• Title/Summary/Keyword: 부위분류

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Analysis of Gene Expression in Helicobacter pylori-associated Nodular Gastritis in Children Using Microarray (소아의 Helicobacter pylori 감염에 의한 결절성 위염의 유전자 발현 양상 분석)

  • Yang, Hye-Ran;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.7-22
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    • 2010
  • Purpose: Nodular gastritis is a characteristic finding of Helicobacter pylori infection in children. The aim of this study was to evaluate the difference in gene expression in the gastric mucosa of H. pylori-infected and non-infected children, and to analyze the difference in gene expression using cDNA microarray analysis of nodular gastritis caused by H. pylori infection. Methods: Twelve children (6 boys and 6 girls; mean age 9.8 years) who underwent upper gastrointestinal endoscopy and biopsy at Seoul National University Bundang Hospital were included in the study. The subjects were divided into three groups according to the presence of H. pylori infection and nodular gastritis on endoscopic examination. Gastric mucosa tissue was kept at $-70^{\circ}C$ and RNA was extracted to perform cDNA microarray analysis in each patient. Results: cDNA microarray analysis in children revealed a clear distinction between H. pylori-infected and non-infected gastric mucosa. Specifically, 182 over-expressed genes and 29 under-expressed genes were identified in H. pylori-infected gastric mucosa compared to non-infected mucosa. H. pylori-infected nodular gastritis revealed different gene expression patterns from H. pylori-infected normal gastric mucosa; five genes were over-expressed and five genes were under-expressed. Conclusion: In the presence of H. pylori infection, gastric mucosa shows distinct differences in gene expression, and nodular gastritis with H. pylori infection in children may be associated with over- or under-expression of some genes. Further studies are required to clarify the host response and the pathogenesis of nodular gastritis in children.

Application of Radiological Study by Small Bowel Disease - Comparison of Diagnostic Results of Small Bowel Series and Abdominal Pelvic Computed Tomography - (소장 질환별 방사선학적 검사의 적용에 관한 연구 - 소장조영술과 복부골반전산화단층촬영의 결과 분석을 중심으로 -)

  • Lee, Hee-Jung;Son, Soon-Yong;Lee, Won-Hong
    • Journal of radiological science and technology
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    • v.28 no.4
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    • pp.279-286
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    • 2005
  • Purpose : There are two modalities, those are small bowel series(SBS) and abdominal pelvic computed tomography(CT), for diagnosis of small bowel disease. The aim of this study is to lend radiological technologists who are doing the two modalities assistance in the understanding characteristic of disease by comparing the two results. Meterials and method : 284 patients were examined the two SBS and abdominal pelvic CT together from 1999 to 2003. 250 ml $BaSO_4$ suspension 40 w/v% and 600ml carboxy methyl cellulose 0.5 w/v% were used for SBS. Abdominal Pelvic CT was examined in one hour before taking 450 ml $BaSO_4$ suspension 1.5 w/v%. The CT scan was done in 72 sec after 150 ml contrast media injection. the used protocol was helical mode 5:5 mm pitch 1.375:1, speed 27.50, exposure 120 kv, 240 mA, tube rotation time 0.5 sec. the statistic analysis was conducted with statistical program SPSS 10 version with frequency and crossing analysis. P-value less than 0.05 were considered significant. Results : In the results of SBS, normal findings were 131 patients(46.1%), inflammatory bowel disease(IBD) 64(22.9%), ischemia+ileocolitis+vasculitis 22(7.7%), Obstruction+stricture 21(7.7%) and Others 45(15.9%). In the results of abdominal pelvic CT, normal findings were 103 patients(36.3%), inflammatory bowel disease 65(22.9%), wall thickening+lymphadenopathy 42(14.8%), Fluid collection 17(6%), and Others 57case(20%). The same results of the two were 130patients(45.8%). 30patients(10.6%) of normal finding in SBS were diagnosed as wall thickening+lymphadenopathy and IBD in CT, and 15patients(5.3%) of normal finding in CT were diagnosed as ischemia+ileocolitis+vasculitis, mass and IBD in SBS(p<0.05). Transit time delay was diagnosed in 10patients(3.5%) on only SBS, wall thickening+lymphadenopathy was diagnosed in 20patients(7%) in only CT(p<0.05). Conclusion : We think that proper examination method will be selected in the small bowel disease, if we understand the characteristics of the disease and method.

