• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.541-545
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• 2005

Respiratory bronchiolitis associated interstitial lung disease is a rare condition among current or ex-smokers, which has features consistent with interstitial lung disease. The presentations are non-specific, but symptoms generally include a cough and dyspnea on exertion, and its pathology is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles and adjacent air spaces, and is associated with mild thickening of the peribronchiolar interstitium. Recently, the case of a 54-year-old woman passive smoker, diagnosed as having respiratory bronchiolitis associated interstitial lung disease, was experienced at our institution.

• Tuberculosis and Respiratory Diseases
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• v.62 no.2
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• pp.98-104
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• 2007

Background: Although there is an increasing incidence of Mycobacterium abscessus pulmonary disease in Korea, the optimal therapeutic regimen has not yet been established and there are no reports of the long-term treatment outcomes. This study examined the long-term treatment outcomes of M. abscessus pulmonary disease. Methods: Twenty-nine patients diagnosed with M. abscessus pulmonary according to the American Thoracic Society criteria and treated from January 1996 to December 2003 were enrolled in ghis study. The clinical characteristics, radiological findings, treatment outcome, and follow up data were analyzed retrospectively. Results: The mean age of the 29 patients was 56.1 (${\pm}13.6$) years and there was a female (22/29) dominance. The chest radiography revealed the nodular bronchiectatic type to be dominant (69%, 20/29). Twenty-seven (93.1%) were prescribed clarithromycin-containing regimens, and injectable drugs, mainly aminoglycosides, were included in the regimen of nineteen patients. The most predominant regimen (48.3%) consisted of clarithromycin and amikacin. The treatment success, failure, and default were achieved in 19(65.5%), 9(31.0%), and 1(3.4%), respectively. The median duration to culture conversion was 42 days (range 15-362) and the median duration of treatment in the success group was 543 days (range 176-1,160). An adjunctive surgical resection was performed in five patients, which resulted in treatment success in two patients. After the completion of treatment, nineteen patients were followed up for a median duration of 931 days (range 230-2,294). Only one (5.3%) patient relapsed 45 days after completing treatment. Conclusion: Treatment with clarithromycin-containing regimens resulted in a successful treatment in approximately two thirds of patients with M. abscessus pulmonary disease. The long-term relapse rate was also quite low.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.205-210
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• 2009

Background: CXCL10 and CXCL11, which are family of CXCR3 ligands, are expressed by lymphocytes and even by bronchial epithelial cells if the cellular immunity is activated. This study evaluated the potential utility of CXCL10 and CXCL11 in the serum for active pulmonary tuberculosis in comparison with lung cancer, which activates the cellular immunity, and benign lung diseases. Methods: Patients who newly visited Pusan National University Hospital from January 2007 to December 2007 and were suspected of having lung cancer or tuberculosis were enrolled prospectively. The patients were classified pathologically and clinically into three groups, 47 with lung cancer, 18 with active pulmonary tuberculosis and 38 control patients with benign pulmonary disease. ELISA was used to determine the levels of CXCL10 and CXCL11 were determined in the serum. Results: The level of CXCL10 and CXCL11 were significantly higher in the active pulmonary tuberculosis group than in the lung cancer and benign lung disease groups (p<0.001, Kruskal-Wallis). The level of CXCL11 was significantly higher in the lung cancer group than in the benign pulmonary disease group, but there was no significant difference in level of CXCL10 between the three groups (p<0.001, p=0.655, respectively, Mann-Whitney U). The level of CXCL10 in patients with stage III+IV lung cancer was significantly higher than those with stage I+II, but there was no significant difference in the level of CXCL11 between the groups (p<0.001, p=0.07, respectively, Mann-Whitney U). There was no significant difference in the level of CXCL10 and CXCL11 between those with the presence and absence of lung cancer metastasis. There was a significant correlation between the level of CXCL10 and CXCL11 (r=0.223, p<0.001). Conclusion: CXCL10 and CXCL11 may be a potential useful markers for active pulmonary tuberculosis if used alongside other diagnostic methods.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.400-406
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• 1992

Background: It has been known that see antigen was used in diagnosis of uterine cervical cancer and also known to be higher in squamous cell lung cancer. There has been no report about see antigen in squamous cell lung cancer in Korea. This study was designed to evaluate the usefulness of see antigen as a diagnostic tool and index for follow up after treatment. Method: The serum level of see antigen was measured in 12 cases with squamous cell lung carcinoma, 9 patients with other types of lung cancer, 7 patients with benign lung disease and 7 normal subjects by radioimmunoassay with Abott see Riabeap radioimmunoassay kit. We also measured see antigen after treatment in 6 patients who had received chemotherapy or sugery. Result: 1) The level of see antigen ($mean{\pm}1$ SD) was $2.27{\pm}1.53$, $0.67{\pm}0.38$, $0.62{\pm}0.53$, $0.53{\pm}0.36\;ng/ml$ respectively. 2) The see antigen activity in squamous cell lung carcinoma according to stage were as gollows. I; $2.07{\pm}1.56$, $III_a$; $5.04{\pm}0.53$ $III_b$; $1.94{\pm}0.7$ IV; $1.07{\pm}0.64$ (ng/ml). 3) In squamous cell lung cancer, 5 of 12 (42%) cases was shown more than 2.0 ng/ml see antigen. (sensitivity; 42%), but there was no case in any other type of lung cancer, benign lung disease, and in control groups (specificity; 100%). 4) The serum sec antigen level after treatment was significantly decreased in patients with partial or complete remission (p<0.01). Conclusion; It was suggested that see antigen might be used as a useful tumor marker for the response of treatment and assessment of prognosis in squamous cell lung cancer, but further study should be performed for the clinical use of see antigen.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.8 no.2
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• pp.509-515
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• 2004

