• Title/Summary/Keyword: 간질성 폐렴

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The Expression of MMPs and TIMPs in IPF and NSIP (IPF와 NSIP에서 MMPs와 TIMPs의 발현)

  • Kim, Yu Jin;Kim, Jung Ho;Jeon, Hyo Keun;Kim, Mi Kyeong;Jo, Young Chan;Kyung, Sun Yong;An, Chang Hyeok;Lee, Sang Pyo;Park, Jung Woong;Ha, Seung Yeon;Jeong, Sung Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.447-455
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    • 2006
  • Background: MMPs and TIMPs are important factors for abnormal remodeling the pulmonary parenchyme in idiopathic interstitial pneumonia(IIP) This study evaluated the expression of MMPs and TIMPs in the tissue of IPF, NSIP and normal control subjects. Method: The MMP-2 and -9 activity in the lung tissue was studied by gelatin zymography, and the expression of MMP-1, -2, -9, TIMP-1 and -2 in the lung tissue was measured by immunohistochemistry. Thirty five patients, who were diagnosed with IIP (UIP ; 22, NSIP ; 13), were enrolled in the immunohistochemical study. Thirteen patients with IIP (UIP ; 9, NSIP ; 4) and five patients with lung cancer were enrolled in the zymographic assay. Results: (1) The immunohistochemistry for MMP-1,-2,-9, TIMP-1 and-2 ; MMP-1,-9 and TIMP-2 were stained stronger in the UIP subjects than NSIP and the normal control. TIMP-2 was strongly stained in the UIP tissue. particularly the fibroblasts in the fibroblastic foci. (2) Zymography for MMP-2 and MMP-9 revealed MMP-2 to have prominent expression in the UIP tissue than in the NSIP tissue. Conclusions: These results suggest that the overexpression of the TIMPs and gelatinases in UIP might be important factors in the irreversible fibrosis of the lung parenchyme.

Radiologic Findings of Idiopathic Interstitial Pneumonia (특발성 간질성 폐렴의 영상 소견)

  • Park, Jai Soung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.330-343
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    • 2005
  • 특발성 간질성 폐렴은 폐포보다는 폐간질을 주로 침범하는 미만성 염증성 섬유화 병변으로 병변의 분류에 임상적 및 병리학적으로 많은 혼동과 변화를 겪어왔다. 최근에는 미국흉부학회와 유럽호흡기학회의 공동 모임에서 이 질환 군에 해당되는 모든 임상과들이 모여서 7가지의 병변으로 재분류 하였는데, 이는 Idiopathic pulmonary fibrosis, Nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia, Acute interstitial pneumonia, Respiratory bronchiolitis interstitial lung disease, Desquamative interstitial pneumonia, Lymphocytic interstitial pneumonia 등이다. 이에 저자는 최근 분류에 의한 특발성 간질성 폐렴의 7가지 병변을 영상 소견을 중심으로 기술하고자 한다.

Recurrent Desquamative Interstitial Pneumonia with Fibrotic Lung Disease (폐섬유화를 동반한 재발성 박리성 간질성 폐렴)

  • Kim, Won Jin;Choi, Jeong Hee;Park, Yong Bum;Cho, Sung Woo;Nam, Eun Sook;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.328-333
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    • 2008
  • Desquamative interstitial pneumonia is an uncommon form of interstitial lung diseases and it has a good prognosis compared with other types of idiopathic interstitial pneumonia. A 69-year old man was admitted to our hospital because of a 3-month history of dyspnea. The patient presented with hypoxemia. High-resolution computerized tomography of the patient showed ground glass opacity and traction bronchiectasis with subpleural early honeycombing on the both lung fields. The pathologic findings of the video-assisted thoracoscopy lung biopsy were compatible with desquamative interstitial pneumonia, and irregularly distributed interstitial fibrosis and inflammation were observed at the peripheral parenchyme. Oral predinsolone was started; his symptoms and chest x-ray were improved, and so he stopped taking the prednisolone. Ten months later, the desquamative interstitial pneumonia recurred. We report here on a case of recurrent desquamative interstitial pneumonia with fibrotic lung disease.

