• Korean Journal of Radiology
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• 제22권5호
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• pp.811-828
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• 2021

Following the introduction of a novel pathological concept of usual interstitial pneumonia (UIP) by Liebow and Carrington in 1969, diffuse interstitial pneumonia has evolved into UIP, nonspecific interstitial pneumonia (NSIP), and interstitial lung abnormality (ILA); the histopathological and CT findings of these conditions reflect the required multidisciplinary team approach, involving pulmonologists, radiologists, and pathologists, for their diagnosis and management. Concomitantly, traction bronchiectasis and bronchiolectasis have been recognized as the most persistent and important indices of the severity and prognosis of fibrotic lung diseases. The traction bronchiectasis index (TBI) can stratify the prognoses of patients with ILAs. In this review, the evolutionary concepts of UIP, NSIP, and ILAs are summarized in tables and figures, with a demonstration of the correlation between CT findings and pathologic evaluation. The CT-based UIP score is being proposed to facilitate a better understanding of the spectrum of pulmonary fibrosis, from ILAs to UIP, with emphasis on traction bronchiectasis/bronchiolectasis.

• Tuberculosis and Respiratory Diseases
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• 제46권4호
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• pp.489-499
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• 1999

연구배경: 기관지확장증은 폐쇄성환기장애와 더불어 반복적인 폐감염으로 인한 주위 폐실질의 섬유화 및 흉막유착 등으로 인하여 경한 제한상 환기장애가 동반될 수 있다. 그리고 주위 폐실질의 과팽창이나 폐기종성변화도 관찰되어 이로 인한 폐용량 및 폐확산능의 변화가 예상된다. 방 법: 저자들은 1994년 1월부터 1996년 12월까지 경북대학교병원 호흡기내과에서 고해상전산화단층촬영으로 기관지확장증으로 진단된 40예를 대상으로 기관지확장증의 형태, 중증도, 범위 및 동반된 폐기종유무와 폐기량, 폐확산능의 관계를 후향적으로 조사하여 다음과 같은 결과를 얻었다. 결 과: 남자가 18예, 여자가 22예였으며 연령은 평균 53세였다. 고해상전산화단층촬영소견상 원통형이 24예, 낭종형이 16예였으며, 기관지확장증이 있는 평균 폐 구역수는 원통형과 낭종형에서 각각 4.7개 및 7.0개로 낭종형에서 유의하게 많았다 (p<0.05). 확장증의 형태 및 중증도에 따른 VC는 낭종형에서 그리고 기관지확장증의 중증도가 심할수록 감소하는 경향이 있었고 RV, TLC, RV/TLC는 유의한 차이가 없었다. LCI는 원통형에 비해 낭종형에서 유의하게 증가하였으며(p<0.05), 기관지확장증의 중증도에 따를 차이는 없었다. $\triangle$N2/L은 확장증의 형태 및 중증도에 따른 차이가 없었으며 개인차가 심하였다. $D_{LCO}$ 및 $D_{LCO}/V_A$는 원통형에 비해 낭종형에서 유의하게 감소하였으며(각각 p<0.1, p<0.05), 확장증의 중증도에 따라서 뚜렷히 감소하였다 (p<0.05). 기관지확장증의 범위와 폐기능성적들과의 상관계수는 VC, $D_{LCO}$ 및 LCI가 각각 -0.322, -0.339, 0.487로 유의한 관계가 있었으나 RV, TLC, RV/TLC, $\triangle$N2/L와 $D_{LCO}/V_A$는 유의한 관계가 없었다. 고해상전산화단층촬영상의 폐기종의 범위와 폐기능성적들과의 상관계수는 VC 및 $D_{LCO}$는 각각 -0.574, -0.381로 유의한 관계가 있었으며 RV, RV/TLC, LCI와 $\triangle$N2/L도 각각 0.435, 0.552, 0.333과 0.427로 유의한 관계가 있었다. 결 론: 이상의 결과로 낭종형과 기관지확장증의 중증도에 따른 폐활량 및 폐확산능의 감소와 흡기의 폐내분포는 기관지확장증의 범위 및 동반된 폐기종의 범위와 관계가 있고, 잔기량은 동반된 폐기종과 관련이 있음을 알 수 있었다.

