• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.45-56
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• 1998

Background: Lung cancer continues to increase worldwide. Also, the proportion of female patients incease and adenocarcinoma is the predominant histological type among lung cancer in many western countries. So, we studied these current trends of lung cancer by clinical approach of recent patients from our department Method: We conducted a retrospective analysis on 212 subjects who were diagnosed with lung cancer at the department of chest medicine in National Medical Center between January 1990 and July 1996. The contents of analysis were patient's profile, clinical manifestation, smoking habits, accuracy of diagnostic methods, histological cell type, staging and treatment, etc. Results: The results were as follows. 1) The ratio of male to female was 5.2 : 1. The peak incidence of age was 7th decade(35.4%). 2) Chief complaints were cough, dyspnea and chest pain, etc. The most common duration of symptoms before the first admission was less than 3 months(57.7%). On the other side, duration more than 1 year represented 6.5%. The early diagnosed patients has been increased from the 1980s. 3) Smokers among the total patients were 77.2%. The proportion of smokers in sqamous cell carcinoma, small cell carcinoma and adenocarcinoma were 88.4%, 85.7% and 55.7%, respectively. Smoking history and histological cell type were correlated in squamous and small cell carcinoma. 4) Squamous cell carcinoma is still the predominant histological type (44.8%), but, adenocarcinoma increased more than the previous study(30.7%). The other histological types were small cell carcinoma(17.0%) and large cell carcinoma(3.8%) in order of their proportions. 5) The accuracy of diagnostic methods were as follows: sputum cytology 75.3%, bronchoscopic biopsy 65.7%, lymph node aspiration cytology 95.8%, percutaneous lung aspiration cytology 94.6% and open lung biopsy 100%. The general accuracies of diagnostic methods were improved than previous studies. 6) Performance status scales on admission were relatively good. After diagnosis, chemotherapy and/or radiotherapy were undertaken in 69.3% of the patients, and only 7.5% of the patients were operated. Conclusion: In our study, squamous cell carcinoma is still the predominant histological cell type, but, adenocarcinoma continues to increase. Because adenocarcinoma is less correlated with smoking habits, further evaluation of other carcinogens than smoking is requested. Screening and early diagnosis of lung cancer is important for good performance status scales in spite of advanced stages. But, we think that the prevention, for example, stop smokings is more important as because of no perfect treatment for lung cancer.

• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.502-510
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• 1992

Background: Neuron specific enolase (NSE) is a neuronal form of the glycolytic enzyme enolase which was first found in extracts of brain tissue, and later in a variety of APUD cells and neurons of the diffuse endocrine system. SCLC shares many APUD properties with normal neuroendocrine cells. NSE immunostaining and serum NSE measurement may be a useful marker of neuroendocrine differentiation in lung tumors and diagnosis of small cell carcinoma. Methods: NSE immunohistochemical staining was done and at the same time serum NSE levels were measured in 22 small cell lung cancer and 21 non small cell lung cancer which were confirmed histologically. Results: 1) NSE immunoreactivity was detected in 9 of the 18 (50%) small cell lung cancer, in 5 of the 16 non small cell lung cancer. 2) Whereas the mean value in non-small cell lung cancer group was $11.79{\pm}4.47\;ng/ml$, the mean level of serum NSE in small cell lung cancer increased up to $59.3{\pm}77.8\;ng/ml$. In small cell lung cancer patients, mean value of limited disease group was $20.19{\pm}12.91\;ng/ml$, while mean value of extended disease group was $91.9{\pm}94.2\;ng/ml$ showing statistically significant difference. If serum levels above 20 ng/ml were tentatively defined as positive, 16 of 22 (73%) patients with SCLC had positive serum NSE level, but only one patient with NSCLC did. There was no correlation between serum NSE level and immunoreactivity of NSE. Conclusion: These studies indicate that serum NSE measurement may be a useful marker for the diagnosis and disease extent and NSE immunostaining can be used to demonstrate the neuroendocrine components of lung tumor.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.16 no.2
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• pp.87-96
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• 2023

