• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.147-151
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• 2008

Non-resolving or slowly resolving pulmonary infiltrates in spite of administering adequate antimicrobial therapy are a clinical diagnostic challenge for physicians. The rate of radiographic resolution varies with the patients' age, the underlying comorbidities, the extent of radiographic involvement, the functional status and the causal pathogens. It is important to differentiate non-resolving or slowly resolving bacterial pneumonia from other uncommon infectious pneumonias or malignancies that require invasive diagnostic techniques to confirm the diagnosis. Bronchioloalveolar carcinoma can present with various clinical and radiographic features. Unfortunately, the radiographic similarity of consolidative BAC to pneumonia often leads to an incorrect diagnosis of pneumonia and possibly significant delays in obtaining appropriate diagnostic studies. We describe here a case of a mixed adenocarcinoma and bronchioloalveolar carcinoma that was initially diagnosed as pneumonia due to the consolidation pattern on the radiography and the patient's initial improvement with antibiotic treatment.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.29-34
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• 2018

Background: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). Methods: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcomes, postoperative drainage, postoperative complications, and mortality were retrospectively analyzed. Results: VATS was completed in 17 patients. Thoracotomy was performed in 18 patients, with 13 planned thoracotomies and 5 conversions from the VATS approach. The median age was $62.7{\pm}7.9years$ in the VATS group and $60{\pm}8.7years$ in the thoracotomy group. The patients in the VATS group tended to have a lower diffusing capacity for carbon monoxide (p=0.077). There were no differences between the 2 groups in the method of diagnosing the N stage, tumor response and size after induction, tumor location, or histologic type. Complete resection was achieved in all patients. More total and mediastinal nodes were dissected in the VATS group than in the thoracotomy group (p<0.05). The median chest tube duration was 5.3 days (range, 1 to 33 days) for the VATS group and 7.2 days (range, 2 to 28 days) for the thoracotomy group. The median follow-up duration was 36.3 months. The 5-year survival rates were 76% in the VATS group and 57.8% in the thoracotomy group (p=0.39). The 5-year disease-free survival rates were 40.3% and 38.9% in the VATS and thoracotomy groups, respectively (p=0.8). Conclusion: The VATS approach following neoadjuvant treatment was safe and feasible in selected patients for the treatment of stage IIIA N2 NSCLC, with no compromise of oncologic efficacy.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1366-1372
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• 1996

Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.545-550
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• 2009

Background: Endobronchial ultrasonogram (EBUS) has increased the diagnostic yield of a bronchoscopic biopsy of peripheral pulmonary lesions (PPL). This study evaluated the diagnostic yield of EBUS-guided transbronchial biopsy (TBB) and the visibility of EBUS PPL. Methods: Between August 2007 and November 2008, 50 patients (32 men and 18 women, median age, 61.1${\pm}$10 yrs; range, 16 to 80 yrs) whose PPL lesions could not be detected with flexible bronchoscopy were enrolled in this study. Among the 50 patients, 40 cases were malignant lesions (adenocarcinoma 25, squamous cell carcinoma 10, small cell carcinoma 5) and 10 cases were benign lesions (tuberculoma 7, fungal ball 1, other inflammation 2). Results: The mean diameter of the target lesion was 35.4${\pm}$4.3 mm. Of the 50 patients examined, the overall diagnostic yield by EBUS-TBLB was 46.0% (23/50). The visualization yield of EBUS was 66.0% (33/50). A definitive diagnosis of PPL localized by EBUS was established using EBUS-TBLB in 69.6% (23/33) of cases. The diagnostic yields from washing cytology and brushing cytology from a bronchus identified by EBUS were 27.0% and 45.4% respectively. The diagnostic yields reached 78.7% when the three tests (washing cytology, brushing cytology and EBUS-TBLB) were combined. The visualization yield of EBUS in lesions <20 mm was significantly lower than that in lesions ${\geq}$20 mm (p=0.04). The presence of a bronchus leading to a lesion (open bronchus sign) on the chest CT scan was associated with a high visualization yield on EBUS (p=0.001). There were no significant complications associated with EBUS-TBLB. Conclusion: EBUS-TBLB is a safe and effective method for diagnosing PPL. The lesion size and open bronchus signs are significant factors for predicting the visualization of EBUS.

