• Title/Summary/Keyword: Lung, interstitial diseases

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 3. Idiopathic Nonspecific Interstitial Pneumonia

  • Lee, Jongmin;Kim, Yong Hyun;Kang, Ji Young;Jegal, Yangjin;Park, So Young;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.277-284
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    • 2019
  • Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.

Idiopathic Interstitial Pneumonias : Radiologic Findings (특발성간질성폐렴의 방사선학적 소견)

  • Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.129-144
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    • 2003
  • Usual interstitial pneumonia/Idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia(bronchiolitis obliterans organizing pneumonia : BOOP), Acute interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, Desquamative interstitial pneumonia, Lymphoid interstitial pneumonia.

Recurrent Desquamative Interstitial Pneumonia with Fibrotic Lung Disease (폐섬유화를 동반한 재발성 박리성 간질성 폐렴)

  • Kim, Won Jin;Choi, Jeong Hee;Park, Yong Bum;Cho, Sung Woo;Nam, Eun Sook;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.328-333
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    • 2008
  • Desquamative interstitial pneumonia is an uncommon form of interstitial lung diseases and it has a good prognosis compared with other types of idiopathic interstitial pneumonia. A 69-year old man was admitted to our hospital because of a 3-month history of dyspnea. The patient presented with hypoxemia. High-resolution computerized tomography of the patient showed ground glass opacity and traction bronchiectasis with subpleural early honeycombing on the both lung fields. The pathologic findings of the video-assisted thoracoscopy lung biopsy were compatible with desquamative interstitial pneumonia, and irregularly distributed interstitial fibrosis and inflammation were observed at the peripheral parenchyme. Oral predinsolone was started; his symptoms and chest x-ray were improved, and so he stopped taking the prednisolone. Ten months later, the desquamative interstitial pneumonia recurred. We report here on a case of recurrent desquamative interstitial pneumonia with fibrotic lung disease.

Interstitial Lung Disease in a Patient with Dyskeratosis Congenita

  • Kim, Hyun Jung;Kim, Kyu Jin;Lee, Kwan Ho;Shin, Kyeong-Cheol;Chung, Jin Hong;Hyun, Myung Soo;Kim, Ki-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.2
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    • pp.70-73
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    • 2013
  • Dyskeratosis congenita is a rare congenital disorder characterized by a triad of reticular pigmentation of the skin, dystrophic nails, and leukoplakia of the mucous membrane. Sometimes it is associated with bone marrow failure, secondary malignancy and interstitial lung disease. Though it is rare, Dyskeratosis congenita is diagnosed relatively easily when clinicians suspect it. It can be diagnosed just by gross inspection with care. Dyskeratosis congenita should be considered as one cause associated with interstitial lung disease. In Korea, interstitial lung disease with dyskeratosis congenita has not been reported. We report a case and review the literature.

Ground-Glass Opacity in Lung Metastasis from Breast Cancer: A Case Report

  • Kim, Sae Byol;Lee, Soohyeon;Koh, Myoung Ju;Lee, In Seon;Moon, Chan Soo;Jung, Sung Mo;Kang, Young Ae
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.1
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    • pp.32-36
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    • 2013
  • A 43-year-old woman with breast cancer who was on neoadjuvant chemotherapy presented with cough, sputum and mild fever. High-resolution computed tomography showed diffuse ground glass opacities in bilateral lungs and subpleural patchy consolidations. Initially, she was thought to have pneumonia or interstitial lung diseases such as drug-induced pneumonitis and treated with antibiotics and steroids. She subsequently got breast cancer surgery because of disease progression, and concurrent thoracoscopic lung biopsy revealed metastatic carcinoma of the lung from breast cancer. The diagnosis of suspected interstitial lung disease can be made without lung biopsy, but malignancy should always be considered and lung biopsy should be performed in the absence of a definitive clinical diagnosis.

The Development of an Expert System for Supporting the Diagnosis of Diffuse Interstitial Lung Diseases by High Resolution Computed Tomography$^1$

  • Heon Han;Chung, Sung-Hoon;Chae, Young-Moon
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2001.01a
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    • pp.378-382
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    • 2001
  • The purpose of this study was to develop an expert system supporting the diagnosis of diffuse interstitial lung disease by high resolution computed tomography. CLIPS(C language integrated production system) with rule-based reasoning was used to develop the system. Development of expert system had three stages knowledge acquisition, knowledge representation, and reasoning. Knowledge was obtained and integrated, from tables and figure legends of a representative textbook in the domain of this expert system, High-Resolution CT of the Lung, by Webb WR, Mueller NL, and Naidich DP. The acquired knowledge was analyzed to form a knowledge base. Overlapping knowledge was eliminated, similar pieces of knowledge were combined and professional terms were defined. The most important knowledge of findings was then selected for each disease. After groupings of combined findings were made, disease groups were analyzed sequentially to determine final diagnoses. The system was based upon the input of 69 diseases, 185 findings, 73 conditions, 387 status, and 62 rules. The system was set up to determine the diagnoses of diseases from the combination of findings using forward reasoning. In an empirical trial, the system was applied to support the diagnosis of 40 cases of diffuse interstitial lung diseases. The performance of two doctors with support of the system was compared to that of another two doctors without support of the system. The two doctors with the support of the system made more accurate diagnoses than the doctors without the support of the system. The system is believed to be useful for the diagnosis of rare diseases and for cases with many possible differential diagnoses. In conclusion, an expert system supporting the high resolution computed tomographic diagnosis of diffuse interstitial lung disease was developed and the system is thought to be useful for medical practice.

