BACKGROUND: Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performend occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. METHODS: We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. RESULTS: The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the thwo groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2 : 62%) on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, preotein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels (1370±208mg/dl) than group 1 (860±71mg/dl, p<0.05). CONCLUSION: In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of posivive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients wihtout residual pleural thickening From these results, we speculate that the amonut of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.
Adenosine Deaminase ; Biopsy ; Diagnosis ; Drug Therapy* ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion ; Pleurisy* ; Sudden Infant Death ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

This survey of 836 midlife women (51.0 +/- 4.0 yrs) was undertaken by exclusively a face to face interview by well-trained interviewers guarantying data collection of higher quality. This survey data was analyzed using the SPSS program. The main purpose of this study was to describe the factors affecting self-rated health status, including dietary habits and physical . mental . social factors. In the self-rated health status of a 'good' group, age was lower (p < 0.05), monthly income was higher (p < 0.01), dietary habits score (p < 0.001) and appetite (p < 0.001) and the degree of movement (p < 0.001) and life satisfaction (p < 0.001), marital intimacy (p < 0.001) and relationship satisfaction with their children (p < 0.001) were significantly higher than the 'bad' group. The level of depression (p < 0.001) and severe feeling of menopausal symptoms (p < 0.001) were significantly higher in the 'poor' group. The results of correlation analysis demonstrated that educational level (r = 0.069, p < 0.05),income (r = 0.157, p < 0.001), eating habits (r = 0.235, p < 0.001), appetite (r = 0.263, p < 0.001), life satisfaction (r = 0.197, p < 0.001), marital intimacy (r = 0.167, p < 0.001), child relationship satisfaction (r = 0.149, p < 0.001), positive attitude toward menopause (r = 0.070, p < 0.05) showed a positive correlation, but depression (r = -0.122, p < 0.001) and menopausal symptoms (r = -0.292, p < 0.001) showed a negative association with self-rated health status. The predictable factors affecting the self-rated health status of middle-aged women were examined by multiple regression analysis. The 'menopausal symptoms - physical discomfort' was the most important variables followed by the 'appetite', 'eating habits', 'menopause symptoms - sensory problems', 'BMI', 'positive attitude toward menopause' and 'high marital intimacy'. These results showed that the 'appetite' and 'eating habits' are important factors affecting the self-rated health status. Therefore, a program of dietary education must be considered for the effective health education and counseling of middle-aged women.
Appetite ; Child ; Counseling ; Surveys and Questionnaires ; Depression ; Eating ; Female ; Food Habits ; Health Education ; Health Status ; Humans ; Menopause ; Women's Health

BACKGROUND AND OBJECTIVES: The effect of the hypertonic nasal douching solutions on mucociliary clearance was studied to ascertain the effect of hypertonic seawater. MATERIALS AND METHODS: Twenty-eight normal subjects were included in a randomized double -blind crossover trial. Hypertonic seawater (3%, Sinomarin(R)) was used as a hypertonic nasal douching solution. In order to determine the effect of hypertonic seawater on nasal mucosa, the mucociliary clearance was measured by the saccharin clearance time (SCT). RESULTS: The resultant SCT after administration of hypertonic seawater was significantly reduced compared with normal saline (0.9%)(p<0.05). CONCLUSION: This results showed that the hypertonic seawater improved mucociliary clearance time in the nasal cavity. The mechanism of this effect is probably brought about by changes in mucus viscoelastic properties.
Mucociliary Clearance* ; Mucus ; Nasal Cavity ; Nasal Mucosa ; Saccharin ; Seawater* ; Therapeutic Irrigation

