A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

The most important prognostic factor of breast cancer is the status of lymph node or distant metastasis, which is resisted by basement membrane and stromal matrix. MMP (matrix metalloproteinase)-2 is a 72-kilodalton type IV collagenase/ gelatinase and degrades the type IV collagen which is a main component of the basement membrane. Therefore, MMP-2 is believed to be one of the key molecule for cancer invasion and metastasis. Enzymatic activity of MMP is inhibited by TIMPs (tissue inhibitors of metalloproteinase). TIMP-2 forms a complex with latent pro-MMP-2 and inhibits the active forms of MMP-2. The balance of MMPs and TIMPs is suspected as the important factor of invasion and metastasis of the tumor cells. We studied the association between the expression of MMP-2/TIMP-2 and growth pattern of tumor border, lymph node metastasis, and estrogen receptor expression in the 57 cases of invasive ductal carcinoma of the breast using immunohistochemical staining methods. The results revealed increased expression of MMP-2 in the infiltrating tumor border and tumors with positive lymph node metastasis and negative estrogen receptor with no statistical significance (p>0.05). But the expression of TIMP-2 was increased in expanding tumor border and tumors with positive lymph node metastasis and negative estrogen receptor without statistical significance (p>0.05).
Basement Membrane ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Collagen Type IV ; Estrogens* ; Gelatinases ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Tissue Inhibitor of Metalloproteinase-2*

No abstract available.
Lung*

Although selective serotonin reuptake inhibitors (SSRIs) have been widely used in both psychiatry and other medicine, few cases have been reported SSRI-related hyperprolactinemia and/or galactorrhea. We experienced one case which showed both galactorrhea and hyperprolactinemia following treatment with paroxetine. In the case, a 37-year-old multiparous woman reported galactorrhea after 8-weeks paroxetine treatment for her depression. After 1 month prescription of bromocriptine, dopamine agonist, as well as switching medication from paroxetine to venlafaxine, serotonin-norepinephrine reuptake inhibitor, both galactorrhea and hyperprolactinemia were disappeared. Both hyperprolactinemia and galactorrhea have not been observed even after the cessation of bromocriptine prescription.
Adult ; Bromocriptine ; Cyclohexanols ; Depression ; Dopamine Agonists ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia ; Paroxetine ; Pregnancy ; Prescriptions ; Serotonin Uptake Inhibitors ; Venlafaxine Hydrochloride

PURPOSE: We evaluated the CT criteria useful for the diagnosis of the site of bowel perforation in patients with this or mesenteric injury caused by blunt abdominal trauma. MATERIALS AND METHODS: CT findings of 26patients with blunt abdominal trauma were retrospectively analyzed by two observers who were unaware of operative findings, and the results of their analysis were compared with those findings. Twenty cases of bowel perforation found at the jejunum (8), ileum (9), and colon (3), and six cases of mesenteric injuries were confirmed byoperation. We evaluated CT findings of 1) segmental bowel wall thickening, b) focal mesenteric fat infiltration, c) loculated fluid collection and d) extraluminal air adjacent to the bowel, and in addition analyzed the locations of ascites and free air, and the associated injuries of solid organs. RESULTS: The most common finding at the site of bowel perforation was segmental bowel wall thickening (17 cases), followed by focal mesenteric fatinfiltration (12 cases), loculated fluid (12 cases) and extraluminal air ajacent to the bowel (9 cases). Segmental bowel wall thickening was present at 34 sites, and the perforations were confirmed at 17 of these(50%). Focalmesenteric fat infiltration was present at 19 sites ; the perforations were proven at 12(63%). Loculated fluid collections were confirmed at 12/20 sites(60%), and extraluminal air adjacent to the bowel at 9/12(75%). Thepositive predictive value of criteria a, b, d, c) was 100%, and the positive predictive values of a, b, c) and a,d) were 60 and 67%, respectively. We observed ascites in 16 cases and intraperitoneal free air in 8 cases, the locations of ascites and free air did not, however, significantly correlate with the perforation sites. CONCLUSION: Extraluminal air adjacent to the bowel was the most specific criterion, and segmental bowel wall thickening wasthe most sensitive criterion. of all criteria, the finding 'a, b, c, d' most accurately predicted the site ofbowel perforation.
Ascites ; Colon ; Diagnosis ; Ileum ; Jejunum ; Retrospective Studies

