• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.291-295
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• 2017

Background: Since the introduction of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) of mediastinal lymph nodes, the incidence of histopathologically-confirmed sarcoidosis has increased. Methods: The electronic medical records of Chonnam National University (CNU) Hospital and CNU Hwasun Hospital (CNUHH) were searched for confirmed cases of sarcoidosis diagnosed between 1996 and 2014. Cases were selected using a combination of clinical, radiological, and pathological evidence. Of 115 cases with the relevant disease codes, 16 cases were excluded, as they had not been confirmed pathologically or had no definitive clinical features of sarcoidosis. Results: Among 99 cases of confirmed sarcoidosis, only nine patients were diagnosed with sarcoidosis before 2008; the rest were diagnosed from 2008 onward, after the introduction of EBUS-TBNA. EBUS-TBNA was used in 75.8% of patients, open surgical biopsy in 13.2%, and mediastinoscopic biopsy in 5.1%. At the time of diagnosis, 42.4% of sarcoidosis cases were at stage I, 55.6% at stage II, and 2% at stage III. Spontaneous remission of sarcoidosis was observed in 33.3% of cases, and stable disease in 37.4%; systemic steroid treatment was initiated in 23.2% of cases. Of the patients treated with systemic steroids, 69.6% showed improvement. The median duration of steroid treatment was 5 months. Conclusion: Following the introduction of EBUS-TBNA, the number of newly diagnosed sarcoidosis patients has increased. Clinical features of sarcoidosis were similar to those previously reported. Spontaneous remission occurred in about one-third of patients, while one-fourth of patients required systemic steroid treatment.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.59-69
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• 1975

Author studied on various psychiatric nursing problems applying with the test of questionnaire to the 376 nurses who are attending at 13 general hospitals and one mental hospital in Korea from Apr. 1, 1974 to July 30. 1974. The results obtained were ai follows: 1. 13.095 of nonpsychiatric registered nurses wanted the psychiatric service for their most attractive assignment and this was the 3rd in order next to the general surgical and operating room. Among the psychiatric nurses, the popularity toward psychiatric ward was 31. 0% and they were 26.0%at the private general hospitals and 6, 0% in national public hospitals. 2, The feelings or attitudes of disgust and apprehension on nursing care of the patients at-flirted with infectious diseases were the highest responses (38.5%) and these 1.ends were also appeared in 6.9% of psychiatric nurses. 3. 85.5% of nonpsychiatric registered nurses have had received course lectures on psychiatric nursing and nursing care training on the psychiatric ward at their school of nursing. 38.0% of psychiatric nurses had received post graduate psychiatric nursing and they were higher in national public hospitals (27.0% ) than in private general hospitals (11.0%). 4. The responses of satisfaction and security on their employment were almost similar patterns between nonpsychiatric registered nurses and psychiatric nurses. But among the psychiatric nurses. they were more satisfied at private general hospitals (33.0%) than that of national public hospitals (10.0%). 5. Almost the half of the nurses (50.8%) were employed by the hospitals without considering their past educational or clinical experience or career. Among the psychiatric nurses, who were employed by hospitals without considering their past experience or career were 35.0% in national public hospitals and 12.0% in private hospitals. On the contrary, the nurses who were employed by their wishes fore more higher (26.0%) in private general hospitals than national public hospitals (2.0%). 6. The nurses who thought their employment was fit for their aptitude were 48.6% in nonpsychiatric registered nurses and 51.0% in psychiatric nurses. Among the psychiatric nurses, this response was higher in private general hospitals (34.0%) than the national public hospitals (17.0%). 7. Responses on wort loadings of nurses showed almost same patterns between nonpsychiatric registered nurses and psychiatric nurses. But. among the psychiatric nurses who felt much heavier than the nurses of other part were 24.0% in national public hospitals and 8.0% in private general hospitals. 8. 92.6% of nurses felt that the psychiatric nurses should have post graduate training in psychiatric nursing prior to their assignment. 9. 96.0% of nurses agreed to the risk coverage on the payment for the nurses assigned to the psychiatric ward and the ward for infection diseases.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.93-98
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• 2000

Acute respiratory distress syndrome (ARDS) has been reported to be associated with a variety of medical and surgical conditions, including All-trans-retinoic acid (ATTA). ATRA is very efficaceous drug to acute promyelocytic leukemia (APL). This drug can induce complete remission at APL without fatal risk of disseminated intravascular coagulation. But ATRA treatment, sometimes, produces the symptoms of fever, weight gain and acute respiratory distress, renal function impairment. The causes of these symptoms are not fully proved, but supposed as the result of leukostasis and capillary leak syndrome from excessive leukocyte differentiation and cytokines release. Recently, we experienced a 24-year-old woman who complained gum bleeding for 6 days. At bone marrow biopsy, she was diagnosed as APL. 2 days after ATRA treatment, she was suffered from the symptoms of dyspnea and general ache. At laboratory examination, total leukocyte count was 50,400/$mm^3$, $PaO_2$ was 42.5 mm Hg and chest PA revealed the findings compatible with ARDS. Treatment with low dose ara-C, corticosteroid and general supportive cares were tried. Within 3 days after treatment, the patient recovered from ARDS by evidence of arterial blood gas study and chest radiographs. She has acquired complete remission of APL with maintenance of A TRA. And so, we present this case with a review of related literatures.

