• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.188-192
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• 2004

Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.487-496
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• 2005

Background : 'Major pulmonary thromboembolism' is defined as right ventricular (RV) dysfunction, with or without shock, accompanied by significant morbidity and mortality. In this study, those with major pulmonary thromboembolism were divided into the shock and RV dysfunction only groups, and then investigated the mortality and complications in thrombolysis or anticoagulation, respectively. Methods : In a retrospective study, between January 1995 and December 2004, 60 eligible patients with a major pulmonary thromboembolism, admitted in Asan Medical Center, were included. Results : A total of 57 patients were treated with medical therapy. Thrombolysis was performed in 13 patients (23%) and anticoagulation in 44 (77%). There were no differences in the APACHEII and SOFA scores between the two groups. 6 (46%) and 11 (25%) patients died in the thrombolysis and anticoagulation groups, respectively (p=0.176). In the 19 patients (33%) showing shock, thrombolysis was performed in 9 (47%) and anticoagulation in 10 (53%). 4 (44%) of the 9 patients treated with thrombolytic agents and 3 (30%) of the 10 treated with anticoagulants died (p=0.650). In the 38 patients (67%) showing RV dysfunction only, thrombolysis was performed in 4 (11%) and anticoagulation in 34 (89%). 2 (50%) of the 4 patients treated with thrombolytics and 8 (24%) of the 34 treated with anticoagulants died (p=0.279). Three patients (23%) who underwent thrombolysis had a major bleeding episode, compared with 2 (5%) who were treated with anticoagulants (p=0.072). Conclusion: The results of our study showed that thrombolysis did not lower mortality and tended to increase major bleeding compared with anticoagulation in both the shock and RV dysfunction only groups. Further evaluation of the efficacy and safety of thrombolytic therapy for major thromboembolism appears warranted in Korea.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.288-293
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• 2002

A 32-year-old woman presented with cough and hemoptysis. The radiologic findings showed increased interstitial markings in the right lung, a slightly decreased lung volume in the RLL and a hypoplastic right pulmonary artery with collaterals in the mediastinum and subpleural area. The pulmonary angiography showed an abrupt occlusion of the right lower pulmonary artery. The echocardiographic findings indicated pulmonary hypertension. A doppler leg ultrasonograph disclosed that the left popliteal vein was occluded with collateral veins, not filling the defect in the venous lumen. The D-dimer increased 1.0 ug/ml. This condition was initially misdiagnosed as a congenital pulmonary artery agenesis. Finally, a chronic pulmonary thromboembolism with a deep vein thrombosis was confirmed.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.569-572
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• 1996

A sixty nine-year-old mate patient was admitted with a chief complaint of exertional dyspnea. Lung perfusion scan revealed total perfusion defect of the of left lung and CT anglography showed the ab- rupt cutoff left pulmonary artery. He denied of trauma history, previous lower leg symptom and sign, or any embolic history. With the impression of chronic pulmonary thromboembolism of unknown etiology, operation was done under the cardiopulmonary bypass through a median sternotomy. After main pulmonary artery clamping and pulmonary arteriotomy, thromboembolectomy was done. Postoperative lung perfusion scan and CT angiography showed near normal left pulmonary blood flow. The patient was discharged on the postoperative 9th day without any postoperative complication.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.3
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• pp.577-583
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• 2002

