Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.
Park, Jeong-Yong;O, Myeong-Hun;Wi, Dang-Mun;Miura, S.;Mishima, Y.
Korean Journal of Materials Research
/
v.4
no.8
/
pp.906-914
/
1994
Plastic behavior of two-phase intermetallic compounds based on $LI_{2}$-type $(Al, Cr)_3$ Ti was investigated using compression test at R.T. and 77K. $LI_{2}$ single phase alloys and two-phase alloys consisting of mainly $LI_{2}$ phase and a few or 20% second phases were selected from AI-Ti-Cr phase diagram. In general, compared with Llz single phase, two-phase alloys consisting of 20% second phase showed relatively high yield strength and poor ductility. Among the alloys, however, AI-21Ti-23Cr alloy consisting of 20% $Cr_{2}Al$ phase showed available ductility as well as high yield strength. Plastic behavior of $LI_{2}$ single phase alloys and two-phase alloys consisting of a few% $Cr_{2}Al$ was also investigated. Homogenization of arc melted ingots substantially reduced the amount of second phases but introduced extensive pore. When Cr content increased in $Ll_{2}$ single phase alloys after the homogenization, the volume fraction of pore in the alloys decreased, and no residual pore was observed in two-phase alloys consisting of a few% $Cr_{2}Al$ phase. Environmental effect on the ductility of the alloys was investigated using compression test at different strain rates($1.2 \times 10^{-4}/s$ and $1.2 \times 10^{-2}/s$). Environmental embrittlement was least significant in A1-25Ti-10Cr alloy consisting of LIZ single phase among the alloys tested in this study. However, based on the combined estimation of the pore formation, environmental embrittlement and ingot cast structure, AI-21Ti-23Cr alloy consisting of 20% $Cr_{2}Al$ as the second phase is expected to show the best tensile elongation behavior.
Purpose : To evaluate the diagnostic value of dipstick urinalysis($Multistix^{(R)}$) as a screening test for urinary tract infection(UTI) in acute febrile children. Methods : We compared dipstick uinalysis (leukocyte estease(LE) and nitrite) with microscopic urinalysis (WBC and bacteria) and urine culture in 80 children with UTI and 605 children without UTI, who were admitted due to acute fever at EWHA Womans University Hospital between Oct. 1994 and Feb. 1996. Results : 1) In dipstick urinalysis, LE and nitrite were positive in 38.7%, and 13.8% of 80 children with UTI and in 2.1%. and 1.2% of 605 children without UTI. 2) In microscopic urinalysis, WBC and bacteria were positive in 31.2%, and 17.5% of 80 children with UTI and in 4.1%, and 0.6% of 605 children without UTI. 3) Positive rate of LE on dipstick urinalysis was 38.7%, which was significantly higher than 31.5% of WBC on microscopic urinalysis (P<0.05). Positive rate of nitrite was not significantly different to that of bacteria. 4) Sensitivity, specificity, positive predictive value, negative predictive value of dipstick urinalysis were 43.7%, 98.3%, 63.6%, 92.9% which were not significant different to 40.0%, 99.0%, 54.0%, 92.3% of microscopic urinalysis. The sensitivity of combined dipstick and microscopic urinalysis were still low(50%). 5) Additional positive rate of microscopic urinalysis to negative dipstick urinalysis was 6.3%(5/80) in 80 children with UTI. Conclusion : The sensitivity of dipstick urinalysis was low and additional value of microscopic urinalysis was minimal in febrile UTI. So urine culture is mandatory in acute febrile children even though dipstick and microscopic urinalysis are negative.
