• Title/Summary/Keyword: diffuse the lung

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 3. Idiopathic Nonspecific Interstitial Pneumonia

  • Lee, Jongmin;Kim, Yong Hyun;Kang, Ji Young;Jegal, Yangjin;Park, So Young;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.277-284
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    • 2019
  • Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.

Inhibition of Phospholipase $A_2$ Diminishes the Acute Alveolar Injury Induced by $Interleukin-1{\alpha}$

  • Lee, Young-Man
    • The Korean Journal of Physiology and Pharmacology
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    • v.1 no.1
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    • pp.71-78
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    • 1997
  • In an attempt to investigate the role of phospholipase $A_2$($PLA_2$) in interleukin-l (IL-l) induced acute lung injury, mepacrine was tried to inhibit $PLA_2$ in IL-l induced ARDS rats. For confirmation of acute lung injury by IL-l, and to know the role of neutrophils in this injury, lung leak index, lung myeloperoxidase(MPO), number of neutrophils and protein content in the bronchoalveolar lavage (BAL) and wet lung weight were measured. At the same time lung $PLA_2$ was measured to know the effect of IL-l on $PLA_2$ activity. Pulmonary surfactant was also measured for an investigation of type II alveolar cell function. Neutrophil adhesion assay was performed to know the effect of $PLA_2$ inhibition in vitro with human umbilical vein endothelial cells (HUVEC). For precise location of injury by IL-l, morpholgical study was performed by electron microscopy. Five hours after instillation of IL-l (50 ng/rat), lung leak index, protein content, number of neutrophils, lung MPO and wet lung weight were increased significantly. Five hours after IL-l instillation lung $PLA_2$ activity was increased significantly, and increased surfactant release was observed in IL-l induced ARDS rats' BAL. In contrast, in rats given mepacrine and IL-l, there was decrease of acute lung injury i.e. decrease of lung leak index, wet lung weight, protein content, number of neutrophils in BAL and decreased lung MPO activity. Mepacrine decreased surfactant release also. Interestingly, inhibition of $PLA_2$ decreased adhesion of human neutrophils to HUVEC in vitro. Morphologically, IL-l caused diffuse necrosis of endothelial cells, type I and II epithelial cells and increased the infiltration of neutrophils in the interstitium of the lung but after mepacrine treatment these pathological findings were lessened. On the basis of these experimental results it is suggested that $PLA_2$ has a major role in the pathogenesis of acute lung injury mediated by neutrophil dependent manner in IL-l induced acute lung injury.

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Humidifier Disinfectant-Associated Lung Injury: Six Years after the Tragic Event

  • Kim, Won-Young;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.351-357
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    • 2017
  • In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.

Two Cases of Microscopic Polyangiitis with Honeycomb Lung (봉소상 폐(Honeycomb Lung) 소견을 보인 현미경적 다발성 혈관염 2예)

  • Hahn, Hye-Sook;Hwang, Jun-Kyu;Jung, Hyuk-Sang;Song, Suk-Ho;Joo, Kwon-Wook;Park, Gye-Young;Lee, Jong-Ho;Oh, Young-Ha;Lee, Hyoun-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.550-556
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    • 2002
  • Microscopic polyangiitis is a systemic small-vessel vasculitis that is associated primarily with necrotizing glomerulonephritis and pulmonary capillaritis. A recurrent and diffuse alveolar hemorrhage due to pulmonary capillaritis is the main clinical manifestation of lung involvement. Recently, and interstitial lung disease that mimics idiopathic pulmonary fibrosis was reported to be rarely associated with microscopic polyangiitis. Here we report two patients with microscopic polyangiitis who showed a honeycomb lung at the time of the initial diagnosis with a brief review of relevant literature.

A Case of Tuberous Sclerosis with Pulmonary Involvement (폐를 침범한 결절성 경화증 1예)

  • Ahn, Jong-Ho;Suh, Gee-Young;Kim, Young-Whan;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.433-437
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    • 1992
  • Tuberous sclerosis is a syndrome characterized by the facial skin lesion, epilepsy, and mental retardation. Pulmonary involvement is uncommon, but when the lung is involved by tuberous sclerosis it shows characteristic reticulonodular infiltration and cystic changes. We experienced a 34-year-old female patient of known tuberous sclerosis admitted due to pneumothorax. Chest PA showed diffuse fine reticulonodular infiltration and chest CT revealed diffuse cystic changes of the lung. Pleurodesis with tetracycline was done to prevent recurrence, but chylothorax occurred four months after the treatment. Pleurosis was tried again and anti estrogen treatment began.

