A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

The purpose of this study was to provide basic data to improve college food service satisfaction with sanitary, environment and service by comparing 2 contract-managed and 2 self-operated college food services in Daejeon and Chungnam area. According to the results, sanitation and environment satisfaction degrees of contract-managed college food services were higher than those of self-operated food services. The satisfaction degrees with service were also higher in contract-managed food services than self-operated food services except the category of quick food delivery. In all categories comprising the food service satisfaction, the satisfaction degrees were lower in female students than in male students. There were more negative self-perceived clinical symptoms in female students than male students. The higher the negative self-perceived clinical symptoms scores were, the lower the satisfaction degrees with food service were, which suggests that the health state of students was one of the factors that influenced college food service satisfaction. There was no difference between contract-managed and self-operated food services in terms of satisfaction with overall food taste and overall satisfaction degree. The average satisfaction degree for the contract-managed food services in terms of price relative to food quality was lower than that for self-operated food services. According to stepwise multiple regression analysis, 'overall food taste', 'price relative to quality', 'kindness of employees', 'coping with proposed opinions' and 'quickness of food delivery' in decreasing order, were the most relatively important attributes for overall satisfaction. There should be further studies on important management factors to improve satisfaction with sanitary, environment and service by self-operated college food service.
Chungcheongnam-do ; Female ; Food Quality ; Food Services* ; Humans ; Male ; Regression Analysis ; Sanitation

College foodservice (FS) demands highly-developed operation technique which can provide adequate nutrients to their students, as well as to guide better eating habits and to meet students' various desires. The purpose of this study was to provide basic data to improve college FS satisfaction with food items by comparing 2 contract-managed and 2 self-operated college FS in Daejeon and Chungnam area. According to the results, 59.1% of students frequently (over 3 times per week) took meals at college cafeteria and the main reason for using college cafeteria was the low-price of meal, although the students' satisfaction degree with price of meal was lower in contract-managed FS than in self-operated FS. There were no differences in the food satisfaction degrees with overall appraisal of food items between 2 operating systems of college FS, but the satisfaction degrees with all food items were high in male as compared with female. The higher the negative self-perceived clinical symptoms scores, the lower the satisfaction with foods, which suggests that the health state of students was one of the factors that influenced college FS satisfaction. According to stepwise multiple regression analysis, 'taste of boiled rice', 'overall appraisal of boiled rice', 'overall appraisal of soup', and 'variety of side dish', in decreasing order, were the most relatively important attributes for overall customer satisfaction with food taste of college FS. Finally, there should be further studies on important management factors to improve college FS satisfaction according to 2 operating systems.
Chungcheongnam-do ; Eating ; Female ; Humans ; Male ; Meals*

The purpose of this study was to provide basic data to improve college food service satisfaction with sanitary, environment and service by comparing 2 contract-managed and 2 self-operated college food services in Daejeon and Chungnam area. According to the results, sanitation and environment satisfaction degrees of contract-managed college food services were higher than those of self-operated food services. The satisfaction degrees with service were also higher in contract-managed food services than self-operated food services except the category of quick food delivery. In all categories comprising the food service satisfaction, the satisfaction degrees were lower in female students than in male students. There were more negative self-perceived clinical symptoms in female students than male students. The higher the negative self-perceived clinical symptoms scores were, the lower the satisfaction degrees with food service were, which suggests that the health state of students was one of the factors that influenced college food service satisfaction. There was no difference between contract-managed and self-operated food services in terms of satisfaction with overall food taste and overall satisfaction degree. The average satisfaction degree for the contract-managed food services in terms of price relative to food quality was lower than that for self-operated food services. According to stepwise multiple regression analysis, 'overall food taste', 'price relative to quality', 'kindness of employees', 'coping with proposed opinions' and 'quickness of food delivery' in decreasing order, were the most relatively important attributes for overall satisfaction. There should be further studies on important management factors to improve satisfaction with sanitary, environment and service by self-operated college food service.
Chungcheongnam-do ; Female ; Food Quality ; Food Services* ; Humans ; Male ; Regression Analysis ; Sanitation

