• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.372-376
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• 2004

저자들은 면역 억제제인 스테로이드를 사용하던 환자에게서 주폐포자충에 의한 폐렴과 함께 미만성 폐출혈이 발생한 환자 1예를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제84권4호
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• pp.255-262
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• 2021

Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated necrotizing vasculitis, which mainly affects small vessels in various organs, especially the lungs. The two key pulmonary manifestations, interstitial lung disease (ILD) and diffuse alveolar hemorrhage (DAH), increase the morbidity and death rate of patients with MPA. ILD is more common in MPA than in other ANCA-associated vasculitis subsets and is primarily associated with myeloperoxidase-ANCA. Unlike alveolar hemorrhage due to pulmonary capillaritis, ILD can initially manifest as isolated pulmonary fibrosis. Of note, its most frequent radiographic pattern is the usual interstitial pneumonia pattern, similar to the characteristic pattern seen in idiopathic pulmonary fibrosis. In this review we present the pathogenesis, clinical manifestations, and radiographic and histopathologic features of ILD and DAH in MPA. We also briefly summarize the outcome and therapeutic options for the two conditions.

• Tuberculosis and Respiratory Diseases
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• 제46권6호
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• pp.856-860
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• 1999

Diffuse pulmonary ossification is rare disease of unknown etiology. Since the first description by Luschka in 1856, about 140 cases have been reported worldwide, but no such case has been reported in Korea yet. We report 40-year-old woman who was diagnosed as diffuse nodular pulmonary ossification on open lung biopsy. She has no respiratory symptoms & physical findings and no previous disease history. She was incidentally found to have multiple pulmonary nodules on roentgenographic examination. Open lung biopsy was done for above lesion and She was proven to have diffuse nodular pulmonary ossification. She was followed by roentgenographic examination and showed no progression.

• Tuberculosis and Respiratory Diseases
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• 제41권6호
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• pp.597-603
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• 1994

연구배경 : 최근 HRCT의 개발로 폐실질의 미세한 변화까지 관찰할 수 있게 되었고, 특히 비침습적 방법으로 용이하게 여러번 반복하여 실시할 수 있는 장점이 있기 때문에, HRCT가 다른 검사보다 병의 경과, 또는 스테로이드 등 치료의 효과를 객관적으로 판단하는데 도움을 줄 수 있을 것으로 추정하여 본 연구를 실시하였다. 방법: 폐섬유증으로 진단받고 두번 이상 HRCT를 시행하였던 환자 13명에 대하여 치료 전후의 임상 증상(호흡 곤란 지수)의 변화, 폐기능 검사 소견의 변화와 영상 분석기로 측정한 HRCT상의 병변 범위의 변화와의 관계를 분석하였다. 결과: 1) 영상 분석기를 이용한 HRCT에서의 병변 범위 변화와 호흡 곤란 지수의 변화는 r=0.716, p=0.0012로 매우 유의한 상관관계를 나타내었다. 2) 호흡 곤란 지수의 변화와 확산능 변화 사이에는 r=-0.707, p=0.0047로 유의한 역상관관계가 있는 것으로 나타났다. 3) HRCT의 변화와 폐확산능의 변화는 유의한 상관관계를 보였으나 FVC나 TLC는 뚜렷한 연관성을 찾을 수 없었다. 결론: HRCT의 변화는 임상 증상의 변화 및 폐확산능의 변화와 서로 유의한 상관 관계를 보이는 것을 알았고, 향후 환자의 경과 관찰에 임상 증상, 폐확산능 및 HRCT의 추적 검사가 도움이 될 것으로 사료되었다.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1104-1113
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• 2020

Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.

