Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous inflammation, which was compatible with tuberculosis, Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin inpatients with severe diarrhea receiving anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.
Background : Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. Method : The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. Results : 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, an S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltration in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). Conclusion : Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from thase reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.
Kim, Byung-Il;Cho, Chul-Ho;Kang, Shin-Wook;Cheon, Seon-Hee;Jang, Sang-Ho;Lee, Jang-Hoon;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
Tuberculosis and Respiratory Diseases
/
v.38
no.2
/
pp.155-163
/
1991
Bronchoalveolar lavage had been done as the treatment of some diseases such as alveolar proteinsois, bronchiectasis, and severe asthma to remove excessive secretion or mucus. But in the recent decade it has been done as a diagnostic method and a tool to understand and evaluate the pathophysiology of diffuse interstitial lung diseases such as sarcoidosis, pneumoconiosis and hypersensitivity pneumonitis. To analyse the bronchoalveolar fluid, it might be useful to have a standard reference (especially cell counts and differetial count of the cells from bronchoalveolar lavage fluid) of normal person. But it is difficult to study the normal volunteers. We investgated the bronchoalveolar lavage fluid of 48 patients (28 nonsmokers, 20 smokers) who visited Severance Hospital because of minor pulmonary symptoms such as cough and sputum. They did neither complain of dyspnea nor cyanosis, and had normal or unilateral minor lesion on physical examination and chest X-ray. We analysed the recovery rate, viability, total cell count and differential count of the cells in fluid obtained by bronchoalveolar lavage. The following results were obtained: 1) Age ranged from 17 to 72 years-old with the mean age of 36.7; there was no difference of age between the nonsmoker and the smoker gorup. Male to female ratio was 2.43:1 for total group, 1.15:1 for nonsmokers, and 19:1 for smokers. 2) The diagnoses of the patients were undetermined in 41.9%, healed pulmonary tuberculosis in 37.5%, laryngitis or pharyngitis in 10.4% and others in 10.4%. 3) Total cell number of the recovered fluid by bronchoalveolar lavage was significantly higher in male[$9.6{\pm}6.2({\times}10^6)$] than in female[$5.1{\pm}3.0({\times}10^6)$](p<0.05), and there was no significant difference in the total cell number between the smokers and nonsmokers [$9.3{\pm}5.8({\times}10^6)$ vs $7.5{\pm}5.8({\times}10^6)$]. 4) The differential count of the cells from bronchoalveolar lavage fluid had no difference between the nonsmokers and the smokers. 5) There was no correlation between the total cell count and smoking or age. 6) In the smoker group, there was no correlation between the amount of smoking and the total cell count of the bronchoalveolar fluid. In conclusion, it should be careful to regard the patients with symptoms or minor radiologic abnormalities as a control group in bronchoalveolar lavage study and further study of cell analysis in bronchoalveolar lavage will be needed between smoker and nonsmoker in the male and female healthy people.
Kim, Hyun-Jin;Hyun, Hong-Keun;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taeg
Journal of the korean academy of Pediatric Dentistry
/
v.37
no.1
/
pp.91-96
/
2010
Many studies have shown that there is a strong relationship between the congenitally missing primary teeth and their succedaneous permanent teeth. However, especially in case of lower anterior region, we can observe the existence of permanent teeth even though their precedent primary teeth were missed at times. The purpose of this study was to reveal the relationship between the congenitally missing primary lower anterior teeth and their succedaneous permanent teeth in Korean children. Total of 14,307 children, under 6 years of age, who attended the department of pediatric dentistry, Seoul National University Dental Hospital, Seoul, Korea from January 1st 2005 to September 5th 2008 were radiologically examined using the panoramic x-ray in order to analyze the relationship between the congenitally missing primary lower anterior teeth and their succedaneous permanent teeth. The results were as follows : 1. The prevalence of congenitally missing lower anterior teeth in primary dentition was 0.24%. The odds ratio of both the primary and permanent anterior teeth being present was 7163.5 and only the permanent anterior teeth being present was 0.79. 2. The percentage of all succedaneous permanent teeth being present was 44.12% in cases of missing lower primary anteriors. The odds ratio of at least one succedaneous permanent teeth being present in cases of bilateral primary anterior teeth missing was 1.57 times more common than in cases of unilateral primary teeth missing. 3. The odds ratio of primary missing teeth being unilateral was 2.2 times higher in females. Moreover, the odds ratio of succedaneous permanent teeth being present in cases of primary teeth missing was 2.22 times higher in males.
