• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.122-127
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• 1997

Carcinosarcoma of the lung is a rare turner with an admixture of malignant epithelial(carcinomatous) and malignant mesenchymal (sarcomatous) components. Clinicopathologically, pulmonary carcinosarcoma has been divided into two types by its anatomical locations and growth nature, peripheral parenchymal and central endobronchial variants. We experienced an endobronchial carcinosarcoma that induced complete atelectasis of the right lung due to polypoid growing mass from the right upper lobe bronchus in a 67 year old male smoker. The patient underwent a successful right pneumonectomy. The tumor was composed of squamous cell carcinoma with variable sarcomatous differentiation into myogenous and undifferenciated sarcoma that demonstrated by immunohistochemical study. The patient has been doing well for the last seven months since the operation, without metastases or turner recurrence.

• Investigative Magnetic Resonance Imaging
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• v.5 no.1
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• pp.18-23
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• 2001

Purpose : To describe the MRI findings in the bronchial anthracofibrosis mimicking lung cancer on CT examination. Materials and methods : Ten patients, who showed CT findings mimicking lung cancer, were selected among fifty patients of bronchial anthracofibrosis proven by bronchoscopic biopsy, consisting of two men and eight women, ranging in age from 58 to 79 years old faverage age, 68 years old). CT scan and MRI were performed in all patients (n=10). Percutaneous lung biopsy on mass was performed in one patient. MRI findings were analyzed with the emphasis on the signal intensity of the mass (n=4), collapsed lung (n=4) and Iymph node (n=10) on axial T1 and T2-weighted images by two radiologists in consensus. No contrast enhancement was used in all cases. Results : CT scan revealed mass (n=4), atelectasis with obstructive pneumonia(n=4) and bronchial wall thickening(n=2). All patients showed enlarged medistinal Iymph nodes(n=10). The mass showed low signal intensity on T1WI and T2WI (n =4). The collapsed lung in patients with atelectasis indicated intermediate signal intensity on T1WI and low signal intensity on T2WI (n= 4). Nine patients showed low sisnal intensity of Iymph node on T1WI and T2WI, except one patient who showed central high signal intensity with peripheral rim of low signal intensity in right lower paratracheal llmph node on T2WI. Conclusion : Low signal intensity of a mass, collapsed lung, and lymph nodes on T2WI in anthracofibrosis patients may be helpful in differentiation of the lesion from lung cancer.

• Parasites, Hosts and Diseases
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• v.27 no.2
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• pp.119-130
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• 1989

An experimental pathological study was performed to observe the effect of prasiquantel treat- ment on the pulmonary lesions of the rat lung cuke, Paragonimus ilektsuenensis. The metacercariae were obtained from the freshwater crab, Sesarma dehaani, and 40 rats (wistar) were fed each with 10 metacercariae. On 20 rats prasiquantel treatment ($100mg/kg/day{\times}5$ days) was done at 5 weeks after the infection while remaining 20 rats were kept untreated for use as controls. The drug.treated rats and the untreated ones were sacrificed 3, 7, 14, 21 or 28 days later for the observation of lung pathology. The rats infected with P. iloktsuenensis showed remarkable pulmonary changes; gross features of hemorrhagic and nodular worm capsules protruded on to the surface of the lung, and histologically local atelectasis, inflammatory cell infiltration, and egg granuloma around the worm capsules each containing one or two worms. Praziquantel treatment of the rats was shorn to be highly effective in killing the worms and to lead them to degenerate, as early as in 3 days post-treatment. Almost all worms in the lung were dead and absorbed by the host cells in 21 days post-treatment, except a few living ones seen in a rat of 14-day post-treatment group. In most of the rats treated the pulmonary lesions showed the signs of resolution; regression of worm capsules with mummification of worms, decrease of inflammatory cell infiltration, improvement in the degree of atelectasis, and decreases in the frequency and size of the egg granuloma. From the results it is concluded that prasiquantel is highly effective for the treatment of rat P. iloktsuenensis infection in the lung, not only by its direct killing effect of the worms but also due to the excellent resolution capacity of the pulmonary tissues.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.41-47
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• 2013

Purpose: To evaluate the usefulness of Integrated PET/CT and compare the gloss tumor volume (GTV) identified on CT, PET, PET/CT to that obtained from fluorodeoxyglucose (FDG). Materials and Methods: This experimental study was obtained using GE Discovery 690 (General Electric Healthcare, Milwaukee, MI, USA) PET/CT simulator with Gammex Laser System for five non-small cell lung cancer (NSCLC) patients. In order to increase the reproducibility of the patient setup, We have to fixed to patients using the Extended Wing Board. GTV delineation was painted using the EclipseTM ver.10 contouring program for CT, PET, PET/CT images. And then, We were to compare the changes in the GTV. Results: These results are drawn from 5 patients who have atelectasis or pneumonitis. Compared to CT defined GTV, PET was decreased by 10.5%, 11.8% and increased by 67.9%, 220%, 19.4%. PET/CT was decreased by 7.7%, 6.7%, 28% and increased by 232%, 24%. Conclusion: We were able to determine the usefulness of PET/CT simulator for NSCLC. PET/CT simulator in radiation therapy is useful to define the target volume and It is possible to delineate Objective and accurate target volume. It seems to be applicable to other areas in the near future.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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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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• v.29 no.12
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• pp.1366-1372
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• 1996

Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.32-40
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• 1984

During the past six years from July 1977 to June 1983, fifteen adult patients of patent ductus arteriosus were surgically treated. The results were as follows: 1. Of the 15 patients, their age range was 17 to 34 years with a mean of 24 years, and sexual predominance was women [9. cf. 6 men]. 2. The most common symptom showed exertional dyspnea, and 10 patients were classed in NYHA class II, the rest were all class III. 3. On physical examination, all patients were auscultated continuous murmur, but concomitantly diastolic murmur was noted apical region in 2 patients. 4. On roentgenogram of chest, normal finding was 3 patients, and the other patients were revealed the evidence of pulmonary congestion. 5. The electrocardiogram was normal in 6 patients, but LVH was seen in 5, and 2 patients were LVH+ LAH. 6. Cardiac catheterization was performed in 12, and mean value of SO2[LPA-RV] was 6.3%, Q/Q 2.09, peak systolic pulmonary arterial pressure 45.3 mmHg, and Rp/Rs 0.365. 7. All operations were carried out by posterolateral thoracotomy. In 6 patients, division and suture of ductus were possible, the other patients were treated by division and ligation with heavy silk or Dacron patch. 8. Postoperative complications were hoarseness, persistent murmur, reoperation for bleeding, and atelectasis. Early and late mortality was 20% [3 patients], and cause of death was mainly aneurysmal rupture of previous operative site.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.128-138
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• 1987

The Hippocratic aphorism, "the spitting of pur follows the spitting of blood, consumption follows the spitting of this, and death follows consumption," gives ancient documentation to the significance of hemoptysis in the intrathoracic disease. Hemoptysis is still one of the most alarming and startling of all symptoms. For most patients and not a few doctors, the expectoration of blood signals either pulmonary tuberculosis or cancer. But with the advent of modern thoracic surgical methods, differential diagnosis has become doubly important and appropriate treatment has provided the patients with full recovery or improvement of hemoptysis. Author reviewed 72 cases of patients with a chief complaint of hemoptysis, who were performed open thoracotomies in the Dept. of Thoracic and Cardiovascular Surgery, Pusan National University Hospital for 5 years from April 1980 to March 1985. The results were as follows: 1. The mean age of hemoptysis patients was 35.1 year old with a range from 16 to 64, and hemoptysis was most prevalent in the twenties and male dominant. 2. The most common underlying lung disease of hemoptysis was bronchiectasis [37.5%]. 3. The monthly peak frequency of hemoptysis was in the February [25.[%]. 4. Left lower lobe was the most common site of developing hemoptysis. 5. Lobectomy was the most frequent operative method of all open thoracotomies. 6. The hemoptysis caused by lung cancer recurred most frequently [21.4%], and the prognosis of operation was desperate. 7. The common postoperative complications of hemoptysis patient were re-hemoptysis [24%], bleeding [20%], and atelectasis [16%], and immediate postoperative mortality rate was 2.8%. was 2.8%.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.528-535
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• 1987

A clinical study was performed on 164 cases of PDA experienced at the Dept. of Thoracic and Cardiovascular Surgery of Pusan National University Hospital during 6 years from Jan. 1981 to Dec. 1986. It was shown that the PDA was a female-dominant heart disease [male to female ratio, 1:2.8] and two most common symptoms were frequent URI [45.6%] and exertional dyspnea [36.7%]. Continuous machinery murmurs were detected in 143 cases [87.2%], increased pulmonary vascularities [89.0%] and cardiomegalies [63.4%] by chest X-ray. The signs of LVH [43.9%], RVH [3.7%] and BVH [4.9%] were noted on the EKG. Cardiac catheterizations were performed on 67 out of 164 patients and the mean systolic pulmonary artery pressure was 48mmHg [range: 18-131mmHg] and the mean Qp/Qs was 3.1 [range:1.2-8.5] and Rp/Rs below 0.25 was 83.6%. Associated cardiac anomalies were VSD [7.9%], ASD [3.0%], pulmonary valvular stenosis [2.4%] and left persistent SVC [2.4%]. Operative methods were as follows; ligations [145; 88.4%] and divisions [6;3.7%] were performed through the left posterolateral thoracotomies without mortality and the remained cases [13;8.0%] were managed under the cardiopulmonary bypass because of the associated cardiac anomalies. Atelectasis [4.9%] and pneumonia [4.3%] were most frequent postoperative complications and the overall mortality rate was 2.4% [4 out of 164 cases].

• Journal of Chest Surgery
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• v.28 no.8
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• pp.772-777
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• 1995

Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.