• 대한방사선기술학회지:방사선기술과학
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• 제44권2호
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• pp.91-100
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• 2021

High-Resolution thoracic CT (HRCT) is a scanning protocol in which thin slice thickness and sharpness algorithm are utilized to enhance image resolution for diagnosis and assessment of interstitial lung disease (ILD). This examination is sometimes performed in both supine and prone position to improve sensitivity to early changes of these conditions. Anatomical structures (the size of lung field and heart and descending aorta) of 150 patients who underwent HRCT were retrospectively compared. HRCT had been conducted in two positions (supine and prone). Data were divided into five groups according to patient body weights (from 40 to more than 80kg, 10kg intervals, 60 patients/each group). Quantitative analysis was utilized in Image J program. In the supine position defined as the control group, the average values of lung fields and heart size and aorta were compared with the prone position defined as the experimental group. The size of the lungs was found to be higher in the supine position, and it was confirmed that there was a statistically significant difference in patients over 70 kg (p<0.05). In addition, both sizes of the heart and descending aorta were larger in prone position, but in the case of the heart, there was no correlation with the presence or absence of ILD disease (p>0.05). Also, the area of prone in the descending aorta was higher than supine position, but there was no statistically significant difference between supine and prone position (p>0.05). In conclusion, when the severity of ILD disease was severe, there was no statistically significant difference in the area difference between supine and prone position, so it is considered that it will be helpful in diagnostic decision.

• Korean Journal of Radiology
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• 제22권3호
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• pp.476-488
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• 2021

Objective: We aimed to develop a deep neural network for segmenting lung parenchyma with extensive pathological conditions on non-contrast chest computed tomography (CT) images. Materials and Methods: Thin-section non-contrast chest CT images from 203 patients (115 males, 88 females; age range, 31-89 years) between January 2017 and May 2017 were included in the study, of which 150 cases had extensive lung parenchymal disease involving more than 40% of the parenchymal area. Parenchymal diseases included interstitial lung disease (ILD), emphysema, nontuberculous mycobacterial lung disease, tuberculous destroyed lung, pneumonia, lung cancer, and other diseases. Five experienced radiologists manually drew the margin of the lungs, slice by slice, on CT images. The dataset used to develop the network consisted of 157 cases for training, 20 cases for development, and 26 cases for internal validation. Two-dimensional (2D) U-Net and three-dimensional (3D) U-Net models were used for the task. The network was trained to segment the lung parenchyma as a whole and segment the right and left lung separately. The University Hospitals of Geneva ILD dataset, which contained high-resolution CT images of ILD, was used for external validation. Results: The Dice similarity coefficients for internal validation were 99.6 ± 0.3% (2D U-Net whole lung model), 99.5 ± 0.3% (2D U-Net separate lung model), 99.4 ± 0.5% (3D U-Net whole lung model), and 99.4 ± 0.5% (3D U-Net separate lung model). The Dice similarity coefficients for the external validation dataset were 98.4 ± 1.0% (2D U-Net whole lung model) and 98.4 ± 1.0% (2D U-Net separate lung model). In 31 cases, where the extent of ILD was larger than 75% of the lung parenchymal area, the Dice similarity coefficients were 97.9 ± 1.3% (2D U-Net whole lung model) and 98.0 ± 1.2% (2D U-Net separate lung model). Conclusion: The deep neural network achieved excellent performance in automatically delineating the boundaries of lung parenchyma with extensive pathological conditions on non-contrast chest CT images.

• Tuberculosis and Respiratory Diseases
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• 제71권6호
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• pp.470-475
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• 2011

So far more than 350 drugs have been reported to be the cause for lung injury and the incidence tends to increase. Although infiltrative lung disease is the most common pattern of drug-induced lung injury, it can appear in the form of alveolar changes, vasculitis and other injury. Herbal medicine also has been known as a cause for interstitial pneumonitis, but it is difficult to identify the key herbal medicine because of the complex components of the contents. Till date, there is no report of pneumonitis caused by golden thread. Here we report a case of a 54-year-old male who developed interstitial pneumonitis with acute liver injury caused by herbal medicine made from golden thread.

• Tuberculosis and Respiratory Diseases
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• 제62권2호
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• pp.134-139
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• 2007

Gefitinib은 진행성 비소세포성 폐암에 사용이 증가되고 있는 새로운 표적 항암 치료제로써 대부분이 경미한 부작용을 보이나 심각한 약제 유발성 간질성 폐렴이 발생 할 수 있다. 발생 빈도가 높은 일본에서는 유병률이 3.5%까지도 보고 된 바 있으나 현재 우리나라에서는 EAP에서 확인된 1건을 제외하고는 보고가 거의 없어 gefitinib로 인한 간질성 폐렴에 대한 낮은 인지도와 감별 진단의 어려움 등이 문제가 되는 것으로 판단된다. 저자들은 gefitinib에 의한 간질성 폐렴 2례를 경험하였기에 이를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제46권1호
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• pp.65-74
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• 1999

