• Tuberculosis and Respiratory Diseases
• /
• v.59 no.6
• /
• pp.591-599
• /
• 2005

Asthma is the most common disease of the lungs, and one that poses specific challenges for the physicians including radiologist. This article reviews for the clinical diagnosis, Radiologic features, and differential diagnosis of asthma, and outlines the radiologic features of the complications of asthma. Bronchial wall thickening and hyperinflation characterize the chest radiograph of the patients with asthma. On CT scan one may see airway wall thickening, thickened centrilobular structures, and focal or diffuse hyperlucency. Apparent bronchial dilatation may be seen, but the diagnosis of bronchiectasis should be made with caution. Quantification of changes in the airway wall and lung parenchyma may be valuable in understanding the mechanisms of asthma and in evaluating the effects of treatment. The challenge for the physician evaluating the images of a patient with asthma is to find complications.

• Journal of Biomedical Engineering Research
• /
• v.11 no.2
• /
• pp.203-208
• /
• 1990

A possible asymmetry in airway inertance was modeled based on previously reported radiographic visualization data of the airway wall fluctuation in intact dogs. Effects of asymmetric Inertance on mean lung volume during high frequency ventilation (HFV) were evaluated in terms of mean inertive pressure drop across the airways. It was found that a negligible inertlve pressure drop was expected ($<1{\;}cmH_20$) in normal subjects, while a sig- nificant rise in mean alveolar pressure compared to mean mouth pressure by approximately $3{\;}cmH_20$ was resulted for about 40% airway fluctuation representing bronchoconstriction state by Histamine induction. These results demonstrate that asymmetric Inertance could lead patients with airway diseases to a significant lung hyperinflation (LHI), and bronchodilation treatment is recommended prior to applying HFV to prevent those patients from a possible barotrauma.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.5
• /
• pp.1184-1193
• /
• 1997

Lymphangioleiomyomatosis(LAM) is rare and essentially limited to women in the reproductive ages. A 39-year-old female was admitted due to progressive exertional dyspnea and intermittent productive cough. Chest PA showed marked hyperinflation of the lung associated with a diffuse reticulo-nodular pattern. High resolution CT scan of the thorax demonstrated that diffusely scattered thin-walled cysts were distributed throughout the bilateral lung fields. Abdominal CT scan showed variable sized multiple angiomyolipoma of both kidney. By open lung biopsy, she was diagnosed as pulmonary LAM associated with Tuberous sclerosis and renal Angiomyolipoma. We present the case and discuss the connection between pulmonary LAM and Tuberous sclerosis.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.1
• /
• pp.5-13
• /
• 2005

Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease, characterized by irreversible airflow limitation, with a partially reversible component. The pathological abnormalities of COPD are associated with lung inflammation, imbalances of proteinase and antiproteinase, and oxidative stress, which are induced by noxious particles and gases in susceptible individuals. The physiological changes of COPD are mucus hypersecretion, ciliary dysfunction, airflow limitation, pulmonary hyperinflation, gas exchange abnormalities, pulmonary hypertension, cor pulmonale and systemic effects. The airflow limitation principally results from an increase in the resistance of the small conducting airways and a decrease in pulmonary elastic recoil due to emphysematous lung destruction. This article provides a general overview of the pathophysiology of COPD.

• Tuberculosis and Respiratory Diseases
• /
• v.81 no.1
• /
• pp.13-18
• /
• 2018

Bronchodilator therapy is central to the management of chronic obstructive pulmonary disease and are recommended as the preferred treatment by the Global Obstructive Lung Disease Initiative (GOLD). Long acting anti-muscarinics (LAMA) and long acting ${\beta}_2$ agonists (LABA) are both more effective than regular short-acting drugs but many patients remain symptomatic despite monotherapy with these drugs. Combination therapy with LAMA and LABA increases the therapeutic benefit while minimizing dose-dependent side effects of long-acting bronchodilator therapy. The TOviTO programme has investigated the benefits of treatment with a combination of tiotropium and olodaterol administered via a single inhaler. Tiotropium+olodaterol $5/5{\mu}g$ significantly improved forced expiratory volume in 1 second ($FEV_1$) area under the curve from 0 to 3 hours, trough $FEV_1$ health status and breathlessness versus the mono-components and placebo. Tiotropium+olodaterol $5/5{\mu}g$ also increased endurance time and reduced dynamic hyperinflation during constant work rate cycle ergometry. On the basis of these and other studies the 2017 GOLD report recommends escalating to dual bronchodilator therapy in patients in groups B and C if they remain symptomatic or continue to have exacerbations and as initial therapy for patients in group D.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.2
• /
• pp.451-456
• /
• 1998

Bronchial atresia is a rare congenital anomaly characterized by a bronchocele resulting from a mucus-filled, blindly-terminating segmental or lobal bronchus, and hyperinflation of the obstructed segment of lung. Characteristically, the patient is young and asymptomatic but has an abnormal chest roentgenogram. The only physical finding may be decreased breathing sounds over the affected parenchyma. We experienced a case of bronchial atresia with mucocele in adult So we report it with a review of the literature.

