• 제목/요약/키워드: Lung, diseases

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 3. Idiopathic Nonspecific Interstitial Pneumonia

  • Lee, Jongmin;Kim, Yong Hyun;Kang, Ji Young;Jegal, Yangjin;Park, So Young;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • 제82권4호
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    • pp.277-284
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    • 2019
  • Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.

소변 중 디아민을 이용한 디이소시아네이트 노출 근로자의 생물학적 모니터링 (Biological Monitoring of Workers Exposed to Diisocyanates using Urinary Diamines)

  • 이종성;김부욱;신정아;백진이;신재훈;김지혜
    • 한국산업보건학회지
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    • 제26권2호
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    • pp.178-187
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    • 2016
  • Objectives: Diisocyanates are a potent inducer of diseases of the airways, especially asthma. In this study, toluenediamine(TDA) and methylenedianiline(MDA) in urine were evaluated as biomarkers of exposure to tolunenediisocyanate(TDI) and methylenediphenyl diisocyanate(MDI), respectively. Methods: Workers exposed to TDI and MDI, as well as non-occupationally exposed subjects, were studied and pre- and post-shift urine samples were collected from 8 control subjects and 8 workers from a factory which manufactures polyurethane products for reducing noise and vibration in automobiles. Airborne TDI and MDI(n=8) were sampled on solvent-free glass filters impregnated with n-butylamine and detected by liquid chromatography atmospheric pressure ionization tandem mass spectrometry. Urinary TDA and MDA were detected as pentafluoropropionic acid anhydride(PFPA) derivatives by liquid chromatography electrospray ionization tandem mass spectrometry. Results: The median levels of urinary 2,6-TDA(p<0.001), 2,4-TDA(p=0.001), and MDA(p<0.001) of workers in post-shift samples were significantly higher than those of controls. The median levels of urinary 2,6-0TDA($0.63{\mu}g/g$ creatinine vs $0.34{\mu}g/g$ creatinine, p=0.017) and MDA($4.21{\mu}g/g$ creatinine vs $3.18{\mu}g/g$ creatinine, p=0.017) of workers in post-shift samples were significantly higher than those of the pre-shift samples. There were significant correlations between the urinary 2,6-TDA, 2,4-TDA, and MDA of workers in post-shift samples and the airborne 2,6-TDI(rho=0.952, p<0.001), 2,4-TDI(rho=0.833, p=0.001), and MDI(rho=0.952, p<0.001). Conclusions: These urinary diamines, metabolites of diisocyanates, in post-shift samples were useful biomarkers to assess occupational exposure to diisocyanates.

A Study on the Mechanism of Immunomodulating Effects of Moxifloxacin in Oleic Acid-Induced Acute Lung Injury

  • Lee, Young-Man
    • Tuberculosis and Respiratory Diseases
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    • 제71권2호
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    • pp.97-105
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    • 2011
  • Background: It was hypothesized that the immunomodulating effects of moxifloxacin contribute to ameliorate oleic acid (OA)-induced acute lung injury (ALI) by suppression of cytosolic phospholipase A2 (cPLA2). This was based on observations from experiments on rats associated with neutrophilic respiratory burst, cPLA2 activity, and expressions of cPLA2, $TNF{\alpha}$, and COX-II in the lung. Methods: ALI was induced by intravenous injection of OA in male Sprague-Dawley rats. Five hours after OA injection, protein content in bronchoalveolar lavage (BAL), lung myeloperoxidase (MPO) activity, and numbers of BAL neutrophils were measured. As an index of oxidative stress-induced lung injury, the content of malondialdehyde (MDA) in lung tissues was also determined. Lung histology, immunohistochemistry and determination of activity of cPLA2 in lung tissues were carried out. In addition, Western blotting of $TNF{\alpha}$ and COX-II in lung tissues was performed. Results: The accumulation of neutrophils in the lungs was observed after OA injection. BAL protein was increased along with neutrophilic infiltration and migration by OA. Moxifloxacin decreased all of these parameters of ALI and ameliorated ALI histologically. The increased malondialdehyde (MDA) in the lung by OA was also decreased by moxifloxacin. Moxifloxacin not only suppressed cPLA2 expression in the lungs and neutrophils but also decreased cPLA2 activity in lung tissues of rats given OA. The enhanced expressions of $TNF{\alpha}$ and COX-2 in the lung tissues of rats given OA were also suppressed by moxifloxacin. Conclusion: Moxifloxacin inhibited cPLA2 and down-regulated $TNF{\alpha}$ and COX-2 in the lungs of rats given OA, which resulted in the attenuation of inflammatory lung injury.

