• Title/Summary/Keyword: Lung Diseases/diagnosis

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Clinical Features, Diagnosis, Management, and Outcomes of Idiopathic Pulmonary Fibrosis in Korea: Analysis of the Korea IPF Cohort (KICO) Registry

  • Jegal, Yangjin;Park, Jong Sun;Kim, Song Yee;Yoo, Hongseok;Jeong, Sung Hwan;Song, Jin Woo;Lee, Jae Ha;Lee, Hong Lyeol;Choi, Sun Mi;Kim, Young Whan;Kim, Yong Hyun;Choi, Hye Sook;Lee, Jongmin;Uh, Soo-Taek;Kim, Tae-Hyung;Kim, Sang-Heon;Lee, Won-Yeon;Kim, Yee Hyung;Lee, Hyun-kyung;Lee, Eun Joo;Heo, Eun Young;Yang, Sei Hoon;Kang, Hyung Koo;Chung, Man Pyo;Korea ILD Study Group,
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.2
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    • pp.185-194
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    • 2022
  • Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients. Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015. Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-age-physiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality. Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.

Bronchial Brushing and Bronchial Washing for Diagnosis of Central Lung Cancer (중심형 폐암 진단을 위한 기관지찰과술과 기관지세척술)

  • Park, Ki-Su;Park, Jae-Yong;Cha, Seung-Ick;Son, Ji-Woong;Kim, Kwan-Young;Kim, Jeong-Seok;Chae, Sang-Cheol;Kang, Tae-Kyong;Park, Tae-In;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.817-825
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    • 1999
  • Background : Forceps biopsy, bronchial brushing, and bronchial washing are used in conjunction with bronchoscopy to provide specimens for histologic and cytologic analysis in patients with suspected lung cancer. This study was performed to evaluate how many times brushing should be done and how much fluid should be used during bronchial washing for increasing diagnostic yield, and to evaluate which combination of these procedures gives the highest diagnostic yield. Methods : Forty patients, with suspected lung cancer, who had bronchoscopically visible lesions were enrolled in this prospective study. During one bronchoscopic examination four forceps biopsies, four bronchial brushings, and bronchial washing were done in all patients. The patients were divided into four groups by the amount of normal saline used for bronchial washing; group I, 10 ml ; group II, 20ml ; group III 30ml, and group IV, 40ml. We analyzed the results in 36 patients confirmed as lung cancer. Results : The diagnostic sensitivity of bronchial washing before and after forceps biopsy and bronchial brushing were 36% and 28%, respectively. The cumulative diagnostic sensitivity of bronchial washing was 47% and significantly higher than that of bronchial washing before or after forceps biopsy and bronchial brushing (p<0.05). The diagnostic sensitivity of bronchial washing with saline of 30ml was significantly higher than that of bronchial washing with saline of 10ml or 20ml (p<0.05). The diagnostic sensitivity of the first brushing was 75%, the second brushing 78%, the third brushing 83%, and the fourth brushing 67%. With repeated brushing up to three times, the diagnostic sensitivity increased to 92% (p<0.05). However, inclusion of the fourth brushing did not give a further increase of the diagnostic sensitivity. The diagnostic sensitivity of forceps biopsy was 86%. The diagnostic sensitivities of forceps biopsy by the type of bronchial lesion were as follows: tumor, 88%; infiltration, 67%; infiltration with nodularity, 80%; and collapse, 100%. The combination of forceps biopsy and bronchial washing gave a diagnostic sensitivity of 89%. The diagnostic sensitivity of combining forceps biopsy with bronchial brushing was 97%. Addition of bronchial washing did not increase the diagnostic yield over forceps biopsy and bronchial brushing. Conclusion : In patients with central lung cancer, forceps biopsies and repeated brushings up to three times should be done for maximal diagnostic yield.

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A Case of Kawasaki Disease with Mycoplasma Pneumonia (마이코플라즈마 폐렴 환아에서 병발한 가와사키병 1례)

  • Lee, Se Min;Park, So Eun;Kim, Yeun Woo;Hong, Jung Yeun
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.438-442
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    • 2005
  • Kawasaki disease is an acute febrile vasculitis that occurs predominantly in young children under 5-years-old. The patients present generally with a high spiking fever that is unresponsive to antibiotics and lasts for more than five days at least. Prolonged fever has been shown to be a risk factor in the development of coronary artery disease. It seems to be certain that infectious agents are associated with the pathogenesis of Kawasaki disease. The differential diagnosis of Kawasaki disease must rule out infectious diseases including scarlet fever, toxic shock syndrome, measles, and so on. This is very important for adequate treatment and prevention of cardiac complications of Kawasaki disease. We experienced a 25-month-old boy who had high fever and pneumonic consolidation in the right middle and lower lobe of the lung that was considered as mycoplasma pneumonia on admission and developed coronary artery aneurysmal dilatation during treatment with roxythromycin.