• Journal of Biomedical Engineering Research
• /
• v.14 no.1
• /
• pp.89-96
• /
• 1993

During high frequency ventilation (HFV), mean alveolar pressure has been measured to increase with mean airway opening pressure controlled at a constant level in both humans and experimental animals. Since this phenomenon could potentiate barotrauma limiting advantages of HFV, the present study theoretically predicted the difference between menu alveolar and airway opening pressures ($MP_{alv}$). In a Weibel's trumpet airway model, approximated formula for $MP_{alv}$ was derived based on momentum conservation assuming a uniform velocity profile. The prediction, equation was a func pion of gas density($\rho$), mean flow rate(Q), and diameter of the airway opening where the pressure measurement was made($D_0$) : $MP_{alv}=4{\rho}(Q/D_0^{2})^2$. This was a result of the difference in crosssectional area between the alveoli and the airway opening. A simple aireway model experiment was performed and the results well fitted to the prediction, which demonstrated the validity of the present analysis. Previously reported $MP_{alv}$ data from anesthetized dogs in supine position were comparable to the predicted values, indicating that the observed dissociation between mean alveolar and airway opening pressures during HFV can be explained by this innate geometric (or cross-sectional area) asymmetry of the airways. In lateral position, however, the prediction substantially underestimated the measurements suggesting involvement of other important physiological mechanisms.

• Child Health Nursing Research
• /
• v.5 no.2
• /
• pp.198-210
• /
• 1999

The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.

• Clinical and Experimental Pediatrics
• /
• v.46 no.3
• /
• pp.230-235
• /
• 2003

Purpose : Lower respiratory tract infections in infant and young children are often due to a virus, especially the Respiratory syncytial(RS) virus. Chest X-ray findings in bronchiolitis and bronchopneumonia are different. The radiographic hallmark of bronchiolitis is pulmonary hyperinflation and similar to that of bronchial asthma. Bronchiolitis is predisposed to later development of bronchial asthma. To evaluate the difference of immuno-pathophysiology between bronchiolitis and bronchopneumonia, we measured $IFN-{\gamma}$(Th1 cytokine), IL-5(Th2 cytokine) and ECP. We also investigated whether X-ray findings in infants with viral infected respiratory disease are useful in predicting the development of asthma. Methods : We measured IL-5, ECP, $IFN-{\gamma}$ levels in serum from 21 infants with bronchiolitis and 21 infants with bronchopneumonia and 16 infants without pulmonary viral diseases. Results : IL-5 levels of bronchiolitis and bronchopneumonia were significantly higher than those of the control(P=0.02, P=0.042). IL-5 levels of bronchiolitis were higher than those of bronchopneumonia but there was no significant difference. $IFN-{\gamma}$ levels of bronchopneumonia were higher than those of bronchiolitis but there was no significant difference. ECP levels of bronchiolitis and bronchopneumonia were higher than those of the control but only those of bronchiolitis were significantly higher than those of the control(P=0.045). IL-5 and ECP levels did not show any significant correlation in bronchiolitis, bronchopneumonia and control groups. Conclusion : We cannot prove the distinct differences in serum Th1/Th2 cytokine profiles between bronchiolitis and bronchopneumonia in infants. These results suggest that the different findings on chest X-ray between bronchiolitis and bronchopneumonia could not be a predictor of later development of asthma.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.4
• /
• pp.288-294
• /
• 2009

Background: A lung hyperinflation, or air trapping, caused by expiratory flow-limitation contributes to dyspnea in patients with chronic obstructive pulmonary disease (COPD). Forced expiratory volume in 1 second ($FEV_1$) has served as an important diagnostic measurement of COPD, but does not correlate with patient-centered outcomes such as dyspnea. Therefore, this study was performed to investigate the role of radiologic quantity in evaluating the dyspnea in patients with COPD by measuring lung hyperinflation in chest x-ray and high resolution chest tomography (HRCT). Methods: Fifty patients with COPD were enrolled in this study. Their subjective dyspnea score (modified Borg scale dyspnea index), spirometry, and lung volume were measured. Simultaneous hyperinflations of chest x-ray score ("chest score") and degree of emphysema of HRCT ("HRCT score") were measured. The "chest score" were composed of lung length, retrosternal space width, and height of the arc of the diaphragm and "HRCT score" were composed of severity and extent of emphysema. Results: The mean age of patients was 69 years old and their mean $FEV_1$ was 51.7%. The Borg score significantly correlated with parameters of spirometry and lung volume, including FVC, $FEV_1$, $FEV_1$/FVC, RV, RV/TLC, and DLCO. The Borg score correlated well with "HRCT score", but did not correlate with "chest score". Also, the Borg scale correlates inversely with body mass index. Conclusion: The quantity of emphysema on chest HRCT may serve as an objective marker of dyspnea in patients with COPD.