BACKGROUND: Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.
Follow-Up Studies ; Humans ; Isoniazid ; Lung ; Mortality ; Pneumonia ; Retreatment* ; Retrospective Studies ; Rifampin ; Risk Factors* ; Sputum ; Tuberculosis, Pulmonary*

No abstract available.
Antibodies, Neutralizing* ; Feces* ; Rotavirus*

Recently, primary lung cancer has increased markedly in incidence and prevalence in korea. From July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:F=8.6:1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asympto- matic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveolar cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, segmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage II 14.8%, stage III a 31.1%, and stage III b 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage I 53.0%, stage II 46.5%, stage III a 28.2%, and stage III b 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were N1 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3%(p>0.05).
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Hemoptysis ; Humans ; Incidence ; Korea ; Lung Neoplasms ; Male ; Mastectomy, Segmental ; Mortality ; Pneumonectomy ; Postoperative Complications ; Prevalence ; Survival Rate ; Thorax ; Tolnaftate

PURPOSE: To evaluate the charateristic CT and MR findings of primary ovarian fibromas. MATERIALS AND METHODS: We retrospectively reviewed 11 cases which had undergone precontrast and postcontrast scanning, and two in which cases T1-weighted (WI) and postcontrast T1WI and T2WI images had been done. All cases were pathologically confirmed after surgical resection. These masses were analysed on the basis of clinical symptom, age, size (longest diameter), laterality, margin, attenuation (unenhanced and enhanced), signal intensity (SI), calcification, and amount of the ascites. RESULTS: The patients' mean age was 46.6 (range, 22-81) years, and the longest diameter was 14.8 (range, 8-28)cm. All tumors were unilateral, and eight were located in the left ovary and five in the right ovary. In all cases, the tumor margin was well-defined; seven were lobulated, four were oval, one was round, and one was nodularly marginated. On CT scan, the masses showed mildl to moderate heterogenous enhancement with irregular lower density portions. The amount of the ascites was marked in three cases (23%) mild in two (15%), and minimal in three cases. Calcifications were seen in 3 of 11 CT cases (27%), and in one, this was extensive. On MR scans, signal intensity (SI) of the masses on T1WI was isoSI, relativetive to the uterine myometrium, and heterogeneously enhanced after infusion of contrast media. On T2WI, SI was slightly lower that of the uterine myometrium with internal high SI portions. CONCLUSION: The characteristic finding of ovarian fibroma is a unilateral, well-defined, oval or lobulated, solid mass with or without ascites and calcification. On CT scan, tumor has mild to moderate heterogeneous enhancement. On MR scan, SI of mass is isoSI on T1WI with heterogeneous enhancement, and low SI on T2WI due to fibrous component.
Animals ; Ascites ; Contrast Media ; Female ; Fibroma* ; Mice ; Myometrium ; Ovary ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Recently, internet-based applications of medicine are in the process of rapid development, where concepts of telemedicine and multimedia are important in these application. Hearing test is one of the essential procedures in the otologic field, especially in telediagnosis. A current study for tele-hearing test has some limitations in masking problems or making fully automated system. The aim of this study is to develop a digital air-conduction pure tone audiometer with automated making, which can be used through web-based or off-line to compare the threshold of hearing using conventional and digitalized audiometer in both normal and handicapped hearer. SUBJECTS AND METHOD: To develop an automated audiometer system, we prepared a test scenario data file according to the pure tone test procedure. This scenario was executed in the audiometer main, which is supported by sound card and keyboard (mouse) for output and feedback, respectively, for the examinee. Pure tone for test and white band noise for masking is generated in audiometer sound generation block. To compare this automated audiometer with the conventional one, 25 normal hearers (50 ears) and 25 handicapped hearers (50 ears) were tested. RESULTS: Easy Audiometer 1.0 was developed. The difference of hearing threshold between the two different system was 3-6 dB in the normal hearer group and 2.5-3.5 dB in the handicapped hearer group. Scatter plots showed a close relationship between these two different systems. CONCLUSION: Easy Audiometer 1.0 showed reliable results of hearing threshold in the patient with unilateral hearing who needs masking procedure. Screening and basic hearing tests may be conducted through this Easy Audiometer 1.0 and it could play a part in telediagnosis in the otologic field.
Information Storage and Retrieval ; Disabled Persons ; Hearing ; Hearing Tests ; Humans ; Masks* ; Mass Screening ; Multimedia ; Noise ; Telemedicine

PURPOSE: South Korea has the highest incidence rate of thyroid cancer in the world, and the incidence rate continues to increase. The aim of this study was to determine the age-period-cohort effects on the incidence of thyroid cancer in Korea. MATERIALS AND METHODS: Using the Korean National Cancer registry database, age-standardized incidence rates and annual percent changes (APCs) in thyroid cancer according to sex and histologic type were analyzed between 1997 and 2011. Age-period-cohort models were applied using an intrinsic estimator method according to sex. RESULTS: In both men and women, the incidence of thyroid cancer showed a sharp increase from 1997 through 2011. Among the histologic types, papillary carcinoma showed the greatest increase, with APCs of 25.1% (95% confidence interval [CI], 22.7% to 27.5%) in men and 23.7% (95% CI, 21.9% to 25.5%) in women, whereas anaplastic carcinoma did not show a significant increase in either sex. An increase in overall thyroid cancer incidence over time was observed in all birth cohorts. An age-period-cohort model indicated a steeply increasing period effect, which increased prominently from 1997 to 2011 in both men and women. The age effect showed an inverted U-shaped trend. The cohort effect tended to show a slight increase or remain constant from 1952 to 1977, followed by a decrease. CONCLUSION: The period effect can explain the sharp increase in thyroid cancer incidence, strongly suggesting the role of thyroid screening.
Carcinoma ; Carcinoma, Papillary ; Cohort Effect ; Cohort Studies ; Female ; Humans ; Incidence* ; Korea ; Male ; Mass Screening ; Parturition ; Thyroid Gland ; Thyroid Neoplasms*

