• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.702-705
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• 2006

Severe left ventricular dysfunction after relief of massive pericardial effusion has been rarely reported. Interventricular volume mismatch, acute distention of the cardiac chambers and interplay of autonomic none system are believed to be the possible causes for ventricular dysfunction. Presenting two patients who had marked decrease in global ventricular systolic function after relief of pericardial tamponade by subxyphoid pericardial window, we recommend gradual removal of pericardial fluid under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

• Parasites, Hosts and Diseases
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• v.21 no.2
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• pp.286-288
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• 1983

폐흡충 감염자에서 나타나는 중추신경계의 병변을 모두 폐흡충이 중추신경계를 침범하여 발생한 것이라고는 할 수 없다. 그러므로 이 경우 원인진단을 위해서는 뇌척수액에 나타나는 폐흡충 특이항체의 측정이 필요하다고 생각된다. 우리는 확인된 뇌폐흡충중 2례와 척수 스파르가눔증 1례, 뇌병변이 없는 폐흡충증 환자 1례와, 기타 중추신경계 질환 환자 10례에서 얻은 뇌척수액을 희석하지 않고 면역효소진단법으로 특이항체를 측정하였다. 그 결과 흡광도 0.25를 양성 기준으로 하면 뇌 폐흡퉁증을 진단할 수 있다고 생각하게 되었다. 폐흡충중 환자 2례의 흉막삼출액에서 특이 IgG 항체가는 혈청에서의 측정치와 다르지 않아, 흉막삼출액도 폐흡충증의 진단에 이용할 수 있다고 생각되었다.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.132-137
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• 2004

Background : The measurement of adenosine deaminase(ADA) level in pleural fluid is useful in the diagnosis of tuberculous(TB) pleural effusion. However, ADA is also elevated in other diseases such as malignancy, bacterial infections, empyema, and collagen vascular disease, ADA alone has limited value. The object of this study is to determine diagnostic usefulness of the combined use of ADA value with lymphocyte/neutrophil ratio(L/N ratio) rather than the use of ADA alone. Method : We evaluated 198 patients(age=$55.9{\pm}12.9$, M/F=2.7:1) with pleural effusion who had admitted in Gyeong-sang National University Hospital from Jan. 1999 to Dec. 2001. retrospectively. Patients were divided into four diagnostic groups: TB pleural effusion(n=91), parapneumonic effusion(n=65), malignant effusion(n=21), and transudative effusion(n=13). The ADA level, differential cell count, biochemistry, cytology, and microbiology of each diagnostic groups were evaluated. The sensitivity, specificity, negative predictive value(npv), positive predictive value(ppv) and efficiency were calculated at each ADA values and combined ADA value with various L/N ratios. Results : The ADA level in TB pleural effusion was significantly higher than that of parapneumonic effusion, malignant pleural effusion, and transudative effusion(p<0.05). Sensitivity, specificity, ppv, npv and efficiency at $ADA{\geqq}50$ IU/L in the diagnosis of TB pleural effusion were 89.0%, 82.2%, 81.0%, 89.8% and 85.5% respectively. When $ADA{\geqq}50$ IU/L was combined with lymphocyte/neutrophil $ratio{\geqq}0.75$, sensitivity, specificity, ppv, npv, and efficiency were 83.5%, 96.3%, 95.0%, 87.9% and 90.5% respectively. Specificity, ppv and efficiency were increased with combination of ADA value and L/N ratio. Conclusion : Combination of ADA value and L/N ratio in pleural effusion is more useful than ADA value alone in the diagnosis of TB pleural effusion.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.135-143
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• 1994

Background: The cell mediated immunity has an important role in the pathogenesis of tuberculosis. sIL-2R has been known as a sensitive marker of T lymphocyte activation Elevated serum levels of sIL-2R have been found in patients with lymphoproliferative disorders, organ transplantation, autoimmune diseases, and various granulomatous diseases. Elevated levels of sIL-2R have been also found in the serum and pleural fluid of the patients with tuberculosis. To evaluate the diagnostic value of sIL-2R in the differentiation of tuberculous pleurisy and nontuberculous pleurisy. We measured the level of sIL-2R in the sera and pleural fluids of 12 patients with tuberculous pleurisy and 32 patients with nontuberculous pleurisy. Method: Samples of pleural fluid and serum were centrifuged at 2500 rpm for 10 min to remove cell pellets. Soluble IL-2R was measured with a sandwitch enzyme immunoassay using the Cellfree(r) Interleukin-2 Receptor Test kit(T-cell science,Inc. Cambridge, MA). Results: The results obtained were as follows: 1) The sIL-2R level in pleural fluid of the patients with tuberculous pleurisy was higher than that of patients with nontuberculous pleurisy(P<0.005). 2) When the sIL-2R level above 5,000 u/ml in pleural fluid was used as the cut-off value to diagnose tuberculous pleurisy, it had a sensitivity of 84.6% and a specificity of 90.9%. 3) The sIL-2R level in the sera of the patients with tuberculous pleurisy was higher than that of patients with bacterial pleural effusions and normal control group(P<0.05) and there was no difference of levels compared with malignant pleural effusions and transudative pleural effusions(P>0.05). 4) In patients with tuberculous pleurisy, the mean concentration of sIL-2R in pleural fluid was higher than that in serum(P<0.005). Conclusion: These findings suggest that the measurement of elevated levels of pleural fluid sIL-2R in tuberculous pleurisy may be useful in the differential diagnosis between patients with tuberculous pleurisy and nontuberculous pleurisy.

