• Title/Summary/Keyword: Lung failure

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Coexisting Bronchogenic Carcinoma and Pulmonary Tuberculosis in the Same Lobe: Radiologic Findings and Clinical Significance

  • Young Il Kim;Jin Mo Goo;Hyae Young KIm;Jae Woo Song;Jung-Gi Im
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.138-144
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    • 2001
  • Objective: Bronchogenic carcinoma can mimic or be masked by pulmonary tuberculosis (TB), and the aim of this study was to describe the radiologic findings and clinical significance of bronchogenic carcinoma and pulmonary TB which coexist in the same lobe. Materials and Methods: The findings of 51 patients (48 males and three females, aged 48-79 years) in whom pulmonary TB and bronchogenic carcinoma coexisted in the same lobe were analyzed. The morphologic characteristics of a tumor, such as its diameter and margin, the presence of calcification or cavitation, and mediastinal lymphadenopathy, as seen at CT, were retrospectively assessed, and the clinical stage of the lung cancer was also determined. Using the serial chest radiographs available for 21 patients, the possible causes of delay in the diagnosis of lung cancer were analyzed. Results: Lung cancers with coexisting pulmonary TB were located predominantly in the upper lobes (82.4%). The mean diameter of the mass was 5.3 cm, and most tumors (n=42, 82.4%) had a lobulated border. Calcification within the tumor was seen in 20 patients (39.2%), and cavitation in five (9.8%). Forty-two (82.4%) had mediastinal lymphadenopathy, and more than half the tumors (60.8%) were at an advanced stage [IIIB (n=11) or IV (n=20)]. The average delay in diagnosing lung cancer was 11.7 (range, 1-24) months, and the causes of this were failure to observe new nodules masked by coexisting stable TB lesions (n=8), misinterpretation of new lesions as aggravation of TB (n=5), misinterpretation of lung cancer as tuberculoma at initial radiography (n=4), masking of the nodule by an active TB lesion (n=3), and subtleness of the lesion (n=1). Conclusion: Most cancers concurrent with TB are large, lobulated masses with mediastinal lymphadenopathy, indicating that the morphologic characteristics of lung cancer with coexisting pulmonary TB are similar to those of lung cancer without TB. The diagnosis of lung cancer is delayed mainly because of masking by a tuberculous lesion, and this suggests that in patients in whom a predominant or growing nodule is present and who show little improvement of symptoms despite antituberculous or other medical therapy, coexisting cancer should be suspected.

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clinical evaluation of chest trauma (흉부손상에 대한 임상적 고찰)

  • 문경훈
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.123-133
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    • 1989
  • A clinical evaluation was done on 182 cases of chest trauma which experienced at the Department of Thoracic and Cardiovascular Surgery, National Medical Center, from Sep. 1980 to Dec. 1987. 1] Of 182 cases, 125 cases resulted from non-penetrating chest trauma and 57 cases from penetrating wound. 2] The ratio of male to female was 4.87:1, and age groups between 3rd and 6th decade were 71.9%. 3] The most common causes of chest trauma were traffic accident in non-penetrating and stab wound by knife in penetrating cases. 4] Left thorax was the preferred site of chest injury. 5] The incidences of hemothorax, pneumothorax, and hemopneumothorax were 69.6% in non-penetrating and 91% in penetrating. 6] Rib fractures between 4th rib and 8th rib were 68.8% of total rib fracture cases and left side was preferred site. 7] Methods of treatment were conservative management in 24.7%, closed thoracostomy in 54.9%, open thoracotomy in 14.3%, and etc. 8] The incidence of complications, were 11.5% of total cases, and they were atelectasis [8 cases], empyema [3 cases], pneumonia [3 cases], acute renal failure [2 cases], lung abscess [1 case], and etc. 9] The overall mortality was 6%, and causes of death were hypovolemic shock, renal failure, hepatic failure, respiratory failure, septic shock, and etc.

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Polymorphisms of Cytochrome P450 2E1 Gene in Korean Patients with Renal Failure

  • Yoo, Min
    • Biomedical Science Letters
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    • v.19 no.4
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    • pp.310-314
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    • 2013
  • CYP2E1 in the liver has been studied intensively because it is involved in the metabolic activation of xenobiotics. It is inducible by alcohol, so it has been suspected as the cause of cancer in the stomach and lung. The possible role of CYP2E1 has been suggested strongly as causing tissue damage in mice with renal failure. It was also suspected that 5'-flanking region of CYP2E1 gene might be involved with renal failure. So, we investigated polymorphism of restriction enzyme sites within CYP2E1 gene using the PCR-RFLP analysis. PstI and RsaI sites were located at 5'-flanking region and DraI site was located at intron 6. All three types (W/W, W/S, S/S) were observed for these enzymes although each incidence was somewhat different depending the enzyme sites. W/W was prominent for PstI whereas W/S was markedly high for RsaI. Overall, polymorphic incidence in patients was somewhat higher than normal population. This research should facilitate further investigation of CYP2E1 at genetic level as the direct cause of tissue damage in various organs.