• Journal of Chest Surgery
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• 제17권3호
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• pp.456-464
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• 1984

Since the advent of potent chemotherapy, the incidence and severity of bronchiectasis have been on the decrease. Up to date, however, the medical treatment of bronchiectasis has not given us much satisfaction. Our purpose here is to show our experiences with pulmonary resections of bronchiectasis to clarify its surgical results and define its surgical indications. Sixty-five patients with bronchiectasis, treated surgically from January 1973 to December, 1982 at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, were given clinical assessment. Of the 65 patients involved in the series, 49 were male and 16, female. The patients ranged from 8 to 51 in ages, with 59 cases [91%] between 10 and 39 years old. The prominent clinical features were as follows: cough [88%], sputum production [78%], recurrent upper respiratory infection [51%], and frequent hemoptysis [32%]. The past history of the patients included measles 29%, whooping cough 14%, pulmonary tuberculosis 12%, and pneumonia or bronchitis 12%. The cylindrical type of the bronchiectasis was found to be most common, accounting for 43% of the cases. The operations were performed on the left lung in 52 cases and the right lung in 13 cases. The most common operative procedure was the left lower lobectomy and lingular segmentectomy, which showed 34%. The second most frequent procedure was the simple left lower lobectomy which was 22%. Incomplete resections of the multisegmental bronchiectasis were carried out in 12 cases, of which 7 cases were satisfactory Four patients underwent bilateral pulmonary resections for the severe multisegmental bilateral bronchiectases, during the first and second operations. Improvement in pulmonary symptoms was generally obtained in all four cases. The follow-up ranged from 1 week to 7 tears, with an average of 18.8 months. The overall results revealed that 87% of these and excellent or good conditions, but 13% had persistent symptoms. There was one operative death, which is a 1.5% mortality.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.67-73
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• 2022

Background: Bronchiectasis patients with neutrophilic airway inflammation develop symptoms of chronic cough, sputum production, and recurrent exacerbations. Roflumilast has anti-inflammatory actions via decreased neutrophilic airway inflammation. The effectiveness of roflumilast to reduce bronchiectasis exacerbation has never been evaluated. Methods: We conducted a double-blinded, randomized, placebo-controlled trial. Our primary objective was to assess the effect of roflumilast compared with that of a placebo in reducing exacerbation rates in bronchiectasis patients. The secondary objectives were the changes in forced expiratory volume in 1 second (FEV₁) and St. George's Respiratory Questionnaire (SGRQ). Bronchiectasis patients older than 18 years who had had two exacerbations during the previous 12 months were randomly assigned to receive either 500 ㎍ of either roflumilast or a placebo once daily for 6 months in a 1:1 ratio. Results: Forty bronchiectasis patients who had experienced exacerbations were screened. Thirty patients completed the study after 6 months of treatment: roflumilast group (n=15) and placebo group (n=15). The rates of exacerbations were 0.57 and 0.59 per patient in the roflumilast and placebo groups, respectively. Prebronchodilator FEV₁ increased by 0.07 L from baseline in the roflumilast group and decreased by 0.015 L in the placebo group, but the difference was not significant. No significant differences were observed in the change of SGRQ scores between the roflumilast and placebo groups. Roflumilast had significant side effects, including loss of appetite and headache. Conclusion: Roflumilast did not significantly affect the rate of exacerbations or quality of life. However, FEV₁ tended to improve more in the roflumilast group than in the placebo group.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.548-557
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• 1993

