• Title/Summary/Keyword: 폐질환진단

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Pulmonary Emphysema: Visual Interpretation and Quantitative Analysis (폐기종의 시각적 분류 및 정량적 평가)

  • Jihang Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.808-816
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    • 2021
  • Pulmonary emphysema is a cause of chronic obstructive pulmonary disease. Emphysema can be accurately diagnosed via CT. The severity of emphysema can be assessed using visual interpretation or quantitative analysis. Various studies on emphysema using deep learning have also been conducted. Although the classification of emphysema has proven clinically useful, there is a need to improve the reliability of the measurement.

The Effect of Transition to Living with Chronic Diseases on Depressive Symptoms (만성질환 진단이 노인의 우울수준에 미치는 영향: 주요 5대 만성질환의 초기 진단기를 중심으로)

  • Park, Min Kyoung;Cho, Kyuyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.2
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    • pp.354-361
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    • 2021
  • This study explored whether the transition to living with a chronic disease changes the level of depression symptoms among middle-aged and older adults in South Korea. We hypothesize that the transition to living with chronic disease leads to a higher level of depressive symptoms. A nationally representative sample (N = 6,284) of adults 45 years and older from the Korean Longitudinal Study of Ageing (KLoSA) was analyzed. Multi-regression modeling was used to examine the association between the diagnosis of chronic disease and the level of depressive symptoms in patients. The findings highlight the need for policy makers, clinicians, as well as patients and their caregivers to become more aware of mental health risks in patients diagnosed with chronic diseases, particularly first-time patients. This study contributes to encouraging greater psychosocial support, including monitoring the level of depressive symptoms of patients who develop chronic conditions and providing appropriate treatments for those at the highest risk.

A Case of Interstitial Lung Disease in Ulcerative Colitis (궤양성 대장염 환자에서 발생한 간질성 폐질환 1예)

  • Yoo, Min-Kyu;Lee, June-Ho;Han, Seong-Beom;Jeon, Young-June;Cho, Seung-Che
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1140-1145
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    • 1997
  • Extracolonic manifestations which occur in approximately 10~20% of patients with ulcerative colitis most commonly affect joints, skin, liver and eyes. In contrast, pulmonary involvement in ulcerative colitis is very rare. However, a variety of respiratory disorders has been associated with ulcerative colitis, including pulmonary vasculitis, bronchiectasis, chronic bronchitis, interstitial fibrosis, pleural effusion. Since the first observation of pulmonary involvement in ulcerative colitis by Kraft in 1976, a few cases have been reported, and probably no such case have been reported in Korea yet. Here we report an experience concerning 56 year-old man interstitial lung disease in ulcerative colitis, who was diagnosed by clinical, radiographic, endoscopic, histologic findings.

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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.

Thallium-201 SPECT in Differential Diagnosis of Malignancy from Benign Pathology in Patients with a Solitary Pulmonary Lesion (단일 폐병변에서 T1-201 SPECT를 이용한 악성 종양의 감별진단)

  • Ahn, Byeong-Cheol;Lee, Jae-Tae;Chun, Kyung-Ah;Kim, Dong-Hwan;Sohn, Sang-Kyun;Kim, Chang-Ho;Park, Jae-Yong;Jeong, Tae-Hoon;Lee, Kyu-Bo;Kim, Chun-K.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.143-150
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    • 1998
  • Purpose: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesion in a population with a high prevalence of benign pulmonary lesion, especially, tuberculosis. Materials and Methods: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergil-loma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B- early L/B) $\div$ early L/B]. Results: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions were also visually positive on both images. Although a statistically significant difference was found between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. Conclusion: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.

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The Clinical Manifestation of Pulmonary Infection in AIDS Patients (국내 일개 대학병원에서 경험한 AIDS 환자의 폐 감염성 질환의 임상적 특성)

  • Jung, Jae Woo;Chung, Jin Won;Song, Ju Han;Jeon, Eun Ju;Lee, Young Woo;Choi, Jae Cheol;Shin, Jong Wook;Park, In Whon;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.554-561
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    • 2006
  • Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.

