• Title/Summary/Keyword: diseases of unknown etiology

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Right Shoulder Pain due to Metastatic Lung Cancer -A case report- (우측 견관절통 치료 중 발견된 전이된 폐암 1예 -증례보고-)

  • Jung, Young Ho;Woo, Seung Hoon;Jeon, Seung Gyu;Lee, Woo Yong;Lim, Yun Hee;Yoo, Byung Hoon
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.164-167
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    • 2008
  • Frozen shoulder is known to be a self-limited disease, and it is associated with chronic pain and limitation of joint movement. Although its etiology is still unknown, frozen shoulder is associated with several diseases. The diagnosis is made based on the medical history, the clinical and radiological examinations and exclusion of other shoulder pathologies. The skeleton is one of the most common sites of metastasis in patients with lung cancer. It has been reported that the incidence of bone metastases in lung cancer patients is approximately 30-40%, and the median survival time of patients with such metastases is 6-7 months. We experienced a case of a 77-year-old female patient who complained of right shoulder pain and limited joint mobility, and these symptoms were due to metastatic lung cancer in the shoulder.

Acute Scrotum in an Infant with Kawasaki Disease (가와사키병에서 나타난 급성 음낭증 1예)

  • Kang, Ha Young;Joo, Eun Young;Kim, Dong Hyun;Hong, Young Jin
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.60-64
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    • 2017
  • Kawasaki disease (KD) is a systemic vasculitis that occurs predominantly in infants and young children. The etiology of KD is unknown and coronary heart disease is a major complication of KD. Acute scrotum is a rare complication of acute KD, and not as well recognized as other manifestations of the disease. We report a 2-month-old boy with acute scrotum in the acute phase of KD. He was treated with intravenous immunoglobulin (total 2 g/kg) and aspirin (50 mg/kg/day). The treatment was effective in resolving his fever and other clinical symptoms, but 2 days after starting treatment he experienced scrotal swelling. Scrotal ultrasound and transillumination were used in the diagnosis of acute scrotum. After 2 months, a follow-up testicular ultrasound revealed a remission of the acute scrotum. Subsequently, he has been followed up for KD.

Utility of Routine Culture for Tuberculosis from Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in a Tuberculosis Endemic Country

  • Hong, Ji-Young;Jung, Ji-Ye;Kang, Young-Ae;Park, Byung-Hoon;Jung, Won-Jai;Lee, Su-Hwan;Kim, Song-Yee;Lee, Sang-Kook;Chung, Kyung-Soo;Park, Seon-Cheol;Kim, Eun-Young;Lim, Ju-Eun;Kim, Se-Kyu;Chang, Joon;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.408-416
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    • 2011
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a technique developed to allow mediastinal staging of lung cancer and also to evaluate intrathoracic lymphadenopathy. In a tuberculosis-endemic area, tuberculosis should be considered as an etiology of mediastinal lymphadenopathy. The aim of this study was to investigate the utility of the routine culture for tuberculosis from specimens of EBUS-TBNA. Methods: We prospectively performed routine culture for tuberculosis from aspiration or core biopsy specimens got from 86 patients who had undergone EBUS-TBNA due to mediastinal lymphadenopathy between March 2010 and March 2011. Results: A total of 135 lymph node aspiration and 118 core biopsy specimens were included in this analysis. We confirmed the malignancy in 62 (72.9%), tuberculosis in 7 (8.1%), sarcoidosis in 7 (8.1%), asperogillosis in 2 (2.3%) and pneumoconiosis in 2 (2.3%) patients. One lung cancer patient had pulmonary tuberculosis coincidentally and 5 patients had unknown lymphadenopathy. The number of positive culture for Mycobacterium tuberculsosis by EBUS-TBNA is 2 (1.5%) from 135 lymph node aspiration specimens and 2 (1.7%) from 118 core biopsy specimens. Out of eight patients confirmed with tuberculosis, only one patient had positive mycobacterial culture of aspiration specimen from EBUS-TBNA without histopathologic diagnosis. Conclusion: These results propose that routine culture for tuberculosis from EBUS-TBNA may not provide additional information for the diagnosis of coincident tuberculous lymphadenitis. However, if there is any possibility of tuberculous lymphadenopathy or pulmonary tuberculosis, it should be considered to perform EBUS-TBNA in patients who have negative sputum AFB smears or no sputum production.

