• 제목/요약/키워드: Interstitial lung injury

검색결과 44건 처리시간 0.021초

Fatal Interstitial Pneumonitis Rapidly Developed after the First Cycle of CHOP with Etoposide Combination Chemotherapy in a Patient with Lymphoma

  • Park, Hyung Chul;Ahn, Jae-Sook;Yang, Deok-Hwan;Jung, Sung-Hoon;Oh, In-Jae;Choi, Song;Lee, Seung-Shin;Kim, Mi-Young;Kim, Yeo-Kyeoung;Kim, Hyeoung-Joon;Lee, Je-Jung
    • Tuberculosis and Respiratory Diseases
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    • 제74권5호
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    • pp.235-239
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    • 2013
  • Several chemotherapeutic agents are known to develop pulmonary toxicities in cancer patients, although the frequency of incidence varies. Cyclophosphamide is a commonly encountered agent that is toxic to the lung. Additionally, granulocyte colony-stimulating factor (G-CSF) being used for the recovery from neutropenia can exacerbate lung injury. However, most of the patients reported previously that the drug-induced interstitial pneumonitis were developed after three to four cycles of chemotherapy. Hereby, we report a case of peripheral T cell lymphoma which rapidly developed a fatal interstitial pneumonitis after the first cycle of combined chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisolone, and etoposide and the patient had also treated with G-CSF during neutropenic period.

Mild Traumatic Brain Injury and Subsequent Acute Pulmonary Inflammatory Response

  • Lim, Seung Hyuk;Jung, Harry;Youn, Dong Hyuk;Kim, Tae Yeon;Han, Sung Woo;Kim, Bong Jun;Lee, Jae Jun;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • 제65권5호
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    • pp.680-687
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    • 2022
  • Objective : The influence of moderate-to-severe traumatic brain injury (TBI) on acute pulmonary injury is well established, but the association between acute pulmonary injury and mild TBI has not been well studied. Here, we evaluated the histological changes and fluctuations in inflammatory markers in the lungs to determine whether an acute pulmonary inflammatory response occurred after mild TBI. Methods : Mouse models of mild TBI (n=24) were induced via open-head injuries using a stereotaxic impactor. The brain and lungs were examined 6, 24, and 72 hours after injury and compared to sham-operated controls (n=24). Fluoro-Jade B staining and Astra blue and hematoxylin staining were performed to assess cerebral neuronal degeneration and pulmonary histological architecture. Quantitative real-time polymerase chain reaction analysis was done to measure inflammatory cytokines. Results : Increased neuronal degeneration and the mRNA expression of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-10, and transforming growth factor (TGF)-β were observed after mild TBI. The IL-6, TNF-α, and TGF-β levels in mice with mild TBI were significantly different compared to those of sham-operated mice 24 hours after injury, and this was more pronounced at 72 hours. Mild TBI induced acute pulmonary interstitial edema with cell infiltration and alveolar morphological changes. In particular, a significant infiltration of mast cells was observed. Among the inflammatory cytokines, TNF-α was significantly increased in the lungs at 6 hours, but there was no significant difference 24 and 72 hours after injury. Conclusion : Mild TBI induced acute pulmonary interstitial inflammation and alveolar structural changes, which are likely to worsen the patient's prognosis.

The Inhibitory Effect of Bamboo Culm Extract on the Development of Pulmonary Inflammation in Pristane-Induced Lupus Mice

  • Chae, Byeong-Suk;Kim, Dae-Keun;Eun, Jae-Soon;Kwon, Gi-Sung;Shin, Tae-Yong
    • Natural Product Sciences
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    • 제16권4호
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    • pp.245-250
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    • 2010
  • Pulmonary pathogenesis in lupus is characterized by interstitial inflammation and vasculitis in lungs. We investigated whether bamboo culm extract (BC) attenuates pulmonary inflammation and lung injury in pristane-induced lupus mice. The pristane-induced lupus mice and healthy mice were administrated with BC 0.5 ml/kg or PBS orally once a day for 14 days. Our results demonstrated that BC significantly attenuated levels of bronchoalveolar lavage (BAL) IL-6, IL-10, IFN-$\gamma$, $PGE_2$ and VEGF, and pulmonary vascular permeability in pristane-induced lupus mice. Therefore, these findings suggest that BC may inhibit development of pulmonary inflammation and lung injury in lupus.

