• 제목/요약/키워드: progressive patient

검색결과 554건 처리시간 0.025초

흉강경으로 진단한 미만성 범세기관지염 1예 (A Case of Diffuse Pan bronchiolitis Diagnosed by Thoracoscopic Biopsy)

  • 서해숙;이명선;백수흠;조동일;김재원;유남수
    • Tuberculosis and Respiratory Diseases
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    • 제39권3호
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    • pp.271-277
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    • 1992
  • Diffuse panbronchiollitis (DPB), a rare progressive disorder, has lately been receiving increasing attention. DPB is a disease of obscure etiology, characterized by chronic inflammation localized mainly in the region of respiratory bronchiole just distal to the terminal bronchioles. In 1983, Homma and coworkers reported 82 cases of a new clinicopathological entity, DPB, in Japan. Also DPB is a disease largely restricted geographically to Japan but the prevalence in other countries is extremely low. Histoloically, it is characterized by a suppurative bronchiolitis involving primarily the respiratory and terminal bronchioles with subsequent progression to bronchiectasis. The disease progresses rapidly and results in respiratory failure due to repeated respiratory infections. We experienced a cases of DPB accompanied with chronic maxillary sinusitis in both sinuses. Diagnosis of DPB was comfirmed by pathological results from thoracoscopic lung biopsy, typical radiological findings, clinical symptoms and pulmonary function test. After treatment with erythromycin for 6 months, the patient's condition and the typical micronodular densities on the chest radiography improved. A few case of DPB was reported in Korea. We report a case of DPB through thoracoscopic lung biopsy.

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소세포성 폐암과 연관된 망막증 1예 (A Case of Cancer Associated Retinopathy with Small Cell Lung Carcinoma)

  • 임성민;배종오;조상건;강상구;이은영;김성국;김영;곽진영;김귀완
    • Tuberculosis and Respiratory Diseases
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    • 제59권6호
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    • pp.679-683
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    • 2005
  • 저자들은 시야 결손 등의 시력 변화를 주 증상으로 내원한 환자에서 소세포 폐암과 이로 인한 부종양성증후군으로 동반된 암 관련 망막증을 진단하고 항암화학요법을 시행하여, 원발 병변의 부분 관해 보였으나, 시야 결손은 회복되지 않았던 1예를 경험하였기에 문헌 고찰과 함께 보고 하는 바이다.

Levels of Exhaled Breath Condensate pH and Fractional Exhaled Nitric Oxide in Retired Coal Miners

  • Lee, Jong-Seong;Shin, Jae-Hoon;Lee, Joung-Oh;Lee, Kyung-Myung;Kim, Ji-Hong;Choi, Byung-Soon
    • Toxicological Research
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    • 제26권4호
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    • pp.329-337
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    • 2010
  • Inhaled inorganic dusts, such as coal, can cause inflammation and fibrosis in the lungs, known as pneumoconiosis. Diagnosis of pneumoconiosis depends on morphological changes by radiological findings and functional change by pulmonary function test (PFT). Unfortunately, current diagnostic findings are limited only to lung fibrosis, which is usually irreversibly progressive. Therefore, it is important that research on potential and prospective biomarkers for pneumoconiosis should be conducted prior to initiation of irreversible radiological or functional changes in the lungs. Analytical techniques using exhaled breath condensate (EBC) or exhaled gas are non-invasive methods for detection of various respiratory diseases. The objective of this study is to investigate the relationship between inflammatory biomarkers, such as EBC pH or fractional exhaled nitric oxide ($FE_{NO}$), and pneumoconiosis among 120 retired coal miners (41 controls and 79 pneumoconiosis patients). Levels of EBC pH and FENO did not show a statistically significant difference between the pneumoconiosis patient group and pneumoconiosis patients with small opacity classified by International Labor Organization (ILO) classification. The mean concentration of $FE_{NO}$ in the low percentage $FEV_1$ (< 80%) was lower than that in the high percentage (80% $\leq$) (p = 0.023). The mean concentration of $FE_{NO}$ in current smokers was lower than that in non smokers (never or past smokers) (p = 0.027). Although there was no statistical significance, the levels of $FE_{NO}$ in smokers tended to decrease, compared with non smokers, regardless of pneumoconiosis. In conclusion, there was no significant relationship between the level of EBC pH or $FE_{NO}$ and radiological findings or PFT. The effects between exhaled biomarkers and pneumoconiosis progression, such as decreasing PFT and exacerbation of radiological findings, should be monitored.