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Short-Term Lung Function Changes and Predictors of Progressive Systemic Sclerosis-Related Interstitial Lung Disease

  • Kaenmuang, Punchalee;Navasakulpong, Asma
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.4
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    • pp.312-320
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    • 2020
  • Background: Systemic sclerosis (SSc) involves multiple organ systems and has the highest mortality among connective tissue diseases. Interstitial lung disease is the most common cause of death among SSc patients and requires closer studies and follow-ups. This study aimed to identify lung function changes and predictors of progressive disease in systemic sclerosis-related interstitial lung disease (SSc-ILD). Methods: A retrospective study extracted SSc patients from an electronic database January 2002-July 2019. Eligible cases were SSc patients >age 15 diagnosed with SSc-ILD. Factors associated with progressive disease were analyzed by univariate and multivariate logistic regression analyses. Results: Seventy-eight SSc-ILD cases were enrolled. Sixty-five patients (83.3%) were female, with mean age of 44.7±14.4, and 50 (64.1%) were diffuse type SSc-ILD. Most SSc-ILD patients had crackles (75.6%) and dyspnea on exertion (71.8%), and 19.2% of the SSc-ILD patients had no abnormal respiratory symptoms but had abnormal chest radiographic findings. The most common diagnosis of SSc-ILD patients was non-specific interstitial pneumonia (43.6%). The lung function values of diffusing capacity of the lung for carbon monoxide (DLCO) and DLCO per unit alveolar volume declined in progressive SSc-ILD during a 12-month follow-up. Male and no previous aspirin treatment were the two significant predictive factors of progressive SSc-ILD with adjusted odds ratios of 5.72 and 4.99, respectively. Conclusion: This present study showed that short-term lung function had declined during the 12-month follow-up in progressive SSc-ILD. The predictive factors in progressive SSc-ILD were male sex and no previous aspirin treatment. Close follow-up of the pulmonary function tests is necessary for early detection of progressive disease.

Research Trends of Interstitial Lung Disease (간질성 폐질환의 연구 동향)

  • Son, Ji-Woo;Lee, Jung-Wook;Lee, Byung-Soon;No, Woon-Serb;Lee, Byung-Ju;Shin, Jo-Young;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.13 no.1
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    • pp.26-38
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    • 2007
  • Interstitial lung disease (ILD) is characterized by progressive scarring of the lung leading to restriction and diminished oxygen transfer. Clinically, the presenting symptoms of ILD are nonspecific (cough and progressive dyspnea on exertion) and are often attributed to other diseases, thus delaying diagnosis and timely therapy. In this study, I analyzed the 10 chinese papers of interstitial lung diseases(ILD). The etiology are body resistance weakness(本虛) and pathogenic factor prevailing(標實). The body resistance weakness(本虛) including deficiency of the lung(肺虛), deficiency of the kidney(腎虛), deficiency of the spleen(脾虛), deficiency of Qi and Yin(氣陰兩虛), pathogenic factor prevailing(標實) including stagnation of phlegm(痰濁), blood stasis(瘀血), noxious heat(熱毒). As an treatment aim at supplementing lung and kidney(益肺腎), resolving phlegm and blood stasis(化痰瘀).

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Radiologic Findings of Idiopathic Interstitial Pneumonia (특발성 간질성 폐렴의 영상 소견)

  • Park, Jai Soung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.330-343
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    • 2005
  • 특발성 간질성 폐렴은 폐포보다는 폐간질을 주로 침범하는 미만성 염증성 섬유화 병변으로 병변의 분류에 임상적 및 병리학적으로 많은 혼동과 변화를 겪어왔다. 최근에는 미국흉부학회와 유럽호흡기학회의 공동 모임에서 이 질환 군에 해당되는 모든 임상과들이 모여서 7가지의 병변으로 재분류 하였는데, 이는 Idiopathic pulmonary fibrosis, Nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia, Acute interstitial pneumonia, Respiratory bronchiolitis interstitial lung disease, Desquamative interstitial pneumonia, Lymphocytic interstitial pneumonia 등이다. 이에 저자는 최근 분류에 의한 특발성 간질성 폐렴의 7가지 병변을 영상 소견을 중심으로 기술하고자 한다.

A Case of Non-Specific Interstitial Pneumonia Associated with Primary Lung Adenocarcinoma (폐선암과 병발한 비특이적간질성폐렴 1례)

  • Sim, Yun Su;Lee, Jin Hwa;Ryu, Yon Ju;Chun, En Mi;Kim, Yoo Kyung;Sung, Sun Hee;Ahn, Jae Ho;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.83-87
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    • 2007
  • Idiopathic pulmonary fibrosis (IPF) is strongly associated with lung cancer compared with the general population. However, other types of idiopathic interstitial pneumonia (IIP) are rarely associated with lung cancer. We describe a case of a primary lung cancer associated with IIP other than IPF, which was considered to be nonspecific interstitial pneumonia (NSIP), and NSIP disappeared spontaneously after treating the primary lung cancer.