• Title/Summary/Keyword: pulmonary lesion

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Tuberculin Skin Test and Plasma Prostaglandin $E_2$ In Patients of New and Intractable Pulmonary Tuberculosis (초치료 및 난치 폐결핵 환자의 투베르쿨린 피부검사와 혈장 Prostaglandin $E_2$)

  • Kim, Ji-Hong;Choi, In-Hwan;Kim, Mee-Ae;Shin, Chul-Shik;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.669-676
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    • 1995
  • Background: The cell-mediated immunity is needed for eradicating the tubercle bacilli. Prostaglandin(PG), especially PG $E_2$, is involved in cellular immunosuppression. It is known that the PG $E_2$ is suppressed by indomethacin. For using indomethacin as a immunomodulator of intractable pulmonary tuberculosis(Tbc) patients, we measured the tuberculin skin test(TST) and the plasma PG $E_2$ levels. Method: The forty-eight inpatients with sputum positive acid-fast stain bacilli were classified into 6 groups according to antiTbc chemotherapy history(new and intractable cases), plain chest roetgenogram(minimal and far advanced cases), and TST reaction(nagative and positive cases). Except for one group(n=2; new, minimal, and negative cases of TST reaction) of the 6 groups, all subjects(n=46) were measured for the plasma PG $E_2$, levels with radioimmunoassay. Results: 1) There was no significant difference in the plasma PG $E_2$ levels among A group(far advanced and positive TST reaction cases, n=10, $11.22{\pm}2.86\;pg/ml$), B group(minimal and negative TST reaction cases, n=9, $11.35{\pm}2.20$) and C group(far advanced and positive TST reaction cases, n=7, $11.11{\pm}2.30$) in the new cases(p>0.05). 2) There was no significant difference in the plasma PG $E_2$ levels between positive(n=10, $9.25{\pm}2.21$) and negative(n=10, $8.25{\pm}1.13$) groups by TST in the intractable cases(p>0.05). 3) Comparing the plasma PG $E_2$ levels between new(n=26, $11.35{\pm}2.41$) and intractable(n=20, $8.75{\pm}1.78$) groups, the intractable group had significi- andy lower plasma PG $E_2$ levels(p<0.05). 4) There was no significant difference in the plasma PG $E_2$ levels between negative(n=19, $9.88{\pm}2.43$) and positive(n=27, $10.46{\pm}2.56$) groups by TST(p>0.05). 5) There was no significant difference in the plasma PG $E_2$ levels between male(n=32, $10.07{\pm}2.44$) and female(n=14, $10.56{\pm}2.70$)(p>0.05). 6) There was no significant difference in the plasma PG $E_2$ levels among 2nd(n=5, $10.21{\pm}2.86$), 3rd(n=9, $9.97{\pm}2.47$), 4th(n=13, $11.35{\pm}2.33$) and 5th(n=19, $9.57{\pm}2.48$) decades(p>0.05). 7) There was no significant correlation between the induration sizes of the TST and the plasma PG $E_2$ levels(r=0.054, p>0.05). Conclusion: From the above results, the plasma PG $E_2$ levels of intractable group are not higher as the authors had expected. There was no significant difference in the plasma PG $E_2$ levels by the lesion sizes of plain chest roentgenogram and the induration sizes of TST, so more study will be needed to use the indomethacin as a immunomodulator for intractable pulmonary tuberculosis patients.

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A Case of Primary Endobronchial Leiomyoma (원발성 기관지내 평활근종 1예)

  • Lee, Hee Kyung;Lee, Jae Hyung;Kim, Sang Heon;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Min, Kyueng Whan;Paik, Seung Sam;Kang, Jung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.273-278
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    • 2006
  • Endobronchial leiomyoma is a rare tumor that accounts for less than 2% of pulmonary benign tumors. A 32 year-old woman was admitted with fever, cough and sputum for a month. She had suffered from intermittent cough over three years. The chest X-ray and chest CT(computed tomography) showed a nodular lesion obstructing the proximal portion of the left lower lobar bronchus and atelectasis of the left lower lobe. Flexible Bronchoscopy detected a mass obstructing the distal portion of the left main bronchus and endobronchial biopsy showed benign smooth muscle cells. There was no abnormal finding in the uterine examination. Therefore this case was diagnosed as primary endobronchial leiomyoma. The lobectomy was performed due to intractable pneumonia and secondary parenchymal destruction. Postoperative course was uneventful and she was discharged in good health.

