• Tuberculosis and Respiratory Diseases
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• v.55 no.4
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• pp.402-407
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• 2003

Mesoblastic nephroma is a neoplasm of the kidney which is characterized by interlacing bundles of spindle mesenchymal cells. It is usually diagnosed during the first six months of life and is mostly benign. Incidence in adults is exceedingly rare. In most cases, only total excision is required without postoperative adjuvant therapy, and the rare cases of local recurrence have usually been related to incomplete removal. However, mesoblastic nephroma may behave aggressively, in contrast to a congenital mesoblastic nephroma. Several cases of metastatic mesoblastic nephroma have been previously described. We report herein a case of a 42-year-old woman with mesoblastic nephroma which recurred as a large metastatic lung mass seven years after the nephrectomy. The patient presented with chest wall discomfort for four days. Seven years previously, total nephrectomy had been performed because of a right renal tumor which had been diagnosed as a mesoblastic nephroma. There had been no evidence of recurrence for five years, after which she discontinued follow-up. On readmission two years later, chest X-ray and CT scan revealed a large lung mass in the left upper lobe. It was completely excised and the pathologic examination was identical with that of the original renal tumor. Synovial sarcoma was excluded because the fusion transcripts of the SYT-SSX fusion gene associated with the t(X;18) translocation were negative. The final diagnosis was a lung metastasis of mesoblastic nephroma and the patient remained free of disease for 7 months postoperatively.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.72-77
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• 2004

Background : A tracheobronchial obstruction in lung cancer is associated with significant morbidity and mortality due to dyspnea, cough, hemoptysis, and recurrent respiratory infection. It is well known that one of standard treatments is photodynamic therapy (PDT) in tracheobronchial obstruction after radiotherapy, chemotherapy, and/or surgery. We reported here the role of PDT in airway obstruction in patients advanced lung cancer. Method : Pre-treatment protocol consisted of clinical, radiologic, and bronchoscopic examination, pulmonary function test, and assessment of Karnofsky performance status. A 2 mg/kg of porfimer sodium was injected intravenously, and then followed by cylindrical and/or interstitial irradiation with 630 nm of laser after 48 hours. The repeated bronchoscopy for debridement of necrotic tissue and re-illumination was performed after 48 hours. Result : Improved airway obstruction and selective tumor necrosis were achieved by photodynamic therapy in all cases. Dyspnea and performance status were improved in three cases. A purulent sputum, fever and hemoptysis were improved in one of five cases. After PDT, all patients showed temporarily aggravation of dyspnea, two of five showed febrile reaction for a few days and nobody presented photosensitivity reaction, hemoptysis and respiratory failure. Conclusion : Our experiences of PDT are effective in palliation of inoperable advanced lung cancer in terms of tracheobronchial obstruction.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.341-348
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• 2015

Background: There have been various results from studies concerning the predictors of recurrence in early-stage nonsmall cell lung cancer (NSCLC). Therefore, an accurate assessment is needed to guide effective adjuvant therapy. We investigated the predictors of a recurrence in patients with resected, early-stage NSCLC and the risk factors associated with locoregional or distant recurrence. Methods: This retrospective study was conducted on patients at the Pusan National University Hospital from January 2006 to December 2011. Patients with pathological stages I or II were included in this study, as based on the seventh edition TNM staging system. Multivariate Cox proportional hazard models were used to identify factors associated with recurrence. Results: Two hundred and forty-nine patients were included. Among them, 180 patients were stage I, and 69 were stage II. Overall, by multivariate analysis, the independent factors associated with a 5-year total recurrence were the presence of visceral pleural invasion (VPI) (p=0.018) and maximal standardized uptake values (SUVs) of tumors on positron emission tomography (PET) >4.5 (p=0.037). The VPI was the only independent risk factor associated with both locoregional and distant recurrence, in the analysis of the patterns of tumor recurrence and their risk factors. In the subgroup analysis of stage I patients, three variables (male, VPI and resection margin positive) were significantly associated with a 5-year recurrence. Conclusion: The independent factors associated with postoperative recurrence in early-stage NSCLC were as follows: PET SUV >4.5 and the presence of VPI. For patients with those factors adjuvant therapy should be recommended as a more efficacious treatment.

• Tuberculosis and Respiratory Diseases
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• v.64 no.5
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• pp.383-386
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• 2008

An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients' clinical condition.

