• Title/Summary/Keyword: 기관 괴사

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A Clinical Consideration of Necrotizing Lymphadenitis (괴사성 림프절염에 대한 임상적 고찰)

  • 유명종;조우령;김학선;이재동;김명구
    • Korean Journal of Bronchoesophagology
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    • v.6 no.2
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    • pp.164-171
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    • 2000
  • Background and Objectives: Necrotizing lymphadenitis or Kikuchi's disease is characterized by cervical lymphadenopathy of unknown etiology with unique histologic findings in young female patients. The importance of this disease lies in the fact that it can be easily misdiagnosed as malignant lymphoma, hence, clinicians need to aware of this disease entity. The purpose of this study is to report the clinicopathologic findings, radiographic findings, and many laboratory tests in order to contribute to the diagnosis and treatment of necrotizing lymphadenitis. Materials and Methods: We evaluated 31 patients, who were diagnosed as necrotizing lymphadenitis by excisional biopsy or fine needle aspiration cytology or ultrasound guided 18G cutting needle biopsy, retrospectively. Result : The median age was 24.8 years (range 12 to 43 years) and the male to female ratio was 1 : 2.4(9:22), with 14 females (45.1%) under 30 years. The common chief complaints were neck mass, easy fatigue and fever. Lymph node enlargement was limited to the cervical area in most cases (28cases : 90.3%). The involved lymph nodes were usually multiple (20cases : 64.5%), unilateral (26cases 83.9%) and small sized. Leukopenia (19cases : 61.3%) and elevation of ESR (18cases : 58.1%) appeared most frequently in the abnormal laboratory data. These symptoms will be gone spontaneoulsy without any specific treatment in several weeks or months. Conclusion : We should consider open biopsy or fine needle aspiration cytology or ultrasound guided cutting needle biopsy with lymph node in patients who have cervical lymphadenopathy with easy fatigue and fever, especially young women to exclude other conditions such as malignant lymphoma and tuberculosis, etc.

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Changes of Biomarker in Manila clam, Ruditapes philippinarum Exposed to Lead (납(Pb)에 노출된 바지락, Ruditapes philippinarum의 생물지표 변화)

  • Shin, Yun Kyung;Park, Jung Jun;Lim, Hyun Sig;Lee, Jung Sick
    • The Korean Journal of Malacology
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    • v.29 no.1
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    • pp.7-13
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    • 2013
  • This study was conducted to find out biological response of Manila clam, Ruditapes philippinarum exposed to lead (Pb). Experimental period was four weeks. Experimental groups were composed of one control condition and three lead exposure conditions (0.25, 0.50 and 1.00 mg/l). The results of the study confirmed that lead induces reduction of survival rate and oxygen consumption rate and histopathology of organ structure of the bivalve. Oxygen consumption rate was observed exposure groups lower than control decline by 25%-72%. Histological analysis of organ system illustrated expansion of hemolymph sinus, disappearance of epidermal layer and degeneration of connective tissue layer of the mantle. Also, histological degenerations as epithelial necrosis and hyperplasia of mucous cells are recognized in the gill and it was observed expansion of hemolymph sinus, disruption of epithelial layer, decrease of mucous cell and degeneration of connective tissue layer in the foot. In the digestive diverticulum, it was showed atrophy of basophilic cell and degeneration of epithelial cell in the digestive tubules, and as the concentration of lead increased the accumulation of lipofuscin increased.

Trophic Factors of Gastrointestinal Tract (위장관의 영양인자)

