• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.779-785
• /
• 1996

Wegener's granulomatosis is characterized by necrotizing granulomatous vasculitis affecting upper and lower respiratory tracts and kidneys. Vascular lesions commonly involve capillaries and small vessels but, less commonly larger vessels. We report a 46-year-old male patient of Wegener's granulomatosis associated with paranasal sinusitis, pulmonary consolidations, glomerulonephritis, skin lesions with obstruction of both anterior tibial and peroneal arteries. Several necrotic lesions of the toes had progressed to gangrene and both transmetatarsal amputations were done. The patient continued to receive cyclophosphamide and prednisolone.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.2
• /
• pp.197-202
• /
• 2012

Microscopic polyangiitis is a necrotizing vasculitis, characterized by inflammation of small vessels (capillaries, venules, and arterioles) with few or no immune deposits. The kidneys are the most commonly affected organs and are involved in 90% of patients, whereas pulmonary involvement occurs in a minority of cases (10% to 30%). In cases of lung disease, diffuse alveolar hemorrhage with pulmonary capillaritis is the most common manifestation. Microscopic polyangiitis is strongly associated with antineutrophil cytoplasmic autoantibody, which is a useful diagnostic serological marker. We report a case of microscopic polyangiitis presented as pleural effusion in a 67-year-old female. Pleural effusions have been reported in some cases previously, but the number of cases were small and their characteristics have not been well described. This report describes characteristic findings of pleural fluid and its histological features in a case of microscopic polyangiitis.

• Journal of Chest Surgery
• /
• v.31 no.6
• /
• pp.624-628
• /
• 1998

Postpneumonectomy syndrome is a rare and delayed complication of left pneumonectomy in most patients with normal mediastinal vascular anatomy. This syndrome is characterized by dyspnea and recurrent pulmonary infection in the remaining right lung that typically occur within the first postoperative year. The condition is believed to be secondary to postsurgical changes that include a marked shift of the mediastinum to the left, clockwise rotation of the heart and great vessels, and herniation of the right lung into the left anterior thorax. These changes lead to compression of the trachea or right main bronchus among the thoracic spine and the right pulmonary artery. We report a case of postpneumonectomy syndrome in 15 year-old girl that followed by left pneumonectomy for bronchiectasis 6 years ago. We have inserted an expandable prosthesis in the left thoracic cavity posterior to the heart. After implantation of an expandable prosthesis, an anatomic reposition of the shifted mediastinum was achieved, which resulted in instantaneous and sustained relief. The post-operative course was uneventful and the patient was followed in OPD from after discharge to now.

• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.407-415
• /
• 1990

A total of 69 patients were treated for congenital lung cysts at Seoul National University Hospital during the period between 1960 and Aug, 1989. They were 37 patients of bronchogenic cyst, 18 patients of pulmonary sequestration, 7 patients of congenital cystic adenomatoid malformation [C.C.A.M.], and 7 patients of congenital lobar emphysema. In cases of bronchogenic cyst, involved age was variable from 7 months to 53 years and most cases were asymptomatic. They were located 14 cases in the right lung, 6 cases in the left lung and 17 cases in the mediastinum. Their sizes were also variable from 2.5 to 12 cm and most of them except 3 cases were solitary cysts. There were 6 cases that had bronchial communication. In cases of pulmonary sequestration, aged from 3 months to 29years, all were intrapulmonary type. 15 cases of them were found in the left lower field and 3 cases in the right lower field. Anomalous vessels were confirmed in 16 cases by aortography and/or surgical exploration. In cases of congenital cystic adenomatoid malformation, aged from 7 days to 6 years, 3 cases of infants were admitted due to severe dyspnea and cyanosis but the remaining 4 cases were admitted due to large cyst or abscess on chest roentgenogram. 3 cases were located in the right lung and 4 cases in the left lung. In cases of congenital lobar emphysema, aged from 14 days to 11 years, 6 cases were located in the right lung and one case was located in the left lung. All of them were male and had shown some degree of dyspnea from birth There were 2 cases of mortality, one in C.C.A.M and one in congenital lobar emphysema. But the remaining cases were well treated and recovered with the surgical resections.

