• Journal of Chest Surgery
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• 제20권1호
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• pp.1-12
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• 1987

Respiratory care with oxygen inhalation is often a necessity to maintain life, and it is one of the important therapeutic adjuncts in respiratory disease and in intensive care after surgery. However, it has been reported that oxygen toxicity occurs after prolonged exposure to 100% 0, [Smith, 1899; Kistler et al. 1967; Schaffner et al. 1967; Rowland and Newman, 1969. Subjective symptoms of oxygen toxicity include tracheal irritation, frequent cough, some burning sensation in the trachea, tachypnea, severe dyspnea, etc. [Welch, 1963; Fisher et al, 1968; Milier et al, 1970; Clark and Lambertsen, 1971; Sackner, 1975]. Pathologic findings are atelectasis, injuries to the pulmonary capillaries and hemorrhage in the alveoli in gross specimens. There can be inflammation, proliferation of fibrin, thickening of alveolar membranes, degeneration of collagen fibers and interstitial edema in the microscopic findings. [Penrod, 1956; Cedergren, 1959; Bean, 1965; Schaffner, 1967]. Dubois and colleagues [1961] found that the amount of pulmonary surfactant was decreased in oxygen toxicity and atelectasis followed by the decreased pulmonary surfactant. Many authors reported that vital capacity, inspiratory force, pulmonary compliance, pulmonary capillary blood flow and pulmonary elasticity were deceased and arteriovenous shunting increased. [Comroe et al, 1945; Fuson et al, 1965; Kistler et al, 1966; Knowles and Blenner-hassett, 1967; Barber et al, 1978]. Many human volunteers were examined after prolonged exposure in a high oxygenated chamber and there were a few reports on animals with oxygen toxicity, subjects including rabbits. Gas partial pressures of alveoli and arteries were measured in rabbits exposed to 100% $O_2$ and the alveolar-arterial gas gradients were analyzed, which is the basis for the study of oxygen toxicity. These rabbits were divided into two groups; rabbits under natural respiration, and second group under artificial respiration with a respirator. The alveolar $PO_2$ [$P]AO_2$] and $PCO_2$ [$PACO_2$], and the arterial $PO_2$ [$PaO_2$] were measured under varying $O_2$ pressures; 15% $O_2$, 21% $O_2$ and 100% $O_2$.

• Journal of Chest Surgery
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• 제15권2호
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• pp.148-154
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• 1982

The experience with operative treatment for peripheral situated solitary circumscribed lesions of the lung at the Department of Thorac. & Cardiovasc. Surg., Korea University Hospital during 8 years from March 1974, through April, 1982 was reviewed. Our criteria for Solitary pulmonary nodule were 1. Round or Ovoid shape 2. Surrounded by normal lung Parenchyme 3. Well circumscribed peripheral location 4. No other visible pulmonary diseases on chest X-ray except minimal atelectasis or pneumonitis 5. Largest diameter less than 8 cm Of the 55 patients reviewed, there were 69% of malignancy and 31% of benign pulmonary diseases. In malignancy 38 patients, there were 18 patients with squamous cell carcinoma, 8 patients with undifferentiated large cell carcinoma, 2 patients with undifferentiated small cell carcinoma, 10 patients with adenocarcinoma and patient with metastatic carcinoma. In benign pulmonary nodule 17 patients, here were 5 patients with tuberculoma, 5 patients with aspergilloma, 2 patients with A-V fistula, 1 patient with pulmonary blastoma, 1 patient with paragonimiasis, and 1 patient with lung abscess. Overall male to female occurrence ratio was 39:16, and most prevalent age incidence was 7th decades. Most frequent size distribution was 4-6 cm in diameter. All of benign diseases were cured by resection and 66% of malignancy performed operation and has 75% resectability.

• Neonatal Medicine
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• 제18권2호
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• pp.404-408
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• 2011

Scimitar증후군은 우측 폐정맥이 하대정맥을 통하여 좌심방이 아닌 우심방으로 연결되는 부분 폐 정맥 환류이상을 보이면서 우측 폐의 발육부전, 우폐동맥의 발육부전 및 폐 분리증 등과 같은 동반 기형을 보이는 매우 드문 심폐기형 가운데 하나이다. 또한 선천성 항문 막힘증은 출생 후 조기에 잘록 창자 창냄술과 같은 적극적인 수술적 치료가 요구되는 항문 직장 기형의 하나로 비뇨기계 이상, 척추 이상, 기관지 식도루, 식도 폐쇄증 혹은 심혈관계 이상 등이 동반될 수 있다. 그러나, 부분 폐 정맥 환류 이상의 하나인 scimitar증후군이 항문 막힘증과 함께 동반됨을 보고한 예는 아직까지 국내외적으로 없었다. 이에 저자들은 호흡 곤란 및 선천성 편측 폐 발육부전 및 항문 막힘증을 주소로 입원한 신생아에서 진단된 scimitar 증후군 1례를 경험하였기에 보고하는 바이다.