• Korean Journal of Microbiology
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• v.39 no.1
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• pp.36-39
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• 2003

The rapid and reliable 16S rDNA multiplex polymerase chain reaction (PCR) assay was established to characterize bacterial etiologies of middle ear effusion. These etiologies included Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumonia, which were detected in middle-ear effusion (MEE) samples taken from patient with otitis media. A total of 39 MEE samples were aspirated from 26 patients. DNA was extracted from MEE samples, and PCR was done with DNA extracts by using the common primers, which is localized at C4 region in the 16S rDNA gene of all bacterial species, and species-specific primers: (i) Haemophilus-specific primer, (ii) Moraxella- specific primer, and (iii) Streptococcus-specific primer. Among 39 samples tested, 24 (61.5%) were positive for H. influenzae, 10 (25.6%) were positive for M. catarrhalis, 3(7.7%) were positive for S. pneumonia, and 11 (28%) were negative for 165 rDNA multiplex PCR reaction. Nine samples (28.6%) exhibited a mixed infection and were positive for both H. infuenzae and M. catarrhalis. We suggested that 16S rDNA multiplex PCR is a useful method to identify rapidly for rapid identification of the pathogenic bacteria and characterization of bacterial etiologies of middle ear effusion.

• Radioisotope journal
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• v.20 no.2
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• pp.4-5
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• 2005

• 대한세포병리학회:학술대회논문집
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• 1993.06a
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• pp.26-27
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• 1993

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.54-59
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• 2018

Pleural paragonimiasis is uncommon in the pediatric population and therefore can be challenging to diagnose. This is a case of a 6-year-old girl with pleural effusion who had been having intermittent persistent epigastric pain and erythematous rash on the face, hands, and arms for 6 months. Exudative pleural effusion with prominent eosinophils and serum eosinophilia were observed. As patient showed high immunoglobulin M (IgM) titers against Mycoplasma pneumoniae, she was treated with antibiotics; however, the pleural effusion did not improve during hospitalization. Despite showing negative stool ova and cyst results, patient's serum and pleural effusion were positive for Paragonimus westermani-specific IgGs on enzyme-linked immunosorbent assay. Respiratory symptoms, pleural effusion, and skin symptoms improved after praziquantel treatment.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.978-982
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• 2004

Background: Malignant pleural effusion is a common clinical problem in neoplastic patients. With the diagnosis of a malignant pleural effusion, palliative therapy was done. One of the treatments was a chemical pleurodesis. Talc was the most commonly used a sclerosing agent, but the quality of patient's life was not improved. We was evaluated by other agents such as Viscum album for relief of malignant pleural effusion. Material and Method: From November 2001 to October 2003, 17 patients who underwent to chemical pleurodesis for the malignant pleural effusion. We compared the talc (group I: 10 patients) and Viscum album (group II: 7 patients). We analysed them retrospectively in term of various factors and results. Result: There were no significant differences between group I and group II in the sex ratio, mean age, origin of primary cancer and site, but, group I had higher successful rate (80% : 71 %) than group II. Group II had better length of chest tube stay after procedure, Karnofsky performance and recurrence than group I. The failed treatement group was related to the pleural fluid pH and interval of initial chemical pleurodesis after thoracostomy. Conculsion: Although the chemical pleurodesis with Viscum album was slightly lower than talc in the successful rate, there was an alternative method instead of the chemical pleurodesis with talc to improve the patient's quality of life in malignant pleural effusion.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.38-45
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• 1996

Background: Diagnosis of subpulmonary effusion is thought to be somewhat difficult more than pulmonary effusion. Clinical course and pathophysiology are thought to be different from typical pulmonary effusion. This study was done for increasing high suspicious index and early diagnosis of subpulmonary effusion. Method: Among the patients at dept. of chest medicine, National Medical Center from January 1990 to Dec. 1993, 232 cases of typical pulmonary effusion and 42 cases of subpulmonary effusion were studied. Result: 1) The ratio of subpulmonary effusion and typical pulmonary effusion was about 1:5. 2) Male to Female ratio was 1:1 in both effusion. 3) Rt. side pleural and subpleural effusion were slightly predominant. 4) Subjective symptoms are chest pain, cough and exertional dyspnea. There is no difference between subpulmonary and typical pulmonary effusion. 5) Duration of symptom was slightly longer in subpulmonary effusion. 6) The most common cases of pleural effusion is tuberculosis in both subpulmonary & typical pulmonary effusion. Non-specific pleuritis was more common in subpulmonary effusion. 7) Pleural effusion was recurred about one fifth in both subpulmonary & pulmonary effusion. Conclusion: We studied clinical course and laboratory findings between subpulmonary & pulmonary effusion. However there are no definite difference between subpulmonary & pulmonary effusion. Duration of symptom was slightly longer in subpulmonary effusion. Most common cause was tuberculosis. Non specific pleuritis was more prevalent in subpulmonary effusion.