Jin Hong Chung

EBUS-TBNA in the differential diagnosis of pulmonary artery sarcoma and thromboembolism

To the Editors: Pulmonary artery sarcoma is a rare tumour of the cardiovascular system. It is often misdiagnosed as acute or chronic pulmonary thromboembolism because its clinical presentation and radiological findings are similar to those of thromboembolism. The diagnosis of pulmonary artery sarcoma by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has not been reported. Herein, we report two cases with mass-like lesion in the pulmonary artery. The lesions were safely approached by EBUS-TBNA, and the tissues obtained by EBUS-TBNA were sufficient to diagnose pulmonary artery sarcoma and thromboembolism. A 79-yr-old female with hypertension and atrial fibrillation presented with sudden-onset left chest and shoulder pain. She had taken warfarin for atrial fibrillation, but the warfarin had been discontinued for 1 week because of a scheduled endoscopy. We performed chest computed tomography (CT), which revealed an extensive intraluminal low-attenuated mass- like lesion involving the entire luminal diameter of the left main and left lower lobar pulmonary artery (fig. 1a). d-dimer was 0.94 μg·mL−1 (reference value <0.4 μg·mL−1). Positron emission tomography (PET)-CT with 18F-fluorodeoxyglucose (FDG) showed increased FDG uptake, with a maximum standardised uptake value (SUV max) of 18.6 in the left main pulmonary artery (fig. 1c). For a tissue diagnosis, EBUS-TBNA was performed targeting the mass-like lesion encasing the pulmonary artery (fig. 1d). The sonograph revealed a round heterogeneous mass with distinct margin that include some necrotic area. The cytopathological examination confirmed spindle cell malignancy with vimentin …

The Effect of Body Composition on Pulmonary Function

Background The pulmonary function test is the most basic test method to diagnosis lung disease. The purpose of this study was to research the correlation of the body mass index (BMI), the fat percentage of the body mass (fat%), the muscle mass, the fat-free mass (FFM) and the fat-free mass index (FFMI), waist-hip ratio (WHR), on the forced expiratory volume curve. Methods Between March and April 2009, a total of 291 subjects were enrolled. There were 152 men and 139 female (mean age, 46.3±9.92 years), and they were measured for the following: forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), and forced expiratory flow during the middle half of the FVC (FEF25-75) from the forced expiratory volume curve by the spirometry, and the body composition by the bioelectrical impedance method. Correlation and a multiple linear regression, between the body composition and pulmonary function, were used. Results BMI and fat% had no correlation with FVC, FEV1 in male, but FFMI showed a positive correlation. In contrast, BMI and fat% had correlation with FVC, FEV1 in female, but FFMI showed no correlation. Both male and female, FVC and FEV1 had a negative correlation with WHR (male, FVC r=-0.327, FEV1 r=-0.36; p<0.05; female, FVC r=-0.175, FEV1 r=-0.213; p<0.05). In a multiple linear regression of considering the body composition of the total group, FVC explained FFM, BMI, and FFMI in order (r2=0.579, 0.657, 0.663). FEV1 was explained only fat% (r2=0.011), and FEF25-75 was explained muscle mass, FFMI, FFM (r2=0.126, 0.138, 0.148). Conclusion The BMI, fat%, muscle mass, FFM, FFMI, WHR have significant association with pulmonary function but r2 (adjusted coefficient of determination) were not high enough for explaining lung function.

A Case of Solitary Fibrous Pleura Tumor Associated with Severe Hypoglycemia: Doege-Potter Syndrome

Solitary fibrous tumor of the pleura (SFTP) is a rare primary intrathoracic tumor that arises from mesenchymal tissue underlying the mesothelial layer of the pleura. It usually has an indolent clinical course. The hypoglycemia that accompanies SFTP was first described by Doege and Potter independently in 1930, hence the eponym Doege-Potter syndrome (DPS). The incidence of DPS is reported to be ~4%. In this report, we present a typical case of DPS that was cured through complete surgical resection.

