• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.654-660
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• 1998

Pulmonary embolism is one of the moot common acute pulmonary disease in the adult general hospital population However, the disease is still frequently unsuspected and underdiagnosed due to the nonspecificity of both clinical findings and laboratory tests. The chest radiography in a patient suspected acute pulmonary embolism do not provide adequate information to establish or exclude the diagnosis of pulmonary embolism. Even in the case of infarction, there is no pathognomonic clues on the chest film. Rarely infarction presents unusual roentgenologic manifestation such as lobar consolidation, coin lesion, multinodular opacity, or massive pleural effusion Especially, lobar consolidation in pulmonary embolism might mislead into the diagnosis of pneumonia. We experienced a case of pulmonary embolism presenting lobar consolidation in a 62 years old woman, originated from deep vein thrombosis. She took a compression stocking and underwent anticoagulant therapy with excellent outcome.

• Journal of Yeungnam Medical Science
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• 제33권2호
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• pp.98-104
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• 2016

Background: Clinical differences in Mycoplasma pneumonia (MP) in children and adolescent patients according to abnormal infiltrate patterns on the chest X-ray were compared. Methods: From 2012 to 2015, patients (n=336) diagnosed with MP at Yeungnam University Medical Center have been classified as eiher lobar pneumonia or bronchopneumonia based on the infilterate patterns observed on chest X-ray. Cases were analyzed retrospectively for gender, age, seasonal incidence rate, main symptoms (fever duration, extrapulmonary symptoms), and laboratory results, including white blood cell count, hemoglobin, platelets, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), as well as concurrent respiratory virus infection. Results: The following results were observed. First, lobar pneumonia affected 22.0% of all MP patients and was the most common in preschool children, with a high incidence rate in November and December. Second, lobar pneumonia had a longer fever duration than bronchopneumonia (p<0.001), and also showed significantly higher platelets (336.8 vs. $299.1k/{\mu}L$, p=0.026), ESR (46.3 vs. 26.0 mm/hr, p<0.001) and CRP (4.86 vs. 2.18 mg/dL, p=0.001). Third, viral co-infection was more common in bronchopneumonia (p=0.017), affecting 66.7% of infants and toddlers (p=0.034). Finaly, lobar consolidation was most common in both lower lobes. Conclusion: MP in children has increased in younger age groups, and the rate of lobar pneumonia with severe clinical symptoms is higher in older children.

• 대한수의학회지
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• 제48권3호
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• pp.317-321
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• 2008

Four 5 month old calves were died after showing respiratory distress after long-distance transportation at winter season. They were diagnosed as fibrinous lobar pneumonia caused by Mannheimia (M.) haemolytica. Grossly, lungs were attached onto the pleura by fibrin, with a rich yellowish fluid in thorax. The cut surface of the lung was showed marbled pattern of the reddish or greyish consolidation and widened interlobular septa by fibrin deposition. Histopathologically, parenchymal necrosis was delineated by a band of the degenerated inflammatory cells, and distended interlobular septa with serofibrinous exudates and vascular thrombosis with alveolar capillaries degeneration and abundant serofibrinous exudates in alveoli. M. hemolytica were isolated from all calves, and bovine viral diarrhea virus and parainfluenza type 3 virus in one calf were detected by RT-PCR. Thus, it was concluded that this case was diagnosed as pneumonic mannheimiosis suggested by complex infection with viruses after long-distance transportation and coldness.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.472-476
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• 1996

Bronchioloalveolar carcinoma is originated from the periphery of the lung and can be mistaken for lobar pneumonia or atypical pneumonia clinically and at gross examination. Recently the authors experienced a 67-year-old woman who had slowly progressed pulmonary lesions for four years. At first, she visited this hospital for intermittent chest pain four years before. And she visited other hospitals for the same problem and had a series of evaluation including two times of biopsy but did not have any conclusive diagnosis. With aggravation of chest pain, she was referred to this hospital again and the lesion was reexamined and confirmed as bronchioloalveolar carcinoma by ultrasonography-guided needle biopsy. Being performed left lower lobectomy, she kept good condition without any complication.

• Tuberculosis and Respiratory Diseases
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• 제49권1호
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• pp.117-121
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• 2000

폐모균증은 치명적인 결과를 초래하는 기회감염으로 조기진단 및 치료가 요망된다. 하지만 본 증례와 같이 폐모균증의 방사선학적 소견은 비특이적이므로 조기 진단이 용이하지 않다. 이에 저자들은 폐모균종의 발생 위험인자를 내포한 환자가 항생제에 반응을 보이지 않으면서 방사선 소견상 폐의 경화, 종괴, 결절, 공동 등의 소견을 보이는 경우 폐모균증올 고려함이 필요하다고 생각되어 문헌고찰과 함께 본 증례를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.467-471
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• 1996

저자들은 발열 및 마른기침을 주소로 내원한 20세 여자에서 기관지내시경검사 및 기관지조직 검사로 기관지 방선균증을 확진하고 소디움페니실린 정맥주사 및 테트라사이클린 경구투여로 완치한 원발성 기관지 방선균증 환자를 경험하였기에 문헌고찰과 함께 보고 하는 바이다.