OBJECTIVE: To evaluate the effectiveness of hysteroscopy and the incidence of endometrial polyps in women with endometriosis. METHODS: A total of 99 patients determined to be with infertility by laparoscopic procedure from March 1999 to February 2000 were prospectively analyzed at Ajou University Hospital, Suwon, Korea. The study group was 63 patients with endometriosis and the control group consisted of 36 patients without endometriosis. The presence of endometriosis was documented laparoscopically and scored according to The American Fertility Society Classification. We confirmed the presence of endometrial polyps by pathologic examination after polypectomy. We compared the results of the operation to that of the hysterosalpingogram(HSG) and transvaginal sonogram(TVS) before the procedure. RESULTS: Among the 99 patients with infertility, endometrial polyps were found in 40 of 63 women(63.5%) with endometriosis but in only 10 of 36 women(38.5%) without endometriosis. The greater the degree of endometriosis was accompanied by increased incidence of endometrial polyps, and in particular, women with stage three endomeriosis or higher all showed the presence of endometrial polyps. The sensitivity and specificity of the HSG detecting the presence of an endometrial polyp is 55.3%, 87.2%, and that of the TVS is 78.9%, 95.7%. DISCUSSION: The presence of endometrial polyps is significantly associated with the presence of endometriosis, and therefore hysteroscopy should be performed in patients with endometriosis who have not been confirmed with endometrial pathology by HSG or TVS.
Classification ; Endometriosis* ; Female ; Fertility ; Gyeonggi-do ; Humans ; Hysteroscopy* ; Incidence ; Infertility ; Korea ; Laparoscopy ; Pathology ; Polyps* ; Prospective Studies ; Sensitivity and Specificity

This erratum is being published to correct the printing error on page 517 of the article. Corrections for Fig. 1 and main text in page 519 are needed. The authors apologize for any inconvenience that this may have caused.

PURPOSE: Some patients with interstitial lung disease (ILD) related to connective tissue disease (CTD) have a delayed diagnosis of the underlying CTD when the ILD is categorized as idiopathic. In this study, we evaluated the frequency of myositis autoantibodies in patients diagnosed with idiopathic ILD and investigated the clinical significance stemming from the presence of the antibodies. MATERIALS AND METHODS: A total 32 patients diagnosed with idiopathic ILD were enrolled in this study. We analyzed a panel of 11 myositis autoantibody specificities in the patients using a line blot immunoassay. Then, we divided them into myositis autoantibody-positive and -negative groups and compared the clinical features and laboratory data between the two groups. RESULTS: Of the 32 idiopathic ILD patients, 12 patients had myositis autoantibodies encompassing 9 specificities, except for anti-Mi-2 and anti-PM-Scl 100 (12/32, 38%). Anti-synthetase autoantibodies including Jo-1, EJ, OJ, PL-7, and PL-12 were present in 7 patients (7/32, 22%). The group with myositis autoantibodies presented more frequently with the symptom of mechanic's hand and showed abnormal pulmonary function test results with low forced vital capacity, diffusing capacity for carbon monoxide, total lung capacity, and high lactate dehydrogenase values in blood when compared with the group without myositis antibodies. CONCLUSION: We strongly suggest that patients undergo an evaluation of myositis autoantibodies, if they are diagnosed with idiopathic ILD in the presence of clinical characteristics including mechanic's hand, arthralgia, and autoantibodies which are insufficient to make a diagnosis of a specific CTD category.
Aged ; Autoantibodies/*blood/immunology ; Female ; Humans ; Lung Diseases, Interstitial/*diagnosis/immunology/physiopathology ; Male ; Middle Aged ; Myositis/*immunology/physiopathology ; Respiratory Function Tests

BACKGROUND: Valsartan is an angiotensin II receptor blocker and is used for patient with hypertension. Although response to valsartan varies each individual, there is no study about factors affecting the variability of valsartan response. METHODS: To investigate the effects of valsartan on the baseline characteristics of blood pressure, single group, open label, pre- and post-comparison clinical study was conducted. Total 21 male Korean volunteers were enrolled. Each subject was administered no drugs in first period and valsartan 80 mg (Diovan HCT) in second period. For pharmacodynamic analysis, 24 hours blood pressure changes were monitored by ambulatory blood pressure monitoring. Twenty-four hour blood pressure changes were matched to valsartan concentration and analyzed by correlation analysis. Changes in blood pressure pattern were also analyzed. Subjects were divided into responder, non-responder, and reverse responder according to pre- and post- 24 hours blood monitoring results. For determination of pharmacokinetic parameters, plasma concentration of valsartan was measured by a validated ultra-performance liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters including area under the plasma concentration versus time curve from 0 hour to the last measurable concentration (AUCt), area under the plasma concentration versus time curve extrapolated to infinity, maximum plasma concentration (Cmax), and time required to reach maximum plasma concentration (Tmax) were calculated by noncompartmental models in the BA-CALC 2008 program ver. 1.0.0. RESULTS: There were no significant associations between blood pressure changes and pharmacokinetic parameters of valsartan. Blood pressure pattern change analysis showed significant results. For AUCt, total amount of absorbed valsartan was 25,808 +/- 6,863.0 ng.hr/mL, 20,683 +/- 8,782.7 ng.hr/mL, and 12,502 +/- 5,566.6 ng.hr/mL in responder, non-responder, and reverse responder, respectively (p = 0.041). In C max, maximum concentration of valsartan was 4,314 +/- 1,522.6 ng/mL, 2,588 +/- 1,273.9 ng/mL, and 2,056 +/- 1,075.5 ng/mL, respectively. CONCLUSIONS: These results showed that response to valsartan was not associated with blood concentration in healthy volunteers and changes in blood pressure patterns to valsartan might be associated with the amount of drugs which are absorbed to subjects.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Humans ; Hypertension ; Male ; Mass Spectrometry ; Plasma ; Receptors, Angiotensin ; Tetrazoles ; Valine ; Valsartan

