• Tuberculosis and Respiratory Diseases
• /
• 제70권6호
• /
• pp.457-461
• /
• 2011

Vaccination in adults is recommended according to the age group and underlying diseases or risks of exposure. Patients with chronic diseases including chronic obstructive pulmonary diseases are susceptible to infectious diseases and related serious complications. They need risk-related vaccination along with age-related vaccination. Both influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary diseases. They are additive if administered simultaneously. Pertussis vaccination is also needed in adolescents and adults. Although there is strong need for these vaccinations, the actual vaccination rate is low. Measures to effectively enhance the vaccination rate are needed.

• Tuberculosis and Respiratory Diseases
• /
• 제46권6호
• /
• pp.869-878
• /
• 1999

표재성 방광암의 치료는 경요도적 절제술 후 방광내 BCG 투여가 표준적인 치료로 알려져 있다. 방광내 BCG 투여 후 가장 흔한 부작용은 방광자극, 빈뇨감, 배뇨 곤란 등이며 항결핵제를 사용해야 할 정도의 전신적인 부작용은 5% 이하로 알려져 있다. 저자들은 표재성 방광암 환자에서 경요도적 절제술 후 방광내 BCG 주입치료 후 폐합병증이 발생한 2예를 경험하여 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제23권6호
• /
• pp.1213-1220
• /
• 1990

During the period of January 1979 to December 1988, 220 patients with empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School Hospital. There were 167 males[75.9%] and 53 females[24.1%] ranging from 18 days to 76 years of age. Occurrence ratio of left and right empyema was 1 : 1.9. The underlying pathologic lesions of empyema were pneumonia[30.9%], pulmonary tuberculosis[22.7%], chest trauma[8.6%] and postoperative complications. In bacteriologic study, staphylococcus, pseudomonas and streptococcus accounted for 26.4%, 11.8% and 9% respectively, and 25% were not identified. Surgical treatment modalities were thoracentesis[10 patients, 4.5%], closed thoracostomy[132, 60%], closed rib resection drainage[4.2, 6%], modified Eloesser’s operation[37, 16.8%], decortication[27, 12.3%], decortication with pulmonary resection[6, 2.7%], thoracoplasty[2, 0.9%], muscle flap closure [1, 0.5%], and staged pneumonectomy[1, 0.5%], The mortality rate was 2.3% and the complications were sepsis[9 patients]. acute renal failure[4], and paralytic ileus[3].

• Journal of Chest Surgery
• /
• 제18권1호
• /
• pp.97-103
• /
• 1985

During the period of seven years from Jan. 1976 to Jan. 1983, one hundred cases of pulmonary tuberculous residual lesions were resected at the Department of Thoracic Surgery, Paik Hospital in Seoul, Korea. During the period of this study, 1764 patients were admitted with the diagnosis of pulmonary and/or pleural tuberculosis in the medical and surgical department as a primary or associated conditions. Among these 1764 patients, one hundred selective cases were operated. The results were as follows; l. Extents of the disease by the predominant clinical pictures were: totally destroyed lung; 18, destroyed lobe; 6, cavitary lesion with or without positive sputum; 35, bronchiectasis; 7, bronchostenosis with atelectasis; 2, empyema with or without BPF; 20, pleural thickening; 4, tuberculoma; 3, bullous cyst with tuberculosis; 5 cases, or per cent [Table 1]. 2. Male and female ratio was 1.2:1 or 55 and 45 per cent. Age distribution ranged 15 and 55 with average of 33 years [Table 2]. 3. Type of procedures were: pleuropneumonectomy; 15, pneumonectomy; 25, lobectomy; 37, bilobectomy; 6, lobectomy plus segmentectomy; 3, pleurectomy; 14 cases, or percent, Site of resections were: right; 58 and left; 42 cases, or per cent [Table 3]. 4. Incidence of complications were 10 per cent and the mortality was 4 per cent. The causes of morbidity were analyzed. The main causes of death were pulmonary insufficiency; 2, cardiac arrhythmia; 1, and hepatic insufficiency; 1 case or per cent [Table 4]. 5. Pathologic examinations of the resected pulmonary and pleuropulmonary lesions were observed by gross specimen, correlating with the pre-operative indications of the disease [Fig. 1, 2, 3, 4, 5, 6].>br> 6. Anti-tuberculous chemotherapy was done for 6 to 18 months, post-operatively, in 80 patients. Of these 49 cases were need medication for 12 months [Table 5]. Except the four operative mortality and a case of post-operative recurrent buberculosis under medication, all the other 95 cases are well in activity and free from the disease at the moment.

• Tuberculosis and Respiratory Diseases
• /
• 제71권5호
• /
• pp.355-358
• /
• 2011

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful, safe diagnostic modality for evaluating mediastinal and hilar lymphadenopathy. We report a 51-year-old male who presented with a left renal mass and multiple pleural masses without lung parenchymal lesions. The pleural masses were thought to be metastatic tumors or malignant mesothelioma. The patient underwent two percutaneous needle biopsies of the pleural mass, but the specimens were insufficient for a histopathological diagnosis. Because one pleural mass was adjacent to the right main bronchus, we decided to perform EBUS-TBNA for the pleural mass. As a result, sufficient core tissue was obtained with no complications, and the histopathological findings were consistent with metastatic papillary renal cell carcinoma. To our knowledge, this is the first case of using EBUS-TBNA for a pleural mass.

