• Journal of Chest Surgery
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• v.35 no.10
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• pp.760-763
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• 2002

Mucoepidermoid cancer of the bronchus in childhood is extremely rare. These tumors generally produce symptoms of airway obstruction, often misdiagnosed as unresolved tuberculosis. Distant metastasis is an uncommon finding of this malignancy, therefore complete surgical resection is treatment of choice. The prognosis of these tumors correlates with the histologic grade of the tumor. We report our clinical experience of mucoepideromoid cancer in a 10-year-old child who visited our hospital with symptoms of recurrent cough and fever. The patients underwent successful removal of tumor by bilobectomy via thoracotomy after bronchoscopic biopsy.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.955-958
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• 2004

Mucoepidermoid carcinoma is an uncommon lesion that accounts for approximately 1% of primary malignant bronchial gland tumors and less than 0.2% of all lung neoplasm. This tumor presents with symptoms of bronchial irritation or obstruction. Distant metastasis is uncommon, therefore complete surgical resection is the treatment of choice. The prognosis of tumor correlates with on the histologic grade of tumor. We experienced mucoepidermoid carcinoma in a 15 year-old girl with symptoms of cough and blood tinged sputum. The patient underwent successful removal of tumor by bilobectomy via explorothoracotomy after chest CT and bronchoscopic biopsy.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.124-128
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• 2007

Bronchiolitis obliterans is a clinical syndrome of chronic obstruction associated with inflammatory changes in the small airways. There are marked variations in the epidemiology of this disease. In childhood, bronchiolitis obliterans has been described as a result of a number of infections such as adenovirus, measles, Bordetella pertussis, Mycoplasma pneumoniae, and influenza A infection. Most common agents are adenovirus types 3, 7, and 21. Diagnosis of bronchiolitis obliterans can be made based on clinical findings, high resolution computed tomography (HRCT) and lung biopsy. In addition to diagnosis, treatment is not yet clearly established. The authors experienced a case of bronchiolitis obliterans developed in 3 year-old girl who suffered from type 7 adenoviral pneumonia. She had been hospitalized and treated for 15 days due to pneumonia. After discharge, productive cough was not improved and auscultation revealed wheezing. HRCT demonstrated multifocal mosaic patterns suggesting bronchiolitis obliterans. She was managed with inhaled steroid and bronchodilator, and her symptoms were improved. However, follow up HRCT showed no interval change.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.878-882
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• 2003

Tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and may be related to inflammatory conditions affecting the lung, including recurrent pneumonia, bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but either clinical or radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6month follow-up period.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1048-1052
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• 2009

Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.236-239
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• 2006

A 32 year-old man was transferred to our hospital due to blood-tinged sputum for 15 days. He had been treated at a private hospital for recurrent pneumonia. The chest X-ray showed an atelectasis on the right middle lobe. Computed tomography of the chest demonstrated a broncholith on right middle lobar bronchus with lobar atelectasis of the right middle lobe. We tried to remove the broncholith through fiberoptic bronchoscopy, but could not remove it. Therefore, we performed surgical removal of broncholith and the right middle lobectomy. The cause of broncholith was identified as actinomycosis by pathologic examination. The broncholith caused by actinomycosis is rare. We report a rare case of broncholithiasis with recurrent obstructive pneumonia caused by actinomycosis, which was treated by surgical operation.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.444-447
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• 2003

Sleeve pneumonectomy can be a method of treatment in a selected patient with bronchogenic carcinoma involving carina. A 64 years old male with a history of mitral valve replacement via midsternotomy 13 years ago and resection of papilloma of the vocal cord 2 years ago. The patient was admitted due to blood-tinged sputum. Bronchoscopy and computerized tomogram of the chest revealed 3.5 cm mass at lower margin of the trachea and totally obstructing the left main bronchus. A biopsy revealed squamous cell carcinoma. He underwent left sleeve pneumonectomy through sequential bilateral thoracotomy without cardiopulmonary bypass, and the pathologic stage was T4N0M0 stage IIIB. The patient is being followed through the outpatient clinic in good general condition.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.149-152
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• 2002

We report successful application of dual trachcobronchial stcnt to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with COB retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stunt. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty Finally we applied dual tracheobronchial stent and resolved the airway obstruction.

• Tuberculosis and Respiratory Diseases
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• v.54 no.2
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• pp.199-209
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• 2003

Background : Unexplained weight loss, which commonly occurs in patients with chronic obstructive pulmonary disease(COPD), is important because weight loss is an independent risk factor of mortality and morbidity in these patients. Leptin is known to play an important role in regulating body weight. In addition, the tumor necrosis factor($TNF-{\alpha}$) might also play a potential role in the weight loss experienced in chronic wasting disease. The aim of this study was to determine the influence of plasma leptin and the circulating $TNF-{\alpha}$ system to the difference in the body compositions in patients with COPD. Methods : Spirometry, body composition analysis and the plasma concentrations of leptin, $TNF-{\alpha}$ and a soluble TNF receptor (STNF-R55, -R75) were measured in 31 patients with chronic bronchitis and 10 patients with emphysema. The COPD subtype was classified by the transfer coefficient of carbon monoxide, DLco/VA. Results : The circulating levels of leptin were significantly lower in those patients with emphysema($108.5{\pm}39.37pg/ml$) than those with chronic bronchitis($180.9{\pm}57.7pg/ml$). The circulating levels of sTNF-R55 were significantly higher in the emphysema patients($920.4{\pm}116.4pg/ml$) than in those with chronic bronchitis($803.2{\pm}80.8pg/ml$). There was no relationship between the circulating leptin levels and the activated TNF system in patients with chronic bronchitis and emphysema. However, the circulating leptin levels correlated well with the BMI and fat mass in both patient groups. Conclusion : These results suggest that the weight loss noted in emphysema patients may be associated with the activation of the $TNF-{\alpha}$ system rather than the plasma leptin level.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.664-669
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• 2005

Objectives : To evaluate the clinical significance of abnormal bronchi originating from the trachea or main bronchi. Methods : 21 patients (male:female ratio, 13:8; mean age, 58.2 years, range 34-77), who were diagnosed with major tracheobronchial anomalies by bronchoscopy from January 2001 to March 2005, were enrolled in this study. The anomalous bronchi consisted of 13 tracheal bronchi and 8 cardiac accessory bronchus. The clinical features, bronchoscopic findings, and outcomes were analyzed retrospectively. Results : Common symptoms, including hemoptysis, cough and dyspnea, resulted from the underlying lung disease regardless of the bronchial anomalies. In this series of 13 tracheal bronchi, 7 cases originated from the trachea within 1cm of the carina (carinal type) and 6 cases originated at a higher level(tracheal type). Most patients had favorable outcome with conservative treatment for the underlying lung disease. Conclusion : Most tracheobronchial anomalies are found incidentally in the process of diagnosing lung disease. The clinical outcome of patients with a bronchial anomaly depends on the underlying lung disease.