• Tuberculosis and Respiratory Diseases
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• 제39권3호
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• pp.261-265
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• 1992

Pleural effusion due to hepatic cirrhosis and ascites is well known. But rarely a pleural effusion may develop in a cirrhotic patient in the absence of detectable ascites. The differential diagnosis of a right-sided transudative pleural effusion in a patient with chronic liver disease with or without ascites includes congestive heart failure and nephrotic syndrome. These diseases are usually ruled out with standard clinical tests. Patients with hepatic hydrothorax should be treated with fluid restriction, diuretics and the correction of hypoalbuminemia. Patients with severe symptoms due to refractory hepatic hydrothorax might benefit from pleural sclerosis and surgical closure of diaphragmatic defect. We experienced a case of right-sided pleural effusion in liver cirrhosis without ascites.

• Tuberculosis and Respiratory Diseases
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• 제38권3호
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• pp.280-286
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• 1991

Dark-blue pigmentation has been thought to be related to smoking or occupational exposure and has been regarded as anthracotic pigmentation. It is also frequently observed in non-smokers without occupational exposure, but there is no proven mechanism of pigmetation. To investigate clinical features and to find other causes of dark-blue pigmentaion, retrospective analysis was done in 59 patients who showed anthracotic pigmentation on bronchoscopy during recent 5 years in Seoul National University Hospital. The results were as follows; 1) Forty cases were non-smokers, while smokers were 19 cases. 2) Fifteen cases had history of tuberculosis, but there was no history of environmental exposure. 3) Mediastinal calcification was observed in 89.7%. 4) There was significant bleeding without exception when biopsy was done at the pigmentation site. 5) In patients with pigmentation only, hemoptysis and productive cough were main chief complaints, and chest X-ray showed atelectasis, infiltration, mass, or pleural change. 6) The number of patients whose lesion of X-ray corresponds to pigmentation site were 19/30 in tuberculosis, 4/30 in DILD and 7/30 in other diseases.

• Tuberculosis and Respiratory Diseases
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• 제77권5호
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• pp.219-222
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• 2014

Pneumatosis intestinalis (PI) is a very rare condition that is defined as the presence of gas within the subserosal or submucosal layer of the bowel. PI has been described in association with a variety of conditions including gastrointestinal tract disorders, pulmonary diseases, connective tissue disorders, organ transplantation, leukemia, and various immunodeficiency states. We report a rare case of a 74-year-old woman who complained of dyspnea during the management of acute asthma exacerbation and developed PI; but, it improved without any treatment.

• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.231-235
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• 2010

Lymphadenopathy in the thoracic cavity is frequently caused by inflammatory diseases. In very rare cases, the node-bronchial fistula has been reported to be the cause of complications of pulmonary tuberculosis. A male patient with necrotizing pneumonia and mediastinal lymph node enlargements identified by chest computed tomography was also found to have a node-bronchial fistula caused by lung cancer. The patient was treated for tuberculosis with pneumonia for one week before a definitive diagnosis was made. A further investigation revealed him to have non-small cell lung cancer (NSCLC, adenocarcinoma) and multiple mediastinal lymphadenopathies accompanied with the node-bronchial fistula. We report this specific case that had been previously treated for tuberculosis but was later revealed to be NSCLC accompanied with a node-bronchial fistula.

• Tuberculosis and Respiratory Diseases
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• 제56권1호
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• pp.103-108
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• 2004

저자들은 44세 여환에서 흉부 단순 촬영상 심장비대로 오인되어 순환기내과로 전원된 환자에서 흉선지방종으로 진단 후 수술적제거로 치료한 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제67권5호
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• pp.445-448
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• 2009

Erlotinib ($Tarceva^{(R)}$) has been considered to be a new, promising oral chemotherapy agent for local advanced or metastatic non-small cell lung cancer (NSCLC). Erlotinib is regarded as relatively safe, but interstitial lung disease (ILD) related to erlotinib has been reported on an infrequent basis in Asia. We report an histologically confirmed case of recurrent erlotinib-induced ILD. Although, the patient was highly responsive to the first erlotinib treatment, the therapy was discontinued due to erlotinib-induced ILD. After intravenous high dose methylpredinisolone treatment, ILD was improved rapidly by radiologic studies, but the particular lung cancer re-emerged. We restarted the patient erlotinib on low-dose oral methylpredinisolone, resulting in a recurrence of erlotinib-induced ILD. Our case suggests that re-administration of erlotinib should be performed on a limited basis in patients that have developed ILD on previous use, even if a therapeutic effect can be estimated.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.93-96
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• 2010

