• Title/Summary/Keyword: Pulmonary pleura

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Clinical Study of 61 cases Benign Lung Tumor (폐양성 종양 61례의 외과적 고찰)

  • 박종원
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.272-289
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    • 1989
  • Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

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Bilateral fibrothorax with constrictive pericarditis (위축성 심낭염 [Constrictive Pericarditis]을 동반한 양측성 섬유흉 [Fibrothorax] 치험 1)

  • Sun, Kyung;Kim, Yo-Han;Baek, Kwang-Je;Lee, Chol-Sae;Kim, Hark-Jei;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.703-708
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    • 1984
  • Fibrothorax is the end stage of chronic pathologic processes of pleura such as hemothorax, empyema, or tuberculous effusion. The pleural space become adherent and obliterated, and the lung parenchyma is covered by a thick, fibrous, unexpandable "peel", so the lung function is diminished markedly with impaired ventilation and oxygenation. Constrictive pericarditis is often accompanied fibrothorax, also cardiac and hemodynamic function is deteriorated. Surgical relief of these fibrous peels causes remarkable improvement in pulmonary function, cardiac and hemodynamic function, and subjective symptoms. We experienced a case of bilateral fibrothorax combined with constrictive pericarditis which occured 3 years after bilateral tuberculous effusion. Decortication and percardiectomy were done at the same time through bilateral submammary thoracotomy with sternal transection. Comparing postoperative Peripheral venous pressure, Circulation time, Pulmonary function test, Arterial blood gas analysis, Subjective symptoms with preoperative conditions showed noticeable improvement.provement.

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CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy

  • Jeon, Min-Cheol;Kim, Ju Ock;Jung, Sung Soo;Park, Hee Sun;Lee, Jeong Eun;Moon, Jae Young;Chung, Chae Uk;Kang, Da Hyun;Park, Dong Il
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.330-338
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    • 2018
  • Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

  • Kang, Hye Seon;Ha, Jick Hwan;Kang, Hyeon Hui;Yeo, Chang Dong;Rhee, Chin Kook;Kim, Sung Kyoung;Moon, Hwa Sik;Lee, Sang Haak
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.284-290
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    • 2017
  • Background: We aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible. Methods: This was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield. Results: We included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], 7.56-103.32; p<0.001 and OR, 4.91; 95% CI, 1.76-13.72; p=0.002). Conclusion: The presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

The Effectiveness of Real-Time PCR Assay, Compared with Microbiologic Results for the Diagnosis of Pulmonary Tuberculosis

  • Kim, Seo Woo;Kim, Sae In;Lee, Seok Jeong;Lee, Jin Hwa;Ryu, Yun Ju;Shim, Sung Shine;Kim, Yookyoung;Lee, Mi Ae;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.1
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    • pp.1-7
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    • 2015
  • Background: The incidence of tuberculosis (TB) in Korea is relatively high compared to the other Organisation for Economic Co-operation and Development (OECD) countries, with a prevalence of 71 per 100,000 in 2012, although the incidence is declining. Real-time polymerase chain reaction (PCR) has been introduced for the rapid diagnosis of TB. Recently, its advantage lies in higher sensitivity and specificity for the diagnosis of TB. This study evaluated the clinical accuracy of real-time PCR using respiratory specimens in a clinical setting. Methods: Real-time PCR assays using sputum specimens and/or bronchoscopic aspirates from 2,877 subjects were reviewed retrospectively; 2,859 subjects were enrolled. The diagnosis of TB was determined by positive microbiology, pathological findings of TB in the lung and pleura, or clinical suspicion of active TB following anti-TB medication for more than 6 months with a favorable response. Results: Sensitivity, specificity, and accuracy were 44%, 99%, and 86% from sputum, and 65%, 97%, and 87% from bronchoscopic aspirates, respectively. For overall respiratory specimens, sensitivity was 59%, specificity was 98%, and accuracy increased to 89%. Conclusion: Positivity in real-time PCR using any respiratory specimens suggests the possibility of active TB in clinically suspected cases, guiding to start anti-TB medication. Real-time PCR from selective bronchoscopic aspirates enhances the diagnostic yield much more when added to sputum examination.