Noninvasive Monitoring of Bleomycin-induced Lung Injury in Rats Using Pulmonary Function Test

  • Yang, Mi-Jin;Yang, Young-Su;Kim, Yong-Bum;Cho, Kyu-Hyuk;Heo, Jeong-Doo;Lee, Kyu-Hong;Song, Chang-Woo
    • 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 $V_M$.

내독소혈증 유발 급성폐손상에서 폐장내 Proinflammatory Cytokines 발현에 관한 고찰 (The Lung Expression of Proinflammatory Cytokines, TNF-$\alpha$ and Interleukin 6, in Early Periods of Endotoxemia)

  • 문승혁;김용훈;박춘식;이신제
    • Tuberculosis and Respiratory Diseases
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    • 제45권3호
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    • pp.553-564
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    • 1998
  • 연구배경: LPS에 대한 숙주의 초기반응은 proin-flammatory cytokines의 분비이다. 이러한 "초기 반응" cytokines는 인지세포에서 표적세포 등에 신호를 전달하여 다른 대식세포를 포함한 면역세포, 폐장내 간엽성 세포들을 자극하여 화학주성인자, 성장인자, 유착분자 등의 발현을 증폭시키게 되면서 전염증단계가 정열하게된다. 내독소유발 급성폐손상에서 폐장내 proinflammatory cytokine 기원 세포들은 활성화된 대식세포/단핵구 외에 폐조직으로 유입된 동원 호중구의 역할이 중요하게 인식되고 있으며 이외에도 간엽성 세포들에서도 발현되고 있는 것으로 밝혀지고 있다. 저자들은 실험 백서에서 내독소를 정백내 주입하여 유발시킨 급성폐손상에서 proinflammatory cytokines인 TNF-$\alpha$ 및 IL 6 기원의 주된 세포(들)를 규명해 보고자 하였다. 방 법: 체중 $250{\pm}50g$의 건강체인 웅성 Sparague-Dawley를 정상 대조군(Normal Control Saline Group)과 내독소유발 급성폐손상군으로 분류하였으며 급성폐손상군은 백혈구결핍 내독소군(CPA-ETX Group)과 대조-내독소군(ETX Group)으로 하였다. 실험백서를 phenthotal sodium으로 마취한 후 생리식염수 0.4ml(control) 혹은 동량의 생리식염수에 용해시킨 LPS (055 : B5 E. coli, Sigma Chemical Co., St. Louis, MO), 5mg/kg를 백서 미부정맥으로 주사한 후 각각 0 및 3, 6 시간에 회생시켰다. 백혈구결핍 내독소군은 cyclophophamide, 7mg/kg를 복강내 주입하여 5 일째에 LPS를 같은 방법으로 주입하여 3, 6시간에 각각 희생시켰다. 각군에서 기관지폐포세척술을 전술한 바와 같이 시행하여 총백혈구수, 분획세포수 및 총단백량을 산출하였고 기관지폐포세척 TNF-$\alpha$ 및 IL 6를 생물학적 방법으로 각각 측정하여 비교하였다. 동시에 기관지폐포세척술을 하지 않은 정상대조군 및 대조-내독소군에서 TNF-$\alpha$ 및 IL 6 단백에 대한 면역조직화학염색을 시행하였다. 결 과: 기관지폐포세척 세포 및 단백량 측정 결과 정상대조군에 비해 대조-내독소군에서 기관지폐포세척 총백혈구수는 3, 6 시간째에 각각 유의한 증가를 보였으나 (p<0.01), 백혈구결핍 내독소군과는 차이가 없었다. 대조-내독소군은 정상대조군에 비해 기관지폐포세척단핵구 및 호중구수가 3, 6 시간째에 각각 유의하게 증가하였으며 (p<0.05) 특히 호중구 분획율의 유의한 증가를 동반하였다(p<0.05). 백혈구결핍 내독소군은 정상대조군에 비해 3, 6시간째에 각각 기관지폐포세척 호중구수 및 호중구분획율의 유의한 감소를 보였으나 (p<0.05) 기관지폐포세척 단핵구수 및 단핵구 분획율에서는 양군간에 차이가 없었다. 기관지폐포세척 총단백량은 내독소군에서 3, 6시간째에 각각 정상대조군에 비해 유의한 증가를 보였으며(p<0.05) 내독소군간에는 6시간째에 대조-내독소군에서 백혈구결핍 내독소군에 비해 유의하게 높았다(p<0.05). 기관지폐포세척 TNF-$\alpha$ 및 IL-6의 농도는 정상대조군에서 각각 $0.06{\pm}0.06$ U/ml(n=5) 및 $0.45{\pm}0.23$ U/ml(n=5)이었다. 내독소군에서 TNF-$\alpha$와 IL-6는 정상대조군에 비해 유의하게 상승되었으며 (p<0.05), 백혈구결핍 내독소군과 대조-내독소군간에 차이는 없었다. 면역조직화학염색결과 내독소 정맥 주입 3시간 및 6시간후의 폐조직에서 TNF-$\alpha$ 및 IL-6 단백이 폐포대식세포와 간질대식세포들에서 강하게 염색되는 소견을 관찰할 수 있었다. 결 론: 내독소혈증 유발 급성 폐손상의 초기 손상에 중요한 역할을 하는 proinflammatory cytokine의 주된 기원세포는 활성화된 폐포대식세포/단핵구세포들일 것으로 사료되며 이들 세포가 내독소혈증 유발 급성폐손상 발생에 주도적인 역할을 할 것으로 사료되었다.

