Tracheal tumors are uncommon comprising less than 0.1% of all malignancies. Metastatic tracheal tumors, especially form the extrathoracic sites, are exceedingly rare. Ovarian cancer tends to metastasize to the serous cavities and the lymph nodes. One large autopsy study reported tracheal involvement in 1% of patients who had died from ovarian cancer. Other studies have not mentioned tracheal involvement at all. Since the main symptoms of cough, hemoptysis, or wheezing are nonspecific, patients may be initially treated for other conditions including asthma or bronchitis. Here we describe a metastatic tracheal tumor from an overain carcinoma that was initally treated for bronchial asthma.
Asthma ; Autopsy ; Bronchitis ; Cough ; Hemoptysis ; Humans ; Lymph Nodes ; Ovarian Neoplasms ; Respiratory Sounds

There are numerous agents with potential toxic effects on the lung. In particular, cytotoxic drugs constitute the largest and most imprtant group of agents associated with lung toxicity. Bleomycin is commonly used, either alone or in combination with other chemotherapeutic agents, in the treatment of squamous cell carcinoma(head and neck, esophagus, and genitourinary tract), lymphoma, and germ cell tumor. One of the therapeutic advantages of bleomycin is its minimal bone marrow toxicity. However, pulmonary toxicity is one of the most serous adverse side effect. Classically, pulmonary toxicity manifests as a diffuse interstitial process or less commonly as a hypersensitivity reaction. This pulmonary toxicity is generally considered to be dose related and can progress to a fatal fibrosis. It is also possible that bronchiolitis obliterans organizing pneumonia(BOOP) is another manifestation of bleomycin induced toxicity. Bleomycin induced BOOP is less common and has a favorable response to steriod therapy. Here we present a case that demonstrates a BOOP, secondary to a relatively small cumulative dose of bleomycin(225mg/??, may be reversible.
Bleomycin* ; Bone Marrow ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia ; Esophagus ; Fibrosis ; Hypersensitivity ; Lung ; Lymphoma ; Neck ; Neoplasms, Germ Cell and Embryonal ; Pneumonia*

BACKGROUND: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. OBJECTIVE: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with?pathologic pulmonary function. METHOD: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the?standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. RESULTS: 109 patients were enrolled. Pulmonary function measurements (FVC, FEV1, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d?and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, FEV1 +0.16 L, PEFR +1.85 L/s, FEF25%-75% -0.13 L/s. With the exception of FEV1, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for FEV1 and FVC and?acceptable differences for clinical use.
Delivery of Health Care ; Humans ; Mass Screening* ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Spirometry* ; Tertiary Healthcare ; Ventilation

A pulmonary arteriovenous fistula is an uncommon malformation. In pregnancy altered hemodynamics and hormones cause changes in a PAVM(pulmonary arteriovenous malformation) that predispose them to deterioration. Therefore, a PAVM can cause serious and life-threatening complications in pregnancy. Death ofter results from a cerebral abscess and a rupture of the malformation with a massive hemorrhage. Recently, we experienced a case of a multiple PAVM in pregnang 38 year old woman, which could not be obseved in the old chest PA, 1 year age. The PAVM was confirmed by CT and was angiography and treated by percutaneous embolization. The patient is suspected to have HHT (Hereditary hemorrhagic telangiectasia)
Adult ; Angiography ; Arteriovenous Fistula ; Arteriovenous Malformations* ; Brain Abscess ; Female ; Hemodynamics ; Hemorrhage ; Humans ; Pregnancy* ; Rupture ; Thorax

A 60-year old male patient admitted with complaints of dyspnea and pleuritic chest pain. The chest X-ray demonstrated right pleural effusion. We planed to do the conventional thoracentesis to evaluate the characteristics of pleural effusion and to relieve the symptom of the patient. Focal reexpansion pulmonary edema was seen on the follow-up chest X-ray. After the 5-day conservative management, the patient recovered without any complications.
Chest Pain ; Dyspnea ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pleural Effusion* ; Pulmonary Edema* ; Thorax

Tuberculosis involving the central airway occasionally results in diffuse stenosis in the distal trachea and main bronchus. When the stenosis is more limited to the main bronchus, sleeve resection can be performed with high likelihood of a good result. Bronchial stenosis limited to 2 cm is considered favorable for bronchial sleeve resection. However, a longsegment stenosis may make sleeve resection difficult or impossible, and pneumonectomy or therapeutic bronchoscopy may be performed. An extended sleeve lobectomy is a procedure to remove more than one lobe using a bronchoplasty technique and its applications to the patients with locally advanced lung cancer were reported. We performed an extended sleeve lobectomy in a patient with tuberculous bronchial stenosis involving the right main bronchus, bronchus intermedius, right middle lobar bronchus and right lower lobar bronchus, and report this case with review of literatures.
Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Humans ; Lung Neoplasms ; Pneumonectomy ; Trachea ; Tuberculosis

