Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well estabilished as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy'has been used increasingly in relation to advance and the salty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safty from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. -CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle (Mann medical products, USA). A diagnosis was made in 27 of 44 cases (61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required The sensitivity of PTNB by one session was 61% (27/44). The sensitivity of malignancy was 79% (19/24) and benignancy was 40% (8/20). These results suggest the usefulness of PTNB using fine needles be increased in eariler diagnosis and improved staging of pulmonary nodular lesions without significant complications.
Biopsy ; Biopsy, Needle* ; Diagnosis ; Fluoroscopy ; Hemoptysis ; Lung* ; Needles* ; Pneumothorax ; Ultrasonography

PURPOSE: To evaluate the effect of Bog Bilberry (Vaccinium uliginosum) extract in eyes with early age-related macular degeneration (AMD). METHODS: Forty-four eyes of forty four patients with early AMD were included in this randomized, double-blinded, and placebo-controlled study. All participants were randomly assigned to either the placebo group (n = 24), or the bog bilberry extract group (n = 20). Before drug administration, an ophthalmic examination which included slit lamp microscopy, best corrected visual acuity, and intraocular pressure was performed, and repeated 1and 3 months after treatment. Objective scatter index, glare and tear film break-up time were checked by Optical Quality Analysis System (OQAS, Visiometrics, Spain) and drusen volume, central macular thickness, and RPE and IS/OS junction thickness were investigated with spectral-domain optical coherence tomography (Spectralis, Heidelberg, Germany). RESULTS: In the bog bilberry extract group, RPE and IS/OS junction thickness was significantly increased compared to the placebo group after 3 months of drug administration. CONCLUSIONS: Bog Bilberry extract may play a favorable role in preventing the atrophic change of RPE and IS/OS junction layer and the progression of early macular degeneration.
Eye ; Glare ; Humans ; Intraocular Pressure ; Macular Degeneration ; Microscopy ; Tears ; Tomography, Optical Coherence ; Vaccinium ; Vaccinium myrtillus ; Visual Acuity ; Wetlands

BACKGROUND: With the increase of interest in health promotion, doctor's role in health promotion has been progressively emphasized. Although there were many findings which showed that interventions by doctors can result in important changes in the health behaviors of patients, little was known about patients perception of doctor's intervention. Therefore, we attempted to find out about the factors related to patients interests in health behaviors (smoking, alcohol drinking, body weight, and exercise) and patient's perception of the need for doctor's intervention in changing these health behaviors. METHODS: The study subjects were patients who visited either two private clinics (265 patients) or the department of family medicine in a tertiary hospital(410 patients) located in Seoul. Questionnaires concerning demographic characteristics, patients interests, health behaviors, and their perception of the need for doctors intervention in changing health behaviors were administered to the study subjects between March 1997 and June 1997. We examined the factors which had significant relatianship with patient's interest and the perceptions of the need for doctor's intervention in health behaviors with multiple linear logistic regression analysis. The relationship between patients interests in health behavior and the perception of the need for doctor's intervention was evaluated with Spearman's correlation coefficients. RESULTS: Patient's interest and the perception of the need for doctors intervention in smoking was significantly higher in males, smokers, and private clinic patients. Patients interest in alcohol drinking was significantly higher in males, exsmokers, and drinkers. Patient's perception of the need for doctor's intervention in drinking was significantly higher in males, smokers, drinker's, and those who had chronic disease. Patient's interest in body weight control was significantly higher in females, exsmokers, tertiary hospital patients, and those who viewed themselves as obese. Patients perception of the need for doctor's intervention in body weight control was significantly higher in private clinic patients and those who viewed themselves as obese, and was significantly lower in those who recognized their body frame as normal. Patients interest in exercise was significantly higher in those who were older and who was exercising more than once a week. Patient's perception of the need for doctor's intervention in exercise was significantly higher among tertiary hospital patients. Significant relationship between patient's interest and the perception of the need for doctor's intervention in health behaviors, especially in smoking and drinking habit, was observed in private clinic patients as well as those in tertiary hospital. CONCLUSIONS: The degree of patients interest in health behaviors and their perception of the need for doctor's intervention in health promotion was significantly different according to the type of health behavior, the individual health habits, the demographic characteristics, and the type of medical center used by the patient. Therefore, doctors should pay more attention to providing interventions that affect the health behaviors of patients in consideration of these factors.
Alcohol Drinking ; Body Weight ; Chronic Disease ; Drinking ; Female ; Health Behavior ; Health Promotion ; Humans ; Logistic Models ; Male ; Seoul ; Smoke ; Smoking ; Tertiary Care Centers ; Surveys and Questionnaires

In an effort to evaluate the usage of preceptorship in a department of family medicine, we analyzed the data which gathered during 10 months, from July 1990 to April 1991. The analyzed results were as follows ; 1. The number of precepting per preceptor was 3.5 during one day. 2. In the clinical learning, the residents needed instruction most frequently in the process for diagnosing the problems of their patients. 3. For the purpose of evaluating the teaching behavior of preceptors, we asked to 21 residents and 8 preceptors of the department who experienced the preceptorship for responding a questionnaire, which contained 30 questions. Residents perceived that the most contributable teaching behavior was "deals with students in a friendly, outgoing manner". Preceptors answered that behavior as "emphasizes problem solving approaches rather than solution per se". About the least contributable teaching behavior, residents and preceptors agreed that it was "emphasis on his/her personal research". For further improvement in clinical instruction and its evaluation, it would be necessary to develop a collaborative methodology for clinical instruction and to organize an ongoing professional communication.
Humans ; Learning ; Preceptorship* ; Problem Solving ; Surveys and Questionnaires