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장 허혈-재관류에서 폐조직의 Inducible Nitric Oxide Synthase유전자 발현에 대한 저체온증의 효과 (The Effect of Hypothermia on Lung Inducible Nitric Oxide Synthase Gene Expression in Intestinal Ischemia-Reperfusion Injury)

  • 김규석;이정훈;서길준;윤여규;강영준;김민아;조상기;신효범
    • Journal of Trauma and Injury
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    • 제19권1호
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    • pp.14-20
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    • 2006
  • Purpose: Although hypothermia has been used in many clinical situations, such as post cardiopulmonary resuscitation, stroke, traumatic brain injury, septic shock, and hemorrhagic shock, the mechanism by which it works has not been clearly elucidated. We aimed to evaluate the effect of hypothermia on the plasma nitric oxide (NO) concentration, lung iNOS expression, and histologic changes in intestinal ischemia-reperfusion (IR). Method: Male Sprague-Dawley rats were randomly divided into the hypothermia group (HT, n=8, $27{\sim}30^{\circ}C$) and the normothermia group (NT, n=8, $36{\sim}37^{\circ}C$). They underwent 30 min of intestinal ischemia by clamping the superior mesenteric artery, which was followed by 1.5 h of reperfusion. They were then sacrificed. The acute lung injury (ALI) score, the plasma NO concentration, and lung iNOS gene expression were measured. Results: Compared with the HT group, the NT group showed severe infiltrations of inflammatrory cells, alveolar hemorrhages, and interstitial hypertrophies in lung tissues. There were significant differences in the ALI scores between the NT and the HT groups ($8.7{\pm}1.5/HPF$ in NT vs $5.8{\pm}1.2/HPF$ in HT, p=0.008). Although the plasma NO concentration was slightly lower in the HT group, there was no significant difference between the two groups ($0.80{\pm}0.24{\mu}mol/L$ in NT vs $0.75{\pm}0.30{\mu}mol/L$ in HT, p=0.917). Lung iNOS gene expression was stronger in the NT group than in the HT group. The band density of the expression of iNOS in lung tissues was significantly increased in the NT group compared to the HT group ($5.54{\pm}2.75$ in NT vs$0.08{\pm}0.52$ in HT, p=0.002). Conclusions: This study showed that hypothermia in intestinal IR reduces inflammatory responses, ALI scores, and iNOS gene expression in lung tissues. There was no significant effect of hypothermia on the plasma NO concentration.

