• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.177-181
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• 2012

Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

• Tuberculosis and Respiratory Diseases
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• v.67 no.4
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• pp.338-344
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• 2009

In photodynamic therapy, a chemical photosensitizer is activated by light of a specific wavelength., Photodynamic therapy has been combined with bronchoscopy in patients who are ineligible for surgical resection in order to treat patients with early central lung cancer. Here, we describe 3 patients with early central lung cancer who were treated effectively using photodynamic therapy. Our experience shows that this approach is a useful modality in the therapy of these types of tumors.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.20-25
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• 1994

Background: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug 1992. Methods: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. Results: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis, 18.2%(22) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. Conclusion : Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.

• Tuberculosis and Respiratory Diseases
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• v.71 no.4
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• pp.266-270
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• 2011

Background: Photodynamic therapy (PDT) is effective in managing small superficial early lung cancer patients who were deemed nonsurgical candidates. However, we do not have any previous report on the usefulness of PDT in early lung cancer in South Korea. Thus we report here our experience of PDT in early lung cancer patients. Methods: 10 patients who underwent PDT for managing early lung cancer between June 2006 and July 2010 were analyzed. PDT was carried out 48 hours after photosensitizer injection. Re-bronchoscopy was carried out 48 hours after PDT in order to remove a necrotic tissue from the PDT site. For evaluation of PDT response, bronchoscopy and chest computed tomography (CT) were performed after 3 months. Results: The median age of patients was 69 (49~77) and all patients were male. The smoking history of patients was 48 (20~75) pack-year and the median follow up of patients was 25 (11~52) months. Complete remission was observed in 10 patients and the recurrence of lung cancer was observed in 3 patients. Out of 10 patients, 3 patients died (one case of lung cancer progression and two cases of pneumonia). Conclusion: The PDT is a safe and effective treatment in early lung cancer patients who are not suitable for surgical resection. The PDT in clinical practice is an attractive option in the treatment of early lung cancer.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.14-18
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• 2001

Background and Objectives： Vegetable Foreign bodies (VFB) in the bronchial tree may be complicated by fragmentation, slippage and impaction during the removal with forceps. This study is to evaluate the safety and efficacy for the technique of removing VFB from the bronchial tree in infants and early childhood using Fogarty balloon catheter. Materials and methods : The subjects consisted of 18 infants and early childhood (7-22 months old) with VFB in the bronchial tree from January 1991 through October 1998. The authors first attempted removal of VFB with forceps and if that failed, removed VFB with Fogarty arterial embolectomy catheter under the ventilating bronchoscopy and general anesthesia. Results: We removed 6 VFB with forceps. could not remove anymore, and so removed 12 VFB with Fogarty catheter. In 8 VFB of less than 24 hours, we could remove 6 VFB with forceps and 2 VFB which could not be removed with forceps were removed with Fogarty catheter. In 10 VFB of more than 24 hours, we could not remove with forceps and removed with Fogarty catheter. Conclusions : VFB in the bronchial tree of infants and early childhood can usually be removed with forceps. But we think that Fogarty balloon catheter technique is a easy, safe method for the removal of bronchial VFB of more than 24 hours, fragmentation, impaction, lower bronchus and too round or slippery to remove with forceps in infants and early childhood.

• Tuberculosis and Respiratory Diseases
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• v.73 no.6
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• pp.325-330
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• 2012

High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7~32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.

• Tuberculosis and Respiratory Diseases
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• v.74 no.4
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• pp.151-162
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• 2013

Diffuse alveolar hemorrhage (DAH) is a life-threatening and medical emergency that can be caused by numerous disorders and presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Early bronchoscopy with bronchoalveolar lavage is usually required to confirm the diagnosis and rule out infection. Most cases of DAH are caused by capillaritis associated with systemic autoimmune diseases such as anti-neutrophil cytoplasmic antibody-associated vasculitis, anti-glomerular basement membrane disease, and systemic lupus erythematosus, but DAH may also result from coagulation disorders, drugs, inhaled toxins, or transplantation. The diagnosis of DAH relies on clinical suspicion combined with laboratory, radiologic, and pathologic findings. Early recognition is crucial, because prompt diagnosis and treatment is necessary for survival. Corticosteroids and immunosuppressive agents remain the gold standard. In patients with DAH, biopsy of involved sites can help to identify the cause and to direct therapy. This article aims to provide a general review of the causes and clinical presentation of DAH and to recommend a diagnostic approach and a management plan for the most common causes.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.262-273
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• 1990