Thyroid hemiagenesis of one lobe of the thyroid is a rare congenital anomaly in which one lobe of the thyroid gland fails to develop. It is more frequently found in women than in men, and absence of the left lobe is more common. The variations of prevalence of the anomaly have been reported to be around 0.05~0.2%. Patients with thyroid hemiagenesis are usually asymptomatic and discovered incidentally with other pathologic condition such as a benign adenoma, multinodular goiter, hyperthyroidism or carcinomas. We report a 29-year-old woman with an incidentally discovered hemiagenesis of the right thyroid.
Adenoma ; Adult ; Carcinoma ; Female ; Goiter ; Humans ; Hyperthyroidism ; Male ; Prevalence ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: Pneumatic reduction has rapidly replaced traditional barium reduction owing to its potential advantages, such as higher reduction rate and greater safety; however, the effects on surgery after reduction failure have not been studied. In this study, we evaluated the influences of attempted barium and pneumatic reductions on subsequent surgical procedures. METHODS: One hundred and sixty-one barium reductions were performed on 158 patients while 153 pneumatic reductions were performed on 145 patients. Statistical comparisons of these two reduction methods were made regarding the following variables: the reduction rates, frequencies of bowel perforations and recurrences, mean operation times, fasting periods, and durations of admission. RESULTS: The reduction rates were similar for both groups with barium reduction being successful in 67.1% of the cases (108/161) and pneumatic reduction in 69.3% (106/153). Two cases of bowel perforation occurred during the pneumatic reductions, none were noted during the barium reductions. Recurrence of intussusception was noted in three cases initially reduced with barium and in nine cases reduced pneumatically. The mean operation time (130.7 minutes vs. 81.7 minutes), postoperative fasting time (61.6 hours vs. 37.6 hours), and duration of admission (6.7 days vs. 5.4 days) were significantly prolonged in the pneumatic reduction group. CONCLUSION: A part from a comparable reduction rate pneumatic reduction demonstrated no favorable outcome relative to barium reduction. Furthermore, it resulted in some obstacles to surgery and recovery, such as prolonged operation time, fasting period, and duration of admission.
Barium* ; Child* ; Fasting ; Humans ; Intussusception* ; Recurrence

No abstract available.
Adenylyl Cyclases* ; Graves Disease* ; Humans ; Thyroid Gland*

BACKGROUND: Molecular methods have rapidly replaced the classic diagnostic procedures of tuberculosis. Especially, the nested polymerase chain reaction (nPCR) is widely used for the diagnosis of tuberculosis in various specimens. In our previous publication, we suggested the availability of nPCR in specimens of solid tissues and in fine needle aspirates for the diagnosis of tuberculous cervical lymphadenitis (TCL), but nPCR has the possibility of false positive due to its repetitive amplification and contamination. Also, nPCR shows variable sensitivity and specificity, depending on the kind of target sequence and the probe used. We intended to improve the diagnostic efficacy of nPCR by the means of combination with the result of fine needle aspiration cytology (FNAC). And we applied restriction fragment length polymorphism (RFLP) to the amplicon of nPCR to rule out false positives. METHODS: Thirty five specimens of aspirates from enlarged cervical lymph nodes of suspected TCL cases were examined by cytological examination and nPCR. Fifteen amplicons from nPCR were analyzed by RFLP. The sensitivity and the specificity were calculated in each nPCR and FNAC. The sensitivity and the specificity based on the result from combining nPCR and FNAC were also calculated. The results of RFLP were compared with the results of the corresponding nPCR. RESULTS: Twenty patients were definitely diagnosed as having tuberculosis based on the result of FNAC, nPCR, and tissue pathology. The sensitivity of FNAC was calculated to be 0.8, and the specificity was 0.92. The sensitivity of nPCR was calculated to be 0.76 and the specificity was 1.0. When we analyzed the patients infected with tuberculosis who had had positive results in FNAC or nPCR, the results showed a sensitivity of 0.95 and a specificity of 0.92. There were no different RFLP fragmentation patterns between the individual amplicons of the same nPCR results. CONCLUSIONS: The result of combining FNAC and nPCR offered good sensitivity and specificity in the diagnosis of TCL. It is suggested that anti-tuberculosis medication be immediately started when the result of FNAC or nPCR reveals a positive reaction. RFLP did not show any diagnostic value in our series, but it could be a great help in differential diagnosis of another strain of M. tuberculosis or atypical mycobacterium in treatment-resistant cases of TCL.
Biopsy, Fine-Needle* ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphadenitis* ; Needles ; Nontuberculous Mycobacteria ; Pathology ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length ; Publications ; Sensitivity and Specificity ; Tuberculosis

This study was attempted to observe the possible effects of open chest and the decubitus position on blood gas values during controlled ventilation. We used a volume-type ventilator to maintain regular tidal volume throughout the operation. A total of 51 cases which underwent open chest surgery between 1979 and 1981 in Department of Anesthesiology in Kyungpook National University Hospital were selected. PaO2, PaCO2, pH and MAP were measured at ten minutes after induction (control group), decubitus position (ducubitus group) and chest was opened(open chest group). The PaCO2 value in open chest and decubitus group revealed a tendency of elevation compared with the control group. The PaCO2 value in open chest revealed no remarkable change compared with the control group. The pH in open chest and decubitus group showed a tendency to increase compared with the control group. The MAP showed a tendency to decrease in open chest & decubitus groups and decreased gradually. From the above results, MAP showed a gradual decrease but the increase of pH and PaO2 suggested the inclination of respiratory alkalosis due to hyperventilation during volume controlled ventilation anesthesia.
Alkalosis, Respiratory ; Anesthesia* ; Anesthesiology ; Gyeongsangbuk-do ; Hydrogen-Ion Concentration ; Hyperventilation ; Thorax* ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical