Park, Byung-Kyu;Kim, Do-Gyun;Ko, Won-Ki;Ahn, Sang-Hoon;Yang, Dong-Gyoo;Kim, Sung-Kyu;Lee, Won-Young;Kim, Kil-Dong
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.
Hong, Yong Kook;Choe, Kyu Ok;Kim, Sung Kyu;Chung, Kyung Young;Chang, Joon;Lee, Won Young
Tuberculosis and Respiratory Diseases
/
v.44
no.1
/
pp.59-68
/
1997
Background : Tuberculous chest wall abscess is a rare complication of tuberculosis. However, there have been few reports about the variable extents and shapes of tuberculous chest wall abscesses. We analyzed the extent and shape of tuberculous chest wall abscess-es and grouped them according to combined pleuroparenchymal lesions by CT scans. Materials and Methods : CT findings were evaluated in 20 patients of tuberculous chest wall abscesses. We classified 29 abscesses in 20 patients into three types according to pleuroparnechymal lesions. Type 1 was defined when there was no active pleuroparenchymal lesion, Type 2, when intrathoracic tuberculosis was contacted with chest wall abscess, Type 3, when ipsilateral subpleural nodules were not contacted with chest wall abscess. Results : The type 1 included 6 abcesses in 6 patients. They showed rib and/or costal cartilage destruction in their center. They were relatively large and round. The type 2 included 13 abscesses in 10 patients. The abscesses in contact with pleural lesion or mediastinal lesion were mainly located in the outer muscle layer, and they were relatively large in size. However, the abscesses in contact with parenchymal lesion were mainly located in extrapleural space. They were relatively small and they were longest along the long axis of ribs. The type 3 included 10 abscesses in 6 patients. They were located mainly in the extrapleural space. Conclusion : Tuberculous chest wall abscess-es showed variable extents and shapes according 10 pleuroparenchymal lesions. CT is a good diagnostic modality to visualize the extent of tuberculous chest wall abscess and combined pleuroparenchymal lesion.
Kim, C.S.;Son, H.D.;Park, M.R.;Seo, J.Y.;Cho, M.D.;Rheu, N.S.
Tuberculosis and Respiratory Diseases
/
v.44
no.5
/
pp.1001-1010
/
1997
Background : PCR technique is useful in diagnosis of pulmonary tuberculosis. But, its sensitivity and specificity is some different among several studies. Our aim is compare our PCR results with other's previous PCR results in AFB smear negative patients. Methods : PCR were performed in patients that their disease were suspected as active pulmonary tuberculosis and that their initial serial sputum AFB smear results were negative. Total number of patients studied by PCR technique was 177. Also, we analyzed the data only in patients whose bronchial washing fluid AFB smear was negative. And the primer had been used was IS 6110. Results : In our retrograde study, the number of patients who are diagnosed as having active pulmonary tuberculosis, inactive pulmonary tuberculosis and nontuberculous pulmonary disease was 99, 28, 50, respectively. In the sputum study, the sensitivity of PCR is 41.5% (27 PCR positive cases/65 active TBc cases). And the sensitivity of TB culture is 53.8% (35 TB culture positive cases/65 active TBc cases). In the bronchial washing specimen study, the sensitivity of PCR is 53.8% (21 PCR positive cases/39 active TBc cases). And the sensitivity of TB culture is 43.6% (17 TB culture Positive cases/39 active TBc cases). The specificity of PCR in our study is 94.9%. (74 PCR negative cases/78 inactive TBc or nontubereulous cases) In the cases of patients who were never takened anti-TBc medication, the sensitivity of PCR (45.6%--25 positive cases/55 cases) is some lower than culture (58.2%--32 positive cases/55 cases). In the cases of patients who had been takened anti-TBC medication. the sensitivity of PCR (60%--18 positive cases/30 cases) is some superior than culture (50%--15 positive cases/30 cases). Conclusion : We think that PCR results in cases of sputum AFB smear negative patients is nearly same as culture. And PCR is especially useful in patients who had been takened anti-TBc medication on admission.
Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.
