• Title/Summary/Keyword: bronchus

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Treatment of Massive Hemoptysis Occurred from Destroyed Lung: Prevention of Contralateral Aspiration Using Endobronchial Blocker Followed by Pneumonectomy (파괴폐에서 발생한 대량객혈의 치료: Endobronchial Blocker를 이용하여 반대측 폐로의 흡인을 방지한 후 시행한 전폐절제술)

  • Kim, Seul-Ki;Lee, Eun-Jung;Park, Ji-Young;Kim, Eun-Young;Kang, Kyung-Hwan;Chung, Hoe-Hoon;Choi, Cheon-Woong;Kim, Yee-Hyung;Yoo, Jee-Hong;Kwak, Young-Tae;Cho, Sang-Ho;Chung, Jun-Young;Kim, Dae-Hyun
    • 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.

A Case of Primary Endobronchial Leiomyosarcoma Noticed by Massive Hemoptysis (대량객혈로 발견된 원발성 기관지내 평활근육종 1예)

  • Kim, Woo Youl;Kang, Gu Hyun;Lee, Jin Ho;Park, Sun Hyo;Kang, Kyung Woo
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.484-489
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    • 2006
  • A primary pulmonary leiomyosarcoma is a very rare pulmonary malignancy that arises from smooth muscle of either the bronchial or arterial walls. Common symptoms of the tumor are cough, dyspnea, chest pain and hemoptysis. The diagnosis of a primary pulmonary sarcoma can be established only after extensive clinical and radiologic examinations have failed to identify an alternative primary source. The only effective treatment for the tumor is a complete surgical resection when feasible. The type of resection is dictated by the local anatomic extent of the tumor. We report a case of a 21-year-old male with a primary endobronchial leiomyosarcoma who presented with massive hemoptysis. A necrotic ulcerative endobronchial lesion was observed in the orifice of left lower lobe bronchus on a bronchoscopic examination. He was treated with a complete sleeve resection of the left lower lobe. Three months later, local recurrence of the tumor was noticed on the follow up bronchoscopy and a then left pneumonectomy was then performed. Fifteen months later, the patient died from empyema with a bronchopleural fistula that was associated with tumor recurrence at the stump of the pneumonectomy.

1 Case of Bronchial Leiomyoma with Intralobar Pulmonary Sequestration (폐 격리증을 동반한 기관지내 평활근종 1례)

  • Jung, Bo Yong;Kim, Do Hwan;Park, Eun Seo;Han, Seung Hoe;Kim, Young Tong;Oh, Mi Hye;Lee, Seok Yul;Choi, Jae Sung;Na, Joo Ock;Seo, Ki Hyun;Kim, Yong Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.678-683
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    • 2006
  • Both bronchial leiomyoma and pulmonary sequestration are rare conditions, and to the best of our knowledge there are no reports of the two conditions coexisting. We report a female patient with bronchial leiomyoma with acquired pulmonary sequestration who presented with dyspnea, cough and purulent sputum. The patient had been treated for pneumonia at a local medical clinic. but was transferred to our clinic beacausr there was no clinical improvement. A 3-D computed tomography scan revealed a 1.5 cm sized mass near the distal portion of the left main bronchus and an anomalous artery arising from the aorta. The patient showed clinical improvement after a left lower lobectomy and a ligation of the anomalous artery.

A Statistical Survey of the Foreign Bodies in the Food and Air Passages (식도및 기도이물의 통계적 고찰)

  • Lee, Min-Hyung;Kang, Baek;Lee, Byung-Hee;Cheon, Kyung-Doo;Kim, Chul-Woo
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.6.3-6
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    • 1983
  • A total of 287 patients with foreign body in the air and food passage was treated in our unit between 1972 and 1982 and the following results were obtained : 1) The ratio between food and air passage was about 8 : 1. 2) The most common foreign bodies in the esophagus were coin (55.8%) and bone (28.5 %). Beans were the most common in the air passage (39.4%). 3) In sex distribution, there was no significant difference between male and females in the esophageal foreign bodies, but in the air passage male were prevalent (M : F = 57.9% : 42.1%). 4) In the age incidence, 61.8 % of the esophageal foreign bodies and 71 % of the foreign bodies in the air passage were under 5 Years of age. 5) The most prevalent site of Lodgement in the esophagus was the first narrowing (82.3 %). In the air passage, bronchial foreign bodies were more common and the right bronchus was the more frequent site (2 : 1). 6) In duration of lodgement, 62.2 % of esophageal foreign bodies and 55.2 % of foreign bodies in the air passage were removed within one day. 7) The most common complication of foreign bodies in the air passage was pneumonia (55.5%). 8) The removal of the foreign bodies in the air passage was performed by ventilation - bronchoscopy (84.3%). Two of 38 cases expired.