A Case of Lymphocytic Interstitial Pneumonitis (임파구형 간질성 폐렴 1예)

  • Jung, Hee-Jin;Cho, Eun-Rae;Shim, Jae-Jung;In, Kwang-Ho;Yu, Sae-Hwa;Kang, Kyung-Ho;Won, Nam-Hee;Choi, Young-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.602-609
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    • 1993
  • Lymphocytic interstitial pneumonitis (LIP) is one of parenchymal pulmonary infiltrative diseases first described at 1966 by Carrington and Liebow. In LIP, there is a predominance of mature small lymphocytes in the interstitium of the lung which form germinal centers. The disease process surrounds, but dose not invade lung parenchyme, tracheobronchial tree and vascular structures. The etiology remains still unknown and the clinical features of this disorder have not been clearly defined. Therefore, the therapeutic modality is obscure. Development of LIP association with AIDS is often reported currently and possibility of progress to malignant lymphoma is emphasized. We experienced a case of primary LIP with pnemomediastinum. She was adimitted due to chest and anterior nuchal pain with chronic coughing, and diagnosed as pneumomediastinum with LIP. Medication with steroid was begun and some improvement of symptoms was observed, but an X-ray film of the chest remained same without improvement. We report above case with review of the literatures.

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MEDIAN CLEFT OF THE LOWER LIP AND MANDIBLE;A CASE REPORT (하순 및 하악골 정중열의 치험례)

  • Cha, Doo-Won;Kim, Hyun-Soo;Baek, Sang-Heum;Kim, Chin-Soo;Byeon, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.263-269
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    • 2001
  • Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.

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The Role of Bronchoscopy in Determining the Etiology of Pleural Effusion (흉막유출증의 원인규명에 기관지내시경의 역할)

  • Kim, Chang-Ho;Son, Ji-Woong;Kim, Gwan-Young;Kim, Jeong-Seok;Chae, Sang-Chull;Won, Jun-Hee;Kim, Yeon-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.397-403
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    • 1998
  • Background: Little information is available concerning the value of bronchoscopy in patients with a lymphocytic exudative pleural effusion in which percutaneous pleural biopsy have been regarded as cornerstone in investigating the etiology. Recently, a few reports suggest that bronchoscopy may be more effective diagnostic method in patients with unexplained pleural effusion accompanied by hemoptysis or other roentgenographic abnormalities, such as mass, infiltrate, atelectasis. Method: Mter initial examinations of sputum and pleural fluid through thoracentesis in 112 patients(male 75 cases, female 37 cases, mean age 53.2 years) who were admitted for evaluation of the cause of pleural effusion, we performed bronchoscopy and closed pleural biology in most patients with undiagnosed lymphocytic exudate and compared the diagnostic yield of both invasive methods according to hemoptysis or other roentgenographic abnormalities, and investigated the sole diagnostic contribution of bronchoscopy. Results: Tuberculosis(57 cases, 51%) was the most common cause of pleural effusion. Percutaneous pleural biopsy showed more diagnostic yield than bronchoscopy regardless of presence or absence of other clinical or radiologic abnormalities. In 25 cases with unknown etiology after pleural biopsy, additional diagnostic yield by bronchoscopy was 36 % (4/11) in patients with associated features and only 7 % (1/14) with lone effusion, and, as the sole mean for diagnsosis in all patients with pleural effusion, was only 4.5%(5/12). Conclusion : In a region of high prevalence of tuberculosis as a cause of pleural effusion, percutaneous pleural biospy is more effective method when invasive method is required for confirmative diagnosis of unexplained lymphocytic exudative pleural effusion, and bronchoscopy is unlikely to aid in the diagnosis of lone pleural effusion.

