• Title/Summary/Keyword: Right middle lobe

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Pulmonary Pneumatocele in a Pneumonia Patient Infected with Extended-Spectrum β-Lactamase Producing Proteus mirabilis

  • Ryou, Sung Hyeok;Bae, Jong Wook;Baek, Hyun Jin;Lee, Doo Hyuk;Lee, Sang Won;Choi, Gyu Ho;Han, Kyu Hyung;Kim, Se Weon;Kim, Hyunbeom;Hong, Goohyeon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.371-374
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    • 2015
  • Pulmonary pneumatoceles are air-filled thin-walled spaces within the lung and are rare in adult cases of pneumonia. We report the case of a 74-year-old male who was admitted with a cough and sputum production. He had been treated with oral dexamethasone since a brain tumorectomy 6 months prior. Contrast-enhanced computed tomography (CT) of the chest revealed a large pneumatocele in the right middle lobe and peripheral pneumonic consolidation. Bronchoalveolar lavage was performed; cultures identified extended-spectrum ${\beta}$-lactamase (ESBL) producing Proteus mirabilis. A 4-week course of intravenous ertapenem was administered, and the pneumatocele with pneumonia resolved on follow-up chest CT. To the best of our knowledge, this is the first reported case of pulmonary pneumatocele caused by ESBL-producing P. mirabilis associated with pneumonia.

A Case of Low-grade B-cell Lymphoma of Bronchial Associated Lymphoid Tissue Mimicking Lipoid Pneumonia (리포이드 폐렴(Lipoid pneumonia)으로 오인된 폐에 발생한 림프절 외 변연부 B-세포 림프종 1예)

  • Cho, Jin Hee;Yang, Min Jae;Yu, Su Kyong;Soe, Kyoung Woo;Kim, Hugh Chul;Sheen, Seung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.194-199
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    • 2007
  • BALT(bronchial associated lymphoid tissue) lymphomas are a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, which are classified as a marginal-zone lymphomas. The majority of the patients are asymptomatic or their pulmonary lesions is often discovered incidentally on a routine chest radiograph. A 50-year-old man was admitted for an the evaluation of cough, dyspnea and fever. His chest CT showed ground glass appearance with interlobular septal thickening in both lower lobes, right middle lobe and left lingular division. He had been initially diagnosed with lipoid pneumonia and was kept under observation. However, his chest lesion showed continuous progression and a video-associated thoracoscopy was performed His pulmonary lesion was confirmed histologically to be a BALT(bronchial associated lymphoid tissue) lymphoma. We report a case of a BALT lymphoma, which was initially misdiagnosed as lipoid pneumonia.

Development of a Method of Cybersickness Evaluation with the Use of 128-Channel Electroencephalography (128 채널 뇌파를 이용한 사이버멀미 평가법 개발)

  • Han, Dong-Uk;Lee, Dong-Hyun;Ji, Kyoung-Ha;Ahn, Bong-Yeong;Lim, Hyun-Kyoon
    • Science of Emotion and Sensibility
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    • v.22 no.3
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    • pp.3-20
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    • 2019
  • With advancements in technology of virtual reality, it is used for various purposes in many fields such as medical care and healthcare, but as the same time there are also increasing reports of nausea, eye fatigue, dizziness, and headache from users. These symptoms of motion sickness are referred to as cybersickness, and various researches are under way to solve the cybersickness problem because it can cause inconvenience to the user and cause adverse effects such as discomfort or stress. However, there is no official standard for the causes and solutions of cybersickness at present. This is also related to the absence of tools to quantitatively measure the cybersickness. In order to overcome these limitations, this study proposed quantitative and objective cybersickness evaluation method. We measured 128-channel EEG waves from ten participants experiencing visually stimulated virtual reality. We calculated the relative power of delta and alpha in 11 regions (left, middle, right frontal, parietal, occipital and left, right temporal lobe). Multiple regression models were obtained in a stepwise manner with the motion sickness susceptibility questionnaire (MSSQ) scores indicating the susceptibility of the subject to the motion sickness. A multiple regression model with the highest under the area ROC curve (AUC) was derived. In the multiple regression model derived from this study, it was possible to distinguish cybersickness by accuracy of 95.1% with 11 explanatory variables (PD.MF, PD.LP, PD.MP, PD.RP, PD.MO, PA.LF, PA.MF, PA.RF, PA.LP, PA.RP, PA.MO). In summary, in this study, objective response to cybersickness was confirmed through 128 channels of EEG. The analysis results showed that there was a clearly distinguished reaction at a specific part of the brain. Using the results and analytical methods of this study, it is expected that it will be useful for the future studies related to the cybersickness.

Clinical Characteristics of Pulmonary Aspergilloma (폐국균종의 임상적 고찰)

  • Kang, Tae-Kyung;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Sohn, Jeong-Ho;Lee, Jun-Ho;Han, Seong-Beom;Jeon, Young-Jun;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Shin, Hyeon-Soo;Lee, Sang-Chae;Kweon, Sam
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1308-1317
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    • 1997
  • Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

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A Case of Lymphocytic Interstitial Pneumonia Manifested as a Multi-focal Consolidation (다발성 경화 소견으로 발현된 림프구성 간질성 폐렴 1예)

  • Hwang, Kyu Sig;Roh, Young Wook;Song, Sung Heon;Kim, Sang Heon;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Oh, Young-Ha;Kim, Tae-Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.37-41
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    • 2009
  • Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it's clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.

