• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.701-708
• /
• 1996

Background : To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. Material and Methods: Thirteen women with tuberculous bronchial stenosis(9cases : left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PIT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. Result : 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(1/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. 8m, significant improvement of PFT was noted in only 25%(1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(1/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. Conclusion : We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery. and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.4
• /
• pp.432-440
• /
• 2000

Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.5
• /
• pp.278-281
• /
• 2012

A 47-year old man visited our hospital because of purulent sputum for 3 months. Chest X-ray showed destruction of both the upper lungs, and bronchoscopy revealed inflammatory change with whitish plaque on the left main bronchus through upper division of the left upper lobe. Tracheobronchial aspergillosis (TBA) was finally diagnosed as a result of histologic and microbiologic examination. However, he went abroad without medication before the diagnosis was made and visited again 10 months later. Follow-up bronchoscopy showed complete regression of the previously noted endobronchial lesion. We describe this case to consider the role of antifungal treatment in immunocompetent hosts, as well as to discuss a rare condition; TBA resolved spontaneously.

• Tuberculosis and Respiratory Diseases
• /
• v.39 no.2
• /
• pp.180-185
• /
• 1992

The most common symptom associated with an pulmonary aspergilloma is hemoptysis, with estimates of frequency ranging from 50 to 85 percent of patients. Hemoptysis may be infrequent and minimal in amount or it may be severe with a fatal outcome. The major options available for the treatment of pulmonary aspergilloma include sugical resection of the lesion, a number of medical therapies, or simple observation of the patient for a time. Surgery is the treatment of choice but it is not feasible in some patients who have diffuse or advanced pulmonary disease that makes them poor candidates for thoracotomy. As an alternative to it, some categories of therapy including bronchial artery embolization and parenteral or endobronchial administration of antifungal drugs were tried without remarkable success. But percutaneous instillation of intracavitary amphotericin B for symptomatic aspergilloma has been reported with better result. The authors present a case of percutaneous intracavitary instillation of amphotericin B for the treatment of pulmonary aspergilloma and its successful result for the repetitive hemoptysis.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.2
• /
• pp.212-217
• /
• 2012

Massive hemoptysis is a life-threatening condition and sometimes leads to death due to airway obstruction rather than exsanguinations. In a critical hemoptysis, endotracheal intubation may be necessary to maintain adequate gas exchange and protect the unaffected side of the lung. Bronchial blockers (BBs), commonly used technique for one-lung ventilation in thoracic or cardiac surgeries, are valuable devices for protecting the airway in massive endobronchial bleeding. We report three cases intubated with BBs, Univent$^{(R)}$, in massive hemoptysis. We suggest that BBs are one of the indispensable equipments for respiratory specialized wards and intensive care units.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.6
• /
• pp.670-673
• /
• 2005

An 81-year-old man underwent bronchoscopy to investigate the cause of his dyspnea symptoms. A benign natured mass was observed in the bronchus and was excised. The pathology examination revealed a fibroepithelial polyp. He has been asymptomatic since the simple bronchoscopic excision. A fibroepithelial polyp is a benign tumor with a mesodermal origin. It is commonly found in the skin, urogenital area and chest, but is extremely rare in the respiratory system. We report a case of a fibroepithelial polyp in the bronchus, which was treated with a bronchoscopic excision, with a brief review of the relevant literature.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.5
• /
• pp.453-461
• /
• 2001

Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequently in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb ($T_3N_0M_0$). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.792-797
• /
• 1996

A 59-year-old woman was admintted to the hospital because of intermittent fever and right side chest pain. She has a same episode eight months before this entry. Chest CT scan demonstrated ill-defined parenchymal consolidation containing dilated bronchi of right lower lung field, but no endobronchial mass in the bronchial trees. Fiberoptic bronchoscopy seeking the cause of recurrent pneumonia revealed a small, round mass nearly completely obstructing me lumen of basal segmental bronchus of right lower lobe. The diagnosis of bronchiolar papilloma was made from the biopsy specimens of the bronchoscopic examination. The patient was treated with right lower lobectomy because of irreversible secondary changes below the obstructed bronchus. This thoracotomic excision resulted in complete relief of symptoms and the postoperative course was uneventful for 12 months. Here we report a extremely rare umor with a brief review of literatures.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.3
• /
• pp.394-401
• /
• 1999

Inflammatory pseudotumor is a infrequent, benign tumor that affects at all ages and involves the lung, gastrointestinal tract, and salivary gland. They are the most common, isolated, primary lesion of the lung in children, and usually present as circumscribed, peripheral, parenchymal tumors or endobronchial tumors, which may be usually static or increase slowly in size without causing symptoms. Surgical excision is the treatment of choice because of the location and benign nature of this lesion. The prognosis after resection is excellent. Other therapeutic modalities include radiation and steroid therapy. We experienced two cases of inflammatory pseudotumor of the lung parenchyme and endobronchus. We report these cases with a review of literatures.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.6
• /
• pp.567-572
• /
• 2006

Endobronchial foreign bodies are difficult to diagnose as the cause of obstructive pneumonia and atelectasis, However, once discovered, they can generally be removed, leading to an immediate and dramatic resolution of the symptoms. Occasionally, small foreign bodies that lodge in the peripheral airway are often initially asymptomatic but become symptomatic several years later. We reported a case of obstructive pneumonia and massive hemoptysis caused by a foreign metallic body. The patient knew that the foreign body was lodged in the peripheral airway on the chest X-ray, but did not want treatment. Several years later, he had a massive hemoptysis and obstructive pneumonia. Removal with a flexible bronchoscope failed, but the metallic foreign body was self-expectorated by coughing after the procedure. The pneumonia was resolved after removing the foreign body. The patient improved and was discharged without any sequela.