• Tuberculosis and Respiratory Diseases
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• v.48 no.1
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• pp.78-83
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• 2000

Endobronchial chondroma is a cartilaginous benign tumor, which arises from bronchial cartilage. As a rare benign tumor, endobronchial chondroma differs from cartilaginous hamartoma in that it includes cartilage components only, but hamartoma contains lipomatous and lymphoid tissue. The clinical manifestations of endobronchial chondroma are associated with the extent of mechanical obstruction of bronchus. Symptoms of endobronchial chondroma are nonspecific, such as cough, sputum, fever, or dyspnea on exertion. Endobronchial chondroma is often misdiagnosed as other diseases, such as asthma, chronic obstructive pulmonary disease, or pulmonary tuberculosis. The treatment is usually surgical procedures, such as resection of lung segment or lobe by thoracostomy, or resection of tumor by bronchoscopy. We report a case of the patient who was diagnosed to have endobronchial chondroma treated by bronchial resection and end to end anastomosis.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.174-178
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• 2002

Primary pulmonary amyloidosis is a rare condition that can be classified into the tracheobronchial, diffuse alveolar septal, and nodular parenchymal type. Tracheobronchial amyloidosis is characterized by deposition of fibrilar proteins in the tracheobronchial tree, and it can be subdivided into diffuse and focal varieties. In this report, a case of diffuse tracheobronchial amyloidosis confirmed by flexible fiberoptic bronchoscopic biopsy is presented. The patient was a 43-year old male with a chief complaint of cough and sputum for 20 days and dyspnea for one day. The chest CT scan showed diffusely thickened walls of both the main and lobar bronchi with calcification. The bronchoscopic findings showed nodular lesions of the trachea, a diffuse bronchial stenosis of both the main bronchi and a pinpoint narrowing of the left upper and right middle lobar bronchus. The biopsy showed submucosal deposits of homogenous eosinophilic amyloid materials and an apple-green birefringence under polarizing microscopy following the Congo-red stain.

• Tuberculosis and Respiratory Diseases
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• v.58 no.4
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• pp.404-409
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• 2005

An 86 year old woman was admitted complaining of dyspnea and right pleuritic pain with a 5 week durations. A physical examination, chest X-ray, and diagnostic thoracentesis upon admission revealed findings consistent with severe pneumonia and empyema on the right lung. Despite the insertion of a chest tube and negative suction via Emersion pump, the continuous air leakage was sustained, and a bronchopleural fistula (BPF) was found on the chest-CT. A flexible bronchoscopic occlusion with an Endobronchial Watanabe Spigot (EWS) was performed after 56 days of admission. An 5 mm diameter EWS was successfully inserted into the anterior segmental bronchus of the right upper lobe by flexible bronchoscope. There was no aAir leakage detected after this procedure. The patient was discharged 30 days after the EWS occlusion.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.467-470
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• 2009

A traumatic pulmonary pseudocyst is a rare complication of blunt thoracic trauma. The clinical symptoms and signs are similar to other respiratory diseases, such as pulmonary tuberculosis. Therefore, a trauma history with the resulting radiologic and clinical findings is important for making a diagnosis. A 26-year-old male was admitted to our hospital due to cough for 3 days. The chest x-ray revealed diffuse infiltrations and a cavitary lesion at the left lung. His left chest had hit a tree as a result of motorcycle accident one day before admission. Initially, it was assumed that his symptoms and chest X-ray might be due to a tuberculosis infection. However, bronchoscopy revealed old blood clots at both lungs, particularly in the left lower lobe bronchus. A transbronchial lung biopsy showed alveolar hemorrhage. A traumatic pulmonary pseudocyst was diagnosed from his trauma history and these findings. Computed tomography of the chest performed 4 months later showed regression of the cavitary lesion.

• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.28-33
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• 2014

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori's methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.240-243
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• 2006

Pulmonary hamartoma is a common benign tumor of the lung, but endobronchial hamartoma is a rare tumor. Although bronchoscopic rcemoval or removal by bronchotomy or sleeve resection with preservation of the lung may be possible, when irreversible lung damage has occurred because of chronic obstruction and pneumonitis, pulmonary resection may be indicated. We herein report a case of endobronchial hamartoma which was treated by left upper lobectomy. A 42-year-old female with 3-week history of cough and left chest pain visited our hospital. Bronchoscopy showed total occlusion of the orifice of the left upper lobe bronchus by a lobulated endobronchial tumor and bronchoscopic biopsy was failed due to bleeding. A left upper lobectomy was performed because of severe consolidation of the left upper lobe by chronic obstruction. The patient was discharged on postoperative 14th day.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.236-239
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• 2006

A 32 year-old man was transferred to our hospital due to blood-tinged sputum for 15 days. He had been treated at a private hospital for recurrent pneumonia. The chest X-ray showed an atelectasis on the right middle lobe. Computed tomography of the chest demonstrated a broncholith on right middle lobar bronchus with lobar atelectasis of the right middle lobe. We tried to remove the broncholith through fiberoptic bronchoscopy, but could not remove it. Therefore, we performed surgical removal of broncholith and the right middle lobectomy. The cause of broncholith was identified as actinomycosis by pathologic examination. The broncholith caused by actinomycosis is rare. We report a rare case of broncholithiasis with recurrent obstructive pneumonia caused by actinomycosis, which was treated by surgical operation.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.416-424
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• 1989

