• Tuberculosis and Respiratory Diseases
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• v.64 no.3
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• pp.177-186
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• 2008

호산구성 폐렴은 혈중 호산구가 $1,000/mm^3$ 이상이거나 폐포 내 호산구 분획이 25% 이상으로 나타나는 다양한 폐 질환을 총괄하여 부르는 용어이다. 혈중 호산구증가증은 특발성 급성 호산구 폐렴의 초기나 이미 부신피질호르몬 제제를 투여받은 환자에서는 나타나지 않을 수 있다. 호산구성 폐렴은 무증상의 폐 침윤에서 기계 환기가 필요한 급성 호흡 부전 증후군까지 증상의 중증도도 다양하다. 호산구성 폐렴의 원인으로 약제나 기생충이 있지만 많은 경우 원인을 찾을 수 없다. 폐 외 증상이 동반될 경우 Churg-Strauss 증후군이나 과다호산구증가 증후군의 가능성을 생가해야 되며 이런 경우 심장을 침범하였는지 여부에 따라 예후가 결정된다. 가능한 원인에 대한 노출을 피하는 것 외에는, 부신피질호르몬 제제 투여가 가장 중요하며 대부분 극적인 호전을 보인다. 하지만 약제의 감량 중이나 치료 종결 후 재발하는 경우가 자주 있다. HES의 골수 증식성 변이형 치료에 imatinib의 효과가 최근 입증 되었다.

• Tuberculosis and Respiratory Diseases
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• v.63 no.2
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• pp.194-199
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• 2007

BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.1-11
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• 2003

Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.171-177
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• 2006

Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.

• Investigative Magnetic Resonance Imaging
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• v.6 no.2
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• pp.152-157
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• 2002

Purpose : The differential diagnosis between Modic type I degenerative spine and infectious spondylitis sometimes is difficult, because the affected bone marrows in both disease show similar signal intensity on conventional MR imaging. We evaluate the usefulness of diffusion-wighted MR imaging for differential diagnosis between Modic type I degenerative spine and infectious spondylitis. Materials and methods : The spin-echo and diffusion-weighted MR images of eight patients with Modic type I degenerative spines and 14 patients with infectious spondylitis diagnosed by clinical findings or CT-guided biopsies we re analyzed. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF). Signal intensity changes of the vertebral bone marrow on conventional spin-echo and diffusion-weighted MR imaging were compared between degenerative spine and infectious spondylitis. Results : On T1-weighte d images, the affeted bone marrow in both disease showed hypointense signals. On T 2-weighted images, all of type I degenerative spine and 11 of infectious spondylitis showed hyperintensity, and three of infectious spondylitis showed heterogeneo us mixed signal intensity. On diffusion-weighted MR images, all of type I degenerative spine were hypointense with peripheral high signal intensity to normal vertebral body, but infectious spondylitis was hyperintense (n = 11) and hypointense (n=3). Conclusion : Diffusion-weighted MR imaging is useful to differentiate Modic type I degenerative spine from infectious spondylitis. On diffusion-weighted images, the high singal intensity of bone marrow suggests infectious spondylitis, whereas the low signal intensity of bone marrow with peripheral focal high signal intensity suggests type I degenerative spine.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.614-623
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• 2000

Background : Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. Method : A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveolar lavage or lung biopsy. Results : Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD ($3.27{\pm}3.15$ mg/dl vs. $1.19{\pm}0.94$ mg/dl, p=0.030). The corresponding drop in hemoglobin level was $2.69{\pm}1.26$ g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by $1.38{\pm}4.22$ days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). Conclusion : The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.