No abstract available.
Solitary Pulmonary Nodule*

BACKGROUND: The peak flowmeter is very useful in monitoring of out-patients as well as those in emergency departments because of its convenience and simplicity with low cost. There have been many studies aimed at determining the accuracy and reproducibility of the peak flow meter in normal population. However, there is a paucity of reports regarding its accuracy in patients with chronic obstructive pulmonary disease(COPD) or asthma. The accuracy of the peak expiratory flow(PEF) measured with a mini-Wright peak flowmeter was assessed by a comparison with the results of a mass flow sensor. METHODS: The PEF measurements were performed in 108 patients aged 19-82 years presenting with either a chronic obstructive lung disease or asthma before and after inhaling salbutamol. The PEF measurements from the mini-Wright flowmeter were compared with those obtained by the calibrated mass flow sensor. RESULTS: The average of the readings taken by the mini-Wright meter were 37-39 l/min higher than those taken by the mass flow sensor. The average percentage error of the mini-Wright meter were higher, ranging less than 300 l/min. The mean of the differences between the values obtained using both instruments (the bias)±limits of agreement(±2 SD) were 37.1±90 l/min for the PEF(p<0.001). CONCLUSIONS: The mini-Wright peak flowmeter overestimated the flows in patients with COPD or asthma. It was also found that the accuracy of the mini-Wright peak flowmeter decreased in its mid to low range. The limits of agreement are wide and the difference between the two instruments is signigicant. Therefore, the measurements made between the two types of machines in patients with asthma or COPD cannot be used in terchangeably.
Albuterol ; Asthma* ; Emergency Service, Hospital ; Flowmeters* ; Humans ; Inhalation ; Outpatients ; Pulmonary Disease, Chronic Obstructive* ; Reading

Use of the rigid ureteroscope has become widely accepted for the removal of ureteral calculi. We evaluated retrospectively the experience with rigid ureteroscopy from March 1992 to February 1993. We performed 68 ureteroscopies for the removal of stone in 67 patients, overall success rate was 86,8%. 52 stones were treated with sedatives only and l6 stones under the anesthesia. The success rates were 86.5% ( 45/52) and 87.5% (l4/l6) each. We failed to remove ureteral stones in 9 case, the failure of ureteroscope introduction was the most common cause of failure. The most common complication was the ureteral mucosal trauma, that was treated by indwelling of ureteral stent. We conclude that ureteroscopy may be an effective and useful procedure for the treatment of 1ower ureter stone (smaller than 10mm in size) under non-anesthesia.
Anesthesia* ; Humans ; Hypnotics and Sedatives ; Retrospective Studies ; Stents ; Ureter* ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

Papillary renal cell carcinoma is a histological variant that may be cystic in appearance. This variety has been termed cystadenocarcinoma to distinguish it from a renal cell carcinoma that has been rendered cystic through necrosis and hemorrhage. Because a greater proportion presented as stage I lesion, papillary renal cell carcinoma has been reported to have a better prognosis than renal cell carcinoma in general. We report a case of cystadenocarcinoma of the kidney that was confirmed by surgical exploration.
Carcinoma, Renal Cell ; Cystadenocarcinoma* ; Hemorrhage ; Kidney* ; Necrosis ; Prognosis

The occurrence of double primary tumors in an individual patient was first described by Billroth approximately 100 years ago. The genitourinary organs appear to be at greater risk for double primary tumors, because the urological system is at higher risk for primary tumors( prostate and bladder ). Multifocal involvement is a well-known feature of transitional cell carcinoma. But the coexistence of two separate primary urothelial carcinomas occurring simultaneously is extremely unusual. We report on a 25-year-old man who had synchronous double primary tumors : squamous cell carcinoma of the bladder and transitional cell carcinoma of the ureter.
Adult ; Carcinoma, Squamous Cell* ; Carcinoma, Transitional Cell* ; Humans ; Prostate ; Ureter* ; Urinary Bladder*

