Journal of Yeungnam Medical Science

Communications

Rehabilitative goals for patients undergoing lung retransplantation: Massimiliano Polastri, Robert M. Reed; J Yeungnam Med Sci. 2024;41(2):134-138. Published online April 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00241

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Abstract PDF: Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Case reports

Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report: Jae Wan Jung, Hyunho Lee, Jimi Oh; Yeungnam Univ J Med. 2021;38(4):374-380. Published online September 6, 2021; DOI: https://doi.org/10.12701/yujm.2021.01284

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Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

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Anesthetic management of broncho- alveolar lavage in pulmonary alveolar proteinosis: A case report
Abinav Sarvesh S P S, Sucheta Gaiwal, Nimitha Prasad
Indian Journal of Clinical Anaesthesia.2024; 11(2): 251. CrossRef

Idiopathic multicentric Castleman disease presenting progressive reticular honeycomb infiltration of lung and immunoglobulin G and immunoglobulin G4 dominant hypergammaglobulinemia: a case report: Hyun-Je Kim, Young-Hoon Hong; J Yeungnam Med Sci. 2022;39(2):153-160. Published online July 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01039

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Abstract PDF: Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

Focused Review article

An update on the role of bronchoscopy in the diagnosis of pulmonary disease: June Hong Ahn; Yeungnam Univ J Med. 2020;37(4):253-261. Published online August 28, 2020; DOI: https://doi.org/10.12701/yujm.2020.00584

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Abstract PDF

Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

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Disposable Versus Reusable Bronchoscopes: A Narrative Review of Cost-effectiveness, Risk of Cross-contamination and Environmental Impact
Illaa Smesseim, Johannes M.A. Daniels, Jouke Annema, Peter I. Bonta, Dirk-Jan Slebos
Archivos de Bronconeumología.2024; 60(4): 250. CrossRef
Flexible bronchoscopy indications and outcomes between indigenous and non‐indigenous patients in the Northern Territory of Australia
Mohammad M. Seyedshahabedin, Timothy P. Howarth, Lin Mo, Edwina Biancardi, Subash S. Heraganahally
Internal Medicine Journal.2023; 53(9): 1634. CrossRef
Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment
Kyung Soo Hong, Jinmo Cho, Jong Geol Jang, Min Hye Jang, June Hong Ahn
Thoracic Cancer.2023; 14(4): 363. CrossRef
Observational findings of transbronchial lung biopsy in patients with interstitial lung disease: a retrospective study in Aleppo University Hospital
Fateh Kashkash, Abdullah Khorri
Annals of Medicine & Surgery.2023; 85(2): 146. CrossRef
Invasive Diagnostic Procedures from Bronchoscopy to Surgical Biopsy—Optimization of Non-Small Cell Lung Cancer Samples for Molecular Testing
Nensi Lalić, Aleksandra Lovrenski, Miroslav Ilić, Olivera Ivanov, Marko Bojović, Ivica Lalić, Spasoje Popević, Mihailo Stjepanović, Nataša Janjić
Medicina.2023; 59(10): 1723. CrossRef
Utility of Radial Probe Endobronchial Ultrasound Guided Transbronchial Lung Biopsy in Bronchus Sign Negative Peripheral Pulmonary Lesions
Kyung Soo Hong, Kwan Ho Lee, Jin Hong Chung, Kyeong-Cheol Shin, Hyun Jung Jin, Jong Geol Jang, June Hong Ahn
Journal of Korean Medical Science.2021;[Epub] CrossRef
Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy
Kyung Soo Hong, Heeyun Ahn, Kwan Ho Lee, Jin Hong Chung, Kyeong-Cheol Shin, Hyun Jung Jin, Jong Geol Jang, Seok Soo Lee, Min Hye Jang, June Hong Ahn
Tuberculosis and Respiratory Diseases.2021; 84(4): 282. CrossRef
Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef

