• Tuberculosis and Respiratory Diseases
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• v.67 no.4
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• pp.318-324
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• 2009

Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5${\pm}$3.98 months with a follow-up period of 28.2${\pm}$26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

• Tuberculosis and Respiratory Diseases
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• v.39 no.2
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• pp.199-204
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• 1992

A 46 years old male showed radiologically a single cavitary nodular lesion in right upper lung, which extended to the regional chest wall. This finding has to be made into differential diagnosis of numerous pulmonary diseases including infections such as mycobacterial, fungal or bacterial, granulomatous diseases, and neoplasms. For the definite diagnosis, fine needle aspiration biopsy guided by biplane fluoroscopy was performed. The aspirates contained several sulfur granules, in the center of which many gram positive, filamentous organisms were compactly intermingled. Such a findings was compatible with pulmonary actinomycosis. Now the lesions is cleared out by medical treatment with amoxicillin for 3 months.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.115-118
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• 1995

A 32-year-old female was admitted for evaluation of known mass on right suprahilar area. Chest PA showed $4{\times}3cm$ round and homogenous mass on suprahilar area. No abnormal findings were found in PFT, cytology, bacterial study, and fine needle aspiration biopsy(FNAB). On chest computed tomography, solitary mass was on right suprahilar area and no evidence of intrapulmonary metastasis or lymphnode metastasis was seen. Right upper lobectomy of lung was performed and Castleman's disease of hyaline vascular type was diagnosed based on the histologic findings of multiple and large lymphoid follicles with prominent vascular proliferation and hyalization in the central portion.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.197-200
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• 2004

A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{\times}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.260-263
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• 1996

High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.147-156
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• 2020

Background: Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea. Methods: We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission. Results: During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate. Conclusion: Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.676-679
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• 1994

A 36-year-old man was studied because of signs and symptoms of superior vena caval syndrome. Chest computerized tomography showed $10{\times}8{\times}6$ cm sized lobulated anterior mediastinal mass, compressing superior vena cava. Fine needle aspiration cytology revealed seminoma. There was no detectable tumor mass in the testes. We report a case of primary mediastinal seminoma presenting with superior vena caval syndrome.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.947-950
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• 1995

We have experienced a case of pulmonary adenocarcinoma looked like cavitary lesion of pulmonary tuberculosis in 49-year-old male patient. He has taken antituberculous medication for 5 months under the impression of pulmonary tuberculosis with cavity at local hospital. The cavitary lesion was changed nodular mass on follow-up chest X-ray. Transthoracic fine needle aspiration was done and cytologic specimen suggested squamous cell carcinoma. Right middle lobectomy was performed. The nodular mass, which was confirmed as adenocarcinoma on microscopic examination, had central cavity filled with hemorrhage.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.649-654
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• 1997

Benign solitary schwannoma of the chest wall is a rare disease of nerve sheath origin A 43-year-old female patient was admitted to our hospital for right upper quandrant pain Chest X-ray shows nonspecific finding, ultrasonography & CT scan revealed a solid tumor on the right lateral chest wall. On aspiration needle biopsy, this mass was turned out to be a schwannoma of the right lateral chest wall. This mass was excised surgically in an encapsulated state by right lateral thoracotomy. Histological section revealed a typical schwannoma, which is characterized by Antoni A and Antoni B tissues of high & low cellularity.

• Korean Journal of Bronchoesophagology
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• v.18 no.2
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• pp.56-59
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• 2012

Tracheo-innominate artery fistula (TIF) is a rare but catastrophic and almost always fatal complication of tracheostomy. TIF can occur anytime but is commonly present 3 to 24 days after tracheostomy. It can first manifest as massive bleeding around and through the tracheostomy tube, but it can also manifest as a small amount of blood with temporary spontaneous resolution. If TIF is suspicious, airway management and prompt surgical intervention are needed. In an 83-year-old man with CVA history 20 years earlier and who had recurrent aspiration pneumonia, tracheostomy was performed for respiratory management and ventilator support. On day 7 post-tracheostomy, the patient had bleeding from the tracheostoma. Immediate surgical exploration was performed to control the bleeding. A defect was seen at the post wall of the innominate artery. The erosive portion of the artery was sutured, but the patient died three weeks after the surgery due to rebleeding and respiratory failure. We present a patient who developed TIF after tracheostomy, with literature review.