• Tuberculosis and Respiratory Diseases
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• v.53 no.2
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• pp.173-182
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• 2002

Background : Nontuberculous mycobacteria (NTM) have usually been considered to be contaminants of colonizers when isolated from respiratory specimens in Korea, where there is a high prevalence of tuberculosis and a low rate of HIV infections. Therefore, there has been few studies on the clinical significance of NTM species in immunocompetent patients were investigated. Methods : Thirty-five NTM isolates, for which species identification was requested by the treating physicians during 1999 at the Asan Medical Center, were retrospectively analyzed. They were identified to the species level by mycolic acid analysis using high-performance liquid chromatography. The medical records of the patients with the NTM isolates were reviewed to identify those patients who met the American Thoracic Society (ATS)'s criteria for mycobacterial pulmonary infection. Their antimicrobial susceptibility data were compared with the clinical outcomes. Results : The NTM were identified as M. intracellulare (6 isolates), M. avium (5), M. abscessus (5), M. gordonae (5), M. terrae complex (4), M. szulgai (2), M. kansasii (2), M. fortuitum (2), M. peregrinum (1), M. mucogenicum (1), M. celatum (1), and M. chelonae (1). All 35 patients showed clinical symptoms and signs of chronic lung disease, but none had a HIV infections; 16 (45.7%) patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria, 5 and 4 cases were affected with M. intracellulare and M. abscessus, respectively; 8 patients had a history of pulmonary tuberculosis. 13 patients received antimycobacterial therapy for an average of 21 months and 9 patients were treated with second-line drugs. Only 4 patients had improved radiologically. Conclusion : A NTM should be considered a potential pathogen of pulmonary infections in immunocompetent patients with chronic pulmonary diseases. Most NTM infections were left untreated for a prolonged period and showed a poor outcome as a result, M. intracellulare and M. abscessus were the two most frequent causes of NTM pulmonary infections in this study. Species identification and antimycobacterial susceptibility tests based on the species are needed for the optimum management of a NTM pulmonary infection in patients.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.145-148
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• 2014

Here, we present a rare case of cardiac parasitic infection found in an adult female patient who had the symptoms of dyspnea upon exertion. She was diagnosed with a double-chambered right ventricle due to infundibular hypertrophy confirmed by transthoracic echocardiography and cardiac computed tomography. We performed surgery of infundibulectomy around the pulmonary valve. In the end, histopathological findings of the resected infundibular muscle demonstrated trichinellosis, a type of roundworm infection.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.246-253
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• 1998

Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safety of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had signs and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were as follows: 1) A total 30 patients were enrolled in the trial. Among them, 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), or lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria by Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggested that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.397-404
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• 2011

Background: To evaluate chest CT findings of pandemic influenza A/H1N1 pneumonia without co-infection. Methods: Among 56 patients diagnosed with pandemic influenza A/H1N1 pneumonia, chest CT was obtained in 22 between October 2009 and Februrary 2010. Since two patients were co-infected with bacteria, the other twenty were evaluated. Predominant parenchymal patterns were categorized into consolidation, ground glass opacity (GGO), and mixed patterns. Distribution of parenchymal abnormalities was assessed. Results: Median age was 46.5 years. The CURB-65 score, which is the scoring system for severity of community acquired pneumonia, had a median of 1. Median duration of symptoms was 3 days. All had abnormal chest x-ray findings. The median number of days after the hospital visit that Chest CT was performed was 1. The reasons for chest CT performance were radiographic findings unusual for pneumonia (n=13) and unexplained dyspnea (n=7). GGO was the most predominant pattern on CT (n=13, 65.0%). Parenchymal abnormalities were observed in both lungs in 13 cases and were more extensive in the lower lung zone than the upper. Central and peripheral distributions were identified in ten and nine cases, respectively. One showed diffuse distribution. Peribronchial wall thickening was found in 16 cases. Centrilobular branching nodules (n=7), interlobular septal thickening (n=4), atelectasis (n=1), pleural effusion (n=5), enlarged hilar and mediastinal lymph nodes (n=6 and n=7) were also noted. Conclusion: Patchy and bilateral GGO along bronchi with predominant involvement of lower lungs are the most common chest CT findings of pandemic influenza A/H1N1 pneumonia.