BACKGROUND: Transcranial Doppler ultrasonography (TCD) can detect microembolic signals (MES) in the patients with a potential embolic source. Clinical significance of MES has not been demonstrated in patients with prosthetic mechanical heart valves. We studied the correlation between cerebral thromboemoblic events after the mechanical heart valve surgery (MHVS) and residual MES during TCD monitoring with 100% oxygen inhalation in patients with mechanical heart valves. MATERIAL AND METHOD: Twenty patients with previous cerebral thromboemoblic events after MHVS and a sex- and age-matched control group (n=30) were studied. TCD monitoring was performed from unilateral middle cerebral artery. After baseline monitoring for 20 minutes, 6L of oxygen was inspired for 40 minutes. RESULT: The site of valve and the duration after MHVS of the patients did not differ from those of controls. During baseline monitoring, there was no significant difference in MES prevalence or counts compared to controls. During oxygen inhalation, patients showed a higher MES prevalence (55%, 27.6%, p=0.045) and a more frequent MES counts (p=0.027) compared to controls. CONCLUSION: TCD monitoring with oxygen inhalation may be useful to differentiate clinically significant MES in patients with mechanical heart valve.
Embolism ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Humans ; Inhalation* ; Middle Cerebral Artery ; Oxygen* ; Prevalence ; Ultrasonography ; Ultrasonography, Doppler, Transcranial

Langerhans cell granulomatosis(LCG), previously termed 'Histiocytosis-X', is one of the rare disease. LCG is characterized by proliferation of Langerhans cells in a unifocal or multifocal pattern. And LCG may be manifested in a variety of way, ranging from a spontaneously regressing solitary lesion to a multisystem life-threatening disorder. This disease usually involves the bone, lung, skin and lymph node. The most common endocrinologic abnormalities in LCG are diabetes insipidus and growth hormone deficiency. LCG involving the thyroid gland is extremely rare and only a small numbers of cases have been reported worldwide. A 41-year-old diabetic female visited the hospital due to the neck swelling for 3 months and she also complained of polyuria, polydipsia and easy fatigue. LCG involving multiple organs included thyroid gland was diagnosed by high-resolution CT of lung, by characteristic histological findings of the thyroid lesion and by the immunohistochemical staining for S-100 protein and OKT 6(CD la). She is followed at OPD without any medication.
Adult ; Diabetes Insipidus ; Fatigue ; Female ; Growth Hormone ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Lung ; Lymph Nodes ; Neck ; Polydipsia ; Polyuria ; Rare Diseases ; S100 Proteins ; Skin ; Thyroid Gland*

Peutz-Jeghers syndrome is a disease entity consisting of gastrointestinal hamartoma, mucocutaneous pigmentation, and autosomal dominant inheritance. From a surgical standpoint, the syndrome is of significance because the hamartoma may lead to intussusception, gastrointestinal bleeding, abdominal pain, and a fifteen-times-increased risk of malignancy in the GI tract, pancreas, breast, ovarles, and testes. Recent reports indicate the STK11 (LKB1) gene, located on region 13.3 of the short arm of chromosome 19, as being the locus of autosomal dominant indentify. The case of a 21-year-old female who required a partial jejunal resection due to intussusception and bleeding from a jejunal hamartoma twice in five years is presented.
Abdominal Pain ; Anemia* ; Arm ; Breast ; Chromosomes, Human, Pair 19 ; Female ; Gastrointestinal Tract ; Hamartoma ; Hemorrhage ; Humans ; Intussusception* ; Pancreas ; Peutz-Jeghers Syndrome* ; Pigmentation ; Testis ; Wills ; Young Adult