• Title/Summary/Keyword: Lung diseases, interstitial

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 2. Idiopathic Pulmonary Fibrosis

  • Lee, Sang Hoon;Yeo, Yoomi;Kim, Tae-Hyung;Lee, Hong Lyeol;Lee, Jin Hwa;Park, Yong Bum;Park, Jong Sun;Kim, Yee Hyung;Song, Jin Woo;Jhun, Byung Woo;Kim, Hyun Jung;Park, Jinkyeong;Uh, Soo-Taek;Kim, Young Whan;Kim, Dong Soon;Park, Moo Suk;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.2
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    • pp.102-117
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    • 2019
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

Spectrum of Pulmonary Fibrosis from Interstitial Lung Abnormality to Usual Interstitial Pneumonia: Importance of Identification and Quantification of Traction Bronchiectasis in Patient Management

  • Takuya Hino;Kyung Soo Lee;Joungho Han;Akinori Hata;Kousei Ishigami;Hiroto Hatabu
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.811-828
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    • 2021
  • Following the introduction of a novel pathological concept of usual interstitial pneumonia (UIP) by Liebow and Carrington in 1969, diffuse interstitial pneumonia has evolved into UIP, nonspecific interstitial pneumonia (NSIP), and interstitial lung abnormality (ILA); the histopathological and CT findings of these conditions reflect the required multidisciplinary team approach, involving pulmonologists, radiologists, and pathologists, for their diagnosis and management. Concomitantly, traction bronchiectasis and bronchiolectasis have been recognized as the most persistent and important indices of the severity and prognosis of fibrotic lung diseases. The traction bronchiectasis index (TBI) can stratify the prognoses of patients with ILAs. In this review, the evolutionary concepts of UIP, NSIP, and ILAs are summarized in tables and figures, with a demonstration of the correlation between CT findings and pathologic evaluation. The CT-based UIP score is being proposed to facilitate a better understanding of the spectrum of pulmonary fibrosis, from ILAs to UIP, with emphasis on traction bronchiectasis/bronchiolectasis.

Lymphoid Interstitial Pneumonia Associated with Primary Sjogren's Syndrome - A Case Report (일차성 Sjogren씨 증후군에서 발생한 림프구성 간질성 폐렴 1예: 증례보고와 국내문헌고찰)

  • Mo, Sang-Il;Lee, Hyeok-Gyu;Cho, A-Ra;Chung, Hye-Kyoung;Lee, Ho-Sung;Choi, Jae-Sung;Seo, Ki-Hyun;Nah, Seong-Su;Kim, Yong-Hoon;Na, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.5
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    • pp.375-380
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    • 2010
  • Lymphoid interstitial pneumonia (LIP) is a rare benign lymphoproliferative interstitial lung disease. LIP has been associated with autoimmune disorders, HIV, viral infections, and so on. Once underlying systemic diseases have been excluded, a diagnosis of idiopathic LIP can be made. Although 6 cases of pathologically confirmed LIP have occurred in Korea, thus far none has been associated with primary Sjogren's syndrome. A 44-year-old man was admitted to hospital due to a dry cough and dypsnea on exertion that had been ongoing for 2 months. A chest radiography showed multiple and variable-sized cystic lesions, on both lungs and both interstitial infiltration and consolidation in both lower lung fields. Tests for autoantibody showed positive results of anti-nuclear antibody and anti-Ro/La antibody. The patient underwent a video assisted thoracoscopic surgery biopsy and pathologically confirmed LIP. We report the first known case of LIP-associated with primary Sjogren's syndrome in Korea.

A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis (침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예)

  • Lee, Young-Min;Yoon, Hye-Kyoung;Kim, Joo-In
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.62-69
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    • 2002
  • Acute interstitial pneumonia (AIP) is a rare fulminant form of lung injury that presents acutely; usually in a previously healthy individual. It corresponds to a subset of cases of idiopathic adult respiratory distress syndrome (ARDS). Invasive pulmonary aspergillosis is a disease occuring predominantly with defects in immunity such as hematologic malignancy, influenza infection, postchemotherapy, long-term corticosteroid treatment. Invasive aspergillosis has worse prognosis and most cases are diagnosed at postmortem autopsies. We experienced a case of acute interstitial pneumonia with an invasive aspergillosis during corticosteroid treatment. Acute interstitial pneumonia with invasive aspergillosis was diagnosed by an open lung biopsy using thoracoscopy, showing fungal hyphae with sepsis and an acute angle branching invasion of the lung tissue and blood vessels. The patient was treated with IV amphotericin-B, but died due to septic shock.