Nitric Oxide 및 Sphingosine 1-phosphate가 말초 호흡 단위에 미치는 영향의 생체 내 분석: 백서의 급성 폐 손상 모델에서 생체 접촉 현미경을 이용한 연구 (The Effects of Nitric Oxide and Sphingosine 1-phosphate on the Pulmonary Microstructure in a Rat Model of Acute Lung Injury: An Intravital Videomicroscopic Approach)

  • 이재익;전상훈;성숙환;김주현
    • Journal of Chest Surgery
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    • 제41권2호
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    • pp.177-188
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    • 2008
  • 배경: 이 연구에서는 급성 폐 손상 백서 모델에 nitric oxide (NO)와 sphingosine 1-phosphate (S1P)를 투여한 후, 폐 미세구조의 변화를 생체 접촉 현미경 (intravital videomicroscopy) 으로 생체 내에서 직접 관찰하고 형태학적으로 분석하여, 급성 폐 손상 치료법으로서 이들의 효과를 평가하고자 하였다. 대상 및 방법: 백서 (Sprague Dawley rat) 35마리를 5군으로 나누었다: 생리 식염수를 흡입시킨 대조군 (n=7), 0.1 N HCl을 흡입시켜 폐 손상을 유도한 폐 손상 대조군 (ALI 군, n=7), 폐 손상을 유도하고 치료제를 투여한 치료군 (S1P군, n=7; NO 군, n=7; S1P+NO군, n=7). 폐포 유순도와 간질성 부종의 정도를 평가하기 위해, 폐 손상 유도 후 60 분과 120분에 측정 가능한 모든 폐포와 폐포간 벽의 두께를 생체 접촉 현미경으로 측정하였다. 폐포 유순도는 호흡 주기에 따른 폐포 직경 변화와 일회 호흡량의 변화에 따른 직경 변화로 평가하였다. 결과: 폐 손상 유도 120분 후에, ALI 군의 폐포 유순도가 대조 군 (호흡 주기에 따른 변화 : ALI군 1.9% vs 대조군 6.5%, p=0.03; 일회 호홉량에 따른 변화: ALI군 3.2% vs 대조군 9.1%, p=0.003)과 NO군(일회 호흡량에 따른 변화: ALI군 3.2% vs NO군 16.9%, p=0.001)에 비해 의미 있게 감소하였다. 폐 손상 유도 120 분 후에, NO군의 폐포간 벽의 두께가 ALI군에 비해 작은 경향을 보였다 (ALI 군 $15.2{\mu}m$ vs NO군 $12.3{\mu}m$, p=0.06). S1P 단독으로는 폐포 유순도와 간질성 부종에 유의한 영향을 미치지 않았다. 결론: 백서 폐 손상 모델을 생체 접촉 현미경으로 관찰한 결과, NO는 폐포 유순도를 개선하고 간질성 부종을 감소시켜 폐 손상 정도를 완화시키는 것으로 사료된다.

