• Title/Summary/Keyword: 미만성 간질환

Search Result 54, Processing Time 0.026 seconds

Surgical Lung Biopsy for Diffuse Infiltrative Lung Disease (미만성 침윤성 폐질환의 외과적 폐생검)

  • Lee, Jang-Hoon;Kwon, Jin-Tae;Lee, Jung-Cheul
    • Journal of Chest Surgery
    • /
    • v.39 no.11 s.268
    • /
    • pp.844-849
    • /
    • 2006
  • Background: The diffuse infiltrative lung disease requires surgical lung biopsy for its final diagnosis. We evaluated the effect of surgical lung biopsy for final diagnosis of duffuse interstitial lung disease and compared video assisted thoracoscopic lung biopsy(TLB) with open lung biopsy(OLB). Material and Method: We evaluated the patients who underwent surgical lung biopsy from March 2000 from December 2005, retrospectively, We divide to two groups(OLB and TLB group) and compared them. Result: There were 36 patients and cough was the most common pre- operative symptom. Surgery time, anesthetic time, hospital stay, duration of chest tube indwelling, specimen volume and the rate of post-operative complication were not significantly different between two groups. Histologic diagnosis was confirmed in all cases. There was one post-operative death who had suffered from respiratory failure since pre-operative period. Conclusion: Surgical lung biopsy is effective method in final diagnosis for diffuse infiltrative lung disease. Video assisted thoracoscopic lung biopsy is lesser invasive method than open lung biopsy and provide similar results, so it is basic diagnostic method of surgical lung biopsy.

Open Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환의 개흉 폐 생검)

  • Seong, Suk-Hwan;Seo, Pil-Won
    • Journal of Chest Surgery
    • /
    • v.27 no.10
    • /
    • pp.850-853
    • /
    • 1994
  • Open lung biopsy was performed in thirty patients for the diagnosis and staging evaluation of interstitial lung disease during the period from January 1987 until December 1992. The age of the patients ranged from 14 to 71 years [mean 48 years], and the patients consisted of 14 males and 16 females. Preoperative FEV1`s were from 0.80 liter to 3.88 liters [mean 1.66]. Other non-invasive diagnostic studies such as PCNA, bronchoalveolar lavage, TBLB, and gallium scan were also done in addition to X-ray and high-resolution chest CT. Tweaty-eight were correctly diagnosed and 2 cases were not [diagnostic yield rate 93.3%]. Among the 28 cases,pathologic diagnosis influenced further treatment regimens and prognostic expectations in 23 cases [82.1%]. The diagnostic non-invasive studies other than open lung biopsy yielded a correct diagnosis without staging only in 5 cases. There was no mortality and only one complication, ARDS ; however, the patient recovered after 5 days ventilator support. Open lung biopsy, which is the gold standard for the diagnosis and staging evaluation of interstitial lung disease can be done safely and has value in clinical decision making. Also knowledge of the involvement of the lesion is important for proper selection of the biopsy site.

  • PDF

A Comparison of Cause-Specific Mortality Between Korea and Japan (한.일 사망원인별 사망력 비교)

  • 박경애
    • Korea journal of population studies
    • /
    • v.22 no.1
    • /
    • pp.37-63
    • /
    • 1999
  • 한국 사망력의 수준 및 특징을 일본과 비교하고자 양국의 1995년 공식통계를 사용하여 사망원인별로 성·연령·혼인상태별 사망률, 연령표준화사망률, 생존기간손실년수(PYLL) 및 동 측정치의 남녀간 비와 한일간 비를 계산하였다. 사망원인 항목은 모든 사인(총사망), 결핵, 악성신생물, 당뇨병, 고혈압성 질환, 심장 질환, 뇌혈관 질환, 간 진환, 교통사고, 자살을 포함한다. 일본과 비교하여 한국 사망력의 두드러진 특징은 다음과 같다 : (1)자살을 제외한 대부분의 사인에서 한국의 사망률이 일본보다 높은데 , 특히 결핵, 고혈압성 질환, 간 질환 및 교통사고의 경우 한국 생산활동연령층의 사망률이 두드러지게 높다 : (2)결핵, 간질환, 교통사고, 암사망이 한국의 소아에게서도 발생한다 : (3)한국의 생산활동연령층에서 간 질환, 결핵, 교통사고에 의한 성별 사망력 격차가 큰데, 남성의 사망률이 여성의 사망률보다 높기 때문이다 : (4)자살률이 한국생산활동연령층 남성의 경우 일본보다 낮고, 10대와 20대 여성의 자살률은 일본보다 높다 : (5)한국의 45세 미만에서는 사인에 따라 사별이나 이혼상태에서, 45세 이상에서는 모든 사인에 대해 남녀 모두 미혼상태에서 사망력이 가장 높다. : (6)한국은 사별상태에서, 일본은 이혼상태에서 성별 사망력 격차가 가장 크다.

