• Tuberculosis and Respiratory Diseases
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• v.77 no.3
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• pp.136-140
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• 2014

Primary ciliary dyskinesia (PCD) is characterized by the congenital impairment of mucociliary clearance. When accompanied by situs inversus, chronic sinusitis and bronchiectasis, PCD is known as Kartagener syndrome. The main consequence of impaired ciliary function is a reduced mucus clearance from the lungs, and susceptibility to chronic respiratory infections due to opportunistic pathogens, including nontuberculous mycobacteria (NTM). There has been no report of NTM lung disease combined with Kartagener syndrome in Korea. Here, we report an adult patient with Kartagener syndrome complicated with Mycobacterium abscessus lung disease. A 37-year-old female presented to our hospital with chronic cough and sputum. She was ultimately diagnosed with M. abscessus lung disease and Kartagener syndrome. M. abscessus was repeatedly isolated from sputum specimens collected from the patient, despite prolonged antibiotic treatment. The patient's condition improved and negative sputum culture conversion was achieved after sequential bilateral pulmonary resection.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1232-1240
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• 1996

From January 1990 through June 1995, we operated on 121 patients who were suspected for pulmonary tuberculosis without definite final diagnosis. After operation the final pathologic diagnoses were as follows: 68 pulmonary tuberculosis in which 29 were tuberculoma, 23 lung cancer, 16 bronchiectasis, 6 aspergilloma, 2 lung abscess, 2 benign cyst and 4 others. In 121 cases, 81 were male and 40 were female and the peak age incidence was 4th decade in tuberculosis (39.7%) and 6th and 7th decade in lung cancer (69.6%). The diagnoses in 44 cases presented roentgenographically as pulmonary nodules were pulmonary tuberculosis(29 cases) and lung cancer(15 cases). Tuberculous nodules tended to be smaller in size with calcification and satellite lesions compared to carcinomas. Indications for operation were solitary nodules 44 cases (36.4%); destroyed lobe 31(25.6%); hemoptysis 25 (20.7%); cavitary lesion 11(9.1 %); bronchostenosis 3 (2.5%); destroyed lung 5(4.1 %) and destroyed lung with empyema 2(1.7%). We conclude that preoperatively suspected pulmonary tuberculosis should be distinguished from various pulmonary lesions such as carcinoma, bronchiectasis, aspergilloma, lung abscess and benign cyst. For the possibility of carcinoma, pulmonary nodules of size greater than 3cm, non-calcified, non satellite lesion, newly developed nodule even under the anti-tuberculous medication, negative PPD skin test with elevated CEA level are recommended for an early resectional surgery and follow-up and delayed surgery is recommended in cases such as pulmonary nodules less than 3 cm in size with calcification, satellite lesion, positive PPD skin reaction and elevated ESR, CRP, ALP levels.

• Korean Journal of Radiology
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• v.25 no.7
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• pp.673-683
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• 2024

Objective: To evaluate the role of visual and quantitative chest CT parameters in assessing treatment response in patients with severe asthma. Materials and Methods: Korean participants enrolled in a prospective multicenter study, named the Precision Medicine Intervention in Severe Asthma study, from May 2020 to August 2021, underwent baseline and follow-up chest CT scans (inspiration/expiration) 10-12 months apart, before and after biologic treatment. Two radiologists scored bronchiectasis severity and mucus plugging extent. Quantitative parameters were obtained from each CT scan as follows: normal lung area (normal), air trapping without emphysema (AT without emph), air trapping with emphysema (AT with emph), and airway (total branch count, Pi10). Clinical parameters, including pulmonary function tests (forced expiratory volume in 1 s [FEV1] and FEV1/forced vital capacity [FVC]), sputum and blood eosinophil count, were assessed at initial and follow-up stages. Changes in CT parameters were correlated with changes in clinical parameters using Pearson or Spearman correlation. Results: Thirty-four participants (female:male, 20:14; median age, 50.5 years) diagnosed with severe asthma from three centers were included. Changes in the bronchiectasis and mucus plugging extent scores were negatively correlated with changes in FEV1 and FEV1/FVC (ρ = from -0.544 to -0.368, all P < 0.05). Changes in quantitative CT parameters were correlated with changes in FEV1 (normal, r = 0.373 [P = 0.030], AT without emph, r = -0.351 [P = 0.042]), FEV1/FVC (normal, r = 0.390 [P = 0.022], AT without emph, r = -0.370 [P = 0.031]). Changes in total branch count were positively correlated with changes in FEV1 (r = 0.349 [P = 0.043]). There was no correlation between changes in Pi10 and the clinical parameters (P > 0.05). Conclusion: Visual and quantitative CT parameters of normal, AT without emph, and total branch count may be effective for evaluating treatment response in patients with severe asthma.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.413-418
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• 1995

