• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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• pp.89-93
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• 2005

Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.243-250
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• 1996

Granular cell tumor(GCT) of tracheobronchial tree is a rare neoplasm comprising approximately 6-10% of all GCT and about 1.6% of all benign tumors of the tracheobronchial tree. Since the first observation of GCT in the bronchus by Kramer in the late 1930s, less than 100 cases have been reported in tracheobronchial tree, and probably no such case have been published in Korea yet. Here we report an experience concerning 53 year-old women with an active pulmonary tuberculosis, who also was diagnosed to have a bronchial GCT on bronchoscopy and immunohistochemistry of the specimens.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.244-250
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• 2006

Splenic abscess is a rare clinical condition with a reported incidence of 0.14 % to 0.70 % in various autopsy series. Primary tuberculosis of the spleen as a cause of splenic abscess is even rarer, especially in the antitubercular era. Infants and children have a higher predisposition to extra-pulmonary tuberculosis than adults and tend to develop severe extra-pulmonary disease such as miliary tuberculosis and meningitis. The diagnosis of tuberculosis in infants and children can be difficult because of nonspecific symptoms and clinical findings. Computed tomography establishes the diagnosis of splenic abscess and demonstrates the number and location of abscesses. Splenectomy is the standard of care in most clinical setting. We present a 4-year-old girl who had multiple tuberculosis splenic abscesses and was treated successfully with splenectomy.

• Tuberculosis and Respiratory Diseases
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• v.55 no.4
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• pp.408-412
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• 2003

Pulmonary blastoma is a rare primary lung neoplasm composed of a mixture of immature mesenchyme and epithelium that morphologically mimics embryonal pulmonary structure. Microscopically, tumors could be divided into two classes; those composed solely of malignant glands of epithelial components (well-differentiated fetal adenocarcinoma) and those with biphasic appearance. A 51-year-old man was admitted with left sided pneumothorax. After closed thoracostomy, chest X-ray showed a circular mass in the left lower zone. The tumor was diagnosed as adenocarcinoma as a result of percutaneous needle aspiration biopsy, and left lower lobectomy was performed. The patient was diagnosed as having biphasic pulmonary blastoma on postoperative histological assessment. This case is the first reported patient with biphasic pulmonary blastoma detected by pneumothorax.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.55-58
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• 2012

Mycobacterium szulgai is a rare nontuberculous mycobacterium found in Korea. It is an opportunistic pathogen and is usually isolated from patients with a history of alcoholism, chronic pulmonary disease, or an immunocompromising condition. We present here a case of M. szulgai isolated from a patient with a history of pulmonary tuberculosis. A 54-year-old man was admitted with dyspnea and febrile sensation. He had a history of pulmonary tuberculosis which occurred 30 years earlier and treatment with anti-tuberculosis medication. His chest computed tomography scan showed cavitary consolidation in both upper lungs. A sputum acid-fast bacilli (AFB) smear was positive and anti-tuberculous medication was started. However, a polymerase chain reaction for mycobacterium tuberculosis was negative and anti-tuberculous medication was stopped. M. szulgai was isolated on 3 separate sputum and bronchial wash fluid AFB cultures. He was treated with clarithromycin, rifampicin, and ethambutol. After 1 month, a sputum AFB smear and culture became negative and no additional M. szulgai were isolated during a 16-month treatment.

• Tuberculosis and Respiratory Diseases
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• v.69 no.1
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• pp.52-55
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• 2010

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

• Tuberculosis and Respiratory Diseases
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• v.65 no.6
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• pp.527-531
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• 2008

Although disseminated cryptococcosis occurs most commonly in immunocompromised patients, particularly those with a human immunodeficiency virus (HIV) infection, it can occur in immune competent persons. There are no case reports of disseminated cutaneous crytpcoccosis associated with pulmonary tuberculosis in Korea. A 71-year-old female presented with fever and multiple cutaneous nodules. She was finally diagnosed with disseminated cutaneous cryptococcosis accompanied by pulmonary tuberculosis, and was treated successfully with anti-tuberculous medication and fluconazole. She had no apparent predisposing conditions for systemic cryptococcosis. We report this case with a review of the relevant literature.

• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.433-437
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• 2011

Sarcoidosis is a multisystemic disorder characterized by the presence of non-caseating granulomas in the involved organ. Tuberculosis is an infectious disease caused by $Mycobacterium$ $tuberculosis$ and is characterized by granuloma with caseous necrosis. The clinical and histological similarity between sarcoidosis and tuberculosis has stimulated research searching for an association between mycobacterium and sarcoidosis. We report a case of a 38-year-old male with sarcoidosis that developed soon after treatment of tuberculous lymphadenitis. He was diagnosed as tuberculous lymphadenitis by microbiological confirmation. He showed clinical improvement after treatment for tuberculosis. One year later, his chest radiography showed bilateral hilar enlargement with diffuse bilateral nodules. A noncaseating granuloma was confirmed by endobronchial ultrasound guided transbronchial needle aspiration and he was diagnosed with sarcoidosis. To our knowledge, this is the first report describing sarcoidosis after treatment of tuberculosis in South Korea.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.315-317
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• 2002

Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.372-377
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• 2007

Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.