• Journal of the Korean Society of Radiology
• /
• v.85 no.4
• /
• pp.714-726
• /
• 2024

Researchers have developed various algorithms utilizing artificial intelligence (AI) to automatically and objectively diagnose patterns and extent of pulmonary emphysema or interstitial lung diseases on chest CT scans. Studies show that AI-based quantification of emphysema on chest CT scans reveals a connection between an increase in the relative percentage of emphysema and a decline in lung function. Notably, quantifying centrilobular emphysema has proven helpful in predicting clinical symptoms or mortality rates of chronic obstructive pulmonary disease. In the context of interstitial lung diseases, AI can classify the usual interstitial pneumonia pattern on CT scans into categories like normal, ground-glass opacity, reticular opacity, honeycombing, emphysema, and consolidation. This classification accuracy is comparable to chest radiologists (70%-80%). However, the results generated by AI are influenced by factors such as scan parameters, reconstruction algorithms, radiation doses, and the training data used to develop the AI. These limitations currently restrict the widespread adoption of AI for quantifying pulmonary emphysema and interstitial lung diseases in daily clinical practice. This paper will showcase the authors' experience using AI for diagnosing and quantifying emphysema and interstitial lung diseases through case studies. We will primarily focus on the advantages and limitations of AI for these two diseases.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.1
• /
• pp.82-88
• /
• 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.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.4
• /
• pp.504-509
• /
• 2001

There are numerous agents with potential toxic effects on the lung. In particular, cytotoxic drugs constitute the largest and most important group of agents associated with lung toxicity. Bleomycin is commonly used, either alone or in combination with other chemotherapeutic agents, in the treatment of squamous cell carcinoma(head and neck, esophagus, and genitourinary tract), lymphoma, and germ cell tumor. One of the therapeutic advantages of bleomycin is its minimal bone marrow toxicity. However, pulmonary toxicity is one of the most serious adverse side effects. Classically, pulmonary toxicity manifests as a diffuse interstitial process or less commonly as a hypersensitivity reaction. This pulmonary toxicity is generally considered to be dose related and can progress to a fatal fibrosis. It is also possible that bronchiolitis obliterans organizing pneumonia(BOOP) is another manifestation of bleomycin induced toxicity. Bleomycin induced BOOP is less common and has a favorable response to steroid therapy. Here we present a case that demonstrates a BOOP, secondary to a relatively small cumulative dose of bleomycin($225mg/m^2$), may be reversible.

• Korean Journal of Veterinary Service
• /
• v.45 no.1
• /
• pp.63-69
• /
• 2022

Proliferative and necrotizing pneumonia (PNP) is a form of interstitial pneumonia that occurs in post-weaning pigs. In this study, we investigated the presence of swine influenza virus (SIV), porcine reproductive and respiratory syndrome virus (PRRSV), porcine circovirus type 2 (PCV2) and Aujeszky's disease virus (ADV) in PNP lesions in Jeju pigs. Based on the histopathologic criteria for PNP, a total of 50 cases were selected in Jeju pigs between 2008 and 2010. Coupled with histopathological examinations, the presence of ADV and SIV by polymerase chain reaction (PCR) and reverse transcription PCR (RT-PCR) and PRRSV and PCV2 by immunohistochemical (IHC) methods were investigated. Based on the PCR and RT-PCR methods, ADV and SIV nucleic acids were not detected in all cases. According to IHC, PRRSV was detected in 38 of the 50 cases examined (76%) and PCV2 in 25 cases (50%). PRRSV or PCV2 were detected in 19 (38%) or 6 (12%) cases, respectively. Both PRRSV and PCV2 were identified in other 19 cases (38%). Antigens of PRRSV and PCV2 were commonly observed in the cytoplasm of macrophages and clusters of necrotic cells in alveolar cavities. The results of the present study demonstrate that PRRSV is predominantly associated with PNP in Jeju pigs. Co-infection with PRRSV and PCV2 may enhance the severity of PNP lesions in affected pigs.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.5
• /
• pp.479-483
• /
• 2006

Acute fibrinous and organizing pneumonia (AFOP) is a histological pattern consisting of prominent intra-alveolar fibrin and organizing pneumonia, with out hyaline membranes or prominent eosinophilia. The clinical manifestations of AFOP resemble those of acute lung injury such as acute interstitial pneumonia (AIP). However, the classic histological patterns of AFOP differ from diffuse alveolar damage (DAD), bronchiolitis obliterans with organizing pneumonia (BOOP) or acute eosinophilic pneumonia (AEP). The characteristic intra-alveolar fibrin ball and lack of classic hyaline membrane are the predominant histological features of AFOP. Although some reports suggest that its clinical course is less catastrophic than DAD, the clinical entity that distinguishes AFOP from DAD has not been established. We present a case of pathologically demonstrated AFOP in a 79-year-old man. The radiological findings of our case were similar to those of DAD, presented with diffuse bilateral lung infiltrations. However, despite the rapid development of respiratory failure, the patient had a better response and outcome to steroid therapy than what would be expected for DAD.

• Journal of Environmental Health Sciences
• /
• v.38 no.6
• /
• pp.451-459
• /
• 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.

• Journal of Chest Surgery
• /
• v.28 no.1
• /
• pp.53-58
• /
• 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
• /
• v.74 no.1
• /
• pp.23-27
• /
• 2013

Multicentric Castleman's disease (CD) is a rare atypical lymphoproliferative disorder, which is characterized by various systemic manifestations. Some patients with multicentric CD may have concomitant lung parenchymal lesions, for which lymphoid interstitial pneumonia (LIP) is known to be the most common pathologic finding. Follicular bronchiolitis and LIP are considered to be on the same spectrum of the disease. We describe a case of multicentric CD with pulmonary involvement, which was pathologically proven as follicular bronchiolitis.

• Journal of Veterinary Clinics
• /
• v.22 no.1
• /
• pp.65-69
• /
• 2005

A two-year-old male Laika weighing 19 kg and a two-year-old female Rottweiler dog weighing 33 kg were presented to the Veterinary Medical Center, Chungbuk National University. Chest radiographs showed miliary interstitial lung pattern in the overall lung fields and the ill-defined mass in the perihilar area, which is consistent with lymphadenopathy in both cases. In the tracheal wash fluid smears in two cases, 90% of cells were eosinophils. Also, Aspergillus fumigatus was isolated from the tracheal wash fluid in Czapek's agar in one case. Ketoconazol (10 mg/kg, PO, ql2hr) alleviated the clinical signs in two dogs. Follow up radiographs showed marked reduction of lung lesions in one case.

• The Journal of Korean Medicine
• /
• v.35 no.4
• /
• pp.104-109
• /
• 2014

Objectives: To present the case of a 76-year-old man diagnosed with idiopathic interstitial pneumonias (IIPs) treated exclusively with traditional Korean medicine (TKM). Methods: The patient was treated with the revised Sasammaekmundong-tang (rSMT), acupuncture, and pharmacopuncture from September 2013 to May 2014 in our outpatient clinic. We prescribed rSMT three times a day for 4 months. Acupuncture and pharmacopuncture were performed twice a week for 9 months. To evaluate therapeutic efficacy, we recorded the patient's chief complaints at each visit, and pulmonary function test was performed at intervals of three months. Chest radiography and chest computed tomography were performed before and after treatment, respectively. Results: During the course of the treatment, dyspnea, cough, sputum, and overall pulmonary function improved. Conclusions: We suggest that traditional Korean medicine (TKM) for IIPs patients might be effective in the control of the main symptoms of IIPs and in the recovery of respiratory function.