BACKGROUND: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. METHODS: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. RESULTS: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial PaO2/FiO2ratio and COHb were 286.4+/-129.6 mmHg and 7.8+/-6.6 %. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. CONCLUSIONS: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.
Bronchoscopy ; Burns ; Cicatrix ; Follow-Up Studies ; Humans ; Inflammation ; Inhalation* ; Intubation, Intratracheal ; Lung ; Pneumonia ; Prospective Studies ; Respiration, Artificial ; Respiratory Function Tests* ; Spirometry ; Thoracic Wall

BACKGROUNDS: The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. METHODS: 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. RESULTS: The mean FEV1/FVC in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. CONCLUSIONS: This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.
Asthma* ; Coronavirus ; Humans ; Influenza, Human ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Pulmonary Disease, Chronic Obstructive* ; Respiratory System ; Rhinovirus ; Sputum

BACKGROUND: Recurrent pneumonia in adults is not uncommon. However, there is no domestic data about recurrent pneumonia in adults. Therefore, we investigated the associated diseases and clinical findings of recurrent pneumonia in adults. METHODS: Among 5513 patients who were treated in five teaching hospitals of Hallym medical center?over a 5-year period, we retrospectively reviewed the medical records of the 58 who were compatible with diagnostic criteria of recurrent pneumonia. RESULTS: The number of patients with recurrent pneumonia was 58 (1.05%, 58/5513) during the 5 years. Thirty- seven patients were male and 21 were female. Mean age was 66.4 (+/-14.9) years. Median interval between each pneumonic episode was 18.5 months. Associated diseases were 25 cases of respiratory diseases, 13 of heart diseases, 13 of diabetes mellitus, 7 of lung malignancies, 11 of malignancies other than lung, 7 of neurologic disease, and 8 of miscellaneous diseases. Three cases had no underlying illness. Of the 8 cases with 2 or more times of recurrence, 4 were associated with respiratory diseases, 2 with aspiration pneumonia due to neurologic diseases, 1 with heart disease and 1 with no underlying illness. Recurrent pneumonic episodes affecting the same location were 30 of the total recurrent pneumonic episodes (30/67, 47.8%) and common associated diseases were respiratory diseases including lung malignancies. The etiology of recurrent pneumonia was Streptococcus pneumoniae, methicillin- resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, atypical organisms, etc. CONCLUSION: Recurrent pneumonia in adults had a low incidence rate compared with children, but most cases had associated illness. Respiratory diseases including lung cancer were the most common associated illness of recurrent pneumonia.
Academic Medical Centers* ; Adult* ; Child ; Diabetes Mellitus ; Female ; Heart Diseases ; Hospitals, Teaching ; Humans ; Incidence ; Klebsiella pneumoniae ; Lung ; Lung Neoplasms ; Male ; Medical Records ; Pneumonia* ; Pneumonia, Aspiration ; Pseudomonas aeruginosa ; Recurrence ; Retrospective Studies ; Staphylococcus aureus ; Streptococcus pneumoniae

BACKGROUND: Optimal management of cutaneous varicella-zoster virus(VZV) and herpes simplex virus(HSV) infections requires rapid and accurate diagnostic method. The Tzanck test is a simple, inexpensive and rapid method, but it shows relatively low sensitivity and cannot distinguish VZV and HSV. The viral culture is the reference method, but it is time-consuming and needs cell culture facilities. Direct immunofluorescence(DIF) method has been known to be rapid and sensitive, but it has not been widely used in Korea. OBJECTIVE: We compared the usefulness of DIF method to Tzanck smear in patients with VZV and HSV infections. METHODS: Smears were collected from the base of fresh vesicular lesions, from a total of 134 patients clinically suspected of having VZV or HSV infections. The two wells of IF slide were stained with FITC-conjugated VZV-specific and HSV-specific monoclonal antibody each. Apple-green fluorescence of cytoplasm was considered positive for VZV or HSV. Glass slide smears were made for Tzanck test and stained with Wright stain. Giant cells with enlarged nucleus were considered positive. RESULTS: Among the 107 patients suspected of having VZV infection, positive rates of DIF method and Tzanck test were 91.6% and 76.6%, respectively. The positive rates of HSV in 27 patients suspected of having HSV infection, were 92.6% and 74.1%, respectively. The positive rates of DIF method were higher than that of the Tzanck test in both VZV and HSV infections. CONCLUSION: The DIF method is a more sensitive and relatively rapid method for the diagnosis of cutaneous VZV and HSV infections.
Cell Culture Techniques ; Cytoplasm ; Diagnosis* ; Fluorescence ; Fluorescent Antibody Technique, Direct* ; Giant Cells ; Glass ; Herpes Simplex* ; Herpesvirus 3, Human* ; Humans ; Korea ; Simplexvirus*

