• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.756-769
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• 2020

Among the various emergency diseases in children, acute pulmonary and airway disease are common clinical conditions encountered by radiologists, and the first imaging modality is chest radiography. Therefore, it is important to be familiar with these diseases and their imaging findings. In this article, we review pneumonia and mimickers of acute pulmonary disease. For acute airway disease, we reviewed croup, acute epiglottitis, tracheomalacia, asthma, postinfectious bronchiolitis obliterans, and foreign body aspiration. We hope this review of special diseases can help the diagnosis and treatment in children.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.907-913
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• 1997

Background : Congenital bronchoesophageal fistula(BEF) presented in adult life is a rare disorder and has characteristic clinical findings such as paroxysmal cough after water ingestion and recurrent respiratory infections. It usually manifested recurrent pneumonia and chronic cough with purulent phlegmon which was mis-or under-diagnosed as chronic bronchitis, bronchiectasis or lung abscess so forth. Methods : We reviewed retrospectively 13 cases of congenital BEF in adult of Paik Hospital, College of Medicine, Inje University including 22 cases of congenital BEF previously reported in literature of Korea from 1979 through 1995. Results : The mean age at diagnosis was $40.2{\pm}14.3$. There was no difference in sex ratio(Male : Female 18 : 17). The most common symptom was cough(91.4%), followed by chronic sputum(74.3), hemoptysis(25.7), and paroxysmal nocturnal cough at specific position(20%). Twenty one of 31 patients who were able to review have the most specific sign, Ono's sign presented as paroxysmal cough after liquid ingestion. By classification of Braimbridge-Keith, Fourteen(45.1%) of 31 patients were group I (associated with esophageal diverticulum), 15(48.4%) were group II (simple fistula), and group Ill and IV was one case in each. The opening of fistula confined to right lower lobe in 26(76.5%), left lower lobe in 6(17.6%), and left main bronchus in 2(5.9%) cases. Conclusion : Congenital bronchoesophageal fistula is uncommon disorder which has characteristic histories and specific symptoms such as chronic and recurrent lower respiratory infections, and paroxysmal cough after liquid ingestion. Medical attention and careful history should be done in patients who have localized recurrent lower respiratory infections in right lower lobe.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1232-1236
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• 1997

Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.383-388
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• 1999

Background: Tracheal hamartoma is a very rare cause of upper airway obstruction. Its clinical features can mimic medical conditions, such as bronchial asthma, chronic bronchitis, and so on. Case; This report presents the case of a 65 year old man whose major symptom was dyspnea. We found a tumor in his distal tracheal lumen, and the tumor was removed with success using rigid bronchoscope. The tumor was histologically proven to be a hamartoma, and his symptoms were much improved. Conclusion: It is important to distinguish it from other conditions because medical management is often not helpful. Surgical correction-with or without thoracotomy-is inevitable.

• Tuberculosis and Respiratory Diseases
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• v.39 no.3
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• pp.236-241
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• 1992

Background: As well as fiberoptic bronchoscopy, chest computerized tomographic scan can now differentiate the benign from malignant causes and the obstructive from non-obstructive causes of lung collapse. This study was designed to evaluate the usefulness of chest CT scan and fiberoptic bronchoscopy in the diagnosis of middle lobe syndrome. Method: We reviewed the clinical features, roentgenographic changes, pathologic findings and bronchoscopic findings in 16 patients with middle lobe syndrome who were admitted to Severance Hospital during period of January, 1987 through January, 1992. Results: The male to female ratio was 1:1. The most common symptoms were cough and sputums. Crackle was the most common physical finding. Underlying disease was lung cancer, pulmonary tuberculosis and endobronchial tuberculosis in 3 each other, benign stenosis in 2, lung abscess, broncholithiasis, bronchial chondroma, pneumonia and nonspecific inflammation in 1 each other. Conclusion: We conclude that the combination of chest computerized tomogram and fiberoptic bronchoscopy was most desirable for the diagnosis of middle lobe syndrome.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1093-1099
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• 1999