Surgical Treatment of Congenital Cystic Lung Disease (선천성 낭성 폐질환의 수술적 치료)

  • Wi, Jin-Hong;Lee, Yang-Haeng;Han, Il-Yong;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.335-342
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    • 2008
  • Background: Congenital cystic diseases of the lung are uncommon, and they share similar embryogenic and clinical characteristics. But they are sometimes vary widely in their presentation and severity. Therefore they are often difficult to make different diagnosis each other, and all require surgical treatment. Material and Method: From 1993 to 2006, 38 patients underwent surgical procedures under these diagnostic categories in the Depart. of Thoracic and. Cardiovascular Surgery, Busan-Paik Hospital, College of Medicine, Inje University. And we retrospectively reviewed these patients' charts for clinical presentations, surgical procedures, pathologic findings and postoperative morbidity and mortality. Result: There were 22 males and 16 females, ages ranged from 1 month after birth to 51 years and mean age was 20.8 years. The main symptoms were 19 fever, cough, sputum production due to recurrent infection, 7 dyspnea, 8 chest discomfort, 4 hemoptysis, but eight patients were asymptomatic. Computed tomography was chosen as diagnostic modalities and available for operation plan for all of patients. For all the cases, surgical resection were performed. Lobectomy was performed in 28 patients, simple excision (resection) in 8 patients, segmentectomy or wedge resection in 2 patients. There were 10 pulmonary sequestrations, 15 congenital cystic adenomatoid malformations (CCAM), 11 bronchogenic cysts, and 2 congenital lobar emphysemas. They all were confirmed by pathologic exams. The complications were 6 wound disruption or infection, 2 chylothorax, 1 ulnar neuropathy, but all of them were resolved uneventful. There was no persistent air leakage, respiratory failure, operative mortality and recurrence. Conclusion: We performed immediate surgical removal of congenital cystic lung lesions after diagnosis and obtained good results, so reported them with literature review.

Study for Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Diseases (폐 비결핵향산균종의 임상적 특징에 관한 연구)

  • Pae, H.H.;Lee, J.H.;Yoo, C.G.;Lee, C.T.;Chung, H.S.;Kim, Y.W.;Shim, Y.S.;Han, S.K.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.735-746
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    • 1999
  • Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

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A Case of Lymphocytic Interstitial Pneumonia Manifested as a Multi-focal Consolidation (다발성 경화 소견으로 발현된 림프구성 간질성 폐렴 1예)

  • Hwang, Kyu Sig;Roh, Young Wook;Song, Sung Heon;Kim, Sang Heon;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Oh, Young-Ha;Kim, Tae-Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.37-41
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    • 2009
  • Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it's clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.

Comparison of Clinical Courses According to the Existence of Patent Ductus Arteriosus in Respiratory Distress Syndrome (신생아 호흡곤란 증후군에서 동맥관 개존 동반유무에 따른 임상적 경과 비교)

  • Seong, Ju Hee;Lee, Hyeon Joo;Hong, Hyun Kee;Bae, Chong-Woo;Choi, Yong-Mook
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1080-1084
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    • 2003
  • Purpose : To compare perinatal characteristics, clinical courses, and overall morbidity between respiratory distress syndrome(RDS) with patent ductus arteriosus(PDA) and RDS without PDA in neonates. Methods : Eighty-three neonates who were diagnosed and treated for RDS in the neonatal intensive care unit(NICU) from Jan. 2000 to Dec. 2002 were included in this study. RDS was complicated with PDA(group A) in 17 patients and not complicated in 66(group B). PDA was diagnosed by echocardiogram in neonates with congestive heart failure symptom, cardiac murmur or chest X-ray findings of cardiomegaly or pulmonary edema. A retrospective study was undertaken of the perinatal characteristics and overall morbidity in group A and group B. Results : The birth weight and gestational periods of group A were less compared with group B. There was more perinatal asphyxia in group A. Incidence of overall morbidity such as bronchopulmonary dysplasia, intraventricular hemorrhage and death was higher in group A. Intravenous indomethacin was administered in 17 PDA infants. Conclusion : The perinatal characteristics in the two groups showed a significant difference. Incidence of overall morbidity in the two groups showed significant differences, however, there is no simple conclusion to draw because we didn't do multifactorial analyses to rule out other many risk factors affecting morbidity, such as gestational weeks or birth weight.