• Tuberculosis and Respiratory Diseases
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• 제49권1호
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• pp.105-110
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• 2000

저자들은 객담, 기침, 발열과 호흡곤란을 보이고 단순 흉부촬영상 다발성 공동과 경변을 보이며 흉부 전산화 촬영과 폐동맥 혈관조영술상 폐 동맥류가 확인된 환자에서 폐 절제술후 만성 괴사성 침입성 폐 국균증으로 진단된 1예를 경험하였기에 이에 보고하는 바이다.

• Journal of Chest Surgery
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• 제12권1호
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• pp.1-8
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• 1979

Pulmonary aspergillosis is being recognized with increasing frequency in recent years and the-rising incidence of this infection parallels certain medical advances in antibiotics, chemotherapeutic and immunosuppressive therapy. The cavities of lungs resulting from tuberculosis, histoplasmosis or neoplasm are apt, to be infected by one of the species of the genus Aspergillus and eventually mycetomas are formed within the cavities. Authors have experienced 6 cases of pulmonary aspergillosis forming mycetoma in Dept. of Thoracic Surgery, Catholic Medical Center from Aug. 1976 to Feb. 1979. Hemoptysis or blood tinged sputum, the predominant symptom, occurred in all cases. All patients underwent pulmonary resection, 1 pneumonectomy, 3 lobectomies, 1 lobectomy with segmental resection and 1 segmental resection and survived well without death or complication. Primary aspergillosis was in 2 cases and underlying diseases were present in 4 cases: 3 pulmonary tuberculosis, 1 bronchiectasis. The common diagnostic study of intracavitary mycetoma was the posterioanterior chest roentgenogram; in cavities suspected of being diseased or in doubtful cases, tomography was most available to find fungus ball with air-meniscus shadow.

• Journal of Chest Surgery
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• 제6권2호
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• pp.171-174
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• 1973

A case of pulmonary aspergillosis, strongly suspected before operation and confirmed after surgical intervention, was reviewed with related literatures. It has become to be a well recognized fact that pulmonary mycosis generally results from sapro-phytic colonization of previous lung cavities usually due to pulmonary tbc, lung abscess, cyst of bronchiectasis. Recently, the author experienced one case of pulmonary aspergillosis which had been diagnosed and treated as tuberculosis for 6 years. Sputum culture, immunologic study and X-ray findings constitute essential part of diagnosis. Surgical resection is the treatment of choice combined with systemic administration of anti-fungal agents to eradicate the disease completely.

• Journal of Chest Surgery
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• 제23권5호
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• pp.998-1002
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• 1990

We managed a 30 years old female pulmonary aspergillosis patient concomitant with staged pneumothorax bilaterally whose lung function decreased severely. Operative indication was fetal hemoptysis. She discharged at four weeks after left upper lobectomy in good general condition. And we .concluded that early resection should be considered in patients with pulmonary aspergilloma and coexistent pulmonary tuberculosis because those are at greater risk of fetal hemorrhage, particularly once severe hemoptysis has occurred although poor lung function in our country.

• Tuberculosis and Respiratory Diseases
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• 제75권6호
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• pp.260-263
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• 2013

Invasive aspergillosis has emerged as a major cause of life-threatening infections in immunocompromised patients. Recently, patients with chronic obstructive pulmonary disease, who have been receiving corticosteroids for a long period, and immunocompetent patients in the intensive care unit have been identified as nontraditional hosts at risk for invasive aspergillosis. Here, we report a case of invasive pulmonary aspergillosis after influenza in an immunocompetent patient. The patient's symptoms were nonspecific, and the patient was unresponsive to treatments for pulmonary bacterial infection. Bronchoscopy revealed mucosa hyperemia, and wide, raised and cream-colored plaques throughout the trachea and both the main bronchi. Histologic examination revealed aspergillosis. The patient recovered quickly when treated systemically with voriconazole, although the reported mortality rates for aspergillosis are extremely high. This study showed that invasive aspergillosis should be considered in immunocompetent patients who are unresponsive to antibiotic treatments; further, early extensive use of all available diagnostic tools, especially bronchoscopy, is mandatory.

• Journal of Chest Surgery
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• 제37권12호
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• pp.1022-1024
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• 2004

국균은 사람에서 발견되는 진균중 가장 흔한 것이기는 하나 낮은 병원성을 갖고 있다. 국균의 호흡기 감염은 국균종, 기관지폐 국균증,괴사성 및 침습형 폐 국균증의 유형으로 분류된다. 이중 괴사성 및 침습형 폐 국균증은 장기 이식 후 면역억제 치료를 받고 있거나, 항암요법을 받는 자, 혈액 이상자 또는 후천성 면역 결핍증 환자 같이 면역 저하자에서 주로 발생하며 정상적인 면역 능력이 있는 자에서는 발병률이 매우 낮다. 본원에서는 정상 면역 능력을 갖은 자에서 흉추에 침범한 침습형 페 국균증을 1예 치험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제19권3호
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• pp.381-384
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• 1986