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Modification of Late Radiation Response of Rat Salivary Glands by Pentoxifylline and Diltiazem (쥐의 타액선 방사선조사 후 만성반응에 Pentoxifylline과 Diltiazem이 미치는 영향)

  • Suh, Hyun-Suk;Yang, Kwang-Mo;Kang, Yun-Kyung
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.230-237
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    • 1999
  • Purpose : To elucidate the effects of pentoxifylline and diltiazem on the late response of the salivary glands of the rat after irradiation. Materials and Methods : Sixteen Sprague-Dawley rats were divided into 4 groups : (a) irradiation alone (b) irradiation with pentixifylline (PTX) (c) irradiation with diltiazem (DTZ) (d) irradiation with both PTX and DTZ. Irradiation was given in a single fraction of 16 Gy using 4 MV photon energy through an anterior port encompassing the left side of the salivary gland leaving the right side of salivary gland as a control. PTX, 20 mg/kg and/or DTZ, 50 mg/kg were infused intraperitoneally before irradiation, Two rats from each group were sacrificed on the 10th week and the rest was sacrificed on the 16th week after irradiation. Histopathologic examinations were undertaken for each section and the proportion of vacuolated cells out of the total number of cells under light microscopic fields was calculated. The statistical significance in the difference of the proportion of the vacuolated cells among the experimental groups was evaluated by a $x^2$-test. Results : Irradiated salivary glands of the 10th week group revealed markedly increased number of vacuolated cells compared to those of unirradiated control. The proportion of vacuolated cells was significantly reduced in both the PTX group (p value=0.001) and the combined PTX and DTX group compared to those of irradiation alone group. The DTZ alone group did not reveal the significant reduction of vacuolated cells compared to those of irradiation alone group (p value, >0.05). The 16th week groups revealed similar findings to those of the 10th week group, but the degree of chronic inflammatory cell infiltrates and interstitial fibrosis was increased and the number of acinar cells was reduced compared to those of the 10th week group. Conclusions : PTX significantly reduced the late radiation response of salivary glands, but DTZ did not reduce the same degree as PTX did. Taking the positive results of this study into consideration, it seems reasonable to apply PTX into the clinical trial for the head and neck irradiation to reduce the late radiation sequelae of salivary glands in the near future. At the same time the further experiment to clarify the subcellar mechni는 involved in PTX should be preceded.

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A Study of Clinical Model for Radiation Therapy in Lung Cancer Patients of Busan and South Gyeongnam Province (부산, 경남지역 폐암 환자의 방사선치료 이용에 대한 임상 결정 모델 연구)

  • Son, Jongki;Kim, Yunjin;Jo, Deokyoung
    • Journal of the Korean Society of Radiology
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    • v.9 no.6
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    • pp.393-401
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    • 2015
  • Radiation therapy for lung cancer is an effective treatment during monotherapy or combination therapy. Studies have reported that the optimum utilization rate of radiation therapy is estimated at 61% to 74%. Radiation therapy in Korea has been investigated to be low; further studies are needed. This study was intended to assess the appropriateness of the use of radiation and to reveal the use of radiation therapy-related factors by examining radiation therapy in lung cancer patients of Busan and South Gyeongnam Province. This study was aimed at the population diagnosed with lung cancer in Busan and South Gyeongnam Province. To conduct the study, 1036 patients enrolled in two hospitals were collected and 897 appropriate as subjects were selected. We compared the optimum utilization rate and actual rate of radiation therapy, and revealed the adequacy and related factors for use of radiotherapy. Of 897 patients, 503 (56%) were treated with medical therapy and 394 (44%) were given radiotherapy. The radiotherapy utilization rate of all lung cancer patients was 42%. The proportion of non-small cell lung cancer by histologic type was 33% and that of small cell lung cancer was 90%. Factors related to radiation therapy used in cancer were age, histological type, clinical stage, doctor refereed to, and clinical examination. Compared to radiation utilization by region (site), curative chest therapy was 42%; palliative treatment was 26%. In the comparison of histologic types, utilization of small-cell lung cancer is lower; the lowest especially in the stage III. Utilization of radiation therapy in Busan and South Gyeongnam Province was lower than the reasonable one. Utilization difference could be explained by patient factors, tumor factors, and health service factors. To improve utilization,development ofoutreach service programs and activation of the multidisciplinary team are required.