College foodservice (FS) demands highly-developed operation technique which can provide adequate nutrients to their students, as well as to guide better eating habits and to meet students' various desires. The purpose of this study was to provide basic data to improve college FS satisfaction with food items by comparing 2 contract-managed and 2 self-operated college FS in Daejeon and Chungnam area. According to the results, 59.1% of students frequently (over 3 times per week) took meals at college cafeteria and the main reason for using college cafeteria was the low-price of meal, although the students' satisfaction degree with price of meal was lower in contract-managed FS than in self-operated FS. There were no differences in the food satisfaction degrees with overall appraisal of food items between 2 operating systems of college FS, but the satisfaction degrees with all food items were high in male as compared with female. The higher the negative self-perceived clinical symptoms scores, the lower the satisfaction with foods, which suggests that the health state of students was one of the factors that influenced college FS satisfaction. According to stepwise multiple regression analysis, 'taste of boiled rice', 'overall appraisal of boiled rice', 'overall appraisal of soup', and 'variety of side dish', in decreasing order, were the most relatively important attributes for overall customer satisfaction with food taste of college FS. Finally, there should be further studies on important management factors to improve college FS satisfaction according to 2 operating systems.
Chungcheongnam-do ; Eating ; Female ; Humans ; Male ; Meals*

Cellular oncogenes are expressed as an intrinsic part of the transformed or neoplastic phenotype. More than 60 of the known cellular oncogenes play a specific role in normal cellular development and differentiation. To examine the correlation between ras oncogene expression and the development of cervical cancer, this study investigated the reactivity of cervical intraepithelial neoplasia(CIN) and carcinoma of the uterine cervix by using anti-ras P21 mouse monoclonal antibody. The expression of ras oncogene significantly increased with the grade of malignancy from 11% in severe dysplasia, 30% in carcinoma in situ, 43% in microinvasive carcinoma, to 53% in invasive cancer. The expression of ras oncogene was not correlated with histologic type, tumor size, and nodal status of cervical cancer. It was concluded that expression of ras oncogene is related to early phase of carcinogenesis and tumor invasion of carcinoma of the uterine cervix.
Animals ; Carcinogenesis ; Carcinoma in Situ ; Cervix Uteri* ; Female ; Genes, ras* ; Mice ; Oncogenes ; Phenotype ; Uterine Cervical Neoplasms

OBJECTIVES: Rapidly progres s ive glomerulonephritis (RPGN) is a clinico- pathologic entity characterized by extens ive crescent formation(usually involving 50% or more of glomeruli) as the principal his tologic finding and a rapid deterioration of kidney function, which can lead to end s tage renal disease within a few weeks. T he etiology and incidence of RPGN has been well defined in Europe and North America, however, there has been no report of a large series in Korea. T he aim of the present s tudy was to analyze the etiology and clinico- pathologic features of 26 patients with RPGN, seen during 1983-1997. METHODS: T wenty-six patients with RPGN(crescents in > 50% of glomeruli) were obs erved during a period of las t 14 years. Male to female ratio was 1:1.4, and the mean age was 30(6-75) years. Mean time from the initial symptoms to the ESRD was 3.1 months . RESULTS: The incidence of RPGN in our series was 2.1% of primary glomerulonephritis. Immunecomplex mediated disease was presented in 14 cases (54%), including 6 sys temic lupus erythematos us, 3 post- streptococcal glomerulonephritis, 3 Henoch- Schonlein purpura, and 2 IgA nephropathy. Pauci- immune disease was presented in 12 cases (46%), including 3 Wegener' s granulomatos is, one necrotizing crescentic glomerulonephritis, and 8 idiopathic crescentic glomerulonephritis. However, there was none of anti-GBM- mediated disease in our s tudy. ANCA were found in 6 patients. All 3 patients with WG were C- ANCA pos itive, whereas one patient with PSGN, necrotizing cres centic GN, and idiopathic crescentic GN were P- ANCA pos itive, respectively. Initial clinical and laboratory features included edema(80%), hypertens ion(72%), oliguria(68%), a decreased renal function(serum creatinine > 5mg/dL, 35%), and gros s hematuria(36%). Renal biopsy showed large crescents more than 80% of the glomeruli in 14 cases (54%) which were predominantly fibrocellular. Fifteen patients (58%) were treated with prednis olone alone, and 12 of them received puls e doses of corticosteroids. Five patients were treated with prednisolone and cyclophos phamide IV pulse. Two cases received plasma exchange. During the mean follow-up of 31+/-37 months, 18 patients (69%) developed inexorable progression of renal failure, three(12%) showed recovery of renal function, and two(8%) showed partial improvement, which is followed by varying degrees of renal insufficiency. During follow-up, three patients died : two from res piratory failure with severe pulmonary hemorrhage and one from opportunistic pulmonary infection during immunosuppressive therapy. Poor prognos is is as sociated with hypertension, increased serum creatinine level at the time of diagnosis, large crescents more than 85% of glomeruli, and glomerular scleros is . CONCLUSION: We conclude that an earlier diagnos is including kidney biopsy and the more aggressive treatment are essential in the management of RPGN.
Adrenal Cortex Hormones ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Creatinine ; Diagnosis ; Europe ; Female ; Follow-Up Studies ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Hemorrhage ; Humans ; Hypertension ; Immune System Diseases ; Incidence ; Kidney ; Kidney Failure, Chronic ; Korea ; Male ; North America ; Plasma Exchange ; Prednisolone ; Purpura ; Renal Insufficiency ; Systemic Vasculitis

