• Title/Summary/Keyword: 미만성 간질환

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Analysis on Usefulness of Non-invasive Liver Fibrosis Evaluation Method according to the Liver Disease : Focused on Hepatitis C patients (간질환 종류에 따른 비침습적 간섬유화 평가법의 유용성 분석 : C형 간염 보균자 중심으로)

  • Nam, Ji-Hee;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.42 no.5
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    • pp.345-350
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    • 2019
  • Liver biopsy is the gold standard for diagnosing liver fibrosis, but it is invasive and has a risk for complications. For this reason, recently, study has been actively conducted on non-invasive liver fibrosis evaluation method. But, there is no established standard for the type of diffuse liver disease. Therefore, this study was suggest the usefulness and cut-off values of Fibroscan, FIB-4, APRI and AAR of patients with hepatitis C in Korea. According to the diagnosis, 240 people in hepatitis C are classified into fatty liver, chronic hepatitis, and liver cirrhosis. The statistical analysis was performed by ANOVA to verify difference between groups. The ROC curve was analyzed to determine the usefulness and practical cut-off value. As a result, for all diseases, the AUC value for Fibroscan was 0.8 over and the APRI was 0.7 over. Cut-off value of serum based liver fibrosis markers was increased in order of fatty liver, chronic hepatitis and liver cirrhosis. If Fibroscan and serological liver fibrosis markers are applied to predict liver fibrosis, it is expected that excessive liver biopsy can be reduced.

Risk Factors Analysis of Alcoholic Liver Diseases by Ultrasonography (초음파검사에 의한 알코올성 간질환의 위험요인 분석)

  • Lee, Man-Koo;Han, Nam-Sook;Lim, Cheong-Hwan;Jung, Hong-Ryang;Cho, Jung-Keun
    • The Journal of the Korea Contents Association
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    • v.9 no.3
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    • pp.185-194
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    • 2009
  • This research attempted to find risk factors of alcoholic liver diseases by ultrasonography at the K image medicine clinic center located in Kwangju city, Kyunggi-Do from March to May, 2007. Six risk factors were selected for this study, age, sex, frequency of alcohol drinking, body mass index(BMI), cholesterol and GPT. The data collected from 353 patients of aged between 20 and 69. This study found the relationships between liver diseases and alcohol drinking style by liver ultrasonography. The results of the analyses showed that the male were 2.12 times more likely to have liver diseases than the female. The persons drinking alcohol more than 3 times per week had 2.37 times higher likelihood of showing liver diseases than below 2 times per week or non drinking at all.. The persons with normal body mass index have 0.52 times lower probability of liver diseases than the persons with abnormal BMI. The persons with abnormal cholesterol level have 9.13 times higher probability of liver diseases. The persons with abnormal GPT have 4.66 times higher probability of liver diseases. The results of this study suggested applying ultrasonography in health promotion programs for diagnosis of liver diseases.

The Role of Open Lung Biopsy in Diagnosis and Treatment of Diffuse Interstitial Lung Disease in High-resolution Computed Tomography Era (고해상도 전산화단층촬영 시대에 있어서 미만성 간질성 폐질환의 진단 및 치료에서의 개흉폐생검의 역할)

  • Kim, Gye Su;Lee, Jae Chul;Lee, Seung Joon;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Min, Kyung Up;Im, Jung-Gi;Kim, You Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.746-754
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    • 1996
  • Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share conUTIon clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCf) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide infonnation on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treannent plan in patients who have undergone high-resolution CT. Method : Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results : High-resolution cr suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confinned (0 be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution cr was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lWlg biopsy in only 2 cases. Conclusion: The aoove fmdings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.

