• Title/Summary/Keyword: granulomatous inflammation

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Occupational Lung Diseases: Spectrum of Common Imaging Manifestations

  • Alexander W. Matyga;Lydia Chelala;Jonathan H. Chung
    • Korean Journal of Radiology
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    • v.24 no.8
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    • pp.795-806
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    • 2023
  • Occupational lung diseases (OLD) are a group of preventable conditions caused by noxious inhalation exposure in the workplace. Workers in various industries are at a higher risk of developing OLD. Despite regulations contributing to a decreased incidence, OLD remain among the most frequently diagnosed work-related conditions, contributing to significant morbidity and mortality. A multidisciplinary discussion (MDD) is necessary for a timely diagnosis. Imaging, particularly computed tomography, plays a central role in diagnosing OLD and excluding other inhalational lung diseases. OLD can be broadly classified into fibrotic and non-fibrotic forms. Imaging reflects variable degrees of inflammation and fibrosis involving the airways, parenchyma, and pleura. Common manifestations include classical pneumoconioses, chronic granulomatous diseases (CGD), and small and large airway diseases. Imaging is influenced by the type of inciting exposure. The findings of airway disease may be subtle or solely uncovered upon expiration. High-resolution chest CT, including expiratory-phase imaging, should be performed in all patients with suspected OLD. Radiologists should familiarize themselves with these imaging features to improve diagnostic accuracy.

Clinical Study on 1 Case of Soyangyin Patient Diagnosed as Crohn's Disease (크론씨병으로 진단된 소양인 환자 치험 1 례)

  • Lee, Seung-Hyun;Park, Darn-Seo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.5
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    • pp.1346-1351
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    • 2007
  • Crohn' disease is an auto-immune disease characterized by intermittent chronic diarrhea, high fever, weight loss, abdominal spastic pain or abdominal discomfort which is followed by granulomatous necrosis and cicatrical inflammation. It is also called segmental enteritis or granulomatous enteritis. In western medicine the exact cause is undefined, however it is presumed as an immunological unbalance in alimentary tract commoonly occured in ileum portion of small intestitine or ascending colon and therefore immuno suppressive agents(usually steroids) and anti-inflammatory drugs are prescribed. In case of emergency such as ileus, perforation of intestinal wall surgical methods are considered. In oriental medicine this falls under the category of diarrhea(泄瀉), dysentery(痢疾), splenic diarrhea(脾泄). As to the pathological mechanism the abnormal ascending and descending circulation of stomach and splenic energy(脾不升淸, 胃不下降) the hepatic stagnation(肝鬱氣滯) and dysfunction of small intestine in expelling urine and feces(小陽淸獨不利) all together causes such condition. Main treatments are inducing diuresis(利小便), warming kindey to reinforce yang(溫賢助陽), nourishing the middle energy to invigorate spleen(補中健脾), elimination of the dampness by cooling(淸熱燥濕). In this case the patient was diagnosed as soyangyin(少陽人) constitution and herb medicine soyangyin Hyongbangjihwan-tang(少陽人 荊防地黃湯), Sa-am acupuncture Sojangjeonggyeok(小腸政格) was applied. There was an significant improve in chief complaints and general conditions.

The oriental-western literal study of Crohn's disease (크론씨병(극한성(局限性) 장염(腸炎))에 관(關)한 한의학적(韓醫學的) 고찰(考察))

  • Choi, Chang-Woo;Son, Chang-Gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.9 no.2
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    • pp.251-268
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    • 2001
  • We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

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Granulomatous Meningoencephalitis in an Old Dog ; magnetic resonance imaging and immunohistopathologic findings (노령견에서 병발한 육아종성 뇌수막염 증례 보고: 자기 공명 영상 및 면역조직병리학 소견)