  • PDF

The Expression of Adhesion Molecules on Alveolar Macrophages and Lymphocytes and Soluble ICAM-1 Level in Serum and Bronchoalveolar Lavge(BAL) Fluid of Patients with Diffuse Interstitial Lung Diseases(DILD) (간질성 폐질환환자들의 기관지 폐포세척액내 폐포 대식세포와 임파구의 접착분자 발현 및 Soluble ICAM-1 농도에 관한 연구)

  • Kim, Dong-Soon;Choi, Kang-Hyun;Yeom, Ho-Kee;Park, Myung-Jae;Lim, Chai-Man;Koh, Yoon-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.42 no.4
    • /
    • pp.569-583
    • /
    • 1995
  • Background: The expression of the adhesion molecules on the cell surface is important in the movement of cells and the modulation of immune response. DILD starts as an alveolitis and progresses to pulmonary fibrosis. So adhesion molecules in these patients is expected to be increased. There are several reports about adhesion molecules in DILD in terms of the percentage of positive cells in immuno-stain, in which the interpretation is subjective and the data were variable. Methods: So we measured the relative median fluorescence intensity(RMFI) which is the ratio of the FI emitted by bound primary monoclonal antibody to FI emitted by isotypic control antibody of the cells in BALF of 28 patients with DILD(IPF:10, collagen disease:7, sarcoidosis:9, hypersensitivity pneumonitis:2) and 9 healthy control. Results: RMFI of the ICAM-1 on AM($3.30{\pm}1.16$) and lymphocyte($5.39{\pm}.70$) of DILD were increased significantly than normal control($0.93{\pm}0.18$, $1.06{\pm}0.21$, respectively, p=0.001, P=0.003). RMFI of the CD18 on lymphocyte was also higher($24.9{\pm}14.9$) than normal($4.59{\pm}3.77$, p=0.0023). And there was a correlation between RMFI of ICAM on AM and the % of AM(r=-0.66, p=0.0001) and lymphocyte(r=0.447, p=0.0116) in BALF. Also RMFI of ICAM on lymphocyte had a significant (r=0.593, p=0.075) correlation with the % of IL-2R(+) lymphocyte in BALF. The soluble ICAM(sICAM) in serum was also significantly elevated in DILD($499.7{\pm}222.2\;ng/ml$) compred to normal($199.0{\pm}38.9$) (p=0.00097) and sICAM in BAL fluid was also significantly higher than normal control group($41.8{\pm}23.0\;ng/ml$ vs $20.1{\pm}13.6\;ng/ml$). There was a Significant correlation between sICAM level in serum and the expression of ICAM-l on AM(r=0.554, p=0.0259).Conclusion: These data suggest that in DILD the expression of adhesion molecules is increased in the AM and BAL lymphocytes with elevated serum sICAM, and these parameter may be useful in determining disease activity.

  • PDF

Thoracoscopic Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환에서 비디오 흉강경을 이용한 폐생검)

  • 심성보;연성모
    • Journal of Chest Surgery
    • /
    • v.29 no.7
    • /
    • pp.741-746
    • /
    • 1996
  • Diffuse interstitial lung disease due to a wide variety of conditions are amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy site and reduced postoperative chest pain compared with the standard open lung biopsy Video assisted thoracoscopic lung biopsy was performed in twenty patients for diagnosis of diffuse in- terstitial lung disease during the period from January 1993 to June 1994. The ages of the patients ranged from 18 to 69 years(mean 48.5 years), and the patients consisted of 10 males and 10 females. In all twenty, thoracoscpic lung biopsy samples were obtained; 9 from left lower lobe, 7 from right lower lobe, 2 from right upper lobe, 1 from left upper lobe, and 1 from right middle lobe. All patients were correctly diagnosed. The two common diseases were usual in erstitial pneumonia(UIP)(8120) and mil- liary tuberculo si s(4120) . Mean duration of the chest drainage was 3.2 days. There was no complication.

  • PDF

A Study on Effectiveness of Designed Composite Filter with Noise Reduction in Ultrasound Image for Diffuse Liver Disease (미만성 간질환의 초음파 영상에서 노이즈 감소를 위한 복합필터의 설계 및 유용성에 관한 연구)

  • Lee, Jin-Soo;Kim, Changsoo;Im, In-Chul;Yang, Sung-Hee
    • Journal of the Korean Society of Radiology
    • /
    • v.11 no.2
    • /
    • pp.69-77
    • /
    • 2017
  • This paper proposes a composite filter for noise reduction of image. To improve the image quality by reducing the noise in the liver ultrasound image, we tried to help the accurate image analysis. In the experiment, the top seven composite filters were selected by combining the Gaussian blur filter, the sharpening filter, and the median filter using the ATS-539 ultrasonic phantom, and applied to the ultrasound image in which this was done. As a result, it was found that the values of SNR, CNR and MSR all increased when the top seven composite filters were applied. In addition, PSNR of more than 30 dB, close to SSIM 1 showed that the image loss rate is small. Therefore, the appropriate application of the proposed composite filter in this research will be useful for accurate video reading and analysis.

