• Journal of Chest Surgery
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• v.28 no.11
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• pp.1014-1018
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• 1995

To confirm diagnosis and to set proper therapeutic strategy, open lung biopsies were done in 57 patients who were suspected for diffuse interstitial lung disease from January 1985 to December 1994. Among them, 35 were male and 22 were female[M:F=l.6: 1 and mean age of the patients is 53.5$\pm$ 2.3[24-81 years. Tissue for histologic studies were obtained from left lung in 33, from right lung in 24according to the distributions of the pathology. Preoperative diagnostic work-up`s were chest X-ray, CT[HRCT scan, sputum study, bronchoscopy[BAL, TBLB and PTNA and all of them were unsuccessful to confirm diagnosis. In comparison of pulmonary function tests between preoperative and postoperative values, there were no significant differences in FVC, FEV1, FEV1/FVC[p 0.05 but in AaDO2[p[0.05 . Postoperative complications including atelectasis, wound infection, pulmonary edema and respiratory insnfficiency, were shown in 5 cases[8.8% , and two of them were died of respiratory failure and sepsis[mortality rate 3.5% . Pathologic diagnosis was confirmed in 53 cases postoperatively but it was undetermined in 4[diagnostic yield rate 93.0% . In comparison between preoperative clinical diagnosis and postoperative pathologic diagnosis, new diagnosis were made in 17 cases[29.8% and preoperative tentative diagnosis were confirmed histologically in 36 cases[63.2% . In 4 cases[7.0% , however, diagnoses were not confirmed after biopsies. Therapeutic plans were reset in 46 cases[80.7% in accordance with the final diagnosis.In conclusion, open lung biopsy is recommended for a specific diagnosis and proper therapeutic plan in diffuse interstitial lung diseases because of its high diagnostic yield Irate and it`s relatively low morbidity and mortality rate in these tompromised patents.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.936-940
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• 1997

Pulmonary aspergilloma is potentially a life threatening disease resulting from the colonization of lung cavities by Aspergillus fumigatus. A case is reported: a 43-year-old man with symtomatic cavitary aspergilloma presenting with severe productive coughing, hemopt sis, occasional fever, and chilling. On preoperative plain chest radiograph and CT scan, we could find a rounded irregular opacity in a large pulmonary cavity. He received 2 separate operations for therapeutic need. At the first opertion, we performed cavernostomy and thoracoplasty because of severe pleural adhesions, tearing of cavity wall, and high risk of respiratory insufficiency. At the second operation, we performed myoplasty and omentoplasty for closure of remaining air space and complete wrapping of the BPF site. All symptoms of dyspnea and hemoptysis have since resolved. We believed that in the high risk patients who have severe respiratory symptoms, such as in aspergilloma and open cavity with a risk of respiratory insufficiency, cavernostomy followed by myoplasty or omentoplasty should be recommended.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.788-790
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• 2005

Chondromyxoid fbroma (CMF) is a rare, benign tumor of the bone that represents fewer than $2\%$ of all benign tumors of bone. CMF is most often found in the long tubular bones, especially the tibia and femur near the knee joint. Less common sites included the pelvis, fibula, calcaneus and rib. A 54-year-old male patient presented to us with history of swelling and mild, intermittent local pain without any rise in overlying skin temperature in lateral portion of left 7th rib for one-month duration, which was diagnosed as benign rib tumor by plain chest X-ray and CT scan, and treated successfully by excision of rib with good result. Pathologic diagnosis of this tumor was CMF. Without any medical therapy, there was no evidence of recurrence after operation. We report this case and follow-up of the patient.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.384-387
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• 2007

The finding of a tracheal penetrating injury that's caused by a foreign body is rare in adulthood. A 42-year-old man had experienced penetrating trauma due to a glass fragment 10 years ago. He presented with blood tinged sputum and dyspnea on exertion, and this had developed 1 year previously. Chest CT scan and bronchoscopy revealed a foreign body crossing the tracheal lumen and the object arose from outside of the trachea; this was all associated with airway edema. We removed the foreign body, which was a 5cm length of glass fragment, and we repaired the tracheal defect using a simple primary suture. The postoperative course of the patient was uneventful and he is now being followed up at the outpatient department; he has had no additional symptoms.

• Tuberculosis and Respiratory Diseases
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• v.65 no.6
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• pp.532-536
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• 2008

We report on a case of a patient with laryngo-tracheobronchial amyloidosis who complained of cough, sputum, and hoarseness. A chest X-ray showed consolidation in the right middle lobe. A chest CT scan showed diffuse, irregular narrowing of the tracheobronchial tree and atelectasis of the right middle lobe, with calcification of bronchial wall. Bronchoscopic findings were multinodular submucosal thickening of the right vocal cord, and yellowish multinodular submucosal thickening from the lower trachea through both main bronchi, as well as the lingular division of the left upper lobe, the right middle lobe, and the right lower lobe. The right middle lobe bronchus was nearly obstructed. The diagnosis of amyloidosis was made by multiple ronchoscopic biopsies on the right vocal cord and both bronchi. Pathologic findings were characteristic apple-green birefringence under polarized microscopy with Congo-red stain. The patient had no evidence of systemic amyloidosis. The patient is under conservative symptomatic treatment.

