No abstract available.
Atrial Fibrillation* ; Humans ; Tachycardia, Ventricular* ; Wolff-Parkinson-White Syndrome*

No abstract available.
Spirometry*

No abstract available.
Common Cold ; Sinusitis

Idiopathic pulmonary arterial hypertension (previous primary pulmonary hypertension) was a progressive disease with high mortality. Many patients with idiopathic pulmonary arterial hypertension did not show vasoreactivity, rapidly resulted in marked disability, right heart failure and death. Recent advances of therapeutic modalities have revolutionized the treatment of idiopathic pulmonary arterial hypertension. Irrespective of pulmonary arterial vasoreactivity, new vasodilatng agents, such as epoprostenol, treprostinil, iloprost, bosentan, and sildenafil, significantly improved hemodynamics, symptoms, exercise capacities, quality of life, and survival. The median survival of patients with idiopathic pulmonary arterial hypertension has been prolonged from 2.8 years to more than 5 years. In a near future, pulmonary arterial hypertension could be easily controlled like a systemic arterial hypertension.
Diagnosis* ; Epoprostenol ; Heart Failure ; Hemodynamics ; Humans ; Hypertension* ; Iloprost ; Mortality ; Quality of Life ; Sildenafil Citrate

Cannabinoids have been proposed to possess neuroprotective properties; though their mechanism of action remains contentious, they are posited to prevent neurodegenerative disorders, including Parkinson's disease, the pathogenesis of which has not been established. Recent studies have demonstrated that induction of proteasomal dysfunction in animal models results in a phenotype similar to Parkinson's disease. Here, we investigated the neuroprotective function of a synthetic cannabinoid-receptor agonist (WIN55.212.2) in dopaminergic neuronal death induced by a proteasomal synthase inhibitor (PSI), additionally testing the hypothesis that WIN55.212.2 modulates cytoplasmic accumulation of parkin and alpha-synuclein, a key feature of proteasomal dysfunction in Parkinson's. WIN55.212.2 protects PC12 cells from PSI-induced cytotoxicity, concomitantly inhibiting PSI-induced polyADP ribose polymerase expression and activation of caspase-3. While PSI induces cytoplasmic accumulation of alpha-synuclein and parkin, WIN55.212.2 counters these effects. Interestingly, however, while PSI induces the activation and nuclear translocalization of nuclear factor kappaB, WIN55.212.2 potentiates this effect. These data are suggestive that WIN55.212.2 might confer a neuroprotective benefit in PSI-induced proteasomal dysfunction, and could further protect against neuronal degeneration stemming from cytoplasmic accumulation of alpha-synuclein and parkin. These results indicate that WIN55.212.2 may be a candidate for treatment of neurodegenerative diseases, including Parkinson's disease.
alpha-Synuclein ; Animals ; Cannabinoids ; Caspase 3 ; Cytoplasm ; Dopaminergic Neurons ; Models, Animal ; Neurodegenerative Diseases ; Neurons ; NF-kappa B ; Parkinson Disease ; PC12 Cells ; Phenotype ; Receptors, Cannabinoid ; Ribose

The healing process of tracheobronchial tuberculosis (TB) results in tracheobronchial fibrosis causing airway stenosis in 11% to 42% of patients. In Korea, where pulmonary TB is still prevalent, post-TB tracheobronchial stenosis (PTTS) is one of the main causes of benign airway stenosis causing progressive dyspnea, hypoxemia, and often life-threatening respiratory insufficiency. The development of rigid bronchoscopy replaced surgical management 30 years ago, and nowadays PTTS is mainly managed by bronchoscopic intervention in Korea. Similar to pulmonary TB, tracheobronchial TB is treated with combination of anti-TB medications. The indication of rigid bronchoscopy is more than American Thoracic Society (ATS) grade 3 dyspnea in PTTS patients. First, the narrowed airway is dilated by multiple techniques including ballooning, laser resection, and bougienation under general anesthesia. Then, most of the patients need silicone stenting to maintain the patency of dilated airway; 1.5 to 2 years after indwelling, the stent could be removed, this has shown a 70% success rate. Acute complications without mortality develop in less than 10% of patients. Subgroup analysis showed successful removal of the stent was significantly associated with male sex, young age, good baseline lung function and absence of complete one lobe collapse. In conclusion, rigid bronchoscopy could be applied to PTTS patients with acceptable efficacy and tolerable safety.