  • Jung, Dong-In;Yoo, Jong-Hyun;Kang, Byeong-Teck;Park, Chul;Gu, Su-Hyun;Kim, Ju-Won;Jeon, Hyo-Won;Lee, So-Young;Woo, Eung-Je;Sur, Jung-Hyang;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.406-409
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    • 2007
  • A 12-year-old female mixed Chihuahua dog was referred because of acute blindness and progressive tetraparesis. Mutifocal lesions in the cerebrum were noted on brain magnetic resonance images and cerebrospinal fluid analysis showed monocytic pleocytosis. Based on these results, granulomatous meningoencephalitis (GME) was strongly suspected. Cerebral lesions were definitely diagnosed as GME based on histopathological findings and positive results of immunohistological stains of brain with T-cell marker (CD3). This report describes the clinical findings, diagnostic imaging characteristics, and immunohistopathologic features of GME in an old dog. In addition, this case demonstrates that clinical signs of GME were mediated by perivascular infiltration of T lymphocytes and identification of causes in T cell-mediated inflammation should be further studied.

Soft Tissue Infection with Mycobacterium abscessus on the Chin of a Healthy Child: A Case Report (건강한 소아의 턱에 발생한 Mycobacterium abscessus에 의한 연부조직 감염: 증례 보고)

  • Kim, Hong-Ryul;Kim, Deok-Woo
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.289-292
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    • 2010
  • Purpose: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. Methods: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1 cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. Results: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. Conclusion: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.

Dose-response Effects of Bleomycin on Inflammation and Pulmonary Fibrosis in Mice

  • Kim, Soo-Nam;Lee, Jin-Soo;Yang, Hyo-Seon;Cho, Jae-Woo;Kwon, Soon-Jin;Kim, Young-Beom;Her, Jeong-Doo;Cho, Kyu-Hyuk;Song, Chang-Woo;Lee, Kyu-Hong
    • Toxicological Research
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    • v.26 no.3
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    • pp.217-222
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    • 2010
  • Many studies have reported that bleomycin, anti-cancer drug, induces pulmonary fibrosis as a side effect. However, few investigations have focused on the dose-response effects of bleomycin on pulmonary fibrosis. Therefore, in the present study, we investigated the effects of different doses of bleomycin in male mice. ICR mice were given 3 consecutive doses of bleomycin: 1, 2, or 4 mg/kg in bleomycin-treated (BT) groups and saline only in vehicle control (VC) groups. The animals were sacrificed at 7 and 24 days postinstillation. The severity of pulmonary fibrosis was evaluated according to inflammatory cell count and lactate dehydrogenase (LDH) activity in the broncho alveolar lavage fluid (BALF), and lung tissues were histologically evaluated after hematoxylin and eosin (H&E), and Masson's trichrome staining. BT groups exhibited changed cellular profiles in BAL fluid compared to the VC group, which had an increased number of total cells, neutrophils, and lymphocytes and a modest increase in the number of macrophages at 7 days post-bleomycin instillation. Moreover, BT groups showed a dose-dependent increase in LDH levels and inflammatory cell counts. However, at 24 days after treatment, collagen deposition, interstitial thickening, and granulomatous lesions were observed in the alveolar spaces in addition to a decrease in inflammatory cells. These results indicate that pulmonary fibrosis induced by 4 mg/kg bleomycin was more severe than that induced by 1 or 2 mg/kg. These data will be utilized in experimental animal models and as basic data to evaluate therapeutic candidates through non-invasive monitoring using the pulmonary fibrosis mouse model established in this study.

