Two Cases of Pharyngeal Tuberculosis Secondary to Pulmonary Tuberculosis / 감염과화학요법

Pharyngeal involvement of tuberculosis is rare and is seen only in massive sputum positive patients with cavitating pulmonary tuberculosis. The pharyngeal lesions are secondary to aspiration of heavily infected sputum from lung and consist of painful shallow ulcers in pharynx. Chronic sore throat and unexplained dysphagia should alert the clinician to possibility of tuberculosis, especially in the countries where tuberculosis is endemic. We report two cases of pharyngeal tuberculosis with pulmonary tuberculosis, one of which has concurrent laryngeal and intestinal tuberculosis. Histological and bacteriological examinations established the diagnosis of pharyngeal tuberculosis associated with pulmonary focus.

Two Cases of Pharyngeal Tuberculosis Secondary to Pulmonary Tuberculosis / 감염과화학요법

Pharyngeal involvement of tuberculosis is rare and is seen only in massive sputum positive patients with cavitating pulmonary tuberculosis. The pharyngeal lesions are secondary to aspiration of heavily infected sputum from lung and consist of painful shallow ulcers in pharynx. Chronic sore throat and unexplained dysphagia should alert the clinician to possibility of tuberculosis, especially in the countries where tuberculosis is endemic. We report two cases of pharyngeal tuberculosis with pulmonary tuberculosis, one of which has concurrent laryngeal and intestinal tuberculosis. Histological and bacteriological examinations established the diagnosis of pharyngeal tuberculosis associated with pulmonary focus.

Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation / 결핵및호흡기질환

An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The O2 saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

Unresolving Pneumonia / 결핵및호흡기질환

A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of 39degrees C, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still 39degrees C despite the aggressive therapy of community- acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.

Necrotizing Pneumonia Complicated by Streptococcus Pyogenes Bacteremia in Patient with COPD / 결핵

No abstract available.

A Case of Gastric Metastasis from Small Cell Lung Carcinoma / 대한소화기학회지

Gastric metastasis of lung carcinoma is a rare entity which is detected mostly at autopsy. Patients diagnosed as having those on lifetime are extremely rare. In addition to our case, 54 cases of lung carcinoma metastasis to the gastro-intestinal tract have been reported in the literature since 1961. We report a case of gastric metastasis originated from small cell lung carcinoma. The patient was a 87-year-old man. He refused lung biopsy and further treatment and died 2 months after the diagnosis. This is the case of gastric metastsis originated from lung carcinoma, which was confirmed by immunohistochemical staining.

The Correlation of Ovarian Follicular Concentrations of IGF-II, IGFBP-1, and 3 between Cumulative Embryo Score in Patients Undergoing IVF-ET / 대한산부인과학회잡지

OBJECTIVE: To investigate the correlation between the concentrations of insulin-like growth factor-II (IGF-II), insulin-like growth factor binding protein-1, 3 (IGFBP-1, 3) in the follicular fluid and the cumulative embryo score (CES) in the patient who underwent in vitro fertilization and embryo transfer (IVF-ET). MATERIALS AND METHODS: A total of 21 cycles of 18 patients which underwent IVF-ET cycle after controlled ovarian hyperstimulation (COH) were included in this study. Using immunoradiometric assay (IRMA), we measured the concentrations of IGF-II, IGFBP-1, 3 in the follicular fluid. The patients were grouped into the pregnant and non-pregnant group. The concentrations of IGF-II, IGFBP-1, 3 in the follicular fluid were compared between the two groups and the correlations of the follicular concentrations of IGF-II, IGFBP-1, 3 and cumulative embryo score were evaluated. Results were analyzed with Mann-Whitney U test and Spearman's rank correlation coefficient and statistical significance was defined as p<0.05. RESULTS: There were no statistical significance in the follicular concentrations of IGF-II, IGFBP-1, 3 between the pregnant group and non-pregnant group. There were signifiant correlation between the follicular concentration of IGF-II and cumulative embryo score (p=0.001). There might be correlations between the follicular concentration of IGFBP-3, and free IGF-II and cumulative embryo score (p=0.053, p=0.056, respectively). CONCLUSION: The follicular IGF-II and free IGF-II might have an influence to development of good- quality embryos in patients undergoing IVF-ET.

Usefulness of Rapid PSA Kit(R) / 대한비뇨기과학회지

PURPOSE: The incidence rate of prostate cancer has increased remarkably in Korea. The serum prostate specific antigen (PSA) value has been used for screening, although its clinical significance in prostate cancer screening is still inconclusive. However, if the measurement time was short and the cost was low, such an assay kit should be sufficient for prostate cancer screening. MATERIALS AND METHODS: We developed pared monoclonal antibodies against PSA which could be used in assay kits for PSA. The Rapid PSA Kit(R) used an immunochromatographic method to qualitatively judge a positive or negative result. Serum specimens from 78 men with benign prostate hyperplasia or prostate cancer were tested using the kit. RESULTS: The sensitivity of the kit was determined to be 4ng/ml. 33 samples had a value of greater than 5ng/ml, so were considered positive. 5 samples had values between 4ng/ml and 5ng/ml, of which 3 were positive. The other 40 samples had values less than 4ng/ml, and 11 of these were judged positive. These results indicated that the sensitivity and specificity of the Rapid PSA Kit(R) were 94.7 and 72.5%, respectively. CONCLUSIONS: Tests using the Rapid PSA Kit(R) can be easily performed at outpatient clinics or elsewhere. This kit is useful in the initial screening of prostate cancer as the results can be obtained within 15 minutes and the cost is lower than with ordinary serum PSA tests.

Usefulness of Rapid PSA Kit(R) / 대한비뇨기과학회지

PURPOSE: The incidence rate of prostate cancer has increased remarkably in Korea. The serum prostate specific antigen (PSA) value has been used for screening, although its clinical significance in prostate cancer screening is still inconclusive. However, if the measurement time was short and the cost was low, such an assay kit should be sufficient for prostate cancer screening. MATERIALS AND METHODS: We developed pared monoclonal antibodies against PSA which could be used in assay kits for PSA. The Rapid PSA Kit(R) used an immunochromatographic method to qualitatively judge a positive or negative result. Serum specimens from 78 men with benign prostate hyperplasia or prostate cancer were tested using the kit. RESULTS: The sensitivity of the kit was determined to be 4ng/ml. 33 samples had a value of greater than 5ng/ml, so were considered positive. 5 samples had values between 4ng/ml and 5ng/ml, of which 3 were positive. The other 40 samples had values less than 4ng/ml, and 11 of these were judged positive. These results indicated that the sensitivity and specificity of the Rapid PSA Kit(R) were 94.7 and 72.5%, respectively. CONCLUSIONS: Tests using the Rapid PSA Kit(R) can be easily performed at outpatient clinics or elsewhere. This kit is useful in the initial screening of prostate cancer as the results can be obtained within 15 minutes and the cost is lower than with ordinary serum PSA tests.