Interstitial Lung Disease (간질성 폐질환)

  • Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.163-171
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    • 2011
  • Recently published articles on interstitial lung disease (ILD) have focused on the accurate diagnosis of idiopathic pulmonary fibrosis (IPF), serum biomarkers, acute exacerbation of IPF, the prognostic factors of ILD and the trial of new treatment. In particular, reports on the serum biomarkers such as CC-chemokine ligand 18, surfactant protein, circulating fibrocytes, and acute exacerbation of IPF are sufficient to be mentioned here. Pirfenidone therapy is the most important trial for the treatment of IPF. Other newer treatment trials such as interferon-gamma, sildenafil and imatinib have been reported to be unsuccessful. On the other hand, the sirolimus trial for lymphangioleiomyomatosis is promising. Combined pulmonary fibrosis and emphysema and IgG4-related disease are established to be the new disease entities of ILD.

Diagnostic Approaches for Idiopathic Pulmonary Fibrosis

  • Jae Ha Lee;Jin Woo Song
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.40-51
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    • 2024
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia with a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomes but remains a major medical challenge due to variability in clinical presentation and the shortcomings of existing diagnostic tests. Medical history collection is the first and most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarette smoking. Systemic assessment for connective tissue disease is essential in the initial evaluation of patients with suspected IPF to identify potential causes of interstitial lung disease (ILD). Radiologic examination using high-resolution computed tomography plays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computed tomography images can be considered. If additional tests such as surgical lung biopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsy should be considered as an alternative to surgical lung biopsy in medical centers with experience performing this procedure. Diagnosis through multidisciplinary discussion (MDD) is strongly recommended as MDD has become the cornerstone for diagnosis of IPF, and the scope of MDD has expanded to monitoring of disease progression and suggestion of appropriate treatment options.

Usefulness of Temporal Subtraction for The Detection of Interval Changes of Interstitial Lung Diseases on Chest Radiographs

  • Higashida, Yoshiharu;Ideguchi, Tadamitsu;Muranaka, Toru;Akazawa, Fumio;Miyajima, Ryuichi;Tabata, Nobuyuki;Ikeda, Hirotaka;Ohki, Masafumi;Toyofuku, Fukai;Doi, Kunio
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.454-456
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    • 2002
  • The evaluation of interval changes between temporally sequential chest radiographs is necessary for the detection of new abnormalities or interval changes, such as pulmonary nodules and interstitial disease. For interstitial lung disease, the interval changes are very important for diagnosis and treatment. Especially, interstitial lung disease may show rapid changes in the radiographs, show changes in the entire lung field in minute detail, or show changes in multiple parts depending on the type. It is therefore difficult to have an accurate grasp of the condition of the disease only with conventional radiographs. The temporal subtraction technique which was developed at the University of Chicago, provides a subtraction image of the current warped image and the previous image. A temporal subtraction image, shows only differences and changes between the two images, can be very useful for a diagnosis of interstitial lung disease. However, the evaluation of the temporal subtraction technique for interstitial lung disease using receiver operating characteristic(ROC) studies has not been reported yet. Therefore, we have evaluated the clinical usefulness of a temporal subtraction technique for detection of interval changes of interstitial lung disease by ROC analysis.

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A Case of Interstitial Lung Disease in Ulcerative Colitis (궤양성 대장염 환자에서 발생한 간질성 폐질환 1예)

  • Yoo, Min-Kyu;Lee, June-Ho;Han, Seong-Beom;Jeon, Young-June;Cho, Seung-Che
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1140-1145
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    • 1997
  • Extracolonic manifestations which occur in approximately 10~20% of patients with ulcerative colitis most commonly affect joints, skin, liver and eyes. In contrast, pulmonary involvement in ulcerative colitis is very rare. However, a variety of respiratory disorders has been associated with ulcerative colitis, including pulmonary vasculitis, bronchiectasis, chronic bronchitis, interstitial fibrosis, pleural effusion. Since the first observation of pulmonary involvement in ulcerative colitis by Kraft in 1976, a few cases have been reported, and probably no such case have been reported in Korea yet. Here we report an experience concerning 56 year-old man interstitial lung disease in ulcerative colitis, who was diagnosed by clinical, radiographic, endoscopic, histologic findings.

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