A total of 322 patients with endobronchial tuberculosis (8.1%) out of 3,982 subjects who had a flexible fiberoptic bronchoscopic examination at the Department of Pulmonary Medicine of Hanyang University Hospital between the beginning of March 1982 and the end of Apr11 1996 were included in this study. The peak incidence occurred in the second decade, and the male to female was 1 : 3.0. The barking cough with variable amounts of sputum was the most common chief complaint in 56.9% of the 313 patients. Other complaints included dyspnea, chest pain, fever, hemoptysis, and generalized weakness. Localized wheeze was heard over the chest in 16.9% of the 313 patients. Infiltration/consolidation was the most common roentgenographic finding of the chest in 64.2%. Bronchoscopically, hypertrophy with luminal narrowing was the most common findings in 32.3% of the 322 patients and left main bronchus was the most frequently involved in 24.0%. Using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also makes a differential diagnosis of lung cancer in older patients. We need further evaluations of standard bronchoscopic classification of endobronchial tuberculosis, diagnostic accuracy of endobronchial tuberculosis by PCR, a large prospective study of effects of corticosteroids in endobronchial tuberculosis patients, and appropriate treatment of atelectasis by endobronchial tuberculosis.
Adrenal Cortex Hormones ; Bronchi ; Bronchoscopy ; Chest Pain ; Classification ; Cough ; Diagnosis, Differential ; Dyspnea ; Female ; Fever ; Hemoptysis ; Humans ; Hypertrophy ; Incidence ; Lung Neoplasms ; Male ; Phenobarbital ; Polymerase Chain Reaction ; Pulmonary Atelectasis ; Pulmonary Medicine ; Sputum ; Thorax ; Tuberculosis*

No abstract available.
Central Venous Catheters* ; Fibrin*

No abstract available.
Adult* ; Humans ; Respiratory Distress Syndrome, Adult*

PURPOSE: We have examined the utility of 99mTc-MAG3 perfusion indices for assessing renal graft function in early post-transplantation period. MATERIALS AND METHODS: Our study included 80 renal transplant recipients (48 men and 32 women, mean age: 40.3 years). Diagnosis was based on biopsy, laboratory data and clinical course. Renal scintigraphy (RS) was obtained using 100 MBq of 99mTc-MAG3 from 11 days to 23 days of kidney transplantation. We measured 5 indices in whole-kidney (WK) and cortical (C) renograms; Hilson's perfusion index (PI), transplant perfusion index (TP) and transplant function index (TF) as perfusion parameter, and the time to peak activity (Tmax) and the ratio of renal counts at 20 min to that at 3 min (K20/3) as functional parameter. RESULTS: The diagnoses at the day of RS were normal graft (NG) in 44, acute rejection (AR) in 14, acute tubular necrosis (ATN) in 10, and Cyclosporine A nephrotoxicity (CsA) in 12. TP and TF were significantly decreased in AR, ATN and CsA, compared to those in NG. K20/3 of AR and ATN were significantly greater than that of NG. WK-Tmax of AR was significantly longer than that of NG. K20/3 of AR and C-K20/3 of ATN were significantly prolonged relative to those of CsA. There were no statistically significant perfusion indices among complication groups. CONCLUSION: TP and TF reflecting microperfusion and initial tubular extraction are reliable in assessing graft function. However, it is required to correlate perfusion indices with functional indices and clinical course in differentiating from one another among complication groups.
Biopsy ; Cyclosporine ; Diagnosis ; Female ; Humans ; Kidney Transplantation ; Male ; Necrosis ; Perfusion* ; Radionuclide Imaging ; Technetium Tc 99m Mertiatide* ; Transplantation ; Transplants

To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over 610,000 won, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (P<0.05). Parents noticed the child's abnormality first in 85.1% of the case whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.
Acupuncture ; Busan ; Cerebral Palsy* ; Child Development ; Child* ; Daegu ; Diagnosis ; Disabled Persons ; Education ; Fathers ; Humans ; Male ; Mothers ; Parents ; Rehabilitation Centers ; Schools, Medical ; Specialization