• Journal of Chest Surgery
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• 제24권9호
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• pp.903-906
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• 1991

Retrospective review of 26 patients undergoing open lung biopsy at the Yonsei University during 10 years period was conducted to evaluate open lung biopsy for DILD. From January 1980 to August 1990, open lung biopsy was performed in 26 patients through a limited thoracotomy incision[a limited anterior or a posterolateral thoracotomy]. Open lung biopsy was indicated for diffuse interstitial pulmonary diseases undiagnosed by indirect clinical and radiological diagnostic methods. The types of incision were limited anterior[11] and limited posterolateral[15]. Preoperative evaluation of the lung disease included sputum culture[26], sputum cytology [19], bronchoscopy[9] and TBLB[7]. In 23 patients the histologic appearances after open lung biopsy were sufficiently specific histologic pictures to confirm diagnosis. The results of the biopsies changed usual therapeutic plan in 17 patients among them. The complications were resp. insufficiency[3], pulmonary ed6ma[3], sepsis[2], and others[3] in 6 patients. Diagnosis from the open lung biopsy was included respiratory pneumonia[7], fibrosis[7], infection[5], malignancy[2], others[5]. 4 patients died of respiratory insufficiency. The causes of the other three death were not due to direct result of the biopsy itself. Open lung biopsy in the patient with a diffuse infiltrative lung disease is an one of the accurate diagnostic method and frequently leads to change of the therapeutic plans. So we conclude that open lung biopsy remains our diagnostic method of choice in diffuse infiltrative lung disease undetermined etiology.

• Journal of Chest Surgery
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• 제28권1호
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• pp.53-58
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• 1995

Open lung biopsy still has important roles for the marking of diagnosis of diffuse infiltrative lung disease even though transbronchial bronchoscopic lung biopsy and percutaneous needle aspiration biopsy gain popularity nowadays. This is clinical retrospective review of the 56 patients with diffuse infiltrative lung disease undergoing open lung biopsy by minithoracotomy from 1984 to Dec. 1992 in the Department of Thoracic & Cardiovascular Surgery of Catholic University Medical College. 27 men and 29 women, aged 17 to 73 year [mean 49 year , were enrolled & divided into 2 groups;Group A consisted of patients with immunocompromised state [n=19 , Group B patients with non-immunocompromised state[n=38 . Pathologic diagnosis was made in 54 cases[96.4% of these two groups and as follows: infectious; 12 patients[21.4% , Neoplastic; 10 patients[17.9% , granulomatous; 4 patients[7.1% , interstitial pneumonia; 12 patients[21.4% , Pulmonary fibrosis; 8 patients[14.3% , others; 3 patients[5.4% , nonspecific; 5 patients[8.9% , and undetermined; 2 patients[3.6% . Therapeutic plans were changed in 39 patients[69.6% after taking of tissue diagnosis by open lung biopsy. Group B has higher incidence of infectious diseases and change of therapeutic plan than the Group A. The postoperative complications developed in 8 cases[14.3% ,and there is no difference of incidence between the 2 groups. 4 patients belongs to group A, died of respiratory distress syndrome [2 and sepsis [2 which were not related with open lung biopsy procedure. In conclusion, open lung biopsy is a reliable method to obtain a diagnosis in diffuse pulmonary infiltrates and can be performed safely, even in acutely ill, immunosuppressed patients.

• Tuberculosis and Respiratory Diseases
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• 제61권6호
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• pp.585-590
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• 2006

저자들은 편측성으로 우측 폐전체를 침범한 미만성 폐동정맥루에 대해 색전술 등의 중재적 시술이 불가능하여 비디오흉강경을 이용해서 폐절제술로 치료한 1예를 경험하였기에, 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.122-136
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• 2022

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents and surgical approaches may be beneficial in patients with CPFE, but further studies are needed.

• Journal of Chest Surgery
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• 제37권12호
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• pp.1032-1035
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• 2004

미만간질폐병에서 확진을 위해 개흉 폐 생검을 한다. 미만간질페병은 많은 경우에 있어서 페암과 병발한다. 미만간질페병환자의 폐생검후 발견된 폐 선암 증례 1예를 통해서, 미만간질폐병과 폐암의 상관관계의 고찰과, 폐 생검시 부위 및 생검 횟수에 대한 일반적 기준의 정립에 관해서 논의해보고자 문헌 고찰과 함께 보고한다.