OBJECTIVE: We investigated the incidence of the vascular abnormalities associated with spontaneous intracerebral hemorrhage (ICH) using three-dimensional computed tomographic angiography (3D-CTA). METHODS: We prospectively assessed consecutive 76 patients with spontaneous intracerebral hemorrhage (ICH) who underwent 3D-CTA between June 2003 and May 2005. The patients with a recent history of trauma or mainly subarachnoid hemorrhage were excluded. We investigated relationship between vascular abnormality and ICH location. The findings of 3D-CTA were classified as one of three patterns with ICH; type A (without evidence of vascular abnormality), type B (with no vascular abnormality as the source of hemorrhage, but with incidental vascular abnormality), and type C (presence of a vascular abnormality as the source of hemorrhage). RESULTS: Sites of ICH were lobar 26, basal ganglia 23, thalamus 17, posterior fossa 6 and dominant intraventricular hemorrhage (IVH) 4. Among 76 patients, sixteen (21.1%) vascular abnormalities were noted excluding 13 cases of stenoocclusive disease. Sixteen cases included 6 cases of cerebral aneurysms (7.9%), 5 moyamoya diseases (6.6%), 4 arteriovenous malformations (5.3%) and 1 dural sinus thrombosis (1.3%). Lobar ICH (30.8%) had a higher vascular abnormalities than other types, and younger age (<40) group had a higher incidence of vascular abnormalities than old age group. The patterns of 3D-CTA include sixty cases (79.0%) of type A, 6 cases (7.8%) of type B and 10 cases (13.2%) of type C. The vascular abnormalities were found in 8 (13.5%) of 59 hypertensive patients and 8 (47.0%) of 17 non-hypertensive patients (p=0.006). CONCLUSION: 3D-CT angiography is considered a useful screening tool for ICH patients with suspected cerebrovascular abnormalities and should be considered in such clinical settings, especially in lobar type and in non-hypertensive younger patients.
Angiography* ; Arteriovenous Malformations ; Basal Ganglia ; Cerebral Hemorrhage ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Mass Screening* ; Prospective Studies ; Sinus Thrombosis, Intracranial ; Subarachnoid Hemorrhage ; Thalamus

OBJECTIVES: The purpose of this study was to investigate the prevalence of musculoskeletal symptoms in oriental melon-growing farmers and to evaluate the ergonomic risk factors of melon cultivation. METHODS: The study included 217 subjects growing oriental melons mainly in 3 villages. Subjects were interviewed by means of a structured questionnaire. Instruments used the general features and symptom table of NIOSH to evaluate tasks using ergonomic tools (REBA, OWAS). RESULTS: A total of 202 final respondents answered. The prevalence of musculoskeletal symptoms based on the NIOSH standard criteria was 162 (75.2%). The prevalence per body part for lower back, knee and shoulder were 102 (50.5%), 86 (42.6%) and 71 (35.1%), respectively. The prevalence of pain complaints of the musculoskeletal symptom was 91 (45.0%). The prevalence of complaints per body part of lower back, knee and shoulder were 54 (26.7%), 41 (20.3%) and 37 (18.3%), respectively. Logistic regression analysis showed men were at higher risk compared to women (OR=2.409, 95% CI=1.071~5.389), and ore than 30 years of work having a higher risk compared to less than 30 years of work (OR=2.445, 95% CI=1.150~5.197). High risk tasks were moving around boxes and nursery plants for planting, transplanting nursery plants, and picking melons. CONCLUSIONS: Musculoskeletal symptoms were very highly prevalent in oriental melon-growing farmers, showing up in 75.2% of cases. They were exposed to ergonomic high risk factors such as squatting. These risk factors must be improved in some way.
Cucurbitaceae ; Data Collection ; Female ; Humans ; Knee ; Logistic Models ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Nurseries ; Plants ; Prevalence ; Questionnaires ; Risk Factors ; Shoulder ; Transplants

OBJECTIVES: This study was conducted to investigate the job stress factors, psychosocial stress and their associations in workers engaged in the research and development of vehicles, and according to job role. METHODS: We recruited 4,066 subjects from workers at a research and development center of an automobile company. A total of 2,764 workers answered the questionnaire about socio-demographic factors, health behaviors, work-related factors, subjective labor intensity, KOSS, and SF-PWI. The final analysis included 2,282 male manufacturing and research workers. Univariate analyses and multiple logistic analyses were conducted on the complete questionnaire data to compare the job stress factors, psychosocial stress and their associations between research and manufacturing workers. RESULTS: The adjusted Odds ratios comparing the high risk group to the low risk group regarding PWI group were 2.23(95%CI=1.63-3.04) in "Lack of rewards", 1.64(95%CI=1.20-2.24) in "Interpersonal conflict", 1.59(95%CI=1.15- 2.20) in "Organizational injustice", 1.58(95%CI=1.17-2.14) in "Occupational climate" and 1.43(95%CI=1.05-1.94) in "Job insecurity" among research workers, and 2.46(95%CI=1.59 -3.80) in "Lack of rewards" and 1.94(95%CI=1.17-3.22) in "Organizational injustice" among manufacturing workers. CONCLUSIONS: There are differences in job stress factors between research and manufacturing workers. Further studies and discussions based on quantitative methodology for seeking more fundamental causes of these differences are required to establish job stress intervention plans and policies.
Automobiles ; Health Behavior ; Humans ; Male ; Odds Ratio ; Questionnaires

No abstract available.
Intracranial Hypotension*