• 농촌의학ㆍ지역보건
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• 제23권2호
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• pp.259-268
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• 1998

It has been reported that among mushroom farmers, respiratory diseases such as hypersensitivity pneumonitis can be developed by inhalation of mushroom (Pleurotus ostreatus) spores. For the evaluation of respiratory symptoms among mushroom farmers, a questionnaire was made. The Questionnaire included general characteristics, past occupational histories, durations of the mushroom cultivation and characteristics of the symptoms. Following the questionnaire we interviewed the 72 mushroom farmers (12 males, 10 females) from Kyungbuk Province. We also examined white blood counts, erythrocyte sedimentation rates, eosinophil counts and total IgE counts for the 5 farmers. The results obtained are as follows. 1. The mean age among the 22 mushroom farmers was 46.9 years, and the mean duration of cultivation was 7.5 years. 2. Among the 22 mushroom farmers. 18 farmers (81.8 %) suffered from respiratory symptoms at work. The main symptom was coughing (100.0%), followed by chilling sensation (50.0 %), sputum (38.9 %) and sore throat (27.8 %). 3. Coughing and other associated symptoms occurred during work and disappeared after work or several days later when the exposure had been stopped. 4. Total IgE counts were elevated in all farmers examined the test. With above results, the respiratory symptoms that developed among mushroom farmers were typical patterns of hypersensitivity pneumonitis. Epidemiological studies and preventive measures for mushroom farmers should be established.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.200-208
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• 2021

Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. Methods: An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. Results: The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. Conclusion: The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.

• Tuberculosis and Respiratory Diseases
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• 제59권4호
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• pp.423-426
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• 2005

Imatinib-mesylate는 만성 골수성 백혈병과 소화기 위장관 기질암의 효과적인 치료제로 인정되면서 사용량이 급격하게 증가하고 있다. Imatinib-mesylate로 치료 중 발생하는 기침이나 호흡곤란은 대부분 폐부종이나 흉수, 간질성 폐질환에 의하여 발생하며, 간질성 폐질환의 경우 조직학적으로는 비특이적 간질성 폐렴, 과민성 폐렴, 호산구 침착 등의 형태로 발생한다. 그러나 imatinib-mesylate에 의하여 간질성 폐질환이 발생하는 기전은 아직 알려져 있지 않다. 치료는 대부분 imatinib-mesylate를 중단하거나 부신피질호르몬제를 사용한 후 호전된다. Imatinib-mesylate를 사용하는 경우 호흡기계에 발생하는 부작용에 대한 관찰이 필요할 것이다. 저자들은 위장관 기질암으로 imatinib-mesylate를 복용하던 중 발생한 과민성 폐렴을 경험하여 보고하는 바이다.

• 대한영상의학회지
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• 제82권4호
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• pp.817-825
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• 2021

과민성폐렴(hypersensitivity pneumonitis)은 기도를 통해 흡입된 항원물질이 세기관지와 폐포에 면역매개 염증병변을 일으켜 발생하는 간질성폐질환(interstitial lung disease)이다. 다양한 유기물질이 발생원인으로 작용할 수 있기에 환자의 흉부영상검사와 임상증상을 통해 과민성폐렴을 의심하고 직업 또는 주변 환경을 통해 노출되는 항원을 파악하는 것이 과민성폐렴 진단의 핵심이다. 하지만 다양한 임상증상과 진행 형태로 인해 간질성폐질환 환자의 진단에서 과민성폐렴을 정확히 감별할 수 있느냐는 풀기 쉽지 않은 주제이다. 이에 2020년 미국흉부학회, 일본호흡기학회 그리고 라틴아메리카흉부학회는 과민성폐렴 진단에 대한 새로운 임상진료지침을 발표하였다. 이번 임상진료지침은 과민성폐렴 진단에 있어서 흉부 고해상도 전산화단층촬영(high-resolution CT; 이하 HRCT)의 역할을 강조하며 과민성폐렴에 대한 새로운 분류 기준도 제시하고 있다. 본 종설은 흉부 HRCT 내용을 포함해 새롭게 소개된 과민성폐렴 진단에 대한 전반을 살펴보고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제56권2호
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• pp.203-209
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• 2004

MTX는 골육종이나 진행된 비호치킨씨 임파종과 같은 종양성 질환 뿐아니라 건선이나 류마치스 관절염, 유육종증, 웨그너씨 육아종증등의 양성질환에서도 널리 쓰여지는 약물이다. MTX에 의한 폐독성은 약제를 투여받은 환자들 중 0.3-7.5%정도에서 나타나는 것으로 알려져 있다. 급성 또는 만성의 경과로 나타나는 MTX 폐렴의 예가 기술되어 있지만 전형적으로는 MTX를 투여한지 수개월내에 증상이 나타나는 아급성의 임상경과를 취하는 경우가 많다. 조직병리학적으로는 NSIP의 형태로 나타나는 경우가 가장 흔한 것으로 되어 있으나 BOOP나 DAD로 나타나는 경우도 드물게 보고되고 있으며 그 중 육아종의 형성을 보이는 예는 34.7% 정도로 알려져 있다. 우리나라에서는 NSIP나 DAD로 나타난 MTX 폐장염의 예가 보고되어있다. 저자들은 과민성 폐장염의 형태로 발현한 MTX에 의한 폐독성의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 생약학회지
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• 제18권4호
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• pp.216-232
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• 1987