Case report

Whole lung lavage using a rapid infusion system to treat a patient with pulmonary alveolar proteinosis: Seung Won Ra, Soon Eun Park, Hyung Kwan Lee, Il Sang Han, Se Hun Park; Yeungnam Univ J Med. 2020;37(1):67-72. Published online October 17, 2019; DOI: https://doi.org/10.12701/yujm.2019.00360

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Abstract PDF

Whole lung lavage (WLL) is a therapeutic procedure to remove accumulated material by infusing and draining the lungs with lavage fluid. This procedure has been regarded as the current standard of care to treat pulmonary alveolar proteinosis. However, the WLL protocol has not yet been standardized and the technique has been refined and modified a number of times. A rapid infusion system is a device used to infuse blood or other fluids at precise rates and normothermic conditions. This device is not typically used in WLL, which relies on the passive infusion of fluids using the gravitational force. However, in this study we performed WLL using a rapid infusion system, since we aimed to take advantage of its shorter operation time and greater degree of control over fluid volume and temperature. The patient’s symptoms improved without the occurrence of any complications.

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Autoimmune Pulmonary Alveolar Proteinosis: A Review of Pathogenesis and Emerging Therapies
Akshay Mathavan, Akash Mathavan, Swaminathan Perinkulam Sathyanarayanan, Cormac McCarthy, Ali Ataya
Current Pulmonology Reports.2024;[Epub] CrossRef
Whole-Lung Lavage—a Narrative Review of Anesthetic Management
Santiago M. Mata-Suarez, Agustina Castro-Lalín, Santiago Mc Loughlin, Juan De Domini, Juan C. Bianco
Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(2): 587. CrossRef
Lung injury induced by different negative suction pressure in patients with pneumoconiosis undergoing whole lung lavage
Mingyuan Yang, Baoping Li, Bin Wang, Lei Li, Yurong Ji, Yunzhi Zhou, Rui Huang, Qinghao Cheng
BMC Pulmonary Medicine.2022;[Epub] CrossRef
Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report
Jae Wan Jung, Hyunho Lee, Jimi Oh
Yeungnam University Journal of Medicine.2021; 38(4): 374. CrossRef

Review article

Pathological interpretation of connective tissue disease-associated lung diseases: Kun Young Kwon; Yeungnam Univ J Med. 2019;36(1):8-15. Published online January 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00101

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Abstract PDF

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

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Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist’s Key Role
Stefano Lucà, Francesca Pagliuca, Fabio Perrotta, Andrea Ronchi, Domenica Francesca Mariniello, Giovanni Natale, Andrea Bianco, Alfonso Fiorelli, Marina Accardo, Renato Franco
International Journal of Molecular Sciences.2024; 25(7): 3618. CrossRef
Acute fibrinous and organizing pneumonia: two case reports and literature review
Haihong Chen, Yukun Kuang, Xinyan Huang, Ziyin Ye, Yangli Liu, Canmao Xie, Ke-Jing Tang
Diagnostic Pathology.2021;[Epub] CrossRef

Original Articles

Effects of small tidal volume and positive end-expiratory pressure on oxygenation in pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation: Sung Hye Byun, So Young Lee, Jin Yong Jung; Yeungnam Univ J Med. 2018;35(2):165-170. Published online December 20, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.165

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Abstract PDF

Background
The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV).
Methods
The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCVVG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP (5 cmH2O; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure (Ppeak), mean airway pressure (Pmean), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP (5 cmH2O), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more.
Results
The Ppeak was significantly lower in group TV6 (19.3±3.3 cmH2O) than in group TV8 (21.8±3.1 cmH2O) and group TV6+PEEP (20.1±3.4 cmH2O). PaO2 was significantly higher in group TV8 (242.5±111.4 mmHg) than in group TV6 (202.1±101.3 mmHg) (p=0.044). There was no significant difference in PaO2 between group TV8 and group TV6+PEEP (226.8±121.1 mmHg). However, three patients in group TV6 were dropped from the study because PaO2 was lower than 80 mmHg after ventilation.
Conclusion
It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with 5 cmH2O PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.

