• Title/Summary/Keyword: Pulmonary infection

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Mycobacterium avium Infection Presenting as Endobronchial Lesions in an Immunocompetent Patient (Mycobacterium avium에 의한 기관지 질환 1 예)

  • Lee, Jae Hee;Son, Kyung Sik;Park, Ji Hyun;Kim, Jun Chol;Lee, Hyun Woo;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.571-575
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    • 2006
  • Mycobacterium avium has been traditionally described as an opportunistic organism that causes disseminated disease in human immunodeficiency virus-positive patients and acts as a pulmonary pathogen in patients with underlying lung diseases such as chronic obstructive pulmonary disease or previously treated tuberculosis. Infections caused by M. avium in immunocompetent hosts usually manifest as 2 distinct subtypes, the upper lobe cavitary form and the nodular bronchiectatic form. However endobronchial lesions due to M. avium infections in immunocompetent host are reasonably rare, and there are no reports of this condition in Korea. We report here a case of endobronchial lesions involved in an M. avium infection in an immunocompetent 21 year-old female patient with no preexisting lung disease.

Clinical Analysis of Ventricular Septal Defect (심실중격결손증의 임상적 고찰)

  • 인강진
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.620-629
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    • 1989
  • A clinical analysis of 138 cases of ventricular septal defect operated on from 1983 to June 1988 at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Chung-nam National University was done. The following results were obtained. 1. The VSD were 27.6 % and 41.0 % respectively of 500 open heart surgery cases and 334 congenital heart disease. 2. The range of age when the VSD was repaired was 3 months to 45 years, the mean age was 10.4 years and the 53.6 % of patients were under 7 years. The sex ratio was 6:4 in males favor. 3. The two common symptoms were frequent upper respiratory infection and dyspnea whose frequency was 62.5 % and 58.7% respectively. 4. 52% of the patients was below 25 percentile of the standard body weight. 5. The most common chest PA findings were cardiomegaly and increased pulmonary vascularity. 6. On anatomical classification, perimembranous type was most common [65.5%], subpulmonary arterial type was 27.6 %, perimembranous plus subpulmonary arterial type was 3.4 % multiple VSD was 0.8 % and LV-RA defect was 2.6 %. 7. Associated cardiac anomalies were founded in 39 cases [35.5 %] and PDA and aortic valve prolapse were most common associated anomalies and extracardiac anomalies were founded in 6.7 % of patients. 8. Mean extracorporeal circulation time was 68 min. and mean aortic cross-clamping time was 42 min. 9. The postoperative complications developed in 26 % of patients and the most common one was minor wound infection. 10. Right bundle branch block developed in 54.8% of the patients who had right ventriculotomy, 40.0% of the patients who had right atriotomy and 10.5% of the patients who had pulmonary arteriotomy. 11. The overall operative mortality was 5.1 % and the operative mortality of the patients who body weigh under 10 Kg was 23.8%.

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Long term management of people with post-tuberculosis lung disease

  • Wan Seo;Hyung Woo Kim;Ju Sang Kim;Jinsoo Min
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.7-24
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    • 2024
  • Post-tuberculosis lung disease (PTLD) is emerging as a significant area of global interest. As the number of patients surviving tuberculosis (TB) increases, the subsequent long-term repercussions have drawn increased attention due to their profound clinical and socioeconomic impacts. A primary obstacle to its comprehensive study has been its marked heterogeneity. The disease presents a spectrum of clinical manifestations which encompass tracheobronchial stenosis, bronchiectasis, granulomas with fibrosis, cavitation with associated aspergillosis, chronic pleural diseases, and small airway diseases-all persistent consequences of PTLD. The spectrum of symptoms a patient may experience varies based on the severity of the initial infection and the efficacy of the treatment received. As a result, the long-term management of PTLD necessitates a detailed and specific approach, addressing each manifestation individually-a tailored strategy. In the immediate aftermath (0-12 months after anti-TB chemotherapy), there should be an emphasis on monitoring for relapse, tracheobronchial stenosis, and smoking cessation. Subsequent management should focus on addressing hemoptysis, managing infection including aspergillosis, and TB-associated chronic obstructive pulmonary disease or restrictive lung function. There remains a vast expanse of knowledge to be discovered in PTLD. This review emphasizes the pressing need for comprehensive, consolidated guidelines for management of patients with PTLD.

