• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.515-521
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• 2004

With the increasing resolution of modern CT scanners, analysis of the larger numbers of images acquired in a lung screening exam or diagnostic study is necessary, which also needs high accuracy and reproducibility. Recent developments in the computerized analysis of medical images are expected to aid radiologists and other healthcare professional in various diagnostic tasks of medical image interpretation. This article is to provide a brief overview of some of computer-aided diagnosis schemes in chest CT.

• Tuberculosis and Respiratory Diseases
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• 제49권6호
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• pp.760-773
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• 2000

Background : Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treament treatment of hemoptysis Methods : We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. Results : The mean age at diagnosis was 49.3 years and male to female ratio was 2.1 : 1. The main causes were active pulmonary pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronic bronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. Sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial arteη embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases(43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. Conculsion : The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

• Korean Journal of Microbiology
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• 제19권3호
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• pp.142-152
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• 1981

One hundred and thirteen healed pulmonary tuberculosis patients and 11 patients with other underlying diseases were studied for evidence of pulmonary fungal infection because of persisting hemoptysis or chronic cough. Rediological, mycological and serological investigations revealed that 54 out of 124 patients were evidently infected with one or more species of fungi. A. fumigatus was isolated from 4 out of 70 patients whose sera did not react with antigens from this fungus, while it was isolated from 43 out of 47 serological reactors to this fungus. Chest radiography showed a distinct fungus ball in a cyst of one patient and in a preformed cavity in the lung of 17 healed tuberculosis patients and two other patients. The latter two patients were infected with A.flavus. Two patients, who were under the long period of immunosuppressive therapy, apparently succumbed to invasive aspergillosia due to A.fumigatus. A single or dual infection with A. flavus, A. nidulans, A.nidulans var. latus, C. albicans, and P. boydii were noticed in some patients without mycetomal shadow on chest radiographs. Young mycelial extract (ME) of A.fumigatus detected antibody in 95.8 percent of the sera from patients infected with this fungus, while it was isolated from 43 out of 47 serological reactors to this fungus. Chest radiography showed a distinct fungus ball in a cyst of one patient and in a performed cavity in the lung of 17 healed tuberculosis patients and two other patients. The latter two patients were infected with A. flavus. Two patients, who were under the long period of immunosuppressive therapy, apparently succumbed to invasive aspergillosis due to A.fumigatus. A single or dual infection with A. flavus, A. nidulans, A. niduans var. latus, C. albicans, and P. boydii were noticed in some patients without mycetomal shadow on chest radiographs. Young mycelial extract (ME) of A.fumigatus detected antibody in 95.8 percent of the sera from patients infected with this fungus, while the commercial culture filtrate antigen (GL) yielded 78.7 per cent positive result. Culture filtrate antigen, however, was comparable with ME. There was no single antigen with which all the serum specimens reacted. Fractionation of ME resulted in a loss of some activity although it excluded substances that reacted with C-reactive protein in a loss of some activity although it excluded substances that reacted with C-reactive protein. Most reactive and specific precipitinogens distributed in the fraction (FB) which was precipitable at 75 percent saturation with ammonium sulfate and eluted in a second peak in order from gel-filtration and which contained mostly proteinic components. Glycoproteins or polysaccharides rich fractions (FA and ASI) were relatively less effective in detecting antibody. Demonstration of antibody in the serum from patients using a battery of fungal antigens and of etiologically related fungi from clinical specimens are very useful laboratory procedures for the diagnosis of pulmonary fungal infection which is a common complication of tuberculosis.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.52-55
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• 2010

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.871-881
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• 1996

Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

• Tuberculosis and Respiratory Diseases
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• 제44권4호
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• pp.930-934
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• 1997

Drug-induced thrombocytopenia and purpura have been developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects are fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent, Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.

• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.449-453
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• 1993

A 64-year-old male was admitted due to abruptly developed, severe dyspnea via local clinic. He had been a heavy smoker and alcoholic for a long time. Chest PA showed huge haziness in right upper lung field. Sputum culture for bacteriology was positive for Klebsiella pneumoniae. Immediately, appropriate antibiotics were administered and artificial ventilation was started. On 40th hospital day, simple chest roentgenogram taken due to sudden aggravated dyspnea showed marked hyperlucency in right upper lung field, suggestive of rupture of abscess cavity and resultant pneumothorax. At that time, chest tube was inserted but air leakage from the chest tube persisted. Chest CT scan taken after chest tube insertion showed the tube inserted into a thin-walled cavity in the above lesion. on 84th hospital day, right upper lobectomy with decortication was performed. Pathologically, cavittary lung abscess was diagnosed on the findings of partial re-epithelialization of ciliated columnar epithelium with severe pulmonary vascular occlusion and extensive fibrous pleural adhesions.

• Tuberculosis and Respiratory Diseases
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• 제44권3호
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• pp.649-654
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• 1997

Benign solitary schwannoma of the chest wall is a rare disease of nerve sheath origin A 43-year-old female patient was admitted to our hospital for right upper quandrant pain Chest X-ray shows nonspecific finding, ultrasonography & CT scan revealed a solid tumor on the right lateral chest wall. On aspiration needle biopsy, this mass was turned out to be a schwannoma of the right lateral chest wall. This mass was excised surgically in an encapsulated state by right lateral thoracotomy. Histological section revealed a typical schwannoma, which is characterized by Antoni A and Antoni B tissues of high & low cellularity.

• Tuberculosis and Respiratory Diseases
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• 제38권2호
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• pp.179-185
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• 1991

We experienced a case of sarcoidosis accompanied with azoospermia due to the involovement of epididymis, besides the generalized involvement of the para tracheal and hilar lymph nodes, skin and lung. Final diagnosis of sarcoidosis was established by pathological evidence of noncaseating granuloma from the involved organs, typical radiological findings and consistent clinical features. A movable, nontender $1.5{\times}0.8\;cm$ sized nodule was palpated on epididymis, and multiple small nodules were noticed in both testis and epididymis by scrotal ultrasonogram. Semen analysis showed azoospermia initially. After treatment with prednisolone for 12 months, sperm was increased to 64,800,000/ml, and 70% of them were motile when they were measured at 15 minutes after ejaculation. The patient's condition became better and the typical radiological findings of involved organs were improved as well. As far as we studied, sarcoidosis is known to involve multiple organs, but epididymal sarcoidosis is very rare. So we report a case of sarcoidosis involving epididymis which caused azoospermia.

• Tuberculosis and Respiratory Diseases
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• 제38권2호
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• pp.135-142
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• 1991

We reviewed 15 cases of mesothelioma of the pleura, of which three cases were localized benign form and 12 cases were malignant diffuse form. The tumors were distributed equally in both sexes, and occured most commonly in fifth to seventh decades. The history of exposure to asbestos was present in only one case. The chief complaints were mainly chest pain and dyspnea. Associated symptoms were cough, sputum, hemoptysis, weight loss, anorexia, chill. On physical examination, unilateral, decreased breathing sound was main feature. The simple chest radiograph showed masses in all localized mesotheliomas (100%) and in 2 diffuse mesotheliomas (17%). 8 cases of diffuse mesotheliomas (67%) showed unilateral pleural effusions. Pleural effusions were mainly bloody (67%), and almost all were exudates. In all localized mesotheliomas, final diagnosis was made by open thoracotomy. In diffuse mesotheliomas, final diagnosis was made by open thoracotomy in 7 cases, chest wall mass biopsy in 2 cases, thoracoscopic biopsy in 1 case, pleural biopsy in 1 case, and pleural biopsy combined with axillary lymph node biopsy in 1 case. Localized mesotheliomas were treated by simple excision with good prognosis. In diffuse mesotheliomas, surgical treatment (pleuropneumonectomy, pleurectomy), chemotherapy, or radiotherapy, alone or in combination, were used with dismal prognosis. The prognostic factors were not found due to the small number of cases, incomplete follow up, and early drop out.