• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.481-491
• /
• 1995

Background: Recently there has been a trend of an increasing incidence of mediastinal tuberculous lymphadenitis(MTL) in adults. MTL often cause bronchial stenosis or esophago-mediastinal fistula. In spite of effective treatment, it is difficult to cure. Moreover, relapse frequently occurs. Authors analyzed chest CT findings and clinical features of 29 cases with MTL Methods: 29 cases with MTL were retrospectively studied with the clinical and radiologic features from April 1990 to March 1995 Results: 1) A total of 29 cases were studied. 12 cases were male and 17 cases were female. The male to female ratio was 1:1.4 Mean age was 29 years old. The 3rd decade(45%) was the most prevalent age group 2) The most common presenting symptoms and signs were palpable neck masses(62%) followed by cough(59%) and sputum(38%) 3) Except in one case of MTL, all patients had coexisting pulmonary tuberculosis, cervical tuberculous lymphadenitis, endobronchial tuberculosis and tuberculous pleurisy. Among the coexisting tuberculous diseases, Pulmonary tuberculosis was the most common(76%) 4) On simple chest X-ray, mediastinal enlargement was noted in 21 cases(72%), but it was not noted in 8 cases(28%). The most frequently involving site was the paratracheal node in 16 cases(72%). Rt side predominence(73%) was noted 5) Patterns of node appearance on a postcontrast CT scan were classified into 3 types. There were 19 cases(30%) of the Homogenous type, 30 cases(47%) of the Central low density type and 15 cases(23%) of the Peripheral fat obliteration type. The most common type was the central low density type. The most common lymph node size was 1~2 cm(88%) 6) The most frequently involved site was the paratracheal node in 26 cases(89%) by chest CT. Rt side(63%) was predominant 7) 9 cases(43%) had complete therapy and most common treatment duration was 13 - 18 months. 12 cases(57%) had incomplete continuing antituberculous medication and half of the cases had been treated above 19 months. Conclusion: Chest CT findings of MTL showed central low density area and peripheral rim enhancement, so this characteristic findings could differentiate it from other mediastinal diseases and help a diagnosis of tuberculosis. In spite of effective antituberculous medication, it is difficult to cure. Moreover, relapse frequently occurs. Further studies will be needed of the clinical features and the treatment of MTL.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.9 no.1
• /
• pp.92-97
• /
• 2006

Congenital diaphragmatic eventration is the abnormal elevation of the diaphragm into the thoracic cavity. Sometimes, it is not easy to differentiate congenital diaphragmatic eventration from diaphragmatic hernia by either prenatal sonography or postnatal chest radiography. However, differential diagnosis of both diseases is practical because of different prognosis and surgical approaches. Careful interpretation of postnatal serial chest X-rays is mandatory to differentiate between both diseases. We report two neonates with congenital diaphragmatic eventration of left diaphragm that initially misdiagnosed as diaphragmatic hernia by prenatal sonography and postnatal chest radiography.

• Journal of Chest Surgery
• /
• v.35 no.4
• /
• pp.315-317
• /
• 2002

Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.3
• /
• pp.353-364
• /
• 2000

Background : Bronchoscopy is a useful diagnostic tool, for accurate localization of the bleeding site and the management of hemoptysis. However, there is some controversy about the optimal timing of bronchoscopy. Method : To determine the optimal timing of bronchoscopy in hemoptysis, we reviewed the medical records of 118 patients and analyzed the following relationships amongst simple chest PA findings, namely, the duration and amount of hemoptysis, and the timing of bronchoscopy retrospectively. Results : The major causes of hemoptysis were active tuberculosis(28.8%), inactive tuberculosis(10.2%), bronchiectasis(17.0%), lung cancer(7.6%), and aspergilloma(7.6%). Localization of the bleeding focus by bronchoscopy was possible in 87.5% (21/24 cases) during active bleeding, and it was possible in 40.4% after bleeding had stopped(p<0.05). The localization rate of bleeding focus was 59.8% when the chest PA showed certain abnormalities, but it decreased to 27.8% when the chest PA finding was normal(p<0.05). When chest PA showed diffuse abnormalities or its finding was normal, the localization rate of bleeding focus significantly increased if bronchoscopy was performed during bleeding or within 48 hours of the cessation of active bleeding. The localization rate was higher as the amount of hemoptysis became larger(p<0.05). The localization rate of early bronchoscopy(during bleeding or within 48 hours of the cessation of active bleeding) was significantly higher when the duration of hemoptysis was less than 1 week, but there was no advantage if the duration was 1 week or longer. Early bronchoscopy was also necessary to localize the bleeding focus for surgical resection in 4 patients, and the bronchoscopy itself was therapeutic in 1 patient whose bleeding was successfully managed with thrombin-application via bronchoscope. Conclusion : It is concluded that flexible bronchoscopy is useful at not only localizing the bleeding focus but also in preparing a therapeutic plan, and early bronchoscopy is more favorable in hemoptysis.

