• Title/Summary/Keyword: Lung Diseases/diagnosis

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Diagnostic Value of Transbronchial Lung Biopsy -Including Diagnostic Yield According to Tumor-bronchus Relationship- (경기관지폐생검의 진단적 가치 -병변과 기관지의 관계에 따른 진단율을 포함한 연구-)

  • Kang, Tae-Kyong;Cha, Seung-Ick;Park, Jae-Yong;Chae, Sang-Chul;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.438-447
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    • 2000
  • Background : Transbronchial lung biopsy (TBLB) is a relatively simple and convenient procedure to obtain lung tissue from a patient with diffuse or localized lesion on chest radiographs, whose disease cannot be diagnosed through routine tests. The authors tried to evaluate the diagnostic value of TBLB, especially, the concordance between CT scan and TBLB with respect to the location of the lesion and diagnostic yield according to tumor-bronchus relationship. Method : We reviewed the medical records, plain chest films, and chest CT scans of 278 patients who underwent TBLB at Kyungpook National University Hospital between January 1996 and June 1998. Results : One hundred and sixteen (41.7 %) patients were diagnosed by TBLB. Diagnostic yield of TBLB of malignant tumors tended to be higher than that of benign diseases (64.7% versus 53.9%, p=0.09). Of primary lung cancers, TBLB was more diagnostic in adenocarcinoma and small-cell carcinoma than other cell types (p<0.01) and, of benign diseases, more diagnostic in tuberculosis than in non-tuberculous diseases (p<0.05). There was no significant difference in the diagnostic rate according to the location of the tumor. The diagnostic rate tended to increase with the size of tumor (p=0.06). The diagnootic rate of TBLB did not differ according to the pattern of lesion in benign diseases. However, in malignant diseases TBLB was more diagnostic in diffuse/multiple nodular lesions than in localized lesions(p<0.05). According to the tumor-bronchus relationship, TBLB was more diagnootic in type I/II groups than in other types. CT scan and TBLB showed a strong correlation with respect to the localization of the lesion (r=0.994, p<0.01). Conclusion : The above results show that TBLB is useful in the diagnosis of lung disease. CT scan and TBLB showed a strong correlation in determining the location of the lesion. Diagnostic yield of TBLB is higher in lesions with 'bronchus sign' (type I and II). TBLB and other diagnootic methods such as transthoracic needle aspiration are expected to complement one another in the diagnosis of lung diseases.

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Pulmonary vascular Segmentation Using Insight Toolkit(ITK) (ITK를 이용한 폐혈관 분할)

  • Shin, Min-Jun;Kim, Do-Yeon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2011.10a
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    • pp.554-556
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    • 2011
  • The occurrence of various vascular diseases due to the need for accurate and rapid diagnosis was emphasized. Several limitations to the presence of pulmonary vascular angiography for chest CT imaging was aware of the need for diversity in medical image processing with Insight Toolkit(ITK) suggested pulmonary vascular division. In this paper, by contrast, based on the value of a two-step partitioning of the lungs and blood vessels to perform the process of splitting. Lung area segmentation of each stage image enhancement, threshold value, resulting in areas of interest cut image acquisition and acquired pulmonary vascular division in lung area obtained by applying the fill area. Partitioned on the basis of pulmonary vascular imaging to obtain three-dimensional visualization image of the pulmonary vascular analysis and diagnosis of a variety of perspectives are considered possible.

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Lesion Mimicking Lung Tumor (폐종양으로 오인된 병소)

  • Ko, Hoon;Cho, Yongseon;Lee, Yang Deok;Han, Min Soo;Kang, Dong Wook
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.197-200
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    • 2004
  • A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{\times}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.

Secondary Adrenal Insufficiency Associated with Megestrol Acetate in a Patient with Lung Cancer (Megestrol Acetate와 관련된 이차성 부신기능저하증의 폐암 1예)

  • Park, Ji Chan;Park, Suk Young
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.47-51
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    • 2009
  • Loss of appetite is an important factor in the quality of life for advanced cancer patients. Megestrol acetate is used to stimulate appetite, but it can cause suppression of the pituitary adrenal axis due to the affinity of the glucocorticoid receptor. Adrenal insufficiency is a life threatening disorder if left, untreated, but the initial clinical symptoms of the patients are vague. Awareness of the glucocorticoid-like activity of megestrol acetate and its side effects are important for the diagnosis of adrenal insufficiency. We present a case of secondary adrenal insufficiency associated with megestrol acetate in a patient with lung cancer.

A Case of Partial Spontaneous Regression of Non-Small Cell Lung Cancer (부분 자연 관해를 보인 비소세포폐암 1예)

  • Hong, Sung Ho;Park, Sang Myeon;Shin, Tae Rim
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.132-135
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    • 2009
  • Spontaneous regression is extremely rare in lung cancer and this in spite of its global high incidence. So far, less than 30 such cases have been reported in the literature. We report here on the case of a 68-year-old man who had the diagnosis of adenocarcinoma and in absence of any medical therapy, he had a partial spontaneous regression of tumor.

Variation of Blood T Lymphocyte Subgroups in Patients with Non- small Cell Lung Cancer

  • Wang, Wen-Jing;Tao, Zhen;Gu, Wei;Sun, Li-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4671-4673
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    • 2013
  • Objectives: To study variation in T lymphocyte subgoups and its clinical significance in non-small cell lung cancer (NSCLC). Methods: Levels of CD3+, CD4+, CD8+, CD4+/CD8+, NK and Treg cells in peripheral blood of NSCLC cases and healthy adults were determined by flow cytometry. Results: CD3+, CD4+ and CD4+/CD8+ ratio and NK cells in NSCLCs were decreased significantly in comparison with the control group (P < 0.01), and decreased with increase in the clinical stage of NSCLC, while CD8+ cells demonstrated no significant change (P > 0.05). Treg cells were significantly more frequent than in the control group (P < 0.01), and increased with the clinical stage of NSCLC. Conclusion: The cellular immune function of the NSCLC patients is lowered. It is important to detect change of T lymphocyte subgroups by flow cytometry for the diagnosis, treatment and prognostic assessment of NSCLC patients.