Purpose: Our purpose was to evaluate spinal bony metastasis which could be missed on an F-18 FDG PET/CT (FDG PET/CT) alone, and to characterize discordant metastatic lesions between FDG PET/CT and bone scan. Material and Methods: FDG PET/CT and bone scans of 43 patients with spinal bony metastasis were analyzed retrospectively. A McNemar test was performed comparing the FDG PET/CT alone to the FDG PET/CT plus bone scan in the spinal bony metastases. A one-way chi-square test was performed to characterize the metastases that were missed on the FDG PET/CT alone. To evaluate discordant lesions between FDG PET/CT and bone scan, we performed logistic regression analyses. The independent variables were sites (cervical, thoracic, and lumbar), size (large and small), and maximum SUVs, and the dependant variable was bone scan uptake (positive and negative MDP uptake). Results: A significant difference was found between the FDG PET/CT alone and the FDG PET/CT combined with the bone scan (p < 0.01). Using the FDG PET/CT only, diffuse osteoblastic metastasis was missed with a significantly higher frequency (p = 0.04). In the univariate analysis, cervical vertebra and small size were related to negative MDP uptake, and thoracic vertebra and large size were related to positive MDP uptake. However, in the multivariate analysis, only the large size was related to positive MDP uptake. Conclusion: A bone scan in addition to the FDG PET/CT increased the ability to evaluate spinal bony metastases, especially for diffuse osteoblastic metastasis. Large metastasis was related to positive bone scan uptake in spinal bony metastasis.
Mathematical, verbal, and spatial abilities are known as three important indicators for the success in the STEM disciplines. In this study, Purdue Spatial Visualization Test-Rotation, College Entrance Scholastic Aptitude Test- Math and Verbal score of engineering freshmen students have been used to find the relationships among these areas. In addition, gender differences in spatial visualization, verbal achievement and mathematical achievement have been investigated, too. In this research, I found that gender difference was highest in spatial visualization ability, followed by verbal achievement and smallest in mathematical achievement. Substantial number of male students possess high level of spatial abilities, but only half of female students were at the same level where their male colleagues were. The correlation between spatial ability and mathematical ability was negligible, contrary to former researches on elementary and middle school students. But the correlation was stronger for female students than male students. The correlation between mathematical achievement and verbal achievement was negative. It reflects the fact that when one section of SAT score is low, score of other sections should be higher to get admitted to college. Gender difference in mathematics was smallest for high achieving spatial ability group. For low spatial ability group gender difference in mathematics achievement has been observed, too. To find the combined contribution of spatial and verbal abilities to mathematics achievement, students were divided into 4 ability groups. Mathematics achievement decreased in the order of (1) high spatial -low verbal group, (2) low spatial - low verbal group, (3) high spatial - high verbal group, (4) low spatial - high verbal group.
Abnomalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue, which may occur on the midline in any position from the base of the tongue to the mediastinum. Although ectopic thyroid may be asymptomatic, local obstructive, hemorrhagic or other complication may occur. Radinuclide thyroid scan is confirmatory when the diagnosis is suspected. Hypothyroidism is common in lingual thyroid, and thyroid supplementation is generally required. In order to evaluate the features of ectopic thyroid, we investigated the scintigraphic findings, thyroid function test and clinical symptoms of 19 patients with ectopic thyroid. 1) Th frequency of ectopic thyroid was about 5.3 times more common in female than in male. Then patients were mostly below 30 years old (79%). 2) The frequency of location of ectopic thyroid were as follows: 10 cases in the tongue base, 1 case in suprahyoid, 5 cases in infrahyoid and 3 cases over 2 areas. 3) The thyroid function test was done in 16 cases of the ectopic thyroid patients. The hypothyroidism was detected in 7 cases, subclinical hypothyroidism in 4 cases and normal thyroid function in 5 cases. 4) The rate of hypothyroidism is 90% in the lingual thyroid and 33% in the others. The thyroid dysfunction was related with the location of the ectopic thyroid (p < 0.05). 5) The clinical manifestations include a mass in the tongue base, the foreignbody sensation of a throat and a swallowing difficulty in lingual thyroid. The palpable mass was the chief complaint in the others. 6) We prescribed the thyroid hormone to 10 cases with hypothyroidism. The ectopic thyroid was removed in 2 cases with normal thyroid function. The rest is following up through OPD. We must consider the possibility of the ectopic thyroid and take the thyroid scan when the patient has a mass in the tongue base, the sublingual and the prelaryngeal area. Then we have to check the thyroid function and follow up when the ectopic thyroid is diagnosed, because the patient with normal thyroid function can result in the hypothyroidism. Except these, we must mind of the possibility of occurence of the cancer in the ectopic thyroid tissue.
