• Title/Summary/Keyword: Connective Tissue Diseases

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A Case of Bronchiolitis Obliterans Organizing Pneumonia anteceded by Rheumatoid Arthritis (류마티스 관절염에서 동반된 폐쇄성 세기관지염.간질성 폐염 1예)

  • Kim, Sin Gon;Kim, Jin Yong;Lee, Young Ho;Cho, Jae Youn;Kim, Han Kyeom;Song, Gwan Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.630-636
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    • 1996
  • Bronchiolitis obliterans organizing pneumonia(BOOP) is a pathologic entity characterized by the formation of plugs of fibrous tissue in bronchioles and alveolar ducts. It clad been described in association with several connective tissue diseases, i.e. systemic lupus erythematosus, Behcet's disease, polymyositis-dermatomyositis, polymyalgia rheumatica and Sjogren's syndrome. Recently, there were few additional reports on BOOP, anteceded by rheumatoid arthritis. We clad experienced a case of 60 years old female patient who clad been admitted for acute respiratory difficulty and abnormal chest roentgenographic findings. She was diagnosed as having rhematoid arthritis 20 years ago. On the course of our treatment, she did not respond to antibiotics. Moreover, no microorganism grew in the sputum and blood. Thus, the bronchoscopic biopsy was done. The patient showed a dramatic response to steroid therapy, and the pathologic bindings of the bronchoscopic biopsy confirmed as BOOP. To our knowledge, this is the first reported case of BOOP anteceded by rheumatoid arthritis in Korea.

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Charlson comorbidity index as a predictor of periodontal disease in elderly participants

  • Lee, Jae-Hong;Choi, Jung-Kyu;Jeong, Seong-Nyum;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.48 no.2
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    • pp.92-102
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    • 2018
  • Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

Clinical Predictors of Survival in Idiopathic Pulmonary Fibrosis

  • Kim, Ji Hye;Lee, Jin Hwa;Ryu, Yon Ju;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.3
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    • pp.162-168
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    • 2012
  • Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease. Effective treatment is not currently available and the prognosis is poor. The aim of our study was to identify clinical predictors of survival in patients with IPF. Methods: By using medical record database of a university hospital, we reviewed the records of patients who had been diagnosed as having IPF from January 1996 through December 2007. Results: Among 89 patients considered as having interstitial lung disease (ILD) on computed tomography (CT) of the chest, 22 were excluded because of the diagnosis of other ILDs or connective tissue disease, and finally, 67 met the criteria of IPF. The mean age at the diagnosis of IPF was 70 years (range, 41~87 years) and 43 (64%) were male. The mean survival time following the diagnosis of IPF was 40 months (range, 0~179 months). Among them, 28 cases were diagnosed as the progressive state of IPF on the follow-up CT examination, and the mean duration between diagnosis of IPF and progression was 31 months. Multivariate analysis using Cox regression model revealed that body mass index (BMI) less than 18.5 $kg/m^2$ (p=0.030; hazard ratio [HR], 12.085; 95% confidence interval [CI], 1.277~114.331) and CT progression before 36 months from the diagnosis of IPF (p=0.042; HR, 13.564; 95% CI, 1.101~167.166) were independently associated with mortality. Conclusion: Since low BMI at the diagnosis of IPF and progression on follow-up CT were associated with poor prognosis, IPF patients with low BMI and/or progression before 36 months following the diagnosis should be closely monitored.

A Study on the morbid status of a rural area and comparison of its study methodology (일부(一部) 농촌주민(農村住民)의 상병현황조사(傷病現況調査)와 조사기법(調査技法)의 비교연구(比較硏究))

  • Lee, Eun-Il;Min, Jae-Gee;Song, Dong-Bin
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.39-45
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    • 1984
  • This research was done to gain the health information in one of the target areas(rural area) of the Korea University Community Health Project, and to improve and standardize the methodology of the health interview survey. There were two types of questions;one was the simple open-ended question and the other was check list in the interview survey for a total of 1,406 inhabitants. And so the result obtained from the above survey was analysed. The results as follows; 1) The morbidity rate in general was 11.2% by simple open-ended question and 32.5% by check list during recent 20 days in interview method. 2) Women had higher morbidity rate in both kinds of method. 3) The most prevalent diseases in the interview method using check list were the ones of the musculo-skeletal system and connective tissue (22.5%), and diseases of the respiratory system (19.8%) and digestive system (13.7%) were in order of frequency. 4) By the position in the family, housewives had highest morbidity rate in the interview method unrespectedly, and the reason seemed that the respondents were houseweives themselves and the morbidity rate was the one by spell not by person. But morbidity rate by the socio-economic status had no significant difference in both methods. 5) The agreement rate on simple open-ended question and check list was 72.5%, but if limiting respondents themselves only, the rate was falled to 54%. 6) The morbidities were diverse in the review of the results of previous morbidity surveies, but the morbidity rate was higher and less variable in case of using check list and getting the replies individually than using simple open-ended question and proxy respondents.

