• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.257-260
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• 2011

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

• 대한의생명과학회지
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• 제27권3호
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• pp.111-120
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• 2021

Asbestos products had been widely used until 2007 in Korea since the 1930s. A total ban on their production and applications has been imposed because of the toxic effect of asbestos fibers on the human health. The inhaled asbestos fibers increase reactive oxygen species and inflammatory reactions in the respiratory airway including the alveolar sac, resulting in DNA damages and secretion of several inflammatory cytokines or chemokines. These paracrine communications promote the proliferation of fibroblasts and the synthesis of collagen fibers, thereby depositing them into the extracellular matrix at the interstitial space of alveoli. The fibrotic tissue hindered the gas exchange in the alveolus. This reviews describes not only the cytotoxic effects of asbestos fibers with different physical or chemical characteristics but also the interaction of cells that make up the respiratory airway to understand the molecular or cellular mechanisms of asbestos fiber-induced toxicity. In addition, we propose a pulmonary toxicity research technique based on the mini-lung that can mimic human respiratory system as an alternative to overcome the limitations of the conventional risk assessment of asbestos fibers.

• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.226-230
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• 2010

Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/ day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.

• 수면정신생리
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• 제24권1호
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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.

• Tuberculosis and Respiratory Diseases
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• 제44권5호
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• pp.1140-1145
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• 1997

저자들은 2년전 궤양성 대장염으로 진단 받고 Sulfasalazine, Mesalamine등을 투약 해 오던 중 호흡곤란을 주소로 내원한 환자에서 임상양상및 방사선학적 소견, 경기관지 폐조직 생검소견등을 실시하여 궤양성 대장염으로 진단하고 스테로이드 제재등을 정하였으나 호흡부전으로 사망한 증례를 경험 하였기에 이를 문헌고찰과 함께 보고 하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제43권2호
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• pp.164-172
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• 1996

연구배경 : TGF-$\beta$는 25kD의 단백으로써, 폐섬유증의 병인에 있어 TGF-$\beta$의 발현과 밀접한 관계가 있다고 보고되고 있다. TGF-$\beta$는 세포외 분자들의 합성 및 생산을 촉진할 뿐만아니라 세포간질의 붕괴를 감소시킨다. 특발성 폐섬유증을 포함한 다른원인에 의한 간질성 폐질환의 폐섬유증에 있어 TGF-$\beta$의 발현양상은 상향조절된다고 알려져 있다. 연구방법 : 본연구는 특발성 폐섬유증과, bleomycin, 유육종증, 및 폐의 호산구성 육아종에 의한 간질성 폐질환에 있어서 TGF-$\beta$의 발현 양상를 연구하고자 개흉 폐생검으로 채취된 특발성 간질성 폐섬유증 3예의 6절편과 폐절제시 채취한 5예의 정상조직을 연구재료로 하였고 bleomycin, 유육종증 및 폐의 호산구성 육아종에 의한 간질성 폐질환환자 각각 3예로부터 얻은 6절편에서 TGF-$\beta$의 단세포군항체를 이용하여 면역조직화학적 검색을 실시하였다 결과 : TGF-$\beta$은 5예의 정상조직의 기관지 상피세포나 폐포세포에서는 약하거나 중등도로 발현되었다. 3예의 특발성 폐섬유증 6절편 중 5절편에서 폐포벽의 간질성 섬유모세포들에서 발현되었고, 1절편에서는 증식된 폐포내 폐포세포에서 발현되었으며 그 정도는 비균질적인 양상을 보였다. 3예의 6절편 중 5절편에서 강한발현을 1절편에서는 중등도의 발현을 나타냈으며 bleomycin이 원인이 되는 간질성 폐질환 6절편중 2절편에서는 중등도의 발현을 4절편에서는 강한발현을 보였고, 유육종증이 원인이 되는 간질성 폐질환 6절편 중 3절편에서 중등도의 발현을, 3절편에서 강한 발현을 보였다. 폐의 호산구성 육이종이 원인이 되는 간질성 폐질환 6절편중 2절편에서 중등도의 발현을, 4절편에서 강한 발현을 보였다. 결론 : TGF-$\beta$의 발현 증가는 특발성 폐섬유증, bleomycin, 유육종증 및 폐의 호산구성 육아종에 의한 간질성 폐질환에 있어서 폐섬유증의 병인과 상당한 관련이 있음을 암시해 주는 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제63권1호
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• pp.83-87
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• 2007

원발폐암과 특발성폐섬유화증(idiopathic pulmonary fibrosis)이 병발하는 경우는 비교적 흔하여, 폐암의 발생률이 일반 인구보다 특발성폐섬유화증 환자에서 더 높다고 알려져 있으나, 비특이적간질성폐렴(non-specific interstitial pneumonia)이 원발폐암과 병발한 경우는 매우 드물다. 이에 저자 등은 최근에 우연히 발견된 원발폐암과 병발한 비특이적간질성폐렴 환자에서 원발폐암의 치료 후에 비특이적간질성폐렴이 저절로 호전된 예를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제51권1호
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• pp.59-64
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• 2001

급속히 악화되는 임상 경과를 보인 비특이성 간질성폐렴을 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제87권2호
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• pp.185-193
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• 2024

Background: The mechanisms leading to lung fibrosis are still under investigation. This study aimed to demonstrate whether antacids could prevent the development of interstitial lung disease (ILD). Methods: This population-based longitudinal cohort study was conducted between January 2006 and December 2010 in South Korea. Eligible subjects were ≥40 years of age, exposed to proton pump inhibitors (PPI)±histamine-2 receptor antagonists (H-2 blockers) or H-2 blockers only, and had no history of ILD between 2004 and 2005. Exposure to antacids was defined as the administration of either PPI or H-2 receptor antagonists for >14 days, whereas underexposure was defined as antacid treatment administered for less than 14 days. Newly developed ILDs, including idiopathic pulmonary fibrosis (IPF), were counted during the 5-year observation period. The association between antacid exposure and ILD development was evaluated using adjusted Cox regression models with variables, such as age, sex, smoking history, and comorbidities. Results: The incidence rates of ILD with/without antacid use were 43.2 and 33.8/100,000 person-years, respectively and those of IPF were 14.9 and 22.9/100,000 person-years, respectively. In multivariable analysis, exposure to antacid before the diagnosis of ILD was independently associated with a reduced development of ILD (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.45 to 0.71; p<0.001), while antacid exposure was not associated with development of IPF (HR, 0.88; 95% CI, 0.72 to 1.09; p=0.06). Conclusion: Antacid exposure may be independently associated with a decreased risk of ILD development.

• Journal of Yeungnam Medical Science
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• 제36권1호
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• pp.8-15
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• 2019

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.