No abstract available.
Humans ; Somatoform Disorders*

BACKGROUND: Hypothyroidism may be involved in a significant portion of the causes of hypercholesterolemia in Korea. In this study, we determined the frequency of suspected hypothyroidism in hypercholesterolemic patients and compared the frequency of elevated thyrotropin levels among the groups with various total cholesterol levels. METHODS: The study subjects were healthy, asymptomatic people who visited Health Promotion Center of Seoul National University Hospital. We excluded subjects with history of hypertension, DM and hypothyroidism. The study subjects underwent physical examination and filled out a questionnaire on health risk factors. Also blood chemistry and thyroid function test were done. RESULTS: Among 6479 subjects, 194(2.99%) had elevated(>4.1 microIU/ml) thyrotropin levels. Among the hypercholesterolemic(> or=240mg/dl) patients(n=868), 40(4.60%) had elevated thyrotropin levels. And there was statistically significant difference between normal cholesterolemic and hypercholesterolemic subjects(P<0.05). Among the patients with total cholesterol above 280mg/dl (n=180), 15(8.33%) had elevated thyrotropin levels. As amount of the total cholesterol increased, the frequency of elevated thyrotropin levels Increased(P=0.001). And this result was consistent following adjustment for age, sex, BMI, smoking and drinking status(P<0.01). CONCLUSIONS: Practicing physicians should be aware of the possibility of secondary hypercholesterolemia due to hypothyroidism and keep in mind the importance of evaluating TSH level.
Chemistry ; Cholesterol* ; Drinking ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Hypothyroidism ; Korea ; Physical Examination ; Risk Factors ; Seoul ; Smoke ; Smoking ; Thyroid Function Tests ; Thyrotropin* ; Surveys and Questionnaires

On July 3, 1928, the Wonsan Labor Union established the Wonsan Laborers' Hospital in Seoku-dong, Wonsan for the purpose of reducing medical consultation fees for its members. The union's efforts to improve the welfare of its members include the establishment of an educational institute, a consumers union, a barbershop, and a relief department. The Laborers' Hospital, which began with ten wards, was led by a team of two doctors, one midwife, two pharmacists, and four nurses. The two doctors were Cheol-sun Cha and Jeong-kwon Lee, and the midwife/nurse was Sun-jeong Kim. Union members received a 40% discount on medicine, and this was utilized by a daily average of 60 to 70 workers, or 21,000 workers annually. The Laborers' Hospital was clearly distinct from medical facilities founded as charity institutions in that funds were raised by the recipients themselves, and that the recipients formed a community based on their common status as laborers. However, the Wonsan Laborers' Hospital was shut down in roughly April 1929 due to the breaking of the general strike, and the heightened suppression of union activities prevented any additional opening of laborers' hospitals until Korea's liberation from Japan. Nevertheless, the history of the Wonsan Laborers' Hospital represents a key development in Korea's health coverage. It is not adequate to declare, as was the case in past research, Korea's health coverage to be simply an imitation of the Western system and lacking its own history. Despite some differences in scale and operation, the development of health coverage in the Korean peninsula is in line with the history of health coverage development in the West. The Wonsan Laborers' Hospital, founded and operated by the laborers themselves, thus holds great significance in the history of Korea's health coverage, The findings of this study are expected to stimulate new and more diverse discussions on the history of health coverage in Korea.
Asian Continental Ancestry Group* ; Charities ; Fees and Charges ; Financial Management ; Humans ; Japan ; Korea ; Labor Unions ; Midwifery ; Occupations* ; Pharmacists ; Strikes, Employee

Body fluid Lactate dehydrogenase and its isoenzyme Measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudates in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudates and the activity of LD4 isoenzyme was also incereased compared with that of serum (P<0.05). 3. The inflammatory exudates of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity statistically compared with that of serum and malignant exudates (P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.
Ascites ; Ascitic Fluid ; Body Fluids* ; Erythrocyte Count ; Exudates and Transudates ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid* ; Leukocyte Count ; Leukocytes ; Liver Cirrhosis ; Peritonitis ; Pleural Effusion, Malignant ; Pleurisy

No abstract available.
Animals ; Embryonic Structures* ; Mice*