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A Case of Pulmonary Cavernous Hemangiomatosis Presented with Right Shoulder Pain (우측 어깨의 통증을 주소로 내원한 해면상 폐혈관종증 1례)

  • Lee, Eun-Young;Hong, Sang-Bum;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Dong-Kwan;Lee, In-Chul;Moon, Dae-Hyuck;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.99-104
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    • 2000
  • Pulmonary hemangiomatosis is a rare disease of unknown etiology characterized by diffuse proliferating microvessels that infiltrate not only the lung but also all of the thoracic tissues. The disease is rapidly progressive and usually results in death due to complications of pulmonary hypertension and pulmonary hemorrhage. There are two histologic patterns of pulmonary hemangiomatosis : capillary and cavernous. We describe a 21-year-old man with cavernous-type pulmonary hemangiomatosis presented with right side shoulder pain. He was treated with percutaneous transarterial embolization and then followed with interferon alfa-2a for one year with favorable clinical and radiological response.

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A Case of Endobronchial Lipoma Causing Right Middle and Lower Lobes Collapse and Bronchiolitis Obliterans-organizing Pneumonia (우중하엽 폐허탈 및 폐쇄세기관지기질화 폐렴을 유발한 기관지 지방종 1예)

  • Son, Ji Young;Jung, Ji Ye;Ha, You Jung;Hong, Soo Jung;Jung, Min Kyu;Chung, Moon Jae;Seo, Yong Sung;Moon, Ji Ae;Byun, Min Kwang;Park, Byung Hoon;Moon, Jin Wook;Park, Moo Suk;Kim, Young Sam;Chang, Joon;Kim, Sang Kyum;Chung, Kyung Young;Kim, Se Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.313-317
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    • 2008
  • Lipoma is a common neoplasm in soft tissues. However, an intrapulmonary lipoma is a rare benign tumor. Patients with a bronchial lipoma might have a malignant potential related to their smoking history due to the case reports of lung cancer accompanied with lipoma. Endobronchial lipoma can cause irreversible parenchymal lung damage if not diagnosed and treated early. Therefore, it should initially be treated by fiberoptic bronchoscopy or surgery depending on the status of distal parenchymal lung damage. Bronchiolitis obliterans with organizing pneumonia (BOOP) is a pathological syndrome that is defined by the presence of buds of granulation tissue consisting of fibroblasts and collagen within the lumen of the distal air spaces. BOOP is caused by drug intoxication, connective tissue disease, infection, obstructive pneumonia, tumors, or an unknown etiology. We encountered a 58 year-old male patient with endobronchial lipoma, causing the collapse of the right middle and lower lobes, and BOOP due to obstructive pneumonia.

A Case of Pulmonary Sarcoidosis Combined with Neurosarcoidosis (신경유육종증이 병발한 폐유육종증 1예)

  • Park, Byung Hoon;Park, Seon Cheol;Shin, Sang Yun;Jeon, Han Ho;Jung, Kyung Soo;Chung, Woo Young;Byun, Min Kwang;Moon, Ji Ae;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.549-553
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    • 2007
  • Sarcoidosis is a multi-systemic syndrome of an unknown etiology, and it is characterized by the formation of multiple noncaseating granulomas that disrupt the architecture and function of the tissues in which they reside. The most commonly affected organs are lung, skin and lymph nodes. Overt clinical involvement of the nervous system is uncommon and this occurs in about 5% of all patients during the course of their disease. The most common manifestations are granulomatous leptomeningitis, cranial nerve palsy, electrolyte or other endocrinologic abnormalities, but isolated memory impairment is a rare manifestation. This is a case of 59 years-old male with recent memory impairment, and he was previously diagnosed with pulmonary sarcoidosis by transbronchial lung biopsy. The brain MRI imaging revealed the leptomeningeal and parenchymal involvement of sarcoidosis. He was treated with high dose corticosteroid and his memory function was improved to nearly a normal level. We report here on a case of successful treatment of pulmonary sarcoidosis combined with neurosarcoidosis with using high dose corticosteroid, and the patient presented with recent memory impairment.

A Case of Successful Management of Sarcoidosis with Chylothorax Using Octreotide (옥트레오타이드를 이용한 유육종증과 동반된 유미흉의 보존적 치료 1예)

  • Jung, Kyung Soo;Moon, Ji Ae;Yoon, Sul hee;Byun, Min Kwang;Jung, Woo Young;Jung, Jae Hee;Choi, Sang Bong;Kim, Dae Joon;Pyo, Ju Yeon;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.119-124
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    • 2007
  • Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.