To find out differential points between benign and malignant pleural disease.

We retrospectively analyzed the CT scans of 33 patients(20 men and 13 women ; mean age, 56) with pleural diseases including 12 malignant diseases(lung cancer(n=10), metastasis(n=2)) and 21 benign diseases(tuberculous empyema(n=12), bacterial empyema(n=7), hemothorax related exudate(n=2)).

In malignant diseases, irregular(n=3) or nodular(n=3), and mediastinal pleural thickening(n=6) were observed but extrapleural fat accumulation or pleural calcification were not.

In benign diseases, irregular pleural thickening was not observed in bacterial empyema but in tuberculous empyema(n=3) and hemothorax related exudate(n=1). Mediastinal pleural thickening and extrapleural fat accumulation were observed in tuberculous(n=5, 5) and bacterial(n=2, 2) empyema and hemothorax related exudate(n=1, 2) and pleura calcification was observed in tuberculous(n=3) and bacterial(n=2) empyema.

Findings of irregular or nodular pleural thickening were observed only in malignant disease with exception of tuberculous empyma and hemothorax related exudate. Extrapleural fat accumulation and pleural calcification were observed only in benign disease.

Helicobacter pylori infection is now recognized as a cause of chronic gastritis, peptic ulcer disease and is also a major risk factor for development of gastric carcinoma and gastric lymphoma. Several diagnostic methods of H. pylori infection, such as histopathology, Giemsa stain, culture, rapid urease test, urea breath test and serologic test have been used. Recently, the polymerase chain reaction(PCR) assay has provided a means of rapid and sensitive detection of H. pylori. This study aimed to evaluate PCR assay for the diagnosis of H. pylori infection.

I compared the PCR assay using the ureC gene specific for H. pylori with culture in gastric biospy specimens from 30 chronic gastritis, 10 gastric ulcer and 41 duodenal ulcer patients and evaluated the positive rates of H. pylori according to the gastroduodenal diseases.

Fifty-seven out of 81(70%) patients were culture positive and 64 out of 81(79%) patients were PCR positive. In seventy-two out of 81 patients, PCR was concordant with culture, but 8 patients had only positive-PCR and one patient had only positive-culture. Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficiency of culture were 85%, 100%, 100%, 58% and 88%, respectively and those of PCR were 96%, 100%, 100%, 82% and 96%, respectively. The positive rates of H. pylori using PCR were 73%, 90% and 80% and those using culture were 63%, 90% and 71% in chronic gastitis, gastric ulcer and duodenal ulcer patients, respectively.

These findings suggest that the PCR assay using the ureC gene in gastric biopsy is more sensitive and rapid than culture and an effective test for the diagnosis of H. pylori infection.

Levofloxacin, an oral fluroquinolone antibacterial agent, is the optical S-(-) isomer of ofloxacin. In vitro it is generally twice as potent as ofloxacin and active against most aerobic gram positive and gram negative organisms, but only moderate activities against anaerobics.

Our purpose was to investigate the therapeutic efficacy and tolerability of levofloxacin in patients with several kinds of cutaneous infections.

Levofloxacin(CRAVIT®; Korea Daiich Parm. Co.) 300-600mg/day for 5-14days was administrated to eighteen patients with cutaneous and subcutaneous infections. The Bacterial culture and laboratory tests were performed prior to and after treatments. Clinical effects and adverse events were evaluated on laboratory indics.

1) Nine of thrteen cases(70%) were useful, four cases(30%) were slightly useful.

2) Clinically twelve of eighteen cases were cured and eight cases were partial response to the drug.

3) There were no laboratory abnormalities after levofloxacin treatment

4) Side effects were not significant except dizziness and sleep disturbance.

Levofloxacin was evaluated as a highly effective antibacterial agent against dermatologic infections.

Experiment was designed to compare cellular profile of bronchoalveolar lavage following induced bacterial infection, acute rejection and acute rejection plus bacterial infection after lung allotranplantation.

After single lung allotransplantation, dogs were immunosuppressed with standard triple therapy and divided into 4 groups. Group I(n=4) was maintained on immunosuppression as controls. In group II(n= 6), infection was induced by bronchoscopic inoculation of E. coli at postoperative day 5. In group III(n=6), triple therapy was discontinued to induce acute rejection from postoperative day 5. In group IV(n= 8), triple therapy was discontinued and bacterial infection was induced by bronchoscopic inoculation of E coli at postoperative day 5.