Recently, research on predicting the treatment results of diseases using deep learning technology is also active in the medical community. However, small patient data and specific deep learning algorithms were selected and utilized, and research was conducted to show meaningful results under specific conditions. In this study, in order to generalize the research results, patients were further expanded and subdivided to derive the results of a study predicting mortality after lung cancer diagnosis for men and women in their 80s, 90s, and 100s. Using AutoML, which provides large-scale medical information and various deep learning algorithms from the Health Insurance Review and Assessment Service, five algorithms such as Decision Tree, Random Forest, Gradient Boosting, XGBoost, and Logistic Registration were created to predict mortality rates for 84 months after lung cancer diagnosis. As a result of the study, men in their 80s and 90s had a higher mortality prediction rate than women, and women in their 100s had a higher mortality prediction rate than men. And the factor that has the greatest influence on the mortality rate was analyzed as the treatment period.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.149-155
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• 1995

Background: Cytokeratin 19 is 40KD acidic molecule whose distribution is restricted to simple or pseudo-stratified epithelia, such as the epithelial layer of the bronchial tree. Immunohistochemical study have shown that cytokeratin 19 is overexpressed in lung carcinoma tissue. An immunoradiometric assay, CYFRA 21-1 has been developed using two monoclonal antibody, BM 19-21 and KS 19-1, reactive to different epitopes on cytokeratin 19. We studied the diagnostic value of CYFRA 21-1 in lung cancer. Method: The serum CYFRA 21-1 level using immunoradiometric kit(ELSA-CYFRA 21-1) was measured in 54 patients who admit to Yeungnam University Hospital from April, 1993 to August, 1994. Lung cancer group was 39 primary lung cancer patients(19 patients with squamous cell carcinoma, 11 patients with adenocarcinoma and 9 patients with small cell carcinoma). Control group was 15 patients with non malignant lung diseases(8 patients with pulmonary tuberculosis, 3 patients with chronic obstructive pulmonary disease, 2 patients with pneumonia and 2 patients with chronic obstructive pulmonary disease combined with pulmonary tuberculosis). Results: The mean serum value of CYFRA 21-1 was $20.2{\pm}4.7ng/ml$ in squamous cell carcinoma, $7.2{\pm}1.6ng/ml$ in adenocarcinoma and $15.5{\pm}4.7ng/ml$ in non-small cell lung cancer. The serum value of CYFRA 21-1 in control group was $1.7{\pm}0.5ng/ml$. All of the serum values of 3 histologic types were significantly higher than that of control group(p<0.01). The serum value of CYFRA 21-1 of squamous cell carcinoma was significantly higher than that of adenocarcinoma(p <0.05). Serum value of CYFRA 21-1 in small cell lung cancer was $2.9{\pm}0.9ng/ml$ and not significantly different compared with control group. Using cut off value of 3.3ng/ml, sensitivity and specificity was 11.1%, 65.2% in small cell lung cancer, 70.0%, 62.5% in non-small cell lung cancer, 73.7%, 75% in squamous cell carcinoma and 63.6%, 78.9% in adenocarcinoma, respectively. Conclusion: The serum levels of CYFRA 21-1 may be useful in diagnosis of non-small cell lung carcinoma, especially in squamous cell carcinoma with its high specificity.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.448-463
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• 2000

Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.54-62
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• 1996

Background: $^{99m}Tc$ MIBI(Methoxyisobutylisonitrile complex), a member of the isonitrile class of coordination compounds, is a lipophilic cation presently under investigation for clinical use as myocardial perfusion imaging agent and is widely used to detect myocardial infarction. Preliminary reports indicate that $T_1$-201 accumulate in human neoplasm and several authors reported $^{99m}Tc$ MIBI may also localized in primary malignant tumor and metastatic deposits from lung cancer. We evaluated the uptake of $^{99m}Tc$ MIBI in lung cancer and localization of mediastinal and other site metastasis, and compared the benign lesion of the lung. Method: Thirty four patients of lung cancer and ten patients of benign lung lesion were studied with chest CT and $^{99m}Tc$ MIBI Lung SPECT. $^{99m}Tc$ MIBI uptake ratio was assessed by TR/NL(Lung lesion/ Normal area), HT/NL (Heart/Normal area) and HT/TR(Heart/Lung lesion). Results: 1) All lung cancer patients showed increased uptakes of $^{99m}Tc$ MIBI in malignant lung lesion and Tc-99m MIBI uptake was also increased in mediastinal and lymph node metastasis except two cases. 2) There was significant different ratio of TR/NL between malignant and benign lesion, $3.79{\pm}1.82$ and $1.67{\pm}0.63$ on planar images, respectively(p<0.001). 3) There was no significant difference of $^{99m}Tc$ MIBI uptake ratio between squamous cell carcinoma, small cell carcinoma and adeno carcinoma($3.64{\pm}1.66$, $3.57{\pm}0.72$, $4.31{\pm}2.28$ respectively). Conclusion: $^{99m}Tc$ MIBI lung SPECT was useful in the localization of tumor and mediastinal or other site metastatic lesion in lung cancer and also in the differential diagnosis between benign and malignant lesion.

