• Title/Summary/Keyword: Chest CT

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A Case of Acute Respiratory Distress Syndrome(ARDS) after Talc Pleurodesis (Talc를 이용한 늑막유착술 후 발생한 급성 호흡곤란증후군 1례)

  • Kim, Ki-Up;Cha, Kun-Young;Han, Sang-Hoon;Yun, Yeo-Il;Park, Sung-Woo;Kim, Do-Jin;Na, Mun-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.265-269
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    • 2001
  • Presently talc is one of the agents most commonly used for producing a pleurodesis in patients with either a recurrent pleural effusion or a spontaneous pneumothorax. Talc can be instilled into the pleural space either as an aerosol (insufflation) or as a suspension (slurry) in saline. They are quite effective in producing a pleurodesis. However, they rarely have acute serious adverse effects including acute respiratory distress syndrome, and recently a discussion for using pleurodesis has been reported. We experienced a case of acute respiratory distressed syndrome after talc pleurodesis. A 64 year old man, who was diagnosed lung cancer with a malignant pleural effusion at the same side, was treated by pleurodesis using talc to control the effusion. After 3 days, he suffered fever, chill and breathlessness. The chest P A and CT revealed a bilateral infiltration in both lungs and the blood gas analysis confirmed hypoxemia, which required mechanical ventilation.

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Clinical Characteristics and Management of Intrathoracic Bronchogenic Cysts: A Single Center Experience

  • Lee, Deok-Heon;Park, Chang-Kwon;Kum, Dong-Yoon;Kim, Jae-Bum;Hwang, Il-Seon
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.279-284
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    • 2011
  • Background: The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts. Materials and Methods: Twenty-four (n=24) patients with intrathoracic bronchogenic cysts were treated surgically between August 1990 and December 2009 at our institution. Patients were divided into two groups by bronchogenic cyst location: mediastinal or intrapulmonary. Symptoms at diagnosis, radiologic findings, locations, surgical methods, pathological findings, and surgical outcomes were investigated retrospectively from consecutive patient medical records. Results: There were 12 females (50.0%). The mean age was 26.8 (range, 5 to 64) years. The mean follow-up period was 27.3 (range, 1 to 121) months. There were 15 (62.5%) mediastinal and 9 (37.5%) intrapulmonary bronchogenic cysts. Symptoms occurred in 8 patients with mediastinal bronchogenic cysts (53.3%) and 5 patients with intrapulmonary bronchogenic cysts (55.6%) (p=1.000). On computed tomography (CT), 7 patients (46.7%) showed homogenous solid masses in mediastinal bronchogenic cysts and five (55.6%) patients exhibited heterogeneous cystic masses with air-fluid levels in intrapulmonary bronchogenic cystic masses. Open thoracotomy was performed in 17 (70.8%) patients, and video-assisted thoracic surgery was performed in 7 (29.2%) patients. On pathological findings, there were 16 (66.7%) complicated cysts, and in 13 symptomatic patients, 11 (84.6%) patients had complicated cysts. There was no operative death in this study. During the follow-up period, no recurrence was detected. Conclusion: Intrathoracic bronchogenic cysts have a wide variety of clinical characteristics and radiologic findings. Even though some patients do not experience symptoms and signs caused by bronchogenic cysts, serious symptoms and complications may develop with the passage of time.

Thyroid Tuberculosis (갑상선 결핵)

