• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.907-913
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• 1997

Background : Congenital bronchoesophageal fistula(BEF) presented in adult life is a rare disorder and has characteristic clinical findings such as paroxysmal cough after water ingestion and recurrent respiratory infections. It usually manifested recurrent pneumonia and chronic cough with purulent phlegmon which was mis-or under-diagnosed as chronic bronchitis, bronchiectasis or lung abscess so forth. Methods : We reviewed retrospectively 13 cases of congenital BEF in adult of Paik Hospital, College of Medicine, Inje University including 22 cases of congenital BEF previously reported in literature of Korea from 1979 through 1995. Results : The mean age at diagnosis was $40.2{\pm}14.3$. There was no difference in sex ratio(Male : Female 18 : 17). The most common symptom was cough(91.4%), followed by chronic sputum(74.3), hemoptysis(25.7), and paroxysmal nocturnal cough at specific position(20%). Twenty one of 31 patients who were able to review have the most specific sign, Ono's sign presented as paroxysmal cough after liquid ingestion. By classification of Braimbridge-Keith, Fourteen(45.1%) of 31 patients were group I (associated with esophageal diverticulum), 15(48.4%) were group II (simple fistula), and group Ill and IV was one case in each. The opening of fistula confined to right lower lobe in 26(76.5%), left lower lobe in 6(17.6%), and left main bronchus in 2(5.9%) cases. Conclusion : Congenital bronchoesophageal fistula is uncommon disorder which has characteristic histories and specific symptoms such as chronic and recurrent lower respiratory infections, and paroxysmal cough after liquid ingestion. Medical attention and careful history should be done in patients who have localized recurrent lower respiratory infections in right lower lobe.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1125-1131
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• 1997

Occult papillary adenocarcinoma of the thyroid is known to be indolent, slow metastatic, and has a good prognosis. Occult thyroid carcinoma presenting as a blood-borne metastasis without obvious cervical lymph node involvement is extremely rare. A 65-year-old male patient was visited for hoarseness, dysphagia, and shortness of breath. Bronchoscopy with biopsy revealed a papillary carcinoma of thyroid by immunohistochemical staining. Head & neck CT revealed that involving both the upper esophagus and the posterior tracheal wall, extending into the mediastinum along the upper thoracic spine at $T_1-T_2$. We have experienced a rare case of occult papillary carcinoma which invaded the trachea, esophagus and fascia of thoracic spine. Treatment was initiated with radioactive iodine and external bean therapy.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.812-817
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• 1996

There were so many causes of chronic coughing including postnasal drip, pneumonia, nasal polyp, asthma, interstinal lung disease etc. Congenital bronchoesophageal fistula was not usually thought as cause of chronic coughing. A 46-year-old female patient suffered from chronic coughing without usual causes. Her chest X-ray viewed normally. She coughed especially after swallowing foods. So we recommended her esophagogram and it revealed broncho-esphageal fistula. She underwent surgical resection of broncho-esophageal fistula. She was well without cough after the surgery. We reported a case of congenital broncho-esphageal fistula that had caused chronic coughing without any evidence of pneumonia, malignancy, tuberculosis, bronchiectasis, inflammation, asthma, nasal polyp, etc. So we should suspect the bronchoesophageal fistula when patients cough chronically with eating, and recommend the esophagogram.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.639-648
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• 1997

Background : Arterial hypoxemia has been noted in patients with liver cirrhosis because of bronchial vessel dilatation. Cabenes et al. reported that bronchial hyperresponsiveness to the metacholine inhalation was observed in patients of left side heart failure, he suggested that one of the mechanism was bronchial vessel dilatation. We hypothesized that patients of liver cirrhosis might have bronchial hyperresponsiveness to metacholine inhalation due to portal hypertension. We evaluate the relationship between bronchial responsiveness and severity of liver cirrhosis, severity of portal hypertension. Methods : In the 22 patients of the liver cirrhosis with clinical portal hypertension, metacholine provocation test was done and determined $PC_{20}FEV1$. We classified liver cirrhosis according to Pugh-Child classification. Esophagogastroscopies were performed for the evaluation of the relationship between bronchial hyperresponsiveness and severity of esophageal varix. Results : In the 22 cases of the liver cirrhosis with clinical portal hypertension. The causes of liver cirrhosis, alcoholic hepatitis was 9 cases, hepatitis B virus was 12 cases, hepatitis C virus was 1 case, and 151 cases (68.18%) of total 22 cases were positive in metacholine provocation test. In positive cases. There was no significant relationship between $PC_{20}FEV1$ and severity of liver cirrhosis which were classified by Pugh-Child classification or severity of esophageal varix(p<0.05). Conclusion : we observed that bronchial responsiveness to metacholine increased in the patients of liver cirrhosis and there was no significant relationship between the severity of liver cirrhosis and the severity of esophageal varix.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.8.2-8
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• 1982

