• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.266-270
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• 2011

Background: Photodynamic therapy (PDT) is effective in managing small superficial early lung cancer patients who were deemed nonsurgical candidates. However, we do not have any previous report on the usefulness of PDT in early lung cancer in South Korea. Thus we report here our experience of PDT in early lung cancer patients. Methods: 10 patients who underwent PDT for managing early lung cancer between June 2006 and July 2010 were analyzed. PDT was carried out 48 hours after photosensitizer injection. Re-bronchoscopy was carried out 48 hours after PDT in order to remove a necrotic tissue from the PDT site. For evaluation of PDT response, bronchoscopy and chest computed tomography (CT) were performed after 3 months. Results: The median age of patients was 69 (49~77) and all patients were male. The smoking history of patients was 48 (20~75) pack-year and the median follow up of patients was 25 (11~52) months. Complete remission was observed in 10 patients and the recurrence of lung cancer was observed in 3 patients. Out of 10 patients, 3 patients died (one case of lung cancer progression and two cases of pneumonia). Conclusion: The PDT is a safe and effective treatment in early lung cancer patients who are not suitable for surgical resection. The PDT in clinical practice is an attractive option in the treatment of early lung cancer.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.212-215
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• 2008

본 증례는 와파린을 복용하던 72세 여자가 기침을 심하게 하던 중 하복부 통증과 압통을 보이는 복부 팽만이 발생하여 복부 전산화단층촬영을 통해 복직근초 혈종을 진단한 경우이다. 복직근초 혈종은 매우 드물지만 항응고제를 복용하는 고령 환자나 분만을 했거나 복부 수술을 받은 경우 등에서 발생할 수 있고, 드물게 기침에 의해서도 발생할 수 있다. 따라서 이런 환자에서 심한 복통이나 복부 종물이 관찰되는 경우 그 가능성을 한 번쯤 생각해보아야 하겠다. 전산화단층촬영은 복직근초 혈종 진단의 특이성과 민감도가 높아 진단에 도움이 되며 대부분은 보존적인 치료만으로 회복되므로 본 질환의 위험인자와 진단방법에 대해 숙지하고 정확한 진단을 하는 것이 무엇보다도 중요하겠다.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.216-221
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• 2008

저자들은 대량 객혈로 발현한 흉곽 내 만성 팽창성 혈종 1예를 보고한다. 이 증례는 이전의 증례와 달리 결핵성늑막염이나 흉부 수술, 외상의 과거력 없이 자연 발생한 증례라는 점에서 의의가 있다. 또한 무증상, 호흡곤란 등으로 발현했던 대부분의 증례와는 달리 드물게 대량객혈로 발현하였으며, 이러한 대량객혈이 기관지흉막루를 동반하여 발생하여 기관지동맥 색전술과 수술로 치료되었다는 점에서 특징적이다. 증례보고와 함께 문헌고찰을 통해 과거 보고된 흉곽 내 만성 팽창성 혈종의 임상양상에 대해 표로 정리하였다.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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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.

• 대한간호학회지
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• 제5권1호
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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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• 제49권1호
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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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• 제38권3호
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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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• 제66권6호
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• pp.457-462
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• 2009

역설적 반응은 감수성 있는 항결핵제를 복용중인 결핵 환자에서 치료시작 당시의 병변이 악화되거나 새로운 병변이 생기는 현상이고 이는 치료실패와 감별을 요한다. 일반적으로 역설적 반응은 기존 항결핵 치료로 좋은 결과를 보이므로, 이러한 임상 경과를 잘 이해함으로써 불필요한 검사나 치료약제 변경 등을 하지 않고 적절히 치료할 수 있게 될 것이다. 저자들은 적절한 항결핵제 치료 중에도 역설적 반응으로 결핵성 뇌농양, 결핵성 복막염이 연속적으로 병발한 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제62권4호
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• pp.331-335
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• 2007

전종격동 하부에 심장과 연접한 이소성 흉선종은 폐암뿐 아니라 흉선종, 생식세포암, 림프종, 전이성 종양 등의 여러 질환과 감별이 필요하다. 병리조직상으로는 이소성 흉선종에 대한 주의가 없는 경우, 미분화상피암, 암성병변의 림프절 전이, 또는 림프구가 우세하게 관찰되는 경우 림프종 등으로 오진될 수도 있으므로 감별진단에 있어 주의가 필요하다. 또한 낭성 흉선종은 이러한 감별진단을 더욱 어렵게 한다. 저자들은 하부 종격동에 심장 우측과 연접하여 발생한 이소성 낭성 흉선종 환자 1예를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제75권1호
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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.