Kim, Seog-Ku;Lee, Mi-Kyung;Ahn, Jae-Hwan;Yun, Sang-Leen;Kim, So-Jung
Journal of Korean Society of Environmental Engineers
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v.28
no.4
/
pp.438-446
/
2006
A lab-scale batch test was conducted to develop capping materials to reduce the sediment phosphorus in the stagnant water zone of Gyeongancheon in Paldang Lake. The mean grain size(Mz) of sediment in the investigated area was 7.7 ${\phi}$, which is very fine, and the contents of organic carbon($C_{org}$) was 2.4%, which is very high. For the phosphorous release experiment to select the optimal capping material, sand layer, powder-gypsum($CaSO_4{\cdot}2H_2O$), granule-gypsum, complex layer(gypsum+sand) and the control were compared and evaluated in the 150 L reactor for 45 days. In case of the capping with the sand, it was found that the phosphorous from the sediment could be reduced by around 50%. However, it was found that this caused the reduction of the dissolved oxygen in the water column(by less than 3 mg/L) due to the resuspension of sediment and the organic matter decomposition that comes from the generation of $CH_4$ gas in the 1 cm of the sand layer. Therefore, it is likely that the sand layer has to be thickener in case of the sand capping. Powder-gypsum and granule-Gypsum reduced phosphorous release by more than 80%. However, the concentration of ${SO_4}^{2-}$ in the water column increased, making it difficult to apply it to the drinking water protection zone. We developed Fe-Gypsum and $SiO_2$-gypsum materials to reduce the solubility of ${SO_4}^{2-}$. Powder-Gypsum creates the interception film that does not have any aperture on the sediment layer when it is combined with the water. However phosphorous release caused by the generation of $CH_4$ gas may happen at a time when the gypsum layer has the crack. Capping through the complex layer(granule-Gypsum+sand(1 cm)) found to be suitable for the drinking water protection zone because it was effective to prevent phosphorus release. Moreover, this leads to the lower solubility from the concentration of ${SO_4}^{2-}$ into the water column than the powder-Gypsum and granule-Gypsum. The addition of gypsum($CaSO_4{\cdot}2H_2O$) into the sediment can reduce the progress of methanogensis because fast early diagenesis and sufficient supply of ${SO_4}^{2-}$ to the sediment, stimulate the SRB(sulfate reducing bacteria) highly.
Kim, Kwan-Hyoung;Oh, Yong-Seok;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
Tuberculosis and Respiratory Diseases
/
v.39
no.3
/
pp.219-227
/
1992
Background: Acute and chronic airway inflammation are important in the pathogenesis of bronchial asthma. Corticosteroids have proved to be very effective in the management of asthma. Although the mechanism by which they produce this effect is still debated, suppression of the inflammatory response is thought to be the most likely. Although inhaled steroids are known to be safe and have less side effects than oral steroids, the extent which inhaled steroids have beneficial and the detrimental effects in the treatment of asthma has remained open to question. Budesonide is a recently developed corticosteroid for inhalation treatment with a strong local effect combined with rapid inactivation in the systemic circulation. We set out to look in more detail at the time course of change in bronchial reactivity, clinical symptoms and the effects on the adrenal function during 6 weeks of treatment with budesonide (800 ug per day). Methods: Clinical symptoms, pulmonary function test, histamine $PC_{20}$, serum ACTH and cortisol (8 AM and 4 PM) were measured in 23 allergic asthmatic patients before and after 6 weeks of treatment with budesonide. Results: 1) Pulmonary function test; PEFR, FEV1 and FVC after 6 weeks of treatment with budesonide were higher than those before treatment. 2) Clinical symptoms; Clinical symptoms were significantly improved after 3 weeks and 6 weeks of treatment with budesonide. 3) Histamine provocation; Histamine $PC_{20}$ after 6 weeks of treatment with budesonide was significantly higher than that before treatment. 4) Adrenal function; 6 weeks of budesonide therapy did not significantly affect the level of serum ACTH and cortisol. Conclusion: From these results, it is concluded that budesonide therapy improved the clinical symptoms, pulmonary function and bronchial hyperreactivity after 3 weeks of treatment and the improvement after 6 weeks of treatment was higher than that after 3 weeks of treatment. During 6 weeks of treatment with budesonide, the inhibitory effect on the adrenal function was not obvious.