배경 : 류마티스성 승모판막 폐쇄부전증과 퇴행성 승모판막 폐쇄부전증에서 승모판막 성형술의 결과와 비교하여 류마티스성 승모판막 폐쇄부전증에서도 승모팍막성형술이 적합한 치료방법이 될 수 있는지를 알아보았다. 대상 및 방법 : 95년 1월부터 98년 12월 까지 승모판막 성형술을 시행받은 184명의 환자중에서 류마티스성 승모판막 폐쇄부전증 49례(1군)의 퇴행성 승모판막 폐쇄부전증 78례(2군)를 대상으로 하였다. 평균연령은 1군이 36.3$\pm$14.6(16-74세) 2군은 52.5$\pm$13.4(14-77)세였다 총 추적 관찰기간은 1군이 72.2인년 2군이77.2인년이었다 두군에서 수술후와 수술후 6개월 1년 및 이후 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과 : 두 군간에 수술전 혈류역학적인 차이를 보이지 않았고 수술전 평균 승모판막 폐쇄 부전의 정도는 1군이 3.0$\pm$0.4, 2군이 3.9$\pm$0.3였으나 수술후 추적 관찰에서 각각 0.9$\pm$0.9와 0.8$\pm$0.7정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의 변화나 승모판막에서의 평균압력차이 등 혈류역학적인 결과에도 차이를 보이고 있지 않았다 수술조기 사망과 후기 사망은 없었으며 재수술율은 1군이 인년대비 1.4% 2군이 인년대비 2.6%였고 색전발생율은 1군이 인년대비 2.8% 2군이 1.3%였다. 심내막염발생은 1군에서만 1례있었으며 상기 결과들에서 두군간에 의미있는 차이를 보이고 있지는 않았다 결론 : 향후 장기적인 추적 관찰이 필요하나 중기 성적에서 승모판막 성형술이 류마티스성 승모판막 폐쇄 부전증에서도 효과적인 치료방법임을 알수 있었다.다 출생후 폐포막의 FN의 활성은 출생후 5일 및 7일에 최고주에 달했다. 출생직후 1-2일경에 혈관의 조직내 FN의 활성이 양성을 나타내지만 3일이후 활성이감소되었다. 폐포대식세포내 FN의 활성은 출생후 증가되었다. 폐조직내 소기관지의 FN의 활성은 출생후 완만하게 상승되었다. 큰 폐포세포는 출생 1-3일에 일정량의 FN 반응이 세포질과 미세융모내에 관찰되었다. 결론 : 이상과 같은 결과로 흰쥐의 폐포의 분화과정이 계속되는 출생후 폐에서 FN의 분비는 7일이내에 성숙흰쥐의 폐포내 반응과 비슷한 반응으르 보이며 이때 폐의 실질조직은 분화가 거의 완료되었을 것으로 사료되었고 큰 폐포세포에서도 FN이 분비되는 것으로 결론지울수 있다.X>에서 $1,332.75{\mu}g/mL$으로 최 대값을 나타내었으며, 추출시간 4.24시간 및 시료에 대한 용매비 9.71 mL/g에서 가장 높게 나타났다. 추출온도가 높고, 추출시간이 증가할수록 총 polyphenol 함량이 증가하는 경향을 나타내었다. Gallic acid 함량은 $65.84^{\circ}C$에서 $30.51{\mu}g/mL$으로 최대값을 나타내 었으며, 추출시간 1.65시간 및 시료에 대한 용매비 17.17mL/g에서 가장 높은 추출율을 보였다. Gallic acid 함량에 대한 추출조건의 영향은 추출시간과 용매비에 영향을 받는 것으로 나타났으며, 설정된 범위 내에서 온도에 대한 영향은 거의 나타나지 않는 것으로 나타났다. 실험연구가 더 필요하리라 본다. 혈액학적 변화를 유도하고 환자의 연령, 혈소판 수, 대동맥 차단 시간, 체외 순환 시간, 술후 PT 및 aPTT와 같은 다인적 상황들이 술후 출혈에 영향을 미친다는 점들을 시사하고

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.564-570
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• 2006

Toxic gases and soot deposition as a consequence of smoke inhalation can cause direct injury to the upper and lower airways and even to the lung parenchyma. A delay in proper and prompt therapy can be detrimental to critically ill burn patients with an inhalation injury. Therefore, serial chest radiography is an important diagnostic tool for pulmonary complications during treatment. The radiographic findings of the chest include normal, consolidation, interstitial and alveolar infiltrates, peribronchial thickening, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, and a pneumothorax as acute complications of smoke inhalation. In addition, bronchiectasis, bronchiolitis obliterans and pulmonary fibrosis can occur as late complications. We encountered a case of 44-year-old male who presented with acute lung injury after an inhalation injury. He required endotracheal intubation and mechanical ventilation due to respiratory failure. He was managed successfully with conservative treatment. Later, a cavitary lesion of the left upper lobe was observed on the chest radiography and computed tomography, which was complicated by massive hemoptysis during the follow-up. However, the cavitary lesion disappeared spontaneously without any clinical consequences.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.183-187
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• 2004

Bronchiolitis obliterans (BO) is a nonspecific inflammatory injury affecting primarily the small airways. Its inflammatory process is characterized by fibrotic obliteration of the lumen of bronchioles. BO can be idiopathic or associated with connective tissue disease, inhaled toxins, infections, drugs, and chronic graft-versus-host-disease (GVHD). Pulmonary complications occur in 40~60% of patients who undergo allogeneic bone marrow transplantation (BMT), causing 10~40% of transplant-related deaths. BO is a characteristic pulmonary complication which occurs usually within a few years after BMT. Documented complications of BO include air-leak syndromes such as pneumomediastinum, subcutaneous emphysema and pneumothorax. We report a case of a 30-year-old male patient with BO due to chronic GVHD after allogenic BMT who presented with recurrent bilateral pneumothoraces.

• Tuberculosis and Respiratory Diseases
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• v.65 no.5
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• pp.410-415
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• 2008

Bronchiolitis obliterans (BO) is a serious noninfectious complication following an allogeneic bone marrow transplant (BMT). A 21-year-old female received an allogeneic BMT as a treatment for myelodyplastic syndrome. Four months after the BMT, progressive dyspnea developed and BO was also diagnosed by a lung biopsy. The patient was administered steroid and immunosuppressive agents for 1 year but there was no improvement in pulmonary function. Azithromycin was prescribed (500 mg q.d. for 3 days followed by 250 mg three time a week) because macrolides might decrease the inflammatory reaction leading to BO. The patient's pulmonary function improved after administration of azithromycin for 1 year. The forced expiratory volume in a one second ($FEV_1$) increase was 220 mL (28.2%) and the forced vital capacity (FVC) increase was 460 mL (25.7%). We report the improvement in the pulmonary function after the administration of azithromycin for 1 year in a patient with BO after a BMT.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.709-717
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• 1999

Background & Method : Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. Results : Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. Conclusion : If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation would be recommended for the definitive diagnosis of BOOP.