연구배경 : 기관지 확장증은 비가역적 병변으로 만성적이고 반복적인 폐기관지의 감염으로 인하여 많은 예에서 만성기관지염, 폐기종 및 기관지천식등이 동반되는 경우가 많다. 따라서 이들에서의 폐기능도 동반되는 질환이나 침범범위등에 따라서 다양하리라 생각이 되어 기관지 확장증의 병리해부학적 형태의 차이, 그리고 호흡곤란의 정도에 따른 폐기능의 차이를 조사하였다. 방법 : 1985년 1월부터 1991년 12월까지 경북대학병원에서 기관지 조영술사진에 의해 기관지확장증으로 확진된 93예를 대상으로 폐활량, 최대환기량, 노력성호기곡선 및 기류-용량 곡선에서 계측할 수 있는 각종지표와 closing volume을 구하여 기관지조영술상의 낭종형, 원통형 및 혼합형 등의 기관지확장증의 형태 및 Hugh-Jones의 호흡곤란의 정도에 따른 성적을 비교검토 하였다. 결과: 1) 이환된 폐구역수의 평균은 원통형(tubular), 낭종형(saccular) 및 혼합형(mixed) 에서 각각 4.7, 6.9, 7.8개였고 폐활량 및 노력성 호기곡선의 모든 계측치와 PEF를 제외한 호기류속도를 반영하는 계측치는 낭종형 및 혼합형에서 저명하게 감소하였다. 2) MVV는 낭종형 및 혼합형에서 감소하는 경향이었으며 CV/VC는 낭종형 및 혼합형에서 증가하는 경향이었다. 3) 호흡곤란의 정도가 심할수록 이환된 폐구역수는 유의하게 증가되었으며 폐환기능은 이와 비례하여 저하하였다. 결론 : 이상의 결과로 기관지확장증에서의 환기기능은 제한성환기 장애와 폐쇄성환기 장애가 동반되어 있으며 이는 호흡곤란의 정도가 심할수록, 낭종형 및 혼합형일수록 뚜렷하였다.

• Journal of Chest Surgery
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• 제28권11호
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• pp.1007-1013
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• 1995

We managed 80 patients of bronchiectasis from Jan.1983 to Dec.1992 admitted to the department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital. We evaluated clinically these patients and summarized as follows. Alpha-hemolytic streptococcus was the most commonly found bacterial strain in microbial study. For the conservative treatment, first generation cefalosporins, aminoglycosides and ampicillin were used as antibiotic therapy in this order of frequency. The preoperative final diagnosis was made by bronchography and HRCT. In the image study saccular type bronchiectasis was 47.1%, cylindrical 27.5%, mixed 17.6% and varicose 7.8%. Anatomically left side involvement was more frequent than the right as 61.2% to 38.8% and the most commonly invading lobar area was left lower. Reversibility after conservative treatment for all the types of bronchiectasis was 66%. Surgical treatment were done in 50 cases, among these left lower lobectomy was 38.0%, left lower lobectomy with ligular segmentectomy 22.0%, right middle and lower bilobectomy 16.0%, right lower lobectomy 10.0%, left pneumonectomy 10.0%, right pneumonectomy 4.0%. In 10 cases, there remained some lesion in the other sites of lung parenchyme after first attempt surgical resection because the distribution of lesion is too broad to resect out in single thoracotomy hoping improvement by medical management.

• Clinical and Experimental Pediatrics
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• 제53권7호
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• pp.770-773
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• 2010

A 13-year-old girl was diagnosed with non-cystic fibrosis (CF)-related multifocal bronchiectasis accompanied by nephrotic-range proteinuria of unknown cause. On renal biopsy, there were many segmental homogeneous deposits of amyloid tissue with positive Congo red staining in the glomeruli and interstitium. On electron microscopy, relatively straight, non-branching, randomly arranged amyloid fibrils were showed in the mesangium of the glomeruli. These fibrils were approximately 10 nm in diameter, compatible with secondary amyloidosis. Her level of serum amyloid A was remarkably elevated. To our knowledge, this girl is the first case of secondary renal amyloidosis induced by bronchiectasis in Korean children.