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Pressure-Controlled Ventilation-Volume Guaranteed Mode Combined with an Open-Lung Approach Improves Lung Mechanics, Oxygenation Parameters, and the Inflammatory Response during One-Lung Ventilation: A Randomized Controlled Trial
Jianli Li, Baogui Cai, Dongdong Yu, Meinv Liu, Xiaoqian Wu, Junfang Rong
BioMed Research International.2020; 2020: 1. CrossRef

Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery: Hyuckgoo Kim, Jisoo Han, Sung Mee Jung, Sang-Jin Park, Nyeong Keon Kwon; Yeungnam Univ J Med. 2018;35(1):54-62. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.54

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Abstract PDF

Background
The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
Methods
This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.
Results
Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.
Conclusion
Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

Citations

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Strategies for intraoperative glucose management: a scoping review
Nathaniel Morin, Sarah Taylor, Danae Krahn, Leyla Baghirzada, Michael Chong, Tyrone G. Harrison, Anne Cameron, Shannon M. Ruzycki
Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2023; 70(2): 253. CrossRef
Impact of total intravenous anesthesia and total inhalation anesthesia as the anesthesia maintenance approaches on blood glucose level and postoperative complications in patients with type 2 diabetes mellitus: a double-blind, randomized controlled trial
Xinghui Xiong, Yong He, Cheng Zhou, Qin Zheng, Chan Chen, Peng Liang
BMC Anesthesiology.2023;[Epub] CrossRef
Current trends in management of hyperglycaemia in surgical patients with diabetes mellitus: a review
Vladimir N. Kuklin, J. Matri, N. P. Barlow, S. H. Tveit, J. E. Kvernberg, E. -M. Ringvold, V. Dahl
Annals of Critical Care.2022; (4): 33. CrossRef
Effects of sevoflurane anesthesia and abdominal surgery on the systemic metabolome: a prospective observational study
Yiyong Wei, Donghang Zhang, Jin Liu, Mengchan Ou, Peng Liang, Yunxia Zuo, Cheng Zhou
BMC Anesthesiology.2021;[Epub] CrossRef

Case Reports

Glandular papilloma of the lung with malignant transformation: Woo Jung Sung; Yeungnam Univ J Med. 2017;34(2):298-302. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.298

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Abstract PDF

Glandular papilloma of the lung is one of three histologic types of solitary endobronchial papillomas. It is known as an uncommon benign neoplasm. No malignant glandular papillomas have been reported. Herein, the first case of granular papilloma with malignant transformation is reported. A 74-year-old man with huge right lung mass extended upper and lower lobe was admitted to the hospital complaining of progressive cough and dyspnea. An open lung biopsy was performed. Microscopically, the tumor showed papillary growth pattern with thick fibrovascular cores. The stroma of the fibrovascular cores shown the infiltration of lymphoplasmacytic cells and proliferation of capillaries. The epithelial cells surrounding the papillary fronds were cilliated columnar cells with focal cellar atypia, and frequent mitoses. Suspicious pleural invasion foci were identified. The Ki-67 labeling index was about 24.3% and p53 labeling index was about 31.7%. Glandular papilloma is known as a benign neoplasm, which is lack of atypia and mitosis. In present case, there were several indications of malignant transformation, such as cellular atypia, frequent mitosis, architectural distortion, and pleural invasion. Pathologists must be aware that glandular papilloma can have a changes of malignant transformation. Further studies about disease behavior and molecular characteristics are needed.

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Adenocarcinoma-Papillary Cystic Pattern Arising in a Mixed Squamous and Glandular Papilloma of the Lung
Ae Ri An, Seung Yong Park, Jong Hun Kim, Kum Ju Chae, Myoung Ja Chung
International Journal of Surgical Pathology.2020; 28(6): 658. CrossRef

Partial spontaneous remission of small cell lung carcinoma with neurologic symptom: Kyung Hyun Yun, Sung Heon Song, Chung Hyoun Kim, Chan Hee Hwang, Jun Ho Lee, Je Hyoung Choi, Sun Young Kim; Yeungnam Univ J Med. 2017;34(2):275-278. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.275

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Abstract PDF: Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status: Oh Jung Kwon, Min Hyeok Lee, Sung Ju Kang, Seul Gi Kim, In Beom Jeong, Ji Yun Jeong, Eun Jung Cha, Do Yeun Cho, Young Jin Kim, Ji Woong Son; Yeungnam Univ J Med. 2017;34(2):270-274. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.270

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Abstract PDF: A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.

