• Title/Summary/Keyword: Recurrent pulmonary tuberculosis

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A Case of Pulmonary Sequestration Diagnosed by Doppler Sonography (도플러초음파로 진단한 폐분리증 1례)

  • Kwon, Sung-Ho;Ha, Hyoung-Keun;Chung, Myoung-Jin;Park, Man-Sil;Bae, In-Kyu;Kim, Sang-Hoon;Ahn, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.66-70
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    • 2002
  • Pulmonary Sequestration is a rare congenital malformation during embryouic development which results in a cystic mass of nonfunctioning lung tissue. A diagnosis of a pulmonary sequestration has traditionally relied upon identifying the pathological arterial vessels by arteriography, computed tomography, and magnetic resonance imaging. We reported a case of pulmonary sequestration diagnosed by Doppler sonography and subsequent CT angiography. A 21-year-old-woman admitted to hospital for an investigation of recurrent pneumonia with left lower chest pain. A doppler ultrasound sonography showed an aberrant blood supply from the descending thoracic aorta to the left lower chest lesion. The pulmonary sequestration was confirmed by the subsequent CT angiograph.

A Case of Recurrent Pulmonary Inflammatory Myofibroblastic Tumor with Aggressive Metastasis after Complete Resection

  • Moon, Chae Ho;Yoon, Jong Ho;Kang, Geon Wook;Lee, Seong Hyeon;Baek, Jeong Su;Kim, Seo Yun;Kim, Hye-Ryoun;Kim, Cheol Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.4
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    • pp.165-169
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    • 2013
  • An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs. It is thought to be a neoplastic or reactive inflammatory condition, controversially. The treatment of choice for myofibroblastic tumor is surgery, and recurrence is known to be rare. The optimal treatment method is not well-known for patients ineligible for surgery. We report a 47-year-old patient with aggressive recurrent IMT of the lungs. The patient had been admitted for an evaluation of back-pain two years after a complete resection of pulmonary IMT. Radiation therapy was performed for multiple bone recurrences, and the symptoms were improved. However the patient presented again with aggravated back-pain six months later. High-dose steroid and non-steroidal anti-inflammatory drugs were administered, but the disease progressed aggressively, resulting in spinal cord compression and metastasis to intra-abdominal organs. This is a very rare case of aggressively recurrent pulmonary IMT with multi-organ metastasis.

Incidence and Risk Factors of Recurrent Venous Thromboembolism after Pulmonary Embolism

  • Hwang, Hun-Gyu;Choi, Won-Il;Lee, Bora;Lee, Choong Won
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.341-347
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    • 2019
  • Background: Information about the epidemiology of venous thromboembolism (VTE) recurrence in Korea is lacking. The purpose of this study was to investigate VTE cumulative recurrence rates and identify risk factors for VTE recurrence among Korean adults. Methods: A retrospective cohort study was conducted on adult patients (${\geq}18years$) admitted to a university teaching hospital for pulmonary embolism (PE) from 2005 to 2013. The main outcome of interest was a recurrence of VTE. We used Cox proportional hazard regression analyses to calculate the relative risk of VTE recurrence. Results: Five-year cumulative incidence of recurrent VTE events was 21.5% (95% confidence interval [CI], 17.7-25.4) in all cases of PE; 17% after provoked and 27% after unprovoked PE. Multivariate analysis showed that body mass index (BMI) of ${\geq}25$ (hazard ratio [HR], 2.02; 95% CI, 1.17-3.46; p=0.01) and longer anticoagulation therapy duration (HR, 0.90; 95% CI, 0.84-0.96; p<0.01) were independently associated with risk of VTE recurrence. Risk factors not found to be statistically significant at the <0.05 level included history of VTE (HR, 1.81; 95% CI, 0.84-3.88; p=0.12), unprovoked PE (HR, 1.70; 95% CI, 0.89-3.25; p=0.10), symptomatic deep vein thrombosis (HR, 1.62; 95% CI, 0.89-2.94; p=0.10), and female sex (HR, 1.42; 95% CI, 0.78-2.55; p=0.24). We found that age, history of cancer, and other co-morbidities did not significantly affect the risk of VTE recurrence. Conclusion: Recurrence of VTE after PE is high. Patients with BMI ${\geq}25$ or reduced anticoagulation therapy duration have a higher risk of recurrent VTE.

A Study of Etiology and Treatment of Spontaneous Pneumothorax (자연기흉의 원인 및 치료에 관한 연구)

  • 김종원;김진식
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.125-134
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    • 1975
  • The record of 137 patients with spontaneous pneumothorax seen at Busan National University Hospital during past 3years were reviewed to study the possible pathogenesis and its effective management. and the results obtained as follows; 1] The incidence of the "spontaneous" pneumothorax which developed without underlying pathology was 13-1%. The majority of those cases was considered as the result of rupture of subpleural blebs. 2] The incidence of secondary pneumothorax which developed with underlying pathology was 50.0%, in which 42.3% was combined with pulmonary tuberculosis and 8, 0% was combined with pulmonary infection. The traumatic pneumothorax was developed in 36-5% of total series. 3] In age distribution, there was pronounced difference between spontaneous and secondary pneumothorax. The majority of spontaneous pneumothorax cases was 20-30 decade and tall and tall and thin in body structure. In secondary pneumothorax, however, the incidence was relatively high in age group more than 50 years old. 4] The incidence of pneumothorax combined with pulmonary tuberculosis was particularly high in our country, and the cause of pneumothorax was seemed due to the rupture of subpleural caseous foci in some cases, but the majority was seen due to the rupture of emphysematous blebs which were formed with a pathological process of chronic tuberculosis. 5]Closed [tube] thoracotomy was the main therapeutic approach of choice in the great majority ,of pneumothorax in our series with the relapse rate of 19.6%. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage over 7 days and recurrent attack of pneumothorax.