• Clinical and Experimental Vaccine Research
• /
• 제13권3호
• /
• pp.184-201
• /
• 2024

Tuberculosis (TB) is consistently ranked among the deadliest diseases worldwide, causing millions of deaths annually. Mycobacterium tuberculosis is the causative agent for this infection. Different antibiotics and vaccines have been discussed as potential treatments and prevention. Currently, there is only one licensed vaccine against TB, Bacillus Calmette-Guérin (BCG). Despite its protective efficacy against TB in children, BCG has failed to protect adults against pulmonary TB, lacks therapeutic value, and can cause complications in immunocompromised individuals. In this review, BCG, the most widely administered vaccine, is discussed, and the newest vaccines available in medicine are discussed. Based on the restrictions that prevent optimal BCG efficacy and the vaccines that are now being tested in various clinical studies, some criteria need to be considered in designing future vaccines.

• Journal of Chest Surgery
• /
• 제21권1호
• /
• pp.109-115
• /
• 1988

With the decreasing incidence of new cases and the highly effective results with antituberculous drug therapy, there is a marked decline in the need for surgery which was formerly such an important part in the successful program of management of this disease. During the period of two years and a half from Jun. 1984 to Dec. 1986, this study represents an analysis of 163 cases of several surgical management for eventual control of pulmonary tuberculosis at National Kon-ju tuberculosis Hospital. 1. Mode of surgical treatment was: Resection; 123 cases [Pneumonectomy: 83, lobectomy: 35, lobectomy plus segmentectomy; 4 segmentectomy: 1], thoracoplasty: 20 and others: 20. 2. Age distribution ranged 16and 68 with average of 34 years. Male and female ratio was 1.2: 1. 3. Surgical indications were: totally destroyed lung; 64, Destroyed lobe of segment; 13, cavity positive sputum; 10, cavity c negative Sputum; 6, Bronchostenosis c atelectasis; 2, empyema c or s BPF; 46, Aspergilloma; 8, Questions of Associated tumor; 4 and other 5. 4. Incidence of Complications was 10.4% and the mortality was 5.5 percent. The cause of mortality were analyzed. The main causes of death were respiratory insufficiency; 4, fulminant hepatitis; 1, hemorrhage; 1 and unknown; 1 in pneumonectomy, and asphyxia; 1 in lobectomy and sepsis; 1 in other procedure. 5. Conversion rare of positive sputum to negative state related to resectional surgery was 91.5%. In pneumonectomy, drug resistant group preoperatively showed 88.1% conversion rate postoperatively and drug sensitive group showed that 100% conversion rate. In lobectomy, both drug resistant and sensitive groups showed that 100% conversion rate postoperatively.

• Journal of Chest Surgery
• /
• 제25권5호
• /
• pp.480-493
• /
• 1992

Between October 1964 and August 1979, 2,537 patients underwent operation for pulmonary disease including tuberculosis at the National Kongju Hospital. Ages at operation ranged from 6.6 to 67.6 years with a mean age of 30.8 years and the male to female ratio was 3.07: l. Indications for operation were, respectively, as follows; destroyed lobe or segment with /without cavity[68.6%], ipsilateral total destroyed lung[14.8%], empyema with/wit-hout fistula[6.0%], atelectasis with bronchostenosis[2.6%], bronchiectasis[2.4%], tuberculoma[1.6%], lung abscess[1.7%], etc. There were 1,416 thoracoplasties[most common], 915 lobectomies, 591 pneumonectomies, etc. 1,073 patients with hemoptysis were found, streaking[23.8%], mild[42.3%], moderate[26.6%], severe[3.4%] and massive[3.9%] as the severity. Tuberculosis was the most common cause of severe and massive hem-optysis. Postoperative complications were developed 16.% of the operated cases, bleeding was the most frequent complication found in these cases. The mortality of operation was 8%, the most common cause of death was bleeding also.

• Tuberculosis and Respiratory Diseases
• /
• 제72권2호
• /
• pp.232-235
• /
• 2012

Acute pulmonary embolism (PE) ranges from asymptomatic to often fatal, incidentally discovered emboli to massive embolism causing immediate death. Acute PE may occur rapidly and unpredictably and may be difficult to diagnose. Mortality and complications can be reduced by prompt diagnosis and therapy. Untreated PE is associated with a mortality rate of approximately 30 percents. Most patients with PE have endogenous fibrinolysis, although it is not effective enough to prevent PE. A case of spontaneous remission of untreated acute PE has not previously been reported. Here we present a case of spontaneously resolved acute PE without any treatment.

• Tuberculosis and Respiratory Diseases
• /
• 제72권1호
• /
• pp.1-7
• /
• 2012

Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.