A total of 322 patients with endobronchial tuberculosis (8.1%) out of 3,982 subjects who had a flexible fiberoptic bronchoscopic examination at the Department of Pulmonary Medicine of Hanyang University Hospital between the beginning of March 1982 and the end of Apr11 1996 were included in this study. The peak incidence occurred in the second decade, and the male to female was 1 : 3.0. The barking cough with variable amounts of sputum was the most common chief complaint in 56.9% of the 313 patients. Other complaints included dyspnea, chest pain, fever, hemoptysis, and generalized weakness. Localized wheeze was heard over the chest in 16.9% of the 313 patients. Infiltration/consolidation was the most common roentgenographic finding of the chest in 64.2%. Bronchoscopically, hypertrophy with luminal narrowing was the most common findings in 32.3% of the 322 patients and left main bronchus was the most frequently involved in 24.0%. Using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also makes a differential diagnosis of lung cancer in older patients. We need further evaluations of standard bronchoscopic classification of endobronchial tuberculosis, diagnostic accuracy of endobronchial tuberculosis by PCR, a large prospective study of effects of corticosteroids in endobronchial tuberculosis patients, and appropriate treatment of atelectasis by endobronchial tuberculosis.
Adrenal Cortex Hormones ; Bronchi ; Bronchoscopy ; Chest Pain ; Classification ; Cough ; Diagnosis, Differential ; Dyspnea ; Female ; Fever ; Hemoptysis ; Humans ; Hypertrophy ; Incidence ; Lung Neoplasms ; Male ; Phenobarbital ; Polymerase Chain Reaction ; Pulmonary Atelectasis ; Pulmonary Medicine ; Sputum ; Thorax ; Tuberculosis*

No abstract available.
Adult* ; Humans ; Respiratory Distress Syndrome, Adult*

We report three cases of hereditary hemorrhagic telangiectasia in one family. The punctiform, spider-like and nodular telangieectatic lesions were presented in these all patients, the father, son an daughter. But nevus flammeus-like lesion which was the unusual manifestation of hereditary hemorrhagic telangiectasia was noticed on daughters chest. There were no abnormal laboratory findings and no evidence of systemic disease. Histological findings showed only dilated telangiectatic blood vessels in the upper dermis.
Blood Vessels ; Dermis ; Fathers ; Humans ; Nevus ; Nuclear Family ; Telangiectasia, Hereditary Hemorrhagic* ; Thorax

Radiographic increase in the size of tibial and femoral tunnels has been observed following the reconstruction of the ACL with a bone-patellar tendon-bone autograft. The purpose of this study is to determine if any differences exist in the amount of enlargement of the bone tunnel with the clinical results and to know the factors which affected to the enlargement of the bone tunnels. Total 27 patients were retrospectively reviewed for tunnel enlargement radiographically at one year after operation. Anteroposterior and lateral x-ray were obtained and the tunnel were measured by two independent observers. The measurements were made at the widest part of the tunnel. The distance between tibial interference screw and knee joint line also measured. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed with Wilcoxon rank sum test. The radiographic tunnel enlargement was an average of 1.7+/-1.3mm for the femur and 1.9+/-0.8mm for the tibia. The proximal migration of the tibial interference screw was an average of 2.3++/-1.1 mm. There was no statistically significant correlation between the changes in tunnel diameter and either the modified Hughston knee score, Lysholm knee score, or the joint laxity measured by a KT-2000 arthrometer, Lachman test. There were no correlations between the mild proximal migration of the tibial interference screw and the clinical results. Conclusively, the tunnel enlargement and mild proximal migration of the interference screw did not appear to affect the functional outcome adversely. It needs longer follow up for the evaluation of etiology and natural history of this tunnel enlargement.
Anterior Cruciate Ligament Reconstruction ; Autografts ; Femur ; Follow-Up Studies ; Humans ; Joint Instability ; Knee ; Knee Joint ; Natural History ; Patellar Ligament* ; Retrospective Studies ; Tibia ; Transplants*

