• Tuberculosis and Respiratory Diseases
• /
• v.66 no.3
• /
• pp.211-215
• /
• 2009

Pulmonary thromboembolism occurs in old patients with risk factors, such as, immobilization, chronic medical disease, trauma, a hereditary hypercoagulable state, and others. However, we experienced a young man with a massive pulmonary thromboembolism attributed to immobilization due to computer gaming. The patient had been playing computer games in a seated position for at least five hour continually, and for twelve hours per day over a two-week period. The 36-year-old patient was transferred to our institute rule out the possibility of an acute myocardial infarction. Computer tomography revealed intraluminal filling defects in the distal main pulmonary artery and the left popliteal vein. He received thrombolytic therapy and subsequently recovered without complications. This case raises the possibility that prolonged computer gaming is a risk factor of thromboembolism in young adults.

• Tuberculosis and Respiratory Diseases
• /
• v.39 no.1
• /
• pp.73-78
• /
• 1992

Background: From 1973 we performed EPPT for the 3,500 cases of the cavitary tuberculosis who were not responded well to the antimicrobial drugs, and we evaluated the 1,003 cases who could be followed up to more than 3 years postoperatively. Method: The key of the EPPT was that the 5-8 ribs of unilateral chest were denuded at the one stage operation and the paraffine was used as the plomb of filling the dead space out of the collapsed periosteums and intercostal muscles. Result and Conclusion: Number of patients who had unilateral EPPT was 759 and bilateral 244. The late complication were subscapular abscess (12) lump formation (42) and paraffine expectoration (26). All of those complications was cured after removal of the packed paraffine. Sputum conversion rates were 91.6% in the group with cavity less than 3 cm and 41.8% in the group with cavity bigger than 5cm.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.5
• /
• pp.975-991
• /
• 1997

Background : Many patients with isoniazid and rifampin-resistant pulmonary tuberculosis have organisms that are also resistant to other first-line drugs. Despite of aggressive retreatment chemotherapy, the results are often unsuccessful, with a failure rate approaching 40%. Recently, there has been a revival of resectional surgery for the treatment of multidrug-resistant pulmonary tuberculosis. Methods : A retrospective analyses of the case records and radiographic findings were done. Between January 1991 and December 1995, 14 human immunodeficiency virus (HIV)-seronegative patients with multidrug-resistant pulmonary tuberculosis were selected for resection to supplement chemotherapy. All patients had organisms resistant to many of the first-line drugs, including both isoniazid and rifampin. Results : Despite of aggressive therapy for median duration of 9.5 months, 12 of the 14 patients (86%) were still sputum smear and/or culture positive at the time of surgery. The disease was generally extensive. Although main lesions of the disease including thick-walled cavities were localized in one lung, lesser amounts of contralateral disease were demonstrated in 10 of 14 (71%). Types of surgery performed were pneumonectomy including extrapleural pneumonectomy in six patients, lobectomy or lobectomy plus in six patients, and segmentectomy in two patients. The resected lung appeared to have poor function ; preoperative perfusion lung scan showed only 4.8% of the total perfusion to the resected portion of the lung. There were no operative deaths. Two patients had major postoperative complications including empyema with bronchopleural fistula and prolonged air leak, respectively. Of the 14 patients, 13 (93%) remained sputum-culture-negative for M. tuberculosis for a median duration of 23 months and one remained continuously sputum smear and culture positive for M. tuberculosis. Conclusion : On the basis of comparison with historical controls, adjunctive resectional surgery appears to play a significant beneficial role in the management of patients with multidrug-resistant pulmonary tuberculosis if the disease is localized and there are adequate reserve in pulmonary function.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.6
• /
• pp.973-979
• /
• 2000

A glycogen storage disease(GSD) type I is a metabolic disease caused by a deficiency in one of the components of the glucose-6-phosphatase(G-6-Pase) system. This disorder results in hypoglycemia, hepatomegaly, lactic acidemia, hyperlipidemia, and hyperuricemia. Comon long(-)term complications include growth retaradation, gout, hepatic adenomas, osteoporosis and renal disease. However the cardiovascular system is rarely involved, and only six cases of pulmonary hypertension associated with GSD I have been reported in the literature. We experienced a case of pulmonary hypertension with type I GSD. A 31-year-old rnan, who had discovered type I GSD and received portocaval shunt operation 22 years ago, was admitted to the hospital with the chief complaint of dyspnea. Echocardiographic examination and cardiac catheterization revealed severe pulmonary hypertension. Nitric oxide and oral prostacycline derivative(beraprost) were tried without acute favorable response. After one year with beraprost, dyspnea, exercise capacity and hemodynamic parameters were improved. We report this case with a review of the literature.

• Tuberculosis and Respiratory Diseases
• /
• v.76 no.6
• /
• pp.295-298
• /
• 2014

Pulmonary systemic arterialization to normal basal lung without sequestration is a rare congenital anomaly. In this rare abnormality, arterialization of the left lower lobe is the most common type. In general, surgical treatments have been performed. Recently, for reducing the complications and risks of surgery, embolization is mainly attempted by using coils. We report a case of 22-year-old male patient with a 10 mm anomalous arterial supply to his normal lung, which is being successfully treated by transcatheter embolization when using the Amplatzer Vascular Plug that has been adapted for the treatment of high-flows and large artery occlusions.