Park, Seung-Kyu;Lee, Woo-Chul;Hwang, Soo-Hee;Kwon, Eun-Si;Lee, Hung-Soon;Lee, Duk-Hyoung
Tuberculosis and Respiratory Diseases
/
v.53
no.4
/
pp.389-400
/
2002
Background : The rapid diagnostic tests for tuberculosis are needed to facilitate early treatment of tuberculosis and prevention of Mycobacterium tuberculosis transmission. The Xeniss Rapid TB kit is a rapid, card-based immunochromatographic test for the detection of antibodies directed against M. tuberculosis antigens including antigen 5(38-kDa antigen). The objective of this study was to evaluate the performance of the Xeniss Rapid TB kit for the diagnosis of active tuberculosis with serums from patients, asymptomatic healthy and close contact controls. Methods : 188 patients with active tuberculosis were tested; 177 with pulmonary tuberculosis(18 with combined pleurisy), and 11 with extrapulmonary tuberculosis. The control groups were composed of 82 close contacts and 57 healthy adults. Study subject were drawn from one national tuberculosis hospital for patients and close contacts, and another private hospital for healthy adults in Masan city, Korea. The Xeniss Rapid TB kit(Xeniss Life Science Co., Ltd., Seoul, Korea) was evaluated by using serum samples according to the instructions of the manufacturer by an investigator masked to the clinical and microbiological status of the study subjects. Results : The diagnostic sensitivity of the Xeniss Rapid TB kit was 73.9% in patients and specificities were 73.2% and 93.0% in close contact and healthy adults respectively. The positive predictive value in patients was 84.2% and the negative predictive value in controls was 85.8%. Conclusion : This study shows that the Xeniss Rapid TB test is a simple and fast method to diagnose active TB. The results of the sensitivity and specificites suggest that serodiagnosis using this point of care testing(POCT) device would be valuable and advantageous for screening tuberculosis in the clinical field.
KSCE Journal of Civil and Environmental Engineering Research
/
v.31
no.3A
/
pp.235-249
/
2011
A new form of I-type PSC bridge girder, which has hole in the web, is proposed in this paper. Three different concepts were combined and implemented in the design. First of all, a girder was precast at a manufacturing plant as divided pieces and assembled at the construction site using post-tensioning method, and the construction period at the site will be reduced dramatically. In this way, the quality of concrete can be assured at the manufacturing factory and concrete curing can be well controlled, and the spliced girder segments can be moved to the construction site without a transportation problem. Secondly, a numerous number of holes was made in the web of the girder. This reduces the self-weight of the girder. But more important thing related to the holes is that about half of the total anchorages can be moved from the girder ends into individual holes. The magnitude of negative moment developed at girder ends will be reduced. Also, since the longitudinal compressive stresses are reduced at ends, thick end diaphragm is not necessary. Thirdly, Prestressing force was introduced into the member through multiple stages. This concept of multi-stage prestressing method overcomes the prestressing force limit restrained by the allowable stresses at each loading stage, and maximizes the magnitude of applicable prestressing force. It makes the girder longer and shallower. Two 50 meter long full scale girders were fabricated and tested. One of them was non-spliced, or monolithic girder, made as one piece from the beginning, and the other one was assembled using post-tensioning method from five pieces of segments. It was found from the result that monolithic and spliced girder show similar load-deflection relationships and crack patterns. Girders satisfied specific girder design specification in flexural strength, deflection, and live load deflection control limit. Both spliced and monolithic holed web post-tensioned girders can be used to achieve span lengths of more than 50m with the girder height of 2 m.
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