• 대한기관식도과학회지
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• 제6권2호
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• pp.196-200
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• 2000

Nasopharyngeal tuberculosis is a rare pathological condition. It is most often associated with lymph node and pulmonary lesions, but it may be an isolated lesion. The clinical manifestation may resemble a malignant tumor of the nasopharynx and the nasopharyngeal tuberculosis is occurred occasionally primary infection but more frequently secondary infection to pulmonary tuberculosis. The nasal endoscopic evaluation of nasopharynx is necessary in patient with possible pulmonary or extrapulmonary tuberculosis. The author reports two cases of nasopharyngeal tuberculosis in a 45-years old and 34-years old woman with a review of the literature.

• Asian-Australasian Journal of Animal Sciences
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• 제24권7호
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• pp.889-897
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• 2011

Mycoplasma Pneumonia of swine (MPS) decreases the daily growth of pigs, and, co-infection with a virus sometimes causes severe pneumonia. Genetic selection of pigs resistant to the pulmonary MPS lesion might solve the economic loss due to MPS in animal production. Here, we examined the immunophenotype of Landrace line (Miyagino L2), genetically selected to reduce the incidence of pulmonary MPS lesion for 5 generations in Miyagi Prefecture Animal Industry Experiment Station. Although this line is expected to be resistant to the pulmonary MPS lesion, the biological characteristics of its immune function are not clear. We investigated details of the immunorelated phenotype of Miyagino L2 at the hematological and molecular biological level, including cytokine expression, and compared the results with that of non-genetically selected Landrace. Miyagino L2 showed decreased antigen-specific IgG and IgM production and increased CD8-positive T-cell population, and high levels of cortisol concentration, suggesting that the MPS-resistant phenotype is associated these immunological differences. Additionally, T-cell CD4 expression was highly correlated with the MPS expected breeding value. Although the detailed mechanisms underlying this high correlation remain unknown, our result suggested that the genetic selection of the expression level of CD4 might be useful to improve MPS resistance in pig production.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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• pp.284-290
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• 2017

Background: We aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible. Methods: This was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield. Results: We included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], 7.56-103.32; p<0.001 and OR, 4.91; 95% CI, 1.76-13.72; p=0.002). Conclusion: The presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

• Journal of Chest Surgery
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• 제30권5호
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• pp.524-527
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• 1997

폐동맥폐쇄, 심실중격결손증 그리고 큰 대동맥폐동맥 부행혈관이 합병된 선천성심장병은 매우 드물고 폐 혈류공급원에 있어서 매우 다양한 형태를 가지는 복합병변이다. 세종병원 흉부외과는 이러한 질환이 있는 9 개월된 남아 1례에서 정중절개를 톤해 자가조직만을 이용한 폐동맥형성을 포함한 조기 일차완전교정술을 시 행하여 좋은 결과를 얻었기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제45권5호
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• pp.1058-1066
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• 1998