Study on the Usefulness of respiration compensation PET/CT (호흡보정 PET/CT의 유용성에 관한 연구)

  • Kim, Ki-Jin;Bae, Seok-Hwan;Kim, Ga-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.5
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    • pp.2209-2213
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    • 2011
  • When taking PET/CT, the distortion of the image happens due to the movement of a lesion with respiration. In this study, the experiment was conducted to see if the change in SUV value and distortion of the image could be somewhat corrected by comparing the image which was not compensated with that of the region of lung nodule, compensated with respiration compensation Plumonary Toolkit possessed by this hospital. The records of 17 patients with Lung cancer between May and August 2008. As the result of the experiment, Max SUV value increased by from 4.08% minimum to 43.10% maximum, and the average Max SUV value of lung nodule increased from 6.07 to 7.00(12.16%). In the case of respiration compensation PET/CT, the distortion of the image improved. As there was no significance in the comparison of SCC and Adenocarcinom respectively, though there was a statistically significant level(P<0.05) before and after respiration compensation in SCC-Adenocarcinoma, there was an effect in respiration compensation regardless of Cell types. As the result of the experiment, it was found out that the distortion of standard intake coefficient value and the image was compensated Therefore, the diagnosis of lung cancer and follow up will be able to help.

The Surgical Results of Stage I Lung Cancer (제 1기 폐암의 수술성적)

  • 김길동;정경영;홍기표;김대준
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.982-987
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    • 1998
  • Background: Surgical resection is the standad therapy for the stage I lung cancer. We analysed the risk facturs of stage I lung cancer patent and tryed to establish more effective and aggressive treatment modality. Materials and methods: A detailed analysis was undertaken to evaluate the surgical results and to define the risk factors associated with the recurrence and the survival time in 146 consecutive patients with stage I lung cancer who were diagnosed, and resected at Yonsei Medical Center from January 1990 to December 1996. Results: There were 115 males and 31 females. Their ages ranged from 27 to 79 years(mean age:58.9$\pm$9.3 years). The histologic types were squamous carcinoma in 72 cases(49.3%) and adenocarcinoma in 45 cases(30.8%). A pulmonary resection and mediastinal lymph node dissection were done in all cases. A lobectomy was performed in 96 cases(65.7%) and a pneumonectomy in 48 cases(32.9%). There were 5 operative mortalities(3.4%) and complications occured in 24 cases(16.5%). The overall 5-year survival was 64.1%, and survival time did not depend on the type of operation or histologic type. Significant predictors of decreased survival were visceral pleural invasion(p=0.0079), T2 lesion(p=0.0462), and tumor size($\geq$5 cm) in adenocarcinoma(p=0.0472). The overall incidence of recurrence was 33.3%(47 cases; local or regional 6.4%, distant 26.9%). Almost all recurrences(44cases) occurred in T2 lesions. The distant organs that failed were the contralateral lung in 13 patients, the brain in 12, the bone in 10, and other organs in 3. Conclusions: even in stage I lung cancer, we suggest that postoperative adjuvant therapy is recommended in patients with poor prognostic factors such as visceral pleural invasion, T2 lesions, and a tumor size($\geq$5 cm) in the adenocarcinoma.

