• Title/Summary/Keyword: Lung parenchyma

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Features and Interpretation of Olfactory and Gustatory Disorders in the Corona Virus Disease-19 (코로나바이러스감염증-19에서 나타나는 후미각손상의 특성과 한의학적 분석)

  • Chi, Gyoo-yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.6
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    • pp.309-318
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    • 2020
  • Besides respiratory infection, COVID-19 has many neurological symptoms not only loss of smell and taste but also fatigue and brain fog. But it is a challenge to treat the neurological symptoms especially of anosmia and ageusia. In order to search for the therapeutic methods, the geographical diversity and pathological mechanisms of the COVID-19 and two symptoms were investigated from the latest clinical studies. Because the environmental conditions of the monsoon climate zone of East Asia and the Mediterranean and Oceanic climate zone of Italy, Britain, United States and tropical Brazil are different, each of diverse etiology and internal milieu should be considered differently in the treatment. SARS-CoV-2 exhibits the dampness-like characteristics and the olfactory and gustatory disorders are particularly more common than other flu or cold. and it tends to show features of damaging the lung qi of olfaction and heart-spleen qi of gustation. The mechanisms of olfactory and gustatory loss are various according to precursory, inflammatory, non-inflammatory and sequelar forms, so the therapeutic method should be designed for each period and pathology. If the process of inflammation arises from nasal and respiratory, olfactory epithelium to the central nervous structure by way of blood brain barrier, the treatment should be corresponded with the stage and depth of pathogen place. And if the olfactory loss is asymptomatic or in the initial stage, it can be applied intranasal topical scent therapy to relieve temporary locking of qi movement, but maybe also used in parallel together with herbs of relieving dampness toxin latent in the lung parenchyma.

Poor Prognosis of Grade 2 Spread Through Air Spaces in Neuroendocrine Tumors

  • Chae, Mincheol;Cho, Sukki;Chung, Jin-Haeng;Yum, Sungwon;Kim, Kwhanmien;Jheon, Sanghoon
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.101-107
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    • 2022
  • Background: Spread through air spaces (STAS) has recently emerged as a prognostic factor in lung adenocarcinoma, but little is known about the association of STAS and its grade with recurrence in neuroendocrine tumors (NETs). This study investigated the prognostic effect of STAS grade in NETs after curative resection. Methods: Seventy-seven patients were retrospectively reviewed, including 9 with typical carcinoid (TC), 6 with atypical carcinoid (AC), 26 with large cell neuroendocrine carcinoma (LCNEC), and 36 with small cell carcinoma (SCC). STAS was defined as the presence of floating tumor cells within air spaces in the lung parenchyma beyond the edge of the main tumor. STAS was classified as grade 1 or 2 depending on whether it was found within or beyond one ×10 objective lens field away from the main tumor margin, respectively. Results: Fifty-four patients (70%) had STAS, including 22% with TC, 50% with AC, 69% with LCNEC, and 86% with SCC. Patients with STAS had more nodal metastasis, lymphatic and vascular invasion, tumor necrosis, and tumor subtypes other than TC. Among STAS cases, grade 2 STAS was present in 33% of AC, 78% of LCNEC, and 87% of SCC. The 5-year recurrence-free survival (RFS) rate was 81%, 63%, and 35% in patients with no STAS, grade 1, and grade 2 STAS, respectively. Multivariate analysis found that grade 2 STAS was an independent negative prognostic factor for RFS. Conclusion: Although STAS itself was not associated with a poor prognosis, grade 2 STAS was an independent negative prognostic factor for RFS.