Serum Leakage Control using PP/PDMS Composite Membrane (PP/PDMS 복합막을 이용한 혈청누출 제어)

  • 김기범;이삼철;정순량;정경락
    • Membrane Journal
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    • v.10 no.1
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    • pp.47-53
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    • 2000
  • The artificial lung is a device used to replace the function of the lungs. The major function of the lung is to remove carbon dioxide from the venous blood and replace it with oxygen, or arterialize the blood. And the function of the artificial lung is to provide an adequate amount of oxygenated blood to all the tissues of body during the open heart surgery. Extracorporeal life support(ECLS or ECMO) is standard treatment for severe respiratory failure but poses many contributions to future lung transplantation. Artificial Lung or membrane oxygenators available today, based on microporous polypropylene fibers, are associated with two major problems. They require systemic anticoagulation of the patient and they allow serum leakage across the membrane from the blood side to the gas side during long-term use. We obtained newly fabricated polypropylene(PP)/polydimethylsiloxane(PDMS) membranes which combined PP membrane, a microporous support layer with PDMS, and we had investiaged a technique for minimizing serum lekage of polypropylene(PP) membrane. The gas permeability of each PP/PDMS membrane was almost constant before and after the whole blood test by Lee-White method, while that of PP membrane was significantly reduced. Therefore the PP/PDMS membrane could be prevented serum leakage of PP membrane. In addition, the gas permeability of $CO_2$ in PP/PDMS membrane was 11.5 times higher as compared with that of $O_2$.

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Pulmonary Infarction Associated with Fracture of Right Clavicle and Multiple Ribs (우측 쇄골 및 늑골골절과 동반된 폐경식 1례)

  • 김수성;이종임
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.941-944
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    • 1997
  • Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both l ng fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

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Effects of Increased Pulmonary Blood Flow Produced Bb Experimental left Pulmonary Artery Ligation on the Pulmonary Vascular Bed in Neonateal Goats (신생 염소에서 실험적 좌폐동맥 결찰술로 유발시킨 폐혈류량 증가가 폐혈관상에 미치는 영향)

  • 서경필
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1057-1066
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    • 1990
  • The possible relationship between pulmonary vascular pathologic changes and an increased pulmonary blood flow and pulmonary blood pressure has been the subject of investigation for many years. In an attempts to study the effects of increased pulmonary blood flow. long-term observations have been made in neonatal goats in which the total pulmonary vascular bed was restricted by means of ligation of left pulmonary artery, thereby diverting the total right ventricular output through the right lung. The left pulmonary artery and patent ductus arteriosus were ligated in 6 neonatal goats of under 3 weeks of age, and the goats were put to death at interval between 1 and 7 months of age. Pulmonary arterial development in both right and left lungs was studied by applying quantitative morphometric techniques, and compared with control group of goats between 1 and 6 months of age. The axial pulmonary artery and its branches were larger in the right lung than in the control group in all animals, and they were abnormally small in the left lung. In the right lung, arteries smaller than 50\ulcornerm showed abnormal increase in `% wall thickness’ in postoperative 2,3,5 and 6th months[p<0.05]. The proportion of non-muscular arteries was over 50% at postoperative 1st month in both right and left lungs, but an increase in proportion of partially muscular and wholly muscular arteries occurred thereafter. The ratio of alveoli/arteries was lower than normal in the right lung of postoperative 1st month[p<0.05], but was elevated thereafter. The failure to perfuse one pulmonary artery in neonatal goats changed growth and development of both lungs.

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AN EXPERIMENTAL STUDY FOR ESTABLISHMENT OF ORTHOTOPIC SALIVARY TUMOR MODELS IN MICE (마우스에서 타액선암 동위종양 모델 제작을 위한 실험적 연구)

