• Tuberculosis and Respiratory Diseases
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• 제40권2호
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• pp.192-196
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• 1993

저자들은 10일간의 우측 흉통을 주소로 내원한 17세 남자환자에서 흉벽에 발생한 악성 T 세포형 임파종 1예를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.84-90
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• 2000

저자들은 안정시 호흡곤란을 주소로 내원하였고 흉벽에 종괴가 있었던 68세 남자환자에서 조직학적 검사상 전형적인 투명세포형의 원발성 신장암으로 진단된 1 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.200-208
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• 2021

Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. Methods: An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. Results: The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. Conclusion: The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.

• 대한두경부종양학회지
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• 제16권2호
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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.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.130-141
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• 1995

연구배경: 기관지 결핵은 조기 진단하여 유효적절한 치료를 시행하지 않을시 기관지 협착증이 병발하며, 일단 기관지 협착증이 발생되면 이에대한 치료가 어려울 뿐만아니라 원위부 폐의 허탈로 지속적인 호흡 곤란, 기침, 객혈 및 천명음을 초래하며 무기폐, 기관지 확장증, 이차적 폐렴과 같은 합병증을 유발한다. 따라서 기관지 결핵 치료시 기관지 협착의 예방을 위해 스테로이드 병용 투여가 시도되어 왔는데, 지금까지의 연구 결과에 의하면 스테로이드의 유용성은 확실하지 않다. 이에 저자 등은 스테로이드 사용의 유용성을 판단하고 기관지 결핵 치료에 따른 기관지 내시경 경과 관찰 소견, 폐기능 검사 및 흉부 방사선 호전 소견을 관찰하여 기관지 결핵에 의한 기관지 협착증의 예방 및 치료에 도움이 되고자하였다. 방법: 1988년부터 1992년까지 중앙대학교 부속병원에서 기관지 결핵을 진단 받은 환자 58명을 대상으로 하여 항결핵 요법만을 시행한 군(control group, n=39)과 스테로이드 병용 요법을 시행한 군(steroid group, n=19) 사이의 기관지 내시경 추적 관찰 소견, 폐기능 검사 및 흉부 방사선 촬영상 호전 소견을 비교 분석하였다. 결과: 1) 기관지 결핵은 20대 젊은 여성에서 호발하였다. 2) 치료전 양 군간 기관지 내시경에 의한 형태학적 분포상 가장 많은 형태는 건락성 괴사형과 섬유화를 동반하지 않은 협착형이었다. 3) 기관지 내시경에 의한 육안적 경과 관찰 소견상 양군 모두에서 호전 소견을 관찰할 수 있었으며 행태학적 분류에 따른 호전 소견 빈도에 있어서도 양 군간 유의한 차이는 없었다. 4) 흉부 방사선 및 폐기능 검사 경과 관찰 소견상 양군에서 모두 호전소견을 관찰할 수 있었으며 양군간 유의한 차이는 없었다. 5) 스테로이드 사용을 중단할 만한 부작용은 관찰되지 않았다. 결론: 이상의 결과로 기관지 결핵 치료에 있어서 스테로이드 병용 요법은 질환의 치료 경과에 커다한 영향을 미치지는 않는 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.310-313
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• 2016

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.88-92
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• 2012

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

• Tuberculosis and Respiratory Diseases
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• 제71권6호
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• pp.438-444
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• 2011

Background: Lung abscess is necrosis of the pulmonary parenchyma caused by microbial infection. At present, clinical outcomes after treatment are good. However, the pulmonary parenchymal changes on the chest computed tomography (CT) after treatment are not well known. We studied the changes of pulmonary parenchyma on plane chest radiography and chest CT in patients with lung abscess following the administration of antibiotics. Methods: We retrospectively reviewed 39 patients who had lung abscess with or without combined pneumonia from January 2006 to July 2010. We studied the therapeutic response in plane chest radiography of them at 1, 2, or more than 3 months following treatment. If any chest CT of them during the study period, we reviewed. Results: Mean age of the patients was about $61.3{\pm}11.2$. Mean duration of antibiotics administration was about $36.7{\pm}26.8$ days. After 3 months of following plane chest radiography, 10 patients (36%) showed without residual sequelae among 28 patients. Findings from other patients showed decrease in densities (11 patients, 39%), fibrostreaky sequelae (4 patients, 14%) and bullae (3 patients, 10%). After more than 2 months, chest CT was checked only in 7 patients. Among the 7 patients, 4 patients showed no residual lesion, 3 patients showed decreased densities on plane chest radiography. Chest CT revealed fibrostreaky densities in 2 patients, ground glass opacities in 3 patients, bullous formation in 1 patient, and cystic bronchiectasis in 1 patient. Conclusion: After more than 2 months following treatment for lung abscess even though there were no lesions on plane chest radiography, chest CT showed fibrostreaky or ground glass opacity.

• Tuberculosis and Respiratory Diseases
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• 제47권1호
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• pp.103-110
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• 1999

저자 등은 폐색전증이 확인된 환자에서 지속적인 경구 warfarin 항응고 치료에도 불구하고 색전에 의한 호흡곤란 증상이 악화하여 시행한 색전제거술 후 혈전에서 원발 미상의 미분화 편평 상피 세포암이 확인된 1예를 경험하여 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.441-447
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• 2012

Background: Chest tube drainage (CTD) is an indication for the treatment of pneumothorax, hemothroax and is used after a thoracic surgery. But, in the case of incomplete lung expansion, and/or persistent air leak from CTD, medical or surgical thoracoscopy or, if that is unavailable, limited thoracotomy, should be considered. We evaluate the efficacy of bronchoscopic injection of ethanolamine to control the persistent air leak in patients with CTD. Methods: Patients who had persistent or prolonged air leak from CTD were included, consecutively. We directly injected 1.0 mL solution of 5% ethanolamine oleate into a subsegmental or its distal bronchus, where it is a probable air leakage site, 1 to 21 times using an injection needle through a fiberoptic bronchoscope. Results: A total of 15 patients were enrolled; 14 cases of spontaneous pneumothorax [idiopathic 9, chronic obstructive pulmonary disease (COPD) 3, post-tuberculosis 2] and one case of empyema associated with broncho-pleural fistula. Of these, five were patients with persistent air leak from CTD, just after a surgical therapy, wedge resection with plication for blebs or bullae. With an ethanolamine injection therapy, 12 were successful but three (idiopathic, COPD and post-tuberculosis) failed, and were followed by a surgery (2 cases) or pleurodesis (1 case). Some adverse reactions, such as fever, chest pain and increased radiographic opacities occurred transiently, but resolved without any further events. With success, the time from the procedure to discharge was about 3 days (median). Conclusion: Bronchoscopic ethanolamine injection therapy may be partially useful in controlling air leakage, and reducing the hospital stay in patients with persistent air leak from CTD.