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박영진 ( Young Jin Park ),정훈 ( Hoon Jung ),박이내 ( I Nae Park ),최상봉 ( Sang Bong Choi ),허진원 ( Jin Won Hur ),이혁표 ( Hyuk Pyo Lee ),염호기 ( Ho Kee Yum ),최수전 ( Soo Jeon Choi ),구호석 ( Ho Seok Koo ),이양행 ( Yang Haeng 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.2
연구배경: CCAM은 드문 하부 호흡기의 선천성 발달 기형으로 대부분은 생후 2년 내에 진단되는 것으로 보고되고 있다. 그리고 매우 드물게 성인이 되어서 호흡기 합병증이 생기거나 무증상인 채로 우연히 진단된 증례들이 보고되었다. 우리는 본원에서 수술을 통해 조직학적 소견으로 확진된 6명의 성인 CCAM 환자들을 기술하였고 이들의 임상적, 방사선학적 및 조직학적 특성을 분석하고자 하였다. 방법: 2001년 8월부터 2007년 2월까지 본원에서 성인기에 수술을 통한 조직학적 소견으로 확진된 6명의 CCAM 환자를 확인하였다. 의무기록 검토를 통해 그들의 인구학적 및 임상적 특성, 흉부 방사선 자료 그리고 조직학적 특성을 후향적으로 분석하였다. 결과: 6명의 CCAM 환자 중 4명이 여자였고 진단 당시의 평균 나이는 23.5세(범위 18∼39세)였다. 내원 당시 주요 임상 양상은 하부 호흡기 감염, 객혈, 그리고 기흉이었다. 흉부 전산화 단층촬영을 보면 5명의 환자는 공기 액체층을 동반한 다발성 격막을 가진 낭종성 병변을 가지고 있었고 나머지 1명에서는 우상엽에 공기 액체층을 동반한 다발성 공동성 병변과 주위에 다발성 침윤성 병변을 가지고 있었다. 모든 환자는 폐엽 절제 수술을 받았는데 5명은 개흉술을 통한 폐엽 절제술을 그리고 1명은 흉강경을 이용한 폐엽 절제술을 시행 받았다. 조직학적 검사결과 Stocker씨 분류법에 따라 3명의 환자는 1형 그리고 나머지 3명은 2형으로 분류되었다. 모든 환자의 검체에서 동반된 악성 종양의 증거는 없었다. 결론: CCAM이 하부 호흡기 감염, 기흉, 객혈 등의 다양한 호흡기 합병증과 악성화를 일으킬 가능성이 있고 수술적 치료와 연관된 합병증이 거의 없기 때문에 CCAM으로 의심되거나 확실치 않은 폐의 낭종성 혹은 공동성 병변이 있을 때 정확한 진단과 적절한 치료를 위해서 반드시 수술적 치료가 필요하다. Background: Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare congenital developmental anomaly of the lower respiratory tract. Most cases are diagnosed within the first 2 years of life, so adult presentation of CCAM is rare. We describe here six adult cases of CCAM and the patients underwent surgical resection, and all these patients were seen during a five and a half year period. The purpose of this study was to analyze the clinical, radiological and histological characteristics of adult patients with CCAM. Methods: Through medical records analysis, we retrospectively reviewed the clinical characteristics, the chest pictures (X-ray and CT) and the histological characteristics. Results: Four patients were women and the mean age at diagnosis was 23.5 years (range: 18∼39 years). The major clinical presentations were lower respiratory tract infection, hemoptysis and pneumothorax. According to the chest CT scan, 5 patients had multiseptated cystic lesions with air fluid levels and one patient had multiple cavitary lesions with air fluid levels, and these lesions were surrounded by poorly defined opacities at the right upper lobe. All the patients were treated with surgical resection. 5 patients underwent open lobectomy and one patient underwent VATS lobectomy. On the pathological examination, 3 were found to be CCAM type I and 3 patients were CCAM type II, according to Stocker`s classification. There was no associated malignancy on the histological studies of the surgical specimens. Conclusion: As CCAM can cause various respiratory complications and malignant changes, and the risks associated with surgery are extremely low, those patients who are suspected of having or who are diagnosed with CCAM should go through surgical treatment for making the correct diagnosis and administering appropriate treatment. (Tuberc Respir Dis 2008;65:110-115)
노은지 ( Eun Ji No ),허진원 ( Jin Won Hur ),이성순 ( Sung Soon Lee ),이영민 ( Young Min Lee ),이혁표 ( Hyuk Pyo Lee ),김주인 ( Joo In Kim ),염호기 ( Ho Kee Yum ),최수전 ( Soo Jeon Choi ),최석진 ( Suk Jin Choi ),김찬환 ( Chan Hwan 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.1