2008 National Survey of Idiopathic Interstitial Pneumonia in Korea (2008년도 특발성 간질성 폐렴(IIP) 전국실태조사보고)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.141-151
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    • 2009
  • Background: There is limited data on the epidemiology and relative frequency of idiopathic interstitial pneumonia (IIP) worldwide. This survey was performed to assess the epidemiology and relative frequency of IIP in Korea. Methods: The patients with IIP and who were confirmed by lung biopsy, except those patients with idiopathic pulmonary fibrosis, (IPF) over a 5 year period (from Jan. $1^{st}$, 2003 to Dec. $31^{st}$, 2007) were registered by a web-base questionnaire. Results: A total of 3,156 cases were registered, but 970 cases were excluded due to duplicative registration, inadequate data and the unmet ATS/ERS diagnostic criteria. A total of 2,186 cases were analyzed. The male to female ratio was about 2 : 1 and their mean age was 65 (range: 11-94). The most frequent disease was IPF (77.1%), followed in decreasing order by nonspecific interstitial pneumonia (NSIP) (11.9%), cryptogenic organizing pneumonia (COP) (8.5%), acute interstitial pneumonia (AIP) (1.1%), desquamative interstitial pneumonia (DIP) (0.9%), respiratory bronchiolitis-interstitial lung disease (RB-ILD) (0.4%) and lymphocytic interstitial pneumonia (LIP) (0.1%). The mean age of the patients with IPF, NSIP and COP was 67.8, 57.1 and 57.7 years old, respectively. The most frequent symptom was dyspnea on exertion (69%) followed by coughing (61%) and sputum (33%) for the whole population. The three year survival rate was 62% for the patients with IPF and the five year survival rate was 85% in both the NSIP and COP patients. Conclusion: This survey provides helpful information for the management of IIP and to produce management guidelines for this illness in Korea.

A Case of Nonspecific Interstitial Pneumonia in a Patient with Ulcerative Colitis (궤양성 대장염에 병발된 비특이적 간질성 폐렴 1예)

  • Noh, Young Wook;Baik, Eun Kyung;Ryu, Yon Ju;Kim, Seong-Eun;Lee, Jin Hwa;Sim, Sung Shin;Lee, Shi Nae;Chun, Eun Mi
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.56-61
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    • 2007
  • Pulmonary complications of ulcerative colitis are relatively uncommon and may present as a variety of disorders. Ulcerative colitis-related interstitial lung disease is extremely rare. There are a few case reports of nonspecific interstitial pneumonia in ulcerative colitis worldwide but none in Korea. We report a patient with ulcerative colitis related biopsy-proven nonspecific interstitial pneumonia, who responded to prednisolone (1 mg/kg) and mesalazine therapy.

Interstitial Pneumonia and Lung Cancer Surgery (간질성 폐렴과 폐암수술)

  • Sa Young-Jo;Wang Young-Pil;Park Jae-Kil
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.304-309
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    • 2006
  • Background: Interstitial pneumonia is associated with an increased risk of lung cancer but the outcome of surgical resection in this setting is unknown. The purpose of this study was to determine the relationship between pre-operative interstitial pneumonia (IP) and post-operative respiratory failure. Material and Method: A retrospective review of 672 patients with lung cancer who underwent curative pulmonary resection at the Hospital of Catholic University Medical College between 1997 and 2005 was undertaken. The patients were divided into two groups according to preexisting interstitial pneumonia and not by the pre-operative chest HRCT or findings of pathologic papers. The pre-operative data and cancer-related findings were analyzed between the IP group and non-IP group, and between the respiratory failure group and non-failure group in IP patients. Result: Twenty-eight patients (4.2%) of the developed post-operative respiratory failure and this proved to be fatal in 21 of these patients. We could find preoperative interstitial pathology in 53 patients (7.9%) among the 672 patients. The incidences of respiratory failure were 11.3% (6/53 cases) and 3.6% (22/619 cases) in IP group and non-IP group respectively, Conclusion: Interstitial pneumonia was considered one of the risk factors for developing postoperative acute respiratory failure in patients with lung cancer.

Gefitinib-Related Interstitial Pneumonia (Gefitinib 투여 후 발생한 간질성 폐렴)

  • Lee, Ho Jin;Nam, Seung Bum;Jung, Jae Wook;Na, Im Il;Kim, Cheol Hyeon;Ryoo, Baek-Yeol;Choe, Du Whan;Kang, Jin Hyung;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.134-139
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    • 2007
  • Gefitinib is a novel drug used to treat advanced non-small cell lung cancer. However, drug-related interstitial pneumonia is a major life-threatening side effect, which has a worldwide prevalence of 0.3-0.4%. In Japan, the prevalence is high as 3-4% but the actual frequency in Korea has not been officially assessed. We report two cases of gefitinib-induced interstitial lung disease during the treatment of non-small cell lung cancer. High-resolution computerized tomography (HRCT) of one case showed nonspecific ground glass opacity and the chest x-ray of another case showed diffuse bilateral ground glass opacity. The former patient showed a rapid good response to corticosteroid treatment whereas the latter died despite receiving aggressive treatment with high dose corticosteroid and empirical antibiotics.

