• Tuberculosis and Respiratory Diseases
• /
• v.40 no.1
• /
• pp.52-57
• /
• 1993

Congenital esophagobronchial fistula presented in adult life is rare and usual1y manifests as recurrent pneumonias or other chronic suppurative complications such as bronciectasis. Most of congenital esophagobronchial fistula can be diagnosed by esophagography and can be cured by fistulectomy and/or resection of destroyed pulmonary lobes. We recently experienced 5 cases (2 female and 3 male patients) of congenital esophagobronchial fistula (all of them were Braimbridge type I). Mean age of the patients at the time of diagnosis of esophagobronchial fistula was 53.8 year-old (44-70 year-old) and mean duration of symptoms and complications such as cough after swallowing water, recurrent pneumonias and bronchiectasis was 29 years (12-50 years). 4 patients were treated by fistulectomy and resection of destroyed lobes with abolition of symptoms. So we report 5 cases of congenital esophagobronchial fistula with review of literatures.

• Journal of Yeungnam Medical Science
• /
• v.15 no.2
• /
• pp.246-253
• /
• 1998

Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safety of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had signs and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were as follows: 1) A total 30 patients were enrolled in the trial. Among them, 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), or lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria by Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggested that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.1
• /
• pp.20-25
• /
• 1994

Background: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug 1992. Methods: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. Results: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis, 18.2%(22) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. Conclusion : Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.

• Journal of Yeungnam Medical Science
• /
• v.32 no.2
• /
• pp.71-79
• /
• 2015

Background: Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. Methods: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. Results: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. Conclusion: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

• Pediatric Infection and Vaccine
• /
• v.24 no.3
• /
• pp.152-159
• /
• 2017

Purpose: X-linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the Bruton's tyrosine kinase (Btk) gene. The aim of this study was to investigate the clinical manifestations, molecular features, and treatment status of XLA in Korean patients at Seoul National University Children's Hospital. Methods: Fourteen Korean boys with XLA showing serum agammaglobulinemia, non-detectable to less than 2% of peripheral B-cells, and mutation of the Btk gene were enrolled. We observed the clinical features, laboratory findings, status of treatment, and complications in these XLA patients. Results: All XLA patients had a history of recurrent bacterial infections before diagnosis, and 20% of them had a neutropenia. Of the XLA patients 35.7% had a family history of XLA and 75% of their mothers were carriers. Btk gene analysis showed variable gene mutations in Xq22 including 9 amino acid substitutions, 3 frameshifts, 1 premature stop codon, and 1 splice defect. After intravenous immunoglobulin replacement therapy, infection episodes decreased, but complications such as bronchiectasis and chronic sinusitis remained. Conclusions: In patients less than 4 years of age with recurrent infection, analysis of serum gamma globulin levels and the Btk gene are recommended for the early diagnosis of XLA and for the appropriate prevention of recurrent infection.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.3
• /
• pp.337-343
• /
• 2002

A tracheal bronchus, an aberrant bronchus arising directly from the trachea, is an infrequent congenital anomaly. The incidence of this anomaly ranges from 0.5 to 5%. It usually originates from the right lateral wall of the trachea at the level <2 cm above the tracheal bifurcation. These patients usually are asymptomatic, but some patients may experience recurrent pneumonia, chronic bronchitis, bronchiectasis, or asthmatic episodes. A tracheal bronchus may be associated with other anomalies such as a tracheal stenosis, pulmonary agenesis, pulmonary sequestration, congenital heart disease, a pulmonary venous anomaly and Down's syndrome. This anomaly is usually diagnosed incidentally during bronchoscopy in patients with respiratory problems. Here we report a case of a 20-year-old man with a past history of bronchial asthma, which was incidentally diagnosed as a tracheal bronchus during a medical examination prior to military service, and was associated with a bilateral superior vena cava anomaly.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.1
• /
• pp.75-81
• /
• 1999

Background : Recently, there are many patients with lipoid pneumonia by ingestion of shark liver oil in Korea, but only a few animal experimentations have been carried out. The purpose of this study is to evaluate sequential change of the lung after aspiration of shark liver oil and to provide the radiologic-pathologic correlation. Methods: A single intratracheal administration of shark liver oil was given to 14 white rabbits. They were then sacrificed sequentially from 1 week to 6 weeks after injection. We investigated the HRCT and pathologic findings Results: One was sudden death immediately after injection. Six of the 13 rabbits showed pneumonic infiltrations on the HRCT. There were air space consolidation with air-bronchogram on the HRCT of the first week. They were associated with the volume loss in the 4th week, and the traction bronchiectasis in the 6th week. The important pathologic findings were peribronchial alveolar inflammation with septal widening and cuboidal metaplasia of the alveolar wall. The number of macrophages in an alveoli was peaked in the second week and then gradually decreased. On the 6th week, we could find the proliferation of fibroblasts. Conclusion: We can prove the development of lipoid pneumonia after aspiration of squalene by animal experimentation, and the understanding of HRCT and pathologic findings may be helpful in proper evaluation of pneumonia due to aspiration of fish-extracted lipid.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.805-811
• /
• 1996