• Tuberculosis and Respiratory Diseases
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• v.38 no.3
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• pp.236-244
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• 1991

The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway, its treatment needs such special measures as steroid therapy, surgical intervention and/or laser therapy, but the therapeutic result is often disappointing. To exploit a new treatment modality for bronchial stenosis, balloon dilatation was carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under fluoroscopic guide in two others. Endobronchial tuberculoses were subdivided into two(16.7%) with actively caseating type, seven (58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four (57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with actively-caseating type and three with stenotic type without fibrosis) were improved with this method. $FEV_{1.0}$ or FVC increased 10% or more after procedure in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of twelve, in whom follow-up examination was done after the procedure. Balloon dilatation of bronchial stenosis is more effective, when endobronchial tuberculosis is in active stage than in healed fibrotic stage. It is suggested that bronchial stenosis can be minimized by early diagnosis and early application of balloon dilatation in the course of disease.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.457-462
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• 2009

While receiving appropriate treatment, patients with tuberculosis occasionally have unusual, paradoxical reactions, with transient worsening of lesions or the development of new lesions. This report is a case of tuberculosis brain abscess and tuberculosis peritonitis with intra-abdominal abscess that developed during appropriate anti-tuberculosis chemotherapy. A 45-year-old male patient had been diagnosed as with all-drug susceptible pulmonary tuberculosis with pleurisy. Subsequently, the patient underwent standard treatment with anti-tuberculosis therapy; the pulmonary lesions improved. Three months after initial treatment, the patient developed brain abscesses and peritonitis. With the addition of corticosteroid treatment, the patient's neurologic symptoms were relieved. Exploratory laparotomy with surgical drainage was performed and a diagnosis of tuberculosis peritonitis was confirmed on biopsy. Anti-tuberculosis therapy was continued for 19 months, the patient improved eventually without further complications, although the therapeutic regimen had not been altered. In this case, the paradoxical response to treatment may have been involved in the pathogenesis of disease.

• Tuberculosis and Respiratory Diseases
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• v.62 no.4
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• pp.331-335
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• 2007

A thymoma commonly occurs in the superior mediastinum or the upper part of the anterior mediastinum but can be located in other places in rare cases. Cystic degeneration in a thymoma is a relatively common but focal event. In rare cases, the process proceeds to the extent that most if not all of the lesion becomes cystic. We report a case of a patient with a paracardial cystic thymoma in the lower aspect of the anterior mediastinum. A 49-year-old woman was referred to our hospital because of a mass discovered incidentally on a chest X-ray. She showed no symptoms or signs. Contrast-enhanced chest CT scan revealed a $5{\times}5cm$ sized, well-marginated, right paracardial cystic mass with a curvilinear and oval enhancing solid portion. A Surgical resection was performed. The mass was discontinuous with normal thymic tissue. Microscopy revealed a type B1 thymoma with prominent foci of medullary differentiation according to the WHO classification. There was no capsular or local invasion. The postoperative course was uneventful and the patient was discharged in good health.

• Tuberculosis and Respiratory Diseases
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• v.75 no.1
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• pp.25-27
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• 2013

Carbohydrate antigen 19-9 (CA 19-9) is a widely-used tumor marker in patients with pancreatic cancer. However, some patients with respiratory disease also exhibit elevated serum CA 19-9 levels. We report a case of normalization of elevated serum CA 19-9 levels after treatment of the nodular bronchiectatic form of Mycobacterium abscessus lung disease. A 40-year-old man visited our hospital because of chronic cough and sputum. A computed tomography scan revealed severe bronchiectasis in the right upper and right middle lobes. Nontuberculous mycobacteria were repeatedly isolated and identified as M. abscessus. The serum CA 19-9 level was elevated to 142.35 U/mL (normal range, <37 U/mL). Surgical resection was performed because of failure of sputum conversion after antibiotic treatment. The serum CA 19-9 level returned to the normal range after surgery. This case suggested that serum CA 19-9 levels could be elevated in patients with the nodular bronchiectatic form of M. abscessus lung disease.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.144-149
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• 2014

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.127-131
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• 2009

Most mediastinal teratomas are histologically well-differentiated tumors and benign. The majority of patients with a mediastinal teratoma are asymptomatic and their tumors are usually discovered incidentally on chest radiography. On rare occasions this tumor will rupture spontaneously into the adjacent organs. A 72-year-old female patient was admitted for dyspnea and she had a multiloculated pleural effusion in the left lung field. Although repeated pleural biopsy and pleural fluid cytology did not prove the presence of malignancy, we assumed that this was a malignant effusion because it revealed consistently high levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and the chest CT scan did not show typical fat or bone density in the mass. Secondary infection and an uncontrolled septic condition due to pleural empyema finally compelled the patient to undergo a surgical operation. Mature teratoma was the final diagnosis and she has done well without recurrence for 2 months.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.230-235
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• 2009

Idiopathic bronchiolocentric interstitial pneumonia is one of idiopathic interstitial pneumonia, which has a relatively aggressive course and poor prognosis. It is characterized by diffuse centrilobular nodules radiologically with mainly bronchiolocentric inflammation and fibrosis associated with patchy alveolitis lacking interstitial granuloma histologically. This disorder is a recently classified disease category, and to our knowledge, there is no case report in Korea. We present a case of idiopathic bronchiolocentric interstitial pneumonia. A 62-year-old man presented with exertional dyspnea with a 1 month duration. The radiological findings showed extensive centrilobular lesions at both lungs. The surgical lung biopsy specimen demonstrated a centrilobular inflammatory process with small airway fibrosis and inflammation partially radiating into the interstitium. Therefore, the patient was diagnosed with idiopathic bronchiolocentric interstitial pneumonia. He was treated with immunosuppressants including steroids and azathioprine. However, his symptoms did not improve and he expired 7 months later due to an acute exacerbation of the interstitial pneumonia and probable infectious pneumonia.