A Case of Tolosa-Hunt Syndrome with Facial Palsy (안면마비를 동반한 Tolosa-Hunt Syndrome 환자 1례)

  • Sim, Sung-Yong;Um, Yu-Sik;Hong, Chul-Hee;Kim, Kyung-Jun;Byun, Hak-Sung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.2
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    • pp.86-92
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    • 2005
  • Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

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Fine Needle Aspiration Cytology of Pulmonary Lesions in Wegener's Granulomatosis - A Case Report - (Wegener's Granulomatosis 폐병변의 세침흡인 세포학적 소견 - 1예 보고 -)

  • Seo, Eun-Joo;Kwon, Hi-Jeong;Min, Ki-Ouk
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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    • pp.85-88
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    • 1998
  • We described the findings of fine needle aspiration cytology of the lung from a patient with Wegener's granulomatosis. Early diagnosis and prompt treatment of the patients with Wegener's granulomatosis is essential for a better prognosis. However, the variety of clinical presentations and nonspecific radiologic infiltrates of Wegener's granulomatosis frequently make the diagnosis difficult. Although an open lung biopsy is required for a firm diagnosis, fine needle aspiration cytology & biopsy preparation can also provide an adequate tissue sample, when the findings of fine needle aspiration are considered with clinical manifestations and ANCA value in the serum. The cytologic smears showed scattered necrotic tissue fragments entrapping many neutrophils and occasional epithelioid cells. Multinucleated giant cells were infrequently observed. Ziehl-Neelsen stain for acid fast bacilli was negative. All the cytologic features recapitulated the histopathologic findings of purulent and necrotizing granulomatous inflammation seen in Wegener's granulomatosis.

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Tuberculous Tenosynovitis of Flexor Tendon of the Hand (수부 굴곡건에 발생한 결핵성건초염)

  • Min, Hee-Joon;Chung, Yoon-Kyu
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.708-711
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    • 2010
  • Purpose: The sheath of tendon is uncommon site of tuberculous involvement as compared to other parts of the body. Especially, tuberculous tenosynovitis affecting flexor tendon of the hand is a rare condition. In recent years, furthermore, the incidence of tuberculosis is increasing in our country. Tuberculous tenosynovitis is a chronic, slowly destructive disease, which is difficult to diagnosis before operation, but can be definitively diagnosed by the pathologic microscopic examination. Early detection and surgical excision combined with antituberculous medication is important. We report a rare case of tuberculous tenosynovitis of the flexor tendon of the hand. Method: A 12-year-old woman presented with a painless, nontender mass on palmar side between distal interphalangeal joint and proximal area of metacarpophalangeal joint of the left third finger. We had surgical excision of the involved flexor tendon sheath and studied histopathologically. Result: The histopathological findings were chronic granulomatous inflammation with caseating necrosis consistent with tuberculosis. We started antituberculous medication. Conclusion: Tuberculous tenosynovitis is a rare condition, especially involving on the flexor tendon of the hand. But because of increasing tendency of tuberculosis, it is important to differentiate it from other tumors of the hand.

The Effect of Low Molecular Weight Heparin on Groin Flap Transplantation in Rat (저분자량 헤파린이 쥐 서혜부 유리피판 이식술에 미치는 영향)

  • Lee, Jun-Mo;Lee, Gang-Wook;Lee, Dong-Geun
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.77-81
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    • 1993
  • Free tissue transplantation is commonly performed with the brilliant achievement in microsurgery and anticoagulants and antithrombotic agents have been prescribed in the procedures. However, there is no clean-cut indication as to which agents would be more effective in every steps and final consequences. Low molecular weight heparins inhibiting coagulation in plateletrich plasma and acting on the vascular endothelium have antithrombotic and fibrinolysis action. The experiment with rat groin free flap transplantation after 6-hour ischemia and injection of the low molecular weight heparin was performed and the results between the injection and non-injection group were analysed as follows, 1. Both of the 24-hour groups, vessel patency was not proportional to color change of the groin flap. 2. On the second day after anastomois, heparin-injection group showed intact intima, patent lumen without thrombus, and mild granulomatous inflammation around the suture material and control group with doubtful patency revealed intimal loss and thrombus formation. 3. On the 5th, 7th, and 9th postoperative day, heparin group was patent in anastomosis and showed acute inflammatory cells. 4. The 7th-week period, heparin-injection group showed intact flap color, patent lumen with intact intima and persistent foreign body granuloma.

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