  • Park, Young-Wook;Chung, Seong-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.81-93
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    • 2007
  • Purpose: Adenoid cystic carcinoma (ACC) is a relatively rare tumor that arises in glandular tissues of the head and neck region and sometimes has a protracted clinical course with perineural invasion and delayed onset of distant lung metastasis. Treatment failure of salivary ACC is most often associated with perineural and hematogenous tumor spread. However, very little has been known about the cellular and molecular mechanisms of perineural invasion and hematogenous distant metastasis of parotid ACC. This study was designed to develop an orthotopic tumor model of parotid adenoid cystic carcinoma in athymic nude mice. Experimental Design: A melanoma cell line was injected into the parotid gland of athymic mice to determine whether such implantation was technically feasible. A parotid ACC cell line was then injected into the parotid gland or the subcutaneous tissue of athymic mice at various concentrations of tumor cells, and the mice were thereafter followed for development of tumor nodule. The tumors were examined histopathologically for perineural invasion or regional or distant lung metastasis. We used an oral squmous cell carcinoma cell line as control. Results: Implantation of tumor(melanoma) cell suspension into the parotid gland of nude mice was technically feasible and resulted in the formation of parotid tumors. A parotid ACC cell line, ACC3 showed no significantly higher tumorigenicity, but showed significantly higher lung metastatic potential in the parotid gland than in the subcutis. In contrast, mucosal squmous cell carcinoma cell line doesn’t show significantly higher lung metastatic potential in the parotid gland than in the subcutis. The ACC tumor established in the parotid gland seemed to demonstrate perineural invasion of facial nerve, needs further study. Conclusion: An orthotopic tumor model of salivary ACC in athymic nude mice was successfully developed that closely recapitulates the clinical situations of human salivary ACC. This model should facilitate the understanding of the cellular and molecular mechanisms of tumorigenisis and metastasis of salivary ACC and aid in the development of targeted molecular therapies of salivary ACC.

A Case of Primary Lung Cancer Producing Alpha-fetoprotein (알파 태아단백을 분비하는 원발성 폐암 1예)

  • Yu, Ji-Hyun;Ahn, Joong-Hyun;Chung, Han-Hee;Kim, Young-Wook;Yu, Jin-Sok;Kim, Ju-Sang
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.1
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    • pp.72-76
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    • 2012
  • We observed a very rare case of primary lung cancer producing alpha-fetoprotein (AFP). A 70-year-old male with a history of smoking 50 packs per year was diagnosed with large cell carcinoma of the lung. The clinical stage was T2bN3M0 (IIIB), and serum AFP was 23,247 ng/mL. There was no evidence of metastasis to the liver, scrotum or other organs. While undergoing chemotherapy for 1 year, as the cancer progressed the AFP value steadily increased. The patient died of respiratory failure due to pneumonia 12 months after being diagnosed with lung cancer.

Therapeutic potential of targeting kinase inhibition in patients with idiopathic pulmonary fibrosis

  • Kim, Suji;Lim, Jae Hyang;Woo, Chang-Hoon
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.269-276
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    • 2020
  • Fibrosis is characterized by excessive accumulation of extracellular matrix components. The fibrotic process ultimately leads to organ dysfunction and failure in chronic inflammatory and metabolic diseases such as pulmonary fibrosis, advanced kidney disease, and liver cirrhosis. Idiopathic pulmonary fibrosis (IPF) is a common form of progressive and chronic interstitial lung disease of unknown etiology. Pathophysiologically, the parenchyma of the lung alveoli, interstitium, and capillary endothelium becomes scarred and stiff, which makes breathing difficult because the lungs have to work harder to transfer oxygen and carbon dioxide between the alveolar space and bloodstream. The transforming growth factor beta (TGF-β) signaling pathway plays an important role in the pathogenesis of pulmonary fibrosis and scarring of the lung tissue. Recent clinical trials focused on the development of pharmacological agents that either directly or indirectly target kinases for the treatment of IPF. Therefore, to develop therapeutic targets for pulmonary fibrosis, it is essential to understand the key factors involved in the pathogenesis of pulmonary fibrosis and the underlying signaling pathway. The objective of this review is to discuss the role of kinase signaling cascades in the regulation of either TGF-β-dependent or other signaling pathways, including Rho-associated coiled-coil kinase, c-jun N-terminal kinase, extracellular signal-regulated kinase 5, and p90 ribosomal S6 kinase pathways, and potential therapeutic targets in IPF.

Application of Extracorporeal Membranous Oxygenation in Trauma Patient with Possible Transfusion Related Acute Lung Injury (TRALI) (수혈 관련 급성 폐손상이 동반된 외상환자에서 체외막 산화기의 적용 경험)

  • Lee, Dae-Sang;Park, Chi-Min
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.34-38
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    • 2015
  • The case of a patient with a transfusion-related acute lung injury (TRALI) to whom extracorporeal membrane oxygenation (ECMO) had been applied is reported. A 55-year-old male injured with liver laceration (grade 3) without chest injury after car accident. He received lots of blood transfusion and underwent damage control abdominal surgery. In the immediate postoperative period, he suffered from severe hypoxia and respiratory acidosis despite of vigorous management such as 100% oxygen with mechanical ventilation, high PEEP and muscle relaxant. Finally, ECMO was applied to the patients as a last resort. Aggressive treatment with ECMO improved the oxygenation and reduced the acidosis. Unfortunately, the patient died of liver failure and infection. TRALI is a part of acute respiratory distress syndrome (ARDS). The use of ECMO for TRALI induced severe hypoxemia might be a useful option for providing time to allow the injured lung to recover.

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