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 x 82degrees / K2 = 45.88 x 172degrees, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair of kerarings was implanted with the assistance of a femtosecond laser in September 2008; the one segment was 250 microm and the other was 150 microm and both were placed at 70degrees. Three months after the kerarings were implanted, clear-cornea phacoemulsification and IOL implantation were performed on the left eye. After surgery, both the UCVA and the BSCVA of the left eye improved by eight lines. Postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Both the postoperative refraction (-0.75 -0.75 x 60degrees) and the keratometric reading (K1 = 50.05 x 93degrees / K2 = 48.83 x 3degrees) remained stable one month following the procedures. Thus, the sequential order of intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract.
Cataract/*complications/diagnosis ; Corneal Stroma/pathology/*surgery ; Corneal Topography ; Follow-Up Studies ; Humans ; Keratoconus/complications/diagnosis/*surgery ; Lens Implantation, Intraocular/*methods ; Male ; Middle Aged ; Phacoemulsification/*methods ; Severity of Illness Index

Congenital lobar emphysema (CLE) is a rare entity of unknown incidence. The main signs and symptoms are tachypnea, tachycardia, cyanosis, retractions, wheezing, tympanic chest percussion, asymetric breath sounds, or displaced cardiac tones within the first month of life. Occasionally a superimposed pulmonary infection exacerbates the condition, prompting hospital admission and medical treatment of the pneumonia followed by surgical treatment of the CLE. We now report a case of left upper CLE in a 15-day-old infant. Anesthesia was induced with thiopental sodium and maintained with intravenous fentanyl and midazolam. Endotracheal intubation was uneventful. Muscle relaxation was done with rocuronium. Gentle manual ventilation with a Mapleson D circuit was begun and changed to intermittent mandatory ventilation with an infant ventilator. During the left upper lobe resection, we used high frequency oscillation ventilation (HFOV) at FIO2 1.0, 12 Hz frequency, 12 cmH2O amplitude for 25 minutes. The minimal lung movement during HFOV was found to provide excellent operating conditions for the surgeons and adequate oxygenation without cardiovascular compromise. The PaCO2 was increased to 71 mmHg 25 minutes after the start of HFOV, and returned to normal value with intermittent mandatory ventilation. The remainder of the operation and anesthesia were uneventful. The patient was transferred to the neonatal intensive care unit.
Anesthesia ; Cyanosis ; Emphysema* ; Fentanyl ; High-Frequency Ventilation* ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Intubation, Intratracheal ; Lung ; Midazolam ; Muscle Relaxation ; Oxygen ; Percussion ; Pneumonia ; Reference Values ; Respiratory Sounds ; Tachycardia ; Tachypnea ; Thiopental ; Thorax ; Ventilation ; Ventilators, Mechanical