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Epidemiological and Clinicopathological Characteristics of Lung Cancer in a Teaching Hospital in Iran

  • Hajmanoochehri, Fatemeh;Mohammadi, Navid;Zohal, Mohammad Ali;Sodagar, Abolfazl;Ebtehaj, Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2495-2500
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    • 2014
  • Background: Lung cancer is one of the most commonly diagnosed cancers and the most frequent cause of cancer-related death worldwide. In Iran, it ranks second and third as the cancer-causing death in men and women, respectively. We carried out this study to find out the demographic, clinical, and histological characteristics and risk factors of lung cancer in a referral tertiary center in Iran. Materials and Methods: A retrospective study was conducted on cases of primary lung cancer based on the results of registered cancer reports of cytological and pathological specimens between March 2001 and March 2012. Demographic variables, clinical manifestations, histology and location of tumors were determined based on the data found in the medical records of each patient. Definite or probable etiologic factors were identified. Data analysis was performed with SPSS version 16 and a p-value ${\leq}0.05$ was considered as significant. Results: A total of 203 patients, with a mean age of 65.7 years (SD=11.2), with primary lung cancer were identified, 81.3% being men. Of the total, 110 cases (54.2%) were living in urban areas. In 53.2% of cases, the site of tumor was on the right side and in 72.9% of cases the lesion was centrally located. The histological types of lung cancer were squamous cell carcinoma (SCC) in 107 cases (52.7%), adenocarcinoma (AC) in 30 cases (14.8%), and small cell carcinoma (SC) in 27 cases (13.3%). Significant correlations between the gender and residence, smoking, and the histological type and location (central or peripheral) of tumor were found. The percentage of smokers was 75.2% in men and 15.8% in women. Conclusions: Smoking was the most important risk factor and squamous cell carcinoma the most common histological type of lung cancer in our study. Male sex and being a smoker was associated with histological types of SCC while being nonsmoker had relationship with adenocarcinoma.

Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.

A Case of Primary Leiomyosarcoma with Prominent Osteoclast-like Giant Cell of Lung with Cardiac Invasion (심장 침습을 동반한 현저한 파골세포 모양의 거대세포로 구성된 원발성 폐평활 근육종 1예)

  • Song, Ki Ryong;Cho, Yongseon;Sin, Sung Kyun;Jeon, Ho Seok;Hyun, Woo Jin;Lee, Yang Deok;Han, Min Soo;Rho, Ji Young;Kim, Kyung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.278-283
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    • 2004
  • The incidence of a pulmonary leiomyosarcoma as a primary lung tumor is quite rare. We report a case of primary leiomyosarcoma with a cardiac invasion in a 76 year old man. He was admitted due to left anterior chest wall pain for one month. Chest computed tomography showed a $9{\times}8{\times}10cm$ sized, large round mass in the left upper and lower lobes, and an amorphous low density lesion within the left atrium. Chest magnetic resonance imaging showed a large round mass in the left upper and lower lobes with growth into the left atrium. A diagnosis of leiomyosarcoma with prominent osteoclast-like giant cells was made based on the microscopic and immunohistochemical findings of a permanent specimen by explothoracotomy. The pathologic features of the tumor showed round mononuclear hyperchromatic cells and multinucleated giant cells that resembled osteoclasts. The immunohistochemical staining showed that the giant cells are positive for CD68 but negative for the muscle markers while the round cells were positive for the muscle marker. The patient refused further treatment and died after two months.

Comparison of immune cell populations in bronchoalveolar lavage cells and PBMC cytokine expressions in porcine reproductive and respiratory syndrome and porcine respiratory disease complex