Superoxide Generation by Blood Monocyte and Pulmonary Alveolar Macrophage in Patients with Pulmonary Tuberculosis (폐결핵환자의 폐포대식세포 및 말초혈액내 단구세포에서 분비하는 과산화음이온의 비교 관찰)

  • Song, Jeong-Sup;Lee, Suk-Young;Jang, Jie-Jung;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.1
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    • pp.11-19
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    • 1994
  • Background: Mycobacterium tuberculosis is a facultative intracellular pathogen which persists and multiplies within macrophage. Competent cell mediated immunity by cooperation of both T lymphocyte and macrophage of the host is required to kill the Mycobacterium tuberculosis. But a precise understanding of the pathogenesis of tuberculosis infection in pulmonary alveolar macrophage has not been achived. Research on the macrophage's basic microbicidal mechanism has elucidated the importance of oxygen-dependent or oxygen-independent components. Oxygen dependent processing begins with the reduction of oxygen by NADPH oxidase and generation of superoxide. In this study, the oxidative metabolic status of blood monocyte and pulmonary alveolar macrophage in patients with active pulmonary tuberculosis was accessed and compared with that of healthy control subjects to know whether there was a basic difference in superoxide generation by mononuclear cells between two groups. Methods: Pulmonary alveolar macrophage was purified after performing BAL(bronchoalveolar lavage) through the bronchi of infected lesion by plastic adhesion method. Blood monocyte was purified by Ficoll-Hypaque method. Superoxide generation by blood monocyte and pulmonary alveolar macrophage was measured by ferricytochrome-C reduction method after either stimulated with PMA(phorbol myristate acerate) or non-stimulated states. We also measured the effect of pulmonary tuberculosis patient's serum on superoxide generation by monocyte. Results: 1) Generation of superoxide by alveolar macrophage obtained from patients with pulmonary tuberculosis was little higher than those of controls, and PMA enhanced the generation of 2) Generation of superoxide by blood monocyte obtained from patients with pulmonary tuberculosis was little higher than those of control(p>0.05), and PMA more enhanced the generation of superoxide in patientswith pulmonary tuberculosis than those in controls(p<0.02). 3) Patient's serum enhanced the generation of superoxide by blood monocyte obtained from patients with pulmonary tuberculosis and controls, but not in the case of PMA stimulated blood monocyte. Conclusion: The present study suggest that the phenomenon of M.tuberculosis escape the microbicidal action of macrophage was not result of suppressed superoxide generation by blood monocyte and pulmonary alveolar macrophage, rather there might be a factor to stimulate the generation of superoxide by blood monocyte in pulmonary tuberculosis patient serum, but the comparision with effect of control's serum on superoxide generation needs further elucidation.

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Microbiological and Pathological Features of Experimentally Induced Leptospirosis in Guinea Pigs (실험적으로 기니픽에 유발시킨 렙토스피라병에 대한 미생물학적 및 병리학적 연구)

