• Journal of Chest Surgery
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• 제39권5호
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• pp.403-406
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• 2006

폐경색은 폐동맥의 폐색으로 인해 발생하며 기관지내 세균오염에 의해 폐감염이 흔하게 속발하며 이는 폐농양, 농흉 그리고 기관지 흉막루 등을 일으켜 결국 패혈증에 이르게 할 수 있다. 이러한 이유로 조기 진단이 중요하며 감염 조절을 위해 폐절제 등을 조기에 고려해야 한다. 67세 남자가 호흡곤란을 주소로 응급실에 내원하였다. 흉부 전산화 단층 촬영에서 좌하엽에 침윤성 병변과 소량의 흉수 그리고 늑막 비후가 관찰되었다. 폐색전은 하엽 폐동맥에서 상엽 폐동맥까지 자라나 있었다. 출혈성 경색이 완연한 좌하엽은 절제되었고 좌주폐동맥을 열어 나머지 폐색전을 제거하였다. 수술 후 15개월간 추적 관찰하고 있으며 폐색전이나 폐경색의 재발은 보이지 않았다.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.181-184
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• 2010

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1221-1224
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• 1990

Fifty -six cases of tuberculous peripleural abscess were experienced in the department of thoracic and cardiovascular surgery, college of medicine, Hallym university from January 1980 to June 1990. Tuberculous peripleural abscess seems to originate from the space between the parietal pleura and endothoracic fascia. But rib caries, originated by hematogenous spread of mycobacteria to the rib, shows the rib destruction first, thereafter periosteal erosion and regional tissue involvement follows. In our 56 cases, results were as follows: 1. Their age ranged from 6 to 82 years, and female dominant [M: F=21: 35]. 2. The locations of abscess were 31 right, 23 left, and 2 sternal portions. 3. On X \ulcornerray findings, 37 cases showed active or old lesion of the tuberculosis in the lung field, 7 cases periosteal destruction of the ribs, and 29 cases pleural thickening. 4. Operative findings showed cold abscess with multiple fistulous tracts leading to intercostal space in most of the cases, and their origin were presumed to be from the space between the endothoracic fascia and parietal pleura. 5. The pus showed negative AFB stain in most of the cases except 3 cases. 6. Partial costectomy and radical curettage with drainage were performed in all cases. 7. 7 cases recurred after the first operations, but no recurrence after second operations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.102-107
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• 2004

저자들은 객담을 뱉지 못하는 뇌성마비 환아에서 객담 검사와 방사선학적 검사, 대장 조영술과 복부전산화단층촬영 검사를 통해, 폐결핵에 동반되어 상행 결장을 침범한 장결핵을 진단하고 항결핵제를 투여하여 임상적 호전을 가져온 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제40권10호
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• pp.711-714
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• 2007

결합조직염식도염은 식도의 점막하층과 근육층의 세균감염에 의해 발생하며 드문 질환이며 높은 사망률을 보인다. 69세 남자가 7일간의 흉통과 발열을 주소로 내원하였다. 흉부전산화단층촬영에서 종격동의 확장, 식도 주행을 따라 있는 식도벽의 비후와 공기 음영, 우측 흉수가 관찰되었다. 환자는 우측 개흉술을 통해 배농, 죽은조직제거술, 천공된 식도 근육층의 1차 봉합술을 시행 받았다. 추가 수술은 없었으며 퇴원시 식도 누출과 연하장애 없이 경구 식이는 원활하였다.

