• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.346-352
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• 2007

Background: Pulmonary hypertension is one of the cardiovascular complications of in COPD. However, a diagnosis of pulmonary hypertension requires an invasive test, such as right heart catheterization. NT-proBNP is a cardiac hormone that is elevated when a cardiac volume or pressure overload is present. It was hypothesized that NT-proBNP might play a role in detecting of pulmonary hypertension in COPD patients. Method: The 31 COPD patients, who underwent all of NT-proBNP, echocardiography, and spirometry in Seoul National University Bundang Hospital during the period from November 2003 to July 2005, were retrospectively analyzed. Result: Of the 31 COPD patients, 9 patients had pulmonary hypertension. A significant positive correlation was observed between the NT-proBNP and pulmonary arterial pressure (r=0.589, p=0.002). However, there was no significant correlation observed between the $FEV_1$ and NT-proBNP and $FEV_1$ and pulmonary arterial pressure. Conclusion: NT-proBNP might indicate the presence of pulmonary hypertension in COPD patients.

• Tuberculosis and Respiratory Diseases
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• v.67 no.4
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• pp.356-358
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• 2009

Although tuberculosis is a chronic infectious disease that can occur in any section of the body, oral tuberculosis is rare. Here, we report a case of oral tuberculosis in which the patient sought treatment for a painful oral lesion. A histopathologic examination revealed the characteristics of tuberculosis and pulmonary lesions were detected on subsequent examination. The patient was treated with antituberculosis therapy, and his symptoms improved. This case emphasizes the importance of including oral tuberculosis as part of the differential diagnosis for mucosal lesions.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.260-267
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• 2000

Giant cell interstitial pneumonia. a synonym for hard metal pneumoconiosis, is a unique form of pulmonary fibrosis resulting from an exposure to hard metal dust. A case of biopsy-proved giant cell interstitial pneumonia in the absence of appropriate history of exposure to hard metal dust is reported. The patient presented with clinical features of chronic interstitial lung disease or idiopathic pulmonary fibrosis. He worked in a chemical laboratory at a fertilizer plant, where he had been exposed to various chemicals such as benzene and toluene. He denied having any other hobby in his house or job at work, which may have exposed him hard metal dust. High-resolution CT scan revealed multi-lobar distribution of ground glass opacity with peripheral and basal lung predominance. The retrieved fluid of bronchoalveolar lavage contained asbestos fiber and showed neutrotphil predominance. Surgical lung biopsy was performed for a definite diagnosis. Lung specimen showed alveolar infiltration of numerous multinucleated giant cells with mild interstitial fibrosis. Upon detailed examination of the lung tissue, one asbestos body was found. An analysis for mineral contents in lung tissue was performed. Compared with the control specimen, the amount of cobalt and several hard metal components in the lung tissue of this patient was ten times higher. We speculated that the inconsistency between occupational history and the findings of pathologic and mineralogical analyses could be explained by the difference in individual immunologic reactivity to hard metal dust despite the relatively small amount of unrecognized environmental exposure(ED: It's hard to understand what this phrase is trying to say).

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.560-564
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• 2009

Sarcoidosis is a granulomatous disease that can involve any organ, although it primarily involves the lungs, intrathoracic lymph nodes, skin, and eyes. We present a case of sarcoidosis with pancytopenia, resulting from bone marrow involvement. A 35-year-old man was admitted to hospital for chronic cough and blurred vision. On chest computed tomography, there were multiple pulmonary nodules and mediastinal lymph nodes enlargement. As the patient also showed pancytopenia, we performed a bone marrow biopsy, as well as a transbronchial lung biopsy. Both biopsies showed non-caseating granulomas. We diagnosed the patient with sarcoidosis with pulmonary, bone marrow, uvea, liver and spleen involvement. After oral steroid therapy, the patient's symptoms as well as his pancytopenia improved. We present this case to demonstrate the significance of bone marrow biopsy in cases of sarcoidosis with pancytopenia, as well the possibility of clinical improvement with steroid treatment.