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A Clinical Study of the Foreign Body in the Air Passage (기도이물의 임상적 고찰)

  • 조진규;안회영;홍남표;이익재
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.13.3-14
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    • 1983
  • A clinical study was done on 24 cases with foreign body in the air passage, who were treated at the department of otolaryngology of Kyung Hee university hospital during the period from Apr. 1973 to Feb. 1983. The obtained results were as follows : 1) The incidence of sex was much higher in male than female and children under 4 years old were predominant. 2) Almost of all patients came in the hospital within 3 days after onset. However one patient came in hospital 5 months later. 3) The variety of foreign body was numerous, among which vegetables and plastic materials were most frequently found. 4) The most common sites of lodgement were trachea and right main bronchus. 5) The common clinical manifestations were dyspnea, decreasing breathing sound and cough. Negative X-ray findings did not exclude a foreign body in the air passage. 6) The important pulmonary complications due to foreign body were atelectasis, emphysema and pneumonia. 7) Foreign body was successfully removed by use of peroral or inferior endoscopy in all cases except one case, on whom thorachotomy was done. 8) The important complications due to the surgical procedure were decannulation difficulty and pneumothorax.

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A Case of Spontaneously Regressed Endobronchial Sarcoma after Obstructive Pneumonia (폐쇄성 폐렴 후 자연 퇴행을 보인 기관지내 육종 1예)

  • Park, Sun Hyo;Jeon, Yong June;Kwon, Kun Young;Han, Seung Beom
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.94-99
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    • 2007
  • The spontaneous regression (SR) of cancer is defined as the complete disappearance of a malignant disease without adequate treatment. SR is a very rare biological event, particularly in a pulmonary sarcoma. We report the first documented case of an endobronchial sarcoma that regressed spontaneously in Korea. We encountered a rare case of a 72-year-old woman with an undiagnosed intrapelvic cystic mass, who presented with a smooth surfaced endobronchial tumor obstructing the orifice of the right lower lobe bronchus on a bronchoscopic examination. She had a prior history cervical cancer and adenocarcinoma in the right middle lobe lateral segment of her lung for which she had undergone radiation therapy. The tumor was diagnosed as an endobronchial sarcoma by the histopathology findings and immunohistochemistry. It was unclear if the tumor was a primary sarcoma of the lung or a metastatic lesion of an intrapelvic cystic mass because she refused a diagnostic exploratory laparotomy. Two months later, obstructive pneumonia of the right lower lobe with parapneumonic effusion developed with fever above 38.5degrees C for 10 days. After recovering from pneumonia, she was followed up regularly in the outpatient clinic without any specific treatment. One year later after treating the obstructive pneumonia, the follow-up bronchoscopy revealed complete SR of endobronchial sarcoma. It is believed that the obstructive pneumonia accompanied by fever above 38.5degrees C for 10 days might have played a role in this SR.

Primary Endobronchial Leiomyoma Combined with Uterine Leiomyoma (자궁근종을 동반한 원발성 기관지 평활근종)

  • Shim, Hyun Jeong;Lim, Jung-Hwan;Lee, Seok;Kim, Dae Hyun;Park, Kang Jin;Lee, Se Ryeon;Jeong, Jong-Pil;Son, Jun-Gwang;Kim, Soo-Ok;Oh, In-Jae;Kim, Kyu-Sik;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul;Kim, Seok-Mo;Na, Kook-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.490-495
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    • 2006
  • Leiomyoma of the bronchus is a very rare benign tumor of the lung. Most endobronchial leiomyomas occur as secondary foci of primary uterine leiomyoma. We herein report a case with endobronchial tumor that had a different pathology from a primary resected uterine leiomyoma and was therefor considered a primary endobronchial leiomyoma. A 51-year-old woman with a history of uterine myoma presented with productive cough and fever. Bronchoscopy revealed a lightly yellow colored mass lesion that totally obstructed the orifice of the left lower lobe of the lung. The diagnosis of leiomyoma was made by histological examination of the obtained specimen. We considered the possibility of a benign metastasizing pulmonary leiomyoma. For treatment and differential diagnosis, a left lower lobe lobectomy of the lung and total hysterectomy with bilateral salphingooopherectomy were performed. The differences between lung and uterine lesions were confirmed by morphologic finding and immunohistochemical staining. The pathological diagnosis was primary endobronchial leiomyoma combined with uterine myoma.

