• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.114-120
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• 2018

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

• 대한기관식도과학회지
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• 제3권1호
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• pp.84-93
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• 1997

The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.358-363
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• 2004

연구배경 : 폐암에서 광역동치료는 미세침습성 비소세포폐암 및 기관지폐쇄를 일으키는 악성종양에 대한 기관지내 치료를 미국식품의약국(FDA)에서 승인한 상태이다. 국내에서는 폐암세포주에 대한 보고 외에 폐암에 대한 광역동치료 연구가 많지 않아 임상 성적에 대한 보고가 없어 이에 저자들은 폐암에서 시행된 광역동치료에 대한 결과를 문헌고찰과 함께 보고하고자 한다. 방 법 : 2002년 8월부터 2003년 5월까지 조선대학교 병원에서 기관지 내시경을 통해 조직학적으로 진단된 폐암환자 중 10명을 대상으로 하여 광역동치료 48시간 전에 광과민제(Photogem$^{(R)}$, Lomonosov institute of Fine Chemical, Russia)를 2.0mg/Kg을 정맥 주사한 후 48시간, 72시간에 Diode LASER system(Biolitec Inc., Germany, wavelength; 633nm)을 사용하여 광역 동치료를 시행하였다. 결 과 : 10명 중 9예에서 부분관해와 함께 기관지 개통을 보였으며, 1예에서는 변화를 보이지 않았다. 결 론 : 저자들은 광역동치료를 통해 기관지폐쇄로 인한 호흡곤란 및 기관지 폐쇄와 관련된 폐렴이 개선됨을 확인 하였으며, 합병증이 적어 안전한 기관지내 치료법으로 생각된다. 앞으로 광역동 치료에 대한 장기적인 결과 및 적절한 치료 적응증 및 조기 폐암에서 치료효과 등에 대한 연구가 필요할 것으로 생각된다.

• 대한영상의학회지
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• 제84권4호
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• pp.900-910
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• 2023

목적 정상으로 보이는 chest CT를 정량화 분석하여 흡연 및 폐쇄성 폐질환(chronic obstructive pulmonary disease; 이하 COPD) 여부에 따른 차이가 있는지 확인하고자 하였다. 대상과 방법 2013년 1월부터 2014년 12월까지 chest CT가 정상이면서 정량화 분석이 있는 90명의 남자 환자[COPD 없는 비흡연자(n = 38)와 흡연자(n = 45), COPD 흡연자(n = 7)]를 대상으로 하였다. COPD 흡연자 7명을 대상으로 나이를 추출하여 환자-대조군 연구도 하위 분석하였다. Pi10, 왜도, 첨도, 평균감쇠계수, 저감쇠영역%와 같은 정령화 변수를 분석하였다. 결과 COPD가 없는 환자 중에서 흡연자의 Pi10 (4.176 ± 0.282, n = 45)이 비흡연자에 비해 약 0.1 mm 정도 두꺼웠고(4.070 ± 0.191, n = 38, p = 0.047), 흡연자의 왜도와 첨도(2.628 ± 0.484 and 6.448 ± 3.427)가 비흡연자보다 낮았다(2.884 ± 0.624, p = 0.038 and 8.594 ± 4.944, p = 0.027). COPD가 있는 흡연자들의 Pi10 (4.427 ± 0.437, n = 7)이 COPD가 없는 비흡연자들보다 약 0.4 mm 두꺼웠다(4.001 ± 0.108, n = 14, p = 0.005). 그러나 평균감쇠계수와 저감쇠영역%에서는 유의한 차이가 없었다. 결론 정상 chest CT를 보이더라도 QCT로 COPD의 유무와 상관없이 흡연자들의 소기도가 두꺼운 것을 알 수 있으며 이는 폐실질 변화보다 더 선행한다.

