• Title/Summary/Keyword: 폐질환, 간질성

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A Study on Computer-Aided Diagnosis System for Interstitial Lung Disease in Chest Radiograph (흉부 영상에서 간질성 폐질환 검출을 위한 컴퓨터지원진단 시스템 연구)

  • 김진철;송종태;이우주;이배호
    • Proceedings of the Korean Information Science Society Conference
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    • 2003.04c
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    • pp.316-318
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    • 2003
  • 간질성 폐질환(Interstitial Lung Disease) 컴퓨터지원진단(Computer-Aided Diagnosis: CAD)시스템은 방사선의사들이 흉부 X-ray영상에서 석회화와 섬유화를 탐지하고자 적용하였다. 진단 중에 발생할 수 있는 오진율을 줄이고 간질성 폐질환이 존재하는 폐야에서 이상유무를 판단하여 검출을 표시하도록 하였다. 본 논문에서는 디지털 흉부영상에서의 간질성 폐질환을 검출하기 위해 폐 텍스처(texture)의 물리적 척도를 측정하기 위한 방법을 제안한다. 2차원의 푸리에 변환으로부터 얻어지는 파워스펙트럼(power spectrum) 분석에 기반을 두는 방법으로 각각의 ROI(Region Of Interest)에서 구한 평균제곱자승오차(Root Mean Sguare: RMS)와 파워스펙트럼의 첫 번갠 모멘트(Moment)는 폐 텍스처의 밀도변동의 크기(magnitude)와 섬세함(fineness)을 나타낸다. 실험결과 다양한 간질성폐질환을 가진 비정상 폐 텍스처의 RMS와 첫 번째 모멘트와는 차이가 있었다. 디지텔 흉부영상으로부터 계산되어진 정량화된 텍스처의 척도는 방사선의사의 간질성 폐 질환을 진단함에 효율적인 질환 탐지를 가능하게 하였으며 진단율을 향상시킬 수 있었다.

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Computer Analysis of Interstital Lung Diseases in Chest Radiographs (흉부 X선 사진내의 간질성 폐질환의 컴퓨터 해석)

  • Kim, Eung-Kyeu
    • Proceedings of the KIEE Conference
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    • 1999.11c
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    • pp.775-777
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    • 1999
  • 흉부 단순 X선 사진에 있어서 폐의 간질성 음영의 특징을 컴퓨터를 이용하여 해석하는 시스템을 구축하여 그 정확도를 검토하였다. 이 시스템에서는 X선 사진을 디지털화 해서 관심영역을 설정하여 4방향 라플라시안-가우시안 형상필터를 행하여 2치화 한후, 계속해서 선상음영 판정처리 및 선상음영 차분처리를 행해 간질성 음영의 특징을 나타내는 몇가지 물리적인 지표를 계산 하였다. 82명의 정상예와 이상예에 대하여 이들 물리적 지표의 ROC 해석을 행하여 간질성 폐질환 변화의 양호한 검출결과를 얻었다.

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Thoracic Surgeon's Role in Differential Diagnosis of the Interstitial Lung Disease (간질성 폐질환의 확진을 위한 흉부외과의 역할)

  • Kim Sung-Whan;Yahang Jun-Ho;Kim Jong-Woo;Choi Jun-Young;Rhie Sang-Ho;Jang In-Seok
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.382-386
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    • 2006
  • Background: Pathologic confirmation is needed to diagnose various forms of interstitial lung diseases. We wanted to find out how much the thoracic surgical lung biopsies will be needed for definite diagnosis of interstitial lung diseases. Material and Method: 17 patients underwent surgical lung biopsy in the department of thoracic and cardiovascular surgery, Gyeongsang National University Hospital from June 1995 to November 2002. Chart review and telephone questionnaire were done for retrospective study. Result: Mean age was $49{\pm}22$ years. Age ranged from 1 to 70 years. Dyspnea was the most common complaint. They were referred for definite differential diagnosis from pediatrics and internal medicine. Biopsy methods were thoracotomy in 11 cases, and thoracoscopy in 6 cases. Pathologic confirmation was possible in 11 cases (65%). According to the pathologic reports, treatment plans were changed in 13 cases (76%). Conclusion: Surgical lung biopsy was effective method in differentiating diagnosis of the interstitial lung disease, There was no mortality during operation. It is important that undiagnosed fibrous lung disease should be recommanded the lung biopsy for planning patient's treatment.