Lowe et al. have described a disease characterized by organic aciduria, decreased renal ammonia production, hydrophthalmos, and mental retardation, this disease is now called as Lowe's syndrome or oculo-cerebro-renal syndrome which manifests growth plates, metabolic acidosis, and characteristic eye changes, including bilateral cataract, glaucoma and nystagmus. It is a congenital hereditary affectation. Most of the patients with this syndrome are male sex. We report a new case of Lowe's syndrome in a 5-year old girl.
Acidosis ; Ammonia ; Cataract ; Child ; Female ; Glaucoma ; Growth Plate ; Humans ; Hydrophthalmos ; Intellectual Disability ; Male

Systemic lupus erythematosus is an autoimmune disease characterized by multisystem involvement and various laboratory findings. A retrospective study was made of the medical records of 59 patients with SLE at Severance hospital, Yonsei University College of Medicine, for the analysis of clinical and laboratory findings during the years 1970 through 198I. The results were compared with those of previous serial studies in Korea and western countries. The results obtained are as follows: l. In 59 patients with SLE, 7 patients were men and 52 patients were women (M: F=l: 7.4). Their age at onset of the dsiease ranged mainly in the 3rd and 4th decades. 2. The major clinical manifestations were skin eruptions (81%), fever(73%), renal involvements(66%), pulrnonary(66%) and cardiac(61%) abnomalities. 3. The variety of skin and mucus membrane manifestations seen included butterfly rash of face(53%), maculopapular eruption (34%), purpura(22%), and mucosal ulcer (19%) in that order. 4. Mucosal ulcers and alopecia were correlated closely with exacerbations of disease activity. Patients with Raynauds phenomenon were not likely to have severe organ involvement. 5. Compared with Western series, renal manifestation, anemia and thrombocytopenia were more frequent, and lymphadenopathy, Raynauds phenomenon and alopecia were less frequent. 6. The ANA test showed a, high sensitivity(96%) and a high titer. Compared with the patients showing a speckled pattern(30%), those showing a homogenous pattern(60%) had more severe organ involvement and poorer prognosis. 7. The anti-nDNA antibody test had a high sensitivity(81%), and indicated. severe renal involvement and poorer prognosis. Also, the titer correlated well with disease activity. 8. The disease was associated with autoimmune hemolytic anemia, Buergers disease, thyroid diseases, myelofibrcsis and chilblain. 9. A bimodal rnortality pattern was seen with infection being the major cause of early death, and renal failure and cardiopulmonary abnormalities in late death.
Alopecia ; Anemia ; Anemia, Hemolytic, Autoimmune ; Autoimmune Diseases ; Butterflies ; Chilblains ; Exanthema ; Female ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Male ; Medical Records ; Membranes ; Mucus ; Prognosis ; Renal Insufficiency ; Retrospective Studies ; Skin ; Thromboangiitis Obliterans ; Thrombocytopenia ; Thyroid Diseases ; Ulcer

