• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.826-837
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• 2021

Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

• Tuberculosis and Respiratory Diseases
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• v.58 no.1
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• pp.25-30
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• 2005

Background : An insertion-deletion polymorphism of angiotensin converting enzyme (ACE) gene has been shown to be associated with enzyme activity levels of ACE. Reported results that have been mutually contradictory about asthmatic hypersensitiveness and occurrence according to ACE gene insertion (I)/deletion (D) polymorphism. Also, the involvement of the ACE genes as the genetic basis of bronchial asthma is currently controversy. We investigated whether there was any association between polymorphisms of the ACE genes and airway hyper-responsiveness in chronic obstructive pulmonary disease (COPD). Methods : A total of 100 patients with COPD were enrolled in this study. The ACE genotypes were determined in all subjects by polymerase chain reaction. Pulmonary function test including bronchodilator response (BDR), methacholine bronchial provocation test (MBPT) were done in those patients. Airway hyper-responsiveness include any findings of positive BDR or MBPT. Results : In COPD patients, the ACE genotype distribution did not differ significantly among groups of patients with severities of COPD, and with or without airway hyper-responsiveness. Conclusions : These results suggest that polymorphisms of the ACE gene may not be associated with airway hyper-responsiveness, development and severity of COPD.

• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.763-768
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• 2003

Purpose : This study was conducted to investigate the pulmonary cellular profiles and IL-8 levels in patients with post-measles wheezing. Methods : Twelve previously healthy infants with a minimum of three episodes of wheezing after measles pneumonia(Measles wheezing, median age, 1.3 years) were recruited by a retrospective examination of hospital records. They underwent bronchoalveolar lavage(BAL) with flexible bronchoscopy, and high-resolution computed tomography(HRCT) with a mean six(1-15) months interval. Comparisons were made with seven normal controls(Control, median age : 7.4 years). BAL cell counts and differentials were determined. IL-8 levels also were measured by ELISA. Results : The BAL cellular profiles were characterized by a significantly increased percentage of neutrophils in the Measles wheezing group(median 16.0%) compared to the control group(median 3.8 %)(P<0.01). IL-8 levels were markedly increased in the Measles wheezing group($mean{\pm}SD$, $512.7{\pm}324.0pg/mL$) compared to the control group($41.7{\pm}67.7pg/mL$)(P<0.01). Furthermore, IL-8 levels correlated significantly(r=0.816, P=0.001) with neutrophil percentages in BAL fluids in the Measles wheezing group. Abnormal HRCT findings were mosaic perfusion, bronchiectasis, bronchial wall thickening, and decreased vascularity. Conclusion : These results suggest that pulmonary neutrophils and IL-8 may play an important role in the pathogenesis of the post-measles wheezing.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.354-362
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• 1994

Objectives and Methods : The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. Results : Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinoma: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer patients was 32.7%(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+G2M>22%) in lung cancer patients was 42.9%(15/35), but none in benign diseases. In fifty-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy. There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. Conclusions : The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.624-631
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• 1994

Background: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. Method: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; Results: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic "fungus ball" pattern were observed in 53.8% of the 52cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed fine needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9%(12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. Conclusion: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.281-286
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• 1999

Background: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. Material and Method: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6${\pm}$11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. Result: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). Conclusion: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.

• Journal of Oriental Neuropsychiatry
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• v.19 no.2
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• pp.209-221
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• 2008

목적 : 구절초는 국화과에 속하는 다년생 초본으로 가을에 줄기와 잎을 가을에 채취한 것을 한약재로 사용하여 대한, 월경불순 등 각종 여성질환과 함께 위냉증, 소화불량, 감고, 폐렴, 기관지염, 배뇨장애 및 신경퇴행성 질환에 활용되고 있다. 본 연구에서는 LPS로 염증유도된 대식세 포주를 활용하여 구절초의 항염증효능을 확인하고자 하였다. 방법 : 구절초 추출물의 항염증효과를 관찰하기 위하여 RAW264.7 대식세포주에서 MTT cytotoxic assay, iNOS 및 COX-2 발현, NO와 PGE2 생성 및 $NF-{\kappa}B$ 활성실험을 수행하였다. 결과 : 세포독성실험을 통하여 구절초 추출물의 안전성이 확인되었으며 LPS로 염증유도된 RAW264.7 대식세포주에서 증가된 iNOS의 발현이 감소되었음을 확인하였다. 또한 NO 및 PGE2의 생성을 억제하였다. 이러한 결과는 구절초가 염증매개물질의 생성을 억제하는 효과가 있음을 확인할 수 있었으며, $NF-{\kappa}B$ 활성도를 감소시킴을 관찰하였다. 결론 : 이러한 결과는 구절초가 $NF-{\kappa}B$ pathway를 조절해 줌으로써 항염증효과를 나타내는 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• v.40 no.1
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• pp.29-34
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• 1993

Background: The development of the flexible fiberoptic broncoscope by Ikeda was an important technologic advance in the diagnosis and management of patients with pulmonary disease. But, cross contamination related to fiberoptic bronchoscope was reported in cases involving tubercle bacilli, MOTT and other agents. Therefore, cleaning and disinfecting of fiberoptic bronchoscope requires careful attention. Methods: From September 1991 to May 1992, medical records of all patients with positive culture for MOTT in bronchial washing specimens were reviewed. Also to evaluate bactericidal effect of 2% glutaraldehyde, culture was performed after inoculum of MOTT, Serratia marsescens and Pseudomonas aeruginosa to the disinfectant solution. Results: In 2% alkaline glutaraldehyde, MOTT was not survived only after 30 minute exposure, but P. aeruginosa and S. marsescens were rapidly inactivated with no survivors after exposure to 2% glutaraldehyde. Since vigorous mechanical cleansing and more than 30 minute of contact time within washing machine, no more outbreak was observed. Conclusions: It is also very important that bronchoscopes must be meticulously cleaned after each procedure and more than 30 minute exposure would be required for eradication of MOTT with 2% glutaraldehyde. However even the most strictly applied infection control measures cannot exclude contamination completly and clinicians have to stay alert to this possibility. Prompt detection of pseudoepidemics is possible if abrupt increase in isolation rates, especially if they involve unusual or generally nonpathogenic organisms, are readily recognized.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.467-470
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• 2009

Serum CA 125 is the most useful marker for monitoring patients with epithelial ovarian cancer. However, it can be elevated above normal level in a variety of conditions other than ovarian cancer such as endometriosis, pelvic inflammation disease, and other malignant or nonmalignant disorders, including pulmonary diseases. Recently, we experienced a case of bronchiectasis in which the serum CA 125 level was elevated, changing with the patient's condition. There was no evidence of underlying malignant disease on positron emission tomography or on gynecologic examination, including transvaginal ultrasonography. During follow-up for 14 months, we could not find any clue of malignant disease that could have been the cause of the elevated levels of serum CA 125. Elevated serum CA 125 level should be interpreted carefully according to the patient's clinical condition. In addition, our case suggests that CA 125 may be used as a surrogate marker for acute inflammatory status for chronic pulmonary diseases.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.633-638
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• 2000

Pulmonary mucormycosis is an opportunistic infection in patients with severe underlying illness such as immunocompromised diseases or uncontrolled diabetes mellitus. While patients with leukemia and lymphoma usually present with diffuse parenchymal disease, diabetic patients usually have a localized endobronchial disease involving central airways. We report upon a case of pulmonary mucormycosis in diabetes mellitus patient presenting as an endobronchial mass, which was cured with antifungal therapy, rigid bronchoscopic mass removal and right pneumonectomy.