• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.318-324
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• 1992

Acquired tracheobronchial stenosis has resulted from vehicular accidents, prolonged tracheal intubation, sleeve resection, tuberculosis and sarcodosis. Various modalities of therapy for the relief of such stenosis included surgery, cryotherapy, laser photoresection, and sometimes balloon dilatation. Several recent reports have described the use of self-expandable metal stents for the dilatation of stenotic areas in the tracheobronchial tree. Three patients of benign acquired tracheobronchial stenosis were treated with self-expandable metal stents, who had shown little response to several times of balloon dilatations; One patient had a tracheal stenosis caused by intubation, one a right main bronchial stenosis developed after reconstructive surgery of traumatic bronchial rupture, and the other a left main bronchial stenosis caused by longstanding endobronchial tuberculosis. We found that the using stent in benign acquired tracheobronchial stenosis can be effectively performed with alleviation of clinical symptoms and lung function. And even in longstanding localized stenosis of main bronchus without distal bronchial destruction, lung perfusion also improved.

• Tuberculosis and Respiratory Diseases
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• v.53 no.3
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• pp.285-293
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• 2002

Background : The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. Materials and Methods : The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. Results : The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. Conclusion : An endobronchial metastasis is an ominous finding, and is associated with advanced-stage diseases. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.

• Tuberculosis and Respiratory Diseases
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• v.53 no.2
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• pp.196-201
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• 2002

Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant. melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.441-447
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• 2012

Background: Chest tube drainage (CTD) is an indication for the treatment of pneumothorax, hemothroax and is used after a thoracic surgery. But, in the case of incomplete lung expansion, and/or persistent air leak from CTD, medical or surgical thoracoscopy or, if that is unavailable, limited thoracotomy, should be considered. We evaluate the efficacy of bronchoscopic injection of ethanolamine to control the persistent air leak in patients with CTD. Methods: Patients who had persistent or prolonged air leak from CTD were included, consecutively. We directly injected 1.0 mL solution of 5% ethanolamine oleate into a subsegmental or its distal bronchus, where it is a probable air leakage site, 1 to 21 times using an injection needle through a fiberoptic bronchoscope. Results: A total of 15 patients were enrolled; 14 cases of spontaneous pneumothorax [idiopathic 9, chronic obstructive pulmonary disease (COPD) 3, post-tuberculosis 2] and one case of empyema associated with broncho-pleural fistula. Of these, five were patients with persistent air leak from CTD, just after a surgical therapy, wedge resection with plication for blebs or bullae. With an ethanolamine injection therapy, 12 were successful but three (idiopathic, COPD and post-tuberculosis) failed, and were followed by a surgery (2 cases) or pleurodesis (1 case). Some adverse reactions, such as fever, chest pain and increased radiographic opacities occurred transiently, but resolved without any further events. With success, the time from the procedure to discharge was about 3 days (median). Conclusion: Bronchoscopic ethanolamine injection therapy may be partially useful in controlling air leakage, and reducing the hospital stay in patients with persistent air leak from CTD.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.7.1-7
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• 1979

This paper was attempted to analyze 31 cases of fiberoptic bronchoscopy during the period of 8 months from October 1978 till February 1979 in the Chung-Ang University Hospital. The results were as follows; 1) Among 31 cases. 20 cases were male, 11 cases female. Sex ratio was 2 : 1. 2) In age distribution, 22 cases (70.1%) were in 4th-7th decade, and the other age groups showed relatively even distribution. 3) The chief complaints were hemoptysis (11 cases, 35.5%), coughing (9 cases, 29.0%), chest pain (6 cases, 19.4%), dyspnea (3 cases, 9.7%) and others (2cases, 6.5%). 4) In Gram staining of bronchial secretion, Gram (-) diplococci were in 12 cases (38.7%), Gram (+) cocci 10 cases (32.3%), Gram (+) rods 6 cases (19.4%)and Gram (-) rods 3 cases (9.7%). In culture of bronchial secretion, no growth were in 17 cases (54.8%). Neisseria group 6 cases (19.4%), Proteus and Klebsiella group 1 case (3.2%) and mixed group 3 cases (9.7%). In histopathological study, 11 cases (35.5%) revealed chronic bronchitis, 9 cases (29.0%) bronchogenic carcinoma, 3 cases (9.7%) chronic granulomatous disease and 2 cases (6.5%) no specific findings. In 6 cases biopsy specimens were too small to be examined histopathologically. 5) In diagnosis by bronchoscopic appearance and by laboratory examination of bronchoscopically removed specimens, 9 cases(29.0%) were primary carcinoma of bronchus, 6 cases (19.4%) chronic bronchitis, 4 cases (12.9%) pneumonia in the order of freguency

