• Title/Summary/Keyword: 특발성

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A Case of Fulminant Bronchiolitis Obliterans Organizing Pneumonia (특발성 폐섬유화증과 감별진단을 요하는 전격성 폐쇄성 세기관지염 기질화 폐렴 (Fulminant Bronchiolitis Obliterans Organizing Pneumonia) 1예 보고)

  • Kim, Mi-Seon;Chang, Jung-Hyun;Kim, Tai-Hee;Cha, Ju-Hyun;Kim, Hae-Young;Sung, Sun-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.204-212
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    • 1998
  • Bronchiolitis obliterans organizing pneumonia(BOOP) is a type of diffuse interstitial lung disease that has emerged in the past decade as an important cause of acute respiratory illness in adult. Clinically, the entity usually starts with a subacute influenza-like illness, followed by cough, progressive dyspnea, and weight loss. Organized inflammatory polypoid materials predominantly affecting distal bronchioles, alveolar ducts, and peribronchial alveolar spaces are a key pathologic findings. BOOP is characterized by a good response to glucocorticoid and an excellent prognosis. However, there is a subset of BOOP who presents with a fulminant course leading to death or chronic severe fibrosis with marked impairment of lung function. Recently, we have experienced a case of rapidly progressive BOOP, diagnosed by open lung biopsy and showed a reluctant response to corticosteroid.

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Steroid Responsive Tremor Syndrome in a Maltese Dog (말티즈 견에서 발생한 스테로이드 반응성 진전 증후군)

  • Kang, Byeong-Teck;Jung, Dong-In;Park, Chul;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Ko, Ki-Jin;Cho, Sue-Kyung;Lee, So-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.337-339
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    • 2006
  • A 4-year-old, spayed female Maltese dog was presented for evaluation of acute onset of generalized tremor, right-sided head tilt, horizontal nystagmus, and mild ataxia with 4-day duration. However, the dog was bright, alert, and responsive. The neurological examinations revealed that bilateral horizontal-, positional nystagmus, and mild ataxia. Menace responses were also absent in both eyes. Typically, moderate generalized intension tremors were noted in four limbs and the head. No abnormalities were found in hemogram, radiography, and magnetic resonance imaging(MRI). Cytologic examination of cerebrospinal fluid(CSF) revealed a mild nonsuppurative inflammation. Thus, steroid responsive tremor syndrome(SRTS) was strongly suspected because of its inflammatory and idiopathic features. The dog excellently responded to immunosuppressive doses of corticosteroid. Therefore, we definitively diagnosed the dog as SRTS based on the exclusion of other causes of the tremor, clinical signs, and response to treatment. This is a first case report of SRTS in our country and we here describe clinical and neurological features in SRTS.

Clinical Evaluation and Diagnosis of Children with Chest Pain (흉부 통증을 호소한 소아에서의 임상적 고찰 및 검사)

  • Shin, Su A;Kim, Yong Joo;Lee, Jae Whan;Kim, Nam Su;Moon, Soo Ji
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1248-1252
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    • 2003
  • Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

The Usefulness of F-18 FDG PET to Discriminate between Malignant and benign Nodule in Idiopathic Pulmonary Fibrosis (특발성 폐섬유증에서 발견된 폐결절의 악성여부 감별에서 F-18 FDG PET의 유용성)