Pulmonary function tests are widely used to diagnose and determine patients' therapy in clinic. And it was also applied in the research of the physiology and dynamics for lung disease. Among the pulmonary function tests, spirometry is the most easy and economic test. Spirometers are medical instruments that measure the instantaneous rate of volume flow of respired Bas. The mechanical spirometer was mostly used in the past. Up to the present, the most popular method of spirometer is the differential pressure technique with which change in the volume of flow are transferred to change in pressure. This kind of instrument suffers from several limitations, pressure drop, difficulty in maintenance and short period of calibration. Therefore, this study has begun to implement ultrasound spirometer, which is free of pressure loss and has wide range, focusing on the flow measurement technique and diagnostic algorithm.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1391-1396
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• 2023

Malignant lymphoma has various pulmonary manifestations on chest CT, including nodules, masses, areas of consolidation, and ground-glass opacity. These presentations can pose a diagnostic challenge, as they mimic other disease patterns. Herein, we report a case of diffuse large B-cell lymphoma (DLBCL) manifesting as miliary nodules in a 67-year-old male initially presenting with dyspnea and fever. Radiologic findings included diffuse, bilateral, multiple tiny nodules consistent with metastasis, miliary tuberculosis, and fungal infection. However, further investigations, including laboratory tests, imaging, and biopsies, led to the diagnosis of DLBCL involving the lungs. Herein we reported a rare case of lymphoma involvement of the lung presenting as miliary nodules. Accurate diagnosis relies on a comprehensive evaluation of the clinical history, physical features, laboratory test results, and imaging findings.

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.31-40
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• 2003

Background : A CT scan is a useful modality for the diagnosis and evaluation of disease activity in patients with pulmonary tuberculosis. However, the CT diagnosis of pulmonary tuberculosis is sometimes difficult in patients with an atypical CT pattern, especially with lobar consolidation mimicking pneumonia. The aim of this study was to evaluate the clinical and CT features of pulmonary tuberculosis, simulating pneumonia, from a CT scan. Materials and Methods : The clinical and CT features in 21 patients, where the CT diagnosis was pneumonia, or the CT differential diagnosis included pneumonia, were retrospectively analyzed. Results : Of the 21 patients, 6 were immunocompromised, 15 presented with fever or leukocytosis and 15 showed positive sputum smear test for acid fast bacilli. Also, 17 of the 21 patients showed a positive sputum culture test. On the CT scan, consolidation was noted in all patients (100%), volume loss of the involved lobe or segment in 12 (57%), bronchogenic spread in 15 (71%), a cavity in 7 (33%) and bronchial wall thickening also in 7 (33%). The location of the consolidation revealed a relatively even distribution, with no specific predilection site. The other associated pulmonary diseases included ARDS, bronchiectasis, severe pulmonary emphysema, idiopathic pulmonary fibrosis and pulmonary alveolar proteinosis. Conclusion : In the immunocompromised patients, or patients with an underlying pulmonary disease, whose CT scans showed pulmonary consolidation, especially in association with findings of bronchogenic spread, a cavity or bronchial wall thickening, meticulous examination for pulmonary tuberculosis is recommended.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1058-1066
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• 1998

Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

• The Transactions of the Korean Institute of Electrical Engineers D
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• v.51 no.3
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• pp.122-128
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• 2002

In this paper, a robust pattern classification of breath sounds for the diagnosis of pulmonary dysfunction in noise environment is proposed. The feature parameter extraction method by highpass lifter algorithm and PM(projection measure) algorithm are used. 17 different groups of breath sounds are experimentally classified and investigated. The classification has been performed by 6 different types of combinations with proposed methods to evaluate the performances, such as ARC with EDM and LCC with EDM, WLCC with EDM, ARC with PM, LCC with PM, WLCC with PM. Furthermore, all feature parameters are extracted to 80th orders by 5th orders step, and all experiments are evaluated in increasing noise environments by degrees SNR 24dB to 0dB. As a results, WLCC which is derived from highpass lifter algorithm, is selected for the feature parameter extraction method. Pm is more robust than EDM in noisy environments to test and compare experimental results. WLCC with PM method(WLCC/PM) has a better performance in an increasing noise environment for diagnosis of pulmonary dysfunction.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1083-1093
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• 1997

Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.