Experimental studies were done to research the Clinical effects of Insambakhab-tang on the Anti-allergic effect and pulmonary function of O₃ intoxicated Mice. Anti-allergic effect experiment consisted of vascular permeability responses to intradermal histamine and serotonin, 48hrs homologous passive cutaneous anaphylaxis provoked by the IgE-like antibody against egg white albumin, and delayed type hypersensitivity responses to Picryl Chloride and SRBC. Pulmonary function of O₃ intoxicated Mice experimental consisted of pulmonary thromboembolism (Sodium Arachidonate-induced and ADP-induced), lung TBA value, and serum Na/sup +/, K/sup +/, Cl/sup +/ level. The results obtained as follows; 1. In the effects of Insambakhab-tang on the pulmonary thromboembolism by Sodium Arachidonic acid and ADP, Insambakhab-tang group revealed significant effect. 2. In the effects of Insambakhab-tang on the vascular permeability responses to intradermal histamine, Insambakhab-tang group revealed significant effect. 3. In the effects of Insambakhab-tang on the vascular permeability responses to intradermal serotonine, Insambakhab-tang group revealed significant effect. 4. In the 48hrs homologous passive cutaneous anaphylaxis provoked by the IgE-like antibody against egg white albumin, Insambakhab-tang group revealed significant effect. 5. In the delayed type hypersensitivity responses to Picryl Chloride, Insambakhab-tang group revealed significant effect. 6. Insambakhab-tang group revealed significant effect on decrease of the lung TBA value of lung. 7. In the effects of Insambakhab-tang on Serum Na/sup +/, K/sup +/ Level in O₃-intoxicated Mice. Insambakhab-tang group revealed none significant effect, but In the effects of Insambakhab-tang on Serum Cl/sup +/ Level in O₃-intoxicated Mice, Insambakhab-tang group revealed significant effect.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.25-28
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• 2016

Nephrotic syndrome is associated with a hypercoagulable state, which results in thromboembolism as one of its main complications. Various pathogenetic factors that cause the hypercoagulable state in nephrotic syndrome have been recognized. We report on a 19-year-old female with a minimal-change disease who developed pulmonary thromboembolism combined with intracardiac thrombus while on tapering steroid. Our patient showed hypoalbuminemia with an episode of shock, and was successfully treated with thrombolysis and anticoagulation therapy.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.540-547
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• 2006

Background : Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism. Methods : Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared. Results : The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively. Conclusion : This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.

• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.6-12
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• 2009

Background: The efficacy of several thrombolytic agents for treating massive pulmonary thromboembolism (PTE) has been reported to be similar. However, the difference of the bleeding complications caused by two commonly used thrombolytic agents in PTE patients is not well known. The aim of this study was to compare the therapeutic efficacy and the bleeding complications between urokinase and recombinant tissue-type plasminogen activatior (rt-PA, alteplase) in a Korean medical center. Methods: We retrospectively reviewed the clinical data of the patients who were treated with thrombolytic agents (urokinase and alteplase) because of massive PTE. Results: A total of 40 patients were included: 16 (40%) treated with urokinase and 24 (60%) with alteplase. The patients treated with alteplase showed a shorter duration of using vasopressor agents than did the patients who were given urokinase, but the duration of mechanical ventilation, the length of the ICU stay and the hospital stay were not different between the thrombolytic agents. Five patients treated with urokinase and eight patients treated with alteplase died (p=0.565): One patient in the urokinase group and four patients in the alteplase group died due to pulmonary thromboembolism. Bleeding complications after thrombolysis were observed in 3 patients (7.5%) treated with urokinase and in 11 (27.5%) patients treated with alteplase (p=0.079). Major bleeding complication occurred in 2 patients who were treated with alteplase. Conclusion: Urokinase seems to have fewer bleeding complications with an equivalent efficacy, as compared to alteplase, in Korean patients who suffer with massive pulmonary thromboembolism.

• Journal of Digestive Cancer Research
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• v.11 no.2
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• pp.108-113
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• 2023

Dyspnea is a common symptom among patients with gastrointestinal cancer, and a comprehensive evaluation of their respiratory function is essential. Self-reporting aids in the assessment of the degree of dyspnea, while objective examination methods are performed to identify the potential underlying causes when subjective symptoms are present. Standard treatment protocols should be followed for potentially reversible and common causes of dyspnea, such as pleural effusion, pneumonia, airway obstruction, anemia, asthma, exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, or drug-induced interstitial lung disease. Careful and close monitoring is required due to the high frequency of pulmonary thromboembolism and the risk of cardiovascular accidents, drug-induced interstitial lung disease, or other complications from some anticancer drugs. In case of hypoxemia with an oxygen saturation of 90% or less, palliative treatment should comprise standard oxygen therapy such as nasal cannula, mask, or high-flow nasal cannula. If non-pharmacological oxygen therapy is not effective, pain control through systemic narcotic analgesics and anti-anxiety therapy with benzodiazepines may be helpful.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.429-439
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• 2003