Hoarseness is the change of voice quality which represents the abnormal function of phonation and is the main symtom of the laryngeal diseases. The etiology of hoarseness are known more than 50 causes, among them, viral upper respiratory infection is the main cause of hoarseness and the laryngeal nodule and polyp, laryngeal paralysis, laryngeal cancer, laryngeal papilloma and the laryngeal tuberculosis are the other causes of hoarseness in that order. Recently, the authors experienced 4 cases of uncommon etiology of hoarseness, so we present the cases with the brief review of literatures. Case 1. 29 years old male Admitted in Dept. of neurosurgery due to Traffic Accident. He had a trauma on the anterior neck. Hoarseness was developed on 1 month after the accident. Laryngoscopic finding; Paramedian paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 2. 53 years old male Admitted in Dept. of General Surgery due to Clonorchis Sinensis, under the general endotracheal anesthesia, Choledochostomy was performed. Laryngoscopic finding; Median paralysis of left vocal cord. Case 3. 56 years old male Admitted in Dept. of Internal Medicine due to Aortic Aneurysm. Hoarseness was developed on 3 months prior to admission. Laryngoscopic finding; Intermediated position paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 4. 74 years old male Admitted in Dept. of Internal Medicine due to Bronchogenic carcinoma. Hoarseness was developed on 3 years prior to admission. Laryngoscopic finding; Paramedian paralysis of right vocal cord.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.137-142
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• 2006

Background: Recent studies have suggested an association between chronic cough and gastroesophageal reflux. Our study aimed to assess the utility of a proton-pump inhibitor in unexplained chronic cough patients. Methods: Patients with chronic cough of unknown etiology were evaluated using a chest x-ray, methacholine challenge test, and an empirical trial of postnasal drip therapy. After excluding other potential causes of the cough, forty patients were included in the study and treated for 8 weeks with a proton-pump inhibitor. Results: Eleven and three patients in the first and second 4 weeks were lost to follow-up, leaving twenty-six patients finally included in the study. Of these patients, two were unimproved, eight partially responded to the proton-pump inhibitor and sixteen responded completely after the 8 week treatment. Conclusion: We suggest that empirical treatment with a proton pump inhibitor in all patients with persistent cough, which is not secondary to asthma or postnasal drip syndrome, represents a practical and simple approach to this ailment.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.5.1-5
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• 1978

Since Ikeda in traduced flexible fiberoptic bronchoscope in 1968, use of bronchoscopy was expanded rapidly. Wide use of flexible bronchoscopy enabled us to get tissue diagnosis with more ease and safety. Authors analyzed 71 cases of tissue biopsy of 233 bronchoscopies from June '76 to. Jan. '78 and concluded as following : 1. 233 bronchoscopies af 20 Month duration, cases which needed tissue biopsy were 71 cases (30.5%). 2. Chief complaints af above cases are coughing, dyspnea, sputum, chest pain, hemoptysis in frequency. 3. Biopsy sites were as following in frequency: Rt.upper lobe, Lt. main bronchus, Lt. upper lobe, Rt. main bronchus, Lt. lower lobe. 4. The final diagnosis of biopsied cases were cancer 80%, tuberculosis 15%, and malignant mesothelioma, anthracosis, aspergillosis, were one case each. 5. Among 57 case of lung cancer, biopsy confirmed cases were 36 cases (63%). 6. Pathologic finding of 36 case of Biopsy confirmed lung cancer was as following: Squamous cell ca : 64% Anaplastic ca : 25% Adeno ca : 2.8% Unclassified: 2.8% 7. Bronchographies were done in 36cases (51%), one quarter of cases before biopsy, and three quarters of cases after biopsy. 8. Cytology was requested in 76% of cases with following results; PAP class V 15%, class IV 7.5%, class III 1.8%.

