No abstract available.
Cough*

No abstract available.
Solitary Pulmonary Nodule*

Both fibronectin and vitronectin bind to Pneumocystis carinii (P. carinii) and mediate the attachment of the organisms to respiratory epithelial cells. Surfactant A and D play a role in the interaction between P. carinii and host cells. In this study we examined the expression of fibronectin, vitronectin, surfactant-A and D in the interaction between P. carinii and alveolar epithelial cells by immunohistochemistry and pre-embedding immunoelectron microscopy. The experimental rat model of P. carinii pneumonia was induced by administration of low protein diet (8%) and drinking water containing dexamethasone (2 mg/liter) for 6 to 8 weeks. The primary antibodies for light and electron microscopic immunohistochemistries were monoclonal antibodies including fibronectin (1:100) and vitronectin (1:100), and polyclonal antibodies including surfactant A (1:50) and D (1:50), respectively. Light microscopic immunohistochemistry for the fibronectin, vitronectin, surfactant-A and D showed strong expressions on the P. carinii and surface linings of type I alveolar epithelial cells. The electron microscopic immunohistochemistry of the fibronectin and vitronectin showed a strong immunoexpression along the surface pellicles and tubular extensions of P. carinii trophozoites, and surface membranes of the type I epithelial cells. The surfactant-A and D proteins showed a strong expression on the pellicles of P. carinii and surface membranes of the type I epithelial cells, but a weak expression on the free-floating surfactant materials. In conclusions, the trophozoites of P. carinii were mostly attached to type I epithelial cells. The fibronectin, vitronectin, surfactant-A and D were strongly expressed, and played an enhancing role in the binding between the P. carinii organisms and the type I alveolar epithelial cells.
Antibodies ; Antibodies, Monoclonal ; Dexamethasone ; Diet, Protein-Restricted ; Drinking Water ; Epithelial Cells* ; Fibronectins* ; Immunohistochemistry ; Membranes ; Microscopy, Immunoelectron ; Models, Animal ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Trophozoites ; Vitronectin*

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

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

Alveolar macrophages participate in the host defense against P. carinii, but the mechanisms in degradation and clearance of the organism from lung has not been well established. We observed the transmission and scanning electron microscopic features and evaluated the expression of TNF-alpha and Surfactant-D in the interaction of P. carinii with alveolar macrophages. Expression of TNF-alpha and Surfactant-D in the experimentally induced P. carinii pneumonia in rat was examined by immunohistochemistry and immunoelectron microscopy. Electron microscopically, the alveolar macrophages phagocytized trophozoites and cysts of P. carinii micro-organisms. Immunohistochemically TNF-alpha was strongly expressed in the cytoplasms of alveolar macrophages. Postembedding immunogold labeling for Surfactant-D protein was expressed on the pellicles of trophozoites and cysts, P. carinii micro-organisms in the cytoplasms of macrophages, free floating surfactant materials and multilamellar bodies of type II epithelial cells. We conclude that alveolar macrophages interacted with P. carinii micro-organisms respond with increased expression of TNF-alpha. TNF-alpha may bind to P. carinii and exert a direct toxic effect upon the micro-organisms. Surfactant-D protein may augment binding of P. carinii to the alveolar macrophages and enhance the clearance of the micro-organisms.
Animals ; Cytoplasm ; Epithelial Cells ; Immunohistochemistry ; Lung ; Macrophages ; Macrophages, Alveolar* ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Trophozoites ; Tumor Necrosis Factor-alpha*

Treatment of benign urethral strictures is difficult because of a high rate of recurrence. In general, electrocautery resection of fibrous scar tissues has been unsatisfactory. Since the irregular thermal injury may only promote further scarring. Because of their unique physical properties and tissue erect lasers theoretically offer advantages over conventional techniques for treatment of urethral strictures. The thermal injury resulting from neodymium:YAG laser irradiation may heal with more elastic properties and less fibrous contraction than an electocautery bum. According endoscopic application of laser energy could produce thermal coagulation of the fibrous area with a secondary slough or the scar tissue and reepithelization without scar. Contraction and epithelization are two phenomena of wound healing which are retarded by steroid Triamcinolone activates collagenase which enhanced degradation of scar tissue. A totaI 28 cases with benign urethral strictures underwent treatment with circumferential triamcinolone injection and application of neodymium:YAG laser irradiation to the scarred area after endoscopic cold urethrotomy. There were no adverse effects and although 6 patients suffered recurrent strictures within 2-17 months. the postoperative results were good in all patients including recurrent cases. We reviewed our experience with neodymium:YAG laser treatment of benign urethral strictures.
Cicatrix ; Collagenases ; Constriction, Pathologic ; Electrocoagulation ; Humans ; Lasers, Solid-State* ; Recurrence ; Triamcinolone* ; Urethral Stricture* ; Wound Healing

No abstract available.
Tuberculosis, Pulmonary*

Extracolonic manifestations which occur in approximately 10-20% of patients with ulcerative colitis most commonly affect joints, skin, liver and eyes. In contrast, pulmonary involvement in ulcerative colitis is very rare. However, a variety of respiratory disorders has been associated with ulcerative colitis, including pulmonary vasculitis, bronchiectasis, chronic bronchitis, interstitial fibrosis, pleural effusion. Since the first observation of pulmonary involvement in ulcerative colitis by Kraft in 1976, a few cases have been reported, and probably no such case have been reported in Korea yet. Here we report an experience concerning 56 year-old man interstitial lung disease in ulcerative colitis, who was diagnosed by clinical, radiographic, endoscopic, histologic findings.
Bronchiectasis ; Bronchitis, Chronic ; Colitis, Ulcerative* ; Fibrosis ; Humans ; Joints ; Korea ; Liver ; Lung Diseases, Interstitial* ; Middle Aged ; Pleural Effusion ; Skin ; Ulcer* ; Vasculitis

Calcific tendinitis usually occurs in the supraspinatus tendon of the shoulder. Calcific tendinitis of the peroneus longus tendon has not been reported on the Korean journals. Differential diagnosis includes bipartitis os peroneum, os peroneum fracture and peroneal tendinitis. We report a rare case of calcific tendinitis of the peroneus longus tendon which responded well with the conservative treatment.
Diagnosis, Differential ; Shoulder ; Tendinopathy ; Tendons