Multifocal nodular lymphoid hyperplasia of the lung: Gil Tae Lee, Eun Kyoung Kim, Eirie Cho, Seung Sook Lee, Seo Yun Kim, Cheol Hyeon Kim, Hye Ryoun Kim; Yeungnam Univ J Med. 2017;34(1):84-87. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.84

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Abstract PDF: Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.

Pumpless extracorporeal interventional lung assist for bronchiolitis obliterans after allogenic peripheral blood stem cell transplantation for acute lymphocytic leukemia.: Yeon Hee Park, Chae Uk Chung, Jae Woo Choi, Sang Ok Jung, Sung Soo Jung, Jeong Eun Lee, Ju Ock Kim, Jae Young Moon; Yeungnam Univ J Med. 2015;32(2):98-101. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.98

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Abstract PDF: Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate CO2 effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

Original Articles

Microbiologic distribution and clinical features of nontuberculous mycobacteria in the tertiary hospital in Daegu.: Kyung Soo Hong, June Hong Ahn, Eun Young Choi, Hyun Jung Jin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2015;32(2):71-79. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.71

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Abstract PDF

BACKGROUND
Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. METHODS: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. RESULTS: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. CONCLUSION: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

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Epidemiological Characteristics of Nontuberculous Mycobacterial Pulmonary Disease in South Korea: A Meta-analysis of Individual Participant Data
Geunin Lee, Sol Kim, Shihwan Chang, Hojoon Sohn, Young Ae Kang, Youngmok Park
Tuberculosis and Respiratory Diseases.2024; 87(3): 386. CrossRef
Distribution and Antimicrobial Resistance of Non-Tuberculous Mycobacteria during 2015∼2020: A Single-Center Study in Incheon, South Korea
Jiwoo Kim, Hyo-Jin Ju, Jehyun Koo, Hyeyoung Lee, Hyeonhwan Park, Kyungcheol Song, Jayoung Kim
The Korean Journal of Clinical Laboratory Science.2021; 53(3): 225. CrossRef
Study on the Prevalence of Lung Disease of Non-Tuberculosis Mycobacterium Isolated from Respiratory Specimens in Gwangju Second Hospital over the Last 10 Years
Hae-Gyeong Baek
The Korean Journal of Clinical Laboratory Science.2020; 52(4): 349. CrossRef
Recovery Rates of Non-Tuberculous Mycobacteria from Clinical Specimens Are Increasing in Korean Tertiary-Care Hospitals
Namhee Kim, Jongyoun Yi, Chulhun L. Chang
Journal of Korean Medical Science.2017; 32(8): 1263. CrossRef

Weekly irinotecan and carboplatin for patients with small cell lung cancer.: Hye Won Lee, Eu Gene Jeong, Dong Hyun Kim, Hyuk Lee, Bo Hyoung Kang, Soo Jung Um, Meesook Roh, Choonhee Son; Yeungnam Univ J Med. 2014;31(2):82-88. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.82

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Abstract PDF: BACKGROUND
Lung cancer is the most common cause of cancer-related death worldwide and in Korea, and small cell lung cancer (SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study. METHODS: Patients with histologically or cytologically confirmed extensive stage SCLC were included. Patients with limited stage (LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irinotecan 60 mg/m2, carboplatin 2 area under the curve at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occurred. No more than 6 cycles of chemotherapy were given. RESULTS: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5% (complete response, 14.9%; partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocytopenia (8.5%), sepsis (4.3%), and pancytopenia (2.1%). There was no treatment related death. CONCLUSION: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a first line therapy for both stage of SCLC. Large scaled, controlled study is feasible.

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