• Tuberculosis and Respiratory Diseases
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• 제51권1호
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• pp.70-75
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• 2001

저자들은 폐결핵의 병력이 있던 2명의 환자에서 기침과 객담을 주소로 내원하여 단순 흉부 방사선과 흉부 전산화 단층 촬영 결과 흉막비후와 기관지흉막루를 의심할 수 있는 공동형성을 보이고 흉막 천자액 배양과 수술후 조직배양검사결과 Aspergillus fumi-gatus가 확인되어 수술 및 항진균제를 사용하여 치료한 2례를 경험하였기에 이를 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제18권1호
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• pp.80-84
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• 2011

흉벽 천공성 농흉(Empyema necessitatis)은 농흉이 흉막 외의 공간으로 확장되어 나간 것을 말한다. 결핵성 흉벽 천공성 농흉은 결핵의 드문 합병증으로서 특히 소아에서는 더욱 드물다. 본 저자들은 결핵에 노출된 병력이 없던 21개월 남자아이에서 7번째 늑골의 골수염에 동반된 결핵성 흉벽천공성 농흉을 경험하여 이에 대해 보고한다. 우리는 환자의 진단과 치료를 위해 수술적 치료를 시행하였고, 조직을 이용한 PCR 및 분자생물학적 검사에서 M. tuberculosis complex를 확인하여 항결핵제를 이용해 합병증 없이 치료하였다.

• Journal of Chest Surgery
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• 제12권4호
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• pp.403-410
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• 1979

A Clinical analysis of 64 patients of thoracic empyema was done who received surgical intervention at Dept. of Thoracic Surgery of the Chosun University Hospital in the period of 3 years from September 1976 to October 1979. Following was the results: 1. Seven cases [10.9%] were under the age of 15 years, 16 cases [25%] was between 15-30 years and 41 cases [64.1%] was above the age of 30 years. A proportion of children and adult was 1:8. 2. Male and female ratio was 3:1. Right and left side pleural cavity ratio was 2.4:1. 3. Predisposing factors were pneumonia [35.9%] and pulmonary tuberculosis [28.1%]. 4. Most frequently encountered symptoms were dyspnea, cough, chest pain and fever in order. 5. Etiologic organisms were confirmed in 39 cases [86.7%] which requested in 45 cases. Staphylococcal infections were 11 cases and streptococcal, pneumococcal pseudomonas infection was infected in order. 6. Pneumothorax was associated with empyema on 21 cases [32.8%]; among those 13 cases [61.9%] were tuberculous in nature. 7. Sensitivity test was revealed that Minocin was most very sensitive drug, and next Erythromycin, Gentamycin and Penbrex in order. But most resistant drugs were Penicillin, Kanamycin, Streptomycin and Tetracycline in order. 8. Treatments were combined with antibiotics therapy and several surgical procedures for empyema. 26 cases [40.6%] were treated with closed thoracotomy drainage, 17 cases [26.6%] with open thoracotomy tube drainage and 9 cases decortication and 9 cases thoracoplasty. 9. 2 death cases occurred in 64 cases of thoracic empyema, and 79.7% cases were discharged with recovery and improvement.

• Tuberculosis and Respiratory Diseases
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• 제73권3호
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• pp.178-181
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• 2012

Streptococcus suis causes meningitis and sepsis in pigs, but human infection has increased over the past few years in those who are exposed to pigs or raw pork. Most cases have occurred in Southeast Asia, but only two cases have been reported in South Korea, presenting with arthritis and meningitis. Here, we report a rare case of S. suis infection, a 60-year-old sailor, who visited the emergency room presenting septicemia, pneumonia with empyema and meningitis, showed full recovery; however, neurologic sequale of severe cognitive dysfunction was present after the usage of antibiotics and percutaneous drainage. S. suis was isolated from blood and pleural fluid and the strain was susceptible to penicillin and vancomycin. Increased awareness of S. suis infection and prevention are warranted.

• Journal of Chest Surgery
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• 제7권1호
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• pp.47-60
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• 1974

During the past 10 years 114 patients with empyema have been treated in hospital of Chonnam University. There were 87 males and 27 females ranging from 20 days to 70 years of age. The etiology was pyogenic pneumonia in 36.7%, tuberculosis in 22.7%, paragonimiasis in 8.8%, post-thoracotomy in 5.4%, post-trauma in 4.4%, lung abscess in 3.5%, malignancy in 3.5%, post-esophageal operation in 1.8%, and sterile in 10.5%. The over-all mortality rate was 2% [3 patients]. The majority of deaths occurred in patients with associated systemic illness [liver cirrhosis in I, and renal tuberculosis in I] and resistant tuberculosis for anti-tuberculosis drugs in one patient. Adequate drainage and obliteration of the pleural space continues to be the most important aspect of treatment and can frequently be achieved by closed chest tube thoracostomy in acute empyema especially in children. The more chronic thick-walled or loculated cavities require open drainage [open window therapy], decortication, thoracoplasty, sterilization, and myoplasty for closure of tracheobronchial fistula.

• Journal of Chest Surgery
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• 제54권3호
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• pp.228-231
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• 2021

Herein, we report a case in which thoracomyoplasty was performed to manage chronic postlobectomy empyema (PLE). A 54-year-old male patient with a surgical history of right upper lobectomy and thymectomy 35 years previously who had undergone adjuvant radiotherapy presented with purulent discharge on the anterior chest wall. The patient was diagnosed with chronic PLE with ascending infection and concurrent osteonecrosis of the parasternum. Proper drainage was performed for local infection control and the dead spaces were successfully closed with muscle flaps. There have been no complications to date.