Patients with severe emphysema have a higher risk of developing lung cancer, and their surgical risk increases when emphysema is accompanied by a giant bulla. Here, we describe a patient who had an emphysematous giant bulla in the right upper lobe that was treated with an endobronchial valve placement. Subsequently, a cancerous lesion on the contralateral lung was successfully removed by lobectomy.
Emphysema ; Humans ; Lung Neoplasms* ; Lung*

A fibroepithelial polyp of the bronchus is a rare, benign, and endobronchial tumor, histologically consisting of fibrovascular stroma covered by normal respiratory epithelium. We report a case of a fibroepithelial polyp arising from the left main bronchus. On CT, a characteristic lobulating contour of the endobronchial nodule was well visualized, which histopathologically represented a typical papillary growth pattern of the nodule. Such a lobulating contour of the nodule might help make a correct diagnosis of this rare disease among other various endobronchial neoplasms.
Bronchial Neoplasms/pathology/*radiography ; Bronchoscopy ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Neoplasms, Fibroepithelial/pathology/*radiography ; Polyps/pathology/*radiography ; *Tomography, X-Ray Computed

BACKGROUND: Bronchoscopy is an essential procedure for identifying the bleeding site and evaluating cause of hemoptysis. However, it is controversial regarding to the timing of bronchoscopy in patients with hemoptysis. Early bronchoscopy, which was performed during hemoptysis or with 48hour after cessation of bleeding, was better for identifying the site of bleeding compared with delayed bronchoscopy, which was performed 48 hours after cessation of bleeding. The diagnostic yield of identifying the bleeding site by bronchoscopy was variable in reported literature and the safety of early bronchoscopy was not mentioned in previous literature. Therefore, we evaluated the efficacy and safety of early bronchoscopy in patients with hemoptysis. METHOD: From October 1994 to August 1996 in Samsung Medical Center, bronchoscopy was performed in patients with hemoptysis. Early bronchoscopy was performed prospectively during hemoptysis or within 48 hours after cessation of bleeding from May 1995 to August 1996. Delayed bronchoscopy group included patients who did not recieved early bronchoscopy at the same period or in whom bronchoscopy was performed 48 hour after cessation of bleeding from October 1994 to May 1995. RESULTS: Early bronchoscopy group was performed 73 times in 71 patients. Delayed bronchoscopy was performed in 57 times in 55 patients. There was no difference as to amount and underlying cause of hemoptysis between both groups. Indentification of bleeding site by visualizing active bleeding was significantly higher in early bronchoscopy(38.3%) than delayed bronchoscopy group (8.7%) (p<0.05). Indentification of bleeding site by bleeding after clot removal was 8 in early and 10 in delayed bronchoscopy. Indentification of bleeding site by visualizing active bleeding and bleeding after clot removal was 36 in early and 15 patients in delayed bronchoscopy(p>0.05). Causes of hemoptysis was found in 18 patients in early and 16 patients in delayed bronchoscopy group. patients who had early bronchoscopy underwent surgery. We diagnosed the site of bleeding in 4 patients preoperatively. In 3 patients we made a treatment plan promptly right after bronchoscopy. Among early bronchoscopy group, bleeding over 100cc during bronchoscopy occurred in 2 patients. In early bronchoscopy group there was no other major complication during bronchoscopy. CONCLUSION: In patients with hemoptysis, early bronchoscopy which performed within 48 hours after cessation of bleeding was more effective procedure for indentifying the bleeding site than delayed bronchoscopy which was performed after 48 hour cessation of bleeding.
Bronchoscopy* ; Hemoptysis* ; Hemorrhage ; Humans ; Prospective Studies

BACKGROUND: Cytologic diagnosis of pulmonary adenoid cystic carcinoma (AdCC) is frequently challenging and differential diagnosis with small cell carcinoma is often difficult. METHODS: Eleven cytologically diagnosed cases of pulmonary AdCC were collected and reviewed according to fifteen cytomorphologic characteristics: small cell size, cellular uniformity, coarse chromatin, hyperchromasia, distinct nucleolus, frequent nuclear molding, granular cytoplasm, organoid cluster, sheet formation, irregular border of cluster, hyaline globule, hyaline basement membrane material, individual cell necrosis or apoptotic body, and necrotic background. Twenty cases of small cell carcinoma and fifteen cases of non-pulmonary AdCC were also reviewed for the comparison. RESULTS: Statistically significant differences were identified between pulmonary AdCC and small cell carcinoma in fourteen of the fifteen cytomorphologic criteria (differences in sheet formation were not statistically significant). Cellular uniformity, distinct nucleolus, granular cytoplasm, distinct cell border, organoid cluster, hyaline globule, and hyaline basement membrane material were characteristic features of AdCC. Frequent nuclear molding, individual cell necrosis, and necrotic background were almost exclusively identified in small cell carcinoma. Although coarse chromatin and irregular cluster border were observed in both, they favored the diagnosis of small cell carcinoma. Hyaline globules were more frequently seen in non-pulmonary AdCC cases. CONCLUSIONS: Using the fifteen cytomorphologic criteria described by this study, pulmonary AdCC could be successfully distinguished from small cell carcinoma. Such a comprehensive approach to an individual case is recommended for the cytologic diagnosis of pulmonary AdCC.
Adenoids* ; Antibody-Dependent Cell Cytotoxicity ; Basement Membrane ; Carcinoma, Adenoid Cystic* ; Carcinoma, Small Cell* ; Cell Size ; Chromatin ; Cytoplasm ; Diagnosis ; Diagnosis, Differential ; Fungi ; Hyalin ; Lung ; Necrosis ; Organoids