• Tuberculosis and Respiratory Diseases
• /
• v.71 no.1
• /
• pp.37-45
• /
• 2011

Background: Pulmonary emphysema (PE) is major cause of obstructive pulmonary function impairment (OPFI), which is diagnosed by spirometry. PE by high resolution CT is known to be correlated with OPFI. Recently, low dose CT (LDCT) has been increasingly used for screening interstitial lung diseases including PE. The aim of this study was to evaluate OPFI risks of subjects with PE detected by LDCT compared with those detected by simple digital radiography (SDR). Methods: LDCT and spirometry were administered to 266 inorganic dust exposed retired workers, from May 30, 2007 to August 31, 2008. This study was approved by our institutional review board and informed consent was obtained. OPFI risk was defined as less than 0.7 of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), and relative risk (RR) of OPFI of PE was calculated by multiple logistic regression analysis. Results: Of the 266 subjects, PE was found in 28 subjects (10.5%) by LDCT and in 11 subjects (4.1%) by SDR; agreement was relatively low (kappa value=0.32, p<0.001). FEV1 and FEV1/FVC were significantly different between PE and no PE groups determined by either SDR or LDCT. The differences between groups were larger when the groups were divided by the findings of SDR. When PE was present in either LDCT or SDR assays, the RRs of OPFI were 2.34 and 8.65, respectively. Conclusion: LDCT showed significantly higher sensitivity than SDR for detecting PE, especially low grade PE, in which pulmonary function is not affected. As a result, the OPFI risks in the PE group by LDCT was lower than that in the PE group by SDR.

• Tuberculosis and Respiratory Diseases
• /
• v.62 no.2
• /
• pp.149-153
• /
• 2007

A pulmonary blastoma is a rare malignant tumor of the lung that is composed of epithelial and mesenchymal elements and resembles the structure of an embryonic lung. Pulmonary blastomas have a very poor prognosis and make up 0.25 to 0.5 percent of all primary malignant lung tumors. A pulmonary blastoma usually manifests as a solitary parenchymal mass or nodule and multiple subpleural mass with effusion on chest X-ray and computed tomography. We encountered a very rare case of pulmonary blastoma in a 52 years old male. He complained of abdominal pain, fullness, and dyspnea. The radiology examination revealed a huge lung mass invading the mediastinum, heart, diaphragm, and liver. The percutaneous needle biopsies were performed, and this tumor was diagnosed as a pulmonary blastoma. We report a biopsy confirmed case of a huge pulmonary blastoma invading multiple organs.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.1
• /
• pp.103-106
• /
• 2000

Primary mediastinal liposarcoma is very rare, and only a few cases have ever been reported. A 25 year-old man who had coughing and mild fever for a month is reported. The simple delete X-ray and computed tomography of the chest revealed a huge mass in the right thoracic cavity that originated in the anterior mediastinum. Cytologic examination of the needle aspiration biopsy confirmed the diagnosis of a primary mediastinal liposarcoma. Through an exploratory right thoracotomy and a median sternotomy, the huge mass, lobulated and weighing about 2,500 gm delete, was extirpated. Mass was attached to a portion of the pericardium and diaphragm, but there was no invasion or metastasis to the pleura and lung. The patient was discharged 12 days after the operation. He is continuously receiving radiotherapy.

• The Journal of Advanced Prosthodontics
• /
• v.2 no.1
• /
• pp.7-13
• /
• 2010

Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS. In vitro, the human platelets were activated with application of shear stress, $20\;{\mu}g/ml$ collagen, 2 mM $CaCl_2$ and 10U thrombin/$1\;{\times}\;10^9$ platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with $\beta$-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS. In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION. Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.1
• /
• pp.43-50
• /
• 2011