A 23-year old woman was admitted to our hospital with hemoptysis. The chest X-ray showed reticulonodular opacity and multiple cysts throughout the entire lung field. The chest CT scan revealed numerous bilateral cysts with various sizes, some of them with thickened walls. An open lung wedge resection was performed. The resected specimen showed scattered small nodules, 0.3 to 0.6 cm in size. Microscopically, each nodule was composed of atypical glands with an occasional papillary architecture spreading to the alveolar septa, which were morphologically consistent with a papillary adenocarcinoma with a bronchioloalveolar carcinoma growth pattern. Immunochemically, the tumor cells were negative for the S-100 protein. The patient was diagnosed with an adenocarcinoma of the lung. A variety of diseases can produce or mimic multiple, thin-walled cysts in the lung. Lung cancer with multiple cysts is quite rare. Nevertheless, adenocarcinoma should be a diagnostic consideration. We report a case of a multiple cystic adenocarcinoma of the lung.

• Tuberculosis and Respiratory Diseases
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• 제67권5호
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• pp.467-470
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• 2009

A traumatic pulmonary pseudocyst is a rare complication of blunt thoracic trauma. The clinical symptoms and signs are similar to other respiratory diseases, such as pulmonary tuberculosis. Therefore, a trauma history with the resulting radiologic and clinical findings is important for making a diagnosis. A 26-year-old male was admitted to our hospital due to cough for 3 days. The chest x-ray revealed diffuse infiltrations and a cavitary lesion at the left lung. His left chest had hit a tree as a result of motorcycle accident one day before admission. Initially, it was assumed that his symptoms and chest X-ray might be due to a tuberculosis infection. However, bronchoscopy revealed old blood clots at both lungs, particularly in the left lower lobe bronchus. A transbronchial lung biopsy showed alveolar hemorrhage. A traumatic pulmonary pseudocyst was diagnosed from his trauma history and these findings. Computed tomography of the chest performed 4 months later showed regression of the cavitary lesion.

• Tuberculosis and Respiratory Diseases
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• 제69권2호
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• pp.124-128
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• 2010

Septic pulmonary embolism is the process in which an infected thrombus becomes detached from its site of origin and lodges in a pulmonary artery, and is usually associated with infective endocarditis, especially right-sided, or infection-associated with indwelling catheters, peripheral septic thrombophlebitis, and periodontal diseases, etc. Here, we report a case of septic pulmonary embolism associated with tricuspid valve infective endocarditis. A 23-year-old female was admitted to our hospital, due to fever, sore throat, and myalgia. In her past medical history, she had undergone a surgical operation for closure of a ventricular septal defect, but was informed that the operation resulted in an incomplete closure. The initial chest radiograph demonstrated multiple rounded, parenchymal nodules in various sizes; several nodules had central lucency suggesting cavitations. Echocardiography demonstrated a large vegetation attached to the septal tricuspid valve leaflet, extending from right ventricular inflow tract to outflow tract. Computed tomography of thorax revealed bilateral peripheral nodules and wedge-shaped consolidation at various sizes, mostly accompanied by cavitations.

• 동의생리병리학회지
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• 제19권5호
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• pp.1105-1111
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• 2005

In order to investigate the meanings and bases of transforming theories of diseases(病傳論), several relevant theories were collected from medical books since . The outside-to-inside changing process(pyoree jeon) was the fundamental pattern in febrile diseases regardless of slang han and wen bing after Han dynasty. But in case of numb disease the three exogenous pathogenic factors of wind, cold and dampness got into each viscera through five tissues like skin, vessesl, flesh, tendons, bones respectively. It was called corresponding changing process(sanghap jeon) here. The pathogenic changing process(byungsa jeon) had complicated details to explain pathologic processes, but could give useful informations on evaluating relative strength of pathogens and tendency ahead. The changing process of diseases of internal injuries were explained in case of emotional distress which is outbroken abruptly didn't follow regular order of viscera-emotion relations. So it was named random changing process(bulcha jeon) after 's usage. And marasmus and asthenic disease followed top-to-down or down-to-top changing process(sangha jeon) based on . There are many types of changing process of diseases between viscera and viscera or viscera and bowels like generation changing process, restriction changing process, changing process between couple, changing process of mutual transmission based on attributions of each element by the theory of 5 phases(五行論). And changing process to a neighbor doesn't have any special relations within two organs but has anatomical contiguity and physiological continuity between them. The transforming theories of diseases bring forth useful understanding on comings and goings of pathogenic factors and tendency and prognosis of disease, so they are needed to be taught in the course of pathology class.