Searching for Novel Candidate Small Molecules for Ameliorating Idiopathic Pulmonary Fibrosis: a Narrative Review

  • Kyung-il Kim;Rajib Hossain;Xin Li;Hyun Jae Lee;Choong Jae Lee
    • Biomolecules & Therapeutics
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    • v.31 no.5
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    • pp.484-495
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    • 2023
  • Idiopathic pulmonary fibrosis (IPF) can be defined as a progressive chronic pulmonary disease showing scarring in the lung parenchyma, thereby resulting in increase in mortality and decrease in the quality of life. The pathophysiologic mechanism of fibrosis in IPF is still unclear. Repetitive microinjuries to alveolar epithelium with genetical predisposition and an abnormal restorative reaction accompanied by excessive deposition of collagens are involved in the pathogenesis. Although the two FDA-approved drugs, pirfenidone and nintedanib, are under use for retarding the decline in lung function of patients suffered from IPF, they are not able to improve the survival rate or quality of life. Therefore, a novel therapeutic agent acting on the major steps of the pathogenesis of disease and/or, at least, managing the clinical symptoms of IPF should be developed for the effective regulation of this incurable disease. In the present review, we tried to find a potential of managing the clinical symptoms of IPF by natural products derived from medicinal plants used for controlling the pulmonary inflammatory diseases in traditional Asian medicine. A multitude of natural products have been reported to exert an antifibrotic effect in vitro and in vivo through acting on the epithelial-mesenchymal transition pathway, transforming growth factor (TGF)- β-induced intracellular signaling, and the deposition of extracellular matrix. However, clinical antifibrotic efficacy of these natural products on IPF have not been elucidated yet. Thus, those effects should be proven by further examinations including the randomized clinical trials, in order to develop the ideal and optimal candidate for the therapeutics of IPF.

Penetrating chest trauma from a "less lethal" bean bag in the United States: a case report

  • Gloria Sanin;Gabriel Cambronero;Megan E. Lundy;William T. Terzian;Martin D. Avery;Samuel P. Carmichael II;Maggie Bosley
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.421-424
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    • 2023
  • This case report presents the case of a 49-year-old man who presented to our level I trauma center after sustaining injuries in an altercation with local law enforcement in which he was shot with a less lethal bean bag and tased. In a primary survey, a penetrating left supraclavicular wound was noted in addition to a taser dart lodged in his flank. No other traumatic findings were noted in a secondary survey. Given hemodynamic stability, completion imaging was obtained, revealing a foreign body in the left lung, a left open clavicle fracture, a C5 tubercle fracture, a possible grade I left vertebral injury, and a left first rib fracture. Soft tissue gas was seen around the left subclavian and axillary arteries, although no definitive arterial injury was identified. The bean bag projectile was embedded in the parenchyma of the left lung on cross-sectional imaging. The patient underwent thoracotomy for removal of the projectile and hemostasis. A thoracotomy was chosen as the operative approach due to concerns about significant bleeding upon foreign body removal. A chest tube was placed and subsequently removed on postoperative day 5. The patient was discharged on postoperative day 7. At a 2-week outpatient follow-up visit, the patient was doing well. This case report is the first to describe this outcome for a drag-stabilized bean bag. Although law enforcement officers utilize bean bag projectiles as a "less lethal" means of crowd control and protection, these ballistics pose significant risk and can result in serious injury.

Diagnosis of Hypersensitivity Pneumonitis: 2020 Clinical Practice Guideline (2020년 개정 진료 치침에 따른 과민성폐렴의 진단)

  • Soojung Park;Yu-Whan Oh;Eun-Young Kang;Hwan Seok Yong;Cherry Kim;Ki Yeol Lee;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.817-825
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    • 2021
  • Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

One Case of Video-Assisted Thoracoscopic Removal of Acupuncture Needle in Lung Parenchyma (폐실질 내 침술 침의 비디오 흉강경 제거 1예)

  • Jeong, Yeong-Gyu;Lee, Ho-Sung;Choi, Jae-Sung;Na, Joo-Ock;Seo, Ki-Hyun;Kim, Yong-Hoon;Lee, Seung-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.450-453
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    • 2011
  • We report the case of a 32-year-old woman presenting with intermittent chest pain resulted from a migratory acupuncture needle. The patient received acupuncture treatment approximately 3 years prior to this presentation, for the treatment of chronic left shoulder and lumbar pain after delivery. Chest radiography revealed a retained needle in the lingular segmental area. Video-assisted thoracoscopy was then used to remove the migratory acupuncture needle attached between the lingular segmental lobe and the pericardial fat. The patient recovered without complications and was discharged home.