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Comparative Analysis Per Area of the Liver Diseases in Ultrasound Diagnosis of Healthcare Center (건강검진 초음파에서 지역별 간질환 유병률 비교 분석)

  • Lee, Mi-Yeon;Jung, Hong-Rayng;Lim, Chung-Hwan
    • The Journal of the Korea Contents Association
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    • v.9 no.3
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    • pp.278-287
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    • 2009
  • The study find out developmental factors of the liver diseases in 29,531 subject of the healthy adults who diagnosed by using ultrasound at healthcare centers located at 6 cities around the nation. The results are as follows. Based on the result of the study, the liver diseases diagnosed by using ultrasound revealed to show 43.1% of prevalence, and the occurrence was significantly higher in male(23.3%) than in female (19.8%)(p<0.001). The disease revealed to show highest prevalence rate in regionally, Dae-jeon was found to record the highest prevalence by showing 49.6% (p<0.001). The order of liver disease prevalence was the highest in Dae-jeon(49.6%),which was followed by Seoul(48.2%), Busan(42.9%), Incheon(36.2%), Daegu(36.2%), Kangju(32.1%)(p<0.001). The order of hepatic disease prevalence was the highest in fatty liver (69.7%), which was followed by intrahepatic cysts (13.2%), intrahepatic calcification (9.6%), intrahepatic hemangioma (4.5%), intrahepatic tumor (1.4%), diffuse liver disease (1.0%),and liver cirrhosis (0.5%) (p<0.001). The liver disease revealed to show highest prevalence rate in 40s and regionally, disease was found to record the highest prevalence from 30s to 50s (p<0.001). The distribution of the liver diseases by sex revealed to show the higher occurrence of the fatty liver and the diffuse liver diseases in male, but the intrahepatic cysts, intrahepatic calcification and intrahepatic tumors were highly distributed in female. In the regional evaluation, the fatty liver was most often found in Busan, and intrahepatic cysts, intrahepatic hemangioma, intrahepatic calcification and intrahepatic tumors were highly found in Dae-jeon and Seoul revealed to show higher occurrence of diffuse liver disease than other regions (p<0.001). The multiple regression analysis for the related factors which affect the prevalence of the liver diseases resulted to show the higher prevalence by age. sex,

Analysis of Image for Liver Disease using Blood Test in the Ultrasound Fibroscan (Fibroscan에서의 혈액검사를 이용한 간질환의 영상분석)

  • Lee, Jeong-Hyun;Kim, Dong-Hyun;Kim, Changsoo
    • The Journal of the Korea Contents Association
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    • v.15 no.8
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    • pp.389-396
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    • 2015
  • The liver fibrosis is a disease we often see in clinical medicine, and the persistence and repeatition of inflammation and necrosis of liver cells continue for several years, and it is proceeded to cirrhosis. So decrease of death rate and prevalence rate by complications of cirrhosis and hepatocellular carcinoma is main task of clinical medicine by protection of chronic liver ailment patients from proceeding to cirrhosis and hepatocellular carcinoma. So this study tried to represent the ultrasonic image, blood test, the relationship with liver stiffness of diffuse liver ailment patients as numbers. This study was performed with patients from whom the image was taken by ultrasonic and 141 people who were treated by fibroscan, the basic data for blood test was obtained from the test results at the time when ultrasonic image and liver fibroscan was performed. The statistical analysis was performed by One-way analysis of variance(ANOVA) to verify difference between groups. The value of liver stiffness was increased in the order of normal, chronic liver disease and cirrhosis. As a results, ALT and Albumin have no statistical difference between object groups, and there are statistical differences in the results of ultrasonic decoding at age, AST, ALP, Bilirubin, PLT, PT, and kPa, and they are statistically meaningful(p<0.005). And the value of liver stiffness of chronic liver ailment was presented only as over 12.5kPa in other study, but it was represented as numbers for quantitative diagnosis by presenting average kPa threshold value according to disease in this study. And by presenting relationship of diagnosed results, it is considered that it could be used as first tool to diagnose chronic liver ailment patients according to their disease.