• Journal of Chest Surgery
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• 제11권1호
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• pp.35-41
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• 1978

After the advent of the effective antimicrobial drugs, empyema of the pleural cavity came to be considered an infrequent disease. However, in recent years the problem of empyema is increasing, probably due to bacterial changes associated with the use and misuse of antimicrobials as well as alterations in the host associated with increased longevity and chronic disease. During the 10 years period from 1957, Sop. to 1977, Aug., we experienced 152 cases of empyema, of which 37 were scheduled on open thoracotomy drainge for chronic empyema. 1. The ratio of male to female was 3.6:1 with male predominance and 64% of total was above 40 years old in age distribution. 2. The cardinal symptoms were fever[70%], dyspnea[40.5%], and sputum[40.5%]. The leucocytosis were observed in 75.7% of all cases. The hemoglobin level showed subnormal in 21.6% of all cases. 3- The underlying pathology predisposing to empyema were postoperative empyema [35.1%] and tuberculosis[32.4%] in order. 4. The pathologic organisms by bacterial culture in 37 patients were Pseudomonas [24.3%], Staphylococccus [21.6%], Streptococcus [21.6%]., no growth [8. 1%] and the remainders. 5. The late results were as follow; a. Spontaneous closure was seen in 10 patients and all of them belongs to non-tuberculous group. Their mean duration was 14 months. b. Still opened are eight; 6 in tuberculous group, remainders in non-tuberculous group. c. Secondary closure was performed in 6 patients, of which 5 cases showed successful secondary closure but one failed. The mean duration from OTD to secondary closure was 46.3 days. d. Eleven patients were not followed. e. Two patients were expired; one was due to progressive cachexia and pulmonary insufficiency, the other due to gastrointestinal bleeding unrelated to empyema.

• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.579-583
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• 2004

환자는 지속적인 객담을 동반한 기침 및 발열이 있었고, 방사선학적 검사에서 좌측폐에 air-fluid level을 동반한 거대한 공동이 관찰되었다. 임상 양상이 폐농양에 부합되어 항생제 투여와 배농을 시행 하였으나 호전이 없어 개흉술을 시행하였다. 수술 소견상 폐농양이 아닌 농흉이 관찰되었으며, 조직병리검사에서 폐방선균증으로 진단되었다.

• Journal of Chest Surgery
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• 제26권4호
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• pp.298-302
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• 1993

The 40 patients who admitted with chief complaints of pleural effusion and were performed closed thoracostomy and pleural biopsy at the same time with only one incision during the period from Mar,1990. To Feb. 1992. At the department of Thoracic & Cardiovascular Surgery; HanYang University were reviewed retrospectively and the results are as follows: 1. The age of patients ranged from 16 to 73-years old [Mean 44.3-years old]. The peak incidence was fifth decade [25 %] and the next was third decades [22.5 %]. 2. 28 patients were male and 12 patients were female with male preponderance[More than 2 times]. 3. The etiologic of pleural effusion were 25 cases of pulmonary tuberculosis[62.5 %], 8 cases of empyema [20 %], and 7 cases of malignant diseases [17.5 %]. 4. The most common chief complaints were dyspnea[21 cases:29.2%], chest discomfort[16 cases:22.2%], and the coughing with sputum [12 cases: 16.7 %]. 5. The duration of symptom were varied from 3 days to lyear [Mean 3.2 weeks]. 6. The amounts of drained pleural effusion after closed thoracostomy were ranged from 100ml to 2,400 ml [Mean 650 ml], but the amounts in case of malignant pleural effusion were varied from 400ml to 1,700ml [Mean 950ml]. 7. The diagnostic rate was 84.6 % with routine examination of tuberculous pleural effusion [Lymphocyte predominance] and the same rate was acquired by pleural biopsy. 8. The diagnostic rate by pleural biopsy in case of malignant pleural effusion was 57.1% and lower than tuberculous pleural effusion. 9. The etiology of malignant pleural effusion were squamous cell carcinoma [3 cases:42.8 %], adenocarcinoma [2 cases:28.6 %] and metasiatic breast cancer [1 case:14.3%].

• Journal of Chest Surgery
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• 제25권8호
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• pp.850-855
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• 1992

Dead space of empyema occurrs from incomplete obliteration of infected pleural space from pulmonary tuberculosis, pyogenic infection, esophageal disease and post pulmonary resection. Chronic empyema can be treated by obliteration of dead space with autologous tissues such as, extrathoracic muscle flap and omental flap and thorachoplasty. Between May, 1986 to July, 1991 we treated 17 chronic empyema patients with autologous tissues and analysed the result. 1. Sex distribution was 14 males and 3 females between 5~62 years old. [mean 39.7 years old] 2. The volume of the dead space ranged from 100 to 450cc. [mean 213. 76cc] 3. The majority of used muscle flap were serratus anterior and latissimus dorsi, and there were 2 cases of am ntal flap. 4. The majority of underlying disease were pulmonary tuberculosis and there were 8 BPF[47%] in 17 patients 5. In 7 cases, thorachoplsty was needed. 6. Three cases recurred and there were no death.