• Journal of Chest Surgery
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• 제23권1호
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• pp.73-80
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• 1990

A total of 129 patients with a confirmed diagnosis of primary lung cancer were treated at Dep. of Thoracic k Cardiovascular Surgery, National Medical Center, Seoul, Korea, between July, 1981 and Dec., 1988. Particular emphasis was given in this review to the 72 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The age group of fifty k sixty decade occupied 55.8 %, and the youngest being 24 years and oldest 78 years. The incidence ratio of male to female was 3,2:1. The subjective symptoms of the patients were coughing [72.6%], chest pain [48.2%] and hemoptysis [35.6%], which were due to primary local influence. The confirmed diagnostic procedures were bronchoscopic biopsy, sputum cytology needle aspiration biopsy, open lung biopsy, anterior mediastinotomy & lymph node biopsy. By pathologic classifications, the squamous cell carcinoma was the most prevalent, 67 cases [51.9 %], and the adenocarcinoma in 36 cases [27.9%], undifferentiated small cell carcinoma in 13 cases [10.1 %], undifferentiated large cell carcinoma in 9 cases [6.9%], bronchioloalveolar carcinoma was 4 cases [3.1%]. The lymph node dissection with pneumonectomy [42 cases], lobectomy [14 cases] and pneumonectomy [6 cases], lobectomy [9 cases] without lymph node dissection were performed. The post operative TNM Staging[AJC] in 72 cases were Stage I in 24 cases, Stage II in 27 cases, and Stage III in 21 cases. Overall resectable was possible in 72 cases [55.8 %], and the operation mortality was 5.6 % [4 cases].

• Journal of Chest Surgery
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• 제22권6호
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• pp.1013-1024
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• 1989

One hundred and seventy two patients of primary lung cancer, confirmed by tissue diagnosis at the Dept. of Thoracic and Cardiovascular Surgery in Korea University Hospital between June 1973 and August 1988, were evaluated and restaged with New International TNM classification, and the actuarial survival rate was obtained using Kaplan-Meier equation. The results of analysis were as follows. 1. Male to female ratio was 3.8:1, and prevalent age groups were sixth and seventh decades [76.4 %]. 2. The most common subjective symptom was cough [55.2 %], and 67.4 % of all patients were visited to hospital less than 6 months of symptoms. 3. Positive rates for tissue diagnosis were 100% in open chest or metastatic lymph node biopsy, 80 % in mediastinoscopic biopsy, 60 % in pleural biopsy, 59 % in pleural fluid cytology, 36% in bronchoscopic biopsy, and 22 % in sputum cytology. 4. The order of frequency of cell type was squamous cell carcinoma [53.0%], adenocarcinoma [22.0 %], small cell carcinoma [14.5 %], and so on. 5. Operability and resectability were 44% and 62% respectively, but they were improved recently. 6. Open and closure was done in 44 % of operated patients, uni or bilobectomy in 38 % and pneumonectomy in 24 %. 7. Overall operative mortality rate was 2.6 %. 8. The order of frequency of stage level was S3b [42.0 %], S3a [25.1 %], S1 [15.6%], and so on. 9. Distant metastasis, i.e. stage 4, was noted in 9.5 % of cases, and the sites of frequency were bone, brain, skin, and so on. 10. Actuarial survival rate was 1 year 48.2%, 2 year 36.9%, 3 year 31.2%, and 5 year 20.8%. According to above listed factors, 5 year survival rate was highest in squamous cell carcinoma, lobectomized cases, stage 1, NO in TNM system, and resectable cases. But T factor in TNM system and radiation therapy in nonresectable cases did not show statistical significance in life expectancy.

• Tuberculosis and Respiratory Diseases
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• 제46권6호
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• pp.856-860
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• 1999

Diffuse pulmonary ossification is rare disease of unknown etiology. Since the first description by Luschka in 1856, about 140 cases have been reported worldwide, but no such case has been reported in Korea yet. We report 40-year-old woman who was diagnosed as diffuse nodular pulmonary ossification on open lung biopsy. She has no respiratory symptoms & physical findings and no previous disease history. She was incidentally found to have multiple pulmonary nodules on roentgenographic examination. Open lung biopsy was done for above lesion and She was proven to have diffuse nodular pulmonary ossification. She was followed by roentgenographic examination and showed no progression.

