• Tuberculosis and Respiratory Diseases
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• 제53권1호
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• pp.66-70
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• 2002

저자들은 반복적인 폐렴의 병력을 가지고 있는 여성에서 도플러초음파를 이용하여 하행복부대동맥으로부터 분리폐로 체동맥의 주행을 확인하여 폐분리증을 진단하고 이를 수술로 확인하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.182-186
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• 2012

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.

• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.172-177
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• 2014

Background: Pseudomonas aeruginosa infection is particularly associated with progressive and ultimately chronic recurrent respiratory infections in chronic obstructive pulmonary disease, bronchiectasis, chronic destroyed lung disease, and cystic fibrosis. Its treatment is also very complex because of drug resistance and recurrence. Methods: Forty eight cultures from 18 patients with recurrent P. aeruginosa pneumonia from 1998 to 2002 were included in this study. Two or more pairs of sputum cultures were performed during 2 or more different periods of recurrences. The comparison of strains was made according to the phenotypic patterns of antibiotic resistance and chromosomal fingerprinting by pulsed field gel electrophoresis (PFGE) using the genomic DNA of P. aeruginosa from the sputum culture. Results: Phenotypic patterns of antibiotic resistance of P. aeruginosa were not correlated with their prior antibiotic exposition. Fifteen of 18 patients (83.3%) had recurrent P. aeruginosa pneumonia caused by the strains with same PFGE pattern. Conclusion: These data suggest that the most of the recurrent P. aeruginosa infections in chronic lung disease occurred due to the relapse of prior infections. Further investigations should be performed for assessing the molecular mechanisms of the persistent colonization and for determining how to eradicate clonal persistence of P. aeruginosa.

• Tuberculosis and Respiratory Diseases
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• 제48권5호
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• pp.788-793
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• 2000

결절성 경화증의 폐침윤은 드문 것으로 알려져 있는데 저자들은 결절성 경화증과 신장의 혈관근지방종으로 추적 관찰중인 환자에서 폐의 기흉이 발생하여 고해상 전산화단층촬영과 병리조직소견에서 HMB-45 양성인 평활근의 증식을 보인 폐의 림프관평활근종증을 진단받은 1예를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제49권4호
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• pp.514-519
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• 2000

저자들은 급성 호흡부전과 방사선학적으로 양측성 유리음영 및 국소적 낭성 변화를 보인 36세 남자 환자에서 임상 소견이 급격히 악화되는 경과를 보여 시행한 개흉 폐생검에서 후천성 면역 결핍증에 병발한 주폐포자충과 거대세포바이러스 동시 감염에 의한 폐렴으로 진담하고 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.448-451
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• 2012

Invasive pulmonary aspergillosis (IPA) has emerged as a severe infection in patients with immunocompromised hosts. However, recently, several IPA cases, without an apparent predisposition to immunodeficiency, has been reported. A 72-year-old woman was admitted for evaluation of general weakness and poor oral intake. She reported no medical history, except for intraarticular injection of a corticosteroid for joint pain for the duration of two months. A chest radiography revealed multiple cavitary nodules in both lungs. Examination of specimens, obtained by percutaneous needle biopsy, led to a diagnosis of invasive aspergillosis. Brain magnetic resonance imagining revealed numerous peripheral thin enhancing cystic nodules in both cerebral hemispheres. We initiated intravenous administration of amphotercin B. However, the patient died after nine days. Here, we report an invasive aspergillosis case, which involves the lungs and brain after a short period of steroid injection.

• Tuberculosis and Respiratory Diseases
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• 제44권2호
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• pp.430-434
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• 1997

A 29-year-old male patient was admitted due to subacute onset of right chest pain. He had no history of trauma, chest surgery or other medical disease. Chest roentgenogram showed an expansile, radiolucent lesion on the posterior segment of right seventh rib. Computed tomogram of the chest also showed lytic expansile mass with septation. He took an en-bloc resection of the involved rib. Pathologically there were multiple cystic spaces, filled with blood and collage no fibrous tissue proliferation and locally areas of new bone formation and giant cells of osteoclastic type, which was compatible with aneurysmal bone cyst. We report a case of aneurysmal bone cyst of the rib with a brief review of literature.

