• 제목/요약/키워드: interstitial disease

검색결과 287건 처리시간 0.025초

Rapid deterioration of preexisting renal insufficiency after autologous mesenchymal stem cell therapy

  • Kim, Jun-Seop;Lee, Jong-Hak;Kwon, Owen;Cho, Jang-Hee;Choi, Ji-Young;Park, Sun-Hee;Kim, Chan-Duck;Kim, Yong-Jin;Kim, Yong-Lim
    • Kidney Research and Clinical Practice
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    • 제36권2호
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    • pp.200-204
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    • 2017
  • Administration of autologous mesenchymal stem cells (MSCs) has been shown to improve renal function and histological findings in acute kidney injury (AKI) models. However, its effects in chronic kidney disease (CKD) are unclear, particularly in the clinical setting. Here, we report our experience with a CKD patient who was treated by intravenous infusion of autologous MSCs derived from adipose tissue in an unknown clinic outside of Korea. The renal function of the patient had been stable for several years before MSC administration. One week after the autologous MSC infusion, the preexisting renal insufficiency was rapidly aggravated without any other evidence of AKI. Hemodialysis was started 3 months after MSC administration. Renal biopsy findings at dialysis showed severe interstitial fibrosis and inflammatory cell infiltration, with a few cells expressing CD34 and CD117, 2 surface markers of stem cells. This case highlights the potential nephrotoxicity of autologous MSC therapy in CKD patients.

Differential Diagnosis of Thick Myocardium according to Histologic Features Revealed by Multiparametric Cardiac Magnetic Resonance Imaging

  • Min Jae Cha;Cherry Kim;Chan Ho Park;Yoo Jin Hong;Jae Min Shin;Tae Hoon Kim;Yoon Jin Cha;Chul Hwan Park
    • Korean Journal of Radiology
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    • 제23권6호
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    • pp.581-597
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    • 2022
  • Left ventricular (LV) wall thickening, or LV hypertrophy (LVH), is common and occurs in diverse conditions including hypertrophic cardiomyopathy (HCM), hypertensive heart disease, aortic valve stenosis, lysosomal storage disorders, cardiac amyloidosis, mitochondrial cardiomyopathy, sarcoidosis and athlete's heart. Cardiac magnetic resonance (CMR) imaging provides various tissue contrasts and characteristics that reflect histological changes in the myocardium, such as cellular hypertrophy, cardiomyocyte disarray, interstitial fibrosis, extracellular accumulation of insoluble proteins, intracellular accumulation of fat, and intracellular vacuolar changes. Therefore, CMR imaging may be beneficial in establishing a differential diagnosis of LVH. Although various diseases share LV wall thickening as a common feature, the histologic changes that underscore each disease are distinct. This review focuses on CMR multiparametric myocardial analysis, which may provide clues for the differentiation of thickened myocardium based on the histologic features of HCM and its phenocopies.

Cystic Lung Disease: a Comparison of Cystic Size, as Seen on Expiratory and Inspiratory HRCT Scans

  • Ki-Nam Lee;Seong-Kuk Yoon;Seok Jin Choi;Jin Mo Goo;Kyung-Jin Nam
    • Korean Journal of Radiology
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    • 제1권2호
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    • pp.84-90
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    • 2000
  • Objective: To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. Materials and Methods: The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. Results: All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. Conclusion: In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary.

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Clomifen 호르몬제 복용후 호흡곤란이 악화된 환자에서의 미만성 망상형 간질성 폐침윤 (Diffuse Reticular Interstitial Infiltrations in the Patient with Worsening Exertional Dyspnea after Clomifen Hormonal Therapy)