• Journal of the Korean Society of Radiology
• /
• v.7 no.3
• /
• pp.165-173
• /
• 2013

The purpose of this study is to examine how much the movement at X-ray examinations like breathing or the positioning affects the image during chest or abdomen X-ray examination so as to create an image containing information as much as possible. The study method adopted is doing the X-ray in each of the states including breathing (inspiration & expiration) and movement in the standing chest PA X-ray and simple abdomen X-ray among the kinds of examination selected the most in hospitals and then evaluating them by applying the standards of image evaluation for each region. According to the study result, about the standing chest PA X-ray, the images taken at inspiration contain more information than those taken at expiration or having subtle movement during the examination. About the simple abdomen X-ray, the images taken at expiration contain more information than those taken at inspiration or movement. The above study results imply that regarding general X-ray examination, information we can find from the images may differ significantly according to the region examined, examination purpose, or movement during the examination like breathing.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.5
• /
• pp.558-564
• /
• 1993

Background: Gallium scans was used clinically for detection of inflammatory lesion, granulomatous process and neoplasm and inflammatory activity in interstitial disease. So we had perfomed $Ga^{67}$ scan to see the finding of $Ga^{67}$ scan in miliary tuberculosis and to correlate $Ga^{67}$ uptake with that of the chest PA and the clinical severity. Method: We examined 10 patients who were confirmed as having miliary tuberculosis, with $Ga^{67}$ scan, chest PA and arterial blood gas analysis. Results: 1) Diffuse, positive gallium uptake was seen in all cases of miliary tuberculosis. 2) In most of cases, gallium uptake was noted only at the lung field in spite of hematogenous spread of tuberculous foci. 3) The strong correlation between chest PA and $Ga^{67}$ scan finding was seen. 4) The intimate correlation between arterial hypoxemia and $Ga^{67}$ scan finding was also noted. Conclusion: Gallium scan showed diffuse pulmonary uptake in all cases of miliary tuberculosis and it may provid a useful information to assess the disease severity in miliary tuberculosis.

• Journal of Chest Surgery
• /
• v.31 no.11
• /
• pp.1085-1088
• /
• 1998

Background: In trauma patients, bony thorax are exposured to the trauma in many cases. With simple x-ray, we can not detect all definitive bony abnormalities, especially in less severe cases. Bone scan is very sensitive diagnostic method in such cases. Materials and methods: We experienced 680 cases and results were as follows. Results: 1. Diagnostic sensitivity was 97.4% and false negative rate was 2.6%. 2. In sensitivity study, the time factor(when we perform bone scan) was the most important thing according to trauma pattern. In rib fracture, sensitive test time was after 1 week. In sternal fracture, sensitive test time was after 1 week, too. In costochondral junction fracture and combined cases, it was after 3 days. Conclusions: We recommend timely using of bone scan as definitive diagnostic method in bony thorax trauma patients.

• Journal of Chest Surgery
• /
• v.35 no.6
• /
• pp.491-494
• /
• 2002

Inflammatory myofibroblastic tumor was widely known as inflammatory pseudotumor, commonly developed as a solid mass in lung. The endobronchial inflammatory myofibroblastic tumor is a very rare case where only a few cases have been reported. We report a 13-year-old girl who had coughing for 5 months. The simple chest X-ray and computued tomography of the chest revealed a mass which obstructed the right lower lobe bronchus and pneumonic consolidation. The fiberoptic bronchoscopic finding was mostly gelatinous, gray-yellowish mass that obstructed the airway of right lower lobe bronchus nearly, and was considered as a chondroid hamartoma pathologically. Right lower lobectomy of lung was performed. The mass was confirmed as a endobronchial inflammatory myofibroblastic tumor The patient was discharged without complication and with outpatient followup.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.4
• /
• pp.586-590
• /
• 1999

Tracheobronchial rupture is one of the less-common injuries associated with blunt chest trauma. The diagnosis of tracheobronchial rupture is not easy, but failure to diagnosis may lead to death or long-term disability. Early diagnosis and appropriate management can reduce the mortality and morbidity. Bronchoscopy is the diagnostic method of choice for patients with tracheobronchial rupture. We report a case of tracheal rupture after blunt chest trauma. A 40-year-old man was transferred to our hospital for dyspnea after blunt chest trauma. He was promptly diagnosed as tracheal rupture by fiberoptic bronchoscopy and chest computed tomogram. He was successfully managed by thoracotomy and primary repair.

• Journal of Chest Surgery
• /
• v.39 no.1 s.258
• /
• pp.56-59
• /
• 2006

Background: Spontaneous pneumomediastinum (SPM) is a relatively rare and benign condition that generally occurs in young adults without any precipitating factor or disease. The purpose of this study was to assess whether more uncomforting diagnostic procedures are necessary and to establish standards in the diagnosis and treatment of spontaneous pneumomediastinum. Material and Method: A retrospective study was done on 18 patients from the hospitals of Hanyang University Seoul Hospital and Hanyang University Guri Hospital between February, 1997 and June, 2004. All patients had presence of mediastinal air without a pneumothorax and no evidence of trauma or barotrauma. Result: Among the 18 patients, the majority were male patients with only two female patients. Their mean age was 20.95 years old with standard deviation of 14.3 years. The most common complaints were chest pain, dyspnea, and coughing. Evaluation included simple chest roentgenogram in all patients, 10 patients had a chest tomographic scan, 10 patients had an esophagoscopic exam, 6 patients had a bronchofiberoscopic exam, and 3 patients had an esophagogram done. The mean hospital stay was 10.9 days. All patients were treated conservatively and in a follow-up of 1 $\∼$ 8 years only one recurrence was found. Conclusion: SPM is caused by alveolar rupture in the pulmonary interstitium leading to dissection of air towards the hilum and mediastinum. Although SPM is a self-limiting condition, evaluation should include chest roentgenogram and chest tomographic scans to rule out any other secondary condition. More aggressive evaluation seems unnecessary.