A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis (침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예)

  • Lee, Young-Min;Yoon, Hye-Kyoung;Kim, Joo-In
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.62-69
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    • 2002
  • Acute interstitial pneumonia (AIP) is a rare fulminant form of lung injury that presents acutely; usually in a previously healthy individual. It corresponds to a subset of cases of idiopathic adult respiratory distress syndrome (ARDS). Invasive pulmonary aspergillosis is a disease occuring predominantly with defects in immunity such as hematologic malignancy, influenza infection, postchemotherapy, long-term corticosteroid treatment. Invasive aspergillosis has worse prognosis and most cases are diagnosed at postmortem autopsies. We experienced a case of acute interstitial pneumonia with an invasive aspergillosis during corticosteroid treatment. Acute interstitial pneumonia with invasive aspergillosis was diagnosed by an open lung biopsy using thoracoscopy, showing fungal hyphae with sepsis and an acute angle branching invasion of the lung tissue and blood vessels. The patient was treated with IV amphotericin-B, but died due to septic shock.

Characteristic CT Images in Diffuse Lung Disease (미만성 폐질환(肺疾患)에 있어서 특징적(特徵的)인 CT상(像)에 관하여)

  • Ichikawa, Hidel;Kanamori, Isao
    • Journal of radiological science and technology
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    • v.18 no.2
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    • pp.37-48
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    • 1995
  • 1) 천식 기관지 확장증에서는 기종상 음영이나 기관지가 확장된 상이 있고, 또한 미만성 범세기관지염 5예에서는 미세 반점상 음영이 전체 예에서 인정이 되었다. 2) 폐염에서는 기관지의 확장이나 점액이 고여 침윤음영이 전체 예에 나타나고 있었다. 한편, 간질성 폐염 29예에서는 반점상 음영(불균일 CT치의 상승과 내부에 작은 기관지 확장으로 작은 air상)이 보였다. 폐섬유증 19례에서는 기종상 농포상 음영이나 혈관 기관의 부정 확장, 반점상 음영이 15예로 79 %를 차지하고 있다. 만성 폐기종에서는 기종상, 다발성 농포상 음영, 고목상 혈관이 특징적인 소견이었다. 3) 속립성결핵에서는 작은 입상 음영, 폐결핵 15예에서는 공동 음영 7예, 원형의 융합음영 8예, 침윤음영, 다수의 석회화상, 혈관 기관의 부정 확장 등이 특징적이었다. Aspergillus증에서는 공동 음영 내부에 fungus ball이 보였다. 이상은 미만성 폐질환의 특징적인 CT의 이상 소견에 대해서 검토하였으나, 꼭 일치되는 것은 아니며, 기타 기초적 검사나 임상적인 경과관찰이 필요하였다. 끝으로, 대한방사선기술학회의 발전과 학회원 여러분의 건승을 기원합니다. 그리고 한국과 일본의 우호적인 학술교류가 지속되기를 희망합니다.

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Diffuse Dendriform Pulmonary Ossification with Spontaneous Pneumothorax (자발성 기흉을 동반한 미만성 수지상 폐 골화증)

  • Cho, Hyun-Jin;Kim, Yong-Hee;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.292-294
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    • 2008
  • Diffuse pulmonary ossification is a rare entity which was reported just a case in Korea, defined as "wide spread heterotropic bone formation within the lung parenchyme", and it's pathogenesis remains unclear. Generally, diffuse pulmonary ossification is diagnosed by autopsy because most of case is asymptomatic, and classified as either nodular and dendriform diagnosed pathologic examination. We reviewed a case of diffuse dendriform pulmonary ossification with spontaneous pneumothorax.

Lung Clearance of Inhaled $^{99m}Tc$-DTPA by Urine Excretion Ratio (소변내 방사능배설량비를 이용한 $^{99m}Tc$-DTPA 폐청소율에 관한 연구)