연구배경: 흉부 방선균 감염에서 흉곽벽 혹은 늑골까지 폐 방선균 감염이 파급되는 경우는 감소되고 있는 것으로 보고 되었다. 또한 흉부 방선균증은 흔한 질환이 아니고 아급성 내지는 만성 폐 감염의 경과를 보이프로 폐결핵 혹은 폐암과의 감별 진단이 어려운 것으로 알려져 있다. 아직 진단 방법에 대해 추천되는 것은 없는 실정이며 기관지경 검사의 역할에 대해서는 아직 자세히 기술된 적은 없었다. 저자들은 총 17예의 흉부 방선균증을 경험하였고 진단에 있어서 기관지내시경의 역할과 타호흡기 질환과의 동반 여부에 대하여 보고하는 바이다. 연구방법: 1989년 이래 서울중앙병원에 입원하여 흉부 방선균증으로 진단되었던 17예(연령 24~72세, 평균 53세 ; 남녀 비 11 : 6)의 임상적 특징을 후향적으로 분석하였다. 연구결과: 흉부 방선균종의 진단시 증상은 기침이 14예(82%)로 가장 많았고, 객혈 8예, 화농성 객담 8예, 흉막염성 흉통 6예 순이었으며, 체중 감소와 만성 피로감이 각 6예에서 관찰되었고, 섭씨 38.3도 이상의 발열이 있었던 예는 없었다. 증상 발현에서 진단까지의 기간은 평균 6개월 (3주~2년)로서 폐결핵의 추정 진단하에 항결핵제를 5예에서 투여하였다. 기저 폐질환으로는 기관지 확장증이 2예, 폐기종이 1예였고, 과거 폐결핵 병력이 있었던 예는 5예로서 이 중 2예에서 다시 항결핵제 투여를 하고 있었다. 흉부 방사선 촬영 소견은 폐종괴 8예, 무기폐 3예 및 폐렴 소견 3예로서 상기 소견은 모두 1개 폐엽에 국한되었고 이중 흉막염 동반에는 1예였으며, 나머지 3예는 정상 소견이었다. 확진전 임상적 추정 진단은 폐암에 11예, 그리고 폐결핵이 6예였다. 흉부 방선균중이 진단된 방법은 기관지 내시경하 조직 검사에 의해 7예, 세척세포진이 2예였고, 경피적 세침 흡인술 3예, 폐엽 절제술 및 종격동경 검사가 각각 4예 및 l예였다. 기관지 내시경 검사 육안 소견은 점막 종창에 의한 기관지 협착이 5예, 종괴 5예, 그리고 기판지가 괴사 물질로 덮인 경우가 3예에서 관찰되었으며, 정상 소견은 3예였다. 최종 진단은 방선균 폐렴 10예, 기관지 방선균증 6예, 그리고 종격동 임파선 방선균 감염 1예 였으며, 폐외 병소 감염이 있었던 예는 1예로서 다발성 뇌결절의 양상을 보였다. 객담 결핵균 검사상 도말은 음성이었으나 배양이 양생인 예가 2예 있었고, 폐암과의 공존 예도 2예 있었다. 항생제 치료를 시행한 16예 중에서 1예는 폐암으로 사망하였고, 지속적 치료가 가능하였던 15예에서 항생제 치료 기간은 평균 9.2개월이었고, 경구 약제 복용을 중단한 1예에서 재발이 있었다. 결 론: 흉부 방선균증은 만성의 비교적 국소성인 폐질환으로 폐암 혹은 폐결핵과 유사한 양상을 보이고, 상기 질환들과의 공존 가능성도 염두에 두어야 한다. 또한 흉부 방선균증은 병변의 위치가 중심부인 경우는 기관지 내시경이 중요하고, 말초부인 경우는 경피적 세침 흡인술이 중요할 것으로 사료된다.

• 대한핵의학회지
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• 제34권2호
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• pp.129-134
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• 2000

목적: 흉부방사선 사진으로 결핵의 진단과 활동성의 판정이 어려운 경우가 많다. 이에 핵의학적 방법으로 결핵의 활동성을 판정하고자 하는 시도들이 있었으며, 핵의학 검사는 결핵의 활동성을 잘 반영하는 것으로 알려져 왔다. 그러나 객담결핵균의 음전을 '활동성'의 소실이라고 표현하는 치료자와 방사능섭취 소실을 '활동성'의 소실이라고 판정하는 핵의학의사 사이에는 용어 사용상의 차이가 있을 수 있다. 객담결핵균의 음전과 방사능섭취의 소실이 서로 일치하는지 여부를 확인하여 보고자 하였다. 대상 및 방법: 세균학적으로 활동성 결핵으로 진단된 15명의 환자들에서 $^{99m}Tc$-MIBI를 이용하여 폐스캔을 시행하였다. 3-7개월간의 항결핵약물치료로 객담 결핵균이 음전된 6명의 환자에 대해 $^{99m}Tc$-MIBI 스캔을 다시 시행하였다. 결핵병소와 정상 폐 부위의 방사능을 측정하여 정상 폐에 대한 결핵병소의 방사능 섭취율을 비교하였다. 결과: 활동성 폐결핵 환자 15명 중 12명(80%)에서 $^{99m}Tc$-MIBI 스캔 양성을 보였다. 항결핵약물치료로 객담 결핵균이 음전된 후 6명에서 $^{99m}Tc$-MIBI 스캔을 반복했을 때 6명 모두에서 섭취율이 치료 전에 비해서 감소하는 경향을 보였다. 그러나 5명에서는 정상 폐에 비해서는 여전히 높았다. 결론: $^{99m}Tc$-MIBI 스캔은 폐결핵 병변에서 염증반응의 정도를 판정하는데 도움이 된다. 그렇지만 객담 결핵균의 음전으로 정의되는 '활동성'과 1:1로 일치하지는 않았다.