Diagnosis of Interstitial Lung Disease -Comparison of HRCT, Transbronchial Lung Biopsy and Open Lung Biopsy- (간질성 폐질환의 진단 -HRCT, 경기관지폐생검, 개흉폐생검의 비교-)

  • Park, Jae-Seuk
    • Tuberculosis and Respiratory Diseases
    • /
    • v.46 no.1
    • /
    • pp.65-74
    • /
    • 1999
  • Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

  • PDF

Clinical Evaluation of Video-Assisted Thoracic Surgery (VATS) (비디오 흉강경 수술의 임상적 고찰)

  • 원경준;최덕영
    • Journal of Chest Surgery
    • /
    • v.29 no.10
    • /
    • pp.1133-1137
    • /
    • 1996
  • From September 1994 to October 1995, we are reporting clinical results of 67 patients whom underwent video-assisted trio rabic surgery(VATS). 1. They were diagnosed as spontaneous pneumothorax In )5, diffuse interstitial lung disease in 9, empyema in 7, hemothorax in 5, malignant pleural effusion in 3, hyperhidrosis in 3, foreign body in chest cavity in 2, mesothelioma in 1, miliary tuberculosis in 1 and organizing pneumonia in 12. In pneumothorax, bullectomy in 33 and open bellectoiny in 2 due to pleural adhesion was done Hemostasis in 5, irrigation in 7, foreign body removal in 2, talcum powder insufrlation in 3, sympathectomy 3 as done. Thoracoscopic biopsy watt done In 12 3. For pneumothorax, operation was indicated as recurrent pneumothorax in 18, persistent air leak in 12, visible bullae In chest X-ray in 5. 4 Thoracoscopic biopsy was done in 12. They were interstitial pulmonary fibrosis in 9, miliary tuberculosis in 1, mesothelioma in 1, and organizing pneumonia in 1 .Among interstitial pulmonary fibrosis, usual interstitial pneumonia were 2 and diffuse interstitial pneumonia were 7. 5. Wo complication was found in 6) patients among 67 patients. The complication was found in 4 patients (2 persistent air leak, 2 contralateral lung atelectasis). We concluded that VATS was safe and beneficial in reducing postoperative complication and the role of thoracic surgery will increase markefdly.

  • PDF

Analysis of Hemodynamic Change in Diffuse Hepatocellular Diseases (미만성 간질환에서의 간혈류 동태의 분석에 관한 연구)

  • Lee, Sung-Yong;Chung, Soo-Kyo;Lee, Yung-Il;Kim, Jong-Woo;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
    • /
    • v.20 no.2
    • /
    • pp.53-59
    • /
    • 1986
  • Radionuclide angiography of the liver and spleen with rapid bolus injection of 5 mCi of $^{99m}Tc-Sn-phytate$ was performed for evaluation of dynamic flow change of the liver in 5 normal subjects and 11 patients with diffuse hepatocellular diseases. And quantification of hepatic arterial index (HAI) was generated from those TACs of the liver and compared with HAI generated from hepatic TAC with injection of $^{99m}Tc-TcO_4^-$ as previously reported method by former investigators, 67 patients with diffuse hepatocellular diseases undergoing hepatic scintigraphy were also evaluated by 2 minutes-hepatosplenic scintiangiography with 5 mCi of $^{99m}Tc-phytate$ and followed injection of 7 mCi of $^{99m}Tc-TcO_4^-$. Those heaptic and splenic TACs were analysed and compared with HAIs of 99m Tc-phytate for evaluation of relative change (%) of count at 30 seconds and 1 minuite after peaks of rapid influx phase to the peaks (100%) in T ACs of $^{99m}Tc-phytate$ and at 1 minuite and 3 minuites after in 5 minuite-TAC of $^{99m}Tc-TcO_4^-$. Correlation between HAIs with $^{99m}Tc-phytate$ and $^{99m}Tc-TcO_4^-$ was highly significant (R=0,984, P=0), and there was most significant and useful correlation (R=0,708, p<0.0001) between HAI and splenic TAC generated by $^{99m}Tc-phytate$.

  • PDF

A Case of Pulmonary Eosinophilic Granuloma in a Passive-Smoking Reproductive Female (가임기 간접흡연 여성에서 발생한 폐 호산구성 육아종 1예)

  • Shin, Jae-Ho;Kim, Ji-Young;Oh, Soo-Hwan;Park, Hong-Soo;Chung, Sang-Su;Na, Sang-Kyu;Kim, Hyung-Jung;Ahn, Chul-Min;Kim, Hae-Kyun;Kim, Sang-Jin;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.45 no.2
    • /
    • pp.421-428
    • /
    • 1998
  • Pulmonary eosinophilic granuloma, a rare form of Langerhans cell histiocytosis confined to lung, has no known etiology and variable natural history. It is characterized by discrete proliferation of Langerhans cells. It is known that over 90% of the patients are cigarette smokers, and it is rarely reported in non- or passive-smoking patients, especially female. Here we describe a case of pulmonary eosinophilic granuloma in a passive-smoking, reproductive female patient presented with spontaneous pneumothorax. We identified S-100 and CDla positive histiocytes on immunohistochemical stain of the lung tissue obtained by open lung biopsy.

  • PDF