  • Lee Jae-Hoon;Chung Woung-Yoon;Kang Hae-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.201-205
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    • 2000
  • Objectives: Despite of high prevalence of tuberculosis in Korea, thyroid tuberculosis is very rare and only a few records are available. This study was carried out to evaluate the clinicopathologic characteristics of thyroid tuberculosis and to find out optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1986 to July. 2000, of 5,493 patients who were underwent thyroidectomy, only 8(0.14%) had discovered to have thyroid tuberculosis. The medical records of them were analyzed retrospectively. Results: There were one man and seven women with a mean age of 40.3 years. Only one had tuberculosis sequalae on chest X-ray and two had past history of tuberculous lymphadenitis. However, none of them had symptomatic pulmonary tuberculosis. Most frequent symptom was palpable neck mass. The preoperative U/S, CT and FNAB failed to diagnose thyroid tuberculosis. The pathologic reports were chronic granulomatous thyroiditis with caseous necrosis in all the cases and AFB stain was positve in 5 cases. All cases were successfully treated by surgical resection and anti-Tbc. medications. Conclusions: The incidence of thyroid tuberculosis was extremely low and most of them have been presented as a palpable neck mass especially in relatively young-aged female patients. Although any diagnosis for thyroid tuberculosis prior to microscopical study of tissue removed at operation was not yielded, the preoperative diagnostic workups will be available with experience. Surgical resection and anti- Tbc medication would be the choice in the management of thyroid tuberculosis.

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A Case of Pleural Endometriosis Presented as Right Sided Hemothorax in a Patient Who Underwent Kidney Transplantation (신장이식 후 우측 혈흉으로 발현한 흉막자궁내막증 1예)

  • Shin, Eun-Hye;Shin, Bo-Mi;Ha, Yeon-Jung;Jang, Il-Young;Jung, Ji-Won;Cho, Hyung-Jin;Park, Su-Kil
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.145-148
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    • 2013
  • Thoracic endometriosis is an uncommon disease that has four main forms: catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. Since the growth of endometrial tissue depends on the presence of estrogen, thoracic endometriosis usually occurs in menstruating women between 25 and 35 years of age. Menstrual disturbances are common in women with chronic kidney disease (CKD). However, they could be reversed after kidney transplantation. Therefore, previously asymptomatic endometriosis may become symptomatic after kidney transplantation. A 49-year-old woman with CKD underwent kidney transplantation. A month later, she experienced dyspnea, and hemothorax in her right hemithorax. However, there was no evidence of infectious diseases and malignancy in thoracentesis, pleural biopsy, and computed chest tomography (CT). The serum and pleural fluid levels of his carbohydrate antigen 125 were elevated. Hemothorax secondary to pleural endometriosis was suspected. We tried hormonal therapy, and the hemothorax disappeared. At the sixth-month follow-up, there was no recurrence of hemothorax.

A Case of Vascular Ring Associated with Tracheitis Due to Type b Haemophilus influenzae (헤모필루스 인플루엔자 기관염이 확인되면서 진단된 혈관륜 1례)

  • Kim, Su Hyun;Chung, Yoon Sook;Oh, Sung Hee;Kim, Nam Su;Kim, Hyuck
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.261-266
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    • 2002
  • Vascular ring, originating from abnormal regression of the aortic arch during fetal life, can cause prolonged and recurrent respiratory symptoms and dysphagia when the diagnosis is delayed. We report a 4 month old girl with vascular ring, who had been treated for persistent respiratory symptoms including stridor, wheezing, and dyspnea soon after birth. Initially her respiratory symptoms were thought to be due to bronchiolitis, for which respiratory syncytial virus was confirmed by immunofluorescent staining. Her clinical course was again complicated with tracheitis and pneumonia due to Haemophilus influenzae type b. The possibility of anatomical anomaly was investigated when it was felt to be difficult to insert a suction catheter deep down through a endotracheal tube which was placed for adequate ventilatory management. A three-dimensional chest CT revealed a vascular ring consisting of a double aortic arch. For 5 months following surgery, her respiratory symptoms have slowly been improving. She developed another episode of pneumonia which was milder than the one which occurred before the surgery.

Clinical Study of Stroke Type (뇌졸중(腦卒中) 환자(患者) 형태(形態)에 관(關)한 임상연구(臨床硏究))

  • Youn, Hyoun-min;Ahn, Chang-beohm;Song, Choon-ho;Son, In-seok;Jang, Kyung-jeon
    • Journal of Acupuncture Research
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    • v.20 no.2
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    • pp.29-41
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    • 2003
  • Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. And among the 52 cases of Stroke cerebral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebellar or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of exercising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.