Melkersson-Rosenthal syndrome(MRS) is a rare neuro-muco-cutaneous disease of unknown origin. The classic triad of this clinically defined entity consists of orofacial swelling, facial nerve palsy, and lingua plitica. MRS may occur as a complete triad of symptoms or a combination of any features of the classic triad, termed monosymptomatic and oligosymptomatic forms. The complete triad has been reported to occur in only 10% to 20% in different series. Because of the rarity of reported cases in Korea, we report a case of complete form of MRS, in which clofazimine showed a partial response.
Clofazimine ; Facial Nerve ; Korea ; Melkersson-Rosenthal Syndrome* ; Paralysis

Actinic granuloma presents in chronically sun-damaged skin as normally colored to erythematous papules that coalesce to form centrifugally enlarging annular patterns. Histologically, a granulomatous infiltrate of giant cells and histiocytes is seen to be intimately related to the presence of elastotic fibers in the upper dermis. We report a typical case of actinic granuloma that developed on the V-area of anterior chest in a 59-year-old male.
Actins* ; Dermis ; Giant Cells ; Granuloma* ; Histiocytes ; Humans ; Male ; Middle Aged ; Skin ; Thorax

Actinic granuloma presents in chronically sun-damaged skin as normally colored to erythematous papules that coalesce to form centrifugally enlarging annular patterns. Histologically, a granulomatous infiltrate of giant cells and histiocytes is seen to be intimately related to the presence of elastotic fibers in the upper dermis. We report a typical case of actinic granuloma that developed on the V-area of anterior chest in a 59-year-old male.
Actins* ; Dermis ; Giant Cells ; Granuloma* ; Histiocytes ; Humans ; Male ; Middle Aged ; Skin ; Thorax

Pityriasis lichenoides et varioliformis acuta is a cutaneous disease of unknown origin characterized by an acute polymorphous eruption which heals with superficial scarring and pigmentation. It occurs mainly in young adults and less commonly in children. Although various types of therapy have been proposed for pityriasis lichenoides, including systemic steroids, tetracycline, methotrexate, sulfones, an UV radiation, there is no definitive treatment and there is few studies of appropriate, efficacious therapy in children. We report a case of pityriasis lichenoides et varioliformis acuta in children treated with roxithromycin.
Child* ; Cicatrix ; Humans ; Methotrexate ; Pigmentation ; Pityriasis Lichenoides* ; Pityriasis* ; Roxithromycin* ; Steroids ; Sulfones ; Tetracycline ; Young Adult

Pityriasis lichenoides et varioliformis acuta is a cutaneous disease of unknown origin characterized by an acute polymorphous eruption which heals with superficial scarring and pigmentation. It occurs mainly in young adults and less commonly in children. Although various types of therapy have been proposed for pityriasis lichenoides, including systemic steroids, tetracycline, methotrexate, sulfones, an UV radiation, there is no definitive treatment and there is few studies of appropriate, efficacious therapy in children. We report a case of pityriasis lichenoides et varioliformis acuta in children treated with roxithromycin.
Child* ; Cicatrix ; Humans ; Methotrexate ; Pigmentation ; Pityriasis Lichenoides* ; Pityriasis* ; Roxithromycin* ; Steroids ; Sulfones ; Tetracycline ; Young Adult

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin