• Title/Summary/Keyword: Lung, diseases

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Clinical Year in Review of Interstitial Lung Diseases: Focused on Idiopathic Interstitial Pneumonia (사이질 폐병의 최신지견: 특발사이질 폐렴을 중심으로)

  • Lee, Won-Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.275-280
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    • 2009
  • Interstitial lung disease (ILD) is a group of diseases characterized by pulmonary interstitial inflammation. Finally the inflammation results in pulmonary fibrosis and impairment of oxygen transportation. The causes of idiopathic interstitial pneumonia (IIP) are unknown. Diagnosis of IIP is not easy, especially distinguising between nonspecific interstitial pneumonia and usual interstitial pneumonia (UIP). First line treatments of IIP include corticosteroids and immune modulators, which have limited effect. Currently, several drugs are being researched to prevent and treat fibrosis. Newer drugs that may useful to treat pulmonary fibrosis include endothelin receptor antagonist, recombinant soluble TNF receptor antagonist, and cotrimoxazole. The causes of IIP are largely unknown, treatment is not specific, and prognosis is poor. Recent studies are underway to investigate the pathogenesis and treatment of IIP and pulmonary fibrosis. As the pathogenesis of IIP is elucidated, better treatments will emerge.

Current Diagnosis and Management of Hypersensitivity Pneumonitis

  • Leone, Paolo Maria;Richeldi, Luca
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.122-131
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    • 2020
  • Hypersensitivity Pneumonitis (HP) one of the most common interstitial lung diseases (ILDs) is characterized by exposure to an inhaled inciting antigen that leads to a host immunologic reaction determining interstitial inflammation and architectural distortion. The underlying pathogenetic mechanisms are unclear. The absence of international shared diagnostic guidelines and the lack of a "gold-standard" test for HP combined with the presence of several clinical and radiologic overlapping features makes it particularly challenging to differentiate HP from other ILDs, also in expert contests. Radiology is playing a more crucial role in this process; recently the headcheese sign was recognized as a more specific for chronic-HP than the extensive mosaic attenuation. Several classification proposals and diagnostic models have been advanced by different groups, with no prospective validation. Therapeutic options for HP have been limited to antigen avoidance and immunosuppressant drugs over the last decades. Several questions about this condition remain unanswered and there is a need for more studies.

Effect of the Changing the Lower Limits of Normal and the Interpretative Strategies for Lung Function Tests (폐기능검사 해석에 정상하한치 변화와 새 해석흐름도가 미치는 영향)

  • Ra, Seung Won;Oh, Ji Seon;Hong, Sang-Bum;Shim, Tae Sun;Lim, Chae Man;Koh, Youn Suck;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.129-136
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    • 2006
  • Background: To interpret lung function tests, it is necessary to determine the lower limits of normal (LLN) and to derive a consensus on the interpretative algorithm. '0.7 of LLN for the $FEV_1$/FVC' was suggested by the COPD International Guideline (GOLD) for defining obstructive disease. A consensus on a new interpretative algorithm was recently achieved by ATS/ERS in 2005. We evaluated the accuracy of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases, and we also determined the effect of the new algorithm on diagnosing ventilatory defects. Methods: We obtained the age, gender, height, weight, $FEV_1$, FVC, and $FEV_1$/FVC from 7362 subjects who underwent spirometry in 2005 at the Asan Medical Center, Korea. For diagnosing obstructive diseases, the accuracy of '0.7 of LLN for the $FEV_1$/FVC' was evaluated in reference to the $5^{th}$ percentile of the LLN. By applying the new algorithm, we determined how many more subjects should have lung volumes testing performed. Evaluation of 1611 patients who had lung volumes testing performed as well as spirometry during the period showed how many more subjects were diagnosed with obstructive diseases according to the new algorithm. Results: 1) The sensitivity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases increased according to age, but the specificity was decreased according to age; the positive predictive value decreased, but the negative predictive value increased. 2) By applying the new algorithm, 34.5% (2540/7362) more subjects should have lung volumes testing performed. 3) By applying the new algorithm, 13% (205/1611) more subjects were diagnosed with obstructive diseases; these subjects corresponded to 30% (205/681) of the subjects who had been diagnosed with restrictive diseases by the old interpretative algorithm. Conclusion: The sensitivity and specificity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases changes according to age. By applying the new interpretative algorithm, it was shown that more subjects should have lung volumes testing performed, and there was a higher probability of being diagnosed with obstructive diseases.

Influence of Hazy Weather on Patient Presentation with Respiratory Diseases in Beijing, China

  • Ping, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.607-611
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    • 2015
  • Background: Chronic respiratory disease is an important factor for development of lung cancer. To explore the influence of hazy weather on respiratory diseases and its variation the present study was conducted. Materials and Methods: Data from air pollution surveillance from January to October 2014 and case records of visiting patients in the $263^{th}$ Hospital of Chinese PLA in the corresponding period were collected to analyze the relevance between different degrees of air pollution (hazy weather) and the number of visiting patients in Department of Respiratory Disease. Results: Air quality index (AQI) of hazy weather had significantly positive association with particulate matter 2.5 ($PM_{2.5}$) and the number of patients with 5 kinds of respiratory diseases i and different pollutants had distinct influences on various respiratory diseases. Conclusions: The degree of air pollution in Beijing City is in close association with the number of patients with respiratory diseases, in which $PM_{2.5}$ and $SO_2$ are in more significant influences on all respiratory diseases. This could have essential implications for lung cancer development in China.

