• 제목/요약/키워드: Lung, pathology

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자가 호기말 양압(auto-PEEP)을 보인 환자에서 원인질환에 따른 PEEP적용 효과의 차이 (Different PEEP Effects on Lung Volume According to Underlying Lung Disease in Patients with Auto-PEEP)

  • 손장원;고윤석
    • Tuberculosis and Respiratory Diseases
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    • 제57권6호
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    • pp.567-572
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    • 2004
  • 배 경 : 인공 호흡기 치료 중 auto-PEEP을 보이는 환자에게 PEEP을 적용할 경우에 폐 용적에 미치는 영향은 일정하지 않다. COPD와 같이 동적 호기류 제한이 있는 경우에 auto-PEEP 수치의 85%에 해당하는 PEEP까지는 안전하게 적용할 수 있으나, 동적 호기류 제한이 없으면 낮은 PEEP에서도 폐 용적의 증가가 나타난다. 이에 저자들은 auto-PEEP이 있는 환자에서 임상진단에 의한 질환별로 PEEP적용의 효과에 차이가 있는지 보고자 하였다. 대상 및 방법 : 인공 호흡 중 auto-PEEP을 보인 환자 16명을 대상으로 병력, 임상 증상 및 흉부방사선 소견을 기준으로 천식, COPD, 결핵성 변화군 등 3가지 환자 군으로 분 류한 뒤 각각 auto-PEEP 수치의 25, 50, 75, 100%에 해당하는 PEEP을 적용하고 포획 가스용적을 측정하여 폐 용적의 증가를 비교하였다. 결 과 : 천식 환자 군에서는 75% PEEP부터 폐 용적의 증가가 의미 있게 나타났다. COPD 군에서는 100% PEEP에서 폐 용적이 증가 하였다. 결핵성 변화 군에서는 낮은 PEEP에서도 폐 용적이 증가하는 경향을 보였으나 통계적으로 의미 있는 증가는 100% PEEP에서만 나타났다. 결 론 : Auto-PEEP을 보이는 환자에서 폐 용적에 대한 PEEP의 효과는 폐의 병리 상태에 따라 달랐다. 천식 환자 군에서는 auto-PEEP 수치의 50%이상에 해당하는 PEEP 적용은 포획 가스 용적의 증가를 가져올 수 있다.

Lymphosarcoma in a Brown Bear (Ursus arctos)

  • Kim, Jin-Hyun;Lee, Jung-Keun;Park, Jae-Hoon;Shin, Nam-Shik;Kwon, Soo-Wahn;Kim, Dae-Yong
    • 한국수의병리학회:학술대회논문집
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    • 한국수의병리학회 2001년도 추계학술대회 및 정기총회
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    • pp.25-25
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    • 2001
  • An example of lymphoblastic lymphosarcoma was diagnosed in a 7-year-old male brown bear (Ursus arctos) that died after having a 7-month history of depression, anorexia and watery diarrhea. Grossly the mesenteric lymph nodes were enlarged to approximately 4 to 6 times their normal size and histologically diagnosed as lymphoblastic lymphosarcoma. The small intestinal mucosa was corrugated and had severe mural thickening due to infiltrated neoplastic cells. Hepatic metastasis was also noted. the mother of this bear which died at the age of 20 also had similar gross changes on necropsy, but histological examination was not performed at that time and therefore the exact type of neoplasm remained to be determined. Since the daughter also died of neoplasm, genetic factor could be suspected in this family. This is the first reported case of lymphosarcoma in Ursidae in Korea. As an incidental finding, endogenous lipid pneumonia was noted in the lung.

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폐의 미세유두상 패턴을 보이는 선암종의 기관지세척 세포소견 - 짧은 증례보고 - (Pulmonary Adenocarcinoma with a Micropapillary Pattern Detected by Bronchial Washing - A Brief Case Report -)

  • 박재홍;하승연;조현이;정동해;김나래;박상희
    • 대한세포병리학회지
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    • 제19권2호
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    • pp.206-208
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    • 2008
  • Adenocarcinomas with micropapillary patterns are generally aggressive and show lymphotropism. Only a few reports on pulmonary adenocarcinoma with micropapillary patterns have described cytologic findings. A 70-year-old Korean woman was admitted to the hospital because of intermittent dry cough and chest pain. Cytology after bronchial washing showed neoplastic cells in small, angulated, cohesive clusters consisting of 3-20 cells without a fibrovascular core. The resected right middle lobe showed a tumor occupying almost the entire lobe. Histologically, about 90% of neoplastic cells proliferated with micro papillary morphology in the background of bronchioloalveolar carcinoma. Cytologic smears of a bronchial washing showing tumor cells in small, cohesive clusters without a fibrovascular core may indicate an adenocarcinoma with micropapillary pattern.