Thoracoscopic Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환에서 흉강경폐생검)

  • Son, Dong-Seop;Jo, Dae-Yun;Yang, Ki-Min
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1232-1236
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    • 1997
  • Diffuse lung disease is 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 sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

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Expression of Transforming Growth Factor-Beta in Patients with Interstitial Lung Diseases (ILD) (간질성 폐질환환자에서 Transforming growth factor-beta의 발현에 관한 연구)

  • Park, Sung-Soo;Lee, Kyung-Sang;Yang, Suck-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Lee, Dong-Hoo;Lee, Jung-Dal;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.164-172
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    • 1996
  • Background : Transforming growth factor-$\beta$(TGF-$\beta$) may play a role in a variety of fibroproliferative disorders including pulmonary fibrosis via the induction of extracellular matrix accumulation. TGF-$\beta$ not only stimulates extracellular matrix production, but also decreases matrix degradation. Interstial lung diseases have demonstrated marked expression of TGF-$\beta$. Methods : To evaluate the possible role of TGF-$\beta$ in human pulmonary fibrosis, by using neutralizing antibody of TGF-$\beta$ we investigated immunohistochemically the expression of TGF-$\beta$ in the formalin-fixed, paraffin-embedded tissue sections of the 5 normal cases for the control, and a couple of pieces of tissues taken out of 3 cases with idiopathic pulmonary fibrosis, 3 cases with ILD from bleomycin toxicity, 3 cases with ILD from sarcoidosis, and 3 cases with ILD from eosinophilic granuloma. Results : In the 5 normal cases for the control, the TGF-$\beta$ was expressed in bronchial and alveolar epithelial cells. Up-regulation of the TGF-$\beta$ expression was showed in the interstitial fibroblast cells of alveolar septa in 5 pieces and proliferated alveolar pneumocytes in 1 piece among 6 pieces tissues taken out of 3 cases with idiopathic pulmonary fibrosis. Also up-regulation of the TGF-$\beta$ expression was showed in alveolar lining pneumocytes, intra-alveolar mononuclear cells, and epithelioid cells in most of cases of ILD from bleomycin toxicity, sarcoidosis and eosinophilic granuloma. Conclusion : These findings suggest that up-regulation of the TGF-$\beta$are involved in pathogenesis of interstitial lung fibrosis from variety of causes.

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The Correlation of TUNEL Apoptotic Index with Clinicoradiologicopathologic Scores in Interstitial Lung Disease (간질성 폐질환에서 TUNEL 아포프토시스 지수와 임상적, 방사선학적, 및 병리학적 지표와의 상관관계)

  • Kim, Youn-Seup;Myung, Na-Hye;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.136-147
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    • 2002
  • Background : Interstitial lung disease has various manifestations that are differentiated by their pathology, progress and treatment. However, all manifestations eventually progresses to pulmonary fibrosis. Recent studies have shown that apoptosis of pulmonary epithelial cells might be related to pulmonary fibrosis. The correlation of the apoptotic index with the clinical manifestations, pathological findings, HRCT findings and the response to treatment were examined. Materials and Methods : Twenty subjects (14 men, 16 women), who had been diagnosed with interstitial lung disease through an open lung biopsy, were enrolled in this study. The subtypes were one AIP, two NIP, eight BOOP, and seven UIP cases. The apoptotic index was scaled from 0-2 depending on the fraction of positive staining cells by TUNEL method. The clinical severity was assessed by a modification of a previously developed CRP scoring system. The pathologic scores were based on 4 components: fibrosis, cellularity, desquamation, and granulation. In the HRCT study, each lobe was scored by the radiologists on a scale for both fibrosis and ground-glass attenuation. The treatment response was assessed by an increase in more than 10% of the CRP score, and comparing the results 3 months before and after treatment. Results : The apoptotic index showed no correlation with the CRP and HRCT scoring system. The apoptotic index correlated with the pathologic elements including fibrosis, cellularity and the desquamation score (p<0.05). Of the 16 patients who received corticosteroid therapy, 9 patients (56.3%) responded to therapy. There was no correlation between the response to corticosteroid and the apoptotic index. In the case of patients with acute and subacute ILD, the apoptotic index showed a correlation with the cellularity, desquamation, and the total histological score (p<0.05). In the case of patients with chronic ILD, the apoptotic index correlated with the fibrosis and cellularity score (p<0.05). Conclusion : Apoptosis of the pulmonary epithelial cells is implicated in the pathogenesis of interstitial lung disease particularly on a pathological basis.

Safety and Significance of Surgical Lung Biopsy for Interstitial Lung Disease (간질성 폐질환에 대한 수술적 폐생검의 의의 및 안전성)

  • Lee, Yu Jin;Joung, Mi Kyong;Chung, Chae Uk;Park, Ji Won;Shin, Ji Young;Jung, Sun Young;Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.59-66
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    • 2007
  • Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.