CT Radiologic Findings in Patients with Tuberculous Destroyed Lung and Correlation with Lung Function (결핵성 파괴폐의 흉부 전산화단층촬영 소견 및 폐기능과의 상관관계)

  • Chae, Jin-Nyeong;Jung, Chi-Young;Shim, Sang-Woo;Rho, Byung-Hak;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.202-209
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    • 2011
  • Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second ($FEV_1$), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and $FEV_1$, % predicted (B=-0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.

Gastric Metastasis of Primary Lung Adenocarcinoma Mistaken for Primary Gastric Cancer (원발성 위암으로 오인된 전이성 비소세포 폐암 1예)

  • Park, Young Sik;Lee, Jin Woo;Lim, Hyo-Jeong;Lee, Geon Kook;Hwangbo, Bin;Lee, Hee Seok
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.52-57
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    • 2009
  • The stomach is a rare site for metastasis, with autopsy incidence rates of 0.2% to 1.7%. This low rate makes diagnosis of metastatic gastric cancer challenging for clinicians. The authors report a case of a 64-year-old man diagnosed with gastric metastasis of primary lung adenocarcinoma that was initially mistaken for primary gastric cancer, as well as a review of the medical literature.

A Case of Primary Extranodal NK/T Cell Lung Lymphoma Presenting as Multiple Patchy Pulmonary Infiltrations (다발성 반점형 폐침윤으로 발현한 원발성 NK/T 세포 폐림프종)

  • Jung, Gum Mo;Kwak, Jin Young;Choi, Hyun Jong;Park, Hyo Suk;Chang, Myoung;Lee, Kwang Min;Kim, Nam Don;Park, Yong Jin;Kim, Kwi Wan
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.636-642
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    • 2003
  • Primary lung lymphoma is an uncommon tumor, which constitutes 0.5% of primary lung cancer, and 3% of extranodal lymphoma. The most frequent radiologic presentation of pulmonary parenchymal lymphoma is single mass or nodule. But we have experienced a case which was radiologically presented as patchy lung infiltration at first, and then progressive multiple reticulonodular infiltrations in lung. A 48-year-old woman was admitted to the hospital because of fever and cough. Chest PA obtained on admission revealed multiple patchy infiltration. Eventually, open lung biopsy was performed and the specimen disclosed extranodal NK/T cell lymphoma, and in bone marrow aspiration, hemophagocytosis was present. We report a case of primary extranodal NK/T cell lung lymphoma presented as patchy lung infiltrations, which was treated with chemotherapy.

A Case of Pulmonary Alveolar Proteinosis Associated With Silicosis (진폐와 병발된 폐포단백증 1예)

  • Chi, Dong-Han;Kim, Hyun-Suk;Jeon, Jeong-Bae;Ryu, Jeong-Seon;Kwak, Seung-Min;Lee, Hong-Lyeol;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.437-443
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    • 1998
  • Pulmonary alveolar proteinosis is characterized by the accumulation of PAS positive lipoproteinaceous or amorphous proteinaceous material in the alveolar space with spared delicate septal architecture of the lung interstitium and impaired gas exchange of alveoli. We experienced a case of secondary pulmonary alveolar proteinosis in a 41 year old male patient who have occupational history of engagement as a mason over 4year. He compalined exertional dyspnea and chest discomfort, and presented fine inspiratory crackle at both lower lung field, numerous fine nodular denisties in both lung field with peripheral sparing. Light microscopic finding of lung tissue obtained by transbronchiallung biopsy revealed homogenous eosinophilic colloid-like luminal content in the alveolar space, and electron microscopy of bronchoalveolar lavage fluid concentrate showed electron-dense multilamellated structures. To treat the disease, we tried whole lung lavage of right lung with isotonic saline under general anesthesia. After whole lung lavage of right lung, he showed markid improvement of symptom and partial improvement of chest X-ray findings. The patient has been followed for 12 month until now, with no evidence of aggravation.

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Correlation between Physical Activity and Lung Function in Dusty Areas: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort

  • Han, Yuri;Heo, Yeonjeong;Hong, Yoonki;Kwon, Sung Ok;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.311-318
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    • 2019
  • Background: Although physical activity is known to be beneficial to lung function, few studies have been conducted to investigate the correlation between physical activity and lung function in dusty areas. Therefore, the purpose of this study is to investigate the correlation between physical activity and lung function in a Korean cohort including normal and COPD-diagnosed participants. Methods: Data obtained from the COPD in dusty areas (CODA) cohort was analyzed for the following factors: lung function, symptoms, and information about physical activity. Information on physical activity was valuated using questionnaires, and participants were categorized into two groups: active and inactive. The evaluation of the mean lung function, modified Medical Research Council dyspnea grade scores, and COPD assessment test scores was done based on the participant physical activity using a general linear model after adjusting for age, sex, smoking status, pack-years, height, and weight. In addition, a stratification analysis was performed based on the smoking status and COPD. Results: Physical activity had a correlation with high forced expiratory volume in 1 second ($FEV_1$) among CODA cohort (p=0.03). While the active group exhibited significantly higher $FEV_1$ compared to one exhibited by the inactive group among past smokers (p=0.02), no such correlation existed among current smokers. There was no significant difference observed in lung function after it was stratified by COPD. Conclusion: This study established a positive correlation between regular physical activity in dusty areas and lung function in participants.