  • Yang, Myeon-Sik;Jeong, Chang-Gi;Nazki, Salik;Mattoo, Sameer ul Salam;Lee, Sang-Myeong;Kim, Won-Il;Kim, Bumseok
    • Korean Journal of Veterinary Service
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    • v.42 no.4
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    • pp.201-216
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    • 2019
  • Porcine reproductive and respiratory syndrome (PRRS) is characterized by reproductive failure in sows and respiratory distress in all age pigs. Porcine respiratory disease complex (PRDC) is a disease caused by opportunistic bacterial infection secondary to a weakened immune system by a preceding respiratory infection. In this study, we tried to compare the immune responses in PRRS and PRDC groups to clearly characterize the disease severity. Eighty-five pigs were infected with various Korean field PRRS virus strains. Infected animals were classified into PRRS (n=32) and PRDC (n=53) groups based on lung lesions such as interstitial pneumonia, suppurative pneumonia, and pleuropneumonia. The immune cell population of bronchoalveolar lavage cells (BALc) was evaluated on 14 and 28 days post infection (dpi) and PMBC cytokine expression was measured on 0, 3, 7, 14 dpi to investigate early inflammatory reactions. Pulmonary lesion severity was negatively correlated with alveolar macrophage (AM) in both PRRS and PRDC groups on 14 and 28 dpi. AM in BALc was less populated in PRDC group on 28 dpi compared to PRRS group. AM in BALc was significantly less populated in PRDC group on 28 dpi compared to 14 dpi. In addition, cytotoxic T lymphocyte (CTL) in BALc was higher populated in PRDC group on 14 dpi and 28 dpi compared to PRRS group. In the case of PBMC cytokine TNF-α, IFN-α, IL-1β, IFN-γ, FoxP3, and IL-2, the PRRS group showed higher expression than the PRDC group on 7 dpi, 14 dpi, 7 dpi, 14 dpi, 14 dpi, and 14 dpi, respectively. On the other hand, in the case of IFN-β, IL-6, IL-8, IL-4, and IL-17, the PRDC group showed higher PBMC cytokine expression at 14 dpi, 7 dpi, 14 dpi, 3 dpi, and 3 dpi, respectively, than the PRRS group. Based on these results, our study could characterize differential immune responses in pigs with PRRS or PRDC.

Videothoracoscopic Surgery for Secondary Spontaneous Pneumothorax (비디오 흉강경을 이용한 이차성 자연기흉의 치료)

  • 양현웅;정해동;최종범;최순호
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.692-696
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    • 1998
  • For the management of a secondary spontaneous pneumothorax, videothoracoscopic surgery may offer the potential therapeutic benefits of a minimally invasive approach. We report on a series of 36 patients(33 men and 3 women) with a mean age of 56.3 years(range, 31 to 80 years) who underwent thoracoscopic surgical procedures for the treatment of secondary spontaneous pneumothorax. Twenty-one patients had emphysema and 20 patients had old pulmonary tuberculosis. Nineteen patients presented a persistent severe air leak more than 3 days preoperatively and 15 patients had more than one recurrence. Bullectomy or exclusion of the lesion was performed in 33 patients. Mechanical pleurodesis was performed in the entire patients, talc was sprayed in 22 and vibramycin in 14. Mild pleural adhesion at the upper lobe was shown in 10 patients and severe pleural adhesion in 7 patients. One patient with persistent air leak died of persistent air leak and respiratory failure. The mean postoperative stay was 7.0 days(range, 2 to 17 days). At a mean follow-up of 15.8 months (range, 5 to 45 months), no pneumothorax had recurred. In comparison with the result of the treatment for 112 patients with primary spontaneous pneumothorax, the operating time was not significantly longer and there were no more primary treatment failures, but the duration of postoperative chest drainage and hospital stay was longer. Videothoracoscopic surgery has proved to be an effective treatment for secondary spontaneous pneumothorax in elderly patients who represent high-risk candidates for thoracotomy.

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The Significance of $Gallium^{67}$ Scan in Miliary Tuberculosis (속립성 결핵에서 $Ga^{67}$ 주사의 의의)

  • Kim, Hyung-In;Jin, Choon-Jo;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.558-564
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    • 1993
  • Background: Gallium scans was used clinically for detection of inflammatory lesion, granulomatous process and neoplasm and inflammatory activity in interstitial disease. So we had perfomed $Ga^{67}$ scan to see the finding of $Ga^{67}$ scan in miliary tuberculosis and to correlate $Ga^{67}$ uptake with that of the chest PA and the clinical severity. Method: We examined 10 patients who were confirmed as having miliary tuberculosis, with $Ga^{67}$ scan, chest PA and arterial blood gas analysis. Results: 1) Diffuse, positive gallium uptake was seen in all cases of miliary tuberculosis. 2) In most of cases, gallium uptake was noted only at the lung field in spite of hematogenous spread of tuberculous foci. 3) The strong correlation between chest PA and $Ga^{67}$ scan finding was seen. 4) The intimate correlation between arterial hypoxemia and $Ga^{67}$ scan finding was also noted. Conclusion: Gallium scan showed diffuse pulmonary uptake in all cases of miliary tuberculosis and it may provid a useful information to assess the disease severity in miliary tuberculosis.

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