• Journal of Chest Surgery
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• v.25 no.9
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• pp.948-954
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• 1992

In spite of recent progress in anticancer chemotherapy, the survival of patients with metastases to the lung treated nonsurgically has been extremely poor. So we adopted more aggressive surgical approaches for the treatment of patients with pulmonary metastases since 1985. We experienced 22 operations of metastatic lung cancer in 19 patients in the department of Thoracic & Cardiovascular Surgery in Kosin Medical College since 1985, so we reviewed the results of treatment retrospectively. The results were as follows: 1. The primary organs of metastatic lung cancer were 4 cases in each of the breast, uterus, and extremities, 3 cases in the rectum, 2 cases in the kidney, 1 case in each of the pelvis and liver, and the pathological findings were 13 cases in carcinoma and 6 cases in sarcoma. 2. The treatments for primary lesions were 15 cases of the operations with anticancer chemotherapy or radiation therapy, 2 cases of choriocarcinoma with anticancer chemotherapy only, 1 cases of uterine cervical carcinoma with chemo-radiation therapy, and 1 case of pelvic synovia sarcoma with intra-arterial anticancer chemotherapy. 3. Disease free intrerval were as follows: 7 cases were in 2 years to 4 years, 4 cases were in 1 year to 2 years, and 5 cases were beyond one year, of them one case was discovered primary lesion and metastatic lung tumor concomittently. 3 cases were above 4 years, of them one case of breast cancer were above 13 years especially. 4. The sites of metastatic lung cancer was 15 lesions in the right lung, and 9 lesions in the left lung, And the lobar sites were 10 lesions in the upper lobe, 2 lesions in the middle lobe, and 12 lesions in the lower lobe. 5. The operative methods of metastatic lung cancer were 7 case of partial resection of lung, 12 cases of pulmonary lobectomy, 1 case of pneumonectomy and 1 case of dissection of mediastinal lymph node. 6. The postoperative complications were 1 case of mild respiratory insufficency, 1 cases of pyothorax, and 1 case of urethral stricture. 7. Postoperative adjuvant therapy were as follows: No adjuvant therapy were 4 cases, anti-cancer chemotherapy were 8 cases, radiation therapy was 1 case, and combined with chemo k radiation therapy were 8 cases. 8. The results of long term follow-up were as follows: The 5 patients were died at 2 months, 22 months, 24 months, 32 months, and 49 months postoperatively, so mean survival period was 32 months postoperatively excluding one patient who was died at 2 months postoperatively. And 14 patients are aliving, of them 3 patients are living in recurred state, and the other 11 patients are living without any evidence of recurrence.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.6
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• pp.1530-1537
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• 2006

Platycodi Radix, the root of Platycodon grandiflorum A. DC (Campanulaceae), commonly known as Doraji in Korea (Chinese name, 'Jiegeng', and Japanese name, 'Kikyo') has been used as an expectorant in traditional Oriental medicine. Extracts from the roots of P. grandiflorum have been reported to have wide ranging health benefits. In Korea, Platycodi Radix is also used as a food and employed as a folk remedy for adult diseases, such as bronchitis, asthma and pulmonary tuberculosis, hyperlipidemia, diabetes, and inflammatory diseases, and as a sedative. Several studies on its chemical and immunopharmacological effects including immunostimulation and antitumor activity have been performed. However, the relevant molecular mechanisms are poorly understood. Platycodi Radix, the root of Platycodon grandiflorum A. DC (Campanulaceae), commonly known as Doraji in Korea (Chinese name, 'Jiegeng', and Japanese name, 'Kikyo') has been used as an expectorant in traditional Oriental medicine. Extracts from the roots of P. grandiflorum have been reported to have wide ranging health bensfits. In Korea, Platycodi Radix is also used as a food and employed as a folk remedy for adult diseases, such as bronchitis, asthma and pulmonary tuberculosis, hyperlipidemia, diabetes, and inflammatory diseases, and as a sedative. Several studies on its chemical and immunopharmacological effects including immunostimulation and antitumor activity have been performed. However, the relevant molecular mechanisms are poorly understood. In the present study, we investigated the effects of an aqueous extract from the roots of P. grandiflorum AEPG) on the cell growth of human lung adenocarcinoma NCI-H460 cells in order to understand its anti-proliferative mechanism. AEPG treatment down-regulated the cyclin D1 expression in both transcriptional and translational levels without alteration of cyclin E. In AEPG-treated cells, the levels of cyclin-dependent kinase (C아) 6 mRNA and protein were significantly inhibited, but the levels of Cdk2 and Cdk4 were slightly inhibited by treatment of AEPG. AEPG treatment induced a marked accumulation of Cdk inhibitors, p16 and p27. However, AEPG treatment did not affect not only retinoblastoma protein (pRB) but also tumor suppressor p53 protein expression. The present results indicated that AEPG-induced inhibition of lung cancer cell proliferation is associated with the blockage of G1 phase progression through induction of Cdk inhibitors such as p16 and p27, and inhibition of cyclin D1 and Cdk6. AEPG exposure, as offered by this study, provides cluse for the mechanism of AEPG action. Taken together, these findings suggest that P. grandiflorum has strong potential for development as an agent for prevention and treatiment against human lung cancer.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.458-460
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• 1996