Interstitial Lung Disease in a Patient with Dyskeratosis Congenita

Dyskeratosis congenita is a rare congenital disorder characterized by a triad of reticular pigmentation of the skin, dystrophic nails, and leukoplakia of the mucous membrane. Sometimes it is associated with bone marrow failure, secondary malignancy and interstitial lung disease. Though it is rare, Dyskeratosis congenita is diagnosed relatively easily when clinicians suspect it. It can be diagnosed just by gross inspection with care. Dyskeratosis congenita should be considered as one cause associated with interstitial lung disease. In Korea, interstitial lung disease with dyskeratosis congenita has not been reported. We report a case and review the literature.

The relationships between sarcopenia and decreased bone mineral density in each obstructive airway disease phenotype of Korea

Background: Obstructive airway disease (OAD) and sarcopenia are related to decreased bone mineral density (BMD). The relationship between sarcopenia and BMD in each OAD phenotype is not known, especially asthma-COPD overlap syndrome (ACOS). Method: Among the research subjects of KNHANES IV and V (2008–2011), 5562 were aged ≥ 50 years, who underwent qualified spirometry and DXA. A total of 947 subjects were included in the study, of which 89 had asthma, 748 had COPD, and 110 had ACOS. Results: In the COPD and ACOS phenotype, each T-score were lower in the sarcopenia group than those in the non-sarcopenia group. The osteopenia and osteoporosis prevalence rates of the non-sarcopenia and sarcopenia groups were different (p Conclusion: Sarcopenia is closely related to decreased BMD in OAD phenotype such as COPD and ACOS with systemic inflammation. In the ACOS phenotype, individuals with sarcopenia had the highest prevalence rate and risk of osteopenia and osteoporosis than those with non-sarcopenia among all OAD phenotype

The Differences of the Smoking Habit Between Emphysema and Chronic Bronchitis

배경 및 목적 : 만성폐쇄성 폐질환은 대부분 후천적으로 발생하며, 흡연은 가장 중요한 유발인자이다. 흡연력이 있는 만성폐쇄성 폐질환 환자들이 임상적 그리고 병리학적으로 차이가 분명한 만성기관지염과 폐기종의 두가지 형태로 진행한다는 사실은 단순한 흡연력 이외에 흡연과 관계가 있는 다른 인자가 관여함을 시사하고 있다. 저자들은 흡연력이 있는 남자 중 만성폐쇄성 폐질환으로 진단된 환자를 대상으로 흡연력과 흡연습관 및 행태를 조사하여 만성기관지염과 폐기종의 발생과 관련이 있는 흡연습관을 찾아보고자 하였다. 방 법 : 영남대학교 부속병원 호흡기내과를 방문하였던 환자 중 만성폐쇄성 폐질환으로 진단되고 흡연력이 있는 333명의 남자(폐기종 ; 143명, 만성기관지염 ; 190명)를 대상으로 흡연력에 대하여 설문조사를 하였다. 그러나, 악성 폐종양, 간질성 폐질환, 기관지 확장증, 진폐증, 폐허탈, 흉수 및 흉막유착 등이 있는 경우와 폐렴이나 폐결핵 등 현증 감염성 질환이 있는 경우, 그리고 1초간 노력성 호기량(

The Differences of anthropometric and polysomnographic characteristics between the positional and non-positional obstructive sleep apnea syndrome

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Diagnostic Value of Cyfra 21-1 in Differential Diagnosis of Pleural Effusion

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Isolation of Acid-fast bacilli from Tissues of Extrapulmonay Tuberculosis

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A Case of Idiopathic Hypereosinophihc Syndrome Assoclated with Pulmonary Infiltration

항진제 사용후 10% 이상 증가하는 경우는 대상에서 제외하였다. 결 과 : 만성기관지염 환자에 비해 폐기종 환자는 평균 나이가 많고, 흡연량 및 절대흡연량이 많았으며, 흡연을 일찍 시작하였고, 담배연기를 갚이 흡입하는 경향이 있었다(p 【Background : Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyond just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD according to patients smoking habits. Method : To evaluate the differences in the smoking patterns of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). Result : The patients with emphysema smoked earlier and had a higher smoking history(ie, more packyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of inhalation was also significantly higher in the emphysema patients after taking into account age, cumulative cigarette consumption and the type of cigarette smoked. Conclusion : Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.】