  • Kim, Yong Joo
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.6-10
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    • 2003
  • 동물과 사람의 연구에서 위장관 영양 인자는 위장관 점막이 점막손상으로부터의 회복에 중요하고 출생 후 경구 영양에 적응할 수 있게 하는 데에 중요하다. 경구적으로든 전신적으로 투여된 성장 인자들은 위장관의 성장과 발달을 촉진시킨다. 신생아 혈중의 영양인자들이 장관 세포의 수용체를 통해 작용하여 위장관의 성장을 조율한다. 위장관 영양인자들은 체내에서 합성될 수도 있고 모유를 통해 공급된다. 사람에서 출생 후 위장관이 장관영양에 신속히 적응할 수 있도록 위장관 영양 인자들이 중요한 작용을 한다. 모유 내의 성장 인자들이 신생아 생존에 필수적인 것들은 않아도 모유를 먹은 영아들이 조제분유를 먹은 영아들에 비하여 급성 설사, 괴사성 장염, 크론씨 병과 같은 위장관 질환의 위험율이 낮다. 위장관 영양 인자들의 대부분이 시판 조제분유에는 존재하지 않고 주로 모유에 존재함을 앎으로써 모유의 장점을 설명하는 데에 적용할 수 있을 것이다. 그리고 위장관 영양인자는 위장관 점막 손상된 경우 치료 목적으로 사용될 수 있는 여지가 높다. 이러한 임상적 이용은 특히 미숙아, 수술 후의 영아 등에서 적용될 수 있다. 그러나 향후 더욱 연구되어야 할 항목들로는 작용기전, 경구 및 정맥 투여 방법에 의한 효과의 차이, 체내 성장 인자들과의 상호 작용, 외부적 투여가 체내 인자에 대한 영향, 위장관 이외의 타 기관에 대한 영향, 그리고 안전성과 약물 역동학적인 특성 등이다.

Cavitating Adenocarcinoma and Soluamous Cell Carcinoma in the Same Lobe of the Lung (동일 폐엽내 발생한 공동화 선암과 펀평세포암)

  • 유지훈;김관민;김진국;심영목;한정호
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.153-156
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    • 2002
  • Synchronous primary lung cancers in the same lobe are rare. Cavitating adenocarcinoma as single lung lesion is unusual. We experienced cavitating adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. The patient was a 74-year-old male with chief complaints of hemoptysis. CT scan showd a central mass in right upper lobar bronchus, obstructive pneumonia, and lung abscess in the right upper lobe. Pathologically, the central mass was a 2.3$\times$1$\times$1 cm sized squamous cell carcinoma, and lung abscess was revealed as a 37272 cm sized adenocarcinoma. The patient was discharged without any specific problem after right peumonectomy.

Surgical Treatment of Lemierre′s Syndrome -A case report- (Lemierre 증후군의 수술 치험 -1례 보고-)

  • 오정훈;이정철;이동협;이장훈;정태은;한승세
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.644-647
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    • 2001
  • Lamierre's syndrome is characterized by a rare fulminant condition resulting from primary oropharyngeal infection followed by secondary septic thrombophlebitis of the internal jugular vein and metastatic infection. A forty-year-old man who had been on ventilator due to servere chest trauma, showed severe reddish inflammatory swelling of the right cervical soft tissue and newly developed pneumonia. He went into in septic condition shortly thereafter. Thrombophlebitis with central abscess in the right internal jugular vein was identified by neck CT and MRA(magnetic resonance angiography). Right cervical swelling worsened in spite of clindamycin and heparin therapy. We performed immediate surgery for removal of septic thrombus and resection of internal jugular vein. Patient's septic condition, pneumonia, and local inflammatory reaction were improved within several days after surgery.

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Sequential Bronchoscopic Findings of Endobronchial Tuberculosis (기관지 결핵의 기관지 내서경적 경과 관찰에 관한 연구)

  • Choi, Hyung-Seok;Joeng, Ki-Ho;Lee, Kye-Young;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Kim, Keun-Youl;Han, Young-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.407-416
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    • 1992
  • Background: Endobronchial tuberculosis is an important complication of pulmonary tuberculosis. It is highly infetious, difficult to diagnose mimicking bronchogenic carcinoma or bronchial asthma and it can leave bronchial stenosis with parenchymal collapse or bronchiectasis as complications. Early diagnosis, adequate treatment and follow-up are crucial in the management of endobronchial tuberculosis. The most important diagnostic tool in its diagnosis is bronchoscopic examination. Authors have tried to elucidate changes in sequential bronchoscopic findings in these patients to help diagnose and manage these patients. Method: We have analysed the sequential bronchoscopic findings and clinical features of 83 endobronchial tuberculosis patients admitted in Seoul National University Hospital from August 1987 to December 1990. Results: We can observe the following results: 1) In the actively caseating type, improvement of the bronchial stenosis was observed in 29 patients (76.3%) up to 5 months of treatment. Caseation disappeared in 31 patients (81.6%) during the same period. 2) In the stenotic without fibrosis type, improvement of the stenosis was observed in 8 patients (66.4%) during the same period. 3) In the tumorous type, improvement of the stenosis was observed in 12 patients (92.3%) during the same period. Conclusion: We can conclude that improvement of the endobronchial lesions may occur up to about 5 months after adequate treatment of endobronchial tuberculosis.

