The Clinical Significances of Bronchial Anthracofibrosis in the Patients with Endobronchial Tuberculosis / 결핵

BACKGROUND: Bronchial anthracofibrosis is one of the main manifestations of lung disease that is related to woodsmoke inhalation, and it is frequently associated with various pulmonary diseases, such as tuberculosis. The purpose of this study was to evaluate the clinical significance of bronchial anthracofibrosis in patients with endobronchial tuberculosis. METHODS: 63 patients, who were diagnosed with endobronchial tuberculosis using bronchoscopy, were included in this study. The patients consisted of 12 males and 51 females, having mean age of 59.5 years. The clinical features, radiologic and bronchoscopic findings between the patients with (37) and without (26) bronchial anthracofibrosis were analyzed retrospectively. RESULTS: When the patients were older, bronchial anthracofibrosis was more frequent. The endobronchial tuberculosis, which was located at the right middle lobal bronchus, was more frequent in the patients with bronchial anthracofibrosis than in the patients without bronchial anthracofibrosis. In the morphologic types of endobronchial tuberculosis, patients with bronchial anthracofibrosis had more edematous-hyperemic and ulcerative types, while patients without bronchial anthracofibrosis had more active caseating. CONCLUSION: These findings suggest that the presence of bronchial anthracofibrosis can possibly influence the locations and morphologic types of endobronchial tuberculosis.

The clinical investigation for determining the etiology of bronchial anthracofibrosis / 대한내과학회지

BACKGROUND: The bronchial anthracofibrosis has been thought to be a unique clinical syndrome caused by a fibrotic response to active or old tuberculous infection, but recent studies suggest that long-term exposure to woodsmoke may be the cause of the development of bronchial anthracofibrosis and the tuberculosis is thought to be a disease frequently associated with bronchial anthrocofibrosis, not the main etiology. The purpose of this study was to elucidate the relationship between the bronchial anthracofibrosis and the long-term exposure to woodsmoke and tuberculosis through analyses of the clinical features of patients with bronchial anthracofibrosis. METHODS: 166 patients having bronchial anthracofibrosis confirmed by bronchoscopy were included in this study. They were 23 males and 143 females, having mean sge 72.4 years, ranging from 56 to 91. The epidemiologic features, distinctive clinical features, physiologic findings, radiologic findings and bronchoscopic findings were analyzed retrospectively. RESULTS: All the patients living in rural area (129 of 166) had experienced long-term exposure to woodsmoke. The history of tuberculosis was obtained in 52 patients without history of occupational exposure to dust. The predominant chest CT findings were atelectasis, bronchial stenosis and calcified or noncalcified lymph node enlargements. The most common abnormality of pulmonary function was obstructive pattern, observed in 47.8%. The bronchoscopic examination disclosed multifocal anthracotic plaques mostly at the bifurcation of lobar or segmental bronchi, particularly in upper lobe. The bronchial stenosis was frequently observed in right middle and upper lobe. The associated diseases were obstructive airway disease in 56, obstructive pneumonia in 40, active tuberculosis in 36, and lung cancer in 11 patients. CONCLUSION: The bronchial anthracofibrosis, in the patient who has long-term experience to woodsmoke inhalation without any history of environmental exposure to dust, is one of the manifestation of lung disease related to woodsmoke inhalation, and is frequently associated with various pulmonary diseases, including tuberculosis.

A Case of Unilateral Absence of Left Pulmonary Artery Presenting Hemoptysis / 영남의대학술지

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that is frequently associated with other cardiovascular anomalies first reported by Fraentzel in 1968. Most patients who have no associated cardiac anomalies have only minor or absent symptoms. We experienced a case of isolated UAPA in a young female presenting hemoptysis. The chest radiograph showed a small left lung volume and high resolutional CT of chest showed multiple subpleural nodules and centrilobular nodules in parenchyma. The video-assisted thoracoscopic biopsy revealed diffuse dilated vessels in visceral pleura. The pulmonary angiogram confirmed the absence of the left main pulmonary artery.

Osteoma after Reduction Malarplasty

Osteoma is a benign tumor arising from cancellous or compact bone. Frontal sinus is the most common site, followed by the ethmoidal sinus, maxillary sinus, sphenoidal sinus, maxilla and mandible. Very few cases involving the mandible have been described. A 26-year-old woman who had a limited range of mouth opening was reffered to our clinic. The limited opening had been gradually increasing in severity after first operation(reduction malarplasty and angle resection). Computed tomography images showed a radiopaque mass between left mandibular notch and zygomatic arch. After surgical removal of mass, diagnosis of mass was osteoma from clinical pathology. The postoperative course was uneventful, the patient could open the mouth about 40 mm, 5 months after the operation.

A Case of Scalp Neurothekeoma

Neurothekeoma is a relatively uncommon tumor of nerve sheath origin. Most of these tumors are benign and malignant transformation was not reported. Usually, these tumors arise during childhood or early adulthood life with female preponderance. They have a predilection for the head, neck and shoulder region but any part of the body may be affected. Their usual size is between 0.5-3.0 cm. Rapid growth and ulceration are rare, and local recurrence tends to occur after incomplete excision. We report a case of neurothekeoma developed in the scalp of a 21-year-old woman. It was first noticed about 1year ago. This mass had been increasing in size slowly. On physical examination, 2 x 1.5 cm sized papule with localized alopecia was identified on the frontal scalp area. It was excised in 5.5 x 3.6 cm. The histologic finding of the lesion showed that lobules, fascicles or rests of spindle shaped or epitheloid cells in a myxoid of mucosubstance. The tumor cells were positive for S-100 and vimentin but showed negative for EMA, cytokeratin, desmin, actin and HMB45. After surgical excision of tumor, split-thickness skin graft was done. Three months after the operation, rectangular shape tissue expander (180 cc Sebbin(R)) was inserted on both sides of the previous wound. After removal of tissue expander, the wound closed with local flap. The patient did not have any evidence of recurrence for 6 months.

Correction of pseudoptosis occurred after blepharoplasty

No Abstract Available.

Usefulness of Artificial Dermis ( Alloderm and Terudermis ) for Reconstruction of Soft Tissue Defect

There remains many difficult problems for plastic surgeons when they try to reconstruct soft tissue defect, especially defect on lower extremity with poor vascularity. We experienced two kinds of artificial dermis, Alloderm (LifeCell Corporation, USA) and Terudermis(Terumo, Japan). We applied them for 12 patients from October 1998 to May 1999. Their wounds had various causes. The authors debrided the necrotic tissue and got the artificial dermis soaked enough in saline. After fixing the artificial dermis with suture fixation, thin STSG was harvested. Applying the thin STSG on artificial dermis and Tie-over dressing were done to prevent mobilization. From our experience we had several suggestions to keep in mind. Preoperatively, you have to decrease the discharge with frequent dressing change. Intraoperativeiy, in order to avoid the mobilizaion between the artificial dermis and STSG, you have to fix them well with suture fixation. Postoperatively, the larger is the exposed bone or tendon, the longer the splint applying time is required. Nine patients out of 12 patients(75%) had no problem. Three patients underwent partial loss. Two patients suffered from infection or rough dressing. One patient failed due to careless mobilization before the artificial dermis is completely settled. The authors recommend to appky the artificial dermis rather than more aggressive procedures when the wound size is smaller than 2 x 4 cm with bone or tendon exposure. The authors think that the artificial dermis is also very useful to prevent postoperative scar contracture.