Monitoring on Dose Index Analyzed in the Mammography (유방촬영검사에서 선량지표분석에 대한 모니터링)

  • Cho, Ji-Hwan;Lee, Hyo-Yeong;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.10 no.7
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    • pp.477-482
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    • 2016
  • This study is tried to determine whether the management of medical radiation is well handled by comparison the guidelines of KFDA(korea food & drug administration) with analysis of dose indicator in mammography. As a method, it is analysed that kVp, exposure time, mAs, compressed breast thickness, average glandular dose and body mass index that were classified in the examination of both breasts by CC(cranio-caudal) and MLO(medio-lateral oblique) with EMR(electronic medical record) and dose report that were sent to the PACS(picture archiving communication system). As a result, in the site inspection according to the age, Compressed breast thickness in CC and MLO were the thickest of 45.6 mm and 49.6 mm in the 50-59 year old respectively. In the overall average compressed breast thickness, CC were 44.2 mm and MLO were 48.9 mm. MLO has more thick by 4.7 mm. In average glandular dose, CC were 1.05 mGy and MLO were 1.14 mGy. MLO has higher by 0.09 mGy than CC. As the compressed breast thickness increases 10mm, CC and MLO increases 0.15 mGy and 0.17 mGy respectively. When it was compared with the average glandular dose of 1.16 mGy per 1 film presented by KFDA, CC was showed 1.05 mGy. However, the 60 mm or more was found to exceed a 1.30 mGy. Also, As the compressed breast thickness was higher, body mass index showed high score. And in the case of 25 or more in the obese body index according to body mass index, it was showed obesity in case of the compressed breast thickness was more than 50mm.

Analysis of Relativity Between Invasiveness on Chest of Tomographic Finding and Histopathologic Invasiveness (종격동 종양의 전산화 단층촬영(CT)소견, 수술소견 및 병리조직학적 침윤도 사이의 상관성 분석)

  • 김용희;이현우
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.780-785
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    • 1997
  • Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

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Degradation evaluation of paint films on surface treated steel by electrochemical impedance spectroscopy (전기화학적 임피던스 분광법에 의한 표면처리한 강재 도장의 부식-도막 열화도 평가)

