• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.444-450
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• 1998

PCP remains the leading cause of deaths in patients with AIDS. As familiarity with PCP increases, atypical manifestations of the diseases are being recognized with greater frequency. There are following "atypical" manifestations of PCP ; 1) interstitial lung response that include diffuse alveolar damage, bronchiolitis obliterance, interstitial fibrosis, and lymphoplasmocytic infiltrate 2) striking localized process frequently exhibiting granulomatous features 3) extensive necrosis & cavitation 4) extrapulmonary dissemination of the disease. A wide variety of pathologic manifestations may occur in PCP in human immunodeficiency virus-infected patienst and that atypical features should be sought in lung biopsies from patients at risk for PCP. We had experienced a case of PCP, which presented with severe hypoxia, progressive dyspnea and fine crackles. It was diagnosed as PCP in AIDS with manifestation of BOOP by open lung biopsy and showed good response to Bactrim & corticosteroid therapy.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1408-1413
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• 1997

A 68 year-old male was admitted with complaint of dyspnea and nonproductive cough which developed 6 hours after accidental inhalation of nitrogen dioxide. On admission, acute pulmonary edema and severe hypoxemia were found. With oxygen and bronchodilator therapy, diffuse alveolar consolitation and his dyspnea were improved from the following day. He was discharged at 8th hospital day with prednisolone 30mg daily for prevention of bronchiolitis obliterans. During 6 weeks of follow up, there was no evidence of bronchiolitis obliterans.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.8-15
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• 2019

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.794-801
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• 2000

BOOP(Bronchiolitis Obliterans Organizing Pneumonia) is an inflammatory reaction that follows damage to the bronchiolar epithelium of the small conducting airways. BOOP is characterized by the pathologic finding of excessive proliferation of granulation tissue within the respiratory bronchioles, alveolar duct and spaces, accompanied by organizing pneumonia in the more distal parenchyma BOOP may result from diverse causes such as toxic fumes, connective tissue disorders, infections, organ transplantation and drugs or appear idiopathically. Drug induced BOOP has been described in association with acebutolol, amiodarone, cephalosporin, bleomycine, tryptophan, gold salts, barbiturates, sulfasalazine, and carbamazepine. Carbamazepine is an iminostilbene derivative that is used as both an anticonvulsant and pain reliever for pains associated with trigeminal neuralgia. It is structually related to the tricyclic antidepressants. To our knowledge, there have been no previously reported case that has described development of BOOP during carbamazepine treatment in Korea, and only two cases have been reported in the world. We report a case carbamazepine-induced BOOP with a brief review of literature.

• Tuberculosis and Respiratory Diseases
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• v.59 no.3
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• pp.315-320
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• 2005

A rapid response to corticosteroid treatment and a generally favourable outcome are characteristic features of BOOP (Bronchiolitis obliterans organizing pneumonia). However, with increasing experience of the clinical spectrum of this disease, it is now recognized that some patients are refractory to steroid, which is associated with a poor prognosis. Here, two cases of BOOP initially treated with predinisone and antibiotics without effects, but subsequently responded to secondary cyclosporine treatment, are reported.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.98-101
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• 2015

Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate $CO_2$ effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.182-190
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• 2017

Background: Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. Methods: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. Results: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ${\geq}6$ years. In addition, asthma was predominantly caused by rhinovirus in children aged ${\geq}6$ years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p<0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. Conclusion: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.89-95
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• 1999

Bronchiolitis obliterans organizing pneumonia (BOOP) preceding polymyositis is rare. In this report, a 40-year-old patient with fever, chillness, generalized myalgia and progressive exertional dyspnea, had bilateral interstitial infiltrates on chest radiograph. High-Resolution CT showed subpleural and peribronchial distribution of airspace consolidation. Open lung biopsy was consistent with BOOP. Prednisolone therapy led to improvement, but during tapering of prednisolone for 3 months to 30 mg, he complained of weakness of both lower legs. One month later, prednisolone was tapered to 15 mg a day, fever. chillness and generalized myalgia were recurred. He complained of weakness of both arms. The creatine kinase (CK) with MM isoenzyme, lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) were elevated. Anti-Jo1 antibody was positive. Vastus lateralis muscle biopsy was compatible with polymyositis. After injection of methylprednisolone for 1 week, the patient became afebrile, the dyspnea resolved, the pulmonary infiltrates decreased, and the muscle strength improved. The serum CK, LDH, AST levels declined significantly. Patients with idiopathic BOOP should have follow-up for the possible development of connective tissue disorders including polymyositis.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.561-565
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• 2005

Bronchiolitis obliterans organizing pneumonia (BOOP) is often diagnosed in patients with pneumonia who respond poorly to antibiotics. BOOP is often idiopathic, and the etiology of the remaining cases has been attributed to a wide range of agents or medical conditions. When a patient develops the clinical symptoms characteristic of BOOP, the medical team must endeavor to determine the etiology of this disease because it can be treated with glucocorticoid and avoidance of the causative agent. In particular, if BOOP is diagnosed during or after chemotherapy for a malignancy, the possible culprit agent can be the anti cancer drugs but other drugs used for supportive care must be also be considered. We report a case of BOOP that arose after CHOP chemotherapy and a filgrastim injection in a patient with a diffuse large B-cell lymphoma.

• Journal of Environmental Health Sciences
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• v.44 no.6
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• pp.563-571
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• 2018

Objectives: The purpose of this study was to investigate the environmental pollution caused by exposure to air pollution in Korea. Therefore, it is necessary to investigate environmental and health factors through big data. Methods: Among the environmental diseases, the data centered on "percentage per day in 2015 to 2018". Data of environmental diseases and concentrations of air pollution monitoring network were analyzed. Results: Lung cancer and bronchiolitis obliterans were correlated with 0.027 and 0.0158, respectively, in the contamination concentration of fine dust ($PM_{10}$). Ozone, COPD, allergic rhinitis, and bronchiolitis obliterans were correlated with 0.0022, 0.0028 and 0.0093, respectively. At the concentration of $SO_2$ and the diseases of asthma, atopic dermatitis, lung cancer and bronchiolitis obliterans were 0.0008, 0.0523, 0.0016 and 0.0126, respectively. Conclusions: We surveyed the trends of air pollution according to the characteristics of Seoul area in Korea and evaluated the perception of Korea and the world. As a result, respiratory lung disease is thought to be a major factor in exposure to environmental pollution.