BACKGROUND: Percutaneous needle aspiration biopsy(PNAB) of the lung is a safe procedure for diagnosis of various pulmonary diseases but complications such as pneumothorax can occasionally develop. We reviewed the complications arising after PNAB and analysed the risk factors of pneumothorax. METHOD: We collected data by reviewing medical records and radiographic studies of 403 patients who underwent PNAB of the lung between 1988 and 2002 and analyzed the risk factors of pneumothorax. RESULT: The incidence of complication was 12.9%, 48 patients with pneumothorax and 4 patients with mild hemoptysis. Among the 48 pneumothorax patients, 35 patients showed mild(<20%) and was treated by only oxygen supply, 11 patients had severe pneumothorax(>50%) and chest tube insertion was done and 2 patients were treated by needle aspiration. As the results of multivariate analysis, size and location of lesion, location of approach, diagnosis of lesion showed no significant relationship, while age and gender of patients(p<0.05) and the depth of approach(p<0.001) were significantly related to pneumothorax. Smoking amount(p<0.001) as well as the smoking history(p<0.005) were also significantly related and the examiner displaying various incidence of pneumothorax from 4.0% to 23.1% among individuals also was a significant independent risk factor(p<0.05). While the average depth of approach for 13 patients treated by chest tube insertion or needle aspiration was 8.2+/-1.2cm, 35 patiens treated only by oxygen supply was 6.7 1.6cm suggesting that the depth of approach was lead to a severe pneumothorax. CONCLUSION: The independent risk factors of pneumothorax, the most common complication after PNAB, are age and gender of patients, depth of approach, examiner of procedure, smoking history and smoking amount.
Biopsy, Needle* ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Incidence* ; Lung Diseases ; Lung* ; Medical Records ; Multivariate Analysis ; Needles* ; Oxygen ; Pneumothorax* ; Risk Factors* ; Smoke ; Smoking

OBJECTIVES: This study aims to identify dietary factors related to metabolic syndrome in middle aged Korean men who were participants in the Fourth Korea National Health and Nutrition Examination Survey(KNHANES IV) in 2007. METHODS: The study targeted 361 of the 709 men aged between 40 and 64 years for a final analysis; the other 348 surveys had incomplete data which did not allow for the determination of metabolic syndrome. The definition of metabolic syndrome was based on the National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III). RESULTS: There were significant differences in the metabolic syndrome of middle-aged men according to age, smoking pack-years, and number of resturant meals per week. Dietary factors such as vitamins, riboflavin, natrium, carbohydrate, protein and lipid intakes were not significant. CONCLUSIONS: It was verified that metabolic syndrome in middle-aged men is related to age, smoking pack-years and number of resturant meals per week. Dietary factors were not significantly related. However, further detailed studies in this area are needed.
Adenosine Triphosphate ; Adult ; Aged ; Cholesterol ; Humans ; Korea ; Male ; Meals ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; Riboflavin ; Smoke ; Smoking ; Vitamins

BACKGROUND AND OBJECTIVES: The aims of this study were to compare the lipid distributions and risk factors in an angiographically normal coronary artery group to those of microvascular and coronary artery diseased groups of Koreans, and to find the effects of the variable risk factors on the serum lipid levels according to the coronary atherosclerosis status. SUBJECTS AND METHODS: A total of 1,198 patients (563 males and 635 females), having undergone a coronary angiography (CAG) using Judkins method, were included. According to their coronary angiographic findings, they were divided into normal CAG (n=568), microvascular disease (n=230) and coronary atherosclerosis (n=400) groups. RESULTS: The mean value of the total cholesterol in the patients with normal coronary artery was 175 mg/dl, which progressively increased to 182 mg/dl and 198 mg/dl in the patients with microvascular disease and coronary atherosclerosis, respectively. The frequencies of the risk factors for coronary atherosclerosis also progressively increased in the patients with microvascular disease and coronary atherosclerosis. The mean values of the serum total cholesterol, LDL-cholesterol and lipoprotein(a), progressively increased from the patients with normal angiographic findings to those with microvascular disease and coronary atherosclerosis, and the results were statistically significant. The results for the patients with microvascular disease were in between those of the patients with normal angiographic findings and those with coronary atherosclerosis. CONCLUSION: The correlation between coronary atherosclerosis and the serum cholesterol levels has, until now, been studied epidemiologically, and this is the first study to angiographically elucidate the positive relationship between coronary artery disease and the serum cholesterol levels. Our data showed lower ranges of lipid distributions compared to those of the ATP III guideline.
Adenosine Triphosphate ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels ; Humans ; Lipoprotein(a) ; Male ; Risk Factors* ; Triglycerides

BACKGROUND: Tiotropium is a long acting anticholinergic bronchodilator and it reduces exacerbations and improves the quality of life of patients with stable chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate the effect of tiotropium on dyspnea, the quality of life and the pulmonary function in patients with COPD. METHODS: Between April 2005 and April 2006, the patients with moderate to severe COPD, as based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and who needed to use long-acting bronchodilator were enrolled in this study. They inhaled tiotropium as a dry powder capsule, 18 microgram once daily for six months, with using the Handihaler(R) device. The lung function tests, including lung volume, the St. George's respiratory questionnaire and the MRC dyspnea scale, was measured at baseline and after 6 months treatment with tiotropium. RESULTS: 21 patients with COPD were enrolled. The mean age of the patients was 69 years and the mean baseline FEV1 was 1.0 L (40% predicted). Compared with the baseline, tiotropium produced significant improvement of the FEV1 (1.0+/-0.2 L vs. 1.1+/-0.3 L, respectively, p=0.013), IC (1.65+/-0.3 L vs. 1.7+/-0.3 L, respectively, p=0.037), the RV (4.0+/-0.7 L vs. 3.8+/-0.4, respectively, p=0.003), the SGRQ score (48.7+/-10 vs. 41.3+/-10.4, respectively, p<0.001), and the MRC dyspnea scale (3.4+/-0.6 vs. 3.0+/-0.8, respectively, p=0.009) after 6 months treatment. The dyspnea scale was associated with physical activity, the impact on life, the inspiratory capacity and the residual volume rather than the symptom score or FEV1. The treatment was well tolerated. CONCLUSIONS: Treatment with tiotropium once daily for 6 months improved lung functions, the health related quality of life and dyspnea.
Dyspnea ; Humans ; Inspiratory Capacity ; Lung ; Motor Activity ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Residual Volume ; Respiratory Function Tests ; Tiotropium Bromide ; Surveys and Questionnaires