• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.93-98
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• 1995

Cryptococcosis is a systemic infection caused by the yeast-like fungus Cryptococcus neoformans. Respiratory tract is the usual portal of infection but relatively few cases of pulmonary cryptococcosis have been reported. Recently the incidence of the disease are increasing because the perception to seek the disease is increasing and immunocompromised hosts are more widespread with introduction of immune-suppressants, steroids and advent of AIDS. Because of nonspecific pattern of clinical manifestation, radiologic findings, differentiating the other diseases is essential and it needs fungal culture and biopsy. We describe a patient in the state of bilateral adrenalectomy due to bilateral ACTH-independent macronodular hyperplasia who developed pulmonary cryptococcosis and was later infected with pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.477-481
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• 2009

Leflunomide, a disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis has been available in Korea since 2003. Leflunomide-associated interstitial pneumonitis has been appearing recently. A 25-year-old woman with a 12-month history of seronegative rheumatoid arthritis (RA) presented with acute respiratory insufficiency. She developed fever, dyspnea, and non-productive cough. Her medication history included methotrexate (15 mg/week. commencing 1 year prior) and leflunomide (20 mg/day, no loading dose, commencing 4 months prior). She was diagnosed with leflunomide-associated interstitial pneumonitis based on history, physical examination, laboratory and radiologic findings. She recovered quickly after leflunomide was withdrawn and steroids and cholestyramine were initiated quickly. We report a case of leflunomide-associated interstitial pneumonitis treated successfully with intravenous high-dose steroid and cholestyramine.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.43-47
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• 2007

Sj$\"{o}$gren's syndrome is a systemic, autoimmune disorder of the exocrine glands with associated lymphocytic infiltrates of the affected glands and characteristic of dry eye and mouth. We report a case of Sj$\"{o}$gren's syndrome in which the patient presented systemic symptoms without sicca symptoms and had radiologic findings mimicking multiple skeletal metastasis and was finally confirmed with Sj$\"{o}$gren's syndrome with renal tubualr acidosis.

• Journal of Preventive Medicine and Public Health
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• v.18 no.1
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• pp.41-50
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• 1985

To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7769-7773
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• 2014

Background: Some tumor types are related to HIV, including non-Hodgkin lymphoma (NHL). The morbidity and mortality of NHL has remained high, even after highly active antiretroviral therapy (HAART) was introduced. We collected cases of AIDS with NHL, and evaluated the imaging features and strategies for diagnosis. Materials and Methods: There were 27 patients with AIDS and tumors confirmed by pathology. There were 9 patients with Burkitt lymphoma, 16 with diffuse large B cell lymphomas (DLBCLs), and 2 with primary central nervous system (PCNS) lymphomas. All of the patients underwent a series of imaging studies. Three radiologists analyzed the images, and any disagreement was discussed until consensus was reached. Results: The radiologic manifestations of AIDS with NHL were mainly masses and lymphadenopathy, 3 patients having one mass and 12 two or more masses. 7 patients had lymphadenopathy in one site and 3patients had lymphadenopathy in two or more sites. Coarse mucosal folds, thickening of the gastrointestinal wall, and lumen narrowing were typical manifestations of NHL within the gastrointestinal tract. There were 4 patients with masses and 5 with lymphadenopathy inthe 9 with Burkitt lymphoma, and 11 patients with masses 5 with lymphadenopathy in the 16 with DLBCLs. Conclusion: NHL is a malignancy that usually occurs in patients with AIDS. Imaging is an important method by which to evaluate lesions, masses, and lymphadenopathy. Fine needle aspiration biopsy and stereotaxis biopsy are useful methods by which to diagnose NHL.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.50-55
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• 2002