• The Korean Journal of Physiology
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• 제28권1호
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• pp.71-77
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• 1994

In the animal model of acute respiratory distress syndrome (ARDS) induced by N-nitroso-N-methylurethane (NNNMU) the secretory activity of alveolar type H cells during acute alveolar injury was investigated by determining phospholipid and pulmonary surfactant associated proteins in crude surfactant. The mechanism of the secretory change was studied by determination of DNA and RNA levels in the lung tissue. After induction of acute alveolar injury with NNNMU, pulmonary hemorrhage, atelectasis and gross hypertrophy were observed. Seven days after NNNMU treatment the level of total DNA in lung homogenate was increased markedly indicating that a hypertrophy was induced by cellular proliferation. Although the total DNA level increased, the RNA/DNA ratio was gradually decreased after NNNMU treatment. Seven days after NNNMU treatment the RNA/DNA ratio returned to the normal control level. During the acute alveolar injury, phospholipid and surfactant associated proteins were reduced significantly as compared with the control, implying that the secretory activity of alveolar type II cells was altered during acute alveolar injury induced by NNNMU. The protein content in crude surfactant during peak injury(7 days after NNNMU) was decreased significantly but phospholipid/protein ratios were identical in both control and NNNMU treatment groups. SDS-PAGE of proteins in crude pulmonary surfactant showed a decrease in major surfactant associated protein(M.W. 38,000) during acute alveolar injury. The present study may suggest that while alveolar type H cells proliferate markedly, transcription of alveolar type ll cell gene was inhibited by an unknown mechanism such as DNA methylation induced by NNNMU. Such an inhibition of transcriptional activity is thought to be associated with the decreased secretory activity of alveolar type ll cells, which may lead to pulmonary atelectasis and edema during the acute alveolar injury.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.440-444
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• 2015

Gastric mucosal damage by iron pills is often reported. However, iron pill aspiration is uncommon. Oxidation of the impacted iron pill causes bronchial mucosal damage that progresses to chronic bronchial inflammation, necrosis, endobronchial stenosis and rarely, perforation. We reported a case of a 92-year-old woman with chronic productive cough and significant left-sided atelectasis. Bronchoscopy revealed substantial luminal narrowing with exudative inflammation of the left main bronchus. Bronchial washing cytology showed necroinflammatory exudate and a small amount of brown material. Mucosal biopsy showed diffuse brown pigments indicative of ferrous pigments, crystal deposition, and marked tissue degeneration. After vigorous coughing, she expectorated dark sediments and her symptoms and radiological abnormalities improved. There are a few such reports worldwide; however, this was the first case reported in Korea. Careful observation of aspiration-prone patients and early detection of iron pill aspiration may prevent iron pill-induced bronchial injury.

• Journal of Chest Surgery
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• 제26권5호
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• pp.380-383
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• 1993

Aspergillosis is not only the problem increasing the freguency for recent decades but also a serious one. Coexistent pulmonary diseases are frequent and the most common antecedent disease is Tuberculosis with healed cavitary lesion. Interest of the surgeons is aroused because of it`s predilection to sudden life-threatening, exsanguinating pulmonary hemorrhage. 11 patients with pulmonary aspergillosis evaluated at this hospital in a 7-year period, and the results were as follows: 1.male to female ratio was 1:1.75. 2.The most common symptom was gross or microscopic hemoptysis[72.7%]and other symptoms were chest pain[9.1%] and chronic productive coughing[9.1%]. 3.The right upper lobe was most common involving site[81.8%] 4.Surgical interventions were 8 cases of lobectomy, 1 case of lobectomy with wedge resection, 2 cases of wedge resection. 5.Post-operative complications developed in 5 patients and were 4 cases of wound infections, 2 cases of empyemas, 1 case of bleeding, 1 case of atelectasis.

• Journal of Chest Surgery
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• 제15권1호
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• pp.15-20
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• 1982

During the past ten years from 1972 to 1981, a total of 100 cases of bronchiectasis were treated by pulmonary resection at C.A.F.G.H. Pulmonary tuberculosis and frequent U.R.I. were the most frequent associated disease and encountered in 54% in this series. Various types of pulmonary resection were performed on 100 patients; left lower lobectomy in 40 cases, left lower lobectomy and lingular segmentectomy In 29 cases, right lower lobectomy in 12 cases, right middle and lower lobectomy in 12 cases, lingular segmentectomy in 3 cases, left pneumonectomy in 3 cases and both lower lobectomy in 1 case. Complications developed in 9 cases and 1 case among them died of sepsis following secondary opera-tion. Among complications of 9 cases, postoperative atelectasis showed in 4 cases, hemorrhage in 2 cases, bronchopleural fistula in 2 cases, pulmonary edema in 1 case. Complications were treated by conservative and secondary operative management with satisfactory result except one death. Remainders without complication showed good result without symptom in postoperative and follow-up periods.