고립성 폐결절 (Solitary Pulmonary Nodule)

  • 채성수
    • Journal of Chest Surgery
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    • 제15권2호
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    • pp.148-154
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    • 1982
  • The experience with operative treatment for peripheral situated solitary circumscribed lesions of the lung at the Department of Thorac. & Cardiovasc. Surg., Korea University Hospital during 8 years from March 1974, through April, 1982 was reviewed. Our criteria for Solitary pulmonary nodule were 1. Round or Ovoid shape 2. Surrounded by normal lung Parenchyme 3. Well circumscribed peripheral location 4. No other visible pulmonary diseases on chest X-ray except minimal atelectasis or pneumonitis 5. Largest diameter less than 8 cm Of the 55 patients reviewed, there were 69% of malignancy and 31% of benign pulmonary diseases. In malignancy 38 patients, there were 18 patients with squamous cell carcinoma, 8 patients with undifferentiated large cell carcinoma, 2 patients with undifferentiated small cell carcinoma, 10 patients with adenocarcinoma and patient with metastatic carcinoma. In benign pulmonary nodule 17 patients, here were 5 patients with tuberculoma, 5 patients with aspergilloma, 2 patients with A-V fistula, 1 patient with pulmonary blastoma, 1 patient with paragonimiasis, and 1 patient with lung abscess. Overall male to female occurrence ratio was 39:16, and most prevalent age incidence was 7th decades. Most frequent size distribution was 4-6 cm in diameter. All of benign diseases were cured by resection and 66% of malignancy performed operation and has 75% resectability.

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Diagnosis and Treatment of Nontuberculous Mycobacterial Lung Disease: Clinicians' Perspectives

  • Ryu, Yon Ju;Koh, Won-Jung;Daley, Charles L.
    • Tuberculosis and Respiratory Diseases
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    • 제79권2호
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    • pp.74-84
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    • 2016
  • Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

간질성 폐질환의 연구 동향 (Research Trends of Interstitial Lung Disease)

  • 손지우;이정욱;이병순;노운섭;이병주;신조영;이시형
    • 대한한의정보학회지
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    • 제13권1호
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    • pp.26-38
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    • 2007
  • Interstitial lung disease (ILD) is characterized by progressive scarring of the lung leading to restriction and diminished oxygen transfer. Clinically, the presenting symptoms of ILD are nonspecific (cough and progressive dyspnea on exertion) and are often attributed to other diseases, thus delaying diagnosis and timely therapy. In this study, I analyzed the 10 chinese papers of interstitial lung diseases(ILD). The etiology are body resistance weakness(本虛) and pathogenic factor prevailing(標實). The body resistance weakness(本虛) including deficiency of the lung(肺虛), deficiency of the kidney(腎虛), deficiency of the spleen(脾虛), deficiency of Qi and Yin(氣陰兩虛), pathogenic factor prevailing(標實) including stagnation of phlegm(痰濁), blood stasis(瘀血), noxious heat(熱毒). As an treatment aim at supplementing lung and kidney(益肺腎), resolving phlegm and blood stasis(化痰瘀).

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Migrating Lobar Atelectasis of the Right Lung: Radiologic Findings in Six Patients

  • Tae Sung Kim;Kyung Soo Lee;Jung Hwa Hwang;In Wook Choo;Jae Hoon Lim
    • Korean Journal of Radiology
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    • 제1권1호
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    • pp.33-37
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    • 2000
  • Objective: To describe the radiologic findings of migrating lobar atelectasis of the right lung. Materials and Methods: Chest radiographs (n = 6) and CT scans (n = 5) of six patients with migrating lobar atelectasis of the right lung were analyzed retrospectively. The underlying diseases associated with lobar atelectasis were bronchogenic carcinoma (n = 4), bronchial tuberculosis (n = 1), and tracheobronchial amyloidosis (n = 1). Results: Atelectasis involved the right upper lobe (RUL) (n = 3) and both the RUL and right middle lobe (RML) (n = 3). On supine anteroposterior radiographs (n = 5) and on an erect posteroanterior radiograph (n = 1), the atelectatic lobe(s) occupied the right upper lung zone, with a wedge shape abutting onto the right mediastinal border. On erect posteroanterior radiographs (n = 6), the heavy atelectatic lobe(s) migrated downward, forming a peri- or infrahilar area of increased opacity and obscuring the right cardiac margin. Erect lateral radiographs (n = 4) showed inferior shift of the anterosuperiorly located atelectatic lobe(s) to the anteroinferior portion of the hemithorax. Conclusion: Atelectatic lobe(s) can move within the hemithorax according to changes in a patient s position. This process involves the RUL or both the RUL and RML.

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Recurrent Erlotinib-Induced Interstitial Lung Disease on Non-Small Cell Lung Cancer

  • Park, Sang Don;Kim, Areum;Park, Jin-Seok;Shin, Chun Ho;Nam, Hae Sung;Kim, Lucia;Cho, Jae Wha;Ryu, Jeong Sun;Kwak, Seung Min
    • Tuberculosis and Respiratory Diseases
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    • 제67권5호
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    • pp.445-448
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    • 2009
  • Erlotinib ($Tarceva^{(R)}$) has been considered to be a new, promising oral chemotherapy agent for local advanced or metastatic non-small cell lung cancer (NSCLC). Erlotinib is regarded as relatively safe, but interstitial lung disease (ILD) related to erlotinib has been reported on an infrequent basis in Asia. We report an histologically confirmed case of recurrent erlotinib-induced ILD. Although, the patient was highly responsive to the first erlotinib treatment, the therapy was discontinued due to erlotinib-induced ILD. After intravenous high dose methylpredinisolone treatment, ILD was improved rapidly by radiologic studies, but the particular lung cancer re-emerged. We restarted the patient erlotinib on low-dose oral methylpredinisolone, resulting in a recurrence of erlotinib-induced ILD. Our case suggests that re-administration of erlotinib should be performed on a limited basis in patients that have developed ILD on previous use, even if a therapeutic effect can be estimated.