At postoperative day 9, bronchoalveolar lavage was obtained in the native and transplanted lung resprctively through bronchoscopy. Total cell count and differential cell count of bronchoalveolar lavage were compared in four groups.

In the native lung, there was no significant difffrence in total cell count and differential cell count in four groups. In the transplanted lung, total cell count of group II(Infection) was increased, compared to group III(Rejection) (p <0.05). In the transplanted lung, differential neutrophil count of group II(Infection) and group III(Rejection) were increased, compared to group I(Immunosuppression) (p <0.05). In the transplanted lung, differential macrophage count of group II(Infection), III(Rejection) and IV(Rejecion plus Infection) were decreased, compared to group I(Immunosuppuression) (p<0.05).

Cellular profile of bronchoalveolar lavage reflected the pathological process ofinfection or acute rejection following lung allotransplantation in the transplanted lung. But conventional total and differential cell counts had limitation to differentiate either process.

This study was aimed to investigate whether there is any change in palsma nitric oxide during acute rejection of infection after lung allotransplantation.

After lung allotransplantation, dogs were immunosuppressed with standardized triple therapy and divided into 3 groups : in group 1(control: n=4), immunosuppression was maintained; in group 2(n=7), triple therapy discontinued to induce acute rejection at the postoperative day 5; in group 3(n=6), infection was inudced by bronchoscopic inoculation of E. coli at the postoperative day 5. Plasma nitric oxide was measured by chemiluminescene method prior to surgery(day 0), and at postoperative day 5 and 9. In each group, plasma nitric oxide level at day 9 was compared to that at day 0. Plasma nitric oxide levels at day 9 were compared in three groups.

During acute rejection period, plasma nitric oxide concentration was found to be elevated significantly at postoperative day 9, compared to day 0(11.52±2.58 vs 6.01±0.88uM/L ; p<0.05). However, plasma nitric oxide concentration wasn't altered by the E. coli-induced infection(14.53±5.19 vs 6.12±0.98uM/L ; p>0.05). Plasma nitric oxide of day 9 weren't different in three groups(p>0.05).

Plasma nitric oxide may be a good marker for acute rejection after allotrans-plantation, but not for infection.

Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions.

We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65).

The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) and their resistance rates to carbapenem, while there were significant differences between the 2 groups in the bacterial species (Acinetobacter baumannii) and its resistance rate to carbapenem.

In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for A. baumannii infection unlike other bacterial infections. Further studies on risk factors and patient classification are needed to confirm our results.

Vaginal pH change is known as one of the risk factors for recurrent lower urinary tract infection in female. The objective of this study was to analyze the correlation between lower urinary tract infection & overactive bladder revelation and vaginal pH by age group.

Subjects were schizophrenic out-patients, who fufilled DSM-IV diagnostic criteria, and their families.

This study found a positive correlation between age and vaginal pH(p=0.000). It also found that the contraction of cystitis patients was high in older age group(p=0.035). However, vaginal pH was not a significant factor to the contraction of cystitis(p=0.258). In older age group, the number of overactive bladder patients was higher than that of younger age group(p=0.05), while vaginal pH was not a significant factor to the contraction of overactive bladder(p=0.376).

Diseases that cause lower urinary tract symptom such as overactive bladder and recurrent cystitis increase in proportion to age. Vaginal pH also increases in proportion to age. However, vaginal pH is not a significant factor to the contraction of lower urinary tract symptom when the age is revised.

To evaluate the CT findings of pulmonary tuberculosis in diabetic patients compared with patients without underlying disease.

The chest CT scans of pulmonary tuberculosis in 23 diabetic patients(M : F=21 : 2 ; mean age, 59 yrs.) and in 24 nondiabetic patients(M : F=12 : 12 ; mean age, 48 yrs.) were retrospectively analyzed by two radiologists ; decisions were reached by consensus.

The frequencies of consolidation(100%, 42%), inhomogeneity of consolidation(70%, 21%), multiple small low-density areas(52%, 13%), cavitation(70%, 25%), multiple small cavity(35%, 4%), bizarre-shaped cavity(22%, 0%), air-bronchogram(95%, 54%) were significantly more common in pulmonary tuberculosis in diabetic patients than in nondiabetic patients(p<.05). There was no significant difference in localization of pulmonary lesions between diabetic and nondiabetic patients.

Diabetic patients have a high prevalence of inhomogeneous consolidation containing multiple small low densities and multiple or bizarre-shaped cavities than do patients without diabetics.