A Case of Pulmonary Alveolar Microlithiasis (폐포 미세 결석증 1예)

  • Lee, Bu-Hyun;Kang, Byung-Soo;Min, Joo-Won;Park, Sang-Joon;Kim, Tae-Ho;Chung, Jae-Ho;Park, Chan-Sub
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.55-58
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    • 2011
  • Pulmonary alveolar microlithiasis is a rare disease of unknown etiology that is characterized by the presence of calcific concentrations in the alveolar spaces. The radiographic appearance is pathognomonic. Plain chest radiographs show a white lung or sandstorm lung consisting of fine sand like microcalcifications diffusely scattered throughout both lungs with a higher density at the lung bases. We now report the case of a 67-year-old male whose diagnosis was based on characteristic findings on a chest X-ray and a high-resolution computed tomography scan.

Clinical Characteristics of Slowly Growing Lung Cancer: 6 Case-Series Evaluation (서서히 자라는 폐암의 임상적 특성: 6증례 평가)

  • Nam, Hae-Seong;Yang, Dong-Hyuk;Kim, Jeong-Soo;Kim, Hyun-Jung;Yi, Hyeon-Gyu;Lee, Kyung-Hee;Cho, Jae-Hwa;Yoon, Yong-Han;Kwak, Seung-Min;Lee, Hong-Lyeol;Kim, Kwang-Ho;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.3
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    • pp.180-184
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    • 2010
  • Slowly growing lung cancers are quite rare and the leading cause of length time bias and over-diagnosis bias in lung cancer screening. We report 6 cases of slowly growing lung cancer in a tertiary hospital between January 1999 and December 2008. The clinical characteristics of these 6 cases with slowly growing lung cancer were examined. The median age at diagnosis was 68 years (range, 49~72), and 5 patients (83%) were female. The most common histology type was adenocarcinoma (83%). After excluding two patients who showed no change in the tumor size, the median tumor doubling time was 189 months (range, 86~387). The proportion of patients with slowly growing lung cancer appears to be particularly large in women, especially among patients with adenocarcinoma. Our experience shows that slowly growly lung cancers are more heterogeneous and diverse.

A Quality Assurance on Digital Chest Radiography in Medical Institution for Pneumoconiosis : Compared with Analog Radiography (진폐요양기관의 흉부 디지털촬영과 아날로그촬영의 정도관리 비교)

  • Lee, Won-Jeong;Ko, Kyung-Sun;Park, Jai-Soung;Kim, Sung-Jin;Chu, Sang-Deok;Park, So-Young;Choi, Byung-Soon
    • Journal of radiological science and technology
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    • v.33 no.2
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    • pp.85-91
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    • 2010
  • Digital radiography has been replacing rapidly the analog radiography for diagnosis of pneumoconiosis. The purpose of this study is to compare quality control of digital radiography (DR) and analog radiography (AR) for chest radiography in medical institution for pneumoconiosis (MIP) For the first time, we visited MIP to evaluate the chest radiography which is used for patients with pneumoconiosis, including equipment, technical parameters and reading environment. There were 33 institutions. DR and AR were installed in 24 and 9 institutions, respectively. Between DR and AR, we compared the radiological technique (RT), image quality (IQ) and reading environment (RE) to use the guideline published by Occupational Safety and Health Research Institute (OSHRI). The image quality was rated by two experienced chest radiologists for pneumoconiosis with certified from OSHRI. The chest radiography equipment was not significantly difference between AR and DR, but there were significantly difference in tube voltage and grid ratio used for chest radiography except to tube current, exposure time. Statistically, DR is significantly higher in RT(70.3 vs. 43.8, p = 0.009), RE(77.7 vs. 33.3, p = 0.004) than AR, but it's not significantly difference in IQ (65.6 vs. 52.8, p = 0.050). AR and DR in RT were passed 33.3%, 75.0% respectively (p = 0.044) and 44.4%, 79.2% (p = 0.090) in IQ and 44.4%, 91.7% (p = 0.009) in RE. In MIP, DR needs to replace AR in diagnosis of pneumoconiosis.

A Case of Node-bronchial Fistula by Non-small Cell Lung Cancer (비소세포성 폐암으로 인한 기관지 림프절 누공 1예)

  • Kim, Seo-Woo;Kim, Hyun-Kyung;Jeun, Sung-Joung;Park, Hye-Sung;Jang, Jung-Hyun;Lee, Jin-Hwa;Ryu, Yon-Ju;Sim, Sung-Shin;Chun, Eun-Mi
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.4
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    • pp.231-235
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    • 2010
  • Lymphadenopathy in the thoracic cavity is frequently caused by inflammatory diseases. In very rare cases, the node-bronchial fistula has been reported to be the cause of complications of pulmonary tuberculosis. A male patient with necrotizing pneumonia and mediastinal lymph node enlargements identified by chest computed tomography was also found to have a node-bronchial fistula caused by lung cancer. The patient was treated for tuberculosis with pneumonia for one week before a definitive diagnosis was made. A further investigation revealed him to have non-small cell lung cancer (NSCLC, adenocarcinoma) and multiple mediastinal lymphadenopathies accompanied with the node-bronchial fistula. We report this specific case that had been previously treated for tuberculosis but was later revealed to be NSCLC accompanied with a node-bronchial fistula.