• Journal of Chest Surgery
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• 제36권10호
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• pp.721-727
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• 2003

배경: 흉막 유착 물질로서 정맥 주사용 테트라사이클린은 국내 생산이 중단되어 더 이상 사용할 수 없게 되었다. 본 연구 목적은 쥐에서 경구 독시사이클린의 흉막 유착 효과를 알아보고, 경구 독시사이클린과 자가 혈액과 탈크의 흉막 유착 정도를 비교하여 임상적인 효용성을 알아보고자 하였다. 대상 및 방법: 20마리의 숫쥐를 5마리씩 네 군으로 나누었다. A군은 0.9% 생리식염수 10 $m\ell$/kg를 한 쪽 흉강에 주입하였고, B군은 경구 독시사이클린 10 mg/kg, C군은 동종 혈액 2 ml/kg, D군은 탈크 70mg/kg을 각각 주입하였다. 28일 후 모든 예를 도살하여, 육안으로 확인한 유착과 조직학적 변화를 0에서 3으로 점수화하여 관찰하고, 흉막의 두께를 비교하였다. 걸과: 육안으로 관찰한 A군은 0.0점, B군 1.4$\pm$0.9점, C군 1.0$\pm$0.7점, D군은 2.2$\pm$0.8점이었고, B군과 D군은 유의한 흉막 유착을 보였다(p<0.05). 흉막 두께는 A군이 0.7$\pm$0.2 /$10^2$mm, B군 1.2$\pm$0.4/$10^2$mm, C군 1.4$\pm$0.4/$10^2$mm, D군은 3.5$\pm$0.9/$10^2$mm이었고, D군은 유의한 흉막 비후를 보였다(p<0.05). 조직학적으로 A군은 1.0점, B군 1.7$\pm$0.5점, C군 $1.5\pm$0.4점, D군은 2.8$\pm$0.4점이었고, B군과 D군이 유의한 조직학적 변화를 보였다(p<0.05). 결론: 본 연구에서 대조군과 비교하여 경구 독시사이클린은 육안으로,또한 조직학적으로 유의한 흉막 변화를 일으키는 것으로 관찰되었다. 동종 혈액은 흉막 유착 물질로 적당하지 않은 것으로 관찰되었다. 탈크는 경구 독시사이클린과 동종 혈액과 비교하여 조직학적인 유착이 가장 강력한 흉막 유착 물질이었다.

• Tuberculosis and Respiratory Diseases
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• 제70권5호
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• pp.397-404
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• 2011

Background: To evaluate chest CT findings of pandemic influenza A/H1N1 pneumonia without co-infection. Methods: Among 56 patients diagnosed with pandemic influenza A/H1N1 pneumonia, chest CT was obtained in 22 between October 2009 and Februrary 2010. Since two patients were co-infected with bacteria, the other twenty were evaluated. Predominant parenchymal patterns were categorized into consolidation, ground glass opacity (GGO), and mixed patterns. Distribution of parenchymal abnormalities was assessed. Results: Median age was 46.5 years. The CURB-65 score, which is the scoring system for severity of community acquired pneumonia, had a median of 1. Median duration of symptoms was 3 days. All had abnormal chest x-ray findings. The median number of days after the hospital visit that Chest CT was performed was 1. The reasons for chest CT performance were radiographic findings unusual for pneumonia (n=13) and unexplained dyspnea (n=7). GGO was the most predominant pattern on CT (n=13, 65.0%). Parenchymal abnormalities were observed in both lungs in 13 cases and were more extensive in the lower lung zone than the upper. Central and peripheral distributions were identified in ten and nine cases, respectively. One showed diffuse distribution. Peribronchial wall thickening was found in 16 cases. Centrilobular branching nodules (n=7), interlobular septal thickening (n=4), atelectasis (n=1), pleural effusion (n=5), enlarged hilar and mediastinal lymph nodes (n=6 and n=7) were also noted. Conclusion: Patchy and bilateral GGO along bronchi with predominant involvement of lower lungs are the most common chest CT findings of pandemic influenza A/H1N1 pneumonia.