BACKGROUND: This study tested the efficacy of 0.12% chlorhexidine gluconate for improving oral hygiene in intubated intensive care patients. METHODS: In a group of 57 ventilated patients, 29 received normal saline (NS) for oral hygiene, and 28 were treated with chlorhexidine gluconate (CHG). Data on oral bacterial colonization was collected for 11 months from October 2005 to August 2006. Tests of oral hygiene and oral microorganism culture were performed on the day of the ventilation, and repeated on days 4, 8, and 12. RESULTS: Oral hygiene was significantly improved in the CHG group compared to that in the NS group (P<.001). Further, all patients (100%) in the NS group tested positive for Staphylococcus aureus on the 12th day after the endotracheal intubation, whereas only 42.9% (P=0.026) of the CHG group were positive. The NS group also had higher isolation rates of Pseudomonas aeruginosa at 66.7% on the 8th day after intubation and 87.5% on the 12th day. At these same intervals, the CHG group had isolation rates of 29.4% (P=.028) and 14.3% (P=.010) respectively. CONCLUSION: The longer the period of endotracheal intubation, the more effective the 0.12% CHG treatment was for improved oral hygiene and reduction of S. aureus and P. aeruginosa colonization when compared to treatment with NS.
Chlorhexidine ; Colon ; Humans ; Critical Care ; Intensive Care Units ; Intubation ; Intubation, Intratracheal ; Oral Hygiene ; Pseudomonas aeruginosa ; Sodium Chloride ; Staphylococcus aureus ; Ventilation

No abstract available.
Aneurysm* ; Kidney* ; Renal Artery*

No abstract available.
Paragonimiasis*

BACKGROUND: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. METHOD: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; RESULTS: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic 'fungus ball' pattern were observed in 53.8% of the 52 cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed foe needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9% (12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. CONCLUSION: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.
Anti-Bacterial Agents ; Aspergillus ; Chronic Disease ; Cough ; Diagnosis ; Female ; Fungi ; Glucocorticoids ; Hemoptysis ; Humans ; Korea ; Lung ; Male ; Medical Records ; Needles ; Pulmonary Aspergillosis* ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

p53 gene mutation is commonly accepted to be associated with loss of negative cell cycle control and progression of tumors. The proliferative activity of tumor cells is considered to be a valuable indicator of tumor aggressiveness. This study is intended to compare p53 protein expression with cell proliferation rates in the ovarian epithelial tumors according to the various clinicopathological parameters. Immunohistochemistry using monoclonal p53 antibody (DO-1) and PCNA antibody (PC10) was applied to 56 cases of ovarian epithelial tumors including 17 cases of borderline tumor. The results were as follows. Both immunohistochemical staining of PCNA and p53 protein showed positive reactions confined to the nuclei of tumor cells. There were significant differences of p53 protein expression rates between borderline malignancies (11.8%) and cystadenocarcinomas (56.4%) of ovary. The expression rate of p53 protein was not significantly different according to the differentiation and the stage, but the cases of strong positive reaction to p53 protein were more frequently noted in the poorly differentiated and advanced staged tumors. The PCNA indices of p53 strong positive cases were higher than those of p53 weak positive cases. In summary, p53 protein and PCNA expression may be used as an adjuvant in differentiating borderline lesions from carcinomas of ovary and predicting their biological behaviors.
Cell Cycle Checkpoints ; Cell Proliferation ; Cystadenocarcinoma ; Female ; Genes, p53 ; Immunohistochemistry ; Ovary ; Proliferating Cell Nuclear Antigen*

To elucidate the significance of the nesidiodysplasia of pancreas, histological re-evaluation and immunohistochemical studies for insulin, glucagon and somatostatin were done on 16 consecutive cases (5 premature babies, 2 stillborns, 5 infants and 3 adults) in which paraffin blocks of the pancreas were available. Only one infant was hypoglycemic. All 16 pancreases showed changes of nesidiodysplasia which appeared immunohistochemically to have isulin, glucagon and /or somatostatin. The histologic patterns of nesidiodysplasia included ductoendocrine proliferation, endocrine cell dysplasia, adenomatosis, septal islet, islket cell hypertrophy and islet hypertrophy. All the patterns of nesidiodysplasia except for the adenomatosis were seen in premature babies, infants, stillborns and adults with or without hypoglycemia. The adenomatosis was found only in the hypoglycemic infant. The result suggests that all patterns of nesidiodysplasia of other than the adenomatosis does not imply the pathologic basis of hypoglycemia.
Infant ; Adult ; Male ; Female ; Humans