  • Park, Jun-Mu;Park, Jae-Hyeok;Kim, Sun-Ho;U, Sang-Gyun;Gwon, Yong-Min;Mun, Gyeong-Man;Lee, Myeong-Hun
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2018.06a
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    • pp.95-95
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    • 2018
  • 강재의 방식법 중 도장은 부식을 억제하는데 효과적이고 편리한 방법으로 선박 및 해양 강 구조물의 방식법으로 사용되고 있다. 한편, 강 구조물의 효율적인 유지관리를 위해서는 방식 도장의 도막 열화도를 평가하고 잔존 수명을 예측하여 최적 시기에 보수도장 혹은 재도장하는 것이 필요하다. 일반적으로 선박 및 해양구조물에 적용되는 도막의 방식 성능 평가 방법으로 해수 침지 시험, 염수 분무 시험, 옥외 폭로 시험 등이 있다. 그러나 이러한 시험들은 그 시험 방법에 따라서 정량적인 평가에 한계가 있음은 물론 장기간 소요되는 등 곤란한 문제점이 있다. 그러므로 선박 및 해양구조물을 비롯하여 교량, 각종 강 구조물의 도장 방식에 사용되는 방식용 도료의 성능을 단기간에 적절하게 평가할 수 있는 가속시험법이 제시되며 연구-사용되고 있다. 그 중 도막 방식 성능을 보다 효율적, 비파괴적, 정량적으로 평가할 수 있는 임피던스 분광법(EIS)과 같은 전기화학적 방법은 상대적으로 시험 기간을 크게 단축시킬 수 있고, 대상 방식 도장의 미세한 성능 차이도 분별 가능하다는 장점이 있다[1]. 따라서 본 연구에서는 선박 및 해양구조물 등 가혹한 부식환경에서 강력한 내구성을 가질 수 있도록 다양한 종류의 표면처리 도장 시편을 제작하여 자외선 조사-염수분무-침지환경 등의 열악한 환경조건 하에서 부식-열화 촉진 시험을 실시하였다. 그리고 그 촉진 열화 과정에서 도막의 외관 상태를 관찰 분석함은 물론 전기화학적 임피던스 분광법을 병행 측정하며 그 표면막의 부식 및 도막 열화도를 비교-종합 평가하였다.본 연구에 사용된 시편은 Al 및 Zn 도금 강판에 에폭시, 에폭시-실리콘 우레탄, 에폭시-우레탄 도장 시편으로 Scribe, No Scribe 및 비교재 Al 및 Zn 도금 시편으로 분류하여 각각 실험을 진행하였다. 즉, 도막 열화 시험은 복합 노화 시험법으로 UV 조사 36 시간(ASTM G53), 염수분무 32 시간(ISO 7253), 수분 응축 10 시간을 1 Cycle로 100 Cycle(7800 시간) 동안 실험을 진행하였다. 이때 도막 열화도 평가는 전기화학적 임피던스 분광법을 이용하여 각 실험 조건별로 주파수에 따른 임피던스(Z) 값을 평가하였다. 즉, 상온 $25^{\circ}C$의 3.5% NaCl 100 ml 수용액에 작동 전극(Working Electrode)과 구리 도선을 통해 연결하였고, 노출 면적은 $1cm^2$로 일정하게 유지 하였으며, 상대 전극(Counter Electrode)은 탄소봉, 기준 전극(Reference Electrode)으로 포화카로멜전극(Saturated Calomel Electrode)을 사용하여 측정하였다. No Scribe 시편의 경우에는 Al 기판 에폭시-실리콘 우레탄 도장 시편이 우수한 도막 저항성을 나타내었으며, 에폭시-우레탄 도장시편은 23사이클 이후의 저항값이 가장 낮게 나타났다. Zn 기판의 경우는 에폭시, 에폭시-실리콘 우레탄, 에폭시-우레탄 도장 시편 모두 저항 값이 유사하였으며, Al 및 Zn 도금 시편은 도장 처리된 시편에 비해 훨씬 낮은 저항 값을 보였다. 또한 Scribe 시편의 경우에는 Al 기판 에폭시-실리콘 우레탄 도장 시편에서 높은 초기 저항 값을 보였으며, 23 사이클 후의 저항 값은 세 종류의 도막에서 약 1~0.1 Gohm 으로 나타났다. 그리고 Zn 기판 에폭시-실리콘 우레탄 도장 시편에서 가장 낮은 도막 저항 값이 나타났다. 이상의 실험을 통해서 본 연구 내용은 실내촉진시험으로 선박 및 해양 강 구조물에 사용되는 다양한 종류의 도막의 열화도를 평가하는 기초 설계 지침으로 응용될 수 있을 것으로 사료된다. 한편, 도막은 노출 환경에 따라 방식 성능이 다르므로 실제 도막의 사용환경을 고려하여 도장 사양별 적용 부위에 따른 적정 가속 실험 방법을 선정할 필요가 있다고 사료된다.

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Cytotoxic Effects of Prevotella nigrescens on Cultured Cells (Prevotella nigrescens가 배양된 세포에 미치는 영향)