Carcinosarcoma is an uncommon pulmonary malignancy characterized by carcinomatous parenchyma and sarcomatous stroma. Pulmonary carcinosarcoma represented about 1% of the resected lung tumors. The predominant clinical features are productive cough, chest pain, dyspnea, hemoptysis, bronchiectasis, and atelectasis, but alternate atelectasis is rare. We report a case of pulmonary carcinosarcoma associated with alternate atelectasis of the right upper and lower lobe.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1140-1145
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• 1997

Extracolonic manifestations which occur in approximately 10~20% of patients with ulcerative colitis most commonly affect joints, skin, liver and eyes. In contrast, pulmonary involvement in ulcerative colitis is very rare. However, a variety of respiratory disorders has been associated with ulcerative colitis, including pulmonary vasculitis, bronchiectasis, chronic bronchitis, interstitial fibrosis, pleural effusion. Since the first observation of pulmonary involvement in ulcerative colitis by Kraft in 1976, a few cases have been reported, and probably no such case have been reported in Korea yet. Here we report an experience concerning 56 year-old man interstitial lung disease in ulcerative colitis, who was diagnosed by clinical, radiographic, endoscopic, histologic findings.

• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.172-177
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• 2014

Background: Pseudomonas aeruginosa infection is particularly associated with progressive and ultimately chronic recurrent respiratory infections in chronic obstructive pulmonary disease, bronchiectasis, chronic destroyed lung disease, and cystic fibrosis. Its treatment is also very complex because of drug resistance and recurrence. Methods: Forty eight cultures from 18 patients with recurrent P. aeruginosa pneumonia from 1998 to 2002 were included in this study. Two or more pairs of sputum cultures were performed during 2 or more different periods of recurrences. The comparison of strains was made according to the phenotypic patterns of antibiotic resistance and chromosomal fingerprinting by pulsed field gel electrophoresis (PFGE) using the genomic DNA of P. aeruginosa from the sputum culture. Results: Phenotypic patterns of antibiotic resistance of P. aeruginosa were not correlated with their prior antibiotic exposition. Fifteen of 18 patients (83.3%) had recurrent P. aeruginosa pneumonia caused by the strains with same PFGE pattern. Conclusion: These data suggest that the most of the recurrent P. aeruginosa infections in chronic lung disease occurred due to the relapse of prior infections. Further investigations should be performed for assessing the molecular mechanisms of the persistent colonization and for determining how to eradicate clonal persistence of P. aeruginosa.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.616-620
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• 2002

Tracheal bronchus is a aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and nay be related to inflammatory conditions affecting the lung, including recurrent pneumonia and bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but neither clinical nor radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6-month followup period.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.269-274
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• 1984

Since tuberculosis was a common pulmonary disease in Korea, Aspergillosis was easily misdiagnosed as tuberculosis and an acute form of Aspergillosis was misinterpreted as pneumonia because of their similarities in the X-ray findings. This investigation is designed to illustrate the clinical features and preoperative diagnosis and surgical role in the management of this disease. In a retrospective review of operative cases from Jan. 1963 through Dec. 1983, 36 cases were analyzed. Peak age incidence lies in the 3rd decade [41.7%]. All cases had a history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis and the most common chief complaint was hemoptysis [69.5%]. Only nine cases [25%] showed cavitary lesions with mycetoma and preoperative sputum study for fungus showed low positive valve [42.3%]. Anatomical location of lesion was located mainly upper lobe [66.7%] and most of cases were managed by lobectomy. We experienced 7 cases of complication; they were postoperative empyema, hepatic failure, esophageal varix bleeding. Postoperative pathologic findings showed that 29 cases [80.5%] were combined with tuberculosis 3 cases were combined with bronchiectasis and 4 cases were not combined with other disease. In conclusion, when the patient has a longstanding history of pulmonary tuberculosis and has a hemoptysis, he must be suspected fungus super infection. Resectional surgery is the treatment of choice for symptomatic localized disease and needed resection in asymptomatic patient to prevent possible fatal sequelae in the future.

• 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%.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.583-586
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• 1998

Tracheal bronchus is an uncommon anomaly of the airway in which an ectopic bronchus arises from the trachea superior to its bifurcation. It is usually asymptomatic and no intervention is needed. However in the cases complicated with recurrent pneumonia, bronchiectasis or abscess, surgical excision may be needed. We report 5 cases of tracheal bronchus with or without complication or combined anomaly.