm ; Emperipolesis ; Female ; Fibrosis ; Fluconazole ; Histiocytes ; Histiocytosis ; Histiocytosis, Sinus ; Humans ; Immunoglobulin G ; Middle Aged ; Plasma ; Plasma Cells ; S100 Proteins

PURPOSE: To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). MATERIALS AND METHODS: Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. RESULTS: The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). CONCLUSION: Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cranial Sinuses/pathology/*radiography ; Female ; *Hematocrit ; Hemoglobins/*analysis ; Hepatolenticular Degeneration/complications ; Humans ; Male ; Middle Aged ; Pregnancy ; Pregnancy Complications ; Radiographic Image Interpretation, Computer-Assisted ; Reference Values ; Regression Analysis ; Superior Sagittal Sinus/pathology/*radiography ; Tomography, X-Ray Computed/*methods ; Young Adult

No abstract available.
Acute Lung Injury* ; Inhalation* ; Nitrogen Dioxide* ; Nitrogen*

No abstract available.
Pulmonary Alveolar Proteinosis*

BACKGROUND: Broncholithiasis is uncommon but clinically important because it may cause a variety of nonspecific symptoms and signs prior to the onset of lithoptysis, and rarely massive hemoptysis. METHOD: A retrospective clinical study was done on 11 case of broncholithiasis diagnosed at Kyungpook National University Hospital from Jan. 1985 to Dec. 1993. The study investigated the clinical features, radiologic findings, bronchoscopic findings and management. RESULTS: 1) The common symptoms included cough, dyspnea, hemoptysis, fever and purulent sputum. Lithoptysis occurred in 3 patients. 2) The radiologic findings were variable and nonspecific. Hilar calcification and parenchymal calcification were the most common findings. 3) The bronchoscopy was performed in 10 patients and revealed broncholiths in 9 patients. 4) Chemical composition of broncholiths was analyzed in 2 patients. Calcium carbonate was main component. 5) In 6 out of 9 patients in whom broncholiths was revealed by bronchoscopy, broncholiths were successfully extracted through the flexible bronchoscope. 6) In 9 patients, broncholithiasis was related to tuberculosis and in 1 case, related to silicosis. CONCLUSION: Broncholithiasis shows a variable clinical spectrum. Tuberculosis is the most common cause of broncholithiasis. In the case of no accompanied complication, nonsurgical management such as bronchoscopic removal and conservative therapy is an effective measure.
Bronchoscopes ; Bronchoscopy ; Calcium Carbonate ; Cough ; Dyspnea ; Fever ; Gyeongsangbuk-do ; Hemoptysis ; Humans ; Retrospective Studies ; Silicosis ; Sputum ; Tuberculosis