BACKGROUND: Multidrug-resistant tuberculosis(MDR-TB) in patients is mainly caused by acquired drug resistance, However, a small proportion of MDR-TB is caused by initial drug resistance(IDR), which may be somewhat different from acquired drug resistance. This study analyzed the clinical characteristics of IDR in MDR-TB patients to use the results as basic data in managing the disease. METHODS: A retrospective study of 30 IDR cases in MDR-TB patients from Jan. 1995 to Dec. 1998 was perormed. In order to analyzed the clinical charcteristics, the age, sex, family history, duration of negative conversion, number of resistant drugs, treatment regimens, duration of treatment, extent of disease and cavitary lesion on the chest X-ray was examined. In order too analyzed the level of improvement, the extent of the disease and cavitary lesion on the chest X-ray, tested by Wilcoxon signed rank sum test, and the disease free interval rate of 1-year and 4-year was examined using the Kaplan-Meier method. RESULTS: The mean age of the patients was 46.6 years and the sex ratio 1:1. Six(20%) patients had a family history. The mean negative conversin of the sputum AFB stain was 2.6 months. The number of resistant drugs was 7.6 and the number of used drugs 3.6. Twenty-three(67%) patients were treated for less than 12months and 28(93%) patients were treated with first-line drugs. The extent of the disease and the cavitary lesion on the chest X-ray improved after treatment(p<0.05). Among 13 patients who were followed up for 22.6 months, 2(15%) patients relapsed and the disease free interval rate of 1-year and 4-year was 85%. CONCLUSION: It is recommended that the duration of treatment of IDR in MDR-TB with first-line drugs be 9-12 months even if the extent of disease and cavitary lesion on the chest X-ray improves.
Drug Resistance* ; Humans ; Retrospective Studies ; Sex Ratio ; Sputum ; Thorax ; Tuberculosis, Multidrug-Resistant

No abstract available.
Exanthema* ; Humans ; Infant* ; Leukemia* ; Leukemia, Myeloid, Acute

Objective: While recent studies have found deficits in theory of mind (ToM) skills in individuals at ultra-high risk (UHR) for psychosis, empathic tendencies in these subjects remain unclear. The presence of high schizotypy and compromised executive functions, which are found in UHR individuals, would affect ToM skills and empathic tendencies. We investigated the ToM skills and empathic tendencies of UHR individuals and examined their relationship with schizotypy and executive function. Methods: This study included 28 UHR individuals and 28 age- and sex-matched healthy controls. All participants completed a self-reported empathic scale (Interpersonal Reactivity Index) and the Wisconsin Schizotypy Scales. Additionally, the ToM Picture Stories Task and Wisconsin Card Sorting Test were conducted. Results: UHR individuals showed a trend toward lower self-reported empathic tendencies; however, there were no differences in ToM skills between the two groups. Of the four subscales of the IRI, only empathic concern showed a significant difference between the two groups. Empathic concern was inversely associated with negative schizotypy. Conclusion Our findings suggest that UHR individuals show relatively preserved cognitive empathy but compromised emotional empathy. Furthermore, in UHR individuals, the empathic concern subscale of the IRI was associated with negative schizotypy, while ToM skills were related to positive schizotypy and executive function.

BACKGROUND: This study is to suggest the optimal method as a treatment for the patent ductus arteriosus in the premature infants. MATERIAL AND METHOD: Between April 1994 and April 1997, 45 premature infants with evidence of a hemodynamically significant patent ductus arteriosus associated with cardiopulmonary compromise underwent indomethacin therapy, surgical treatment, or both. Thirty-nine infants received indomethacin and twelve infants among them were surgically ligated because of indomethacin failure(5) or complications(7). Six infants, who weighed less than 1,500 gm at birth, were referred for primary surgical ligation because of contraindication to indomethacin therapy. RESULT: The failure rate of indomethacin therapy was 43%(17/39) and the complications(13/39, 33%) to the indomethacin were associated with a high morbidity and mortality. Among the infants who underwent ligation, there were no failures and complications related to the operation. This data suggests that in the premature neonate with a hemodynamically significant PDA, (1) indomethacin therapy is associated with a high failure rate and significant complications, (2) surgical duct closure is associated with minimal morbidity. CONCLUSION: Although the results of this study cannot suggest the optimal management for PDA in premature infants, primary surgical ligation may be considered. However, long-term studies will be needed to confirm this later.
Ductus Arteriosus, Patent* ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Ligation ; Mortality ; Parturition

PURPOSE: Multidrug-resistant tuberculosis (MDR-TB) is an emerging threat to human beings. However, there is little data on the current status of MDR-TB in Korea. This study investigated the current status of MDR-TB in Korea using a survey of all the data from drug susceptibility tests (DST) performed across the country over the last three years. METHOD: The DST results between Jan. 2000 and Dec. 2002 from 7 laboratories, which were in charge of all antituberculous DSTs across the country as of March 2002, were collected and analyzed to determine the actual number of drug-resistant or MDR-TB patients, annual trend, degree and pattern of resistance against anti-TB drugs, etc. RESULTS: Six laboratories used the absolute concentration method for DST and one used the proportional method. 59, 940 tests had been performed over the 3 year study period. The number of DST performed annually was 18,071, 19,950, and 21,919 in 2000-2002, respectively. The number of resistant tuberculosis patients (resistant against at least one anti-TB drug) had increased by 16.9% from 6,338 in 2000 to 7,409 in 2002. The rate of resistant tuberculosis among all DST results was 35.1% in 2000, 34.5% in 2001, and 33.8% in 2002. The number of MDR-TB patients (resistant against at least both isoniazid and rifampin) showed an increasing trend (14.5%) from 3,708 in 2000 to 4,245 in 2002. CONCLUSION: Approximately 4,000 MDR-TB cases are newly identified by DST annually and the number is showing an increasing trend. This study suggests that in order to cope with the current MDR-TB situation, the DST methods will need to be standardized and more aggressive measures will be required.
Humans ; Isoniazid ; Korea* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

