• Journal of Chest Surgery
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• v.37 no.12
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• pp.1022-1024
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• 2004

Pulmonary aspergillosis is the most common disease of fungal infection and has lower infectivity. Pulmonary asergillosis is classified by aspergilloma, bronchopulmonary aspergillosis, necrotic and invasive aspergillosis. Invasive aspergillosis is found in immune compromised host, immunosuppressive treatment after organ transplantation, anticancerous chemotherapy, blood abnormality, AIDS patients etc. We reported a case of invasive aspergillosis in an immunocompetent host, with review of literatures.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.648-651
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• 2006

A 53 year-old woman visited to our hospital due to increased hemoptysis for 4 days. The chest X-ray showed solitary pulmonary nodule on right upper lobe and computed tomography of chest demonstrated mass on posterior segmental bronchus of right upper lobe. Bronchoscopic examination revealed that this segmental bronchus was completely obstructed by a yellow and brownish mud like mass, which was identified as an aspergilloma by pathologic examination. Patient had undergone bilobectomy because of persistent hemoptysis. Tracheobronchial apergillosis in an immunocompetent person is very rare disease. then, we report this case with review of the Korean literature.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.584-588
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• 2004

Pulmonary aspergilloma usually arises in preexisting lung cavities characterized by recurrent hemoptysis. Although surgical resection of the aspergilloma is the best treatment, most patients are poor candidates for surgery because of far-advanced underlying pulmonary disease. On the other hand, pulmonary actinomycosis is a chronic, indolent bacterial infection and follows aspiration of oropharyngeal material. Bronchiectasis and obstructive lung disease are often associated underlying conditions. We report a case of pulmonary aspergilloma in bronchogenic cyst associated with an actinomycosis in 21-year-old woman treated by thoracoscopic surgery with a review of literature.

• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.165-170
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• 1993

Background: Massive hemoptysis that may induce acute asphyxia can be a fatal problem. Bronchial arteries and other nonbronchial systemic arteries of lungs must be searched by angiography, because they are main source of hemoptysis. Arterial embolization is a well-accepted and widely used for management of massive hemoptysis. This study was designed to evaluate the effectiveness of this method. Method: Prospective analysis was done in 23 cases, that underwent arterial embolization from June 1990 to July 1992. Hemorrhaged arteries were embolized with Gelfoam particles. In cases with severe broad hemorrhagic findings, Coils were added to Gelfoam particles. And they were observed for 6 months at least. Results: Immediate cessation of hemoptysis was achieved in all cases. Recurrent hemoptysis was observed in 7 cases (30%). The patients with nonbronchial artery hemoptysis had increased tendency of recurrence (6/13) than only bronchial artery hemotysis (1/10). The 7 cases treated with Coils had not any recurrence. Conclusion: Arterial embolization in massive hemoptysis is a useful and safe procedure for immediate control. But, the patients with this procedure had a potentiality of recurrence. So diagnostic and therapeutic efforts for underlying causes should be performed.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.590-599
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• 1996

Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.