연구배경: 간질성폐질환의 진단을 위해 개흉폐생검이 전통적으로 이용되어 왔으나, 수술적검사로 인한 합병증의 위험성이 크다. 최근 간질성폐질환의 진단에 있어서 고해상도 전산화단층촬영(HRCT)과 경기관지폐생검이 널리 이용되고 있으며, 비교적 안전하고 진단율 또한 높은 것으로 알려져있다. 이에 저자들은 간질성폐질환의 진단에 있어서 이들 검사방법들의 유용성을 비교하여보고자 하였다. 방 법: 1995년 5월부터 1998년 6 월까지 단국대학교부속병원에서 급성 및 만성 간질성폐질환의 진단을 위해 HRCT와 개흉폐생검을 시행한 19명의 환자들의 의무기록을 후향적으로 조사하여 이들 환자들의 임상소견, 기저질환, HRCT소견, 경기관지폐생검소견, 개흉폐생검소견, 개흉폐생검의 합병증, 개흉폐생검 후의 치료방법 등을 분석하여 다음과 같은 결과를 얻었다. 결 과: 대상 환자 중에서 증상의 시작에서 개흉폐생검까지의 기간이 2주 이상인 만성 간질성폐질환 환자는 13명(68.4%)이었으며, 2주 미만인 급성 간질성폐질환 환자는 6명(31.6%)이었다. 개흉폐생검으로 만성 간질성폐질환 환자중 92%(12/13)에서 특정진단이 가능하였고(Bronchiolitis obliterans organizing pneumonia 5명, Constrictive bronchiolitis 2명, Usual interstitial pneumonia 3명, 과민성폐장염 1명, 호산구성폐장염 1명), 급성 간질성폐질환 환자들은 모두에서 특정진단이 가능하였다(급성 간질성폐렴 5명, 카리니 주폐포자충폐렴 l명). 개흉폐생검으로 특정진단이 가능하였던 12명의 만성 간질성폐질환 환자에서 HRCT의 첫 번째 가능한 진단명이 옳았던 경우는 50%(6/12)였다. 개흉폐생검 후 만성 간질성폐질환 환자의 62%(8/13)에서 특정 치료를 받았고(스테로이드치료 : 7명, 이사: 1명), 급성 간질성폐질환 환자들은 모두에서 특정 치료를 받았다(스테로이드치료 : 5명, 스테로이드와 항생제치료: 1명). 개흉폐생검 후 병원내 사망율은 5.3%(1/19)였다. 결 론: 간질성폐질환에서 HRCT와 경기관지폐생검에서 특정진단을 못 내릴 경우 개흉폐생검은 비교적 합병증이 적으면서 유용한 진단방법이며, 특히 급성 간질성폐질환에서는 치료에 많은 도움을 줄 수 있다.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.186-192
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• 1994

저자들은 Lown grade IVa의 심실성 기외 수축으로 진단 받고, amiodarone을 약 7개월간 투여 받은 환자에서 amiodarone으로 야기된 간질성 폐질환의 1례를 경험하였기에 그 휘기성에 비추어 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제66권3호
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• pp.230-235
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• 2009

특발성 세기관지중심성 간질성 폐렴은 염증 및 섬유화가 주로 소기도 및 주변을 침범하고, 부분적으로 폐포로 퍼져나가는 특징을 보이는 질환으로 아직까지 국내에서는 발표된 증례가 없다. 저자들은 한 달간의 호흡곤란으로 내원한 남자에서 방사선학적으로 망상형 병변과 중심소엽성 결절을 보이면서 조직 검사상 세기관지에 집중된 병리 소견을 보여 세기관지중심성 간질성 폐렴을 진단한 예를 경험하였기에 보고하는 바이다.

• Korean Journal of Radiology
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• 제1권2호
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• pp.84-90
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• 2000

Objective: To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. Materials and Methods: The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. Results: All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. Conclusion: In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary.

• Tuberculosis and Respiratory Diseases
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• 제55권6호
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• pp.631-635
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• 2003

비특이성 간질성 폐렴에서 대개의 경우 스테로이드 치료로 호전지만 스테로이드 저항성 인 경우 여러 가지 면역 억제제가 이차 약제로 치료에 시도되고 있으며 본 증례에서는 cyclosprin을 이차약제로 사용해서 좋은 치료 효과를 얻었기에 문헌 고찰과 함께 보고 하는 바이다.

• The Korean Journal of Medicine
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• 제99권2호
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• pp.69-77
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• 2024

Hypersensitivity pneumonitis (HP) is an inflammatory and fibrosing interstitial lung disease caused by inhaled antigens in susceptible individuals. Various environmental materials can serve as inciting agents of HP. Recent guidelines have defined typical radiologic and histopathologic findings of HP, classifying it into nonfibrotic and fibrotic HP categories, as this classification better correlates with clinical outcomes. Diagnosing HP poses challenges, necessitating multidisciplinary discussions based on clinical assessments and radiologic or histopathological features. The cornerstone of treatment lies in avoiding the causative antigen. Oral glucocorticoids serve as the initial treatment for symptomatic HP. Immunosuppressants may be employed in patients who do not respond to initial treatment, and antifibrotics could be considered for patients displaying progressive fibrosis. This review outlines the clinical features, diagnostic evaluation, and treatment of HP.