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Diffuse Pulmonary Nodular Lesions Persisting for 5 Years (5년간 지속된 미만성 폐결절)

  • Kim, Kyung-Kyu;Kim, Byung-Kyu;Jeong, Ki-Hwan;Jeong, Hye-Cheol;Kim, Je-Hyeong;Park, Sang-Myen;Lee, Sin-Hyung;Shin, Chol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa;Oh, Yu-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.802-807
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    • 2000
  • Diffuse pulmonary nodular lesions have many causes. When they are caused by infection, the likely organisms are M. tuberculosis and various fungi. Silicosis, eosinophilic granuloma and pulmonary metastasis should be considered for differential diagnosis. Differential diagnosis needs detailed clinical history, physical examination and various laboratory tests. A case of persistent diffuse pulmonary nodular lesions which had persisted 5 years is reported. The patient was a 25 years old man with minimal pulmonary symptoms. Detailed past history and physical examination suggested thyroid tumor. Chest radiography showed numerous evenly sized well-defined nodules scattered in entire lung fields. Previous chest X-rays showed similar nodular lesions, which had lasted for 5 years. The number of nodules was slightly increased. Neck CT showed heterogenous mass in left lobe of thyroid gland and multiple lymphadenopathies along both internal jugular chains. Total thyroidectomy was performed. A case of lung metastasis which progressed slowly in papillary thyroid cancer is reported.

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Radioaerosol Scan Manifestations of Diffuse Panbronchiolitis (미만성 세기관지염의 연무흡입 폐환기스캔 소견)

  • Kim, Hak-Hee;Choi, Byung-Gil;Bahk, Yong-Whee;Chung, Soo-Kyo;Park, Seog-Hee;Shin, Kyung-Sub;Park, Sung-Hak
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.192-199
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    • 1994
  • Diffuse pahbronchiolitis(DPB) is a relatively new, chronic, nonspecific, inflammatory disease of the lung that typically involves the airways in the "transitional" zone of the lung. Clinically, DPB strongly resembles chronic obstructive pulmonary disease (COPD) and the distinction between the two is crucial because the former is often fatal, requiring different therapeutic strategies. This study was prospectively carried out to assess diagnostic usefulness of radioaerosol scan(RAS) in DPB. RAS findings were analyzed with respect to the location and extent of abnormal aerosol deposition in the lung divided into the central, intermediary, and transitional airways and the peripheral airspaces. RAS showed mottled aerosol deposits characteristically in the transitional and intermediary airways with peripheral airspace defects. Such a deposition pattern contrasted sharply with central aerosol deposition of COPD. In conclusion, RAS appears to be a convenient, noninvasive, and useful diagnostic method of DPB.

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Lymphoproliferative Disorders in Multiple Primary Cancers

  • Demirci, Umut;Ozdemir, Nuriye;Benekli, Mustafa;Babacan, Nalan Akgul;Cetin, Bulent;Baykara, Meltem;Coskun, Ugur;Zengin, Nurullah;Buyukberber, Suleyman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.383-386
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    • 2012
  • Background: Cancer survivors are at increased risk of second cancers. Lymphoproliferative disorders (LPD) are common neoplasms that are primary or subsequent cancers in cases of multiple primary cancer. We here analyzed metachronous or synchronous LPD in multiple primary cancers. Methods: Between 2001 and 2010, LPD were assessed retrospectively in 242 multiple primary cancers patients. Results: Forty nine (20.2%) patients with LPD were detected. Six patients had two LPD where one patient had three LPD. The median age of patients was 60.5 years (range: 28-81). LPD were diagnosed in 29 patients as primary cancer, in 23 patients as second cancer, and in three patients as third cancer in multiple primary cancers. Primary tumor median age was 56 (range: 20-79). Diffuse large B cell lymphoma (n=16), breast cancer (n=9), and lung cancer (n=6) were detected as subsequent cancers. Alklylating agents were used in 19 patients (43.2%) and 20 patients (45.5%) had received radiotherapy for primary cancer treatment. The median follow-up was 70 months (range: 7-284). Second malignancies were detected after a median of 51 months (range: 7-278), and third malignancies with a median of 18 months (range: 6-72). Conclusions: In this study, although breast and lung cancer were the most frequent detected solid cancers in LPD survivors, diffuse large B cell lymphoma was the most frequent detected LPD in multiple primary cancers.

Plasma and Urine Endothelin Concentrations in Patients with Diffuse Interstitial Lung Disease (미만성간질성폐질환 환자에서 혈장 및 요 중 Endothelin에 관한 연구)

  • Lee, Jong-Deog;Lee, Sang-Do;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.360-368
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    • 1998
  • Background: Endothelin(ET), a potent vasoconstrictor peptide produced by endothelial cells and degraded predominantly in the pulmonary vasculature, have been implicated in the development of various organ dysfunctions. Plasma concentrations of ET-1 are reported to be elevated in patients with diffuse interstitial lung disease(DILD). But, there is no study to establish the exact source and mechanisms involved in the increased plasma ET-1 concentrations in DILD patients. Methods: 12 patients with IPF, 2 patients with sarcoidosis, 2 patients with scleroderma, 1 patient with SLE and 11 healthy volunteers were studied. ET was detected by radioimmunoassay in plasma and bronchoalveolar lavage fluid(BALF) as well as in 24-hr urine specimens. For each subjects, arterial/venous(A/V) ET ratio and renal ET clearance were calculated. Results: Elevated plasma, urine and BALF ET concentrations were found in patients with DILD compared with controls. But, no significant difference was observed in ET A/V ratio and ET renal clearance between patients with DILD and controls. Conclusion: We observed that plasma ET concentrations were elevated in patients with DILD, and that the main site of ET production may be lung parenchyme.

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