A Case of Isoniazid Induced Gynecomastia / 결핵및호흡기질환

No abstract available.

A case of scar sarcoidosis

Infiltration of sarcoid granuloma in old cutaneous scars is one of the uncommon cutaneous manifestations of sarcoidosis. Here, we report the case of a 47-year-old female who presented with swelling and irritation in 5 old scars. She had acquired these scars 9 years ago in a traffic accident. An incisional scar biopsy revealed noncaseating granulomas consistent with sarcoidosis. High-resolution CT (HRCT) revealed right paratracheal, both hilar, paraaortic, and subcarinal lymphadenopathy without any nodular densities in both lung fields. Successful regression of cutaneous inflammation was achieved using a short course of oral steroids.

A Case of Probable Community Acquired Acinetobacter baumannii Pneumonia / 결핵및호흡기질환

No abstract available.

Unusual Presentation of Miliary Tuberculosis / 결핵및호흡기질환

No abstract available.

A Case of Possible Doxycycline-Resistant Scrub Typhus / 결핵및호흡기질환

No abstract available.

A Case of Paragonimiasis that was Suspicious for a Lung Malignancy by PET/CT / 결핵및호흡기질환

Positron emission tomography/computed tomography (PET/CT) is valuable for the diagnosis of malignancies. However, PET/CT is unable to discriminate exactly between inflammation and a neoplasm. We report a case of a 50-year-old man with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by PET/CT. The use of PET/CT revealed multilobulated consolidation on the right lung and patchy consolidation on the left lung, with increased fluorodeoxyglucose (FDG) uptake. In addition, the left paraaortic lymph node (LN) and peripancreatic LN showed enlargement with increased FDG uptake. Lung cancer with multiple lymph node metastases was suspected from the increased standardized uptake values (SUV >4.5) determined by PET/CT. We performed wedge resection via video-assisted thoracic surgery (VATS) and found Paragonimus westermani eggs in the involved tissues.

A Case of Paragonimiasis that was Suspicious for a Lung Malignancy by PET/CT / 결핵및호흡기질환

Positron emission tomography/computed tomography (PET/CT) is valuable for the diagnosis of malignancies. However, PET/CT is unable to discriminate exactly between inflammation and a neoplasm. We report a case of a 50-year-old man with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by PET/CT. The use of PET/CT revealed multilobulated consolidation on the right lung and patchy consolidation on the left lung, with increased fluorodeoxyglucose (FDG) uptake. In addition, the left paraaortic lymph node (LN) and peripancreatic LN showed enlargement with increased FDG uptake. Lung cancer with multiple lymph node metastases was suspected from the increased standardized uptake values (SUV >4.5) determined by PET/CT. We performed wedge resection via video-assisted thoracic surgery (VATS) and found Paragonimus westermani eggs in the involved tissues.

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.

Pulmonary Leptospirosis complicated by Acute Respiratory Distress Syndrome without Hemoptysis / 감염과화학요법

Leptospirosis is an acute febrile illness that is endemic in many tropical areas and considered the most common zoonosis worldwide. It is caused by the spirochete Leptospira interrogans. The clinical manifestations may be extremely variable, ranging from flu-like symptoms with mild constitutional complains like fever, headache, myalgias, and gastrointestinal complaints to a severe presentation with the complete Weil's syndrome and sometimes with acute respiratory distress syndrome (ARDS). In Korea, the more common clinical finding is pulmonary manifestation such as cough, hemoptysis and dyspnea. Respiratory failure is an uncommon complication of leptospirosis and is due to severe pulmonary hemorrhage and/or acute respiratory distress syndrome (ARDS). A 67-year-old farmer was referred to the hospital with a history of fever, dyspnea, and confusion. She was found to have severe arterial hypoxemia but, denied blood-tinged sputum. Radiography showed widespread infiltrations over both lung fields, and hemodynamic features were consistent with ARDS. The patient recovered completely without mechanical ventilation.

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.