BACKGROUND: To compare the diagnostic usefulness of dobutamine stress echocardiography(DSE) and 99mTc-methoxyisobutyl isonitrile SPECT (MIBI SPECT), two studies were performed simultaneously. METHOD: Fifty-six consecutive patients undergoing coronary angiogram and MIBI SPECT for clinical indications without clincal evidence of myocardial infarction were studied prospectively. During the DSE, MIBI was injected at peak stress, and post-stress images of MIBI SPECT were required on hour later. Both echocardiographic and MIBI SPECT images were visually analysed in a blind fashion. RESULTS: On the basis of coronary angiographic findings, the sensitivites of the DSE and MIBI SPECT (n=36) were 89% and 86%, respectively. The specificities of those (n=20) were 90% and 85%, respectively. Among 33 patients without resting perfusion defect on MIBI SPECT, resting regional wall motion abnormalities on DSE were found in only one patient, whereas, resting perfusion defect on MIBI SPECT were found in 9 patients among 41 patients without resting regional wall motion abnormalities on DSE. Among 17 patients who had resting perfusion defects with partial reversibility on MIBI SPECT, resting wall motion abnormalities were present in 11 patients and five of them showed improvement in the regional wall motion during low dose dobutamine infusion. CONCLUSION: Both dobutamine stress echocardiography and MIBI SPECT are useful methods in the detection of the coronary artery disease, however, MIBI SPECT seems to overestimate the regional ischemic myocardium with contractile reserve that can hardly be evaluated with MIBI SPECT.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Myocardial Infarction ; Myocardium* ; Perfusion ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Platinum coordination complex (cisplatin) has been currently used as one of the most effective compound in the treatment of various solid tumors. However, its use has been limited by severe side effects such as renal toxicity. Our platinum-based drug discovery program has been aimed at developing drugs capable of diminishing toxicity and selective cytotoxicity. MATERIALS AND METHODS: A new series of highly water soluble platinum (II) complexes Pt (II) [1,3-Bis (phenylthio) propane) (trans-l-1,2-diaminocyclohexane) (PC-1) and Pt (II) [1,3-Bis-(phenylthio) (propane)]-1,2-diaminocyclohexane (PC-2) were synthesized and characterized by their elemental analysis and by various spectroscopic techniques [infrared (.IR), ""C-nuclear magnetic resonance (NMR)]. In vitro antitumor activity and nephrotoxi -cities of new Pt (II) complexes were tested against MKN-45 human gastric cancer cell- lines and normal kidney cells using colorimetric MTT[3-(4,5-dimethyl thiazol-2-yl)-2,5- diphenyl tetrazolium bromide] assay for cell survival and proliferation. RESULTS: PC-1 showed activity against MKN-45/P and MKN-45/CDDP human gastric adenocarcinoma cells, and the antitumor activity of this compound was comparable or superior to that of PC-2 and cisplatin. The nephrotoxicity of PC-1 and PC-2 were found quite less than that of cisplatin using MTT, [H] thymidine uptake and glucose consumption tests in rabbit proximal tubule cells, human kidney cortical cells and human renal cortical tissues. CONCLUSION: Based on these results, this novel platinum (II) complex compound (PC-1) represent a valuable lead in the development of a new anticancer chemotherapeutic agent capable of improving antitumor activity and low nephrotoxicity.
Adenocarcinoma ; Cell Survival ; Cisplatin ; Drug Discovery ; Glucose ; Humans* ; Kidney* ; Platinum ; Stomach Neoplasms* ; Thymidine

CT is a valuable diagnostic modality in evaluation of bladder injury, extension of paravesical hematoma, pelvic bone fracture or injury of adjacent soft tissue although the diagnostic accuracy of bladder injury itself is lower than that of retrograde cystography. We analized CT findings in thirty cases of bladder injury or paravesical hematoma due to blunt lower abdominal or pelvic trauma and compared them with operation fildings in eight cases. IVP in eight cases and cystography in fifteen cases. The types of bladder injury were classified as contusion, intraperitoneal bladder rupture, extraperitoneal bladder rupture and combined rupture. The locations of paravesical hematoma were classified as perivesical, prevesical or combined. There was no close relationship between the types of pelvic bone fracture and distribution of paravesical hematoma. The paravesical hematomas in fifteen patients without bladder injury were located in prevesical space only. Perivesical hematomas were noted in nine of fifteen patients with bladder injury and were not noted in patients without bladder injury. Thus, we concluded that the presence of perivesical hematoma on CT is a diagnostic sign of bladder injury even though extravasation of contrast from the bladder is not identified, and if there is extraperitoneal hematoma, possibility of bladder injury or other pelvic trauma should be considered.
Contusions ; Hematoma ; Humans ; Pelvic Bones ; Rupture ; Urinary Bladder