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Copper Toxicity on Survival, Respiration and Organ Structure of Mactra veneriformis (Bivalvia: Mactridae) (동죽, Mactra veneriformis의 생존, 호흡 및 기관계 구조에 미치는 구리 (Cu)의 독성)

  • Shin, Yun Kyung;Park, Jung Jun;Lim, Hyun Sig;Lee, Jung Sick
    • The Korean Journal of Malacology
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    • v.29 no.2
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    • pp.129-137
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    • 2013
  • This study was conducted to find out the changes of survivorship, respiration and organ structure of Mactra veneriformis exposed to copper (Cu). Experimental period was four weeks. Experimental groups were composed of one control condition and three copper exposure conditions (0.025, 0.050 and 0.100 mg/L). The results of the study confirmed that copper induces reduction of survival rate and respiration rate and histopathology of organ structure of the bivalve. In the copper concentration of 0.100 mg/L, mortality was 100% after Cu exposure of 3 weeks. Respiration rate was observed exposure groups lower than control decline by 75%. Histological analysis of organ system illustrated expansion of hemolymph sinus, disappearance of epidermal layer and degeneration of connective tissue layer of the mantle. Also, histological degenerations as epithelial necrosis and hyperplasia of mucous cells are recognized in the gill and it was observed expansion of hemolymph sinus, disruption of epithelial layer, decrease of mucous cell and degeneration of connective tissue layer in the foot. In the digestive diverticulum, it was showed atrophy of basophilic cell and degeneration of epithelial cell in the digestive tubules, and as the concentration of copper increased the accumulation of lipofuscin increased.

Changes in Bronchoscopic Findings during Treatment-Course in Active Endobronchial Tuberculosis (활동성 기관지결핵에서 치료경과에 따른 기관지경소견의 변화)

  • Chung, Hee-Soon;Lee, Jae-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.25-34
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    • 1995
  • Background: Endobronchial tuberculosis is classified into 7 subtypes as fibrostenotic type, edematous-hyperemic type, actively caseating type, tumorous type, ulcerative type, granular type and nonspecific bronchitic type by bronchoscopic features, and we make a prospective study to follow up how bronchoscopic findings change during treatment-course in each subtype of active endobronchial tuberculosis. Methods: We planned to do follow-up bronchoscopic examination every month until there was no significant change in endobronchial lesion, then every 3 months and at the end of the treatment in each patient with biopsy proven endobronchial tuberculosis from May, 1990 to August, 1993. Results: 1) This study included 66 cases, but bronchoscopic follow-up was completed as scheduled in 47 cases. 2) In actively caseating and edematous-hyperemic type, bronchostenosis occurred within 2 or 3 months of treatment in about 2/3 of total cases. 3) In fibrostenotic type, bronchostenosis did not improve in spite of the treatment. 4) In tumorous type, the changes in bronchoscopic findings were unpredictable because new lesions occured on other sites even 4 or 6 months after treatment in 2 cases and the size of initial mass increased 6 months after treatment in 1 case (among 7 cases). 5) Granular and nonspecific bronchitic type improved without significant sequelae within 2 or 3 months of treatment. Conclusion: It may be necessary to follow up the patient with bronchoscopy repeatedly 2 or 3 months after starting treatment in active endobronchial tuberculosis, and it is better to perform bronchoscopic examination at 6 months of treatment, especially in patients with tumorous type because there is possibility that new endobronchial lesion occurs. Aggressive therapeutic modalities such as stent-insertion, laser therapy or electrocautery should be considered to prevent bronchostenosis in cases with granulation tissue, fibrostenotic and tumorous types of endobronchial tuberculosis.

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A Case of Churg-Strauss Syndrome with Multiple Tracheobronchial Mucosal Lesions (기관과 기관지내 다발성 점막 병변을 동반한 Churg-Strauss 증후군 1예)

  • Boo, Sun-Jin;Lee, Kwangha;Ra, Seung Won;Jin, Young-Joo;Park, Gyung-Min;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.405-409
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    • 2008
  • Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.

Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm (조산아의 발육성 법랑질 결함의 위험 요인 평가)

  • Shang-yon Park;Jaeho Lee;Hyung-Jun Choi;Chung-Min Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.192-204
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    • 2023
  • This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.