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Acute and Chronic Eosinophilic Pneumonia; Clinical and Laboratory Findings (급성 및 만성 호산구성 폐렴의 임상적 고찰)

  • Hyun, D.S.;Yeo, D.S.;Kim, J.W.;Lee, S.H.;Lee, S.Y.;Kim, S.C.;Seo, J.Y.;Song, S.H.;Kim, C.H.;Moon, H.S.;Song, J.S.;Park, S.H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.795-804
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) is interstitial lung disease characterized by multiple infiltration on radiographic study, accumulation of eosinophils in the alveolar space and interstitium of the lung, chronic persistent symptoms and possible relapse. Acute eosinophilic pneumonia(AEP) is a recently described illness, characterized by rapid clinical course, acute respiratory insufficiency and no relapse. Method : To better characterize acute and chronic eosinophilic pneumonia, we studied the clinical and laboratory features of 16 patients(AEP : 7 patients, CEP : 9 patients), which were clinico-pathohistologically diagnosed and not to be associated with organic disorders producing peripheral blood eosinophilia. Results: The mean age was higher for patients with CEP than for patients with AEP ($55.4{\pm}15.1$ vs. $24.6{\pm}7.9$ years, p<0.05). High fever(above $38^{\circ}C$) was presented in all patients of AEP and in one patient(11%) of CEP. All patients of AEP and eight patients (89%) of CEP showed bilateral pulmonary infiltrates, and 6 patients(86%) of AEP and 2 patients(22%) of CEP showed pleural effusion in chest radiograph. The mean white blood cell count of AEP and CEP were $17,186/mm^3$ and $12,867/mm^3$, respectively. The mean peripheral blood eosinophil count of AEP and CEP were $939/mm^3$ and $2,104/mm^3$, respectively. The mean eosinophil fraction of BAL fluid of AEP and CEP were 32.4% (range: 18~47%) and 35.8% (range: 15.3~88.2%), respectively. The mean $PaO_2$ was lower for patients with AEP than for patients with CEP ($44.1{\pm}15.5$ vs. $62.7{\pm}6.9$mmHg, p<0.05). All patients of AEP and CEP were initially treated with antibiotics. All patients of CEP and one patients of AEP were finally required systemic steroid therapy. 6 patients of AEP were improved without steroid therapy. Relapse was observed in 3 patients(33%) of CEP. Conclusion : Compair with of chronic eosinophilic pneumonia, acute eosinophilic pneumonia was characterized by relatively young age, acute onset, high fever, severe hypoxemia, diffuse pulmonary infiltrates with pleural effusion, steroid therapy is effective but spontaneous improvement with conservative therapy was frequent.

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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 Comparative Study of Endotracheal Aspirates and Protected Specimen Brush in the Quantitative Cultures of the Ventilator-Associated Pneumonia (기계호흡기 관련 폐렴환자의 정량적 배양에 있어서 Endotracheal Aspirates과 Protected Specimen Brush의 비교 관찰)

  • Roo, Kyoung-Ryeol;Kim, Min-Gu;Kim, Gi-Yang;Jung, Ho-Gyeong;Park, Young-Ho;Kang, Byeng-Sun;Kim, Ho-Chul;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.737-743
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    • 1995
  • Background: Pneumonia is a frequent complication in patients undergoing mechanical ventilation, Quantitative culture of protected specimen brush(PSB) have shown satisfactory diagnostic accuracy for the diagnosis of ventilator-associated pneumonia. However PSB method is invasive, expensive, and require a bronchoscopic procedure. But endotracheal aspiration(EA) is simple and less expensive. The purpose of our study was to investigate the diagnosic value of EA quantitative cultures. Method: We studied 15 cases of ventilator-associated pneumonia(for >72h of mechanical ventilation) patients. Patients were divided into two diagnostic categories. Group I was the patients who were suspicious of clinical pneumonia, Group II was the patients for control. The obtained samples by EA and PSB were homogenized for quantitative culture with a calibrated loop method in all patients. Result: Using $10^3cfu/ml$, $10^5cfu/ml$ as threshold in quantitative culture of PSB, EA respectively, we found that EA quantitative cultures represented a relatively sentive(70%) and relatively specific (60%) method to diagnose the ventilator-associated pneumonia. Conclusion: Although EA quantitative cultures are less specific than PSB for diagnosing ventilator-associated pneumonia. EA quantitative cultures correlated with PSB quantitative culture in patients with clinical pneumonia and may be used to treat these patients when bronchoscopic procedures are not available.

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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.

Comparative Evaluation of Chest Image Pneumonia based on Learning Rate Application (학습률 적용에 따른 흉부영상 폐렴 유무 분류 비교평가)

  • Kim, Ji-Yul;Ye, Soo-Young
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.595-602
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    • 2022
  • This study tried to suggest the most efficient learning rate for accurate and efficient automatic diagnosis of medical images for chest X-ray pneumonia images using deep learning. After setting the learning rates to 0.1, 0.01, 0.001, and 0.0001 in the Inception V3 deep learning model, respectively, deep learning modeling was performed three times. And the average accuracy and loss function value of verification modeling, and the metric of test modeling were set as performance evaluation indicators, and the performance was compared and evaluated with the average value of three times of the results obtained as a result of performing deep learning modeling. As a result of performance evaluation for deep learning verification modeling performance evaluation and test modeling metric, modeling with a learning rate of 0.001 showed the highest accuracy and excellent performance. For this reason, in this paper, it is recommended to apply a learning rate of 0.001 when classifying the presence or absence of pneumonia on chest X-ray images using a deep learning model. In addition, it was judged that when deep learning modeling through the application of the learning rate presented in this paper could play an auxiliary role in the classification of the presence or absence of pneumonia on chest X-ray images. In the future, if the study of classification for diagnosis and classification of pneumonia using deep learning continues, the contents of this thesis research can be used as basic data, and furthermore, it is expected that it will be helpful in selecting an efficient learning rate in classifying medical images using artificial intelligence.