We have performed eight, single transplantations of right lung in dogs from September, 1988 to March 1989 at the Thoracic & Cardiovascular Surgical department, Yonsei University, College of Medicine, Seoul, Korea. We wrapped bronchial anastomosis site with great omentum and used cyclosporin in preoperative and postoperative periods in seven cases except one. The one without wrapping the bronchial anastomotic site with omentum and using cyclosporin died due to bronchial anastomotic site rupture in postoperative fourth day. If there is no reason to choose one side over the other, we would generally choose to do left-sided transplant as this is technically somewhat easier because of the long length of recipient bronchus and the ease of clamping the left atrium proximal to the pulmonary veins. The right atrium limits the amount of left atrium that can have incorporated into the clamp proximal to the pulmonary veins on the right side. But we had chosen to do right-sided transplant of lung because we must take variable technical experiences on right sided lung transplant in dogs. We have to anastomose one of pulmonary vein and left atrial wall on right-sided transplant easily only with double ligation of one pulmonary vein because right atrium limited the clamp of left atrium proximal to pulmonary veins with decreased venous return and cardiac output in some dogs. All seven dogs with right-sided lung transplant had survived more than one day with good condition except one. The one dog have to be sacrificed to evaluate the difference between the gas analysis in pulmonary venous and arterial blood in post-operative eight hours. We found hemorrhagic pulmonary edematous changes of contralateral left lung in this dog. And also all dogs have to be sacrificed for the evaluation of surgical problems, anytime in post-operative periods without any cardiopulmonary resuscitative efforts when the general condition would be worse progressively. We found no any surgical technical errors in seven dogs except one with thrombi in suture site of left atrium. There were hemorrhagic pulmonary edematous changes of transplanted right lung in one, of contralateral left lung in one, of contralateral left lung with double ligation of its pulmonary artery in one, thrombi around left atrial sutures sites in one, multiple air leakage in one bronchial rupture in one due to rejection or infection. There were accidental extubation and delayed intubation in one and unknown cause of death in one.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.345-352
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• 1994

We have performed left lung transplantation followed by ligation of right pulmonary artery in 14 dogs at the Chest Disease Research Institute, Yonsei University College of Medicine from May 1992 to February 1994. Excised left lung was perfused with 1500cc of 4$^{\circ}$C cold Euro-Collin`s[E-C] solution at a pressure of 30cmH2O through main pulmonary artery and preserved in 4$^{\circ}$C cold E-C solution for one hour. Left lung transplantation were proceeded in order of left atrium, left main bronchus, left pulmonary artery and right pulmonary artery ligation as usual method. The femoral artery and pulmonary artery pressures were monitored for more than 5 hours after the transplantations in 14 dogs. Six recipient dogs had elevated mean pulmonary artery pressure to greater than 30mmHg after the left lung transplantation and ligation of right pulmonary artery. The cause of elevated mean pulmonary artery pressure was due to inadequate preservation resulting in ischemic damage to donor lungs in 3 cases, and inadequate surgical techniques in 3 cases. Two recipient dogs without surgical complications died immediate post-operatively due to hemorrhagic shock. The bleeding focuses were LA anastomotic site in one case and femoral artery puncture site in another case. The remaining 6 recipient dogs showed mean pulmonary arterial pressure less than 30mmHg. However, one dog had spontaneous pneumothorax in post-operative 4 days, and another dog had rejection phenomenon in post-operative 5 days which was confirmed by pathologic findings of extracted transplanted lung. One dog succumbed of severe hemoptysis which was due to lung abscess with pin point stenosis of bronchial anastomosis in post-operative 38 days. In conclusion, elevated mean pulmonary arterial pressure greater than 30mmHg in immediate postoperative period can be due to inadequate preservation of extracted lung or poor surgical techniques. And the two dogs succumbed of hemorrhagic shock even though the mean pulmonary arterial pressure was less than 30mmHg. It is thought that careful preservation of the extracted donor lung in 4oC E-C solution and complete surgical techniques are the most important factors early and late complications.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.6
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• pp.1593-1597
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• 2006

We hope to evaluate the effects of Gami-Choakwiyeum (GCKY) on the PPAR-${\gamma}$’ in the OVA induced asthma mouse model. Female BALB/c mice, 8 weeks of age and free of murine specific pathogens were used. Mice were sensitized by intraperitoneal injection of OVA emulsified in aluminum hydroxide in a total volume of 200 ${\mu}{\ell}$ on one day and 14 days. On 21, 22, and 23 days after the initial intraperitoneal injection of OVA, the mice were challenged using an ultrasonic nebulizer. GCKY was administered 7 times by oral gavage at 24 hour intervals fromdays 19 after intraperitoneal injection of OVA. Bronchoalveolar lavage was perfromed 72 hours after the last challenge, and total cell numbers in the BAL fluid were counted. Also, the level of PPAR-${\gamma}$ of normal and OVA-induced asthma moused with/without administration of GCKY were measured by Western blot analysis. For the histologic examination, the specimens were stained with hematoxylin 2 and eosin-Y.(H & E). Numbers of total cells were increased significantly at 72 h after OVA inhalation compared with numbers of total cells in the normal and the administration of GCKY. Especially, the increased numbers of eosinophils in BAL fluids after OVA inhalation were significantly increased. However, the numbers of eosinophils reduced by the administration of GCKY. Western blot analysis revealed that PPAR-${\gamma}$ levels in nuclear level were increased slightly after OVA inhalation compared with the levels in the normal group. After the administration of GCKY, PPAR-${\gamma}$ levels in cytosolic and nuclear levels at 72 h after OVA inhalation were markedly increased. On pathologic examination, there were many acute inflammatory cells around the alveoli, bronchioles, and airway lumen of mice with OVA-induced asthma compared with inflammatory cells in the normal group. However, acute inflammatory cells around alveoli, bronchioles, and airway lumen markedly decreased after administration of GCKY, GCKY can increase a PPAR-${\gamma}$ level and could be an effective treatment in asthma patients through the PPAR-${\gamma}$ mechanism for bronchial asthma.