• Journal of the Korean Society of School Health
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• v.1 no.1
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• pp.160-177
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• 1988

This study is an analysis of the teachers' health problems that focuses on the frequencies and types of their visiting to school clinics and the management of health-related problems. The participants for this study are consisted of 1,650 teachers employed at 30 public schools in the Seoul area. Data for the study came from diagnostic records for 1986, the results of a questionaire-type survey conducted between June 20th and of the same year an from other documents recorded by school nurses. The main results of this study are as follows: 1. The teachers' health problems. a) According to health diagnosis records, 6.1 % of all teachers had a health problem. Liver-related ailments topped the list, followed by circulatory and diabetic problems. b) The survey data had 71.9 % of the respondents indicating that trey suffered from some health problem. The most frequent response concerned respiratory problems, followed by gastro-intestinal and nervous system problems. c) A check of clinic utilization records revealed that the main reasons for visiting are concerned with fatigue (30.5 %), gastro-intestinal(18.7 %) and respiratory(18.2 %) ailments. These three categories accounted for 67.4 % of total use. 2. Frequencies of their visiting to school clinics 40.5 % of the teachers indicated that they have visited the school clinic. And 62.0 % visited it with a self-diagnosed ailment and 15.3 % utilized the facility after a problem had been detected in a health examination. Clinics were visited a total of 1,458 times which breaks down to 0.9 times per month per teacher. For a patient, the figures are 2.2 times on the average with a range from 1 to 19. 3. Health management problems a) Of those respondents. 53.4 % stated that they didn't have enough time to consult about their health problems and diagnose their disease b) Also, 47.3 % of the respondents indicated that school nurses should give health counsels and health education. c) When questioned about improvements in the current system, the teachers placed importance on the prevention and management of chronic diseases (35.2 %) and pre- and posteducation concerning periodic health examinations In conclusion, the following points must be considered: First, school administrators need to pay more attention to the health problems of the teachers. Second, school nurses should be more active in managing a health program for teachers. Finally, education and training for nurses should be continually upgraded so that they can dispense proper and timely care for teachers.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.498-503
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• 2011

Background: The causes of exertional desaturation in patients with COPD can be multifactorial. We aimed to investigate factors predict exertional desaturation in patients with moderate to severe COPD. Methods: We tested 51 consecutive patients with stable COPD (FEV1/FVC, $40{\pm}13%$ predicted). Patients performed a six minute walk test (6MWT). Pulse oxymetric saturation (SpO2) and pulse rate were recorded. Results: Oxygen desaturation was found in 15 subjects after 6MWT, while 36 subjects were not desaturated. Lung diffusing capacity was significantly lower in desaturation (DS) group ($62{\pm}18%$ predicted) compared with not desaturated (ND) group ($84{\pm}20$, p<0.01). However there was no statistical difference of FEV1/FVC ratio or residual volume between two groups. The pulse rate change was significantly higher in the desaturated compared with the not desaturated group. Six minute walking distance, subjective dyspnea scale, airflow obstruction, and residual volume did not predict exertional oxygen desaturation. Independent factors assessed by multiple logistic regression revealed that a pulse rate increment (odd ratio [OR], 1.19; 95% confidence interval [CI], 1.01~1.40; p=0.02), a decrease in baseline PaO2 (OR, 1.105; 95% CI, 1.003~1.218; p=0.04) and a decrease in lung diffusing capacity (OR, 1.10; 95% CI, 1.01~1.19; p=0.01) were significantly associated with oxygen desaturation. Receiver operator characteristic (ROC) analysis showed that an absolute increment in pulse rate of 16/min gave optimal discrimination between desaturated and not desaturated patients after 6MWT. Conclusion: Pulse rate increment and diffusion capacity can predict exertional oxygen desaturation in stable COPD patients with moderate to severe airflow obstruction.