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Herpes Simplex Virus Pneumonia in Immunocopmromised Host (면역저하 환자에서 발생한 단순포진바이러스 폐렴)

  • Kim, Jin-Ku;Lee, Choong-Hyun;Kang, Kyeong-Woo;Seo, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Han, Joung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.82-88
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    • 1999
  • Herpes simplex virus pneumonia in immunocompromised host is difficult to diagnose with non-invasive method, and has high mortality rate. Because early diagnosis and early treatment can significantly decrease the mortality rate, the enthusiastic efforts for the early diagnosis should be done. A 41-year-old woman who took prednisolone due to mixed connective tissue disease developed gradually increasing dyspnea with radiological features of interstitial lung disease. Initially, we treated her with empirical antibiotics, but failed to improve her dyspnea. So we performed bronchoalveolar lavage and open lung biopsy. Open lung biopsy specimen showed herpes simplex virus pneumonia. Herpes simplex virus was also isolated from bronchoalveolar lavage fluid. There was both clinical and radiological improvement after treatment with acyclovir for 14 days.

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Bronchiolitis Obliterans Organizing Pneumonia as the First Manifestation of Polymyositis (다발성근염의 선행증상으로 나타난 폐쇄성 세기관지염 기질화 폐렴)

  • Lee, Jong-Hoon;Son, Choon-Hee;Jeong, Won-Tae;Lee, Ki-Nam;Lee, Young-Hoon;Choi, Pil-Jo;Jeong, Jin-Sook;Lee, Chang-Hoon
    • 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.

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A Case of Pleural Effusion due to Vasculitis in Scleroderma (혈관염에 의한 양측성 흉막염이 발생한 공피증 1예)

  • Lee, Young Ho;Sim, Jae Jeong;Kang, Kyung Ho;Song, Gwan Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.786-791
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    • 1996
  • Systemic sclerosis is a multisystemic disease of unknown origin charicterized by degenerative fibrotic and inflammatory changes in the skin, vessels, joints, muscles, and visceral organs. Involvement of the lung in systemic sclerosis is common, but pleural effusion is rare. Although vasculitis commonly accompanies many connective tissue disorders, it has been rarely reported in systemic sclerosis. A 43-year-old woman, with a 10-year history of Raynaud's phenomenon, was admitted due to right chest pain. Her hands showed diffuse thickening and swelling of skin. Chest X-ray showed pleural effusions and esophageal manometry showed hypotonic peristalsis and low lower esophageal sphincter tone compatible with scleroderma esophagus. Antinuclear antibodies were present (titer>1 : 160) with a speckled pattern. She was positive for rheumatoid factor, anti scl-70 and RNP antibodies, but negative for anti-Ro, La, and Sm antibodies. Histology of the pleura revealed the presence of leukocytoclastic vasculiti. After adminisrration of prednisolone 30 mg/day, her chest symptom was improved. We report a case of systemic sclerosis with pleural effusions due to leukocytoclastic vasculitis with review of the literatures.

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A Case of Bronchiolitis Obliterans Organizing Pneumonia from Epstein-Barr Virus (BOOP 형태로 발현된 Epstein-Barr Virus 폐렴 1예)

  • Na, Hyoung Jung;Kim, Sueng Up;Kim, Do Hyun;Nam, Dong Hyug;Lee, Sun Min;Kim, Chong Ju;Kie, Jeong-Hae;Hong, Yong Kug
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.51-55
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    • 2007
  • In the average adult with a normal immune state, Epstein-Barr virus pneumonia is very rare, especially in the form of interstitial lung disease. According to recent studies, the Epstein-Barr virus is also associated with lymphocytic interstitial pneumonia, AIDS and Langerhans cell histiocytosis, but not with sarcoidosis. BOOP is caused by lung injury due to an infection or drug intoxication, and is related to connective tissue disease or bone marrow transplantation, but is sometimes idiopathic. We experienced a patient with symptoms and signs of interstitial lung disease, with confirmed BOOP and EBV ingection from an open lung biopsy and serologic examination, respectively Herein, this case is reported, with a review of the literature.

