• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.420-425
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• 1999

We report a case of hepatopulmonary syndrome defined as a triad of chronic liver disease, increased alveolar oxygen gradient on room air, and intrapulmonary arteriovenous shunting. Chest rediographs showed bilateral, basilar, medium sized reticulonodular opacities. High resolution CT scand showed multiple centrilobular nodules and branching structures in the subpleural lung that suggested dilatation of lung vessels with abnormally large number of visible terminal branches. $^{99m}Tc$-macroaggregated albumin(MAA) perfusion lung scan showed right to left shunt. Contrast echocardiography demonstrated intrapulmonary vascular shunt without intracardiac shunt.

• The Korean Journal of Cytopathology
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• v.4 no.1
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• pp.74-76
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• 1993

Cytologic findings of pleural effusion in three cases of rhabdomyosarcoma are reported. Case 1 was a pleomorphic rhabdomyosarcoma which had devoped at the chest wall of an elderly male patient and caused pleural effusion. The cytologic features were consistent with pleomorphic rhabdomyosarcoma, that was, showing loose clusters, cellular pleomorphism, and abundant finely vesicular cytoplasm. Cases 2 and 3 were embryonal rhabdomyosarcomas in young adults. Primary site was the oral cavity in case 1, but unknown in case 2 and case 3. The effusion cytology was similar in these cases. Clustered or isolated small round cells with hyperchromatic nuclei and scanty cytoplasm were smeared. The cohesiveness of tumor cells was weak and the cells did not show linear arrangement or nuclear melding. Effusion cytology in a sarcoma patient would be diagnostic when the primary site and the type of sarcoma were already known.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.839-844
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• 1989

There appears to be significant problems remained in the treatment of tuberculous empyema with BPF in spite of several surgical methods: decortication, thoracoplasty, and pleuropneumonectomy. We presented one case of tuberculous empyema with BPF. The patient was 42-year-old male and his chief complaint was hemoptysis. In past history, he was treated with left closed thoracostomy and antituberculous medication for two months, 16 years ago. Chest X-ray, tomogram and C. T, revealed a huge mass with central necrosis in the lower 2/3 of left thoracic cavity and shifting of the mediastinal structure to the right. Needle aspiration cytology was undifferentiated large cell carcinoma. Left thoracotomy was made under the impression of lung cancer and pleuropneumonectomy was done. Operative findings; thick walled empyema sac filled with hematoma and BPF, the mediastinum was fixated due to fibrosis and calcification of the pleura and the mediastinum. Postoperative biopsy was consistent with tuberculosis. In the postoperative course, there was massive hemorrhage and so reoperation was done. But there was no active bleeding focuses in the thoracic cavity at the time of reoperation. Massive transfusion, coagulant therapy and intermittent clamping and declamping of the chest tube were carried out. Especially, serum calcium level was chronically decreased and so large amount of calcium gluconate was infused for the calcium level to be normal. Total transfused blood; whole blood was 33 pints, packed cell was 63 pints and fresh frozen plasma was 70 pints. At the postoperative[reop] 45th day, intrathoracic hemorrhage was stopped and the chest tube was removed. In conclusion, this suggest that uncontrollable bleeding after pleuropneumonectomy of the tuberculous empyema with BPF could be treated without reoperation in case of the mediastinal fixation due to fibrosis and calcification of the pleura and the mediastinum.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.86-92
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• 1999

Purpose : The purpose of this study is to know the epidemiology and clinical characteristics in patients with M. pneumoniae pneumonia during study period retrospectively. Methods : We had reviewed 500 patients with Mycoplasma pneumoniae pneumonia who were hospitalized at the pediatric ward of Seoul Adventist Hospital from July 1986 through June 1996. we had analysed clinical and laboratory problems of pulmonary and extrapulmonary manifestations including demographics and epidemiological characteristics. Results : Peak occurrence of the disease was 3 years interval and seasonal occurrence of the disease had no difference. 43.4% of patients was below 4 years old and male to female ratio was nearly 1:1. The most common site of infiltration on chest PA was right lower lobe and the most common type of pneumonia was interstitial pneumonia(43%). Pulmonary complications were atelectasis(11cases), emphysema(5cases), pleural effusion(27cases) and sinusitis(13cases) and extrapulmonary manifestations were hepatitis(109cases), skin rash(29cases), proteinuria(20cases) and hematuria(16cases). cold agglutinin test was carried out in 500cases and mycoplasma antibody test was carried out in 448cases. sensitivity of mycoplasma antibody test was 53.3%. Conclusion : Mycoplasma pneumoniae pneumonia showed epidemics at intervals of 3 year in its major occurrence. it exhibits a tendency that occurs at younger age group not in school age group. diagnosis of the disease need more accurate method due to low sensitivity of mycoplasma antibody test. also we need to carried out other laboratory test(for example, LFT, U/A).