  • 박형천;김영삼;김세규;정경영;신동환;이홍렬;장준;김성규;이원영
    • Tuberculosis and Respiratory Diseases
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    • 제42권4호
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    • pp.624-628
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    • 1995
  • Lymphangioleiomyomatosis is a rare disease which afflicts young women of childbearing age. We experienced a 32-year-old female who was admitted because of worsening exertional dyspnea after hormonal therapy with Clomifen for five months and intermittent hemoptysis. Chest PA showed diffuse ground glass appearance with some reticular infiltrations. High resolution CT scan showed multiple small thin walled cysts distributed homogeneously throughout the entire lung. Pulmonary function test showed characteristic obstructive pattern despite the restrictive interstitial pattern of chest radiography. Thoracoscopic lung biopsy specimen showed abnormal proliferation of smooth muscle cells in the walls of lymphatic vessels, bronchioles, and pulmonary vessels typical of pulmonary lymphangioleiomyomatosis. Hormonal therapy with medroxyprogesterone was initiated.

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Gemcitabine에 의한 약물 유발성 간질성 폐렴 1예 (A Case of Drug Induced Interstitial Pneumonitis by Gemcitabine)

  • 이성순;함초롬;진재용;이혜란;김수영;김미영;이현경;이혁표;염호기;최수전
    • Tuberculosis and Respiratory Diseases
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    • 제56권3호
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    • pp.315-320
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    • 2004
  • Gemcitabine은 최근 사용이 증가되고 있는 항암제로서 호흡기 부작용이 흔히 발생하나 대부분 일시적이고 자연 관해된다. 하지만 드물게 gemcitabine에 의한 심각한 폐 독성이 발생할 수 있으며, 이는 조기 진단 및 치료가 중요하다. 저자들은 gemcitabine 치료 후 발생한 중증 약물 유발성 간질성 폐렴 환자에서 스테로이드 치료 후 호전된 증례를 경험하였기에 보고하는 바이다.

Relationship between Incidental Abnormalities on Screening Thoracic Computed Tomography and Mortality: A Long-Term Follow-Up Analysis

  • Jong Eun Lee;Won Gi Jeong;Hyo-Jae Lee;Yun-Hyeon Kim;Kum Ju Chae;Yeon Joo Jeong
    • Korean Journal of Radiology
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    • 제23권10호
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    • pp.998-1008
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    • 2022
  • Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan-Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02-6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion: Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

Clinical Predictors of Survival in Idiopathic Pulmonary Fibrosis

  • Kim, Ji Hye;Lee, Jin Hwa;Ryu, Yon Ju;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • 제73권3호
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    • pp.162-168
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    • 2012
  • Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease. Effective treatment is not currently available and the prognosis is poor. The aim of our study was to identify clinical predictors of survival in patients with IPF. Methods: By using medical record database of a university hospital, we reviewed the records of patients who had been diagnosed as having IPF from January 1996 through December 2007. Results: Among 89 patients considered as having interstitial lung disease (ILD) on computed tomography (CT) of the chest, 22 were excluded because of the diagnosis of other ILDs or connective tissue disease, and finally, 67 met the criteria of IPF. The mean age at the diagnosis of IPF was 70 years (range, 41~87 years) and 43 (64%) were male. The mean survival time following the diagnosis of IPF was 40 months (range, 0~179 months). Among them, 28 cases were diagnosed as the progressive state of IPF on the follow-up CT examination, and the mean duration between diagnosis of IPF and progression was 31 months. Multivariate analysis using Cox regression model revealed that body mass index (BMI) less than 18.5 $kg/m^2$ (p=0.030; hazard ratio [HR], 12.085; 95% confidence interval [CI], 1.277~114.331) and CT progression before 36 months from the diagnosis of IPF (p=0.042; HR, 13.564; 95% CI, 1.101~167.166) were independently associated with mortality. Conclusion: Since low BMI at the diagnosis of IPF and progression on follow-up CT were associated with poor prognosis, IPF patients with low BMI and/or progression before 36 months following the diagnosis should be closely monitored.