• Clinical and Experimental Pediatrics
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• 제46권12호
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• pp.1230-1234
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• 2003

목 적 : 폐생검은 호흡기 질환을 가진 환아의 진단을 위해서 는 훌륭한 검사방법으로 알려져 있다. 하지만 검사를 위해서는 대부분의 경우 전신마취와 수술이라는 방법이 필요하며 이에 따른 합병증들이 우려되고 있다. 이에 소아 호흡기 질환 환자에서 폐생검이 치료에 미친 효과와 검사에 따른 부작용을 조사하여 폐생검의 유용성을 평가하고자 한다. 방 법 : 1993년 7월부터 2001년 6월까지 9년간 서울아산병원에서 폐질환 환아를 대상으로 폐생검 전과 후의 진단 및 치료의 변화 여부와 검사의 시행에 따른 부작용에 대해 후향적으로 조사하였다. 결 과 : 대상 환자는 총 19명으로 남아 13명, 여아 6명이었다. 검사 당시의 중간연령은 3년 8개월(9개월-8년 7개월)이었고, 폐생검은 개흉술로 시행한 경우가 12명, 흉강경을 이용한 경우가 7명이었다. 폐생검 결과 간질성 폐질환이 12명(64%)이었고 결핵과 바이러스 질환이 4명(21%), 그 외 다른 질환들이 3명(15%)이었다. 특히 흉부 단층 촬영 소견에서 폐쇄성 세기관지염으로 의심된 7명 중 2명에서만 조직학적으로 일치된 결과를 확인할 수 있었다. 조직 검사 후 치료 방법이 달라진 경우는 16명(84%)이었다. 이중 스테로이드 치료를 시작한 경우가 10명, 항바이러스 제제와 항생제, 결핵 제제의 투여를 시작한 경우가 5명, 사용하던 치료를 중단한 경우가 1명이었다. 검사 시행 후 생긴 합병증은 1명으로 농흉이었다. 폐생검 시행 이후 외래에서 추적 관찰한 중간기간은 1년 6개월(10일-8년)이었다. 관찰하는 동안 질병의 경과를 살펴보면 10명(53%)에서는 호전되었으며, 악화된 경우는 5명(26%), 변화가 없는 경우가 3명(16%), 추적되지 않는 경우가 1명이었다. 이들 중에서 4명(21%)이 사망하였고, 사망원인은 급성 호흡 곤란증후군 1명, 호흡부전 2명, 그리고 패혈증 1명이었다. 결 론 : 소아 폐질환에서 폐생검은 확진을 하는데 도움을 주는 비교적 안전한 검사일 뿐만 아니라 적절한 치료 방침의 결정에 많은 기여를 한다. 따라서 소아 폐질환의 진단과 치료에 폐생검의 적극적인 활용이 필요하다.

• Tuberculosis and Respiratory Diseases
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• 제46권1호
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• pp.65-74
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• 1999