• Journal of Veterinary Clinics
• /
• v.25 no.2
• /
• pp.102-105
• /
• 2008

The most common abnormality of the umbilicus in the foal is the patent urachus. Patent urachus may be a congenital or acquired condition in foals in which the urachus fails to close spontaneously at or shortly after parturition. A 17-day-old male Thoroughbred foal was requested to the Veterinary Pathology Laboratory of Cheju National University. The foal showed clinical signs such as umbilical urination, anorexia, depression, lethargy, and abdominal pain for 10 days. Because of the umbilical urination, the surgery for patent urachus was performed, but he died next day. Grossly, many pale yellowish foci 10-20 mm in diameter were scattered on the throughout surface of lungs. Severe subcapsular hemorrhage was observed in left kidney. Large milky yellow mass 10X6-7 cm in size was found in the adjacent area of right kidney. Histopathologically, many abscesses with bacterial cocci were scattered in the blood vessels or adjacent pulmonary parenchyma of lungs. Severe numerous abscesses with intralesional bacterial cocci were mostly occupied in the abdominal mass from right kidney. Gram staining for tissue sections demonstrated numerous Gram positive cocci in pulmonary and abdominal abscesses. In bacterial culture, catalase-positive beta-hemolytic colonies were isolated and confirmed as Staphylococcus (S.) aureus by Vitek system. Based on the results, acquired patent urachus and then multiple abscesses may be originated from the umbilical cord infected with S. aureus in this foal.

• Journal of Chest Surgery
• /
• v.37 no.9
• /
• pp.727-734
• /
• 2004

The Lecompte procedure for transposition of the great arteries has an advantage because it obviates the need for an extracardiac conduit for the reconstruction of the pulmonary outflow tract. We evaluated the effectiveness and the application of the Lecompte procedure. Material and Method: A retrospective review was conducted of the records of 46 patients who underwent the Lecompte procedure during the past 15 years. Mean age at operation was 29.2$\pm$20.3 (range: 3∼83) months. The diagnoses involved anomalies of the ventriculoarterial connection with ventricular septal defect and pulmonary outflow tract obstruction, such as transposition of the great arteries, double-outlet right ventricle, and double-outlet left ventricle. Result: Early mortality was 4.4% (2 of 46 patients) and late mortality was 6.8% (3 of 44). The mean follow-up was 11.2$\pm$6.9 years. Eighteen patients (43.9% of survivors, n=41) had pulmonary stenosis (pressure gradient above 30 mmHg), the main reason for which was a calcified monocusp valve (n=15, 83.3%). Seventeen of 46 patients (37.0%) underwent reoperation: 15 for pulmonary stenosis, 5 for residual ventricular septal defect, 4 for left ventricular outflow tract obstruction, 3 for pulmonary insufficiency, and 4 for other causes. The cumulative survival rates were 91.3$\pm$4.2%, and 87.0$\pm$5.8% at 10 and 15 years, respectively. The actuarial probabilities of freedom from reoperation for pulmonary stenosis were 90.6$\pm$4.5%, 73.9$\pm$7.3%, and 54.0$\pm$10.4% at 5, 10, and 15 years, respectively. Conclusion: The Lecompte procedure is an effective treatment modality. Repair in early age is possible with acceptable morbidity and mortality, but recurrent right ventricular outflow tract obstruction caused by degeneration of the monocusp valve is a problem that needs resolution.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.763-773
• /
• 1996

Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.

