• Title/Summary/Keyword: Lung Disease

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Obstructive Sleep Apnea in Interstitial Lung Disease (폐쇄성 수면 무호흡증과 간질성 폐질환)

  • Kim, Shin Bum;Lee, Sang Haak;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.19-23
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    • 2017
  • Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.

Usefulness of Temporal Subtraction for The Detection of Interval Changes of Interstitial Lung Diseases on Chest Radiographs

  • Higashida, Yoshiharu;Ideguchi, Tadamitsu;Muranaka, Toru;Akazawa, Fumio;Miyajima, Ryuichi;Tabata, Nobuyuki;Ikeda, Hirotaka;Ohki, Masafumi;Toyofuku, Fukai;Doi, Kunio
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.454-456
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    • 2002
  • The evaluation of interval changes between temporally sequential chest radiographs is necessary for the detection of new abnormalities or interval changes, such as pulmonary nodules and interstitial disease. For interstitial lung disease, the interval changes are very important for diagnosis and treatment. Especially, interstitial lung disease may show rapid changes in the radiographs, show changes in the entire lung field in minute detail, or show changes in multiple parts depending on the type. It is therefore difficult to have an accurate grasp of the condition of the disease only with conventional radiographs. The temporal subtraction technique which was developed at the University of Chicago, provides a subtraction image of the current warped image and the previous image. A temporal subtraction image, shows only differences and changes between the two images, can be very useful for a diagnosis of interstitial lung disease. However, the evaluation of the temporal subtraction technique for interstitial lung disease using receiver operating characteristic(ROC) studies has not been reported yet. Therefore, we have evaluated the clinical usefulness of a temporal subtraction technique for detection of interval changes of interstitial lung disease by ROC analysis.

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 5. Connective Tissue Disease Associated Interstitial Lung Disease

  • Koo, So-My;Kim, Song Yee;Choi, Sun Mi;Lee, Hyun-Kyung;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.285-297
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    • 2019
  • Connective tissue disease (CTD) is a collection of disorders characterized by various signs and symptoms such as circulation of autoantibodies in the entire system causing damage to internal organs. Interstitial lung disease (ILD) which is associated with CTD is referred to as CTD-ILD. Patients diagnosed with ILD should be thoroughly examined for the cooccurrence of CTD, since the treatment procedures and prognosis of CTD-ILD are vary from those of idiopathic interstitial pneumonia. The representative types of CTD which may accompany ILD include rheumatoid arthritis, systemic sclerosis (SSc), Sjogren's syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematous. Of these, ILD most frequently co-exists with SSc. If an ILD is observed in the chest, high resolution computed tomography and specific diagnostic criteria for any type of CTD are met, then a diagnosis of CTD-ILD is made. It is challenging to conduct a properly designed randomized study on CTD-ILD, due to low incidence. Therefore, CTD-ILD treatment approach is yet to been established in absence of randomized controlled clinical trials, with the exception of SSc-ILD. When a patient is presented with acute CTD-ILD or if symptoms occur due to progression of the disease, steroid and immunosuppressive therapy are generally considered.

Effects of a Short-term Home-based Pulmonary Rehabilitation Program in Patients with Chronic Lung Disease (만성폐질환자를 위한 가정 호흡재활 단기 프로그램의 효과)

  • 오의금;김순희;박희옥;방소연;이춘화;김소희
    • Journal of Korean Academy of Nursing
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    • v.33 no.5
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    • pp.570-579
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    • 2003
  • Purpose: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. Method: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. Result: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. Conclusion: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.

Importance of Serum SELDI-TOF-MS Analysis in the Diagnosis of Early Lung Cancer

  • Simsek, Cebrail;Sonmez, Ozlem;Yurdakul, Ahmet Selim;Ozmen, Fusun;Zengin, Nurullah;Keyf, Atilla Isan;Kubilay, Dilek;GUlbahar, Ozlem;Karatayli, Senem Ceren;Bozdayi, Mithat;Ozturk, Can
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2037-2042
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    • 2013
  • Background: Different methods of diagnosis have been found to be inefficient in terms of screening and early diagnosis of lung cancer. Cancer cells produce proteins whose serum levels may be elevated during the early stages of cancer development. Therefore, those proteins may be recognized as potential cancer markers. The aim of this study was to differentiate healthy individuals and lung cancer cases by analyzing their serum protein profiles and evaluate the efficacy of this method in the early diagnosis of lung cancer. Materials and Methods: 170 patients with lung cancer, 53 under high risk of lung cancer, and 47 healthy people were included in our study. Proteomic analysis of the samples was performed with the SELDI-TOF-MS approach. Results: The most discriminatory peak of the high risk group was 8141. When tree classification analysis was performed between lung cancer and the healthy control group, 11547 was determined as the most discriminatory peak, with a sensitivity of 85.5%, a specificity of 89.4%, a positive predictive value (PPV) of 96.7% and a negative predictive value (NPV) of 62.7%. Conclusions: We determined three different protein peaks 11480, 11547 and 11679 were only present in the lung cancer group. The 8141 peak was found in the high-risk group, but not in the lung cancer and control groups. These peaks may prove to be markers of lung cancer which suggests that they may be used in the early diagnosis of lung cancer.