  • Chang, Woo-Hyun;Kim, Ik-Sang;Lee, Woo-Kon;Park, Kyung-Hee;Lee, Jae-Ho;Chi, Je-Geun;Lee, Jung-Bin
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.2
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    • pp.211-226
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    • 1986
  • To understand the pathogenesis of anicteric leptospirosis with severe pulmonary hemorrhage occured in Korea, the microbiological and pathological features were observed in the experimentally induced leptospirosis in guinea pigs infected with a virulent strain of Leptospira interrogans isolated from the patient at Wonju, Korea, and the results are summarized as follows. 1. The main pathological features were widespread hemorrhages, especially affecting lung, skeletal muscles, retroperitoneal and perirenal adipose tissues. The hemorrhages accompanied inflammatory process especially of vasculitic pattern as well as occasional coagulation necrosis in the liver, skeletal muscle, and myocardium. The main inflammatory cells were of plasma cell even in the fairly early stage of the infection. 2. Those pathologic changes were more exaggerated in the inoculation site. 3. Within 144 hours of infection, the longer the infection time, the more antigens were observed in the tissues, and the severer the pathologic changes. 4. Leptospiral antigens were detected at first by indirect immunofluorescent and immunoperoxidase technics. As the infection time extended, the antigens were observed in all of the tissues examined except in the skeletal muscle. The shape of the antigens was spiral or thread-like within 72 hours of infection. As the infection progressed, they became fragmented and granular. 5. Leptospires were detected in the blood within 144 hours of infection by darkfield microscopic examination. Thereafter, none was observed. 6. Antibody to leptospires were detected as early as 72 hours of infection. In summary, the virulent strain of L. interrogans used in this experiment induced widespread hemorrhages with inflammatory reaction especially in lung, skeletal muscles, and retroperitoneal adipose tissue. With these findings, it is suggested that the direct toxic effect of leptospires might playa great role in the pathogenesis of this infection.

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Transcriptome sequencing reveals non-coding RNAs respond to porcine reproductive and respiratory syndrome virus and Haemophilus parasuis co-infection in Kele piglets

  • Jing Zhang;Chunping Zhao;Min Yao;Jing Qi;Ya Tan;Kaizhi Shi;Jing Wang;Sixuan Zhou;Zhixin Li
    • Journal of Animal Science and Technology
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    • v.66 no.4
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    • pp.663-681
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    • 2024
  • Co-infection with porcine reproductive and respiratory syndrome virus (PRRSV) and Haemophilus parasuis (HPS) has severely restricted the healthy development of pig breeding. Exploring disease resistance of non-coding RNAs in pigs co-infected with PRRSV and HPS is therefore critical to complement and elucidate the molecular mechanisms of disease resistance in Kele piglets and to innovate the use of local pig germplasm resources in China. RNA-seq of lungs from Kele piglets with single-infection of PRRSV or HPS and co-infection of both pathogens was performed. Two hundred and twenty-five differentially expressed long non-coding RNAs (DElncRNAs) and 30 DEmicroRNAs (DEmiRNAs) were identified and characterized in the PRRSV and HPS co-infection (PRRSV-HPS) group. Compared with the single-infection groups, 146 unique DElncRNAs, 17 unique DEmiRNAs, and 206 target differentially expressed genes (DEGs) were identified in the PRRSV-HPS group. The expression patterns of 20 DEmiRNAs and DElncRNAs confirmed by real-time quantitative polymerase chain reaction (RT-qPCR) were consistent with those determined by high-throughput sequencing. In the PRRSV-HPS group, the target DEGs were enriched in eight immune Gene Ontology terms relating to two unique DEmiRNAs and 16 DElncRNAs, and the unique target DEGs participated the host immune response to pathogens infection by affecting 15 immune-related Kyoto Encyclopedia of Genes and Genomes enrichment pathways. Notably, competitive endogenous RNA (ceRNA) networks of different groups were constructed, and the ssc-miR-671-5p miRNA was validated as a potential regulatory factor to regulate DTX4 and AEBP1 genes to achieve innate antiviral effects and inhibit pulmonary fibrosis by dual-luciferase reporter assays. These results provided insight into further study on the molecular mechanisms of resistance to PRRSV and HPS co-infection in Kele piglets.

The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

A Study on Nursing Needs and Respiratory Self-care Practice Degree in Elderly Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환 노인의 호흡기 자가간호 실천정도와 간호요구)