Congenital cystic adenomatoid malformation of the Lung(CCAM) is characterized by anomalous fetal development of terminal respiratory structures, resulting in an adenomatoid proliferation of bronchiolar elements and cystic formation. CCAM was first described and differentiated from other cystic lung disease in the English literature by Ch'in and Tang in 1949. CCAN is a rare, potentially lethal form of congenital pulmonary cystic disease and the salient features of lesion are an irregular network of terminal respiratory bronchiole-like structures and macrocysts variably lined by pseudostratified ciliated columnar epithelium and simple cuboidal epithelium. Adult presentation of CCAM of the lung is so rare that only 9 cases have been reported in the literature of date. The pathogenesis of CCAM remains disputed and reseachers have variously proposed that the lesion represents a developmental anomaly, hamartoma, or a fonn of pulmonary dysplasia. Van Dijk and Wagenvoort divided CCAM into three subtypes : cystic, intermediated, and solid. These correspond to types I, II, and III of Stocker. In adults, the evaluation of cystic or multi cystic lung disease requires consideration of a differential diagnosis including the acquired lesions of lung abscess, cavitary neoplasm or inflammatory mass, bullous disease, bronchiectasis, and postionflammatory pneumatocele. Congenital lesions such as sequestration, bronchopulmonary-foregut anomalies, and bronchogenic cyst are also encounted. The definitive treatment for CCAM is complele removal of the involved lobe. Panial lobectomy leads to multiple complications, including severe post-operative infection. We report a case of CCAM in a 14-year-old female presentated with a pneumothorax and large bullae, who was treated by surgical remove of the involved lobe.

• Tuberculosis and Respiratory Diseases
• /
• v.55 no.6
• /
• pp.551-559
• /
• 2003

Background : Emergency management in hemoptysis is bronchial artery angiography and embolization. This study was designed to investigate the accuracy of localization of bleeding site by simple roentgenogram, computed tomography(CT) and bronchoscopy prior to embolization and to evaluate the outcome of embolotherapy. Method : We retrospectively evaluated 50 patients performed bronchial artery embolization(BAE), admitted to tertiary university hospital due to hemoptysis. Results : The most common causes were pulmonary tuberculosis, old tuberculous related parenchymal damage, aspergilloma, and bronchiectasis. The success rate of BAE within one month was 90%; within 3 months was 88%; during follow up period of mean 11.6 months was 76%. The concordant rate of simple roentgenogram with angiographic outcome in terms of bleeding site is 70%; in chest CT 80%; in bronchoscopy 81%; in combined information of simple roentgenogram and CT 83%; in combined information of simple roentgenogram and bronchoscopy 78%. Conclusion : The diagnostic accuracy for the bleeding site was similar between chest CT and bronchoscopy, showing high diagnostic yield. The success rate of BAE was comparative to prior studies. Further study will be needed in a large scale in near future.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.2
• /
• pp.107-114
• /
• 2012

Background: This study attempted to investigate the main causes of hemoptysis, the type of examinations used for diagnosis, the treatment modalities and outcomes. Methods: A retrospective study was conducted on the medical records of 221 patients admitted to the Chonnam National University Hospital, between January 2005 and February 2010, with hemoptysis. Results: Bronchiectasis (32.6%), active pulmonary tuberculosis (18.5%), fungus ball (10.8%), and lung cancer (5.9%) accounted for most causes of hemoptysis. Computed tomography scan was the most sensitive diagnostic test when employed alone, with positive yield of 93.2%. There were 161 cases of conservative treatment (72.9%), 42 cases of bronchial artery embolization (BAE) (19.0%), and 18 cases of surgery (8.1%). Regarding the amount of hemoptysis, 70 cases, out of 221 cases, were mild (31.5%), 36 cases moderate (16.2%), and 115 cases massive hemoptysis (52.0%). Most of the patients were treated conservatively, but if there was more bleeding present, BAE or surgery was more commonly performed than the conservative treatment ($p{\leq}0.0001$). In the multivariate model, severe hemoptysis and lung cancer were independently associated with short-term recurrence. BAE was independently associated with long-term recurrence, and lung cancer was associated with in-hospital mortality. The overall in-hospital mortality rate was 11.3%. Conclusion: Hemoptysis is a common symptom with a good prognosis in most cases. However, patients exhibiting massive bleeding or those with malignancy had a poorer prognosis. In-hospital mortality was strongly related to the cause, especially in lung cancer.