• Korean Journal of Radiology
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• 제2권3호
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• pp.138-144
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• 2001

Objective: Bronchogenic carcinoma can mimic or be masked by pulmonary tuberculosis (TB), and the aim of this study was to describe the radiologic findings and clinical significance of bronchogenic carcinoma and pulmonary TB which coexist in the same lobe. Materials and Methods: The findings of 51 patients (48 males and three females, aged 48-79 years) in whom pulmonary TB and bronchogenic carcinoma coexisted in the same lobe were analyzed. The morphologic characteristics of a tumor, such as its diameter and margin, the presence of calcification or cavitation, and mediastinal lymphadenopathy, as seen at CT, were retrospectively assessed, and the clinical stage of the lung cancer was also determined. Using the serial chest radiographs available for 21 patients, the possible causes of delay in the diagnosis of lung cancer were analyzed. Results: Lung cancers with coexisting pulmonary TB were located predominantly in the upper lobes (82.4%). The mean diameter of the mass was 5.3 cm, and most tumors (n=42, 82.4%) had a lobulated border. Calcification within the tumor was seen in 20 patients (39.2%), and cavitation in five (9.8%). Forty-two (82.4%) had mediastinal lymphadenopathy, and more than half the tumors (60.8%) were at an advanced stage [IIIB (n=11) or IV (n=20)]. The average delay in diagnosing lung cancer was 11.7 (range, 1-24) months, and the causes of this were failure to observe new nodules masked by coexisting stable TB lesions (n=8), misinterpretation of new lesions as aggravation of TB (n=5), misinterpretation of lung cancer as tuberculoma at initial radiography (n=4), masking of the nodule by an active TB lesion (n=3), and subtleness of the lesion (n=1). Conclusion: Most cancers concurrent with TB are large, lobulated masses with mediastinal lymphadenopathy, indicating that the morphologic characteristics of lung cancer with coexisting pulmonary TB are similar to those of lung cancer without TB. The diagnosis of lung cancer is delayed mainly because of masking by a tuberculous lesion, and this suggests that in patients in whom a predominant or growing nodule is present and who show little improvement of symptoms despite antituberculous or other medical therapy, coexisting cancer should be suspected.

• 보험의학회지
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• 제2권1호
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• pp.128-134
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• 1985

Circumscribed solitary pulmonary nodule is often founded on the plain chest P-A. Even if many study results of coin lesion have been reported by some scholars, it is still very difficult to judge whether the coin lesion is to be benign or malignant. In order to avoid unnecessary surgical treatment, it must be made an examination and analysis very carefully in advance. In the chest P-A, we can grasp the aspects of the site and size of lesion, marginal state of lesion, calcification, cavity, and the growth rate in comparison to follow-up chest P-A. On the basis of above-mentioned analysis, we have to judge whether it is benign or malignant, and decide the next examinations. And then the doctor make diagnosis definitely by the clinical history, plain chest P-A, tomography, bronchography, CT, variable laboratory findings.

• 대한세포병리학회지
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• 제11권2호
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• pp.99-102
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• 2000

Pulmonary amyloid deposition generally occurs with concurrent primary systemic amyloidosis. Localized forms of pulmonary amyloidosis are rare and appear most frequently as an incidental finding on chest radiographs. We present a case of nodular pulmonary amyloid tumor suggested by fine needle aspiration cytology(FNAC) and confirmed by histology examination with the polarizing light microscopy. A 41-year-old woman presented with ill-defined nodules. In the middle and lower lobes of both lungs. FNAC of the nodules revealed waxy, acellular amorphous fragments. Thoracotomy for diagnosis may be avoided by FNAC diagnosis of this unusual lesion.

• Journal of Chest Surgery
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• 제25권9호
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• pp.900-904
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• 1992

Pulmonary blastoma is a very rare, primary, malignant neoplasm of the lung. The tumor typically is large, well-defined mass and arises in the periphery of the lung. Histologically, it resembles fetal lung tissue evoking the concept that these tumors are drived from the primitive pluripotential pulmonary blastema, but controversy also exit about the nature of this tumor. Clinical evaluation is inconsistant and unreliable as to the diagnostic determination of the tumor type and degree of malignancy. Therefore, diagnosis is usually based on histologic findings. The prognosis after adequate resection appears to be better than for other malignant tumors of the lungs. We experienced a case of pulmonary blastoma occurring in 56-year-old female. She was hospitalized for evaluation of an abnormal shadow in the left lower lung field which found incidentally on chest roentgenogram. We approached the lesion though left posterolateral thoracotomy and performed the left lower lobectomy. The microscopic findings of resected specimen revealed characteristic appearance of pulmonary blastoma. The postoperative course was uneventful without complication.