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.279-285
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• 2005

One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.786-796
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• 1999

Background: It has been anticipated that the amount and composition of mucin are changed in patients with chronic airway diseases. We evaluated whether RTO3(mAb against rat tracheal mucins) could quantify the amount of mucin from the airway in the patients with chronic airway diseases. Methods and results; 1) RTO3 was bound to high molecular weight of mucin based on Western blot in sputum and BALF from patients with chronic airway diseases. 2) The goblet cells and submucosal glands in main bronchus from human were observed by PAS stain. And immunohistochemical stain with RTO3 showed immunoreactivity on some goblet cells. 3) The amount of mucin was more increased in patients with chronic airway diseases compared to those in normal subjects. 4) In the exacerbation of asthmatics, mucin amounts were more increased than stable asthmatics. Conclusion: We suggested that secreted mucin in chronic airway diseases can be quantified by ELISA with RTO3.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.389-393
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• 1999

Endometriosis is defined as an extrauterine growth of endometrial tissue and it is primarily limited in the pelvis but it can also occur in the pleural cavity as well as pulmonary parenchyme. The diagnosis of pulmonary endometriosis is usually based on the clinical history of recurrent hemoptysis in association with menstrual cycle and by histopathologic confirmation of endometrial tissue in the lung parenchyme. Pulmonary endometriosis was first reported by Lattes in 1956. and dozens of cases have been reported so far. We experienced a case of 25 year old single woman with a history of hemoptysis in association with her menstruation. The bleeding focus was localized with chest CT scan and repeated fibrooptic bronchoscopy and basal segmentectomy of the right lower lobe was performed. The resected specimen shows endometrial stroma and glands of early proliferative phase with respiratory epithelium on the laterobasal bronchus. Her postoperative course was uneventful with no recurrence of hemoptysis during 6 months of follow-up in the outpatient clinic.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.440-444
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• 2015

Gastric mucosal damage by iron pills is often reported. However, iron pill aspiration is uncommon. Oxidation of the impacted iron pill causes bronchial mucosal damage that progresses to chronic bronchial inflammation, necrosis, endobronchial stenosis and rarely, perforation. We reported a case of a 92-year-old woman with chronic productive cough and significant left-sided atelectasis. Bronchoscopy revealed substantial luminal narrowing with exudative inflammation of the left main bronchus. Bronchial washing cytology showed necroinflammatory exudate and a small amount of brown material. Mucosal biopsy showed diffuse brown pigments indicative of ferrous pigments, crystal deposition, and marked tissue degeneration. After vigorous coughing, she expectorated dark sediments and her symptoms and radiological abnormalities improved. There are a few such reports worldwide; however, this was the first case reported in Korea. Careful observation of aspiration-prone patients and early detection of iron pill aspiration may prevent iron pill-induced bronchial injury.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.68-71
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• 2012

Untreated massive hemoptysis, especially in patients with tuberculous-destroyed lung, is a serious complication resulting in considerable morbidity and mortality. We report a case of a patient who had active tuberculosis and a destroyed left lung with massive bleeding. He was transferred to our clinic with intubation of a right-sided Robertshaw double lumen tube and right upper lobe collapse likely due to tube malposition that was presented on chest X-ray. Because hemoptysis had persisted after bronchial arterial embolizaton, we replaced the double lumen tube with a conventional endotracheal tube and inserted an endobronchial blocker into the left main bronchus through an endotracheal tube guided by bronchoscopy to prevent aspiration of blood into the right lung. Left pneumonectomy was performed and hemotpysis was ceased. We suggest that the use of an endobronchial blocker followed by surgery may be a safe and effective modality of treatment in patients with persistent bleeding after bronchial arterial embolization.