Mammary Squamous Cell Carcinoma in a Collard Peccary (Tayassy Tajacu) (페커리 (Collard peccary)에서 발생한 유선 편평 세포 선암종)

  • Lee, So-Young;Yoo, Jong-Hyun;Park, Chul;Sur, Jung-Hyang;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.386-390
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    • 2009
  • A 10-year-old female collared peccary (Tayassu tajacu) was referred due to a large palpable mass in caudal abdomen. Physical examination revealed a firm and freely moveable mass (15 ${\times}$ 9 cm) in the right side of caudal abdomen. Thoracic radiographic findings revealed a few well circumscribed nodules. This case was diagnosed as mammary gland squamous cell carcinoma with pulmonary metastasis based on histopathological and immunohistochemical findings. This type of mammary gland tumors is uncommon in wild animals. The patient survived for one month after the diagnosis. This is the first case report of mammary squamous cell carcinoma in a collard peccary and the second case report of metastatic carcinoma to lung in a collared peccary.

Ex Vivo Assay of Trace Nicotine Using a Voltammetric Modified Biosensor

  • Ly, Suw Young;Jang, Myung-Ho;Cha, Jae-Min;Kim, Min-Young;Oh, Hyun-Seok;Jo, Dong-Hyeon;Choi, Seong-Sik
    • Journal of the Korean Applied Science and Technology
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    • v.29 no.1
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    • pp.40-46
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    • 2012
  • In vivo nicotine is associated with Alzheimer's, Parkinson's and lung cancer. Diagnostic assays of these diseases depend on very low analytical detection limits. In this study, a sensitive analytical method was examined using a voltammetric graphite pencil electrode (GPE) and a modified carbon nanotube paste electrode (CNE). The optimum analytical conditions for both electrodes were compared using square wave anodic stripping voltammetry (SW) and cyclic voltammetry (CV) obtaining 400 sec accumulation time and oxidation peak. Under optimum parameters, the stripping working range of GPE was $5.0-40.0{\mu}g/L$, CNE: 0.1-0.8 and $5-50{\mu}g/L$. Quantification limits were $5.0{\mu}g/L$ for GPE and $0.1{\mu}g/L$ for CNE, while detection limits were $0.6{\mu}g/L$ for GPE and $0.07{\mu}g/L$ for CNE. A standard deviation of $10.0{\mu}g/L$ was observed for 0.064 GPE and 0.095 CNE (n = 12) using 400 sec accumulation time. The results obtained can be applied to non.treated urine and ex vivo biological diagnostics.

Congenital Cystic Adenomatoid Malformation Associated with Extralobar Pulmonary Sequestration -1 case report- (외엽형 폐격리증을 동반한 선천성 낭종성 선종양 기형 -1례 보고-)

  • Jeon, Sang-Hyeop;Kim, Byeong-Jun;Lee, Hyeong-Ryeol
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.223-226
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    • 1996
  • Pulmonary sequestration and congenital cystic adenomatoid malformation are two infrequent congenital pulmonary diseases and the combination of these two entities is rare. We had experienced a 3 week old male patient with a pulmonary mass, who had been sufyerring from tachypnea and chest wall retraction after birth. The pulmonary mass was suspected as a congenital cystic adenomat id malformation by chest CT. And therefore, we performed urgent operation via standard thoracotomy incision. Upon a thoracotomy, there was an extrapleural mass with anomalous blood supply near the posterior diaphragm and multiple cystic lesions in right lower lobe. The two anomalous arteries arising from the thoracic aorta and one vein draining into the azygos vein were ligated. and then the extrapleural mass was removed and a right lower lobectomy was performed. Final histologic diagnosis was congenital cystic adenomatoid malformation associated with extralobar pulmonary sequestration. The patient was discharged without any problem.

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A Study of Comparison between Ayurveda and Sasang Medicine based on Constitutional Theory (체질론에 근거한 사상의학과 아유르베다의 비교 연구)

  • Kwon, Gil-Ja
    • The Journal of the Korea Contents Association
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    • v.19 no.7
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    • pp.166-175
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    • 2019
  • The constitution of traditional medicine is distinguished from modern medicine. Sasang medicine describe the constitution which is classified as functional intensity of the lung, spleen, liver and kidney. The functional strength of each part of the human body is not the same in each constitution, and this imbalance is considered as a major factor of the disease. Ayurveda is identified the balance of the three dosha in our body is the basis of health maintenance. The reason for the illness is due to the imbalance among vata which express energy metabolism, pitta which plays a role in metabolism and digestion, and kapha which controls body temperature. The two theories which include knowing the characteristics and trends of diseases according to their constitution, the approach of treatment and the health care of daily life. They are also considered as convergent area about treatment methods in the modern society where individual characteristics and lifestyle are emphasized. The purpose of this study is to understand the concept of constitutional basis for increasing patient satisfaction and to help diversity of treatment in preventive medical area by comparing and analyzing the theory of Sasang and Ayurveda.