Immunoglobulin G4-Related Lung Disease Mimicking Lung Cancer: Two Case Reports (폐암으로 오인된 면역글로불린 G4 연관 폐 질환: 2예에 대한 증례 보고)

  • Dae Yun Park;Su Young Kim;Suk Hyun Bae;Ji Young Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1168-1174
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    • 2022
  • Immunoglobulin G4 (IgG4)-related disease is a rare systemic fibroinflammatory condition characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in various organs. IgG4-related lung disease shows varied radiologic features on chest CT. Patients usually present with a solid nodule or mass mimicking lung cancer; therefore, distinguishing between IgG4-related disease and other conditions is often challenging. Additionally, co-existing radiologic findings of IgG4-related lung disease may mimic metastasis or lymphangitic carcinomatosis of the lung. We report two cases of histopathologically confirmed IgG4-related lung disease mimicking lung cancer. Chest CT revealed a solid nodule or mass with ancillary radiologic findings, which suggested lung cancer; therefore, IgG4-related lung disease was radiologically indistinguishable from lung cancer in both cases. Measurement of serum IgG4 levels and clinical evaluation to confirm involvement of various organs may be useful to establish the differential diagnosis. However, surgical biopsy evaluation is needed for confirmation.

Idiopathic multicentric Castleman disease presenting progressive reticular honeycomb infiltration of lung and immunoglobulin G and immunoglobulin G4 dominant hypergammaglobulinemia: a case report

  • Kim, Hyun-Je;Hong, Young-Hoon
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.153-160
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    • 2022
  • Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

Evaluation of the Predictive Pulmonary Function after Pneumonectomy Using Perfusion Lung Scan (전폐절제술시 폐관류스캔을 이용한 폐기능의 예측에 대한 평가)

  • Kim, Gil-Dong;Jeong, Gyeong-Yeong
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.371-375
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    • 1995
  • Surgical resection of lung cancer or other disease is recently required in patients with severely impaired lung function resulting from chronic obstructive pulmonary disease or disease extension. So prediction of pulmonary function after lung resection is very important in thoracic surgeon. We studied the accuracy of the prediction of postoperative pulmonary function using perfusion lung scan with 99m technetium macroaggregated albumin in 22 patients who received the pneumonectomy. The linear regression line derived from correlation between predicting[X and postoperative measured[Y values of FEV1 and FVC in patients are as follows: 1 Y[ml =0.713X + 381 in FEV1 [r=0.719 ,[P<0.01 2 Y[ml =0.645X + 556 in FVC [r=0.675 ,[P<0.01 In conclusion,the perfusion lung scan is noninvasive and very accurate for predicting postpneumonectomy pulmonary function.

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The Effect of Body Positioning on Physiologic Index in Patients with Unilateral Lung Disease (편측성 폐질환 환자의 체위변경이 생리적 지표에 미치는 영향)

  • Cho, Jee Yeon;Lee, Hyang Yeon
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.122-133
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    • 2000
  • The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

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Lung Biopsy in Congenital Heart Disease (선천성 심장 질환 환자의 폐 생검)

  • 김광호
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.9-16
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    • 1981
  • Twenty eight patients with conpnital heart disuse underwent lung biopsy to assets pulmonary obstructive vascular disease at cardiac surpry. Thirteen patients had patent ductus arteriosus, 10, ventricular septal defects and S, atrial septal defects. The aaes were between 2 and 30 years. In patients with patent ductus arteriosus lung biopsy was performed from the IIngular Hlment. The anterior seament of the right upper lobe was blopsled in cases with ventricular septal defect and atrial septal defect. Grading of pulmonary obstructive vascular disease could not be assessed In 9 cases. In 2 cases poor quality of the slides made us impossible to evaluate and In 7 cases there were no suitable small muscular arteries to evaluate in the slides of lung tissue especially taken from the IIngular seament. Nineteen cases were evaluated pulmonary obstructive vascular disease. Among them 17 cases had Heath-Edwards changes of grade 1 and 2 patients had that of grade 3. The thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic vascular resistance ratio. There were no complications related to the procedure of lung biopsy.

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