• 한국작물학회지
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• 제60권2호
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• pp.239-247
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• 2015

This experiment was conducted to obtain the have higher contents of pharmaceutical constituents as well as higher yield from colchicine induced diploid and tetraploid extracts of Platycodon grandiflorum. In order to determine the biological activity, this study was focused to evaluate the cytotoxicity, antimicrobial on the bronthus disease bacteria, antioxidant enzyme activity of diploid and tetraploid extracts in P. grandiflorum. The activities of antioxidant enzyme according to different solvent extracts were measured as superoxide dismutase (SOD), catalase (CAT), peroxidase (POD), and ascorbate peroxidase (APX). The cytotoxicity of methanol extracts of P. grandiflorum showed significant differences between tetraploid and diploid. That is, the cytotoxic effect against human cancer cell was higher in tetraploid than in diploid. At all extracts concentration, tetraploid samples showed high toxicity and the $IC_{50}$ (concentration causing 50% cell death) value showed the highest on HCT-116 cell ($105.91{\mu}g/mL$), and exhibited significant activity against the Hep 3B cell ($140.67{\mu}g/mL$), SNU-1066 cell ($154.01{\mu}g/mL$), Hela cell ($158.37{\mu}g/mL$), SNU-601 cell ($182.67{\mu}g/mL$), Calu-6 cell ($190.42{\mu}g/mL$), MCF-7 cell ($510.19{\mu}g/mL$). Antimicrobial activities of diploid P. grandiflorum were relatively low compared to tetraploid P. grandiflorum on most of the bacterial strains. In tetraploid P. grandiflorum, K. pneumoniae showed the clear zone formation (18~19 mm) of growth inhibition, followed by the clear zone formation of 13~15 mm on C. diphtheria and S. pyogenes. The antimicrobial activities in diploid P. grandiflorum were the highest on K. pneumonia (14~15 mm), and showed the clear zone formation of 11~12 mm on C. diphtheria and 12~13 mm on S. pyogenes. The antimicrobial activity is thought to look different depending on the bacterial strains and the polyploidy of P. grandiflorum. The root extract of P. grandiflorum had the highest (97.2%) SOD enzyme activity in ethyl acetate partition layer of tetraploid while water partition layer of diploid showed the lowest (48.6%) SOD enzyme activity. The activity of CAT showed higher values in the root of tetraploid than in the diploid of P. grandiflorum in all partition layers except butyl alcohol. The activities of APX and POD showed higher values in the root of tetraploid than in the diploid of P. grandiflorum in all fraction solvents except water layer. These results indicate that the tetraploid P. grandiflorum can be used as a source for developing cytotoxic agent and antimicrobials which can act against bronchus diseases bacterial strains.

• Tuberculosis and Respiratory Diseases
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• 제44권4호
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• pp.942-948
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• 1997

결론적으로 기관내 신경초종은 기관지 천식으로 오인되어 진단이 늦어질 수 있으나 특징적인 증상인 흡기시의 호흡곤란, 가변성 흉곽외 기도폐쇄의 소견을 보이는 폐기능 검사등으로 의심할 수있고, 기관 단층 촬영, 경부 컴퓨터 단층 촬영 및 기관지 내시경을 통해 쉽게 진단이 가능하다. 새로운 치료법으로 기관지경하 레이저 소작술로 완치될 수 있고, 이에 본원에서 경험한 1예를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제56권5호
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• pp.495-504
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• 2004

목 적 : 기관지 결핵에서 기관지 탄분 섬유화증의 동반 정도와 기관지 탄분 섬유화증의 동반 유무에 따른 임상적인 차이를 알아 보고자 하였다. 대 상 : 2000년 1월부터 2003년 6월까지 호흡기 증상이나 흉부 방사선 사진의 이상 소견으로 기관지 내시경 검사를 받은 환자 가운데 기관지 결핵으로 진단된 63예의 환자들을 대상으로 하였으며, 의무 기록지를 통한 후향적 분석에서 대상 환자들의 임상적 소견 및 기관지 내시경 소견 등을 조사하였다. 기관지 탄분 섬유화증은 기관지내 점막의 다발성 색소 침착이 있거나 엽 기관지 또는 구역 기관지에 색소 침착과 동반된 섬유화성 협착이 있는 경우로 하였다. 성 적 : 대상 환자들의 평균 연령은 59.5세(21-97)였으며, 남자가 12예, 여자가 51예였다. 기관지 탄분 섬유화증은 37예(58.7%)였으며, 60세 이상에서 31예로 대부분을 차지하였다. 기관지 탄분 섬유화증이 동반된 군(37예)에서 동반되지 않은 군(26예)에 비하여 평균 연령 이 유의하게 높았으며, 나무 연기에 대한 장기적인 노출력을 가진 예도 유의하게 많았다. 기관지 결핵의 위치는 기관지 탄분 섬유화증이 동반된 군에서 동반되지 않은 군에 비하여 우중엽에 유의하게 많았으며, 기관지 결핵의 형태는 기관지 탄분 섬유화증이 동반된 군에서는 부종형(edematous-hyperemic) 및 궤양형(ulcerative)이, 동반되지 않은 군에서는 건락성 괴사형(actively caseating)이 많은 경향이었다. 결 론 : 기관지 결핵은 고령일수록 기관지 탄분 섬유화증과 동반되는 경우가 많으며, 기관지 탄분 섬유화증의 동반 유무에 따라 기관지 결핵 병변의 위치 및 형태에도 차이가 있을 것으로 생각된다.