• Tuberculosis and Respiratory Diseases
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• v.51 no.1
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• pp.44-52
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• 2001

Background : Oxygen concentrators are convenient to operate and economical for patients with chronic obstructive pulmonary disease (COPD). However, oxygen concentrators are not manufactured domestically and the COPD patients are currently treated with imported oxygen concentrators. To evaluate the efficacy and safety of domestically developed prototype oxygen concentrator before clinical application, the efficacy and safety of the domestic oxygen concentrator were evaluate by comparing with the imported one. Material and Methods : The clinical tests were performed on 36 hyperhydrosis patients from April 1999 to August 1999. Domestic and imported oxygen concentrators were in turn applied to the same patient, who inspired oxygen for 60 minutes at a rate of 3 liters per minute through nasal prong. The oxygen concentrator, which was applied first, was randomly allocated. The arterial partial oxygen pressure ($PaO_2$) was estimated to compare the efficacy; and the carboxy hemoglobin(COHb), pH, arterial $CO_2$ partial pressure, pulse rate, blood pressure, and respiration rate to compare the safety before and after applying each oxygen concentrator. A student t-test was used to analyze the results. Result : In respect to efficacy, the difference in the change of $PaO_2$ before and after the application between two concentrators was not statistically significant. In respect to safety, the differences in the changes of COHb, pH, partial pressure of arterial $CO_2$, pulse rate, blood pressure, respiration rate between two concentrators were also not statistically significant. Conclusion : The domestically developed oxygen concentrator, showed satisfactory efficacy and safety when compared with the imported one.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.729-734
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• 1999

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.411-418
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• 2002

Pulmonary alveolar proteinosis(PAP) is a disorder in which an insoluble, proteinaceous material, rich in phospholipids, is deposited in the alveoli and bronchioles. The deficiency in the clearance and degradation of the intra-alveolar phospholipoproteinaceous material in PAP most likely represents a dysfunction of the type II pneumocytes. Although the pathogenesis and causative treatment of PAP is unclear a whole lung bronchopulmonary lavage is a relatively safe and effective treatment. Here we experienced a case of pulmonary alveolar proteinosis in a 62 year old female patient who had pulmonary tuberculosis approximately 20 years ago. She complained of aggravated dyspnea and chronic cough, and presented fine inspiratory crackles at both lung fields, diffuse ground glass opacity with some area of consolidation and smooth interlobular septal thickenings in both upper, right middled lobes, and a portion of right lower lobe. Optical microscopy of the lung tissue obtained by and open lung biopsy revealed many granulomas containing acid-fast smear positive bacilli and diffuse homogeneous PAS-positive fluid in the alveolar space. Immunohistochemical stain showed surfactant. A in the alveolar space. Antituberculosis drugs with bronchoalveolar lavage were used to treat the disease. Thereafter she showed improvement in her symptoms and a partial improvement in the chest X-ray and HRCT findings. We present a case of PAP associated with pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.602-609
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• 1993

Lymphocytic interstitial pneumonitis (LIP) is one of parenchymal pulmonary infiltrative diseases first described at 1966 by Carrington and Liebow. In LIP, there is a predominance of mature small lymphocytes in the interstitium of the lung which form germinal centers. The disease process surrounds, but dose not invade lung parenchyme, tracheobronchial tree and vascular structures. The etiology remains still unknown and the clinical features of this disorder have not been clearly defined. Therefore, the therapeutic modality is obscure. Development of LIP association with AIDS is often reported currently and possibility of progress to malignant lymphoma is emphasized. We experienced a case of primary LIP with pnemomediastinum. She was adimitted due to chest and anterior nuchal pain with chronic coughing, and diagnosed as pneumomediastinum with LIP. Medication with steroid was begun and some improvement of symptoms was observed, but an X-ray film of the chest remained same without improvement. We report above case with review of the literatures.