이차성 기질화 폐렴이 동반된 피부근염 1예 (A Case of Dermatomyositis with Secondary Organizing Pneumonia)

  • 박철연;권정석;정진욱;이충기;현대성;최정윤
    • Journal of Yeungnam Medical Science
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    • 제25권2호
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    • pp.117-123
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    • 2008
  • Dermatomyositis is characterized by progressive, symmetric, proximal muscle weakness and a nonsuppurative inflammatory myopathy of unknown etiology involving predominantly skeletal muscles. It is also characterized by typical skin lesions. Interstitial lung disease has a poor prognosis when it is associated with dermatomyositis. Organizing pneumonia is a disease in which granulation tissue fills the lumina of terminal and respiratory bronchioles and extends into the distal airspaces. The cryptogenic nature of the process is appreciated in that organizing pneumonia patterns of injury can be seen in secondary forms of the disease (secondary organizing pneumonia). Organizing pneumonia has been reported to occur in 5~10% in dermatomyositis-polymyositis patients. Anti-histidyl tRNA synthetase antibody (anti-Jo-1) is a predictive disease marker that is reported to occur in up to 70% of patients. We describe a 49-year-old male dermatomyositis patient who presented with organizing pneumonia and was found to have negative anti-Jo-1 antibody.

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인공 건삭과 판막륜 성형술을 이용한 외상 후 삼첨판 부전증의 치료 (Repair of Posttraumatic Tricuspid Regurgitation Using Artificial Chordae and an Annuloplasty Ring)

  • 손국희;손호성;정재호;정원재;선경;이성호
    • Journal of Chest Surgery
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    • 제41권4호
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    • pp.489-491
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    • 2008
  • 52세 남자 환자가 교통사고 후 응급실로 내원하였다. 심초음파 상 전엽건삭 파열에 의해 발생한 중증도 이상의 삼첨판 역류가 보였다. 삼첨판 폐쇄부전에 대한 수술을 권유하였으나 증상이 없어 환자가 거부하였다. 이년 후 환자는 경미한 전신 부종과 호흡곤란으로 다시 내원하였다. 심초음파 상 심한 삼첨판 역류와 판막륜 확장이 보였다. 이에 본원에서는 인공 건삭과 판륜성형링을 이용한 판륜 성형술을 사용하여 외상 후 발생한 삼첨판 폐쇄부전증을 치료하였기에 보고하는 바이다.

횡문근융해증이 합병된 중증 저나트륨혈증 환자에서 발생한 삼투성 탈수초 증후군 1예 (A Case of Osmotic Demyelination Syndrome in a Patient with Severe Hyponatremia Complicated by Rhabdomyolysis)

  • 이다영;홍창우;이인희
    • Journal of Yeungnam Medical Science
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    • 제30권1호
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    • pp.25-30
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    • 2013
  • Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

A late onset solitary mediastinal cystic lymphangioma in a 66-year-old woman who underwent kidney transplantation

  • Lee, Jung Mo;Lee, Sang Hoon;Park, Youngmok;Kim, Chi Young;Goag, Eun Kyoung;Lee, Eun Hye;Park, Ji Eun;Lee, Chang Young;Kim, Se Kyu
    • Journal of Yeungnam Medical Science
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    • 제32권2호
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    • pp.155-158
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    • 2015
  • Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

식도 누공으로 자연 배액된 종격동 췌장성 가성낭종 (Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula)