In order to investigate the preventive and therapeutic effects of Herba Houttuyniae, experimental studies on the immune response and histological findings were undertaken. The results of these studies were summarized as follows; Delayed type hypersensitivity and rosette formation rate were significantly increased compared with control group. Hemagglutination, hemolysin titer and NK cell activity were variable, not significantly against the control group. When observed on lung tissue recovery; experimental groups were shown to be significantly recovered as compared with the control group. From these results, it is suggested that Houttuyniae Herba promotes immune response and reduces the recovery time of pneumonitis and lung abscess from the histological viewpoint.

• Tuberculosis and Respiratory Diseases
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• 제77권2호
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• pp.81-84
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• 2014

A patient treated with venlafaxine for major depression developed an interstitial lung disease (ILD) with the characteristic clinical, radiological and pathological features of chronic hypersensitivity pneumonitis. A high resolution computed tomography scan demonstrated ground glass opacity, mosaic perfusion with air-trapping and traction bronchiectasis in both lungs. The pathological findings were consistent with a nonspecific interstitial pneumonia pattern. Clinical and radiological improvements were noted after the discontinuation of venlafaxine and the administration of a corticosteroid. This report provides further evidence that the anti-depressant venlafaxine can cause ILD.

• Tuberculosis and Respiratory Diseases
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• 제50권3호
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• pp.367-372
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• 2001

Bacillus Calmette-Guerin(BCG) has been widely used for the prophylaxis of superficial bladder tumor recurrence and for the treatment of bladder carcinoma in situ. More than 95% of patients who receive BCG instillation tolerate the treatment well and side reactions have been reported in less than 5% of patients. Most side effects are minor and self-limiting. However, a rare occurrence of severe systemic reactions have been reported. Among the severe systemic reactions, hypersensitivity pneumonitis should be considered in patients with pneumonic complications after BCG instillation in cases where the culture for mycobacteria is negative in the sputwn, brochoalveolar lavage and blood specimen. In addition, a fiberoptic bronchoscopy with transbronchial lung biopsy demonstrates a fibrosis of the alveolar septums, where there is and an increased lymphocyte count with out tuberculous inflammatory changes, the and CD4 : CD8 ratio is increased and no symptomatic response to antituberculosis chemotherapy is observed. Here we report a 68 years old man with interstitial pneumonitis following intravesical BCG instillation.

• IMMUNE NETWORK
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• 제8권3호
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• pp.90-97
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• 2008

Background: Hypersensitivity pneumonitis (HP) comprises a group of lung diseases resulting from repeated inhalation of various antigens such as Saccharopolyspora rectivirgula (SR). HP is categorized as a Th1 disease. Therefore, it has been suggested that IL-4, Th2 type cytokine, plays a protective role in the development of HP. However, the functional role of IL-4 in HP has not been extensively investigated in vivo. Therefore, we investigated the functional role of IL-4 in HP using IL-4 knockout (KO) mice. Methods: HP was induced by repeated exposure to SR in C57BL/6 (B6) and IL-4 KO (C57BL/6 background) mice. Results: IL-4 KO mice aggravated HP in terms of histological alteration, SR-specific immune responses, and inflammatory cell infiltration in the lungs compared with B6 mice. IL-4 KO mice produced high levels of IFN-${\gamma}$, TGF-${\beta}$ and TNF-${\alpha}$ in the lungs, whereas B6 mice showed the enhanced production of IL-4. Moreover, chemokines such as MIP-1${\alpha}$, MCP-1, and RANTES were highly expressed in IL-4 KO mice. IFN-${\gamma}$-secreting CD4, CD8 T cells, and neutrophils were enhanced in the bronchoalveolar lavage fluid (BALF) of IL-4 KO mice than those of B6 mice. The administration of recombinant(r) IL-4 restored these immunologic parameters in IL-4 KO mice. Conclusion: These results indicate that IL-4 plays a suppressive role in SR-induced HP by attenuating Th1-dominant immune responses.

• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.236-239
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• 2010

Hot tub lung is a lung disorder associated with exposure to hot tub water contaminated with Mycobacterium avium complex (MAC). Although its pathogenesis remains unclear, it may be considered hypersensitivity pneumonitis (HP) rather than an infectious disease. We report a case which fulfilled the current diagnostic criteria of hot tub lung. A patient had worked as a cleaner in the public bath for approximately one year and presented with dyspnea for over one month. The computed tomographic finding of bilateral ground glass attenuation and pathologic finding of granulomatous inflammation were consistent with HP. MAC was isolated from bronchoalveolar lavage fluid and hot tub water. After corticosteroid treatment without antimycobacterial medication, the patient improved and there has been no recurrence. The patient has since discontinued working in the public bath.