Pulmonary aspergillosis is a relatively rare disease in Korea. Immune suppressive patients, resulting from misuse or long term therapy of antibiotics, steroid and anticancer chemotherapeutics tend to be vulnerable to pulmonary aspergillosis. This study is made to illustrate the clinical features, preoperative diagnosis and surgical role in the management is this diseases. In retrospective study of operative cases from May 1980 through July 1986, 10 cases were analysis. Hemoptysis and blood tinged sputum were the most common chief complaints. Major underlying pathology was cavitary lesion or bronchiectasis caused by pulmonary tuberculosis [5 cases]. 2 cases were disseminated form due to immune suppression. Anatomic location of lesion was in the upper lobe in half case. Systemic antifungal agent is helpful for invasive aspergillosis and Resection is the treatment of choice for localized fungus balls and symptomatic localized forms.

• Journal of Chest Surgery
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• 제40권9호
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• pp.617-623
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• 2007

배경: 침습성 폐아스페르길루스증은 면역체계가 낮은 환자들에게 흔한 진균감염으로, 특히 백혈병으로 항암제 치료를 받고 있는 환자들에서는 항진균제 치료에 반응이 적은 것으로 알려져 있다. 저자들은 백혈병의 치료 중 합병된 폐아스페르길루스증에 대하여 모두 폐절제술을 시행하였으며, 그의 효과 등을 알아보고자 하였다. 대상 및 방법: 1998년 2월부터 2007년 4월까지 혈액암 질환의 진단과 함께 침습성 폐아스페르길루스증 진단을 받은 환자 14명을 대상으로 후향적인 검토를 하였다. 환자의 의무기록을 통해 혈액암(기저질환)의 종류와 그에 따른 치료, 침습성 폐아스페르길루스증의 진단방법, 수술 전 혈액학적 상태와 처치, 수술방법, 수술 후 합병증과 사망여부, 수술 후 폐아스페르길루스증의 재발현율 및 골수이식 여부 등을 조사하였다. 결과: 침습성 폐아스페르길루스증이 합병된 혈액암 환자 14명에서 모두 폐엽절제술이 시행되었다. 수술 후 1명의 환자에서 기관지흉막루가 발생되었으나, 기타 창상감염, 출혈 등의 위중한 합병증이나 수술 후 사망한 환자는 없었으며, 모두 백혈병치료를 지속할 수 있었다. 결론: 침습성 폐아스페르길루스증은 혈액암에 대한 치료 도중 종종 발생되는 위중한 질환이나, 폐엽절제술은 안전하며 효과적으로 혈액암의 치료를 유지시켜 줄 수 있는 치료법으로 생각한다.

• Journal of Chest Surgery
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• 제9권1호
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• pp.73-77
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• 1976

Pulmonary aspergillosis is a rare disease, mostly commonly presenting as secondary invasion of pre-existing cavitary disease. In severance hospital, 9 patients have recognized as having this disorders in the 16 years from 1960 to April, 1976. The diagnosis of the aspergillosis has been made by examination of tissues removed at surgery in severance hospital, all the cases of aspergillosis except one (a Lt upper lobectomy due to bronchiectasis, performed 20 years ago) the case had been diagnosed as pulmonary tuberculosis and treated with anti-tuberculosis drugs for periods ranging from 2 to 14 years the most common presenting symptoms were hemoptysis, blood-tinged sputum and cough for a long time. All of the cases were confirmed by pathological examination to be aspergillosis superimposed on underlying tuberculosis and/or bronchiectasis three cases were suspected clinically by fungus cultures, seven cases were confirmed as aspergillosis, after surgery. One patient died following surgery because of bleeding and pulmonary insufficiency.

• Journal of Chest Surgery
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• 제26권5호
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• pp.380-383
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• 1993

Aspergillosis is not only the problem increasing the freguency for recent decades but also a serious one. Coexistent pulmonary diseases are frequent and the most common antecedent disease is Tuberculosis with healed cavitary lesion. Interest of the surgeons is aroused because of it`s predilection to sudden life-threatening, exsanguinating pulmonary hemorrhage. 11 patients with pulmonary aspergillosis evaluated at this hospital in a 7-year period, and the results were as follows: 1.male to female ratio was 1:1.75. 2.The most common symptom was gross or microscopic hemoptysis[72.7%]and other symptoms were chest pain[9.1%] and chronic productive coughing[9.1%]. 3.The right upper lobe was most common involving site[81.8%] 4.Surgical interventions were 8 cases of lobectomy, 1 case of lobectomy with wedge resection, 2 cases of wedge resection. 5.Post-operative complications developed in 5 patients and were 4 cases of wound infections, 2 cases of empyemas, 1 case of bleeding, 1 case of atelectasis.