  • 박수호;박승근;김상현;최원규;심범진;박희욱;정찬우;최재원
    • Journal of Yeungnam Medical Science
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    • 제34권2호
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    • pp.254-259
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    • 2017
  • Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia- disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

ZAP-70 Protein Expression in B-cell Chronic Lymphoid Leukemia: a Single Center Experience from Pakistan

  • Zeeshan, Rozina;Irfan, Syed Mohammed;Sultan, Sadia;Bhimani, Sanjana
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1587-1590
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    • 2015
  • Background: Chronic lymphoid leukemia (CLL) is the most frequent type of adult leukemia. The Rai and Binet staging systems have been well recognized as standards for assessing the treatment requirements and overall survival in CLL patients. However, there is a need to seek newer prognostic markers to identify stable or progressive forms of CLL that will facilitate risk-adapted treatment strategies. Currently a molecular biomarker ZAP-70 has attracted interest as providing prognostic information in CLL patients. Objective: To determine the frequency of ZAP-70 positivity in B-CLL patients at disease presentation. Materials and Methods: From January 2011 to September 2014, 89 patients were diagnosed to have chronic lymphoid leukemia. Complete blood count was done on an automated analyzer (Cell Dyne, Abott Architect, USA), while immunophenotyping was conducted for each patient to establish the diagnosis of the disease. ZAP-70 expression was evaluated by flow cytometry. Data were compiled and analyzed by SPSS version 21. Results: Out of the total of 89 B-CLL patients, 62 (69.7%) were male and 27 (30.3%) were females with a male to female ratio of 2:1. The mean age was $57.5{\pm}12.1years$. The frequency of ZAP-70 positivity in our B-CLL patients was found to be 13.5%. ZAP-70 positivity was significantly correlated with stage III disease and high absolute lymphocytic count (P<0.05). No correlation of ZAP-70 could be established with age and gender (p>0.05). Conclusions: The frequency of ZAP-70 in our patients appears low. It is approximately half that in international data. We would recommend to screen all the newly diagnosed patients with CLL for ZAP-70 protein expression for risk stratification, family counseling and to predict overall survival.

Changes of Plasma Tumor Necrosis Factor α and C-Reactive Protein Levels in Patients with Hypertension Accompanied by Impaired Glucose Tolerance and their Clinical Significance

  • Xiao, Qiang;Wang, Lan-Ping;Ran, Zhang-Shen;Zhang, Xin-Huan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3389-3393
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    • 2015
  • Background: Chronic inflammation could affect the occurrence and development of malignant tumors. To explore the levels of tumor necrosis factor ${\alpha}$ (TNF-${\alpha}$) and C-reactive protein (CRP) in patients accompanied by impaired glucose tolerance (IGT) and their clinical significance. Materials and Methods: A total of 210 patients hospitalized in Affiliated Hospital of Taishan Medical University from Jun., 2013 to Dec., 2014 were selected, in which 92 cases were accompanied by IGT. Meanwhile, 80 randomly-selected healthy people by physical examination were as the control. The levels of routine biochemical indexes, plasma TNF-${\alpha}$ and CRP in all subjects were measured. Results: Both systolic and diastolic pressures in hypertension group and hypertension plus IGT group were significantly higher than in control group (p<0.01), but there was no statistical significance between these two groups (p>0.05). The levels of fasting plasma glucose (FPG) and blood glucose 2 h after taking glucose in hypertension plus IGT group were markedly higher than other groups (p<0.01). Homeostasis model assessment-insulin resistance (HOMA-IR), TNF-${\alpha}$ and CRP contents were on the progressive increase in control, hypertension and hypertension plus IGT groups, but significant differences were presented among each group (P<0.01). Hypertension accompanied by IGT had a significantly-positive association with CRP, TNF-${\alpha}$, FPG and blood glucose 2h after taking glucose. Conclusions: The levels of plasma TNF-${\alpha}$ and CPR in patients with hypertension accompanied by IGT increase significantly, indicating that inflammatory reaction in these patient increases, thus suggesting that these patients should be focused regarding cancer prevention.