Percutaneous transthoracic fine needle biopsy is a popular technique in the diagnosis ot'pulmonary and pleural diseases and its complication rate is very low. One of the rarest but potential complications is that of implantation of malignant cells along the needle tract and subsequent development of a chest wall mass . We experienced a case of chest wall implantation of lung cancer after percutaneous transthoracic fine needle biopsy. The patient was a 59 year old female who had undergone right upper lobectomy for squamous cell carcinoma of the lung (T,N,Mo). 6 months after operation, a loculated mass was palpated at the right posterior .chest wall where the percutaneous transthoracic fine needle biopsy had been performed before operation. We carried out wide excision of this mass and confirmed squamous cell carcinoma histopathologically.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.35-41
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• 1998

The pulmonary metastasis and bony metastasis finally resulted from the malignant tumors as one of the inevitable problems. Among them, the bony metastasis, which frequently involved the vertebrae, pelvis, ribs, sternum, and skull, have had the frequencies over 30%. Metastasis to the distal part of the knee is rare. However, acrometastasis which occured in bones of the foot is even rarer(0.4%) and a late manifetation of a disseminated disease from the literature review. Acrometastasis should be considered in elderly patients with a history of the previous malignancy, complaint of foot pain and mass lesion. We are reporting one rectal carcinoma with acrometastasis to the second metatarsal bone.

• Journal of Preventive Medicine and Public Health
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• v.52 no.2
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• pp.140-144
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• 2019

Objectives: Investigating the survival of patients with cancer is vitally necessary for controlling the disease and for assessing treatment methods. This study aimed to compare various statistical models of survival and to determine the survival rate and its related factors among patients suffering from lung cancer. Methods: In this retrospective cohort, the cumulative survival rate, median survival time, and factors associated with the survival of lung cancer patients were estimated using Cox, Weibull, exponential, and Gompertz regression models. Kaplan-Meier tables and the log-rank test were also used to analyze the survival of patients in different subgroups. Results: Of 102 patients with lung cancer, 74.5% were male. During the follow-up period, 80.4% died. The incidence rate of death among patients was estimated as 3.9 (95% confidence [CI], 3.1 to 4.8) per 100 person-months. The 5-year survival rate for all patients, males, females, patients with non-small cell lung carcinoma (NSCLC), and patients with small cell lung carcinoma (SCLC) was 17%, 13%, 29%, 21%, and 0%, respectively. The median survival time for all patients, males, females, those with NSCLC, and those with SCLC was 12.7 months, 12.0 months, 16.0 months, 16.0 months, and 6.0 months, respectively. Multivariate analyses indicated that the hazard ratios (95% CIs) for male sex, age, and SCLC were 0.56 (0.33 to 0.93), 1.03 (1.01 to 1.05), and 2.91 (1.71 to 4.95), respectively. Conclusions: Our results showed that the exponential model was the most precise. This model identified age, sex, and type of cancer as factors that predicted survival in patients with lung cancer.

• The Korea Journal of Herbology
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• v.36 no.1
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• pp.97-102
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• 2021

Objectives : Virus infection through the respiratory tract causes various inflammatory diseases such as pneumonia, cystic fibrosis, and obstructive pulmonary disease, causing enormous social damage. Therefore, it is very important to develop a treatment and prevention of infectious diseases. In this study, we investigated the effect of water extracts of Liriope muscari (WELM), known to improve lung function, on the inflammatory response of lung carcinoma cell line A549 cells induced by the viral double stranded RNA mimetic Polyinosinic:polycytidylic acid (Poly I:C). Methods : The cell viability by WELM treatment was analyzed using MTS assay in A549 cells. After inducing an inflammatory response to WELM-treated A549 cells with Poly I:C, the degree of apoptosis was confirmed through bright field microscopy. Interferon beta (IFN-β) mRNA expression level in A549 cells was analyzed by quantitative reverse transcription PCR (qRT-PCR). Results : WELM treatment has no significant effect on cell viability of A549 cells. We confirmed that pre-treatment of WELM effectively reduces the Poly I:C-induced apoptotic cell death in A549 cells. In addition, it was confirmed that the mRNA expression level of IFN-β, a pro-inflammatory cytokine increased by Poly I:C treatment, was significantly suppressed by WELM treatment in A549 cells. Conclusions : These results provide the evidence that WELM is effective at inhibiting inflammation on respiratory viral infections and suggest that Liriope muscari might be a valuable natural substance in the prevention and treatment of infectious diseases.