미역포자엽추출 푸코이단의 X-선 조사 흰쥐 폐장상해에 대한 방오기능 평가 (Protection Effect of Undariia pinnatifida sporophylls-derived Fucoidan in Rat Lung Injury from X-ray Irradiation)

  • 김홍태;정의숙;정덕수;김기홍;김종기
    • 한국수산과학회지
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    • 제42권2호
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    • pp.131-138
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    • 2009
  • The radioprotect effects of fractinated fucoidan, derived from Undaria pinnatifida sporophylls, were examined in lung injured rats treated with partial body irradiation. The right lung of Sprague-Dawley rats, eight separately grouped by including radiation only control group (ROG) and fucoidan+radiation treated group (FRG), were treated with various fraction of Undaria-derived fucoidan every other day by intraperitoneal injection 6 days prior to irradiation and during monitoring at 24 hours, 48 hours, 2 weeks, 4 weeks and 12-weeks post-irradiation of 6 Mev/2 Gy. The rats were euthanized at completion of the treatment. Tissue samples from the injured lung, fixed in formaldehyde using lung perfusion prior to extraction, were H/E stained for histological analysis using optical microscopy. Interstitial congestion (IC), hemorrhage in alveolar sac (HM), number of macrophage (MP) and alveolar wall thickness (AWT) as a measure of early indication of fibrosis were measured. AWTs in 24 hrs post-irradiation rats increased in comparison with $2.49{\pm}0.06{\mu}m$ of control group by $3.67{\pm}0.09{\mu}m$, $3.21{\pm}0.08{\mu}m$ (p=0.013), $2.98{\pm}0.08{\mu}m$ (p=0.00) in ROG, F1-fucoidan+radiation, and F3-fucoidan+radiation group, respectively. AWT of the ROG was further increased by $4.30{\pm}0.13{\mu}m$ in the 12 weeks post-irradiation group, but AWT on average was $2.56{\pm}0.05{\mu}m$ in the FRG. MP in the 24 hrs post-irradiation group markedly increased in comparison with $2.6{\pm}0.34/0.14\;mm^2$ of the control group by $8.0{\pm}1.48/0.14\;mm^2$ in the ROG, but it was only $3.6{\pm}0.48/0.14\;mm^2$ in F3-FRG. MP in the 12 weeks post-irradiation group was $7.2{\pm}1.28/0.14\;mm^2$ in ROG, but it was $2.8{\pm}0.37/0.14\;mm^2$ or $2.4{\pm}0.4/0.14\;mm^2$ (p<0.05) in the FRG. In addition, increased IC and HM in ROG were relatively smaller in FRG of the 24 hr and 12 weeks post-irradiation rats. In conclusion, Undaria pinnatifida sporophylls-derived fucoidan fractions exhibited radioprotectant activity on injured rat lung subjected to X-ray irradiation. However, success was variable according to the fractions and also time of injection post injury.

방수 스프레이 흡입 노출로 인한 급성 호흡기 중독 사례 및 원인 고찰 (Comprehensive Review of Acute Respiratory Failure Following Inhalation Exposure to Waterproofing Agents)

  • 박동욱;최예용
    • 한국환경보건학회지
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    • 제38권6호
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    • pp.451-459
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    • 2012
  • Background: In Korea, a healthy 36-year-old man developed acute interstitial pneumonitis soon after inhaling a waterproofing spray which he had applied at home to his outdoor jacket. Objectives: The objectives of this study were to review cases of varying degrees of respiratory toxicity and poisoning in connection with the use of waterproofing spray and summarize major reasons for cases of poisoning. Methods: We searched articles reporting on a combination of a waterproofing agent and/or respiratory symptoms, including acute respiratory syndrome, lung injury, pneumonia, pulmonary toxicity, and respiratory disease. Results: We reviewed a number of cases of varying degrees of respiratory toxicity and poisoning resulting from inhalation of waterproofing spray containing fluorocarbon co-polymer, solvents and propellants reported in a variety of countries. The literature searches concluded that among the ingredients of waterproofing agents, fluorinated polymer may cause acute respiratory health effects. Conclusion: Environmental policy should be implemented in order to prevent consumers from using household and industrial products including waterproofing agents. In addition, a national surveillance system should be created to collect cases of poisoning caused by the use of consumer products.