• Journal of Chest Surgery
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• v.35 no.7
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• pp.535-541
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• 2002

Background: The prevalence of pulmonary tuberculosis remains high in several areas of the world, and pneumonectomy is often necessary to treat the sequelae of the disease. We retrospectively analyzed the morbidities, mortalities, and long-term outcomes after pneumonectomy for the treatment of tuberculous sequelae. Material and Method: Between 1981 and 2001, 94 patients underwent either pneumonectomy or extrapleural pneumonectomy for the treatment of tuberculous sequelae. There were 44 males and 50 females. The mean age was 40(16~68) years. The pathology included destroyed lung in 80, main bronchus stenosis in 10, and both lesions in 4. Surgical procedures were pneumonectomy in 47, extrapleural pneumonectomy in 43, and completion pneumonectomy in 4. Results: One patient died postoperatively due to empyema. Twenty-three complications occurred in 20 patients; empyema in 15(including 7 bronchopleural fistulas), wound infection in 5, and others in 3. Univariate analysis revealed presence of empyema, extrapleural pneumonectomy, prolonged operation time, and old age as risk factors of postpneumonectomy empyema. In multivariate analysis, old age and low preoperative FEV1 were risk factors of empyema. Low preoperative FEV1 was the risk factor of bronchopleural fistula(BPF) in univariate analysis. Low preoperative FEV1, positive sputum AFB, and presence of aspergilloma were risk factors of BPF in multivariate analysis. There were twelve late deaths. Actuarial 5-and 10-year survival rates were 94$\pm$3% and 87$\pm$4%, respectively. Conclusion: Pneumonectomy could be performed with acceptable mortality and morbidity, and could achieve good long-term survival for the treatment of tuberculous sequelae. In patients with risk factors, special care is recommended to prevent postoperative empyema or bronchopleural fistula.

• Korean Journal of Veterinary Research
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• v.5 no.1
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• pp.21-25
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• 1965

Throughout the studies the followings were obtained and summarized here. 1. Thickenings of plerua were due to the organized fibrin deposition on the pleural surface. 2. Thickenings of plerura were accompanied with increaseness of fibrous connective tissues in the interlobular and alveolar septa. 3. Eosinophilic inclusions seemed to LCL bodies were observed in the cytoplasms of epithelial cells of bronchi, bronchial glands and in the cytoplasms of mononuclear cells. 4. Histo-pathologically, there were some evidences influenced by viruses and the organisms of Psittacosis-Lymphogranuloma Venereum Group.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.585-589
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• 1991

We experienced a rare hepatic tuberculous granuloma with subphrenic abscess. The patient was 45-years old female. She complained the right flank pain and tenderness on the protruding mass for 2 weeks. It was fixed, erythematous and 5x5cm sized mass, which was thought as cold abscess. She has done the hysterectomy as endometriosis at November 1990. Under general endotracheal anesthesia, the mass was incised, but the pus was not found. The needle aspiration was done through the 8th ICS, then the yellowish non-foul odor pus was rushed out. The 7th and 8th ribs were resected segmentally about 5cm. The abscess cavity was placed in the subphrenic area, therefore the operative fields extended along the 8th ICS. After the evacuation of subphrenic abscess, the granulomatous tissues from the superior aspect of liver was seen. The granuloma was resected and the penrose drainage was inserted. The tuberculosis was resulted from the 8th ICS muscles. subphrenic abscess and granuloma on the pathology report.

• Journal of Chest Surgery
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• v.3 no.1
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• pp.17-20
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• 1970

Six cases of broncho-pleural fistula due to complicated liver abscess were experienced at the department of chest surgery, Seoul National University Hospital from October 1967 to March 1970. Amebic liver abscess was the primary cause in the 5 cases and the remaining one case was due to pyogenic liver abscess. Involved lung was right side in all case. The clinical manifestation was fever,chill,cough, sputum, dyspnea, chest pain, hemoptysis and shoulder pain. The methods of the treatment employed were closed thoracotomy [1], thoracotomy & drainage [2],decortication [1],and right lower lobectomy[3]. The average duration of the post-operative course was 19.6 days. There was no operative mortality.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.260-263
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• 2001

비디오흉강경을 통한 기포절제술이 술후 통증, 창상으로 인한 감염등의 합병증을 줄였고, 미관상의 효과와 더불어 짧은 입원기간으로 빠른 사회로의 복귀를 가져왔다. 1999년 11월 18일부터 2000년 4월 19일까지 6개월동안 수술적응증이 되는 20례의 원발성 자연기흉 환자를 개흉술로의 전환 없이 2mm 비디오 흉강경을 이요하여 기포 절제술을 시행하였다. 수술창성은 단순 흉강삽관술을 시행하였을때와 거의 흡사했다. 원발성 자연기흉 환자에서는 병변이 상엽에 국한되어 있는 경우가 대부분이고, 늑막유착이 없거나 심하지 않아서 2mm비디오 흉강경으로도 기포절제술이 가능하게 되어 수술창상을 줄일수 있었다.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.786-791
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• 1984

Mesothelioma is relatively uncommon tumor compared to other thoracic tumors. It is interesting that there is a strong relationship between occurrence of malignant mesothelioma and exposure to asbestos, which was established during the last two decades. Malignant mesothelioma is discouraging in viewing its treatments and survival rates. Surgery with ancillary treatment, such as radiotherapy and chemotherapy, were still palliative, although encouraging results were reported. Between 1958 to 1983 at NMC, we have been experienced 6 cases of mesothelioma, confirmed by pathohistologic findings. The patients were distributed between 19 to 52 y-o age & were 5 males and 1 female. There was evidence of exposure to asbestos in 1 case. The method of operation were decortication [1], decortication with removal of tumor [1], pleuropneumonectomy with chemotherapy [1], chemotherapy [1], exploratory thoracotomy [1], and no treatment in 1 case due to private affairs. Histologic findings were 2 cases of benign mesothelioma type.