Kim, Joung-Ryul;Park, Jong-Sung;Choi, Young-Youn;Song, Oh-Sung
Journal of the Korean Vacuum Society
/
v.17
no.6
/
pp.528-537
/
2008
60 nm and 20 nm thick hydrogenated amorphous silicon(a-Si:H) layers were deposited on 200 nm $SiO_2$/single-Si substrates by inductively coupled plasma chemical vapor deposition(ICP-CVD). Subsequently, 30 nm-Ni layers were deposited by an e-beam evaporator. Finally, 30 nm-Ni/(60 nm and 20 nm) a-Si:H/200 nm-$SiO_2$/single-Si structures were prepared. The prepared samples were annealed by rapid thermal annealing(RTA) from $200^{\circ}C$ to $500^{\circ}C$ in $50^{\circ}C$ increments for 40 sec. A four-point tester, high resolution X-ray diffraction(HRXRD), field emission scanning electron microscopy(FE-SEM), transmission electron microscopy(TEM), and scanning probe microscopy(SPM) were used to examine the sheet resistance, phase transformation, in-plane microstructure, cross-sectional microstructure, and surface roughness, respectively. The nickel silicide from the 60 nm a-Si:H substrate showed low sheet resistance from $400^{\circ}C$ which is compatible for low temperature processing. The nickel silicide from 20 nm a-Si:H substrate showed low resistance from $300^{\circ}C$. Through HRXRD analysis, the phase transformation occurred with silicidation temperature without a-Si:H layer thickness dependence. With the result of FE-SEM and TEM, the nickel silicides from 60 nm a-Si:H substrate showed the microstructure of 60 nm-thick silicide layers with the residual silicon regime, while the ones from 20 nm a-Si:H formed 20 nm-thick uniform silicide layers. In case of SPM, the RMS value of nickel silicide layers increased as the silicidation temperature increased. Especially, the nickel silicide from 20 nm a-Si:H substrate showed the lowest RMS value of 0.75 at $300^{\circ}C$.
We have investigated optical and structural properties of $Al_{0.3}Ga_{0.7}N$/GaN and $Al_{0.3}Ga_{0.7}N/GaN/Al_{0.15}Ga_{0.85}N/GaN$ heterostructures (HSs) grown by metal-organic chemical vapor deposition, by means of Hall measurement, high-resolution X-ray diffraction, and temperature- and excitation power-dependent photoluminescence (PL) spectroscopy. A strong GaN band edge emission and its longitudinal optical phonon replicas were observed for all the samples. At 10 K, a 2DEG-related PL peak located at ${\sim}\;3.445\;eV$ was observed for $Al_{0.3}Ga_{0.7}N$/GaN HS, while two 2DEG peaks at ${\sim}\;3.42$ and ${\sim}\;3.445\;eV$ were observed for $Al_{0.3}Ga_{0.7}N/GaN/Al_{0.15}Ga_{0.85}N/GaN$ HS due to the additional $Al_{0.15}Ga_{0.85}N$ layers. Moreover, the emission intensity of the 2DEG peak was higher in $Al_{0.3}Ga_{0.7}N/GaN/Al_{0.15}Ga_{0.85}N/GaN$ HS than in $Al_{0.3}Ga_{0.7}N$/GaN HS probably due to an effective confinement of the photo-excited holes by the additional $Al_{0.15}Ga_{0.85}N$ layers. The 2DEG-related emission intensity decreased with increasing temperature and disappeared at temperatures above 150 K. To investigate the origin of the new 2DEG peaks, the energy-band structure for multiple AlGaN/GaN HSs were simulated and compared with the experimental data. As a result, the observed high- and low-energy peaks of 2DEG can be attributed to the spatially-separated 2DEG emissions formed at different AlGaN/GaN heterointerfaces.
Effects of soaking time and particle size on physicochemical properties of nonwaxy rice flour were investigated. Nonwaxy rice grains were soaked at $4^{\circ}C$ for 0, 1, 12, and 24 hr, dried at room temperature, and milled, Resulting flours were passed through 45-mesh ($<355{\mu}m,\;IL45$) and 100-mesh ($<150{\mu}m\;IL100$) sieves and separated into $<40{\mu}m\;and\;40-100{\mu}m$ series. IL45 series showed higher amount of large particles ($40-100{\mu}m$) than IL100 series. As the soaking time increased, protein and ash contents decreased, and amylose content, water-binding capacity, swelling power, and solubity of nonwaxy rice flours increased. Swelling power and solibility of nonwaxy rice flours also increased between $65-85^{\circ}C$. Water-binding capacity, swelling power, and solubility of IL100 series were higher than those of IL45 series. 12 hr-soaked nonwaxy rice flour pastes showed higher peak viscosity and breakdown but lower setback and visicosity at $95\;and\;50^{\circ}C$ than 1 hr-soaked ones. X-Ray diffractograms of nonwaxy rice flours were not affected, whereas surface appearance was affected, by soaking time and particle size.