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A Case of Giant Cell Interstitial Pneumonia without History of Exposure to Hard Metal (경금속에 대한 노출력이 없는 거대세포 간질성 폐렴(Giant Cell Interstitial Pneumonia) 1예)

  • Hong, Ji Hyun;Lee, Jae Myung;Kang, Min Jong;Kim, Dong Gyu;Jung, Ki-Suck;Jang, Kee-Tark;Park, Hye-Rim;Lee, In Jae
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.419-424
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    • 2002
  • A 44 year old man was admitted complaining fo exertional dyspnea. The patient denied any occupational history of hard metal exposure. Chest radiography showed an increased interstitial marking at the peripheral portion of both lower lung fields. The spirometric values were within the normal ranges. However, the diffusion capacity of the lungs was lower. In the bronchial lavage fluid, the characteristic multinucleated giant cells were noticed, and the macrophage compartment was 96% and the neutrophils were 4%. High-resolution CT scan revealed ground glass opacities with emphysematous lung changes at the peripheral portion of the whole lung. An open lung biopsy confirmed the presence of numerous multinucleated giant cells (define GIP) with an associated interstitial fibrosis throughout the lung. The radiographic abnormailities and symptoms subsequently improved following treatment with oral corticosteroids.

A Case of Hypersensitivity Pneumonitis by Alternaria as a Suspected Etiology (Alternaria가 원인으로 추정되는 과민성 폐장염 1예)

  • Do, Yun Kyung;Kim, Yeon Jae;Kang, Hyun Jae;Yu, Kyung Sul;Yun, Hae Jin;Jun, Jae Hyun;Lee, Byung Ki;Song, Do Young
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.338-345
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    • 2003
  • A 65-year-old man was admitted due to low grade fever, dry coughing, and dyspnea on exertion. The chest radiograph and CT scan showed diffuse ground glass opacities and small nodules in the both lung fields resulting in a diagnosis of severe interstitial pneumonia. Conservative treatment with antibiotics and bronchodilators decreased the symptoms, but the dyspnea and cough reappeared when he returned home. An inspection of his house revealed the presence of fungi under the wallpaper. His symptoms disappeared completely after these were removed. His clinical course raised the suspicion of hypersensitivity pneumonitis and these fungi believed to be the cause of hypersensitivity pneumonitis. The histological findings of a lung specimen by video-assisted thorachoscopy were compatible with hypersensitivity pneumonitis. The fungi were identified as Alternaria.

A Case of Empyema Caused by Streptococcus Constellatus (Streptococcus Constellatus에 의한 농흉 1예)

  • Ryu, Yong Suc;Lee, Jae Hyung;Lee, Byung Hoon;Kim, Sang Hoon;Yang, Dong Jin;Ryu, Sang Ryol;Yu, Yun Hwa;Cheong, Mi Youn;Chae, Jeong Don
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.463-466
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    • 2009
  • Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.

Intermuscular Hematoma in Esophagus : without Tearing (식도 혈종)

  • 윤용한;김해균;강정신
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.404-407
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    • 1999
  • Spontanous hematoma of the esophagus is a rare condition affecting middle aged or elderly women. We experienced one case of esophageal hematoma which attracted our attention due to its confusing presentation clinically. The pathogenesis has been in dispute so far. The diagnosis has traditionally been made by barium esophagogram. We proved the diagnosis of spontaneous hematoma of the esophagus by utilizing CT scan and MRI. This condition led to conservative treatment and full recovery ultimately, but we performed the surgical correction because the filling defect persisted and the dysphagia got worse on the 20th day of hospital stay. Hematoma was located between the inner layer of circular muscle and the outer layer of longitudinal muscle which we considered as intermuscular hematoma of the esophagus.

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