A Case of Severe Asthma Complicated with Pneumoperitoneum and Pneumomediastinum During AMBU Ventilation / 결핵

Pneumoperitoneum, Pneumomediastinum, subcutaneous emphysema and a pneumothorax are some of the mechanical complications of bronchial asthma. The incidence of pneumoperitoneum during an attack of acute asthma is rare. The pathogenesis is free gas track from the overdistended alveoli, through the bronchovascular sheaths to the mediastinum. If the high pressure is maintained, air can escape retroperitoneally into the abdomen and burst into the peritoneal cavity. A 43-year-old woman was admitted due to a severe asthma attack. She was required endotracheal intubation and AMBU(air mask bag unit) ventilation. Immediately after these procedures, pneumoperiotneum, pneumomediastinum, and subcutaneous emphysema daveloped. She was treated with mechanical ventilation and medical therapy. The pneumoperitoneum was resolved after 27 days. Here, we report this case with the review of the relevant literature.

Areas of Decreased Parenchymal Attenuation Associated with Bronchiectasis: Correlation between Severity and Extent of Bronchiectasis on HRCT with Pulmonary Function Test

PURPOSE: To determine the correlation between areas of decreased parenchymal attenuation seen in cases of bronchiectasis, and the severity and extent of the condition, as revealed by HRCT and the plmonary function test (PFT). MATERIALS AND METHODS: The findings of forty-five patients with bronchiectasis who had undergone PFT and HRCT were retrospectively analysed. CT scores were calculated according to the severity and extent of the condition, and areas of low attenuation, and the correlation coefficients between these were determined. Bronchiectasis was classified as either cylindrical or cystic, and using Student's t test, the statistical significance of the results of the PFT were determined. RESULT: The severity and extent of bronchiectasis correlated with the extent of areas of low attenuation (r > .45, p .44, p < .01). The functional parameters of the PFT which help differentiate between cylindrical and cystic bronchiectasis are FEV1, FVC, MMEF, DLCO (p < .01), RV, and TLC (p < .05). CONCLUSION: In patients with bronchiectasis, the extent of the condition correlated closely with the extent of low attenuation, and the latter, especially in cases of cylindrical bronchiectasis, showed significant correlation with the extent of abnormalities revealed by the pulmonary function test.

A Case of spinal epidural emphysema complicating in patient with bronchial asthma / 결핵

Spinal epidural emphysema is rare, and only a few cases have ever been reported. A 18 year-old man was admitted for neck and chest pain for 3 days. Before admission he experienced rhinorrhea and severe cough. Physical examination revealed wheezing on whole lung field and subcutaneous emphysema over the upper portion of the chest and neck. Chest radiograph showed pneumomediastinum ajdn subcutaneous emphysema in the neck and chest CT images demonstrate a free air in the prevertebral fascia. With coservative management, the patient's condition and the pneumomediastinum improved. The patient was discharged to home on the fourteenth day.

A Case of Primary Duodenal Carcinoid Tumor / 대한소화기내시경학회지

Carcinoid tumors are slow growing, rare neoplasms that arise from enterochromaffin cells, with malignant potential. Primary duodenal carcinoid tumors are rare, the reported incidence being 2.0 ~8.9% of all gastrointestinal carcinoid tumors. Unless the carcinoid syndrome has developed, the non-specificity of the symptoms and physical findings, makes the clinical diagnosis of these tumors difficult. However, with the introduction of large and deep endoscopic biopsies, it is possible to diagnose duodenal carcinoid tumors at an early stage. Usually, local resection is the therapy of choice because of the very slow growth of the lesion and the low incidence of metastasis. Radical surgery is mandatory only in lesions more than 2 cm in diameter, or in the presence of muscular invasion. A 69-year-old female visited our medical department, having had symptoms of upper ab-dominal pain and intermittent melena for 1 week. Endoscopic examination showed 2.5 2.5 cm sized elevated mass lesion with central ulceration in the anterior wall side of the duodenal bulb. Immunohistochemical stains of the biopsy specimen showed that the tumor cells are positive reactivity for NSE (neuron-specific-enolase), chromogranin A, and cyto-keratin.

A case of primary pulmonary angiocentric lymphoma manifested as a mass / 결핵

The primary pulmonary lymphomas are uncommon, accounting for 0.5% of primary lung tumor and 0.4% of all malignant lymphomas. The majority of primary pulmonary lymphomas are of B-cell originating from bronchus associated lymphoid tissue(BALT). Angiocentric lymphoma is a rare type of primary pulmonary lymphomas characterized by polymorphic lymphoid infiltrates, which make it even more difficult to differentiate from benign infiltration. The radiographic findings are variable, depending on the stage of evolution of the disease. The prognosis of angiocentric lymphoma is poor, nearly two-thirds of the patients with grade 2 or 3 angiocentic lymphomas were died within a year of diagnosis. We report a case of primary pulmonary angiocentric lymphoma manifested as a mass of right lower lobe.

A Case of Foreign Body Granuloma of the Posterior Mediastinum / 결핵

21-year-old male was admitted for evaluation of a mass shadow on chest film. On chest computed tomography showed 5 cm sized homogeneous low density based on the second thoracic vertebral body in the posterior mediastinum. The patient had been performed thoracic sympathectomy 6 months before admission and oxidized cellulose was used for hemostasis at that operation Surgical resection was performed and microscopic result was foreign body granuloma caused by oxidized cellulose. Oxidized cellulose is an absorbable sterile mesh and used to control capillary or venous bleeding. Although the manufacturer recommends its removal after hemostasis is achieved, in clinical practice it is usually left in situ to reabsorb spontaneously, usually with no untoward effect.

A Case of Immunoglobulin Deficiency with increased IgM / 대한내과학회지

Immunoglobulin deficiency with increased IgM, as defined by World Health Organization classification of primary immunodeficiency, is characterized by normal or increased concentrations of serum IgM and, in some cases, IgD, but decreased or absent IgG, IgA, and IgE. Patients with these disorders have a high incidence of recurrent pyogenic infections, including otitis media, pneumonia, and septisemia. We recently experienced a case of immunoglobulin deficiency with increased IgM in a 25-year old man. He had been suffered from recurrent pyogenic infections-pneumonia, otitis media-since about 6 months of his age. He was admitted due to pneumonia, and Haemophilus influenza was isolated from the sputum culture. Also chest X-ray showed bronchiectasis. His serum immunoglobulin levels revealed increased concentration of IgM and decreased IgG and IgA. He was successfully treated with antibiotics, and now he is being followed-up. So we present this case with the review of literature.

A Case of Pulmonary Cryptococcosis in Healthy Person / 결핵

Cryptococcosis is a systemic fungal infection caused by Cryptococcus neoformans. This mycosis is best known for meningeal involvement, yet, this disease rarely can be limited to the lungs. The usual portal of entry is respiratory tract. The recently rising incidence of the disease can be attributable to wide use of steroid, immunosuppressive agents and advent of AIDS. We experienced one case of pulmonary cryptococcosis in healthy person, who was admitted to the our hospital because of cough. Cryptococcus neoformans was isolated in the sputum, and lung tissue obtained by CT guide needle aspiration biopsy. Clinical improvement was noted after 6weeks of medical therapy with fluconazole.

The effects of surgical stress and naloxone(NAL) on the concentration of plasma prolactin(PRL) and luteinizing hormone(LH) / 대한산부인과학회잡지

No abstract available.