Koo, So-My;Kim, Song Yee;Choi, Sun Mi;Lee, Hyun-Kyung;Korean Interstitial Lung Diseases Study Group
Tuberculosis and Respiratory Diseases
/
v.82
no.4
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pp.285-297
/
2019
Connective tissue disease (CTD) is a collection of disorders characterized by various signs and symptoms such as circulation of autoantibodies in the entire system causing damage to internal organs. Interstitial lung disease (ILD) which is associated with CTD is referred to as CTD-ILD. Patients diagnosed with ILD should be thoroughly examined for the cooccurrence of CTD, since the treatment procedures and prognosis of CTD-ILD are vary from those of idiopathic interstitial pneumonia. The representative types of CTD which may accompany ILD include rheumatoid arthritis, systemic sclerosis (SSc), Sjogren's syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematous. Of these, ILD most frequently co-exists with SSc. If an ILD is observed in the chest, high resolution computed tomography and specific diagnostic criteria for any type of CTD are met, then a diagnosis of CTD-ILD is made. It is challenging to conduct a properly designed randomized study on CTD-ILD, due to low incidence. Therefore, CTD-ILD treatment approach is yet to been established in absence of randomized controlled clinical trials, with the exception of SSc-ILD. When a patient is presented with acute CTD-ILD or if symptoms occur due to progression of the disease, steroid and immunosuppressive therapy are generally considered.
Park, Sung-Woo;Baek, Ae Rin;Lee, Hong Lyeol;Jeong, Sung Whan;Yang, Sei-Hoon;Kim, Yong Hyun;Chung, Man Pyo;Korean Interstitial Lung Diseases Study Group
Tuberculosis and Respiratory Diseases
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v.82
no.4
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pp.269-276
/
2019
Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.
Mostafa, Amira Ismail;Salem, Ayman Elsayed;Ahmed, Heba Allah Moussa;Bayoumi, Aml Ibrahim;Halim, Radwa M. Abdel;Samie, Rasha M. Abdel
Tuberculosis and Respiratory Diseases
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v.84
no.3
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pp.200-208
/
2021
Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. Methods: An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. Results: The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. Conclusion: The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.
Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
Journal of Audiology & Otology
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v.23
no.2
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pp.96-102
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2019
Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.
Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
Korean Journal of Audiology
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v.23
no.2
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pp.96-102
/
2019
Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.
Kim, Young-Whan;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
Tuberculosis and Respiratory Diseases
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v.39
no.1
/
pp.28-34
/
1992
Background: Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, Noirth American and Korean have been reported. During recent two years we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics. Method: We reviewed the patients' age, sex, duration of illness, smoking history, occupational history and past medical history. And we analyzed patients' symptoms, physical signs, laboratory findings and responses to treatment. Results: 1) Male: female ratio was 2.2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years. 2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB. 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis. 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients. 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients. 6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%). 7) The titers of cold hemaglutinin, RA factor and CRP were elevated in most of the patients. 8) Most of the patients improved after treatment with erythromycin. Conclusion: DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB.
Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.
Purpose To compare the diagnostic performance of rectal CT with that of high-resolution rectal MRI and histopathology in assessing rectal cancer. Materials and Methods Sixty-seven patients with rectal cancer who underwent rectal CT with rectal distension using sonographic gel and high-resolution MRI were enrolled in this study. The distance from the anal verge/anorectal junction, distance to the mesorectal fascia (MRF), extramural depth (EMD), extramesorectal lymph node (LN) involvement, extramural venous invasion (EMVI), and T/N stages in rectal CT/MRI were analyzed by two gastrointestinal radiologists. The CT findings of 20 patients who underwent radical surgery without concurrent chemoradiotherapy were compared using histopathology. Interclass correlations and kappa statistics were used. Results The distance from the anal verge/anorectal junction showed an excellent intraclass correlation between CT and MRI for both reviewers. For EMD, the distance to the MRF, presence of LNs, extramesorectal LN metastasis, EMVI, T stage, and intermodality kappa or weighted kappa values between CT and MRI showed excellent agreement. Among the 20 patients who underwent radical surgery, T staging, circumferential resection margin involvement, EMVI, and LN metastasis on rectal CT showed acceptable concordance rates with histopathology. Conclusion Dedicated rectal CT may be on par with rectal MRI in providing critical information to patients with rectal cancer.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.2
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pp.228-235
/
2004
The development and proliferation of the mandibular condyle can be altered by changes in the biomechanical environment of the temporomandibular joint. The biomechanical loads were varied by feeding diets of different consistencies. The purpose of the present study was to determine whether changes of masticatory forces by feeding a soft diet can alter the trabecular bone morphology of the growing mouse mandibular condyle, by means of micro-computed tomography. Thirty-six female, 21 days old, C57BL/6 mice were randomly divided into two groups. Mice in the hard-diet control group were fed standard hard rodent pellets for 8 weeks. The soft-diet group mice were given soft ground diets for 8 weeks and their lower incisors were shortened by cutting with a wire cutter twice a week to reduce incision. After 8 weeks all animals were killed after they were weighed. Following sacrifice, the right mandibular condyle was removed. High spatial resolution tomography was done with a Skyscan Micro-CT 1072. Cross-sections were scanned and three-dimensional images were reconstructed from 2D sections. Morphometric and nonmetric parameters such as bone volume(BV), bone surface(BS), total volume(TV), bone volume fraction(BV/TV), surface to volume ratio(BS/BV), trabecular thickness(Tb. Th.), structure model index(SMI) and degree of anisotropy(DA) were directly determined by means of the software package at the micro-CT system. From directly determined indices the trabecular number(Tb. N.) and trabecular separation(Tb. Sp.) were calculated according to parallel plate model of Parfitt et al.. After micro-tomographic imaging, the samples were decalcified, dehydrated, embedded and sectioned for histological observation. The results were as follow: 1. The bone volume fraction, trabecular thickness(Tb. Th.) and trabecular number(Tb. N.) were significantly decreased in the soft-diet group compared with that of the control group (p<0.05). 2. The trabecular separation(Tb. Sp.) was significantly increased in the soft-diet group(p<0.05). 3. There was no significant differences in the surface to volume ratio(BS/BV), structure model index(SMI) and degree of anisotropy(DA) between the soft-diet group and hard-diet control group (p>0.05). 4. Histological sections showed that the thickness of the proliferative layer and total cartilage thickness were significantly reduced in the soft-diet group.
Kim, Gyeong-Rip;Sung, Soon-Ki;Kim, Chang-Hyeun;Kwak, Jong-Hyeok
Journal of the Korean Society of Radiology
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v.16
no.1
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pp.7-13
/
2022
This study compared the aortic root image by using the ECG gating and non-ECG gating methods. We observed the presence or absence of progression of the aortic root image in the images examined by the high pitch (flash) chest pain protocol method and in the patients tested without ECG gating by the conventional method. The AAPM phantom was scanned by using high pitch (flash) chest pain protocol and general chest pain protocol. CTDI values were compared. By ECG gating, the blurring of ascending aorta was significantly reduced compared to the existing non-ECG gating test method, and the image quality of the aortic root was improved. Within the parametar range that did not show differences in noise, uniformity, and high contrast resolution, CTDI values were lower when tested with the high-pitch chest pain protocol. It was found that there is an advantage in dose reduction, and if it is applied and applied to diagnostic fields such as dissection using the dose reduction mode in the cardiac field, it is a very important test for patients who need rapid diagnosis and prompt treatment as well as a dramatic reduction in exposure dose. It is presumed to be a method.
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