• Radiation Oncology Journal
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• 제32권1호
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• pp.43-47
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• 2014

Purpose: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. Materials and Methods: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intra-class correlation coefficient (ICC). Results: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. Conclusion: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권3호
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• pp.153-159
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• 2017

Purpose: Acid neutralization during chemical clearance is significantly prolonged in children with cystic fibrosis, compared to symptomatic children without cystic fibrosis. The absence of available reference values impeded identification of abnormal findings within individual patients with and without cystic fibrosis. The present study aimed to test the hypothesis that significantly more children with cystic fibrosis have acid neutralization durations during chemical clearance that fall outside the physiological range. Methods: Published reference value for acid neutralization duration during chemical clearance (determined using combined impedance/pH monitoring) was used to assess esophageal acid neutralization efficiency during chemical clearance in 16 children with cystic fibrosis (3 to < 18 years) and 16 age-matched children without cystic fibrosis. Results: Duration of acid neutralization during chemical clearance exceeded the upper end of the physiological range in 9 of 16 (56.3%) children with and in 3 of 16 (18.8%) children without cystic fibrosis (p=0.0412). The likelihood ratio for duration indicated that children with cystic fibrosis are 2.1-times more likely to have abnormal acid neutralization during chemical clearance, and children with abnormal acid neutralization during chemical clearance are 1.5-times more likely to have cystic fibrosis. Conclusion: Significantly more (but not all) children with cystic fibrosis have abnormally prolonged esophageal clearance of acid. Children with cystic fibrosis are more likely to have abnormal acid neutralization during chemical clearance. Additional studies involving larger sample sizes are needed to address the importance of genotype, esophageal motility, composition and volume of saliva, and gastric acidity on acid neutralization efficiency in cystic fibrosis children.

• Toxicological Research
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• 제9권2호
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• pp.241-251
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• 1993

Present studies were carried out in order to estabilish the bronchoalveolar lavage method and to examine the response of bleomycin and peplomycin on the total cell number and the subpoulations of bronchoalveolar lavage fluid. A total of 24 male F344 rats, weighing 300-350 mg, were divided into 3 groups. Animals recelved either belomycin (BLM` 0.75 mg/0.2 ml/rat), peplomycin (PLM` 0.25mg/0.2ml/rat) for groups 2 and 3 or an equal volume of sterile saline lacking drugs for controls (group 1).

• Toxicological Research
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• 제24권4호
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• pp.273-280
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• 2008

The single intratracheal instillation (ITI) of bleomycin (BLM) is a widely used method for inducing experimental pulmonary fibrosis in rat model. In the present study, pulmonary function tests (PFTs) of tidal volume ($V_T$), minute volume ($V_M$), and respiratory frequency ($F_R$) have been applied to study their possibility as a tool to monitor the progress of BLM-induced lung injury in rat model. Rats were treated with a single ITI of BLM (2.5 mg/kg) or saline (control). Animals were euthanized at 3, 7, 14, 21, and 28 days post-ITI. Lung toxicity effects were evaluated by inflammatory cell count, lactate dehydrogenase (LDH) activity in the bronchoalveolar lavage fluid (BALF), and light microscopic examination of lung injury. The PFT parameters were measured immediately before the animals were sacrificed. BLM treatment induced significant cellular changes in BALF-increase in number of total cells, neutrophils, and lymphocytes along with sustained increase in number of macrophages compared to the controls at days 3, 7, and 14. BALF LDH level was significantly increased compared to that in the controls up to day 14. On day 3, infiltration of neutrophils was observed in the alveolar spaces. These changes developed into marked peribronchiolar and interstitial infiltration by inflammatory cells, and extensive thickening of the interalveolar septa on day 7. At 14, 21, and 28 days, mild peribronchiolar fibrosis was observed along with inflammatory cell infiltration. The results of PFT show significant consistencies compared to the results of other toxicity tests. These data demonstrate that the most suitable time point for assessing lung fibrosis in this model is 14 days post-ITI of BLM based on the observation of fibrosis at 14, 21, and 28 days. Further, the progress of lung injury can be traced by monitoring the PFT parameters of $F_R$, $V_T$, and $V_M$.

• Toxicological Research
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• 제20권1호
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• pp.55-61
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• 2004

Respiratory effects in full time welders include bronchitis, airway irritation, lung function changes, and lung fibrosis. Welder's pneumoconiosis has been generally determined to be benign and not associated with respiratory symptoms based on the absence of pulmonary function abnormalities in welders with marked radiographic abnormalities. Accordingly, to investigate pulmonary function changes during 60 days induced by welding-fume exposure, male Sprague-Dawley rats were exposed to manual metal arc-stainless steel (MMA-SS) welding fumes with concentrations of 64.8$\pm$0.9 mg/$m^3$ (low dose) and 107.8 $\pm$ 2.6 mg/$m^3$ (high dose) total suspended particulates for 2 hr/day, 5 days/week in an inhalation chamber for 60 days. Pulmonary function was measured every week with whole body plethysmograph compensated (WBP Comp, SFT38116, Buxco Electronics, Sharon, CT). The rats exposed to the high dose of welding fumes exhibited statistically significant (p<0.05~0.01) body weight decrease as compared to the control whereas cell number increase of the bronchoalveolar lavage fluid (BALF) (total cell, macrophage, polymorphonuclear cell and lymphocyte) during the 60 days exposure period. And only tidal volume was significantly decreased in dosedependantly during 60 days of MMA-SS welding fume exposure. This pulmonary function change with inflammatory cell recruitment confirms the lung injury caused by the MMA-SS welding fume exposure.