Correlation of Glasgow Prognostic Score or Procalcitonin to Clinical Variables in Patients with Pretreatment Lung Cancer

  • Kim, Young;Seok, Ji-Yoon;Hyun, Kyung-Yae;Lee, Gil-Hyun;Choi, Seok-Cheol
    • 대한의생명과학회지
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    • 제22권1호
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    • pp.9-17
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    • 2016
  • Unfortunately, the five-year survival rate of lung cancer is relatively low compared with other cancers. Therefore, better predictors are need for prognosis, therapeutic strategy, risk stratification and predicting long-term mortality of lung cancer. Recently, increasing data suggest that Glasgow Prognostic Score (GPS) and procalcitonin levels are useful predictor cancer prognosis. In this study, we retrospectively investigated the correlation of GPS or procalcitonin to clinical variables in patients with pretreatment lung cancer. In 135 patients with pretreatment lung cancer, GPS, procalcitonin, demographic characteristics, hematological, coagulation, biochemical, inflammatory and cardiac markers were measured. Monocyte, eosinophil, basophil, neutrophil to lymphocyte ratio, red cell distribution width (RDW), platelet to lymphocyte ratio, mean platelet volume to platecrit ratio, D-dimer and prothrombin time (PT) levels were higher, whereas mean platelet volume was lower than their normal ranges. Glucose and sodium levels were low, whereas gamma glutamyl transferase (GGT), total bilirubin, creatinine and inorganic phosphorus concentrations were increase compared their normal ranges. Procalcitonin, high sensitivity C-reactive protein and troponin-I concentrations were elevated compared with their normal ranges. GPS had significantly positive or negative relations to cancer stage, hematological, coagulation, biochemical, inflammatory and troponin-I. Based on the data, we suggest that GPS may be a potent and useful predictor for prognosis, therapeutic strategy, risk stratification and predicting long-term mortality of lung cancer.

십이지장으로 전이된 폐선암 1예 (A Case of Duodenal Metastasis from Adenocarcinoma of the Lung)

  • 유승현;심윤수;이진화;심기남;장중현;김윤경;성순희
    • Tuberculosis and Respiratory Diseases
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    • 제63권3호
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    • pp.283-288
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    • 2007
  • 원발성폐암의 위장관 전이, 특히 십이지장으로의 전이는 매우 드물며, 부검에서 발견되는 경우가 더 많다. 본 증례의 58세 남자는 왼쪽 등의 통증과 흉부 X-선 촬영에서 좌상엽에 종괴로 의뢰되어 경기관지폐생검 결과 폐선암을 진단 받았으며, 이후 소화불량과 상복부불편감을 호소하여 시행한 위내시경 결과 십이지장 팽대부의 점막 돌출을 발견하여 이에 대한 조직검사에서 폐선암의 십이지장 전이로 밝혀졌다.

폐 재이식 증례 보고; 폐이식 만성거부 반응의 치료 (A Case Report on Redo Lung Transplantation for Treating Chronic Pulmonary Graft Rejection)

  • 함석진;백효채;이두연;임범진;김관욱;유우식
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.734-738
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    • 2010
  • 약 10년전 아이젠멩거 증후군으로 양측 폐이식을 시행받은 43세 여자 환자가 서서히 진행되는 호흡 곤란을 주소로 내원하였다. 환자는 폐이식 후 발생하는 만성거부반응인 폐쇄세기관지염 증후군으로 진단받고 경과 관찰 하였으나 내과적 치료에도 반응이 없이 계속 악화되어 인공 호홉기에 의존하는 상태에서 재폐이식 수술을 시행 받았다. 저자들은 폐이식 후 만성거부반응을 보이는 환자에서 국내 최초로 재폐이식을 시행하였기에 보고하는 바이다.

Keratinization of Lung Squamous Cell Carcinoma Is Associated with Poor Clinical Outcome

  • Park, Hye Jung;Cha, Yoon-Jin;Kim, Seong Han;Kim, Arum;Kim, Eun Young;Chang, Yoon Soo
    • Tuberculosis and Respiratory Diseases
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    • 제80권2호
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    • pp.179-186
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    • 2017
  • Background: Although the World Health Organization (WHO) classification of lung squamous cell carcinoma (SCC) was revised in 2015, its clinical implications for lung SCC subsets remain unclear. We investigated whether the morphologic characteristics of lung SCC, including keratinization, were associated with clinical parameters and clinical outcome of patients. Methods: A total of 81 patients who underwent curative surgical resection of diagnosed lung SCC, were enrolled in this study. Attributes such as keratinization, tumor budding, single cell invasion, and nuclear size within the tumor, as well as immunohistochemistry of Bcl-xL and pS6 expressions, were evaluated. Results: The keratinizing and nonkeratinizing subtypes did not differ with respect to age, sex, TNM stage, and morphologic parameters such as nuclear diameter, tumor budding, and single cell invasion at the tumor edge. Most patients with the keratinizing subtype (98.0%) had a history of smoking, whereas the nonkeratinizing group had a relatively higher proportion of never-smokers relative to the keratinizing group (24.0% vs. 2.0%; p=0.008, chi-square test). Expression of pS6 (a surrogate marker of mammalian target of rapamycin complex 1 [mTORC1] signaling that regulates keratinocyte differentiation), and Bcl-xL (a key anti-apoptotic molecule that may inhibit keratinization), did not correlate significantly with the presence of keratinization. Patients with the keratinizing subtype had a significantly shorter overall survival (85.2 months vs. 135.7 months, p=0.010, log-rank test), and a multivariate analysis showed that keratinization was an independent, poor prognostic factor (hazard ratio, 2.389; 95% confidence interval, 1.090-5.233; p=0.030). Conclusion: In lung SCC, keratinization is associated with a poor prognosis, and might be associated with smoking.