• Tuberculosis and Respiratory Diseases
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• v.69 no.1
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• pp.43-47
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• 2010

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

• Tuberculosis and Respiratory Diseases
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• v.74 no.1
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• pp.7-14
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• 2013

Background: Fractional exhaled nitric oxide (FeNO) can be measured easily, rapidly, and noninvasively for the assessment of airway inflammation, particularly mediated by eosinophil, such as asthma. In bronchiectasis (BE), the pathogenesis has been known as chronic airway inflammation and infection with abnormal airway dilatation; however, there are little studies to evaluate the role of FeNO in BE. Methods: From March 2010 to February 2012, 47 patients with BE, diagnosed by high resolution computed tomography (HRCT), performed FeNO, compared with asthma and chronic obstructive pulmonary disease (COPD). All patients carried out a complete blood count including eosinophil count, chemistry, sputum examination, and spirometry, if indicated. A retrospective analysis was performed to elucidate the clinical role of FeNO in BE patients. Results: The mean FeNO levels in patients with BE was $18.8{\pm}1.5$ part per billion (ppb), compared to $48.0{\pm}6.4$ and $31.0{\pm}4.3$ in those with asthma and COPD, respectively (p<0.001). The FeNO levels tended to increase along with the disease severity scores by HRCT; however, it was statistically not significant. FeNO in BE with a co-infection of nontuberculous mycobacteria was the lowest at $17.0{\pm}3.5$ ppb among the study population. Conclusion: FeNO in BE was lower than other chronic inflammatory airway diseases, particularly compared with asthma. For clinical application of FeNO in BE, more large-scaled, prospective studies should be considered.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1022-1024
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• 2004

Pulmonary aspergillosis is the most common disease of fungal infection and has lower infectivity. Pulmonary asergillosis is classified by aspergilloma, bronchopulmonary aspergillosis, necrotic and invasive aspergillosis. Invasive aspergillosis is found in immune compromised host, immunosuppressive treatment after organ transplantation, anticancerous chemotherapy, blood abnormality, AIDS patients etc. We reported a case of invasive aspergillosis in an immunocompetent host, with review of literatures.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.229-233
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• 2001

The incidence of complications of measles is about 4% and most of the chief complications are in the respiratory system, such as pneumonia, bronchitis. One of other potential dangers of measles is exacerbation of an existing pulmonary tuberculosis. We report a case of exacerbated pulmonary tuberculosis in 15-year old male child after contracting measles during epidemic in year 2001.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1025-1029
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• 1992

We experienced eleven cases of pulmonary aspergllosis treated surgically in the period from 1981 to 1992. There were 5 men and 6 women, ranging in age from 28 to 64 years [mean age 40.4 years]. The most common chief complaint of the patients was hemoptysis and blood tinged sputum[7 cases, 63.6%], On preoperativechest film, the case of cavity with fungus ball[7 cases] and only cavity[4 cases] were seen. The location of the lesion were both upper lobe[6 cases] and lower lobe[5 cases]. The underlying disease were tuberculosis[5 cases], bronchiectasis[2 cases], tuberculosis and bronchiectasis[1 case], pneumonia[1 case] and none[2 cases]. The operative procedures of pulmonary aspergillosis were lobectomy[8 cases], cavernostomy[1 case] and thoracoplasty[2 cases]. The postoperative complications were postoperative massive bleeding[reoperation, 2 cases], wound infection[2 cases] and no operative mortality.

• Journal of environmental and Sanitary engineering
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• v.3 no.1 s.4
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• pp.1-8
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• 1988

It has been reported that the pulmonary mycosis generally results from saprophytic colonization of pre-existing lung cavities usually due to pulmonary tuberculosis etc. Culture of homogenized tissues yield pure colony of slightly brown on the Sabouraud dextrose medium. The fungus was identified as the Scophulariopsis brevieaulis which had been rarely reported in pulmonary fungal infection. Histopathological examination of excised tissues revealed a chronic granulomatous inflammation and many branched hyphal mass. Susceptibility tests were tested with ketoconazole, griseofulvin, nystatin, and amphotericin B. Of these antifungal agents, ketoconazole and griseofulvin proved to be most effective and minimum inhibitory concentration was $10{\mu}g/ml,\;50 {\mu}g/ml$, respectively.