Effect of Extract of Seeds of Carthamus tinctorius L. on Mineralization in Periodontal Ligament Cells and Osteoblastic Cells (홍화씨 추출물이 치주인대세포와 조골유사세포의 골 광물화 작용에 미치는 효과)

  • Kang, Jung-Goo;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.28 no.3
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    • pp.475-489
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    • 1998
  • The main goal for the treatment of periodontal diseases is the regeneration of lost cementum, bone and connective tissue. Clinical and histological research suggests that it is possible to restore periodontal structures. Seeds of Carthamus tinctorius L. has been used for the treatment of bone fracture and osteoporosis in traditional Korean medicine. The purpose of this study is to examine the effect of extract of seeds of Carthamus tinctorius L. on mineralization in periodontal ligament cells and osteoblastic cells. Periodontal ligament cells were primarily obtained from a extracted premolars with non-periodontal diseases, Osteoblastic cells were obtained from calvariae of a fetal rat, Cells were cultured with DMEM at $37^{\circ}C$ with 5% $CO_2$ in 100% humidity incubator. Alkaline phosphatase(ALP) level and the number of calcification nodules were examined and western blot analysis using osteonectin was performed, Measurements of ALP levels and calcification nodules showed that extract of seeds of Carthamus tinctorius L. had significantly higher activity than control in all of both cells. In western blot analysis, protein expression of osteonectin indicated that extract of seeds of Carthamus tinctorius L. showed an increased pattern than control in all of both cells. From the above results, it seems that extract of seeds of Carthamus tinctorius L. has excellent effect on mineralization in periodontal ligament cells and osteoblastic cells.

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Trends in the Use of Oriental Medical Care Service and Treatment Satisfaction (지역주민의 한방의료 이용성향과 진료만족도)

  • Suh, Ho-Suk;Nam, Chul-Hyun;Kim, Jae-Don;Kim, Sung-Jin;Ryu, Jang-Gun;Jun, Bong-Chun;Kim, Mi-Ae
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.41-70
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    • 2007
  • The purpose of this study was to identify a tendency in patients who seek oriental medical service and factors influencing patient satisfaction. The study was conducted with 1,520 residents of a community during the period from February 5, 2005 through June 30, 2005 using a questionnaire. This study results are summarized as follows : 1. Of subjects who sought oriental medical service, 66.2% had musculoskeletal disorder and connective tissue disease, 18.9% had digestive tract disease, 16.4% had respiratory disease, 8.2% had endocrinemetabolic disease, 7.5% had circulatory disease and the remaining subjects had other diseases(p<0.001). 2. Of subjects who sought oriental medical service for the treatment of musculoskeletal disorder, 84.9% preferred acupuncture. Of those who had digestive tract diseases, 47.0% preferred packaged herbal medicine. Of those who had respiratory disease, 63.0% preferred packaged herbal medicine. 3. Acupuncture was the most often sought by subjects with musculoskeletal disorder. Packaged herbal medicine was sought by subjects with respiratory disease, digestive tract disease, endocrine-metabolic disease or circulatory disease. Tablet-type herbal medicine was sought by subjects with musculoskeletal disorder or digestive tract disease. Combined therapy was sought by subjects with musculoskeletal disorder, digestive tract disease, hematopoietic disease or immune disorder. 4. The level of satisfaction with oriental medical service was higher in subjects with circulatory disease, subjects with digestive tract disease, subjects with neurological disorder and subjects with musculoskeletal disorder in descending order. Of total subjects, 39.4% experienced side effects of oriental medical care, 38.1% experienced side effects of herbal medicine. About 51.9% considered the price of herbal medicine costly while 23.2% considered it reasonable. 5. Subjects' knowledge of herbal medicine was measured as $29.2{\pm}3.83$ out of 42 scores or 69 out of 100 points, indicating a low knowledge level. Subjects' knowledge was influenced by occupation, religion, side effects, sex, age, residence area, the type of insurance. These variables explained 15.2% of the variance. 7. Of total subjects, 56.8% were satisfied with oriental medical service. Patient satisfaction varied with occupation, religion, the type of insurance, health state and treatment outcomes. These variables explained 37.3% of the variance. Conclusion : The majority of subjects were satisfied with oriental medical service. However, oriental medical care are not widely used to treat all kinds of diseases while its use skews to a small categories of diseases. It is therefore necessary for the government and oriental medical service providers to develop new therapy approaches for the treatment of a broader range of diseases.

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