Background: Open lung biopsy is used for diagnosis of diffuse infiltrative lung diseases (DILD), but it is invasive and relatively expensive procedure. Fluoroscopy-guided cutting needle lung biopsy (FCNLB) has merits of avoidance of admission and rapid diagnosis. But diagnostic accuracy and safety were not well known in the diagnosis of DILD. Methods: We included 52 patients (37 men, 15 women) having DILD on HRCT with dyspnea, except the patients who could be confidently diagnosed with clinical and HRCT findings. FCNLB was performed using 16G Ace cut needle (length 1.5 cm, diameter 2 mm) at the area of most active lesion on HRCT. Final diagnoses were made by the consensus. Results: The mean interval between the HRCT and FCNLB was 4.5 days. Most cases were performed one biopsy during 5~10 minutes. Specific diagnosis was obtained in 43 of 52 biopsies (83%). The most common diagnosis was nonspecific interstitial pneumonia (11 cases) and followed by cryptogenic organizing pneumonia (7 cases), diffuse alveolar hemorrhage and usual interstitial pneumonia (5 cases in each), hypersensitivity pneumonitis (3 cases), tuberculosis and drug induced interstitial pneumonitis (2 cases in each), the others are in one respectively. Mild complication was developed in 9 patients (8 pneumothorax, 1 hemoptysis). Most of complications were regressed without treatment except one case with chest tube insertion for pneumothorax. Conclusion: Fluoroscopy-guided 16 G cutting needle lung biopsy was an useful method for the diagnosis of DILD.

• Tuberculosis and Respiratory Diseases
• /
• v.77 no.1
• /
• pp.28-33
• /
• 2014

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori's methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.1
• /
• pp.30-34
• /
• 1997

Objectives: Calcification of the thyroid nodule has been reported to have a close relationship with differentiated thyroid carcinoma, however there are limited studies on the relationship between the calcified thyroid nodule and thyroid malignancy. The authors studied the clinical significance of calcification within the thyroid nodule. Materials and Methods: There were total of 60 patients who underwent surgery for calcified thyroid nodules which were identified from plain neck X-ray, ultrasound and computed tomography during the period January 1991 to June 1996 at the Department of Otorhinolaryngology-Head and Neck Surgery of Korea University Hospital. Six patients were not included because of recurrence and previous thyroid surgery. Histopathologic and radiologic analysis was done on the remaining 54 patients. Results: Results showed that 25 of 54 cases(46%) to be malignant histopathologically. Of the 25 malignant cases, papillary carcinoma was the most common with 22 cases followed by 2 cases of undifferentiated carcinoma and I case of medullary carcinoma. Statistically high incidence of malignancy was observed when the consistency of calcified thyroid nodule was solid, shape of calcification was irregular and inhomogenous, and adhesion of calcified thyroid nodule to the regional structure was present. Conclusion: The probability that a thyroid nodule is malignant has been reported to be 3­20%. However, about half of the thyroid nodules with calcification found to be malignant on this study, calcification of the thyroid nodule can be used as a guideline for detecting thyroid malignancy.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.3
• /
• pp.180-184
• /
• 2010

Objective : To prevent temporal depression after the pterional craniotomy, this study was designed to examine the safety and aesthetic efficacy of the brushite calcium phosphate cement (CPC) in the repair and augmentation of bone defects following the pterional craniotomy. Methods : The brushite CPC was used for the repair of surgically induced cranial defects, with or without augmentation, in 17 cases of pterional approach between March, 2005 and December, 2006. The average follow-up month was 20 with range of 12-36 months. In the first 5 cases, bone defects were repaired with only brushite CPC following the contour of the original bone. In the next 12 cases, bone defects were augmented with the brushite CPC rather than original bone contour. For a stability monitoring of the implanted brushite CPC, post-implantation evaluations including serial X-ray, repeated physical examination for aesthetic efficacy, and three-dimensional computed tomography (3D-CT) were taken 1 year after the implantation. Results : The brushite CPC paste provided precise and easy contouring in restoration of the bony defect site. No adverse effects such as infection or inflammation were noticed during the follow-up periods from all patients. 3D-CT was taken 1 year subsequent to implantation showed good preservation of the brushite CPC restoration material. In the cases of the augmentation group, aesthetic outcomes were superior compared to the simple repair group. Conclusion : The results of this clinical study indicate that the brushite CPC is a biocompatible alloplastic material, which is useful for prevention of temporal depression after pterional craniotomy. Additional study is required to determine the long-term stability and effectiveness of the brushite calcium phosphate cement for the replacement of bone.

• Journal of Yeungnam Medical Science
• /
• v.31 no.2
• /
• pp.131-134
• /
• 2014

Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

• Journal of Yeungnam Medical Science
• /
• v.35 no.1
• /
• pp.84-88
• /
• 2018

A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.