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A Study of Pathogenesis and Treatment of Spontaneous Pneumothorax (자연성 기흉의 성인과 치료에 대한 고찰)

  • 홍완일;김진식
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.11-18
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    • 1968
  • Author studied the possible pathogenesis of spontaneous pneumothorax and its effective treatment in 33 cases, and the results obtained as follows:1) Of the 33 cases, 15 cases were originated from pulmonary tuberculosis, 11 cases were non-tuberculous natures and 7 cases were followed by traumatic chest injuries which were not associated with a laceration of the lung or rib fractures.2) So called "Idiopathic spontaneous pneumothorax" seemed mostly to be caused by rupture of the emphy- sematous blebs.3) Spontaneous pneumothorax, in process of the pulmonary tuberculosis, seemed to be caused by the rupture of blebs which was formed with a pathological process of chronic pulmonary tuberculosis.4) Author experienced interesting cases of giant blebs which had been fully occupied the right thoracic cavity. At first, it was misdiagnosed as extensive spontaneous pneumothorax on X-ray which was revealed extensive pleural air shadow with total atelectasis of the right lung. A pneumonectomy was performed together with the giant multiple blebs.5] Generally, closed thoracotomy with water-sealed drainage is the treatment of choice in spontaneous pneumothorax. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage or recurrent attack of spontaneous pneumothorax.aneous pneumothorax.

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A Familial Case of Hereditary Hemorrhagic Telangiectasia (유전출혈모세혈관확장증을 가진 가족 1예)

  • Kim, Min;Song, Hwa Young;Jeong, Hun;Park, I Nae;Choi, Sang Bong;Lee, Hyun Kyung;Lee, Sung-Soon;Lee, Young Min;Kim, Su Young;Kim, Yong Hoon;Huh, Jin Won
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.314-318
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    • 2009
  • Hereditary hemorrhagic telangiectasia (HHT, also called Osler-Weber-Rendu Disease) is a rare systemic fibrovascular dysplasia characterized by recurrent epistaxis, cutaneous telangiectasia, and visceral arteriovenous malformations (AVMs). HHT is an autosomal dominant disease with a prevalence of 1 in 5,000~8,000. Recurrent epistaxis is often the first and most common manifestation, and about 30% of patients reveal pulmonary AVM. Presently, we report a familial case of HHT. A 61-year-old male with asymptomatic multiple pulmonary AVMs was successfully treated with embolization. His older brother who presented with recurrent epistaxis and multiple telangiectasias was treated with laser ablation. Their pedigree revealed a family history of recurrent epistaxis.

A Case of Hughes-Stovin Syndrome (Hughes-Stovin Syndrome 1예)

  • Kim, Joo-In;Lee, Young-Min;Yum, Ho-Kee;Choi, Soo-Jeon;Choi, Seok-Jin;Yang, Young-Il;Sung, Kyu-Bo;Kim, Dong-Soon;Lee, Bong-Choon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.96-101
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    • 1996
  • Hughes-Stovin Syndrome is an exceedingly rare combination of distal pulmonary arterial aneurysm and deep vein thrombosis, mostly found in young patients. There are striking similarities between the vascular manifestation of Behçet's disease and Hughes-Stovin Syndrome. It has been suggested that they may have a similar pathogenesis. Most patients died of massive hemoptysis due to rupture of aneurysm. Recently we have experienced the first case of Hughes-Stovin Syndrome in Korea. A 37 year old male patient was admitted because of recurrent hemoptysis and intermittent fever. He had a history of recurrent aphthous ulcers and erythema nodosum-like skin rash, But no other findings of Behcet's disease was found. Angiography showed multiple pulmonary arterial aneurysm and deep vein thrombosis in Right lower extremity. Histologic examination of specimens of open lung biopsy revealed leukocytoclastic angiitis. Pulmonary arterial aneurysms were successfully treated by coil embolization and he is in good condition with corticosteroid and cyclophosphamide therapy.

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Bronchoplastic Procedures (기관지 성형술)

  • 조건현
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.772-777
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    • 1995
  • Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.

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Two Cases of Microscopic Polyangiitis with Honeycomb Lung (봉소상 폐(Honeycomb Lung) 소견을 보인 현미경적 다발성 혈관염 2예)

  • Hahn, Hye-Sook;Hwang, Jun-Kyu;Jung, Hyuk-Sang;Song, Suk-Ho;Joo, Kwon-Wook;Park, Gye-Young;Lee, Jong-Ho;Oh, Young-Ha;Lee, Hyoun-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.550-556
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    • 2002
  • Microscopic polyangiitis is a systemic small-vessel vasculitis that is associated primarily with necrotizing glomerulonephritis and pulmonary capillaritis. A recurrent and diffuse alveolar hemorrhage due to pulmonary capillaritis is the main clinical manifestation of lung involvement. Recently, and interstitial lung disease that mimics idiopathic pulmonary fibrosis was reported to be rarely associated with microscopic polyangiitis. Here we report two patients with microscopic polyangiitis who showed a honeycomb lung at the time of the initial diagnosis with a brief review of relevant literature.