Endobronchial tuberculosis is frequently associated with lymphadenopathy, bronchial stenosis, atelectasis which needs to be differentiated with other pulmonary disease. Authors are presenting 25 cases of endobronchial tuberculosis which were confirmed boy bronchoscopic biopsy and AFB smear and/or culture. The study was done on patients who visited Yeungnam University Hospital from May 1983 to July 1985. The following results were obtained: 1. Of the 25 cases, 8 cases were male and 17 cased were female (male:female=1:2). 32 percent of the cases was older than 60 years of age. 2. Abnormal findings on chest x-ray were seen on 22 cases of 25 cases (88%) and its most predilective site was right upper lobe (24%). 3. Symptoms were coughing (56%), hemoptysis, hoarseness, chest pain, dyspnea and fever in orders. 4. The positive results were obtained in 73 percent of sputum AFB smear (11 cases of 15 cases). 60 percent of AFB culture (3 cases of 5 cases) and 58 percent of bronchoscopic biopsy (14 cases of 24 cases). 5. Complete pulmonary function test was done on 19 cases and showed normal result in 6 cases, restrictive pattern in 8 cases and small airway dysfunction in 5 cases. No case of obstructive airway disease was detected. 6. Associated disease were hypertension (2 cases), tuberculous meningitis (1 case), diabetes mellitus (1 case), and cataract (1 case). 7. The site of bronchoscopic lesion on bronchoscopic examination were as follow; 8. All 25 patients were treated with anti-tuberculosis therapy and 6 patients were treated with additional steroid therapy because of severe respiratory symptom and showed dramatic improvement of symptom as well as lung function.
Biopsy ; Cataract ; Chest Pain ; Constriction, Pathologic ; Cough ; Diabetes Mellitus ; Dyspnea ; Female ; Fever ; Hemoptysis ; Hoarseness ; Humans ; Hypertension ; Lung ; Lung Diseases ; Lymphatic Diseases ; Male ; Pulmonary Atelectasis ; Respiratory Function Tests ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Meningeal

No abstract available.
Diazepam* ; Humans ; Hypnotics and Sedatives* ; Midazolam* ; Surgery, Plastic*

Red blood cells that agglutinate with most normal adult sera but never with own sera are termed polyagglutinable and can be separated by patterns of lectin reactivity into various types. Among these polyagglutination, activation of the T cryptantigen occurs when carbohydrate structures on glycophorins A and B lose sialic acid and express the disaccharide Gal beta-l-3 GalNac which reacts with the peanut agglutinin, a lectin from Arachis hypogaea. T activation is a temporary condition due to exposure of the membrane antigen to the action of microbial neuraminidase. In T activated red cells, the following hazards, which are theoretically possible, are spontaneous polyagglutination of red cells in vitro, in vivo and severe blood transfusion reactions. We experienced a case of T activation in 6 month old girl with bacterial meningitis caused by Streptococcus pneumoniae. The reactivity to lectins indicated the patient's red cells were T activated. We report a case of T activation in an infant with the review of literature.
Adult ; Arachis ; Blood Transfusion ; Erythrocytes ; Female ; Glycophorin ; Humans ; Infant ; Lectins ; Membranes ; Meningitis, Bacterial ; N-Acetylneuraminic Acid ; Neuraminidase ; Peanut Agglutinin ; Streptococcus pneumoniae

PURPOSE: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-gamma release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON(R)-TB Gold In-Tube (QFT-GIT) and compared their results. METHODS: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. RESULTS: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the non-intrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFT-GIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. CONCLUSION: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.
Adolescent ; Child ; Follow-Up Studies ; Humans ; Interferon-gamma Release Tests ; Korea ; Latent Tuberculosis ; Outpatients ; Skin ; Skin Tests ; Tuberculin ; Tuberculosis

One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddently developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated mulitple aneurysms in both common carotid arteries and abdominal aorta with organizion thrombi and thromboembolism of internal carotid artery.
Adult ; Aneurysm ; Angiography ; Aorta, Abdominal ; Aortography ; Aphasia ; Basal Ganglia ; Brain ; Carotid Artery, Common ; Carotid Artery, Internal ; Facial Nerve ; Female ; Genitalia ; Hemiplegia ; Humans ; Infarction ; Mouth ; Neck ; Paralysis ; Thromboembolism ; Ulcer

No abstract available.