Hypertrophic osteoarthropathy(HOA) is a systemic disorder primary affecting the bones, joints, and soft tissues and characterized by several(or all) of the followings ; 1) Clubbing of digits, 2) Persistent new bone formation particulary involving long bones of the distal extremites, 3) Symmetric arthritis-like changes in the joints and periarticular tissue, most commonly the ankles, knees, wrist, and elbows, 4) Increased thickness of the subcutaneous soft tissues in the distal one-third of the arms and legs, and 5) Neurovascular changes of the hands and feet, including chronic erythema, paresthesis, and increase sweating. Most of cases of HOA are secondary to intrathoracic neoplasms, while the remaining few cases are secondary to other disease in the chest or elsewhere. We experienced a case of HOA in association with lung abscess in 26-yr-old male and reported with a review of literatures.
Ankle ; Arm ; Elbow ; Erythema ; Foot ; Hand ; Humans ; Joints ; Knee ; Leg ; Lung Abscess* ; Lung* ; Male ; Osteoarthropathy, Primary Hypertrophic ; Osteoarthropathy, Secondary Hypertrophic* ; Osteogenesis ; Sweat ; Sweating ; Thorax ; Wrist

Situs inversus totalis is a rare condition with a genetic predisposition that is autosomal recessive. We report an elderly patient with situs inversus, multiple choledocholithiasis, and he was treated via endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, and then his multiple CBD stones were removed with basket and balloon. This paper further expands the application of these techniques and shows that they can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.
Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis* ; Genetic Predisposition to Disease ; Humans ; Situs Inversus*

PURPOSE: Gastric cancer remains the most common type of cancer in Korea, however, early diagnosis and surgical advancements have resulted in a better prognosis in the last few decades. The aim of this study was to investigate chronological changes of the clinicopathological features in patients with primary gastric cancer who had undergone gastric operations in Department of Surgery of Seoul Municipal Boramae Hospital. METHOD: Between November 1991 and April 2001, 634 primary gastric adenocarcinoma patients having undergone gastric operations were included in this study and divided into the two groups: 298 patients between 1991 and 1996 (early group) and 336 patients thereafter (late group). The clinicopathological characteristics, including age, gender, type of operation, gross and histologial findings, stage, and ratio of early gastric cancer, were compared between the two groups. RESULTS: The overall male-to-female ratio was 2: 1, with a mean age of 59.0 years. As the community hospital, eighty two percents of patients were resident within the same administrative district. There were no statistical differences in age, gender, type of operation, and total number of resected lymph nodes between the two groups. In contrast, cancers with a larger size, the distal one third of the location, well-differentiated adenocarcinoma, low depth of invasion, and high nodal metastasis were more prevalent in the late group (P < 0.05). Also, the proportion of earlier stages was increased in the late period (P<0.001). The ratios of early gastric cancers were 24.8, and 38.4% in the early and late groups, respectively (P<0.001) CONCLUSION: Our results suggest that the chronological changes of gastric cancer were closely related to the increased number of early gastric cancer patients, primarily due to the early detection of cancer. Therefore, to obtain the better outcomes from gastric cancer, an early diagnosis was essential from routine health check-ups and the well- organized establishment of a nation- and community-wide screening program and information on public health.
Adenocarcinoma ; Early Detection of Cancer ; Early Diagnosis ; Hospitals, Community* ; Humans ; Korea ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Prognosis ; Public Health ; Seoul ; Stomach Neoplasms*

Renal cell carcinoma (RCC) is rare relative to other urological cancers, but relatively common overall among males. Even when primary tumors are successfully removed by surgery, metastases are often noted within a few years. On the other hand, masses found at other sites in patients with RCC may represent different primary cancers. We present the case of a 63-year-old man with a right lung mass and a left lung nodule who underwent radical right nephrectomy for RCC. We found no local recurrence of RCC in the abdomen. Despite treatment for RCC, the right lung mass increased in size. We performed a lung needle biopsy and diagnosed primary lung cancer. Postoperatively, the remaining left lung nodule also increased in size. It was diagnosed as an RCC metastasis upon biopsy and removed by wedge resection. The patient was treated with everolimus after the second surgery.
Abdomen ; Biopsy ; Biopsy, Needle ; Carcinoma, Bronchogenic ; Carcinoma, Renal Cell* ; Hand ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence ; Urologic Neoplasms ; Everolimus

Lymphangioma is a rare, benign mesenchymal neoplasm, which is characterized by numerous intercommunicating cystic spaces containing lymphatic fluid. It is considered a congenital disease resulting from the obstruction of regional lymph drainage during the developmental period. Lymphangioma may be focal/unilateral or diffuse/bilateral, and in the latter case, it is referred to as lymphangiomatosis. Here, we report a case of a 38-year-old man with perirenal lymphangiomatosis. The patient's chief complaint was left flank pain, and left pleural effusion was found on radiological examination. After radical nephrectomy, the pathological examinations revealed that the kidney was enclosed by a multicystic mass with intrarenal cystic dilatations. We report the case and discuss the management of perirenal lymphangiomatosis with a literature review.
Adult ; Dilatation ; Drainage ; Flank Pain ; Humans ; Kidney ; Lymphangioma ; Lymphatic Diseases ; Nephrectomy ; Pleural Effusion