  • Kim, Bom-Sahn;Kang, Won-Jun;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.163-168
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    • 2006
  • Purpose: Incidence of lung canter in patients with idiopathic pulmonary fibrosis (IPF) is known to be higher than that in general population. However, it is difficult to discriminate pulmonary nodule in patients with IPF, because underlying IPF can be expressed as lung nodules. We evaluated the diagnostic performance of FDG PET in discriminating lung nodule in patients with IPF. Methods: We retrospectively reviewed 28 lung nodules in 16 subjects (age; $67.53{\pm}9.53$, M:F=14:2). Two patients had previous history of malignant cancer (small cell lung cancer and subglottic cancer). The diagnostic criteria on chest CT were size, morphology and serial changes of size. FDG PET was visually interpreted, and maximal SUV was calculated for quantitative analysis. Results: from 28 nodules, 18 nodules were interpreted as benign nodules, 10 nodules as malignant nodules by histopahthology or follow-up chest CT. The sensitivity and specificity of FDG PET were 100% and 94.4%, while those of CT were 70.0% and 44.4%, respectively. Malignant nodule was higher maxSUV than that of benign lung nodules ($7.68{\pm}3.96\;vs.\;1.22{\pm}0.65$, p<0.001). Inflammatory lesion in underlying IPF was significantly lower maxSUV than that of malignant nodules ($1.80{\pm}0.43$, p<0.001). The size of malignant and benign nodule were $23.95{\pm}10.15mm\;and\;10.83{\pm}5.23mm$ (p<0.01). Conclusion: FDG PET showed superior diagnostic performance to chest CT in differentiating lung nodules in patients with underlying IPF. FDG PET could be used to evaluate suspicious malignant lung nodule detected by chest in patients with IPF.

Long-Term Results of Surgical Treatment for the Idiopathic Clubfoot (선천성 만곡족의 장기 수술적 치료 결과)

  • Kim, Hui Taek;Kim, In Hee;Cho, Yoon Je;Ahn, Tae Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.547-556
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    • 2019
  • Purpose: This study evaluated the results of surgical treatment for residual or recurrent deformity after the conservative treatment of idiopathic clubfoot. Materials and Methods: Fifty-one cases (32 patients), who were followed up to skeletal maturity, were reviewed retrospectively. The mean age at the last follow-up was 18.7 years. The surgical options included selective or comprehensive soft tissue release, tendon lengthening and transfer, and various types of osteotomy. The radiology measurements included the talocalcaneal angle and talo-first metatarsal angle in the anteroposterior (AP) view, and the talocalcaneal angle and calcaneal pitch in the lateral view. The radiology measurements were compared with the normal values for adults. The clinical evaluations were made using the ankle-hindfoot score and the midfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS): excellent (>85), good (71-85), pair (56-70), and poor (<56). Results: At the last follow-up, the percentages of the 51 cases, whose parameter values fell within the normal ranges were as follows: in the AP view, 41.2% (talocalcaneal angle); and 90.2% (talo-first metatarsal angle). In the lateral view, the percentage was 84.3% (talocalcaneal angle). For the calcaneal pitch, the percentages were 61%. The mean AOFAS score was 88.1±10.7 on the ankle-hindfoot score and 86.7±11.5 on the midfoot score. Conclusion: The long-term outcome of patients with idiopathic clubfoot, who underwent surgical treatment after conservative treatment, was found to be 43%-90% of the normal range of radiographic indices. Clinically, the mean AOFAS scores were "excellent". Therefore, a satisfactory result can be obtained by analyzing the elements of deformity more accurately and then using the selective operation method, even if the non-surgical correction method fails.

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

  • 원경준;최덕영
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1133-1137
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    • 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.

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Progressive Lung Involvement during Steroid Therapy in Idiopathic Hypereosinophilic Syndrome (특발성 과호산구 증후군에서 스테로이드 투약 중 진행한 폐침윤 1례)

  • Park, Ji Young;Choi, Ju Young;Jung, Ji Min;Sim, Yun Su;Pyun, Gun Woo;Na, Youn Ju;Kang, Min Jung;Kang, In Sook;Lee, Si Nae;Kim, Yookyung;Jeong, Jee-Hyong;Lee, Jin Hwa;Cheon, Eun Mee;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.97-103
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    • 2005
  • Hypereosinophilic syndrome (HES) is characterized by a sustained eosinophilia of $1,500/mm^3$ or more in the absence of any known causes or the signs and symptoms of organ involvement. We report a 64-year-old man with HES initially presenting with involvement of the liver and bone marrow. Despite controlling the eosinophilia by corticosteroid, he developed a cerebral infarction and later progressive interstitial pneumonia. Brain angiography revealed a severe stenosis of the proximal right internal carotid artery (ICA) and a complete obstruction of the intracranial ICA. An open lung biopsy revealed fibrosis and lymphoplasma cell infiltration without eosinophils, which were consistent with nonspecific interstitial pneumonia.