연구배경: 간질성폐질환의 진단을 위해 개흉폐생검이 전통적으로 이용되어 왔으나, 수술적검사로 인한 합병증의 위험성이 크다. 최근 간질성폐질환의 진단에 있어서 고해상도 전산화단층촬영(HRCT)과 경기관지폐생검이 널리 이용되고 있으며, 비교적 안전하고 진단율 또한 높은 것으로 알려져있다. 이에 저자들은 간질성폐질환의 진단에 있어서 이들 검사방법들의 유용성을 비교하여보고자 하였다. 방 법: 1995년 5월부터 1998년 6 월까지 단국대학교부속병원에서 급성 및 만성 간질성폐질환의 진단을 위해 HRCT와 개흉폐생검을 시행한 19명의 환자들의 의무기록을 후향적으로 조사하여 이들 환자들의 임상소견, 기저질환, HRCT소견, 경기관지폐생검소견, 개흉폐생검소견, 개흉폐생검의 합병증, 개흉폐생검 후의 치료방법 등을 분석하여 다음과 같은 결과를 얻었다. 결 과: 대상 환자 중에서 증상의 시작에서 개흉폐생검까지의 기간이 2주 이상인 만성 간질성폐질환 환자는 13명(68.4%)이었으며, 2주 미만인 급성 간질성폐질환 환자는 6명(31.6%)이었다. 개흉폐생검으로 만성 간질성폐질환 환자중 92%(12/13)에서 특정진단이 가능하였고(Bronchiolitis obliterans organizing pneumonia 5명, Constrictive bronchiolitis 2명, Usual interstitial pneumonia 3명, 과민성폐장염 1명, 호산구성폐장염 1명), 급성 간질성폐질환 환자들은 모두에서 특정진단이 가능하였다(급성 간질성폐렴 5명, 카리니 주폐포자충폐렴 l명). 개흉폐생검으로 특정진단이 가능하였던 12명의 만성 간질성폐질환 환자에서 HRCT의 첫 번째 가능한 진단명이 옳았던 경우는 50%(6/12)였다. 개흉폐생검 후 만성 간질성폐질환 환자의 62%(8/13)에서 특정 치료를 받았고(스테로이드치료 : 7명, 이사: 1명), 급성 간질성폐질환 환자들은 모두에서 특정 치료를 받았다(스테로이드치료 : 5명, 스테로이드와 항생제치료: 1명). 개흉폐생검 후 병원내 사망율은 5.3%(1/19)였다. 결 론: 간질성폐질환에서 HRCT와 경기관지폐생검에서 특정진단을 못 내릴 경우 개흉폐생검은 비교적 합병증이 적으면서 유용한 진단방법이며, 특히 급성 간질성폐질환에서는 치료에 많은 도움을 줄 수 있다.

• 대한세포병리학회지
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• 제9권1호
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• pp.85-88
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• 1998

We described the findings of fine needle aspiration cytology of the lung from a patient with Wegener's granulomatosis. Early diagnosis and prompt treatment of the patients with Wegener's granulomatosis is essential for a better prognosis. However, the variety of clinical presentations and nonspecific radiologic infiltrates of Wegener's granulomatosis frequently make the diagnosis difficult. Although an open lung biopsy is required for a firm diagnosis, fine needle aspiration cytology & biopsy preparation can also provide an adequate tissue sample, when the findings of fine needle aspiration are considered with clinical manifestations and ANCA value in the serum. The cytologic smears showed scattered necrotic tissue fragments entrapping many neutrophils and occasional epithelioid cells. Multinucleated giant cells were infrequently observed. Ziehl-Neelsen stain for acid fast bacilli was negative. All the cytologic features recapitulated the histopathologic findings of purulent and necrotizing granulomatous inflammation seen in Wegener's granulomatosis.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.256-259
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• 1995

The diffuse nodular lung lesion has a diagnostic problem and should be made differential diagnosis. A chest X-ray of 62-year-old male patient with dyspnea showed small-sized scattered multinodular lesion on entire lung field. Bronchoalveolar lavage and transbronchial needle aspiration showed the non-specific findings, so open lung biopsy was done and revealed bronchioloalveolar cell carcinoma.

• Korean Journal of Radiology
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• 제1권2호
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• pp.84-90
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• 2000

Objective: To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. Materials and Methods: The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. Results: All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. Conclusion: In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary.

• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.416-423
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• 1993

경북대학교 의과대학 호흡기내과에서 운동시 호흡곤란을 호소하며 입원하여 개흉폐생검, 경기관지 폐생검 및 기관폐포세척을 하여 광학현미경 및 전자현미경소견상 특징적인 lamellar body가 보이는 폐포단백증으로 진단된 3예를 경험하였기에 문헌고찰과 함께 보고하였다.

• Tuberculosis and Respiratory Diseases
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• 제46권1호
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• pp.82-88
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• 1999

Herpes simplex virus pneumonia in immunocompromised host is difficult to diagnose with non-invasive method, and has high mortality rate. Because early diagnosis and early treatment can significantly decrease the mortality rate, the enthusiastic efforts for the early diagnosis should be done. A 41-year-old woman who took prednisolone due to mixed connective tissue disease developed gradually increasing dyspnea with radiological features of interstitial lung disease. Initially, we treated her with empirical antibiotics, but failed to improve her dyspnea. So we performed bronchoalveolar lavage and open lung biopsy. Open lung biopsy specimen showed herpes simplex virus pneumonia. Herpes simplex virus was also isolated from bronchoalveolar lavage fluid. There was both clinical and radiological improvement after treatment with acyclovir for 14 days.