Pulmonary Leptospirosis complicated by Acute Respiratory Distress Syndrome without Hemoptysis / 감염과화학요법

Leptospirosis is an acute febrile illness that is endemic in many tropical areas and considered the most common zoonosis worldwide. It is caused by the spirochete Leptospira interrogans. The clinical manifestations may be extremely variable, ranging from flu-like symptoms with mild constitutional complains like fever, headache, myalgias, and gastrointestinal complaints to a severe presentation with the complete Weil's syndrome and sometimes with acute respiratory distress syndrome (ARDS). In Korea, the more common clinical finding is pulmonary manifestation such as cough, hemoptysis and dyspnea. Respiratory failure is an uncommon complication of leptospirosis and is due to severe pulmonary hemorrhage and/or acute respiratory distress syndrome (ARDS). A 67-year-old farmer was referred to the hospital with a history of fever, dyspnea, and confusion. She was found to have severe arterial hypoxemia but, denied blood-tinged sputum. Radiography showed widespread infiltrations over both lung fields, and hemodynamic features were consistent with ARDS. The patient recovered completely without mechanical ventilation.

The Complementary Role of FEV6 in Bronchodilator Reversibility Test for the Old Age / 결핵및호흡기질환

BACKGROUND: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second(FEV(1)) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds(FEV(6)) in the bronchodilator reversibility test in elderly patients. METHODS: A total of 236 patients more than 65 years of age with a FEV(1)/FVC ratio or = 80% of the predicted value, Group II: 60%

A Case of Mixed Germ Cell Tumor of the Mediastinum / 결핵및호흡기질환

The Mixed germ cell tumors of the mediastinum are very quite rare. The Prognosis is generally dominated by the most aggressive component, which is represented by a choriocarcinoma, an endodermal sinus tumor, an embryonal carcinoma, and a seminoma, in descending order of in the degree of malignancy. We experienced one a case of a mixed germ cell tumor at the anterior mediastinum. The patient was 27-year-old male, who complained of hemoptysis and cough. The Chest X-ray showed a well-defined lobulated mediastinal mass in the left upper lung field. The operation was done and The mass was excised surgically. A Biopsy showed elements of mature tissues, immature neuronal components, and seminoma components.

The Effect of Spacer on the Bronchodilator Response in the First Medical Examination of Old Age

BACKGROUNDS: When measuring lung function and response to bronchodilator, MDI(metered-dose inhaler) is commonly used but unfamiliarity of its use and cold sensation by the puffed gas decrease reliability of the result. Spacer can reduce the cold freon effect and undesired oropharyngeal deposition caused by the rapid evaporation of the propellant and there are many studies which showed more effectiveness of spacer on the treatment of children with asthma but no study whether it is effective on the bronchodilator response test in the first medical examination of old age. Therefore, we tested whether the use of spacer can reduce the cold freon effect and improve the bronchodilator response in the first medical examination of old age. METHODS: Two hundred of elderly patients( 65years) who had never used MDI were measured the bronchodilator response. Subjects were randomised to either spacer-user or spacer-nonuser. Twenty minutes after 400 g fenoterol was administered, FEV1 (forced expiratory volume in one second) was measured. Bronchoconstriction was defined as a decrease in FEV1 by 10% or greater after bronchodilator inhalation. We further devided each group into normal or obstructive group, obstructive group was defined as FEV10.05) but brochoconstriction(n=1) occured only in spacer-nonuser. CONCLUSION: Spacer improved bronchodilator response and prevented bronchoconstriction, in the first medical examination of old age.

A Case of Primary Pulmonary Extranodal Marginal Zone B-Cell Lymphoma of the MALT Type / 결핵

An extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) is the most frequent type of non-Hodgkin's lymphoma that primarily involves the lung. The radiographical discovery of a pulmonary lesion in an asymptomatic patient is the most common clinical presentation. In general, the prognosis of a localized extranodal pulmonary marginal zone B-cell lymphoma of MALT type is excellent. We report a case of a 61-year-old man who sought evaluation of an incidentally discovered mass in the lung.

A Study of Luteinizing Hormone in Patients with Infertility and Recurrent Spontaneous Abortion / 대한불임학회지

OBJECTIVE: To evaluate luteinizing hormone(LH) in patients with infertility and recurrent spontaneous abortion. MATERIAL AND METHOD: LH was tested by solid phase immunoradiometric assay based on monoclonal and polyclonal anti-LH antibodies. RESULTS: Of 100 infertile patients, the number of less than 5 mIU/ml, 5~10 mIU/ml, greater than 10 mIU/ml in LH level was 67(67%), 22(22%), 11(11%), respectively. Of 100 patients with recurrent spontaneous abortion, the number of less than 5 mIU/ml, 5~10 mIU/ml, greater than 10 mIU/ml in LH level was 79(79%), 18(18%), 3(3%), respectively. There was a significant difference between patients with infertility and recurrent spontaneous abortion only in the group with LH level greater than 10 mIU/ml(p=0.325). CONCLUSIONS: High LH in the follicular phase is known to decrease pregnancy rate and increase abortion rate. But in this study the incidence of high LH in patients with recurrent spontaneous abortion was low. On the contrary, there was a significant increase of LH in infertile patients. So recurrent spontaneous abortion does not seem to be related to high LH level.

