• Tuberculosis and Respiratory Diseases
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• v.65 no.5
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• pp.396-399
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• 2008

Factitious hemoptysis is the bleeding type of Munchausen's syndrome, and this describes a group of patients who intentionally produce symptoms. Because factitious hemoptysis is a very rare manifestation of hemoptysis, it generally passes unnoticed. We report here on a case of factitious hemoptysis in a 15-year-old boy who presented with hemoptysis. During his three hospitalizations, we conducted many diagnostic procedures, including chest CT, laryngoscopy, bronchoscopy and bronchial arteriography, yet we failed to find the definitive cause of the patient's hemoptysis. He kept on complaining of repetitive hemoptysis and seizure-like activity. His father discovered that he had collected his blood into the specimen cup via an intravenous line. After we removed the intravenous line, he did not show blood to us again. We suggest that factitious hemoptysis should be considered in the differential diagnosis of hemoptysis of an unclear bleeding focus, and especially when the patient has a bizarre hospital course or unusual behavior. We also include a review of the relevant literature.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.389-393
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• 1999

Endometriosis is defined as an extrauterine growth of endometrial tissue and it is primarily limited in the pelvis but it can also occur in the pleural cavity as well as pulmonary parenchyme. The diagnosis of pulmonary endometriosis is usually based on the clinical history of recurrent hemoptysis in association with menstrual cycle and by histopathologic confirmation of endometrial tissue in the lung parenchyme. Pulmonary endometriosis was first reported by Lattes in 1956. and dozens of cases have been reported so far. We experienced a case of 25 year old single woman with a history of hemoptysis in association with her menstruation. The bleeding focus was localized with chest CT scan and repeated fibrooptic bronchoscopy and basal segmentectomy of the right lower lobe was performed. The resected specimen shows endometrial stroma and glands of early proliferative phase with respiratory epithelium on the laterobasal bronchus. Her postoperative course was uneventful with no recurrence of hemoptysis during 6 months of follow-up in the outpatient clinic.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.303-310
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• 2003

Background : Lymphangioma of the mediastinum is an uncommon benign tumor of lymphatic origin that is most often seen in children, is very rare in adults and is frequently discovered incidentally on chest x-ray exams. While radiology (CT and MRI) may suggest the diagnosis and allow an assessment of the operative difficulties, the histology of the surgical specimen is required for precise diagnosis. Complete resection is the only treatment; however, in some patients resection was incomplete because of the infiltrating character of these tumors, leading to recurrence. We report three cases of mediastinal lymphangioma with a review of the literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.293-298
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• 2010

Purpose: The objective of the present study was to determine the capability of electrospun silk fibroin as a biomaterial template for bone formation when mixed with nano-hydoxyapatite in vivo. Materials and Methods: Ten New Zealand white rabbits were used for this study and bilateral round shaped defects were formed in the parietal bone (diameter: 8.0 mm). The electrospun silk fibroin was coated by nano-hydroxyapatite and grafted into the right parietal bone (experimental group). The left side (control group) did not receive a graft. The animals were sacrificed at 6 weeks and 12 weeks, humanly. The microcomputerized tomogram (${\mu}CT$) was taken for each specimen. Subsequently, they were undergone decalcification and stained for the histological analysis. Results: The average value of all measured variables was higher in the experimental group than in the control at 6 weeks after the operation. BMC in the experimental group at 6 weeks after operation was $48.94{\pm}19.25$ and that in the control was $26.17{\pm}16.40$ (P = 0.027). BMD in the experimental group at 6 weeks after operation was $324.59{\pm}165.24$ and that in the control was $173.03{\pm}120.30$ (P = 0.044). TMC in the experimental group at 6 weeks after operation was $19.50{\pm}6.00$ and that in the control was $10.52{\pm}6.20$ (P = 0.011). TMD in the experimental group at 6 weeks after operation was $508.88{\pm}297.57$ and that in the control was $273.54{\pm}175.91$ (P = 0.06). Gross image of both groups showed higher calcification area at 12 weeks than them in 6 weeks. The average value of ${\mu}CT$ analysis was higher at 12 weeks than that in 6 weeks in both groups. BMC in the experimental group at 12 weeks after operation was $51.21{\pm}8.81$ and that in the control was $33.47{\pm}11.13$ (P = 0.010). BMD in the experimental group at 12 weeks after operation was $323.39{\pm}21.54$ and that in the control was $197.75{\pm}76.23$ (P = 0.012). TMC in the experimental group at 12 weeks after operation was $21.44{\pm}5.30$ and that in the control was $13.31{\pm}4.17$ (P = 0.008). TMD in the experimental group at 12 weeks after operation was $524.47{\pm}19.37$ and that in the control was $299.60{\pm}136.20$ (P = 0.016). Conclusion: The rabbit calvarial defect could be successfully repaired by electrospun silk nano-fiber combined with nano-hydroxyapatite.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.54-60
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• 2004

Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.369-377
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• 1997

Purpose : This study was Performed to identify the histopathologic feature by the reevaluation of the Pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. Materials and Methods : 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology. Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas $(2.08\%)$. Among them thirty six patients were transferred from other hospitals. the biopsy specimens of those Patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin. synaptophysin and Grimelius stain). And we also evaluate the Patients and tumor characteristics. response to radiation. patterns of failures, 5 year overall and disease free survival rates. Results : Thirteen tumors were neuroendocrine carcinomas(13/24 = $54.2\%$) and eleven tumors were squamous carcinomas, small cell type (11/24 = $47.8\%$) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the Patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma, Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were Poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight Patients had FIGO stage IB disease, 12 had stage 11, 3 had stage III and one had stage IV disease, Pelvic lymph node metastases were found in five Patients $(20.8\%)$. three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics. response to radiation. 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma Patients (6/13:$46.2\%$) than in small cell type of squamous carcinoma Patients (2/11:$18.2\%$), but there was no statistically significant difference because of the small number of patients (P>0.05). Conclusion : More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : $54.1\%$) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neurolndocrine carcinoma was greater than those of the small cell type of squamous carcinoma $(46.2\%\;vs.\;18.2\%)$. But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.474-480
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• 2004

The purpose of this in vitro study was to compare the remineralizing effects of three glass ionomer cements (high filled glass ionomer cement, compomer, resin modified glass ionomer cement) with resin composite (control group) on incipient interproximal caries, and to assess long-term change of remineralization effect, in each material, evaluated by microtomography. Proximal restoration was simulated with tooth specimen and Glass Ionomer Cements. And each of these groups was placed into a closed container with artificial saliva at $37^{\circ}C$ and pH 7.0 for a time period of thirty days with constant circulation. At the end of thirty and sixty days, tomographic images were taken from these specimens with micro CT scanner. Materials used in this study were as follows. Group 1: Fuji IX GP (GC Corp., Tokyo, Japan) Group 2: Vitremer (3M ESPE, St. Paul, Minn., USA) Group 3: F2000 (3M ESPE, St. Paul, Minn., USA) Group 4: Z250 (3M ESPE, St. Paul, Minn., USA) Using density-measuring program, the micro-density of carious lesions on the specimens were measured. The mean density changes of each group were compared to the other groups to evaluate the effect of remineralization. The results were as follows: 1. The lesion density of all groups increased. 2. The mean density increase of Group 1, 2, 3 were higher than that of Group 4 every month(p<0.05). 3. There were significant differences of density increase among glass ionomer group(Group 1, 2, 3).

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.179-185
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• 2002

A bronchus-associated lymphoid tissue(BALT) lymphoma of the lung is a rare disorder of patients with Sj$\ddot{o}$gren's syndrome. A 49-year-old woman was admitted for an evaluation of exertional dyspnea and general weakness which had persisted for two years. The patient had suffered from dry mouth and dry eyes for five years. The physical examinations showed a coarse breath sound with inspiratory crackles on the whole lung field, particularly on the both basal lungs. The laboratory data disclosed high titers of anti-nuclear antibodies, and anti-SSA (Ro), and anti-SSB (La) antibodies. Chest radiographs demonstrated the presence of bilateral, diffuse, reticulonodular densities in both lungs. Thin-section CT scans showed diffusely distributed mosaic pattern of an inhomogeneous attenuation extending over the entire lung zone. The histological findings from an open-lung biopsy specimen revealed an accumulation of lymphoid cells around the bronchioles and an extension of malignant lymphoma cells from the bronchiolar epithelium toward the alveolar space. Immunohistochemically, the neoplastic cells reacted positively to the CD 20 antigen and were focally positive for the UCHL 1 antigen. The histological diagnosis was consistent with a low grade marginal zone B-cell lymphoma originating in the BALT. Here, we present a case of a histologically proven BALT lymphoma of the lung in a patient with primary Sj$\ddot{o}$gren's Syndrome.