• Journal of Chest Surgery
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• 제11권3호
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• pp.316-320
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• 1978

This report presents a case of patent ductus arteriosus complicated with total left lung atelectasis and mitral regurgitation. Her mother complained growth retardation and exertional dyspnea. The 3 year old girl had large patent ductus arteriosus [Qp/Qs=5.6] which resulted in moderate pulmonary hypertension, left atrial hypertrophy and enlargement, consequently the left main bronchus was compressed between the dilated left atrium and aorta. We would like conclude the cause of mitral regurgitation as the result of annular dilatation secondary to left atrial enlargement rather than congenital associated to patent ductus arteriosus. 3 weeks later from ligation of patent ductus arteriosus, the left atrial dimension was markedly reduced echocardiographically [from 3.9cm to 2.7cm], and the left lung progressively aerated by halves.

• Clinical and Experimental Pediatrics
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• 제45권4호
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• pp.519-523
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• 2002

목 적: 기관지 천식으로 입원한 환아에서 시행된 단순 흉부 방사선에서 이상 소견을 조사하고, 관찰된 무기폐를 자세히 분석하고자 하였다. 방 법 : 4년간 가톨릭대학교 대전성모병원에 기관지 천식으로 입원한 144명의 357례의 흉부 방사선에서 무기폐를 포함한 폐의 이상 소견과 임상상, 혈액학적 소견 등을 후향적으로 분석하였다. 결 과 : 144례의 환아의 남녀비는 2.1 : 1, 평균 나이는 4.8세, 평균 입원 횟수 2.5회, 평균 입원일 5.0일, 평균 IgE 치 387 IU/mL, 평균 호산구 수 $362/mm^3$ 이었다. 357례의 단순 흉부 방사선 이상 소견으로 과?창 314례(88.0%), 폐침윤 127례(35.0%), 무기폐 19례(5.3%), 중격동기종 1례(0.3%)가 관찰되었다. 19례의 무기폐는 대부분 폐구역성 또는 폐소엽성으로 모두 우측 폐에서 발생하였으며 2세 이하와 남아에서 발생이 많았다. 또한 2세 이하에서는 우상엽에서, 7세 이상에서는 우하엽에서 주로 발생하였다. 결 론 : 천식으로 입원한 환아에서 흉부 방사선 사진에서 무기폐(5.3%)를 포함한 이상 소견을 보이는 경우가 적지 않으며 이에 따른 적절한 치료 방침을 결정해야 할 것으로 사료된다.

• Journal of Chest Surgery
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• 제9권2호
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• pp.175-186
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• 1976

The cellular change of the pulmonary tuberculous lesions may be divided into two groups,exudative and proliferative form by their course and fate. In the most cases, the patients usually have very much complex type of cellular changes. Therefore, the shadows of the chest films in pulmonary tuberculosis are also much variable in nature. And Daniel said that knowledge of the pathology of tuberculosis and an appreciation of the method of progression and healing are essential to proper interpretation of the films. Author, having reviewed 33 cases of resected tuberculous lung obtained in N.M.T.H. for one year from Oct. '75 to Sep. '76 by surgical managements, classified the Pathological findings such as: 1) caseation only, 2) tuberculoma, 3) atelectatic lung 4) cavitary lesion and 5) atelectasis with cavity, and examined the relationship between the roentgenological characteristics of the chest films and the pathological process of tuberculous lesions of the resected lungs, The result were obtained as follows. (1) Tuberculoma was commonly appeared in $S_2$ segment in right and $S_6$ segment in left. (2) Atelectasis and destroyed lung were more commonly appeared in left lung than right, and their containing rate of cavity was 82%. (3) Cavities were mostly appeared in $S_1$ and $S_2$ segments of both lung and the appearance-rate of cavity on $S_6$ segment was higher in left than right. And among the cavitary lesions of the resected lung, cavity was not seen in the preoperative chest films in 22%. (4) The configuration, thickness and sharpness of the walls of cavities, which revealed the cavitary shadows in the preoperative chest films, were mostly depended on the degree of increased collagenous fiber of the wall, existence of perifocalitis, and more or less of the caseous masses on the inner surface of the cavity wall.