• Journal of Yeungnam Medical Science
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• v.21 no.1
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• pp.101-107
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• 2004

Diffuse alveolar hemorrhage is a rare but serious and frequently life-threatening complication of a variety of conditions. The first goal in the management of patients with diffuse alveolar hemorrhage is to achieve or preserve stability of the respiratory status. Subsequently, the differential diagnosis is aimed at the identification of a remediable cause of the alveolar hemorrhage. The most common causes of diffuse alveolar hemorrhage with glomerulonephritis are microscopic polyangiitis and Wegener's granulomatosis, followed by Goodpasture syndrome and systemic lupus erythematosus. Microscopic polyangiitis (MPA) is a distinct systemic small vessle vasculitis affecting small sized vessels with few or no immune deposits and with no granulomatosus inflammation. The disease may involve multiple organs such as kidney, lung, skin, joint, muscle, gastrointestinal tract, eye, and nervous system. MPA is strongly associated with antineutrophil cytoplasmic autoantibody (ANCA) that is a useful serological diagnostic marker for the most common form of necrotizing vasculitis. Our report concerns a case of microscopic polyangiitis with diffuse alveolar hemorrhage in a 54-year-old man. He was admitted to our hospital due to dyspnea upon exertion and recurrent hemoptysis. Laboratory findings showed hematuria, proteinuria and deterioration of renal function. In the chest CT scan, diffuse ground glass appearance was seen in both lower lungs. A lung biopsy revealed small vessel vasculitis with intraalveolar hemorrhage and showed a positive reaction to against perinuclear ANCA. The patient was treated with prednisolone and cyclophosphamide. Chest infiltration decreased and hemoptysis and hypoxia improved. He is still being followed up in our hospital with a low dose of prednisolone.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.235-238
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• 2002

Among the causes of SVC syndrome, intraluminal tumor, especially the leiomyosarcoma is very rare. We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission. On physical examination, facial edema and venous engorgement on upper extermities and upper chast wall were showed. The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC Surgery was performed through median sternotomy. For complete resection of the tumor and thrombus, we used partial and total CPB. The follow up SVC cavogram revealed no abnormality 14 months after the operation.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.578-581
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• 2007

A 59-year old female patient was admitted due to massive hemoptysis. 6-months previously, we performed ascending aorta graft interposition for terating Debakey type 1 acute aortic dissection. Chest CT scan showed the fistula between the descending thoracic aorta and the left lower lobe. We performed descending thoracic aorta graft interposition under cardiopulmonary bypass. She recovered well without any postoperative problems. Distal aorto-bronchial fistula after a previous aortic operation is very rare. We report here the good results of treating aorto-bronchial fistula because we recognized this lesion early and performed an early operation.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.792-797
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• 1996

A 59-year-old woman was admintted to the hospital because of intermittent fever and right side chest pain. She has a same episode eight months before this entry. Chest CT scan demonstrated ill-defined parenchymal consolidation containing dilated bronchi of right lower lung field, but no endobronchial mass in the bronchial trees. Fiberoptic bronchoscopy seeking the cause of recurrent pneumonia revealed a small, round mass nearly completely obstructing me lumen of basal segmental bronchus of right lower lobe. The diagnosis of bronchiolar papilloma was made from the biopsy specimens of the bronchoscopic examination. The patient was treated with right lower lobectomy because of irreversible secondary changes below the obstructed bronchus. This thoracotomic excision resulted in complete relief of symptoms and the postoperative course was uneventful for 12 months. Here we report a extremely rare umor with a brief review of literatures.

• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.62-66
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• 2007

A bronchial artery aneurysm is a rare condition, which needs optimal treatment due to the possibility of a life-threatening hemorrhage by rupture. The surgical removal of the aneurysm is the standard treatment. However, there are a few reports of coil embolization with a transcatheter. A 69 year-old man was referred for a further evaluation of a mass in the right hilum on chest radiography. He denied any respiratory symptoms. A chest CT scan showed a $3{\times}3{\times}4.5cm$ sized vascular mass with strong contrast enhancement on the right hilar area that originated from the bronchial artery. On the angiogram, the bronchial artery originated from the descending thoracic aorta at the T8 level. A bronchial artery aneurysm was catheterized selectively. and embolized successfully with a coil. After coil embolization, the selective bronchial arteriography confirmed complete occlusion. We report this case of bronchial aneurysm that was treated successfully with coil embolization.