Objectives: Thyroid cancer is the most common endocrine malignancy with favorable histologic and prognostic characteristics. Total or near total thyroidectomy has been used as a standard surgical procedure. The aims of this study are to determine the extent of resection of thyroid gland and to find the influencing factors of lymph node metastasis. Materials and Methods: The authors reviewed the records of 194 patients of thyroid cancer surgically treated at Department of General Surgery, Inje University Busan Paik Hospital from January, 1996 to December, 2000. Pathologic classifications, surgical procedures, and lymph node metastasis were analyzed. Results: There were 163 women and 31 men. The age ranged from 12 to 79 years old (mean age 43.2 years). The histological classifications of 194 cases revealed papillary cancer in 171 cases (88.1%), follicular cancer in 17 cases (8.8%), undifferentiated cancer in 3 cases (1.6%), medullary cancer in 2 cases (1.0%) and mixed cancer in 1 case (0.5%). Among the 194 patients, lobectomy was perfomed in 31 patients, subtotal thyroidectomy in 30 patients, near total thyroidectomy in 82 patients and total thyroidectomy in 51 patients. In the subgroup of papillary carcinoma 141 cases with lymph node dissection, lymph node metastasis had no statistical significance according to sex, age and primary tumor size. Conclusions: The mainly performed surgical procedures were total thyroidectomy and near total thyroidectomy. In thyroid cancer surgery, the extent of resection was influenced by age, differentiation and primary tumor size. The lymph node dissection should be decided by lymph node metastasis identified by preoperative radiologic evaluation or intraoperative lymph node findings.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.41-45
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• 2002

Background and Objectives: To evaluate the efficacy of the neoadjuvant chemotherapy and radiation therapy in treatment of patients with advanced hypopharyngeal cancer, which is notorious for its poor prognosis and severe surgical morbidity with functional deficits. Materials and Methods: Medical records and radiologic findings of 107 patients with squamous cell carcinoma of the hypopharynx, Stage III or IV (AJCC, 1997), were retrospectively reviewed. Results: Neoadjuvant chemotherapy followed by radiation therapy showed 74% complete remission (CR) rate. The patients who did not show CR after chemotherapy had a high likelihood of treatment failure, even though they achieved CR following subsequent radiotherapy. Twenty-eight of 57 patients were able to preserve their larynges for more than three years by chemotherapy and radiation. Conclusions: This approach appeared to be as effective as radical surgery with postoperative radiation therapy without comprising of survival. To improve the cure rates, we need to develop better strategies to increase CR rates with chemotherapy and determine the best treatment option for patients who are partially or nonresponsive to chemotherapy.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.718-721
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• 2006

We describe the case of primary pulmonary paraganglioma in a 37-year-old woman who presented recurrent, severe cough. Computed tomography revealed a lobulated inhomogeneous enhanced mass with endobronchial protruding lesion suspected to be lung neoplasm, located in the upper lobe of the left lung. Bronchoscopic biopsy showed chronic inflammation with granulation tissue which was not in accord with the radiologic findings. Subsequently, a left lower sleeve lobectomy was peformed. Histological analysis of the resected tumor proved to be compatible with pulmonary paraganglioma. Primary pulmonary paragangliomas are very uncommon tumors. So we report this case with literature review.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.152-157
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• 1994

Histiocytosis-X is a tenn used to define three diseases with similar morphologic characteristics : Letterer-Siwe diseae, Hand-Schuller-Christian disease and Eosinophilic granuloma. In general, they differ in terms of their age of onset, severity of clinical course and site of involvement. Eosinophilic granuloma typically is seen in young adults. Eosinophilic granuloma is diagnosed in the presense of diffuse pulmonary infiltrate, bony involvement. However, the pulmonary radiologic findings of eosinophilic granuloma are variable accordinary to stage of disease. therefore pathologic diagnosis of involving site is essential for confirmative diagnosis of eosinophilic grananuloma. Pathologically. the three disease are characterized by granulomatous infiltration of alveolar septa and bronchial walls and often involvement of bone. The hallmark of this disease is proliferation of the Langerhans' cell. The identifying feature is the X-body or Birbeck granule that is present in Langerhans' cells and histiocytic cells found in the lung of EG patient. We report a case of bilatera1, recurrent and spontaneous pneumothoraces in a 21 year old man with pulmonary histiocytosis-X, which is confirmed by eosinophilc granuloma in bone marrow biopsy and ultrastructural examination in cells obtained from BAL.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.579-583
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• 2004

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.