• The Korean Journal of Cytopathology
• /
• v.12 no.2
• /
• pp.111-115
• /
• 2001

Solitary fibrous tumor on the pleura is rare but should be included in the differential diagnosis on a peripheral pulmonary nodule. Cytologic features of solitary fibrous tumor of the pleura is not familar to the pathologist and may be misdiagnosed as malignancy. We report fine needle aspiration cytologic(FNAC) findings of a case of solitary fibrous tumor misdiagnosed as adenocarcinoma in a 48-year-old woman. The FNAC displayed a mixture of bland-looking spindle cells and clusters of epithelioid cells, which have hyperchromatic nuclei with prominent nucleoli. The helpful finding to distinguish It from other circumscribed benign and malignant lesions is the presence of fibromyxoid matrix admixed with blood vessels and thin collagen fibers. Familiarity with these features is essential to avoid misdiagnosis and overtreatment.

• Journal of Chest Surgery
• /
• v.24 no.11
• /
• pp.1115-1124
• /
• 1991

Recently the thoracic injuries have been markedly increasing due to the vast increase of traffic accident, industrial disaster, and incidental accident as well as the frequent use of the murderous weapons including gun or rifle. Because the thoracic injuries could involve the heart, lung, and great vessels, and would influence the lives, prompt diagnosis and adequate treatment are essential. Most of thoracic injuries can be managed with the conservative treatment and simple surgical procedure such as closed thoracostomy, but certain cases require open thoracotomy to preserve lives and to return to their normal environment. The authors have analysed the result of 53 cases of open thoracotomy after thoracic injuries mainly according to the patient`s chart review. The mean age was 33.4 years old and male to female ratio was about 5: l. Injury mechanisms that elicited thoracic trauma indicated for open thoracotomy were penetrating[47%] and non-penetrating[53%] injuries. The Most common type of the thoracic lesion was hemothorax with or without pneumothorax and diaphragm rupture was the second. 58\ulcornero of thoracic injuries were accompanied by abdominal injuries and 47% by bone fractures. 34 patients were operated within 24 hours after injury and their average elapsed time was 13.6 hour. The remained patients were operated after 24 hours and their average elapsed time was 7.8 days. 71 cases of operative procedures containing some overlappings were performed: diaphragm repair[28], bleeding control[12], pulmonary and cardiac repair[4 cases] Postoperative complication rate was 32.1% and operative mortality rate was 9.4%[5/53].

• Journal of Chest Surgery
• /
• v.20 no.4
• /
• pp.659-672
• /
• 1987

Nitrofen [2,4-dichlorophenyl-P-nitrophenyl ether] is a diphenyl ether herbicide used for pre and post-emergent control of broad leafed weeds. This chemical was known to induce a variety of congenital cardiovascular anomalies with diaphragmatic hernia and hydronephrosis in the rate fetuses. The present study was conducted to produce congenital cardiovascular anomalies in the rat fetuses by oral nitrofen administration at the indicated doses and days of gestation, and to find the characteristics of nitrofen-induced cardiovascular anomalies. All the observed fetuses were removed from the pregnant Sprague-Dawley rats sacrificed on the twenty-first day of gestation. They were preserved in 10 per cent formalin and dissection for examination were carried out under a dissecting microscope using forceps and scissors. Following results and conclusion were based on dissecting microscopic findings on 482 offsprings. 1. The eleventh day of gestation was the most sensitive day for nitrofen induction of congenital cardiovascular anomalies in the rat. This incidence was dose-related in rats exposed on the eleventh day of gestation. 2. Ventricular septal defect was the most common single anomaly that represented more than half of the total cardiovascular anomalies, followed by aortic arch anomalies and tetralogy of Fallot. 3. Cardiac anomalies derived from infundibular maldevelopment such as tetralogy of Fallot and pulmonary atresia with ventricular septal defect were only observed in the eleventh gestation day treated group. 4. Aortic arch anomalies were found in high frequency and the great majority were characteristically anomalous right subclavian artery with left aortic arch. Key words; nitrofen, congenital cardiovascular anomalies.