Surgical Treatment of Acute Necrotizing Klebsiella Pneumonia -Two cases report- (급성 괴사성 클렙시엘라 폐렴의 외과적 치료 -2례 보고-)

  • 류경민;김삼현;박성식;류재욱;최창휴;박재석;서필원
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.484-488
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    • 1999
  • Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.

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Spectrum Feature Analysis of Crying Sounds of Infant Cold and Pneumonia (소아감기와 소아폐렴간의 울음소리 스펙트럼 특징 분석)

  • Kim, Bong-Hyun;Lee, Se-Hwan;Cho, Dong-Uk
    • The KIPS Transactions:PartB
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    • v.15B no.4
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    • pp.301-306
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    • 2008
  • Recently, various health care methods for infants have been suggested in the impending era of low birth rate society. We propose, in this context, an early diagnosis method for common infant respiratory diseases. Particularly, the method is regarding infant cold and infant pneumonia. Firstly, sounds of infant crying, only expressing means of infants, among the infant cold group and the infant pneumonia group are compared and examined to find the differences from those among the healthy infant group. For this, the link between infected organs and articulatory organs is investigated. Also, resulting wave forms and frequency bandwidths among each group are compared and analyzed, by using the spectrum for a component voice, to diagnose the infant cold and pneumonia. Finally, the effectiveness of this method is verified through the experiments.

A Case of Probable Community Acquired Acinetobacter baumannii Pneumonia (Acinetobacter baumannii 원인균이 의심되는 지역 사회 획득성 폐렴)

  • Han, Sang Hoon;Na, Dong Jib;Yoo, Young Wook;Kim, Dong Gyu;Moon, You Ri;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yong Seon;Han, Min Soo;Yoon, Hee Jung
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.3
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    • pp.273-277
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    • 2007
  • 70세 남자가 내원 7일전 발생한 우측 흉부 통증, 고열 및 가래를 동반한 기침으로 입원하였다. 백혈구와 CRP(C reactive protein)의 상승, 흉부 방사선 소견상 우하엽에 폐렴을 시사하는 소견이 관찰되어 지역 사회 획득성 폐렴에 준한 경험적 항생제를 투여하였다. 처음 두 번의 연속적인 가래 배양 검사에서 항생제 감수성이 있는 Acinetobacter baumannii균이 동정 되었으며 항생제 치료 후 임상 증상 및 방사선 소견이 점차 호전되었다. Acinetobacter baumannii는 중환자실에서 주로 발생하는 병원 획득성 폐렴의 주요 균으로 알려져 있으며 지역 사회 획득성 폐렴의 흔한 원인균은 아니다.

Charaterization of GroEL Homolog from Streptococcus pneumoniae (폐렴구균 열충격 단백질 GroEL의 특성)

  • Choi, In hwa;Kim, Su Nam;Kim, Seung Hwan;Kweon, Chang Hee;Pyo, Suhk Neung;Rhee, Dong Kwon
    • Korean Journal of Microbiology
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    • v.34 no.1_2
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    • pp.43-50
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    • 1998
  • Induction and purification of the GroEL homolog from Streptococcus pneumolliae were characterized. The stress conditions were determined by temperature, ethanol, NaCI, $H_2O_2$ methyl methanesulfonate, and ethyl methanesulfonate. And stress induced proteins were analyzed using [$^{35}S$]-methionine labeling method. Heat shock induced the synthesis of a set of about 3 heat shock proteins (hsps) (65, 73, and 84-kDa). Of those 3 hsps, a 65 kDa protein, hsp65, was purified by DEAE-Sephacel and ATP-agarose column chromatography, and used for antibody preparation. Immunoblot analysis employing antisera raised against pneumococcus hsp65 demonstrated cross-reactivity with a 60 kDa protein in Eschericha coli. Also cross reaction of the purified p65 with anti-Escherichia coli GroEL monoclonal antibody demonstrated that pneumococcal hsp65 is the GroEL homolog.

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Pleuropneumonia in a Cat with Feline Infectious Peritonitis (고양이 전염성 복막염에 의한 흉막폐렴 1례)

  • Park, Seungjo;Bae, Yeonho;Choi, Jihye
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.454-458
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    • 2015
  • This report describes the diagnostic radiographic and CT features of pleuropneumonia in a cat with wet type of feline infectious peritonitis (FIP). In a 1 year-old cat presented with respiratory distress, pulmonary mass, thickened pleural wall with mass-like structures, and a large amount of pleural effusion were identified on radiography, ultrasonography, and CT. About two months later, in addition to the pre-existing lesions, multiple nodules had developed on the intestine and left kidney. The cat was diagnosed with pleuropneumonia caused by FIP through histologic examination and immunohistochemistry. Pleuropneumonia is rarely reported in cats with FIP, and only one cat with non-effusive FIP had pyogranulomatous pneumonia as consolidated lung lobe. In the present case, pleuropneumonia was detected as multiple mass-like lesions on diagnostic imaging.