• Journal of Chest Surgery
• /
• v.29 no.4
• /
• pp.397-402
• /
• 1996

A clinical study of 36 cases of pulmonary tuberculosis that had had a surgical resection during the period of 13 years from January 1979 to December 1992 was performed in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital The ratio between male and female was 3.5 1 and the age of peak incidence was in the 2nd and 3rd decades. The common prodromal symptoms were chest pain (38.9 %) and hemoptysis or blood tinged sputum (36.1 %). Preoperative diagnostic examination of sputum positivity for AFB stain despite antituberculosis chemotherapy was noticed in 22.8 oyo . Surgical indications were destroyed lobe or segment with or without cavity (58.3 oyo), mass unable to differentiate from lung cancer (16.7 %), total destroyed lung (13.9 %), bronchostenosis with atelectasis and distal bronchiectasis (11.1 %). Types of resection were pneumonectomy in 16.7%, lobec omy and segmentectomy 2.7%, lobectomy 50 %, segmentectomy 27.8%, and wedge resection 2.7%. Postoperatively, pulmonary function Improved compared to the preoperative examination, although these changes were not statistically significant. One patient died of ulcerative colitis due to drug hypersensitivity, and the postoperative complications were remnant dead space in 11.1 %, spreading of tuberculosis in 5.5%, and empyema with BPF in 5.5%.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.1
• /
• pp.62-68
• /
• 2005

Background : The clinical results of a Natural stent in patients with a benign tracheobronchial stenosis were examined by comparing the clinical outcomes and complications of those patients who underwent Dumon and Natural stenting in the management of benign airway stenosis. Methods : The medical records of 94 patients (39 Dumon and 55 Natural stent) with a benign tracheobronchial stenosis were reviewed and analyzed. Results : Post-tuberculous stenosis was the leading indication for airway stenting (74%), which was followed by post-intubation stenosis (21%). After intervention, the dyspnea had improved among those patients who underwent Dumon (90%) and Natural (86%) stenting. After stabilizing the dyspnea, the stent could be successfully removed in half of the patients who underwent both Dumon (54%) and Natural (49%) stenting. During the 42 month follow-up period, the complication rate was similar in those patients who underwent Dumon and Natural stenting: migration (46% vs 53%), granulation tissue formation (36% vs 49%), mucostasis (21% vs 16%) and restenosis (51% vs 36%). Conclusion : The clinical results of Natural airway stent was similar to those of Dumon stent in the management of benign tracheobronchial stenosis.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.6
• /
• pp.710-717
• /
• 2001

Two cases of an anomalous systemic arterial supply to the basal segments of the left lower lobe without pulmonary sequestration are presented. In the first case, a preoperative diagnosis was made by chest CT, and confirmed by angiography, in a 22-year old man who had a recurrent hemoptysis. There was systemic arterial supply that originated from the thoracic descending aorta and no pulmonary arterial supply to the basilar segments of the left lower lobe. However, the pulmonary parenchyma was normal without sequestration. Ligation of the abnormal artery and a left lower lobectomy were performed without complications. In the second case, there were characteristic features of this anomaly on chest CT and the angiogram in a 31-year-old man with symptoms of hemoptysis. The patient refused surgery.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.1
• /
• pp.59-62
• /
• 2009

Reexpansion pulmonary edema is not a common phenomenon after chest tube insertion but some reports from 0% to 14%. There are various resulting complications, including acute respiratory distress syndrome. We report a case of focal reexpansion pulmonary edema after chest tube insertion. A 49-year-old male came to the hospital due to ongoing dyspnea and left chest pain for 3 days. On chest X-ray, the patient had a left pneumothrax. We planned to insert a chest tube for symptom relief. To determine whether or not the chest had expanded as a result of the chest tube insertion, the patient underwent repeated chest X-rays the following day. The patient experienced brief respiratory symptoms upon initial suction; a chest PA showed patchy consolidated infiltration at the inserted site. After 5 days of conservative management, the recovered completely.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.6
• /
• pp.457-462
• /
• 2009

While receiving appropriate treatment, patients with tuberculosis occasionally have unusual, paradoxical reactions, with transient worsening of lesions or the development of new lesions. This report is a case of tuberculosis brain abscess and tuberculosis peritonitis with intra-abdominal abscess that developed during appropriate anti-tuberculosis chemotherapy. A 45-year-old male patient had been diagnosed as with all-drug susceptible pulmonary tuberculosis with pleurisy. Subsequently, the patient underwent standard treatment with anti-tuberculosis therapy; the pulmonary lesions improved. Three months after initial treatment, the patient developed brain abscesses and peritonitis. With the addition of corticosteroid treatment, the patient's neurologic symptoms were relieved. Exploratory laparotomy with surgical drainage was performed and a diagnosis of tuberculosis peritonitis was confirmed on biopsy. Anti-tuberculosis therapy was continued for 19 months, the patient improved eventually without further complications, although the therapeutic regimen had not been altered. In this case, the paradoxical response to treatment may have been involved in the pathogenesis of disease.