Immunohistochemical identification of porcine reproductive and respiratory syndrome virus antigen in the lungs of naturally infected piglets (돼지 생식기 호흡기 증후군 바이러스에 자연감염된 포유자돈의 폐장에서 면역조직화학법을 이용한 바이러스 항원의 확인)

  • Cheon, Doo-Sung;Min, Kyoungsub;Chae, Chanhee
    • Korean Journal of Veterinary Research
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    • v.37 no.2
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    • pp.417-423
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    • 1997
  • 돼지 생식기 호흡기 증후군 바이러스의 nucleocapsid와 반응을 하는 SDOW17 단크론항체를 이용하여 중성 포르말린에 고정시킨 자연감염된 포유자돈의 폐장에서 면역조직화학법을 이용하여 돼지 생식기 호흡기 증후군 바이러스 항원을 확인하였다. 서울대학교 수의과대학 병리학교실에 의뢰된 포유자돈들 중에서 병리조직학적으로 폐장에서 간질성 폐렴이 관찰된 포유자돈 7두를 임의로 선택하여 본 실험을 실시하였다. 간질성 폐렴의 병변으로 많은 수의 대식세포 침윤을 동반한 폐포벽 두께의 증가와 제II형 폐포세포의 비후가 관찰되었다. 검사한 7두 포유자돈중에서 6두에서 돼지 생식기 호흡기 증후군 바이러스에 대한 항체를 enzyme-linked immunosorbent assay에 의해 확인하였다. SDOW17 단크론항체를 이용한 면역조직화학염색과 간질성 폐렴의 대식세포에서 돼지 생식기 호흡기 증후군 바이러스의 항원을 검출하였고, 항원은 (주로)대식세포의 세포질에서만 진한 갈색의 양성반응이 관찰되었다. 이상 검사결과 돼지 생식기 호흡기 증후군 바이러스는 폐장의 간질과 폐포강에 분포되어 있는 대식세포에서 주로 증식하는 것으로 판명되었다. 본 실험에서 사용한 면역조직화학법은 돼지 생식기 호흡기 증후군 바이러스 감염여부를 바이러스 분리 또는 혈청검사 없이 진단하는데 사용할 수 있는 유용한 진단방법으로 판명되었다.

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A Case of Acute Fibrinous and Organizing Pneumonia (급성 섬유소성 기질화 폐렴 1예)

  • Cho, Joo Yeon;Lee, Hyun Kyung;Lee, Sung Soon;Lee, Hye Kyung;Lee, Young Min;Lee, Hyuk Pyo;Kim, Joo In;Choi, Soo Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.479-483
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    • 2006
  • Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of prominent intra-alveolar fibrin and organizing pneumonia, with out hyaline membranes or prominent eosinophilia. The clinical manifestations of AFOP resemble those of acute lung injury such as acute interstitial pneumonia (AIP). However, the classic histological patterns of AFOP differ from diffuse alveolar damage (DAD), bronchiolitis obliterans with organizing pneumonia (BOOP) or acute eosinophilic pneumonia (AEP). The characteristic intra-alveolar fibrin ball and lack of classic hyaline membrane are the predominant histological features of AFOP. Although some reports suggest that its clinical course is less catastrophic than DAD, the clinical entity that distinguishes AFOP from DAD has not been established. We present a case of pathologically demonstrated AFOP in a 79-year-old man. The radiological findings of our case were similar to those of DAD, presented with diffuse bilateral lung infiltrations. However, despite the rapid development of respiratory failure, the patient had a better response and outcome to steroid therapy than what would be expected for DAD.

A Case of Nonspecific Interstitial Pneumonia Associated with Systemic Lupus Erythematosus (전신성 홍반성 낭창에 병발된 비특이성 간질성 폐렴 1예)

  • Lee, Ho-Moeng;Hwang, Jae-Kyung;Park, Gae-Young;Park, Jeong-Woong;Park, Jae-Kyung;Jeong, Seong-Hwan;Nam, Gui-Hyun;Lee, Jae-Woong;Ha, Seung-Yeon;Lee, Han-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.732-739
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    • 2001
  • Systemic lupus erythematosus frequently has thoracic involvement among connective tissue diseases. One of the pleuropulmonary manifestations is diffuse interstitial lung disease including nonspecific interstitial pneumonia(NSIP). NSIP is a newly classified disease among interstitial lung diseases. Systemic lupus erythematosus has a better prognosis than usual interstitial peumonia(UIP) and responds well to steroids. In this report, a 34 year-old woman who complained of a dry cough, and exertional dyspnea for 2 months is described. The chest X-ray showed fine reticular opacities and a mild honeycomb appearance in both basal lungs. High resolution computed tomography(HRCT) showed bilateral patchy areas of ground-glass attenuation and a mild honeycomb appearance in the subpleural of both the lower and the middle portion of the lung fields. An open lung biopsy showed prominent lymphocytic interstitial inflammation and fibrosis with small areas with a honeycomb appearance. This case was diagnosed as NSIP associated with systemic lupus erythematosus and was managed with oral steroids. Here we report a case of nonspecific interstitial pneumonia associated with systemic lupus erythematosus confirmed by HRCT and an open lung biopsy with a review of the relevant literature.

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