A Case of Pulmonary Epithelioid Hemangioendothelioma (폐의 유상피성 혈관내피종 1예)

  • Kim,, Kwan-Young;Kim, Chang-Ho;Sohn, Ji-Wung;Cha, Seung-Ick;Chae, Sang-Chul;Park, Jae-Yong;Jung, Tae-Hoon;Park, Tae-In;Kwon, Keun-Yeung
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.691-696
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    • 1999
  • Epithelioid hemangioendothelioma(EH) is a rare pulmonary vascular malignancy. Clinically, EH has been considered as an indolent, generally non-aggressive tumor. We report a case of EH which was confirmed by open lung biopsy. A 34-year-old woman was admitted for further evaluation of multiple small(less than 2cm in size) nodules, incidentally detected on screening chest radiograph. The chest CT showed multiple, relatively well-marginated, variable sized nodules at both whole lung. Transbronchial lung biopsy and transthoracic needle aspiration were nondiagnostic and open lung biopsy was performed from right middle lobe of lung. On light-microscopic examination, the nodules were composed of a poorly cellular hyaline core and a more cellular peripheral zone which extended into air space in a micropolypoid fashion and obliterated blood vessels. The tumor cells at the peripheral zone had intracytoplasmic vacuoles which suggested primitive, vascular differentiation. Immuno-histochemical study revealed the cellular area which gave positive reaction to factor VIII-related antigen. She received no specific therapy after open lung biopsy and chest X-ray films had showed no change for about two years.

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Clinical Evaluation of Surgical Treatment for Hemoptysis Patients (객혈환자의 외과적 처치에 대한 임상적평가)

  • 이성주;문승철
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1097-1104
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    • 1997
  • The expectoration of blood is always a fearful experience for the patient and a matter of grave concern to the attending physician, because it may be the warning sign of serious diseases. When such bleeding occurs, the possibility of its being due to pulmonary tuberculosis, bronchiectasis or carcinoma of the lung is promptly suggested. Nowadays, with the advance of modern diagnostic studies, differential diagnosis has become possible for the hemoptysis patients to have appropriate treatment. This evaluation is based on the review of 75 cases of patients whom we performed emergency open thoracotomies for 6 years from March 1992 to February 1997 in the Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital. The mean age of the patients was 36.6 years old with a range from 19 to 68, and most prevalent age group was thirties. The most common underlying lung disease causin hemoptysis was tuberculosis(44%). Most accurate diagnostic study was bronchoscopy during hemoptysis(95 Vo) and right middle & lower lobe(17.3%) was the most common site of lesion. Lobectomy(50%) was the most frequent operative method and recurrent hemoptysis(31.6%) was the most common postoperative complication. But most of the patients(82.6%) were completely recovered by surgical treatment. Now we concluded that the proper management of hemoptysis was completed by surgical approach with definite diagnosis and supportive medication.

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Effect of LI4-LI11 Electro-acupuncture on Regional Cerebral Blood Flow in Healthy Human - Evaluated by $^{99m}Tc-ECD$ Brain SPECT - (합곡-곡지 전침치료가 정상인의 뇌혈류에 미치는 영향 - Brain SPECT와 SPM을 이용하여 -)

  • Ryu Jong-Man;Kim Young-Suk;Park Sung-Uk;Jung Woo-Sang;Ko Chang-Nam;Cho Ki-Ho;Bae Hyung-Sup;Kim Deok-Yoon;Moon Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.2 s.66
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    • pp.36-43
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    • 2006
  • Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.

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The Clinical Usefulness of Spiral CT Angiography in the Diagnosis of Pulmonary Thromboembolism (폐색전증 진단에서 나선식 전산화 단층촬영 혈관조영술의 임상적 유용성)

  • Kim, Woo-Gyu;Lim, Byung-Sung;Kim, Mi-Young;Hwang, Hweung-Kon
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.669-680
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    • 1999
  • Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

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CT Findings of Bronchogenic Cyst (기관지 낭종의 전산화단층촬영 소견)

  • Cho, Hyun-Cheol;Lee, Yong-Woo;Hwang, Mi-Soo;Cho, Kil-Ho;Byun, Woo-Mok;Cho, Jae-Ho;Chang, Jae-Chun;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.226-236
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    • 1995
  • We studied to evaluate CT characteristics of bronchogenic cysts. We retrospectively evaluated CT of 11 patients with pathologically proved bronchogenic cyst. Precontrast and postcontrast CT scan was performed in all. We analyzed CT with viewpoints of location, size, attenuation on pre- and postcontrast scan, and calcification. Three of 11 bronchogenic cysts were intrapulmonary in location and eight were located in the mediastinum. Two of 3 intrapulmonary bronchogenic cysts were located in the right lower lobe, and the remaining one was left lower lobe. Intrapulmonary bronchogenic cysts ranged from 6cm to 12cm in diameter (average, 9.7 cm). On CT, intrapulmonary bronchogenic cysts appeared as thin-wall air cyst, homogenous water attenuation and soft tissue attenuation with air bubble respectively. Mediastinal bronchogenic cysts were located in posterior mediastinum(n=5), superior mediastinum(n=2), middle mediastinum(n=1) respectively. These cysts ranged in size from 3cm to 8cm in diameter (average, 5.0 cm). On CT, five showed homogenous water attenuation, two soft tissue attenuation similar to that of muscle, one air-fluid level. Calcification or contrast enhancement was not detected in any cases. On operative findings, all of intrapulmonary bronchogenic cysts contained dirty pus-like material and all of mediastinal bronchogenic cysts contained whitish or yellowish mucus material. Bronchogenic cysts showed homogenous water density in many cases, homogenous soft tissue density, air-fluid level and air-filled cyst. The constellation of CT findings may be helpful in the diagnosis and differentiation of bronchogenic cyst.

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