• Tuberculosis and Respiratory Diseases
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• v.50 no.4
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• pp.493-498
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• 2001

Lung involvement in systemic sclerosis(SSC) is common but usually occurs late in the course. Skin changes usually occur before the pulmonary findings. In this report, a patient who developed pulmonary interstitial fibrosis without skin changes is presented. A diagnosis of SSC lung involvement was made histologically. The a nti-scl-70 antibody test was positive. Esophageal manometry revealed a lower amplitude in the lower two-third of the esophagus and pressure in the lower esophageal sphincter. Here we report a case of systemic sclerosis sine scleroderma presenting as pulmonary interstitial fibrosis with a review of the relevant literatures.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.6.2-7
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• 1977

Hoarseness, caused by any condition that interfers with normal phonatory function of larynx, is the most important symtom of the laryngeal disease. The air pollution is the serious social problom today due to irritation of the respiratory mucosa and secondary respiratory disease. It is significant to study whether, in resent years, the patients with complant of hoarseness has being increased or decreased, compare to past years. The authors report a statistical analysis on 400 cases with chief complain of horseness at the Department of Otolaryngology, Hanil Hospital during past 7 years from Jan. I, 1970 to Dec. 31, 1976. The results were as follows; 1) Among total out patients of 14, 731 who visited to the department of otolaryngology, the patients with hoarseness numbered to 400(2.7%). 2) Among total of 400 cases, male were 211 and female were 189. The incidence was slightly higher in male than female with ratio 1.1 to 1 in sex distribution. 3) The uderlying diseases causing hoarseness in order of frequency were Acute Laryngitis (158 cases, 39.5%), Chronic Laryngitis (103 cases, 27.3 %), Vccal Nodule (37 cases, 9.3%), Vocal cord paralysis (34 cases, 8.5%), Laryngeal Polyp (32 cases, 8%), Laryngeal Ca. (13 cases, 3.5%), and Laryngeal Tbc. (9 cases, 2.3%). Particulary, Laryngeal Ca., Laryngeal polyp and Laryngeal Papilloma were extremely high in male but the remainings were equally distributed in sex group distribution. 4) The highest incidence occurred in 3rd decade (113 cases, 28.5%), the next 4th and 2nd decade in the age group distribution. Acute and Chronic Laryngitis were widely distributed in age group distribution but the highest incidence was noted between 3rd and 4th decade (145 cases, 55.5%). The highest incidence was 3rd decade in Laryngeal polyp, 3rd and 4th decade in Vocal Nodule, 4th and 5th decade in Laryngeal Tbc. and Vocal cord paralysis and 5th decade in Laryngeal Ca. 5) The underlying disease causing hoarsness were evenly occurred in monthly distribution but relatively high incidence was observed between April and June (35.5%) compared to winter. 6) In durational distribution, the highest incidence was within 10 days (26%) from onset to consultation. 317 cases (80%) were visited to the clinic within 1 year.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.6.4-7
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• 1983

Hoarseness is the most common and early symptom in laryngeal diseases. A clinico - statistical analysis was performed on 228 cases with chief complaint of hoarseness at the department of otolaryngology, Jeonbug National University during the past 3 years from January 1980 to December 1980. 1) The number of the patient with hoarseness were 228 cases (2.3 %) among total outpatient of 10110 cases. 2) Among the 228 cases with hoarseness, male were 115 cases and female were 113 cases, so sex ratio was nearly same. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 43 cases (18.9 %), chronic laryngitis 36 cases (15.8 %), vocal nodule 30 cases(13.2 %), vocal polyp 30 cases (13.2 %), vocal cord paralysis 26 cases (11.4 %), laryngeal carcinoma 18 cases (7.9 %) and laryngeal tuberculosis 15 cases (6.6 %). There were other diseases of larynx in 30 cases (13.2 %). 4) The incidence of age distribution in order of frequency were 4th decade (26.8 % ), 3rd decade (18.9%), 5th decade (17.1 %), 2nd decade (15.8 %) and 6th decade (9.6 %). 5) The duration from onset to consultation in order of frequency were 11 days-1 month (22.8 %), 1 month-3 months(19.7%), 3 months -6 months (18.9 %), within 10 days (13.6 %), 6 months-l year (13.2 % ), 1 year -3 years(7. 9 %) and 3 years over. 6) The duration from onset to consultation for underlying diseases were as follows ; acute laryngitis was within 10 days, chronic laryngitis was 3 months - 6 months, vocal nodule was 1 month-3 months, vocal polyp was 3 months -1 year, vocal cord paralysis was 11 days -1 month. 7) Associated symptoms with hoarseness in order of frequency were sore throat (25 %), sputum (8.8 %), swallowing difficulty (7.9 %) and dyspnea (6.1 %). But 84 cases (36.8 %), there were no other symptoms except hoarseness.