Twenty Four Cases of Idiopathic Bronchiolitis Obliterans Organizing Pneumonia, Reported in Korea and a Review of Literatures (국내 보고된 특발성 폐쇄성세기관지염 기질화폐렴 24예와 문헌 고찰)

  • Chang, Jung-Hyun;Park, Sa-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.709-717
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    • 1999
  • Background & Method : Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. Results : Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. Conclusion : If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation would be recommended for the definitive diagnosis of BOOP.

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The Effect of the Early Therapeutic Exercise on Idiopathic Scoliosis in Elementary School Children in Seosan City (특발성 척추 측만증이 있는 초등학생을 대상으로 한 조기 운동요법의 효과)

  • Choi, Houng-Sik;Min, Kyung-Jin
    • Physical Therapy Korea
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    • v.7 no.3
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    • pp.1-18
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    • 2000
  • The present study was performed to investigate the prevalence rate of idiopathic scoliosis and to determine the effect of exercise training on scoliotic angle in elementary school children. In this study, two out of five elementary schools in Seosan city were chosen by random sampling. Seven hundred sixty four students (from four grade to the sixth grade student) were selected in two schools. Screening tests were conducted to find idiopathic scoliosis. Among the 764 individuals, 139 subjects who showed positive sign in physical examination took whole spine radiography. Thirty six subjects who had a curve of 10 or greater and consented to participate in the exercise program were selected for the exercise program. The exercise program was performed four times a week for 5 months. The results of this study were as follows: 1) One hundred thirty nine subjects showed positive sign in the scoliosis screening test. 2) The overall prevalence of curve of $10^{\circ}or$ greater in X-ray finding was 8.15%. The prevalencies of curve of $10^{\circ}or$ greater in male and female were 7.1% and 9.2%, respectively. 3) Scoliosis curves were observed at thoracic area (48.4%), at thoracolumbar area (27.4%) and at lumbar area(24.4%). 4) Right side curve was 59.7%, and left side curve was 40.3%. 5) After the 5 month exercise program for scoliosis, the Cobb's angle was significantly decreased. 6) There was no significant difference of Cobb's angle change respect to sex, grades, and scoliosis curve site. Results shown here indicates that an early detection and early exercise for scoliosis can result in decreased the Cobb's angle in elementary school children.

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A Clinical Study about Factors and Improvement Score on Sasang Constitution of Bell's Palsy Patients. (특발성 구완와사로 입원한 환자에 대한 사상체질별 유형분석)

  • Kim, Jeong-Ho;Go, Sueng-Kyoung;Kim, Young-Il;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.24 no.3
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    • pp.19-28
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    • 2007
  • Objectives : This study was conducted in order to analyze the admission patients of facial nerve paralysis by Sasang constitution. Methods: A clinical study was done on 61 admission patients who were diagnosed and treated as facial nerve paralysis (Bell's palsy) from September, 2005 to May 2006 at the Dept. of Acupuncture and Moxibution, Chung-ju Hospital, college of Daejeon Oriental Medicine. We classified 61 patients according to Sasang constitution by QSCC II, attack side, sex, cause factor, concomitant symptom and Yanagihara' s score at the admission and discharge, and analyzed the improvement of Yanagihara's score between Sasang constitution groups. Results: 1. By sex, the ratio of Taeumin was higher than that of Soyangin in female. 2. By attack side, there is no significant difference between constitution groups In concomitant symptoms and cause factors. 3. By improvement of Yanagihara's scores between admission and discharge, the improvement score in Soyangin was a little bit higher than that in Soeumin, but there is no significant difference. Conclusion : The results suggest that there is no significant difference in all aspects except sex in Sasang constitution. But it is considered that we need to keep on studying afterwards because we had limits in getting enough patients.

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