• Tuberculosis and Respiratory Diseases
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• v.64 no.3
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• pp.219-223
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• 2008

Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.80 no.4
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• pp.385-391
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• 2017

Background: Men with chronic obstructive pulmonary disease, have reduced endogenous testosterone levels, but the relationship between pulmonary function and endogenous testosterone levels, is inconsistent. Testicular volume is a known indicator of endogenous testosterone levels, male fertility, and male potency. In the present study, the authors investigated the relationship, between testicular volume and lung function. Methods: One hundred and eighty-one South Korean men age 40-70, hospitalized for urological surgery, were retrospectively enrolled, irrespective of the presence of respiratory disease. Study subjects underwent pulmonary function testing, prior to procedures, and testicular volumes were measured by orchidometry. Testosterone levels of patients in blood samples collected between $7{\small{AM}}$ and $11{\small{AM}}$, were measured by a direct chemiluminescent immunoassay. Results: The 181 study subjects were divided into two groups, by testicular volume (${\geq}35mL$ vs. <35 mL), the larger testes group, had better lung functions (forced vital capacity [FVC]: $3.87{\pm}0.65L$ vs. $3.66{\pm}0.65L$, p=0.037; forced expiratory volume in 1 second [$FEV_1$]: $2.92{\pm}0.57L$ vs. $2.65{\pm}0.61L$, p=0.002; FVC % predicted: $98.2{\pm}15.2%$ vs. $93.8{\pm}13.1%$, p=0.040; $FEV_1$ % predicted: $105.4{\pm}19.5%$ vs. $95.9{\pm}21.2%$, p=0.002). In addition, the proportion of patients with a $FEV_1/FVC$ of <70%, was lower in the larger testes group. Univariate analysis conducted using linear regression models, revealed that testicular volume was correlated with FVC (r=0.162, p=0.029), $FEV_1$ (r=0.218, p=0.003), $FEV_1/FVC$ (r=0.149, p=0.046), and $FEV_1$ % predicted (r=0.178, p=0.017), and multivariate analysis using linear regression models, revealed that testicular volume was a significant predictive factor for $FEV_1$ % predicted (${\beta}=0.159$, p=0.041). Conclusion: Larger testicular volume was independently associated, with favorable indices of lung function. These results suggest that androgens, may contribute to better lung function.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.371-375
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• 2002

The calcifying odontogenic cyst(COC) showed diverse terminology or classification, clinicopathologic features as well as in its biologic behavior, although it was recognized as a distinct clinicopathologic entity. The epithelial lining of a COC appears to have the ability to induce the formation of dental tissues in the adjacent connective tissue wall, and that other odontogenic tumors may sometimes be associated with it. This case is a COC associated with a complex odontoma involving an impacted left maxillary lateral incisor in a 5-year-old female child. Radiographic examination revealed a well-demarcated radiolucent lesion partially occupied by a radiopaque mass, involving the left lateral incisor crown. The histologic sections showed a cystic cavity lined with ameloblastic epithelium containing ghost cell masses with admixed with complex odontoma components. The presence of mixed radiolucent-radiopaque lesion in children as observed in this case, the possibility of COC must be considered. In this case, there was no recurrence 1 year after enucleation and the space control is ongoing now.

• Korean Journal of Oriental Medicine
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• v.15 no.2
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• pp.51-61
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• 2009

Objective: Much has been known that the systematical theory of acupuncture was developed from stone needle as therapeutic tools for orthopedic diseases in ancient times. Stone needle is very old therapeutic method like moxibustion and has been recognized that it was developed since the Stone Age in China so far. In the present study, it was examined for the origination and formation of stone needle based on stone relics of the Stone Age in Korean Peninsular, the medical and geographical literatures. Materials and methods: The facts of stone needle was examined and arranged on the ancient medical or geographical literatures such as The Yellow Emperor's Canon Internal Medicine, Shanhaijing as an ancient geographical book, etc. The clan societies and family related to an origination of stone needle was chased together with their cultural characteristics and origination. The stone relics which have been digged out of historic sites in the North-East Asia were examined for a relevance to stone needle. Results: In The Yellow Emperor's Canon Internal Medicine, it was referred to the stone needle that originated from a fishery zone related to the east coast district in North-East Asia. Through the examination of Shan Hai Jing as an ancient geographical book and its historical reviews, a Go-yi clan society who keep Go's family tree dealt well with the stone needle and jewels including jade in the North-East Asia before the publication periods of The Yellow Emperor's Canon Internal Medicine, and is comprised in the culture of Dong-yi clan society but not the Chinese culture. The obsidian stones, which have been digged out of historical sites in the North-East Asia since the Stone Age, are originated from volcanic areas combined with seashore that seems to be Baekdu mountain district in Korea and Kyushu district in Japan. Furthermore, obsidian stone tools which were found out at Laodung peninsula and the Korean peninsula are archeologically similar to the stone needle with regards to the shape, size and dual-use. In addition, specific obsidian stone tools have been used in orthopedic surgery as well-crafted obsidian blades have a cutting edge up to five times sharper than high-quality steel surgical scalpels. Conclusion: The origin of obsidian stone needle is well corresponded to the explanation about that of the stone needle. It is suggested that the stone needle which influenced in completion of acupuncture and Meridian theory in China seems to be an obsidian stone, and distribution of obsidian stone needle has been closely connected to Dong-yi clan society which are lived in the North-East Asia including Baekdu-mountain district.

• Journal of the Korean Dietetic Association
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• v.15 no.4
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• pp.335-342
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• 2009

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.