• Journal of Chest Surgery
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• 제36권7호
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• pp.523-526
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• 2003

환자는 44세 남자로 호흡곤란과 동반된 복부팽만을 주소로 입원하였다. 심초음파상 우심방내의 종괴와 삼첨판막 협착증, 우심실내강의 감소를 관찰할 수 있었다 수술을 시행하여 우심방내의 종괴를 제거하였고 삼첨판막의 개구부를 확장시킴과 동시에 심실내부의 심내막절제술을 시행하였다. 또한 우심방의 용적부하를 낮추기 위해 심방중격결손을 만들어주었다. 술 후 환자는 증세의 호전을 보였고 별다른 문제없이 퇴원하였고 조직검사상 진단은 심근내막섬유증으로 내려졌다. 술 후 18개월 뒤 환자는 진행된 호흡곤란과 청색증으로 인해 다시 입원하였고 심초음파를 시행하여 우심실내강이 이전보다 더 좁아져 있으며 폐동맥의 혈류가 거의 없음을 확인하였다. 기능적 단 심실 상태였기 때문에 양 방향성 상대정맥폐동맥 단락수술을 시행하였고 술 후 호흡곤란과 청색증은 많은 호전을 보였다. 진행된 우심실의 심근내막섬유증에서 양 방향성 상대정맥-폐동맥 단락수술의 시행은 술 후 초기에 효과적인 증상완화를 제공하지만 장기간의 추적관찰이 요구된다.

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.18-23
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• 2014

Background: Combined pulmonary fibrosis and emphysema (CPFE) have different pulmonary function tests (PFTs) and outcomes than idiopathic pulmonary fibrosis (IPF). The intention of this study was to identify unknown differences between CPFE and IPF by a retrospective comparison of clinical data including baseline and annual changes in pulmonary function, comorbidities, laboratory findings, clinical characteristics and cause of hospitalization. Methods: This study retrospectively enrolled patients with CPFE and IPF who had undergone PFTs once or several times per year during a follow-up period of three years. Baseline clinical characteristics and the annual changes in the pulmonary function during the follow-up period were compared between 26 with CPFE and 42 patients with IPF. Results: The baseline ratio of forced expiratory volume in one second to forced vital capacity ($FEV_1$/FVC%) in patients with CPFE was lower than that in patients with IPF ($78.6{\pm}1.7$ vs. $82.9{\pm}1.1$, p=0.041). The annual decrease in $FEV_1$/FVC in the CPFE was significantly higher than in the IPF. The annual decreases in diffusion capacity of carbon monoxide and FVC showed no significant differences between the two groups. The symptom durations of cough and sputum were in the CPFE significantly lower than in the IPF. The serum erythrocyte sedimentation rate level at the acute stage was significantly higher than in the IPF. There were no significant differences in the hospitalization rate and pneumonia was the most common cause of hospitalization in both study groups. Conclusion: The annual decrease of $FEV_1$/FVC was in patients with CPFE significantly higher than in the patients with IPF.

• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.19-26
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• 2021

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

• Clinical and Experimental Pediatrics
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• 제45권4호
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• pp.529-534
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• 2002

저자들은 1개월 전부터 시작된 호흡 곤란과 마른 기침이 주증상인 10세 된 여아에서 조직학적 소견에서 비특이성 간질성 폐렴으로 진단된 1례를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.567-572
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• 2004

배 경 : 인공 호흡기 치료 중 auto-PEEP을 보이는 환자에게 PEEP을 적용할 경우에 폐 용적에 미치는 영향은 일정하지 않다. COPD와 같이 동적 호기류 제한이 있는 경우에 auto-PEEP 수치의 85%에 해당하는 PEEP까지는 안전하게 적용할 수 있으나, 동적 호기류 제한이 없으면 낮은 PEEP에서도 폐 용적의 증가가 나타난다. 이에 저자들은 auto-PEEP이 있는 환자에서 임상진단에 의한 질환별로 PEEP적용의 효과에 차이가 있는지 보고자 하였다. 대상 및 방법 : 인공 호흡 중 auto-PEEP을 보인 환자 16명을 대상으로 병력, 임상 증상 및 흉부방사선 소견을 기준으로 천식, COPD, 결핵성 변화군 등 3가지 환자 군으로 분 류한 뒤 각각 auto-PEEP 수치의 25, 50, 75, 100%에 해당하는 PEEP을 적용하고 포획 가스용적을 측정하여 폐 용적의 증가를 비교하였다. 결 과 : 천식 환자 군에서는 75% PEEP부터 폐 용적의 증가가 의미 있게 나타났다. COPD 군에서는 100% PEEP에서 폐 용적이 증가 하였다. 결핵성 변화 군에서는 낮은 PEEP에서도 폐 용적이 증가하는 경향을 보였으나 통계적으로 의미 있는 증가는 100% PEEP에서만 나타났다. 결 론 : Auto-PEEP을 보이는 환자에서 폐 용적에 대한 PEEP의 효과는 폐의 병리 상태에 따라 달랐다. 천식 환자 군에서는 auto-PEEP 수치의 50%이상에 해당하는 PEEP 적용은 포획 가스 용적의 증가를 가져올 수 있다.