Effect of Pentoxifylline on the ICSI Program Undergone in Severe Asthenozoospermia / 대한불임학회지

OBJECTIVE: The aim of this study was to evaluate the effect of Pentoxifylline(PF) on the conventional ICSI program undergone in severe asthenozoospermia. METHOD: Total 348 cycles of ICSI programs undertaken at CHA General Hospital from January, 1996 to September, 2000, were divided into two groups - injected with pentoxifylline-treated sperm(PFT, 204 cycles) or non-treated sperm(NPFT, 144 cycles) and the clinical results of PFT group were compared with those of NPFT. RESULTS: PF-treatment on sperm increased their motility of normozoospermia and severe asthenozoospermia. Fertilization rate of PFT group was higher than those of ICSI programs undertaken using sperm of NPFT(70.6% vs. 62.9%, p<0.01). And, ET and clinical pregnancy rates of PFT were slightly higher than those of NPFT(93.1%, 44.2% vs. 90.3%, 36.2%). CONCLUSION: These results showed that treatment of pentoxifylline has a beneficial role on selection of viable sperm in severe asthenozoospermia.

A Case of Mesalazine-induced Eosinophilic Pneumonia in a Patient with Ulcerative Colitis / 결핵

Measlazine(5-Aminosalicylic acid, 5-ASA), a component of Sulfasalazine (sulfapyridine bound to 5-ASA), is used to treat inflammatory bowel disease. Most adverse pulmonary effects caused by sulfasalazine have been attributed to sulfapyridine. However, lung toxicity associated with measlazine(5-ASA) is rare. Here we report a case of eosinophilic pneumonia in a 44-year-old woman with ulcerative colitis, who was treated with mesalazine. She developed symptoms of a dry cough, mild night fever, and evertional dyspnea. Bilateral peripheral pulmonary infiltrates, peripheral blood eosinophilia, and histologic features were consistent with eosinophilic pneumonia. The symptoms improved quite rapidly after the discontinuation of mesalazine and initiation of steroid therapy. Therefore, adverse pulmonary reactions to mesalazine must be considered in a differential diagnosis of pulmonary involvement in patients with inflammatory bowel disease who are receiving with measlazine therapy.

BCL-2 and BAX Expression in Normal Human Endometrium / 대한불임학회지

OBJECTIVE: To investigate the distribution of BCL-2, BAX proteins and DNA fragmented cells in the normal human endometrium during at each menstrual cycle in order to find out whether apoptosis regulates cyclic endometrial change. METHODS: Normal endometrial tissues wee obtained from 40 patients, 32~45 year of age, all with regular menstrual cycle, who were undergoing abdominal hysterectomy for myoma of uterus or cervical intraepithelial neoplasia for period from 1992 through 1997. Immunohistochemical staining was used to determine the expression of BCL-2 and BAX protein with paraffin-embedded tissues. RESULTS: BCL-2 was expressed on the glandular epithelial cells and stromal cells during the proliferative phase. The intensity of BCL-2 was increased predominantly on the basal layer than the functional layer in late proliferative phase. However, BCL-2 immunoreactivity was decreased in the secretory phase. BAX wes expressed predominantly during the secretory phase. the intensity was increased in late secretory phase rather than early secretory phase. DNA fragmented cells were detected in a few cells at each phase. However, it was increased during the late secretory phase. CONCLUSION: Apoptosis-related genes, BCL-2 and BAX, may play a role in the regulation of cyclic endometrial change.

A Case of pulmonary lymphangioleiomyomatosis developed in tuberous sclerosis with renal angiomyolipoma / 결핵

Tuberous sclerosis is a rare hereditary anomaly of variable penetrance characterized by mental retardation, epilepsy, and adenoma sebaceum. Pulmonary involvement is uncommon, but, when involve by tuberous sclerosis, it shows characteristic reticulonodular infiltration and cystic changes. Lymphangioleiomyomatosis is a rare disease of unknown cause that affects women of reproductive age. It is characterized by progressive proliferation of smooth muscle in the lung. We experienced one case of pulmonary lymphangioleiomyomatosis associated with tuberous sclerosis in a 26-year-old female patient. This case is reported with a brief of the literature.