A Case of Lymphangioleiomyomatosis with Pregnancy (임신으로 악화된 폐의 임파관평활근종증 l예)

  • Kim, Seong-Ook;Kim, Min-Gu;Won, Yong-Hwan;Kim, Ho-Cheol;Hwang, Young-Sil;Kim, Jong-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.375-380
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    • 1995
  • The lymphangioleiomyomatosis(LAM) is a rare disorder, which afflicts mainly young woman of childbearing age, characterized by proliferation of immature smooth muscle cell in the lymphatics. We experienced a case of LAM in 26-years-old pregnant woman, confirmed pathologically by inguinal lymph node biopsy. She has suffered from exertonal dyspnea and dry coughing. The symptoms and chest X-ray were aggravated with pregnancy, but improved after delivery with two times of pregnancy. The chest X-ray showed diffuse reticulonodular infiltration and chest HRCT showed diffuse scattered tiny thin-walled cyst of lung parenchyma. We noted chylous ascites of which triglyceride level is 396 mg/dl. After delivery, the symptoms were getting better. We treated with medroxyprogesterone and planned close observation and follow-up.

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A Case of Pulmonary Carcinosarcoma Associated with Alternate Atelectasis (상엽과 하엽에 번갈아 무기폐를 일으킨 폐암육종 1예)

  • Choi, Yo-An;Kim, Kun-Hyung;Cheon, Seog-Bae;Kang, Sang-Gu;Rheu, Hyung-Seon;Lee, Yong-Mi;Lee, Ji-Shin;Kim, Ji-Woon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.413-418
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    • 1995
  • Carcinosarcoma is an uncommon pulmonary malignancy characterized by carcinomatous parenchyma and sarcomatous stroma. Pulmonary carcinosarcoma represented about 1% of the resected lung tumors. The predominant clinical features are productive cough, chest pain, dyspnea, hemoptysis, bronchiectasis, and atelectasis, but alternate atelectasis is rare. We report a case of pulmonary carcinosarcoma associated with alternate atelectasis of the right upper and lower lobe.

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A literature study of pediatric pneumonia in traditional chinese medicine (소아폐렴(小兒肺炎)의 한의학적(韓醫學的) 연구(硏究)에 대한 고찰(考察) -중의학(中醫學) 문헌(文獻)을 중심(中心)으로-)

  • Kim, Jang-Hyun;Kwon, Hyuk-Ran
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.1
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    • pp.99-115
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    • 2003
  • Pneumonia is an acute or recurrent infection of the parenchyma of the lung causing cough, fever, and respiratory distress. Pneumonia was named 'Feiyanchuansou(肺炎喘嗽)' in chinese medicine. This study was progressed for oriental medical treatment for pediatric pneumonia in china. The purpose of this study is current oriental medical approach to pediatric pneumonia In this study, the authors tried to figure out the cause of the pediatric pneumonia and its treatment and came to the conclusion as follows: 1. The study for pediatric pneumonia consists of basic, clinical and experimental study. 2. Basic study consists of etiology and pathogenesis(病因病耭), the rule of treatment(治療原則) and method of treatment(治法). 3. Clinical study consists of symptoms-based treatment(辨證論治), adequate prescription treatment(專病專方), acupuncture(鍼灸治療), and western diagnosis based treatment. 4. The majority of experimental study was pharmacology that consists of antiviral and antibacterial effect, removing heat(淸熱), releasing pulmonary qi(宣肺), dissipating phlegm(化痰).

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A Case of Pulmonary Cryptococcosis in an Immunocompetent Male Patient Diagnosed by a Percutaneous Supraclavicular Lymph Node Biopsy

  • Sung, Ji Hee;Kim, Do Hoon;Oh, Mi-Jung;Lee, Kyoung Ju;Bae, Young A;Kwon, Kye Won;Lee, Seung Min;Kang, Ho Joon;Choi, Jinyoung
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.276-280
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    • 2015
  • Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.