  • Suh, G.Y.;Park, K.Y.;Jung, M.P.;Yoo, C.G.;Lee, D.S.;Kim, Y.W.;Han, S.K.;Jung, J.K.;Lee, M.C.;Shim, Y.S.;Kim, K.Y.;Han, Y.C.
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.357-366
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    • 1993
  • Background: Lung clearance of inhaled $^{99m}Tc$-DTPA reflects alveolar epithelial permeability and it had been reported as more sensitive than conventional pulmonary function tests in detecting lung epithelial damage. However, measuring lung clearance of inhaled $^{99m}Tc$-DTPA by gamma camera may not always reflect alveolar epithelial permeability exactly because it is influenced by mucociliary clearance depending on the site of particle deposition. Moreover, this method takes much time and patient's effort because he has to sit or lie still in front of the camera for a prolonged period. Most of the absorbed DTPA is excreted in urine within 24 hours and the amount of excreted DTPA in urine during the first few hours after inhalation is influenced by absorption rate which is correlated with the alveolar-epithelial permeability suggesting that the urinary excretion, especially in first few hours, may be an alternate index for lung clearance. The purpose of this study was to evaluate the usefulness of ratio of excreted $^{99m}Tc$-DTPA in 2 hour and 24 hour urine as an index of alveolar-epithelial damage. Methods: Pulmonary function tests including diffusing capacity and lung clearance of $^{99m}Tc$-DTPA measured by gama camera ($T_{1/2}$) and 2hr/24hr urine excretion ratio (Ratio) of inhaled $^{99m}Tc$-DTPA in 8 normal subjects and 14 patients with diffuse interstitial lung disease were compared. Results: 1) In the normal control, there was significant negative correlation between the $T_{1/2}$ and the Ratio (r=-0.77, p<0.05). In patients with diffuse interstitial lung disease, there also was significant negative correlation between $T_{1/2}$ and Ratio(r=-0.63, p<0.05). 2) In diffuse interstitial lung disease patients, the $T_{1/2}$ was $38.65{\pm}11.63$ min which was significantly lower than that of normal control, $55.53{\pm}11.15$ min and the Ratio was $52.15{\pm}10.07%$ also signifantly higher than that of the normal control, $40.43{\pm}5.53%$ (p<0.05). 3) There was no significant correlations between $T_{1/2}$ or Ratio and diffusing capactiy of lung in both patients and controls (p>0.05). Conclusion: These results suggests that 2hr/24hr urine excretion ratio of inhaled $^{99m}Tc$-DTPA is a useful simple bedside test in assessing alveolar epithelial permeability and that it may be used as an additive follow-up test in patients with diffuse interstitial lung disease complementing conventional pulmonary function tests.

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Comparison of Epileptic Seizures between Preterm and Term-born Epileptic Children with Periventricular Leukomalacia (뇌실 주위 백질연화증이 있는 간질 환아에서 조산 및 만삭 출산군 간의 간질 발작 유형의 비교)

  • Jeong, Hee Jeong;Lee, Eun Sil;Moon, Han Ku
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1225-1231
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    • 2005
  • Purpose : This study compares the first epileptic seizures between preterm and term-born children with periventricular leukomalacia and epilepsy. Methods : From 108 cases having lesions of high signal intensity around the ventricles in T2 weighted imaging of a brain magnetic resonance study, we selected 37 cases that showed epileptic seizures two times or more and divided them into the group of preterm-born(27 cases) and term-born children(10 cases). A retrospective study was made by comparing the two groups with regard to age, type of the first epileptic seizures, EEG findings and responsiveness to anticonvulsants. Results : The age of the first epileptic seizure was $22.2{\pm}18.3$ months in the preterm-born group and $26.9{\pm}21.1$ months in the term-born group(P=0.505). As for the first epileptic seizure, 11 out of the 27 cases in the preterm-born group had infantile spasms. Out of the 10 cases in the term-born group, 7 had complex partial seizures. In the preterm group, hypsarrhythmias were found in 11 cases, focal epileptiform discharges in 6 cases. In term-born group, focal epileptiform discharges were found in 5 cases but no epileptiform discharge was found in 3 cases. Intractable epilepsies were diagnosed in 6 cases and all of them belonged to the preterm-born group. Conclusion : More severe epilepsies such as infantile spasm and intractable epilepsies seem to be more common in preterm-born epileptic children with PVL as well as more severely abnormal EEG finding compared to term-born epileptic children.