• Journal of Chest Surgery
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• 제26권4호
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• pp.294-297
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• 1993

This study based on the clinical analysis of 42 cases of bronchiectasis treated by surgical resection at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital, during 6 years period from 1986 to 1991. The 42 patients with bronchiectasis were composed of 33 males and 9 females, and the peak incidence of age was in the 3rd decade. The clinical symptoms were cough, purulent sputum, hemoptysis and dyspnea. Based on the morphological classification by bronchograpgy, the common type was present in 19 cases[45%] of cylindrical type. The frequently involved site was left lower lobe, and so left lower lobectomy was the most frequently performed method of surgical resection. Postoperative complications were occurred in 8 cases[18%], such as wound infection, atelectasis, pleural effusion, hemothorax, but there were no fatal cases.

• 대한한방내과학회지
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• 제45권2호
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• pp.287-302
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• 2024

Background: Bronchiectasis is a chronic respiratory condition leading to recurrent respiratory infections. Despite the use of antibiotics and other standard treatments, managing bronchiectasis remains challenging due to the frequent recurrence of airway infections and concerns about antimicrobial resistance. Given these challenges, traditional Korean medicine (TKM) has gained attention due to its potential to reduce the frequency of respiratory infections, possibly minimizing the need for antibiotics. Case report: A 59-year-old female with bronchiectasis experienced recurrent pneumonia and was treated with antibiotics for over 2 weeks without any significant improvement in clinical symptoms. She received comprehensive Korean medicine treatment, including herbal medicine (Sikyungbanha-tang combined with Bigwabojungikki-tang-gami), acupuncture, and Chuna manual therapy, for pulmonary rehabilitation. Post-treatment, clinically meaningful improvements were observed in symptoms, serum C-reactive protein (CRP) levels, and bronchopneumonic lesions on chest X-rays. Conclusion: This case suggests that complex traditional Korean medicine treatments for recurrent chronic airway inflammation due to bronchiectasis can lead to clinically significant improvements in symptoms and help to prevent recurrence.

• Tuberculosis and Respiratory Diseases
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• 제72권6호
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• pp.467-474
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• 2012

Background: The objective of this study was to assess the validity and reliability of the Korean version of chronic obstructive pulmonary disease assessment test (CAT) and Dyspnea-12 Questionnaire for patients with bronchiectasis or tuberculous destroyed lung. Methods: For 62 bronchiectasis patients and 37 tuberculous destroyed lung patients, 3 questionnaires including St. George's Respiratory Questionnaires (SGRQ), CAT, and Dyspnea-12 were obtained, in addition to spirometric measurements. To assess the validity of CAT and Dyspnea-12, correlation with SGRQ was evaluated. To assess the reliability of CAT and Dyspnea-12, Cronbach's ${\alpha}$ coefficient was calculated. Results: The mean ages of the patients were $60.7{\pm}8.3$ years in bronchiectasis and $64.4{\pm}9.3$ years in tuberculous destroyed lung. 46.8% and 54.1% were male, respectively. The SGRQ score was correlated with the score of the Korean version of CAT (r=0.72, p<0.0001) and Dyspnea-12 (r=0.67, p<0.0001) in bronchiectasis patients. The SGRQ score was correlated with the score of CAT (r=0.86, p<0.0001) and Dyspnea-12 (r=0.80, p<0.0001) in tuberculous destroyed lung patients. The Cronbach's ${\alpha}$ coefficient for the CAT and Dyspnea-12 were 0.84 and 0.90 in bronchiectasis, and 0.88 and 0.94 in tuberculous destroyed lung, respectively. Conclusion: We found that Korean version of CAT and Dyspnea-12 are valid and reliable in patients with tuberculous destroyed lung and bronchiectasis.