  • Noh, Hyun-Sook;Min, Hye-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.1
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    • pp.17-29
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    • 2003
  • This study investigated the degree of self-care practice to maintain the stable respiratory function and the required respiratory nursing needs upon the elderly with chronic obstructive pulmonary diseases. The research subjects were 115 elderly people over 60 years old, who were diagnosed to have chronic obstructive pulmonary diseases (the mixed type, chronic bronchitis, bronchial asthma, emphysema) and were hospitalized in 3 university hospitals in Busan or treated as outpatient, and the data was collected over the period between June 1, 2002 and September 30, 2002. In order to measure the respiratory self-care practice degree and nursing needs of the subjects, the instrument on the self-care practice and the instrument on nursing needs were developed by the researcher. The research results are as follows: 1. The mean of respiratory self-care practice degree by the subjects was 2.41 out of 4 for each clause, and the degree of practicing general management was the highest(2.70), and nutrition control(2.66), respiratory exercise(2.65), expectoration of sputum (2.63), oxygen therapy(2.60), environment control(2.50), and medication control(2.36) succeeded. 2. The degree of self-care practice had a significant difference depending on age(F=2.82, P=0.02), frequency of hospitalization(F=3.11, P=0.01), and diagnosed disease(F=15.66, P=0.00). 3. The subjects nursing needs of respiratory system were 3.07 on the average out of 4.00, and 'I want to know how to prevent the infection of respiratory system such as cold scored the highest 3.83, while the clauses like 'want to know how to face the respiratory disorder properly'(3.77) and 'want the specific explanation of the symptoms of my disease'(3.66) also had scored high points. 4. The nursing needs of the respiratory system had a significant difference depending on diagnosed disease such as mixed type of chronic obstructive pulmonary diseases, emphysema, bronchitis, and asthma (F=6.70, P=0.00). The research showed that the subjects degree of self-care practice of respiratory system was low on the whole, while the nursing needs for managing respiratory organ were relatively high. Therefore, specific education concerning the nursing of the disease and self-care upon the elderly having chronic obstructive pulmonary disease is necessary.

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Diffuse Pulmonary Nodular Lesions Persisting for 5 Years (5년간 지속된 미만성 폐결절)

  • Kim, Kyung-Kyu;Kim, Byung-Kyu;Jeong, Ki-Hwan;Jeong, Hye-Cheol;Kim, Je-Hyeong;Park, Sang-Myen;Lee, Sin-Hyung;Shin, Chol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa;Oh, Yu-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.802-807
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    • 2000
  • Diffuse pulmonary nodular lesions have many causes. When they are caused by infection, the likely organisms are M. tuberculosis and various fungi. Silicosis, eosinophilic granuloma and pulmonary metastasis should be considered for differential diagnosis. Differential diagnosis needs detailed clinical history, physical examination and various laboratory tests. A case of persistent diffuse pulmonary nodular lesions which had persisted 5 years is reported. The patient was a 25 years old man with minimal pulmonary symptoms. Detailed past history and physical examination suggested thyroid tumor. Chest radiography showed numerous evenly sized well-defined nodules scattered in entire lung fields. Previous chest X-rays showed similar nodular lesions, which had lasted for 5 years. The number of nodules was slightly increased. Neck CT showed heterogenous mass in left lobe of thyroid gland and multiple lymphadenopathies along both internal jugular chains. Total thyroidectomy was performed. A case of lung metastasis which progressed slowly in papillary thyroid cancer is reported.

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A Case of Pulmonary Sequestration Treated with Arterial Embolization (동맥색전술로 시술한 폐격리증 1예)

  • Lee, Gun-Wha;Kim, Dong-Kyun;Na, Hyun-Sik;Bae, Jun-Yong;Choi, Jun-Ho;Kim, Yang-ki;Kim, Ki-up;Uh, Soo-taek;Kim, Dong-hoon;Hwang, Jung Hwa;Goo, Dong-Erk
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.68-73
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    • 2005
  • Pulmonary sequestration is a very rare congenital malformation in which a mass of pulmonary tissue is detached from the normal lung and receives its blood supply from a systemic artery. It may be clinically asymptomatic or it has a wide spectrum of various clinical manifestations. The clinical therapeutic approach is to resect the sequestered lobe to prevent frequent complication such as infection. The arterial embolization of feeding artery is a new technique and a less invasive treatment than conventional surgical removal. We have experienced a 17-year-old male with pulmonary sequestration whose complaints were pain in left lower chest. He was diagnosed by computed tomography and aortography and successfully treated with embolization of feeding artery. We report a case of pulmonary sequestration treated with arterial embolization instead of surgery.