Lymphangioleiomyomatosis with Bilateral Chylothorax -1 case report- (양측 유미흉을 동반한 림프관평활근종증)

  • 김시욱;최재성;나명훈;임승평;이영;유재현
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1029-1031
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    • 2004
  • We had expierienced pulmonary lymphangioleiomyomatosis(LAM) with bilateral chylothorax and chylous ascites. A twenty-one-year-old lass with chief complaint of abdominal pain was admitted through the emergency room. She received emergent pelvicoscopic surgery for the rupture of the right corpus luteum. We aspirated 1000ml of the uncoagulated blood. The bleeding point was cautherized electrically. LAM was diagnosed with tissue from the retroperitoneum. Chylous ascites and bilateral chylothorax were occurred despite of various treatments. On thoracotomy, bullous changed lung and lymphatic leakage from visceral and parietal pleura were observed. She died of respiratory insufficiency and general weakness after 6 months from admission.

Pathological Pictures of Pasteurella Pneumonia in Swine (돈역성폐염(豚疫性肺炎)에 관한 병리학적연구(病理學的硏究))

  • Lim, Chang Hyeong
    • Korean Journal of Veterinary Research
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    • v.12 no.1
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    • pp.121-126
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    • 1972
  • The pneumonic lungs of 51 pigs, from which the presence of pasteurella organisms was confirmed by bipolar staining, were examined pathologically. The numbers of pigs in each age group were 22 (43.1%) in 3-4 month group, 20 (39.2%) in 1-2 month group, 7 (13.7%) in 5-6 month group, and 2 (4.0%) in group of more than one year. The lungs of 16 pigs which were regarded as pasteurella pneumonia without any other manifestations were studied pathogically. Grossly, the affected lungs showed pulmonary edema, lobular consolidation and interlobular edema. Pigs over 3 months of age frequently showed chronic condition in which the entire lobe was involved as confluent pneumonia. In such pneumonic lungs, infarction and focal necrosis of the lung parenchyma and deposition of fibrinous exudate on the pleura were encountered. Histologically, the alveolar spaces were filled with fibrinous and leukocytic exudates. The interlobular septae showed marked edema and fibrinous exudate. The process of organization was frequently observed in chronic cases.

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Streptococcus equi subsp. zooepidemicus infection in barbary sheep (Ammotragus lervia) (바바리양에서 발생한 Streptococcus equi subsp. zooepidemicus 감염증)

  • Koh, Ba-Ra-Da;Park, Seong-Do;Kim, Jae-Ik;Park, Jong-Tae
    • Korean Journal of Veterinary Research
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    • v.47 no.4
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    • pp.409-415
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    • 2007
  • An eight years old female barbary sheep (Ammotragus lervia), which bred at the Gwangju Uchi Park Zoo had shown anorexia, depression, respiratory problem for several weeks after parturition. In necropsy, extensive necrotizing pneumonia was found with severe immunocytes infiltration in the alveolar spaces and bronchioles. Pulmonary pleura were thickened with fibrin and inflammatory cells. Bacteria were isolated from lung and identified as Streptococcus equi subsp. zooepidemicus (SEZ) by biochemical tests and PCR on sodA and gusA genes, though seel gene was not detected. Isolation of zoonotic SEZ in public place such as a zoo should be emphasized for the public health mangagement.

Remnant parietal serosa detection in a cat with true diaphragmatic hernia using computed tomography

  • Lee, Sang-Kwon;Jeong, Wooram;Choi, Jihye
    • Korean Journal of Veterinary Research
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    • v.59 no.2
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    • pp.105-108
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    • 2019
  • A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.

Pathological interpretation of connective tissue disease-associated lung diseases

  • Kwon, Kun Young
    • Journal of Yeungnam Medical Science
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    • v.36 no.1
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    • pp.8-15
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    • 2019
  • Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.