In Pusan Paik Hospital, Inje University, we experienced 174 cases of pulmonary resections for pulmonary tuberculosis from Jun. 1979 to Feb. 1990. In all of them automatic stapling devices were used for division of lung parenchyme and /or bronchial closure. The results were as follows; l. In 174 cases[male 100, female 74], third and fourth decades were 116 cases [66.7%]. 2. Indications for lung resection in the radiographic findings were destroyed lung 47 cases[27.0%], destroyed lobe 42 cases[24.1%], cavitary lesions 42 cases[24.1%], tuberculoma 22 cases[12.7%], and bronchial lesions 21 cases[12.1%]. 3. The mean of staplers used in the operations was 1.6, and possible stapler-associated complications were only 2 cases of bronchopleural fistula after pneumonectomy. 4. Twenty-seven of 36 patients with bilateral lesions and 52 of unilateral ones on chest X-ray films were AFB positive on preoperative sputum smears. Twenty-three[85.2%] of bilateral lesions and 51[98.1%] of unilateral ones were AFB negative at 6 months after operations. 5. Main complications of resections were operative death 1[0.6%], empyema 4[2.3%], respiratory insufficiency 3[1.7%], pleural dead space 5[2.9%], and bronchial spreading of tuberculosis 2[1.1%]. Bronchopleural fistula were only 2 cases after pneumonectomy and none after lobectomy or segmentectomy. 6. One hundred and forty two patients[92.8%] of 153 with available follow-up data were in the state of good quality of life.
This is a report on four cases of atelectasis which were implicated as one case of mucoid impaction and three cases of blood clots in main bronchus. The 1st case was found to be massive atelectasis on Lt. entire lung due to mucoid impaction with pulmonary tuberculosis. This case was performed the Lt. pneumonectomy. There are contain-ing impacted yellowish-gray jelly like thick materials on the Lt. whole bronchial trees and pathologic findings were consistent with tuberculosis including caseation necrosis and multinucleated giant cell on whole left lung thoroughly in microscopic findings. The 2nd and 3rd case [25 years old female and 30 years old female] were diagnosed as one sided entire lung ateletasis which were led by accumulation of old blood clots on bronchus following incomplete expectoration of sudden massive hemoptysis from pulmonary tuberculosis lesion. These two cases were recovered by removal of blood clots and bronchial irrigation under bronchoscopy. Follow up chest film revealed well aeration. The 4th case [45 years old] was taken the removal of old blood clots and tissue debris under the bronchoscopy as bronchial obstruction following massive hemoptysis. The cytologic findings revealed the class III in fresh sputum and class 1V in bronchial irrigation which may suggest of malignancy. However, we could not found the causative lesions suggestive malignancy by the bronchography and other diagnostic measurements.
A case of endobronchial tuberculosis with left main bronchial stenosis and atelectasis of left lower lobe in a 26-year-old female is reported. She had taken antituberclous agents for 9 months, but she complained of chest pain and coughing. Bronchoscopy revealed patency of left upper bronchus and bronchiectasis of left lower lobe. She underwent left lower lobectomy with bronchoplasty. After the operation she had significant improvement of pulmonary function. Although surgical treatment of endobronchial tuberculosis is controversial, bronchoplastic surgery can be an effective treatment of tuberculous bronchial stenosis because it relieves patients from symptoms by preserving lung functions.
Kim, S.J.;Hong, Y.P.;Bai, G.H.;Kim, S.C.;Jin, B.W.;Chung, C.M.
The Journal of the Korean Society for Microbiology
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v.17
no.1
/
pp.87-93
/
1982
Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex(MAIC) and a case of pulmonary infection ina 69 year-old male patient due to M. fortuitum(MF) were found recently in this institute. All three patients had a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis. A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid(INH), para-aminosalicylic acid(PAS) and streptomycin(SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M. tuberculosis at all. A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide(PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide(TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1981 and he continuously discharged the same bacilli until last examination of January 1982. Whether all three patients were initially !infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological examination records.
Purpose: The purpose of this study was to identify the factors affecting tuberculosis prevention behaviors in North Korean adolescent refugees. Methods: From September 16 to October 8, 2019, a survey was conducted to collect data from 143 North Korean adolescent refugees aged 13 to <25 at alternative and general schools in Seoul and Gyeonggi Province. The scale developed by Park (2008) and adapted by Cha (2012) was used to rate tuberculosis prevention behaviors in daily life with the aim of preventing high school students from getting infected with tuberculosis. The collected data were processed through frequency analysis, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression, using SPSS 25.0. Results: The mean score was 13.65 for knowledge of tuberculosis, 44.23 for attitudes towards tuberculosis, and 41.33 for tuberculosis prevention behaviors. Significant differences were found according to gender, country of origin, duration of stay in South Korea, tuberculosis examination, pre-entry chest x-ray, education about tuberculosis, alcohol intake, and subjective health status. A positive correlation was found between knowledge, attitudes, and prevention behaviors. The factors affecting tuberculosis prevention behaviors were attitudes (β=.38, p<001) and subjective health status (β=.26, p<.001). Conclusion: It is necessary to provide attitude-based education that can reinforce positive attitudes in order to improve North Korean adolescent refugees' tuberculosis prevention behaviors. This is expected to help them pay more attention to health care and become better at prevention behaviors. It is, therefore, necessary to develop a tuberculosis prevention education program with the aim of making them more knowledgeable about tuberculosis and providing them with systematic and sustainable education.
Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.
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