OBJECTIVES: The goal of this study was to predict the factors related to psychiatric inpatients' violence in a mental hospital. This was a follow-up study to assess the psychopathology of patients and the quality of the initial therapeutic alliance between the patient and the therapist, as a predictor of the risk of violent behavior. METHODS: The subjects were 105 psychiatric inpatients admitted to St. Andrews' Neuropsychiatric Hospital from January 1998 to November 1998, but alcohol dependent patients and conduct disorder patients were excluded. Within the first five hospital days, we rated past history of violence, patients' psychopathology using Brief Psychiatric Rating Scale and quality of initial therapeutic alliance. We also evaluated violent behaviors using Overt Aggression Scales during the two weeks before admission and during the two weeks of hospital stay and compared the 67 non-violent ingatients with 38 violent ingatients on the utility of socio-demographics variables, past history of violence, utility of the initial therapeutic alliance and psychopathology in evaluating the risk of violent behaviors. Multiple logistic analysis was conducted to analyze risk factors for violent behaviors. RESULTS: 1) The violent inpatients significantly were more closely related with the previous history of violent behavior. 2) The weaker the initial therapeutic alliance were, the significantly higher violent behavior exhibited. 3) Violent behavior was related significantly with higher BPRS-agitation-excitement factor score and higher BPRS-hostile-suspicious factor score. Violent behavior also was related with lower BPRS-withdrawal-retardation factor score. 4) According to the multiple logistic analysis, the predictors of violent behavior were past history of violence and initial therapeutic alliance and BPRS-agitation-excitement factor. CONCLUSION: The results suggest that initial therapeutic alliance and the specific psychopathology ane useful in evaluating patients' risk for violence.
Aggression ; Brief Psychiatric Rating Scale ; Conduct Disorder ; Follow-Up Studies ; Hospitals, Psychiatric ; Humans ; Inpatients* ; Length of Stay ; Psychopathology ; Risk Factors ; Violence* ; Weights and Measures

A case of generalized pustular psoriasis in a 12 year-old girl is described. She had generalized pustular eruptions on erythematous base, presenting lake of pus, yellowish brown crusts and denudation associated with high fever and chills. With the administration of oral etretinate at a dose of 0.8mg/kg/day for 1 week, rapid and dramatic remission was achieved. About 3 months after her discharge, there developed another wave of new pustules with fever. She was again placed on etretinate therapy. However, there was no expected response as before with developing new pustules continuously. At that time, we tried combination therapy with etretinate and methotrexate. the pustules and erythema began to remit, with eventual clearing of the skin in 6 weeks.
Acitretin* ; Child ; Chills ; Erythema ; Etretinate* ; Female ; Fever ; Humans ; Lakes ; Methotrexate* ; Psoriasis ; Skin ; Suppuration

The conversion of the ankylosed hip to a total hip arthroplasty may be indicated if a fused hip causes low back pain, pain in the ispilateral knee, or a fibrous ankylosis is painful. Fifteen hips converted to total hip arthroplasty between Aug., 1982 and Jul., 1988 have been reviewed one to seven years after operation and the results are as follows:1. Among the 15 hips, 8 cases confirmed as fibrous ankylosis and 7 cases confirmed as bony ankylosis. 2. The causes of ankylosis is as follow tuberculous arthritis(4 cases), secondary osteoarthritis due to pyogenic hip(4 cases), rheumatoid arthritis(4 cases), post-traumatic arthritis secondary to central fracture-dislocation of hip(2 cases), and ankylosing spondylitis(1 cases). 3. The duration of immobility of the involved hip ranged from two to twenty-five years. 4. In the 14 patients, three complained of low back pain, five of ipsilateral knee pain and six of ipsilateral hip pain. 5. The lower back pain due to malposition was relieved in all cases except ankylosing spondylitis, and the pain in ipsilateral knee was also relived in all cases after hip arthroplasty. 6. The average Harris score of the fifteen hips before arthroplasty and after was 50.1 and 88.1.
Ankylosis ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Hip ; Humans ; Knee ; Low Back Pain ; Osteoarthritis ; Spondylitis, Ankylosing

These are 2 cases report of the Characot-Marie-Tooth disease. One patient is a 21 year-old female with gait ataxia, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her older and younger brothers and younger sister showed same symptoms and signs which is rather milder. On neurologic examination, there were atrophy, high arched feet, and steppage gait. There were decreased pain, temperature and touch sensation, and absence of position and vibration, and absence of DTR in lower extremities. On sensory nerve conduction velocity study, the amplitude of evoked action potential is very low. On motor NCV, there are markedly prolonged distal latency and markedly decreased conduction velocity. On EMG study, there are dencervated potentials at rest and reduced interference pattern at maximal contraction. The other patient is 62 year-old female with gait disturbance, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her father, 2 younger brothers and her 3 nephews showed same degree or rather mild degree of symptoms and signs. The findings on physical, neurologic examination and EMG with NCV study are compatible with Charcot-Marie-Tooth disease.
Action Potentials ; Atrophy ; Charcot-Marie-Tooth Disease* ; Clubfoot ; Fathers ; Female ; Foot ; Foot Deformities ; Gait ; Gait Ataxia ; Humans ; Lower Extremity ; Middle Aged ; Muscular Atrophy ; Neural Conduction ; Neurologic Examination ; Sensation ; Siblings ; Vibration ; Young Adult