In order to assess the method which is more sensitive one to detect the early change of lung tissue by the inhaled dust, we have performed the various medical examinations such as chest radiography, pulmonary function test, high resolution chest CT, brnchoalveolar lavage and lung biopsy used bronchoscope and ultrathin bronchoscopy examination to 48 persons. The control group were 8 persons who did not exposed to dust, 40 cases of the experimental group have professionally exposed to the mineral dust. The results were as follows 1. The total number of cells in bronchoalveolar lavage was significantly increased in all of the pneumoconiosis group classified by chest and high resolution chest CT. 2. The composition rate of macrophage to the total number of cells in bronchoalveolar lavage fluid was significantly decreased in all of the pneumoconiosis group compared with the control group. 3. The composition rate of neutophils and lymphocytes to the total number of cells in bronchoalveolar lavage fluid was significantly increased in all of the pneumoconiosis group compared with the control group. 4. The forced expiratory volume in one second ($FEV_{1-0}$), maximal mid-expiratory flow (MMF), and maximal voluntary ventilation (MVV) were significantly increased only in the group of the progressed pneumoconiosis relatively. 5. We observed submucosal edema, anthracotic pigmentation and granuloma formation in transbronchial lung biopsy of the suspected pneumoconiosis (category 0/1) case which is thought to the early change of coal workers' pneumoconiosis.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.69-84
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• 1997

Background : Although the overall prognosis of patients with lung cancer is poor, highly effective treatment exists for the small subset of patients with early lung cancer(carcinoma in situ/micro- invasive cancer). But very few patients have benefit from them because these lesions are difficult to detect and localize with conventional white-light bronchoscopy. To overcome this problem, a Lung Imaging Fluorescence Endoscopic device(LIFE) was developed to detect and clearly delineate the exact location and extent of premalignant and early lung cancer lesions using differences in tissue autofluorescence. Purpose : The purpose of this study was to determine the difference of sensitivity and specificity in detecting dysplasia and carcinoma between fluorescence imaging and conventional white light bronchoscopy. Material and Methods : 35 patients (16 with abnormal chest X-ray, 2 with positive sputum study, 2 with undiagnosed pleural effusion, 15 with respiratory symptom) have been examined by LIFE imaging system. After a white light bronchoscopy, the patients were submitted to fluorescence bronchoscopy and the findings of both examinations have been classified in 3 categories(class I, II, III). From of all class n and III sites, 79 biopsy specimens have been collected for histologic examination: a comparison between histologic results and white light or fluorescence bronchoscopy has been performed for assessing sensitivity and specificity of the two methods. Results : 1) Total 79 sires in 35 patients were examined. Histology demonstrated 8 normal mucosa, 21 hyperplasia, 23 dysplasia, and 27 microinvasive and invasive carcinoma. 2) The sensitivity of white light or fluorescence bronchoscopy in detecting dysplasia was 60.9% and 82.6%, respectively. 3) The results of this study showed 70.3 % sensitivity for microinvasive or invasive carcinoma with LIFE system, versus 100% sensitivity for white light in 27 cases of carcinoma. The false negative study of LIFE system was 8 cases(3 adenocarcinoma and 5 small cell carcinoma), which were infiltrated in submucosal area and had normal epithelium. Conclusion : To improve the ability 10 diagnose and stage more accurately, fluorescence imaging may become an important adjunct to conventional bronchoscopic examination because of its high detection rate of premalignant and malignant epithelial lesion. But. it has limitation to detect in submucosal infiltrating carcinoma.

• Tuberculosis and Respiratory Diseases
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• v.75 no.6
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• pp.260-263
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• 2013

Invasive aspergillosis has emerged as a major cause of life-threatening infections in immunocompromised patients. Recently, patients with chronic obstructive pulmonary disease, who have been receiving corticosteroids for a long period, and immunocompetent patients in the intensive care unit have been identified as nontraditional hosts at risk for invasive aspergillosis. Here, we report a case of invasive pulmonary aspergillosis after influenza in an immunocompetent patient. The patient's symptoms were nonspecific, and the patient was unresponsive to treatments for pulmonary bacterial infection. Bronchoscopy revealed mucosa hyperemia, and wide, raised and cream-colored plaques throughout the trachea and both the main bronchi. Histologic examination revealed aspergillosis. The patient recovered quickly when treated systemically with voriconazole, although the reported mortality rates for aspergillosis are extremely high. This study showed that invasive aspergillosis should be considered in immunocompetent patients who are unresponsive to antibiotic treatments; further, early extensive use of all available diagnostic tools, especially bronchoscopy, is mandatory.