The chemical and optical absorption spectroscopic characters of pink and colorless tourmalines from San Diego mine in California, U.S.A., blue/green tourmalines from anonymous mine, Brazil, and brownis black tourmalines from Uncheon and Haksan mines in Korea have been studied using X-ray diffractometer, electron microprobe, optical absorption spectroscopy, and heat treatment. Least-squares refinements give unit cell diminsions : a = 15.96-16.01 ${\AA}$, c = 7.15-7.16 ${\AA}$ for the brownish black tourmalines, a = 15.82 - 15.87 ${\AA}$, c = 7.09 - 7.10 ${\AA}$ for pink tourmalines, and a = 15.88 - 15.94 ${\AA}$, c = 7.12 - 7.15 ${\AA}$ for blue green tourmalines. The colors of tourmalines are responsible for the transition elements. The pink color is attributed to the $Mn^{3+}$ ions, the blue-green to $Fe^{2+}$ and $Mn^{2+}$, bluish green to $Cu^{2+}$, and the brownish black to $Fe^{2+}$, $Fe^{2+}$ - $Fe^{3+}$, and $Fe^{2+}$ - $Ti^{4+}$. The $Mn^{3+}$ ions of pink color tourmalines are stabilized in the Y sites compressed along the O(1)H-O(3)H axis by Jahn-Teller distortion. Heating removes the pink or red component from tourmalines, producing the colorless stones from the pink and red ones. The bluish green samples change into the greenish blue ones and a certain yellowish green samples change into the light green ones by heat treatment. In the elbaite-schorl series, the concentration of Fe and Mn are variable depending on the color zones. The green zone is characterrized by the high content of Fe and Mn are variable depending on the color zones. The green zone is characterized by the high content of Fe, whereas the pink zone by the high content of Mn. Mn increases in deep yellow zone compared with yellow or colorless zones.
Lee, Ghie Dong;Shin, Min Ki;Lee, Kang Wan;Cho, Yu Ji;Kim, Ho Chul;Hwang, Young Sil
Tuberculosis and Respiratory Diseases
/
v.54
no.5
/
pp.563-569
/
2003
Background : Pleural effusions with high amylase levels are reported frequently in patients with pancreatic diseases, a rupture of the esophagus and a malignancy. However, there is no data available on the clinical features of an amylase-rich pleural effusion in Korea. This report describes the causes of the high amylase levels in a pleural effusion and analyzes its association with malignancy. Methods : The records of patients with an amylase-rich pleural effusion who were assessed at the Gyeongsang National University Hospital from January 1998 to August 2002 were examined retrospectively, and the distribution of amylase levels in those patients, the causative diseases, and the histological type in the case of a malignancy were analyzed. Among the 532 patients whose pleural effusion was evident on a chest X-ray, there were 36 cases with an amylase-rich pleural effusion. The amylase levels were determined by an enzyme method (Hitach 747 autoanalyzer). Results : Of the 36 patients with an amylase-rich pleural effusion, there were 18 patients(50%) associated with a malignancy, 8 patients(22%) with a parapneumonic effusion, 7 patients(19%) with pancreatic disease, and 3 patients with other causes. The amylase level in a pleural effusion due to pancreatic disease was much higher than that due to other causes(p<0.01). Among the malignant pleural effusions with high amylase levels, the origin of the malignancy was a primary lung cancer in 13 cases and metastatic lung cancer in 5 cases. The histological types of malignant causes were adenocarcinoma in 10 cases(56%), squamous cell carcinoma in 2 cases(11%) and unknown type of carcinoma in 6 cases. The amylase level in the adenocarcinoma cases was much higher than that in the other cell type carcinomas(p<0.01). There was no significant association between the amylase level and the glucose level among the malignant cases with amylase-rich pleural effusion(p=0.21). Conclusion : The most frequent cause of an amylase-rich pleural effusion was a malignancy. Primary lung cancer and adenocarcinoma were the most common malignancies and histological types associated with a malignant pleural effusion with high amylase levels. The amylase level in a pleural effusion secondary to pancreatic disease was much higher than from any other causes.
Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75~80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000. Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals. We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors. Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean body-mass-index was $20.2kg/m^2$. None of the patients tested positive for HIV. Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation. Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159). Default rate was high, 21.8% (37/170). Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality. Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data. The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high. Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea.
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