• Tuberculosis and Respiratory Diseases
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• v.74 no.4
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• pp.169-176
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• 2013

Background: Although the lung is a common site of metastasis, endobronchial metastases (EBM) from extrathoracic malignancies are rare. Previous studies were retrospective reviews of the cases from each single institute, and the last one was performed between 1992 and 2002. We evaluated the characteristics of patients with EBM who had been diagnosed in recent 10 years in our hospital. Methods: We retrospectively reviewed 1,275 patients who had undergone diagnostic bronchoscopic procedures between 2001 and 2011. An EBM was defined as bronchoscopically notable lesion, which was histopathologically identical to the primary tumor. Results: A total of 18 cases of EBM were identified. The mean age was 53 years, and 12 cases of the 18 patients were female. The most common primary malignancies were colorectal cancer and breast cancer (4 cases each), followed by cervix cancer (3 cases) and renal cell carcinoma (2 cases). Cough was the most common symptom. The most common radiologic finding was atelectasis, which was identified in 27.7% of the cases. The median interval from the diagnosis of primary malignancy to the diagnosis of EBM was 14 months (range, 0-112 months). The median survival time from the diagnosis of EBM was 10 months (range, 1-39 months). Conclusion: EBM from extrathoracic malignancies were rare. Colorectal cancer and breast cancer were common as primary malignancies. Fiberoptic bronchoscopy should be performed in all patients, who are suspected of having EBM. If atypical clinical and pathological features are present, appropriate diagnostic studies should be undertaken.

• Tuberculosis and Respiratory Diseases
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• v.77 no.5
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• pp.223-226
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• 2014

Aspergillus tracheobronchitis is a form of invasive pulmonary aspergillosis in which the Aspergillus infection is limited predominantly to the tracheobronchial tree. It occurs primarily in severely immunocompromised patients such as lung transplant recipients. Here, we report a case of Aspergillus tracheobronchitis in a 42-year-old man with diabetes mellitus, who presented with intractable cough, lack of expectoration of sputum, and chest discomfort. The patient did not respond to conventional treatment with antibiotics and antitussive agents, and he underwent bronchoscopy that showed multiple, discrete, gelatinous whitish plaques mainly involving the trachea and the left bronchus. On the basis of the bronchoscopic and microbiologic findings, we made the diagnosis of Aspergillus tracheobronchitis and initiated antifungal therapy. He showed gradual improvement in his symptoms and continued taking oral itraconazole for 6 months. Physicians should consider Aspergillus tracheobronchitis as a probable diagnosis in immunocompromised patients presenting with atypical respiratory symptoms and should try to establish a prompt diagnosis.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.124-128
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• 2007

Bronchiolitis obliterans is a clinical syndrome of chronic obstruction associated with inflammatory changes in the small airways. There are marked variations in the epidemiology of this disease. In childhood, bronchiolitis obliterans has been described as a result of a number of infections such as adenovirus, measles, Bordetella pertussis, Mycoplasma pneumoniae, and influenza A infection. Most common agents are adenovirus types 3, 7, and 21. Diagnosis of bronchiolitis obliterans can be made based on clinical findings, high resolution computed tomography (HRCT) and lung biopsy. In addition to diagnosis, treatment is not yet clearly established. The authors experienced a case of bronchiolitis obliterans developed in 3 year-old girl who suffered from type 7 adenoviral pneumonia. She had been hospitalized and treated for 15 days due to pneumonia. After discharge, productive cough was not improved and auscultation revealed wheezing. HRCT demonstrated multifocal mosaic patterns suggesting bronchiolitis obliterans. She was managed with inhaled steroid and bronchodilator, and her symptoms were improved. However, follow up HRCT showed no interval change.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.484-488
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• 2004

In adults, aspiration of foreign bodies into tracheobronchus is sometimes presented atypically, mimicking chronic pulmonary diseases such as bronchial asthma, pneumonia, or empyema, especially without notice of aspiration or choking. In such cases, diagnosis and adequate treatments are often delayed. Suspicion of foreign body aspiration and computed tomography and bronchoscopic examination make correct diagnosis more early. We report a case of bronchial foreign body, which had been misdiagnosed as bronchial asthma with wheezing in the whole lung filed, and reversible airway obstruction in the spirometry.