Differentiation of lymph node from vessels or bowel wall with similar clearity is often difficult in conventional contrast-enhanced computed tomography (CCCT). For optimal differentiation of these structures, arterial-phase dominent CT images by IV bolus injection and rapid scan were obtained. The images were compared from those by CCCT in evaluation of lymphadenopathy. Seventy patients, diagnosed as stomach cancer by pathology, were selected for this study. There were 14 cases of equivocal lymphadenopathy on CCCT while IV bolus CT revealed lymphadenopathy in 9 of there and no lymphadenopathy in the rest. Among the 38 cores without lymphadenopathy on CCCT, IV bolus CT detected 4 lymphadenopathy. In 30 node dissection cases, when we decided 1cm as CT criterion for lymphatic enlargement, the sensitivity and the specificity that there were lymphatic enlargement in gross of lymphatic infiltration above one fourth in pathology even though no lymphatic enlargement in gross were 100%. On conclusion, IV bolus CT is more helpful method to evaluate lymphadenopathy than CCCT and compatible with pathologic findings when we decide 1cm as CT criterion for lymphadenopathy. In conclusion, IV bolus CT is superior to CCCT in evaluation of metastatic Lymphadenopathy when using CT Criferion of 1cm as the diameter of enlarged lymph node.
Humans ; Lymph Nodes ; Lymphatic Diseases* ; Methods ; Pathology ; Sensitivity and Specificity ; Stomach Neoplasms* ; Stomach*

PURPOSE: To evaluate the repeatability of macular thickness and total macular volume measurements made using spectral domain optical coherence tomography (OCT) in normal subjects and subjects with macular disease. METHODS: Among a total of 108 subjects, there were 50 normal subjucts, 20 patients with diabetic macular edema, 10 patients with retinal vein occlusion, 15 patients with age-related macular degeneration, and 13 subjects with other conditions. Two serial macular measurements were obtained from each subject by a single experienced examiner using spectral domain OCT. The repeatability of the measurements was evaluated by comparing two consecutive foveal and perifoveal thickness measurements and total macular volume measurements. The intraclass correlation coefficient was also calculated to evaluate the repeatability of measurements made in normal and macular disease subjects. Result: Spectral domain OCT measurements of macular thickness and macular volume were found to be consistent. Measurements of normal subjects were the most consistent, followed by measurements of patients with age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. CONCLUSIONS: Although measurements made using spectral domain OCT were repeatable across all subjects, they were more consistent in normal subjects than in patients with macular disease. The differences in repeatability should be considered in the context of diseased pathologic anatomy. Physicians should remain cautious when using these measurements for clinical evaluation.
Humans ; Macular Degeneration ; Macular Edema ; Retinal Vein Occlusion ; Tomography, Optical Coherence

Leflunomide is a disease-modifying antirheumatic drug that has been available in Korea since 2003. Leflunomide induced interstitial pneumonitis has been reported as an adverse effect in other countries but not in Korea. A 57-year-old woman was treated with leflunomide since she had been resistant to methotrexate, hydroxychloroquine and sulfasalazine. She developed high fever, dyspnea, and non-productive cough 3 months after the administration of leflunomide. She was diagnosed leflunomide-induced interstitial pneumonitis based on history, physical, laboratory, radiologic and pathologic findings. The patient was treated by prednisolone 1 mg/kg/day with cholestyramine 24 g/day, resulting in dramatic improvement. Here we report a case of leflunomide induced pneumonitis treated successfully with high dose steroid.
Arthritis, Rheumatoid ; Cholestyramine Resin ; Cough ; Dyspnea ; Female ; Fever ; Humans ; Hydroxychloroquine ; Korea ; Lung Diseases, Interstitial* ; Methotrexate ; Middle Aged ; Pneumonia ; Prednisolone ; Sulfasalazine

Solitary superficial angiomyxoma gap (SSA), sometimes referred to as solitary cutaneous myxoma, is a relatively uncommon benign myxoid tumor of soft tissue. It is characterized clinically by slowly-growing, asymptomatic nodules on the head, neck, and trunk of adults. It is locally recurrent, but there have been no reports of metastatic spread. Histologically, SSA consists of the conglomerate of moderate-to-sparse cellular angiomyxoid nodules with scattered, small to medium-sized blood vessels in the dermis, frequently involving subcutaneous fat. We herein report a case of SSA which developed in the genital area of an 80-year-old woman.
Adult ; Aged, 80 and over ; Blood Vessels ; Dermis ; Female ; Head ; Humans ; Myxoma* ; Neck ; Subcutaneous Fat

Solitary superficial angiomyxoma gap (SSA), sometimes referred to as solitary cutaneous myxoma, is a relatively uncommon benign myxoid tumor of soft tissue. It is characterized clinically by slowly-growing, asymptomatic nodules on the head, neck, and trunk of adults. It is locally recurrent, but there have been no reports of metastatic spread. Histologically, SSA consists of the conglomerate of moderate-to-sparse cellular angiomyxoid nodules with scattered, small to medium-sized blood vessels in the dermis, frequently involving subcutaneous fat. We herein report a case of SSA which developed in the genital area of an 80-year-old woman.
Adult ; Aged, 80 and over ; Blood Vessels ; Dermis ; Female ; Head ; Humans ; Myxoma* ; Neck ; Subcutaneous Fat

No abstract available.