Detecting Foreign Objects in Chest X-Ray Images using Artificial Intelligence (인공 지능을 이용한 흉부 엑스레이 이미지에서의 이물질 검출)

  • Chang-Hwa Han
    • Journal of the Korean Society of Radiology
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    • v.17 no.6
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    • pp.873-879
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    • 2023
  • This study explored the use of artificial intelligence(AI) to detect foreign bodies in chest X-ray images. Medical imaging, especially chest X-rays, plays a crucial role in diagnosing diseases such as pneumonia and lung cancer. With the increase in imaging tests, AI has become an important tool for efficient and fast diagnosis. However, images can contain foreign objects, including everyday jewelry like buttons and bra wires, which can interfere with accurate readings. In this study, we developed an AI algorithm that accurately identifies these foreign objects and processed the National Institutes of Health chest X-ray dataset based on the YOLOv8 model. The results showed high detection performance with accuracy, precision, recall, and F1-score all close to 0.91. Despite the excellent performance of AI, the study solved the problem that foreign objects in the image can distort the reading results, emphasizing the innovative role of AI in radiology and its reliability based on accuracy, which is essential for clinical implementation.

Congenital Cystic Adenomatoid Malformation of Lung in Adults: Clinical, Pathologic and Radiologic Evaluation of Six Patients (성인에서 진단된 선천성 낭포성 유선종 폐기형 6예)

  • Park, Young Jin;Jung, Hoon;Park, I-Nae;Choi, Sang Bong;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Koo, Ho-Seok;Lee, Yang-Haeng;Choi, Suk-Jin;Jung, Soo-Jin;Lee, Hyun-Kyung;Kim, Ae Ran
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.110-115
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    • 2008
  • Background: Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare congenital developmental anomaly of the lower respiratory tract. Most cases are diagnosed within the first 2 years of life, so adult presentation of CCAM is rare. We describe here six adult cases of CCAM and the patients underwent surgical resection, and all these patients were seen during a five and a half year period. The purpose of this study was to analyze the clinical, radiological and histological characteristics of adult patients with CCAM. Methods: Through medical records analysis, we retrospectively reviewed the clinical characteristics, the chest pictures (X-ray and CT) and the histological characteristics. Results: Four patients were women and the mean age at diagnosis was 23.5 years (range: 18~39 years). The major clinical presentations were lower respiratory tract infection, hemoptysis and pneumothorax. According to the chest CT scan, 5 patients had multiseptated cystic lesions with air fluid levels and one patient had multiple cavitary lesions with air fluid levels, and these lesions were surrounded by poorly defined opacities at the right upper lobe. All the patients were treated with surgical resection. 5 patients underwent open lobectomy and one patient underwent VATS lobectomy. On the pathological examination, 3 were found to be CCAM type I and 3 patients were CCAM type II, according to Stocker's classification. There was no associated malignancy on the histological studies of the surgical specimens. Conclusion: As CCAM can cause various respiratory complications and malignant changes, and the risks associated with surgery are extremely low, those patients who are suspected of having or who are diagnosed with CCAM should go through surgical treatment for making the correct diagnosis and administering appropriate treatment.

Comparison of the Role of CT and Fiberoptic Bronchoscopy in the Diagnosis of Hemoptysis (객혈 진단을 위한 CT와 가관지경의 역할 비교)

  • Choe, Kyu-Ok;Kim, Hyun-Sook;Hong, Young-Kook;Seo, Jae-Seong;Ryu, Jeong-Ah;Yang, Dong-Gyoo;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.209-217
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    • 1999
  • Backgrounds: To investigate the role of CT as a screening tool and to compare the diagnostic accuracy with that of the fiberoptic bronchoscopy (FOB) in evaluating the causes of hemoptysis. Methods: The retrospective review of plain chest radiograph, CT and FOB was done in 72 patients with hemoptysis. The diagnosis were confirmed by histology (n=33), bacterial culture (n=6), cytology (n=3), serology (n=2), skin test (n= 1), clinical response (n=5), and airway disease mainly by HRCT (n=22). Results: The causes of hemoptysis were shown to be lung cancer (n=29), bronchiectasis (n=19), tuberculosis (n=12), aspergilloma (n=5), invasive aspergillosis (n=l), COPD (n=3) and others (n=3). The sensitivity was 100% and 91,7% by CT and FOB respectively. The diagnostic compatibility was 95.8% and 59.7% by CT and FOB respectively. The diagnostic compatibility in cases with central airway disease was 96.3% and 100 % in CT and FOB. In parenchymal disease, CT and FOB showed 91.3 % and 43.5 % of compatibility, respectively. airway disease, CT and FOB showed 100% and 31.8% compatibility, respectively. That is to say, CT has higher sensitivity and diagnostic compatibility than FOB for identifying the causes of hemoptysis, and is more helpful for patients with hemoptysis from parenchymal or airway disease. FOB had the advantage in obtaining histologic, cytologic and bacteriologic diagnosis with biopsy or washing Conclusion: CT should be used as the screening method before performing FOB for patients with hemoptysis who have normal or nonspecific findings or peripheral airway disease in plain chest radiograph.

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