  • Han, Jin-Soon;Kim, Eun-Sook;Lee, Su-Jong;You, Yong-Ouk;Han, Kyung-Soo;Im, Mi-Kyung
    • Restorative Dentistry and Endodontics
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    • v.27 no.2
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    • pp.183-195
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    • 2002
  • 흑색 색소를 형성하는 그람음성 혐기성 세균은 급성 임상 증상을 가진 환자의 근관에서 자주 발견되는 세균으로서 세균 및 세균의 성분과 산물이 치근단 병소의 생성과 밀접하게 연관된 것으로 알려져 있다. 본 연구는 흑색 색소를 형성하는 그람음성 혐기성 세균 중 가장 발현율이 높은 Prevotella nigrescens가 배양된 세포에 미치는 세포 독성을 연구하고자 하였다. 두 가지 세포주 및 사람의 치은섬유모세포를 일차배양하여 사용하였으며, 세포주에 따른 독성 발현에 차이가 있는지를 비교하였다. P. nigrescens ATCC 33563 표준 균주 및 임상 균주로는 환자의 감염된 근관으로부터 165 rRNA primer를 사용한 중합효소 연쇄반응으로 P. nigrescens 6 균주를 동정하여 사용하였다. 세균배양액, 세균의 초음파 추출단백질 및 lipopolysaccharide (LPS)를 MC3T3-El 조골세포, NIH3T3 섬유모세포 및 치은섬유모세포에 첨가한 후 MTT분석법으로 세포의 활성을 측정하였으며, 세포의 형태학적 변화를 도립현미경으로 관찰하였다. 세균배양액을 100$\mu\textrm{l}$ 첨가한 경우는 세가지 세포주 모두에서 통계적으로 유의하게 세포의 활성을 억제하였다. 세균의 초음파 추출단백질 12.5$\mu\textrm{g}$/ml 와 25$\mu\textrm{g}$/ml 는 NIH3T3세포에 통계적으로 유의한 세포독성을 보였다. 세 가지 세포주에 대한 LPS의 세포 독성 효과는 첨가된 LPS의 농도 및 균주에 따라 다양하게 나타났다. 심하게 손상된 세포는 세포의 단일층이 수축되고 세포가 응집되었으며 세포가 배양용기의 바닥에서 떨어지는 양상이 도립 현미경하에서 관찰되었다. 본 연구의 결과 P. nigrescens가 숙주 반응을 조절하여 치수 및 치근단 병소의 유발 및 악화에 기여하는 세균으로 작용할 수 있음을 시사한다. 조직과 함께 제거하고 포르말린에서 48시간 고정시킨 후 파라핀에 포매한 다음에 micro-tome을 사용하여 6$\mu\textrm{m}$로 serial section을 시행하였다. 정중선 부위의 시편에 Hematoxylin-Eosin staining을 시행한 후 Olsson, Orstavik 그리고 Mjor 등의 방법에 따라 조직학적 변화를 관찰한 후 slight(1), moderate(2), severe inflammation(3)의 단계로 분류하였다. 얻어진 결과를 통계처리 프로그램인 Jandel사의 Sigmastat을 이용하여 Kruskal Wallis Test로 통계처리를 하였다. 결과 : (Table omitted) 결론 : 1) Pulp Canal Sealer를 제외한 모든 군에서 시간이 지남에 따라 유의성 있게 염증이 감소되는 양상을 보였다(p<0.05). 2) Pulp Canal Sealer는 1주, 2주, 12주에서 강한 염증반응을 보였다. 3) AH 26과 AH Plus에서는 1주, 2주에서 강한 염증반응을 보였으나 12주에서는 염증반응이 감소하였다. 4) 새로 개발된 봉함제 Adseal-1,2는 1주, 2주에서는 가장 약한 염증반응을 보이나 4주, 12주 후에는 AH Plus와 비슷한 수준의 염증 반응을 보였다. 5) Pulp Canal Sealer를 제외한 모든 군에서 인정할 만한 생체친화성을 보였다. 6) Adseal-2가 Adseal-1에 비하여 전반적으로 낮은 염증반응을 보였다. 7) 각 군간 결과의 차이에 통계적 유의성은 없었다(p>0.05).mmunity. Then, a hierarchical language is to defeat its own purpose.중 행정부가 북한에 대해 실시한 포용정책이 어떠한 성과를 거두고 어떠한 문제점을 간과하고 있는가에 대해 논의하고, 대북 정책의 새로운 지평을 논의하는 것을 목적으로 하고 있다. 1) 포용 정책은 세계의