• Tuberculosis and Respiratory Diseases
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• 제50권5호
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• pp.641-644
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• 2001

Pulmonary blastoma is a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or embryonic in appearance. There are three subtypes, which include well differentiated fetal adenocarcinoma (pulmonary endodermal tumor), biphasic pulmonary blastoma, and cystic and pleuropulmonary blastomas in children. Among them, biphasic pulmonary blastoma is a primary malignancy of the lung originating from multipotential pulmonary blastema including both the malignant fetal epithelial and mesenchymal components. These make up 0.25 to 0.5 percent of all primary malignant lung tumors. This tumor is usually symptomatic and appears as a large, solitary peripheral mass, with a tendency to favor the upper lobe. Here we report a case where a small sized asymptomatic peripheral lung mass was diagnosed as a biphasic pulmonary blastoma, prior to the operation, A subsequent percutaneous needle biopsy was performed, which revealed features of a large cell neuroendocrine tumor. In addition, a review of the relevant literature is provided.

• Tuberculosis and Respiratory Diseases
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• 제40권6호
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• pp.736-741
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• 1993

Pulmonary sequestration is the part of a spectrum of bronchopulmonary foregut anomalies in which a portion of lung parenchyma does not communicate with the tracheobronchial tree and usually receives its arterial supply from a systemic vessel. The sequestrated portion of the lung is susceptible to infection. The patient with this entity will have a paucity of symptoms and will present himself for treatment because of a persistent pneumonia. The associated aberrant systemic artery makes the preoperative diagnosis of the lesion imperative because of the life-threatening technical hazards posed by this artery. We experienced a case of intralobar pulmonary sequestration. Initially, the diagnosis of sequestration was unsuspected and open thoracotomy was done for management of homogenous cystic mass on left lower lobe, but one anomalous systemic artery from thoracic descending aorta to sequestrated lung was incidentally revealed. Then we underwent lower lobectomy and ligation of anomalous artery.

• Tuberculosis and Respiratory Diseases
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• 제50권5호
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• pp.591-598
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• 2001

연구배경 : 기관과 폐에서 발생하는 선양 낭포성 암종은 타액선에서 발생하는 것과 조직학적으로 동일한 종양으로 기관지에서 발생하는 것은 무척 드물다. 이에 기관지에 원발성으로 발생한 선양 낭포성 암종의 임상적 특징을 조사하고자 하였다. 방 법 : 저자들이 경험한 5예와 지금까지 우리나라에서 문헌상 보고된 8예 등 총 13예를 대상으로 임상 양상, 치료, 경과 등을 조사하였다. 결 과 : 환자의 연령은 20-74세이고 남자가 9예, 여자는 4예이었다. 발현 증상은 기침, 호흡곤란, 객혈 등이었다. 굴곡성 기관지경상 대부분 표면은 부드럽고 점막이 울혈되어 있는 용종성의 종양을 나타내었고, 기도를 거의 혹은 완전히 폐쇄시키고 있었다. 골전이 1예와 경부 림프절 전이 1예 등 2예에서 원격전이가 있었고, 종격동 침범이 1예 있었다. 10예에서 수술적 절제술을 시행하여으며 이중 2예에서 수술후 방사선 치료을 하였다. 수술한 예 중 8예에서 생존기간 정중값이 21개월이었고, 13년간 재발되지 않고 생존한 경우도 1예 있었다. 결 론 : 기관지에 원발성으로 발생한 선양 낭포성 암종이 드물지만 13예를 확인하였으며, 원격전이나 종격동 침범이 적은 편이고 수술 절제가 가능하면 예후가 좋은 경향이므로 기관지 협착이나 폐쇄가 있는 환자에서 기관지경을 활용한 조기 진단과 적극적인 수술 절제 치료가 중요하다.