이차성 기질화 폐렴이 동반된 피부근염 1예 (A Case of Dermatomyositis with Secondary Organizing Pneumonia)

  • 박철연;권정석;정진욱;이충기;현대성;최정윤
    • Journal of Yeungnam Medical Science
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    • 제25권2호
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    • pp.117-123
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    • 2008
  • Dermatomyositis is characterized by progressive, symmetric, proximal muscle weakness and a nonsuppurative inflammatory myopathy of unknown etiology involving predominantly skeletal muscles. It is also characterized by typical skin lesions. Interstitial lung disease has a poor prognosis when it is associated with dermatomyositis. Organizing pneumonia is a disease in which granulation tissue fills the lumina of terminal and respiratory bronchioles and extends into the distal airspaces. The cryptogenic nature of the process is appreciated in that organizing pneumonia patterns of injury can be seen in secondary forms of the disease (secondary organizing pneumonia). Organizing pneumonia has been reported to occur in 5~10% in dermatomyositis-polymyositis patients. Anti-histidyl tRNA synthetase antibody (anti-Jo-1) is a predictive disease marker that is reported to occur in up to 70% of patients. We describe a 49-year-old male dermatomyositis patient who presented with organizing pneumonia and was found to have negative anti-Jo-1 antibody.

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번식장애를 수반한 돼지의 뇌심근염 바이러스 감염증 (Encephalomyocarditis virus infection in pigs associated with reproductive failure)

  • 박남용;정치영;이창영;기혜영;배성열;이봉주;하용공;윤석민;정병탁;김동성
    • 대한수의학회지
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    • 제30권4호
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    • pp.441-446
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    • 1990
  • Encephalomyocarditis virus infection in pigs, characterized by severe reproductive failure in sows and sudden death in less than 7 day-old-piglets, a period of several months from October to December of 1989, in Korea was occurred. The most outstanding gross lesions at necropsy were found in the heart which were consisted of pale, yellow brown necrotic foci of varying size in myocardium. In some cases, pulmonary edema and liver congestion were observed. Histopathology of the heart revealed the interstitial myocarditis, endocarditis and epicarditis with lymphocytic, plasmacytic and macrophage cell infiltration and, in some cases, calcification of the necrotic myocardial muscle fibers. In some cases of brain, the perivascular cuffing and glial nodules were observed. In the liver and the lacrimal gland varying degrees of multifocal necrosis were seen. The virus was isolated from the heart and the brain in a stillborn piglet and a mummified fetus. This outbreak represents the first case of encephalomyocarditis virus infection of pigs in Korea.

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Mycoplasma pneumoniae infection in patients with Kawasaki disease

  • Lee, Mi-Na;Cha, Jie-Hae;Ahn, Hye-Mi;Yoo, Jeong-Hyun;Kim, Hae-Soon;Sohn, Se-Jung;Hong, Young-Mi
    • Clinical and Experimental Pediatrics
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    • 제54권3호
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    • pp.123-127
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    • 2011
  • Purpose: Kawasaki disease (KD) is the main cause of acquired heart disease in children. In addition to cardiovascular involvement, many complications have been recognized in KD. However, respiratory complications have been rarely reported. We investigated the differences in clinical characteristics, laboratory findings, radiography findings, and echocardiography findings of Mycoplasma pneumoniae infection and other types of pneumonia in KD patients. Methods: Among 358 patients with KD, 54 developed concurrent pneumonia. Among the 54 patients, 12 (22.2%) with high titers of anti-M. pneumoniae antibody (AMA) (>1:640) were grouped in the M. pneumoniae group and 42 were included in the control group. Serum AMA was measured in each patient. Clinical laboratory findings and total duration of fever were analyzed. Results: The duration of fever, serum hemoglobin, white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein level, albumin level, and the incidence of coronary arterial lesions showed no statistical difference in the 2 groups. Neutrophil count was significantly higher in the M. pneumoniae group than in the control group. Among various radiography findings observed in pneumonia, consolidation and pleural effusion were more frequent in the M. pneumoniae group than in the control group. On the other hand, parahilar peribronchial opacification, diffuse interstitial lesion, and normal findings prevailed in the control group. Conclusion: KD patients can have concurrent infections, especially pulmonary symptoms. The cause of KD is likely to be associated with M. pneumoniae infection. Thus, immediate treatment of M. pneumoniae infection in KD patients is very important.