Three-Dimensional Finite Element Analysis of Internal Connection Implant System (Gsii$^{(R)}$) According to Three Different Abutments and Prosthetic Design (국산 내부연결형 임플란트시스템(GS II$^{(R)}$)에서 지대주 연결방식에 따른 응력분석에 관한 연구)

  • Jang, Mi-Ra;Kwak, Ju-Hee;Kim, Myung-Rae;Park, Eun-Jin;Park, Ji-Marn;Kim, Sun-Jong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.179-195
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    • 2010
  • In the internal connection system, the loading transfer mechanism within the inner surface of the implant and also the stress distribution occuring to the mandible can be changed according to the abutment form. Therefore it is thought to be imperative to study the difference of the stress distribution occuring at the mandible according to the abutment form. The purpose of this study was to assess the loading distributing characteristics of three different abutments for GS II$^{(R)}$ implant fixture(Osstem, Korea) under vertical and inclined loading using finite element analysis. Three finite element models were designed according to three abutments; 2-piece Transfer$^{TM}$ abutment made of pure titanium(GST), 2-piece GoldCast$^{TM}$ abutment made of gold alloy(GSG), 3-piece Convertible$^{TM}$ abutment with external connection(GSC). This study simulated loads of 100N in a vertical direction on the central pit(load 1), on the buccal cusp tip(load 2) and $30^{\circ}$ inward inclined direction on the central pit(load 3), and on the buccal cusp tip(load 4). The following results were obtained. 1. Without regard to the loading condition, greater stress was concentrated at the cortical bone contacting the upper part of the implant fixture and lower stress was taken at the cancellous bone. 2. When off-axis loading was applied, high stress concentration observed in cervical area. 3. GSG showed even stress distribution in crown, abutment and fixture. GST showed high stress concentration in fixture and abutment screw. GSC showed high stress concentration in fixture and abutment. 4. Maximum von Mises stress in the surrounding bone had no difference among three abutment type. In GS II$^{(R)}$ conical implant system, different stress distribution pattern was showed according to the abutment type and the stress-induced pattern at the supporting bone according to the abutment type had no difference among them.

Prognostic Value of Fibroblastic Foci in Patients with Usual Interstitial Pneumonia (통상성 간질성 폐렴 환자 예후인자로서의 섬유모세포병소(fibroblastic foci)의 유용성)

  • Park, Yong-Bum;Kang, Gil-Hyun;Shim, Mae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong;Kitaichi, Masanori;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.309-318
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    • 2002
  • Background : Usual interstitial pneumonia (UIP) is a fatal progressive fibrotic disorder of the lung with unknown etiology and characterized by a poor response to conventional immunosuppressive therapy. The histologic hallmark of UIP is parchy distribution of subpleural fibrosis and fibroblastic foci(FBF) with interposed normal appearing lung. Because FBF is a collection of actively proliferating myofibroblasts, it can be a marker of activity and prognosis of UIP. However, there were contradictory reports about the correlation between the degree of FBF and survival. Therefore we performed this study to investigate the value of FBF as prognostic marker of UIP. Methods : This was a retrospective study on the 46 patients(M:F=33:13, mean age:$59{\pm}12$ years) with UIP diagnosed by the surgical lung biopsy at the Asan Medical Center, Seoul, Korea between 1990 and 2000 and had follow-up of more than a year. All the biopsy specimens were reevaluated and diagnosed as UIP according to the ATS/ERS classification. Semiquantitative grading of FBF(absent, 0; mild 1; moderate 2; marked 3) by the experienced pathologists who did not know the clinical findings were compared to the clinical data and the follow up course. Results : Thirteen patients(28.2%) died of UIP progression during the study period. The median survival time of all the subjects was 26 months after the biopsy. At the univariate analysis, FVC, $D_Lco$, smoking history and the grade of FBF were significantly related to the survial. The survival was longer in subjects with lesser degrees of FBF, higher DLco, higher FVC and history of smoking. However the multivariate analysis with Cox regression test showed the extent of FBF was the only independent prognostic marker of UIP. Conclusion : These data suggested that the extent of FBF on the surgical lung biopsy can be used as a prognostic marker of UIP.