• Journal of Chest Surgery
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• 제32권5호
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• pp.484-488
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• 1999

광범위 폐괴저는 매우 빠른 폐실질의 파괴를 보이는 대엽성 폐렴의 치명적인 합병증으로서 적절한 치료를 하지 않으면 높은 사망률을 보인다. 주원인균으로는 Klebsiella pneumoniae, Pneumococcus, Aspergillus 등이 있다. 흉부X선 검사상 폐엽의 고형질화 및 폐용적 증가 \ulcorner의한 폐엽간구의 융기현상을 보이며, 컴퓨터 단층촬영에서 작은 공동을 포함한 광범위한 폐실질의 파괴를 나타낸다. 치료는 조기 수술적 절제와 함께 항생제 치료가 추천되며, 수술적 치료가 안되었을 경우 패혈증, 다발성 장기부전에 이어 사망에 이르는 것이 통상적인 진행으로 알려져 있다. 저자들은 Klebsiella 폐렴에 이어 빠르게 진행하는 폐괴저에 대한 2례의 수술을 시행하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제35권6호
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• pp.491-494
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• 2002

염증성 근섬유아세포종은 염증성 가성 종양으로 널리 알려져 있으며, 폐 실질 내의 종괴로 발견되는 경우가 많다. 기관지 내 염증성 근섬유아세포종은 매우 드문 종양으로 극히 적은 보고만이 있을 뿐이다. 5개월 전부터의 기침 증상으로, 13세 여자 환자가 입원하였다. 단순 흉부 X-선 및 흉부단층촬영에서 우하엽 기관지를 막아 폐렴을 일으킨 기관지 내 종괴가 발견되었다. 기관지경 검사에서 젤리 모양의 종괴가 우하엽 기관지를 거의 막고 있는 것이 관찰되었고 조직 검사상 연골성 과오종이 의심되었다. 우하엽 절제술을 시행하였고 최종 병리 결과는 염증성 근섬유아세포종으로 확진되었다. 환자는 수술 후 합병증 없이 퇴원하여 외래에서 추적관찰 중이다.

• Clinical and Experimental Pediatrics
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• 제57권6호
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• pp.271-277
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• 2014

Purpose: A nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory characteristics between children with refractory MP requiring steroid treatment and those with macrolide-responsive MP and evaluated the risk factors associated with refractory MP. Methods: We investigated 203 children who were admitted to our institution with MP from June to November 2011. Refractory MP was defined by persistent fever over $38.3^{\circ}C$ with progressive pulmonary consolidation or pleural effusion despite administration of appropriate macrolide antibiotics for 5 days or longer after admission. Steroid therapy was initiated on the fifth day after admission for refractory cases. Results: There were 26 patients with refractory MP requiring steroid therapy. The mean duration of steroid therapy was 5.4 days and most of the patients were afebrile within 24 hours after initiation of steroid therapy. The prevalence of refractory MP was higher in patients with pleural effusion, lobar pneumonia affecting more than 2 lobes, higher levels of serum lactate dehydrogenase, increased oxygen requirements, and longer duration of hospitalization. Atopic sensitization and history of asthma were also associated with refractory MP after adjusting for age and gender. Conclusion: Children with refractory MP had more severe pneumonia. Atopic sensitization and history of asthma may be risk factors for refractory MP requiring steroid therapy in Korean children.

• Allergy, Asthma & Respiratory Disease
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• 제6권6호
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• pp.295-302
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• 2018

Purpose: It is thought that Mycoplasma pneumoniae infection is more prevalent and causes more severe pneumonia in school-age children and young adults than in preschool children; however, recent studies suggest that the infection may be underdiagnosed and more severe in preschool children. This study investigated the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) and the risk factors of refractory MPP (RMPP) by age. Methods: We retrospectively reviewed the medical records of 353 children admitted due to MPP from January 2015 to December 2016. Demographics, clinical information, laboratory data and radiological findings were collected from all patients in this study. The patients were divided into 2 groups by the age of 6 years. Also, both preschool (< 6 years old) and school-age (${\geq}6$ years old) children were divided into RMPP and non-RMPP patients. Results: Total febrile days, febrile days before admission and the duration of macrolide antibiotic therapy were significantly longer in school-age children than in preschool children. School-age children had significantly greater risk of lobar consolidation (P=0.036), pleural effusion (P=0.001) and extrapulmonary complications (P=0.019). Necrotizing pneumonia and bronchiolitis obliterans tended to occur more frequently in preschool children than in school-age children. In both preschool and school-age children, lactate dehydrogenase (LDH) levels were significantly higher in RMPP patients than in non-RMPP patients. In preschool children, LDH > 722 IU/L (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44-6.50) and ferritin > 177 ng/mL (OR, 5.38; 95% CI, 1.61-19.49) were significant risk factors for RMPP, while LDH > 645 IU/L (OR, 4.12; 95% CI, 1.64-10.97) and ferritin > 166 ng/mL (OR, 5.51; 95% CI, 1.59-22.32) were so in school-age children. Conclusion: Clinical features of MPP were significantly different between preschool and school-age children. LDH and ferritin may be significant factors of RMPP in preschool and school-age children.