• Korean Journal of Radiology
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• 제21권6호
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• pp.746-755
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• 2020

Objective: To identify predictors of pulmonary fibrosis development by combining follow-up thin-section CT findings and clinical features in patients discharged after treatment for COVID-19. Materials and Methods: This retrospective study involved 32 confirmed COVID-19 patients who were divided into two groups according to the evidence of fibrosis on their latest follow-up CT imaging. Clinical data and CT imaging features of all the patients in different stages were collected and analyzed for comparison. Results: The latest follow-up CT imaging showed fibrosis in 14 patients (male, 12; female, 2) and no fibrosis in 18 patients (male, 10; female, 8). Compared with the non-fibrosis group, the fibrosis group was older (median age: 54.0 years vs. 37.0 years, p = 0.008), and the median levels of C-reactive protein (53.4 mg/L vs. 10.0 mg/L, p = 0.002) and interleukin-6 (79.7 pg/L vs. 11.2 pg/L, p = 0.04) were also higher. The fibrosis group had a longer-term of hospitalization (19.5 days vs. 10.0 days, p = 0.001), pulsed steroid therapy (11.0 days vs. 5.0 days, p < 0.001), and antiviral therapy (12.0 days vs. 6.5 days, p = 0.012). More patients on the worst-state CT scan had an irregular interface (59.4% vs. 34.4%, p = 0.045) and a parenchymal band (71.9% vs. 28.1%, p < 0.001). On initial CT imaging, the irregular interface (57.1%) and parenchymal band (50.0%) were more common in the fibrosis group. On the worst-state CT imaging, interstitial thickening (78.6%), air bronchogram (57.1%), irregular interface (85.7%), coarse reticular pattern (28.6%), parenchymal band (92.9%), and pleural effusion (42.9%) were more common in the fibrosis group. Conclusion: Fibrosis was more likely to develop in patients with severe clinical conditions, especially in patients with high inflammatory indicators. Interstitial thickening, irregular interface, coarse reticular pattern, and parenchymal band manifested in the process of the disease may be predictors of pulmonary fibrosis. Irregular interface and parenchymal band could predict the formation of pulmonary fibrosis early.

• Tuberculosis and Respiratory Diseases
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• 제70권5호
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• pp.428-432
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• 2011

Pulmonary lymphangiomatosis is a rare disorder involving the entire intrathoracic lymphatic system from the mediastinum to the pleura. Pulmonary lymphangiomatosis mostly occurs in children and young adults without gender predilection. Although it is pathologically benign, it shows a progressive and fatal course with variable initial presentation. We now report a case of pulmonary lymphangiomatosis in a 35-year-old man. He presented with hemoptysis 6 months previously. Chest x-ray and a chest computed tomography scan showed diffuse interstitial thickening with left pleural effusion. Chylothorax was confirmed by thoracentesis. Lymphangiography showed dilated and tortuous lymphatic channels. Surgical lung biopsy revealed proliferation of complex anastomosing lymphatic channels. He was diagnosed with pulmonary lymophangiomatosis. Closed thoracostomy and chemical pleurodesis were done and the dyspnea was reduced.

• Journal of Yeungnam Medical Science
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• 제21권1호
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• pp.74-81
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• 2004

서론: 면역기능 정상인 환자에서 폐효모균증의 전산화단층촬영상(CT)의 소견을 알아보고자 하였다. 대상 및 방법: 조직학적으로 확진된 25명의 폐효모균증 황자를 대상으로 하였다. 13명은 남자였고 12명은 여자였으며, 평균연령은 53.7세 였다. 주 증상은 기침, 가래, 및 호흡곤란이었고, 12명의 환자에서는 증상이 없었다. 결과: 결절 혹은 다수결절(10명 40%)을 보이거나 분절 혹은 이분절성 폐경결(9명 36%)이 가장 흔한 소견이었다. 주 침범부위는 하엽(57%) 늑막하부(92%)였다. 폐경결 내부에 공기관지 음영(79%)을 보이며 용적감소를 보인 경우(71%)가 흔하였다. 간질비후 음영(44%) 및 공동형성(44%)도 자주 보였으나, 임파절 종대(8%) 및 늑막삼출(4%)은 드문 소견이었다. 결론: 폐 하엽 늑막하 부위에 다수의 결절 혹은 폐경결성 병변이 면역기능 정상인 환자에서 폐효모균증의 가장 흔한 소견이었다.