• Journal of Chest Surgery
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• 제38권9호
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• pp.622-626
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• 2005

배경: 기관지내결핵에 의한 주기관지협착에 대하여 주기관지재건술은 전폐절제술을 피하고 폐실질을 보존할 수 있는 방법이지만 그 위험성 때문에 비침습적인 중재치료가 주를 이루고 있다. 하지만, 적절한 치료가 이루어지고 있는가에 대해서는 논란의 여지가 많다. 본원에서는 지난 10년 간 주기관지재건술을 시행하였고 이후 임상적 경과를 토대로 수술의 성적을 조사, 분석하여 결핵성 주기관지협착에 대한 주기관지재건술의 위험성과 효용성을 판단하고자 한다. 대상 및 방법: 지난 10년 간 결핵성 주기관지협착으로 인해 주기관지재건술을 시행받은 21명의 환자를 대상으로 각 환자들의 임상기록과 외래추적 기록을 통하여 후향적 연구를 하였다. 모든 환자에서 항결핵약제를 복용한 과거력이 있었으며, 기관지내시경 및 흉부전산화단층촬영을 통해 수술 전 평가를 하였다. 결과: 수술로 인한 사망은 없었으며 중증의 합병증도 발생하지 않았다. 단지 두 명의 환자에서 효과적인 객담배출이 이루어지지 않아 치료적 기관지내시경과 기관내삽관을 시행하였다. 모든 환자들은 현재까지 기도폐쇄의 증상 없이 생존해 있다. 걸론: 기관지내결핵으로 인한 주기관지협착에 대해 해부학적으로 용이한 조건에서의 주기관지재건술은 치료에 있어서 초치료의 일환으로 고려해야 한다.

• Journal of Chest Surgery
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• 제25권3호
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• pp.258-270
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• 1992

Benign lung tumors have been considered as relatively rare disease, which comprise approximately 8 to 15% of all solitary pulmonary lesions that are detected radiographically. We clinically analized 30 cases of benign lung tumors underwent the operation from Jan. 1970 to Aug.1991 in the department of thoracic and cardiovascular surgery, Catholic University Medical College. We adopted the classification presented by the World Health Organization[WHO], modified from Liebow, and added benign mesothelioma. There were 11 males & 19 females ranging in age from 2 years to 68 years old % the mean age was 38 years old. Of all 30 benign lung tumors, hamartomas [14 cases, 49%] were the most common & followed by hemangiomas [9 cases, 30%], 3 cases of benign mesotheliomas % a case of teratoma, papilloma, arteriovenous malformation and inflammatory pseudotumor. 14 cases of tumors were asymptomatic & were incidentally detected by plane chest x-ray In other cases, chief complaints at admission were coughing, chest discomfort, dyspnea, hemoptysis, and fever. Diagnosis were made by pathological examination; exploratory thoracotomy in 23 patients[76.7%], bronchoscopy in 4 patients and percutaneous needle aspiration biopsy in 3 patients. Precisely, preoperative diagnosis for confirmation of benign lung tumor was made only in 7 cases[23.6%]. Tumors were located on Rt.side[24 cases], especially Rt. middle lobe, and Lt.side[6 cases]. Operation methods were as follows: 21 cases [70%] of lobectomy, 2 cases of segmentectomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy removal of the endobronchial hamartoma which located at the rt. main stem bronchus and 3 cases of complete resection in benign mesotheliomas. There were no operative death. The post operative complications were developed in 3 cases; post pneumonectomy empyema, wound infection and atelectasis. In conclusion, benign lung tumors must be histologically diagnosed to confirm of benignity and to provide limited resection for preservation of the lung tissue, whenever possible.