Hemorrhargic Effusion Caused by Chronic Torsion of Right Middle Lung Lobe with Concurrent Ovarian Tumor in a Female Miniature Poodle Dog (난소종양이 병발한 암컷 푸들에서 오른쪽 중간엽 폐염전으로 인한 만성적인 출혈성 흉수 증례)

  • Kim, Tae-Hwan;Hong, Subin;Kim, Minkyung;Shin, Jeong-In;Jang, Yun-Sul;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.530-535
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    • 2015
  • An 11-year-old intact female miniature poodle presented with a four-month history of hemorrhagic effusion. The patient was alert on physical examination, although muffled heart sounds were noted upon auscultation of the right hemithorax. The radiographic finding was pleural effusion. Ultrasonography revealed cystic changes in both ovaries and several nodules in the liver. A refractory opacity in the right lung field, as visualized with computer tomography (CT), was diagnosed as right middle lung lobe torsion with a collapsed bronchus. Five days after diagnosis, a right fifth intercostal thoracotomy was performed to remove the right middle lung lobe; the right middle lung lobe was grossly shrunken as a result of chronic lung lobe torsion. Ovariohysterectomy was also performed. Histopathologic examination revealed papillary adenocarcinoma in both ovaries and suspected metastasized ovarian adenocarcinoma cells in the lung lobe. The patient recovered favorably and had been doing well up to two months post-surgery. However, after four months, the dog presented with respiratory difficulty. The radiographic findings were pleural effusion and collapse of the right cranial and left caudal lung lobes. Malignant cells of epithelial origin were observed in the pleural effusion. The tumor cells were suspected to be metastasized cells from the previously resected lung lobe. Although cancer treatment was recommended, the suggestion was suspended and the dog was discharged from hospital. This was a case of lung lobe torsion that had occurred because of hemorrhagic effusion due to tumor. Although ovariohysterectomy and lobectomy were performed, there was a relapse of hemorrhagic effusion because of metastasized tumor from the previously resected lung lobe.

Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy

  • Hong, Kyung Soo;Ahn, Heeyun;Lee, Kwan Ho;Chung, Jin Hong;Shin, Kyeong-Cheol;Jin, Hyun Jung;Jang, Jong Geol;Lee, Seok Soo;Jang, Min Hye;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.282-290
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    • 2021
  • Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

Physicochemical properties and biological activity of three-year-old and seven-year-old Platycodon grandiflorum extracts (3년근 도라지와 7년근 도라지의 이화학 특성 및 생리활성)

  • Chae, Kyu Seo;Baek, Mi Seon;Ryu, Eun Hye;Kim, Ki Deok;Kwon, Ji Wung
    • Korean Journal of Food Science and Technology
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    • v.50 no.6
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    • pp.665-670
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    • 2018
  • This study was designed to evaluate the physicochemical properties and biological activities (antioxidant activity and antimicrobial activities) of three and seven-year-old Platycodon grandiflorum extracts. Three and seven-year-old Platycodon grandiflorum contained crude saponins, free amino acids and minerals. Water extracts of the three and seven-year-old plants were prepared using reflux extraction methods. The total polyphenol contents (TPC), total flavonoid contents (TFC), 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS) radical scavenging activity and antimicrobial effects of the extracts were determined. The seven-year-old Platycodon grandiflorum extract had higher TPC ($5.08{\pm}0.07TAEmg/g$) and TFC ($3.80{\pm}0.07QUEmg/g$). DPPH radical scavenging activity ($IC_{50}$ value: $288{\pm}3.88{\mu}g/mL$) and ABTS radical scavenging activity ($IC_{50}$ value: $568{\pm}2.09{\mu}g/mL$). The three and seven-year-old Platycodon grandiflorum extracts exhibited a strong antimicrobial effect against three kinds of bronchus disease-inducing bacteria; the seven-year-old Platycodon grandiflorum extracts showed a stronger antimicrobial effect than the three-year-old Platycodon grandiflorum extracts.