Alpha-fetoprotein(AFP) is a plasma protein produced in the fetal liver, yolk sac and gastrointestinal tract. The plasma level of AFP decreases markedly 1 year after birth. The AFP level is usually increased in hepatocellular carcinoma and yolk sac tumor but is rare in a primary lung cancer. We report a case of primary adenocarcinoma of lung producing high levels of AFP. (Tuberc Respir Dis 2006; 61: 70-73)
이달의 X-선 : 승모판 건삭 파열로 인한 급성 폐부종 1예
박혜경 ( Hye Kyeong Park ),강윤정 ( Yeun Jeong Kang ),최상봉 ( Sang Bong Choi ),박이내 ( I Nae Park ),정훈 ( Hoon Jeung ),허진원 ( Jin Won Hur ),이현경 ( Hyun Kyung Lee ),염호기 ( Ho Kee Yum ),이혁표 ( Hyuk Pyo Lee ),장지민 ( Ji 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5
최상분 ( Sang Bun Choi ),서정숙 ( Jeong Sook Seo ),한양천 ( Yang Chun Han ),김애란 ( Ae Ran Kim ),허진원 ( Jin Won Hur ),이성순 ( Sung Soon Lee ),이영민 ( Young Min Lee ),이혁표 ( Hyuk Pyo Lee ),김주인 ( Joo In Kim ),염호기 ( Ho K 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.62 No.4
The Inhalation of certain freshly formed metal oxides can cause metal fume fever, which is an acute, self-limiting, flu-like illness. The most common cause of this syndrome is the inhalation of zinc oxide. The inhalation of zinc oxide can lead to tracheobronchiolitis, chemical pulmonary edema or to respiratory failure and acute respiratory distress syndrome(ARDS). We encountered a 43-years-old man who developed severe dyspnea after inhaling of zinc oxide while working for 5 hours in a closed space. He was diagnosed with ARDS and was treated successfully with glucocorticoid. We report a case of ARDS caused by the inhalation of zinc fumes. (Tuberc Respir Dis 2007; 62: 314-317)
고립성폐결절의 경피적 바늘생검 이후 발생한 결핵성 흉수
구호석 ( Ho Seok Koo ),김태균 ( Tae Kyun Kim ),박성길 ( Sung Kil Park ),최상분 ( Sang Bun Choi ),김애란 ( Ae Ran Kim ),최상봉 ( Sang Bong Choi ),정훈 ( Hoon Jung ),박이내 ( I Nae Park ),허진원 ( Jin Won Hur ),이혁표 ( Hyuk Pyo Le 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.3
A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion. (Tuberc Respir Dis 2007; 63: 268-272)
박지영 ( Ji Young Bak ),김광실 ( Kwang Sil Kim ),박이내 ( I Nae Park ),염호기 ( Ho Kee Yum ),이승헌 ( Seung Heon Lee ),이현경 ( Hyun Kyung Lee ),이영민 ( Young Min Lee ),정훈 ( Hoon Jung ),허진원 ( Jin Won Hur ),이성순 ( Seong So 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.1
Hot tub lung has been described as a pulmonary illness associated with exposure to nontuberculous mycobacteria, mainly hot bathtub water contaminated with Mycobacterium avium complex (MAC) and hence the name. Although not entirely clear, its etiology has been thought to involve either an infection or a hypersensitivity pneumonitis secondary to MAC. Herein, we describe 2 female patients (60 and 53 years old) admitted to our hospital with hot tub lung, and both of whom worked in a public bath. Both women were initially admitted following several months of exertional dyspnea and cough. The patients had been working as body-scrubbers in a public bath for several years. Their chest CT scans showed bilateral diffuse ground-glass opacities with multifocal air-trappings and poorly defined centrilobular nodules in both lungs. Pathological findings from lung specimens revealed small non-necrotizing granuloma in the lung parenchyme with relatively normal-looking adjacent alveoli. Discontinuation of working in the public bath led to an improvement in symptoms and radiographic abnormalities, without antimycobacterial therapy.