• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.65-74
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• 1999

Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

• Korean Journal of Veterinary Service
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• v.43 no.4
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• pp.251-256
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• 2020

Two suckling piglets, 4 days and 10 days of age, showed lethargy and dyspnea after birth and mortality had been increased after incoming gilts from breeding farm. At necropsy, the lungs showed diffuse fail to collapse with rubbery consistency, edematous dilatation of interlobular septa, and lobular consolidation with purple red color. Heart was diffuse pale in color and had several irregular linear-shaped macules or patches. Histopathologically, diffuse interstitial pneumonia with the proliferation of type II pneumocytes was present in the lungs of 2 piglets. Alveolar lumens contained necrotic cellular debris derived from neutrophils and macrophages. Multifocal hemorrhage and necrotizing pneumonia with protozoan tachyzoites were observed in the lungs. Severe multifocal to confluent necrotic myocarditis, necrotic encephalitis, and necrotic adrenalitis with intralesional protozoan tachyzoites were observed in piglets. According to immunohistochemical analysis (IHC), Toxoplasma (T.) gondii tachyzoites antigens were confirmed in lung, heart, brain, and adrenal gland. And porcine reproductive and respiratory syndrome virus (PRRSV) antigens were also detected in the cytoplasm of macrophages in lungs using IHC. Based on the gross, histopathologic and immunohistochemical features, two suckling piglets were diagnosed as co-infection of T. gondii and PRRSV.

• Korean Journal of Radiology
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• v.22 no.2
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• pp.281-290
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• 2021

Objective: To assess the performance of content-based image retrieval (CBIR) of chest CT for diffuse interstitial lung disease (DILD). Materials and Methods: The database was comprised by 246 pairs of chest CTs (initial and follow-up CTs within two years) from 246 patients with usual interstitial pneumonia (UIP, n = 100), nonspecific interstitial pneumonia (NSIP, n = 101), and cryptogenic organic pneumonia (COP, n = 45). Sixty cases (30-UIP, 20-NSIP, and 10-COP) were selected as the queries. The CBIR retrieved five similar CTs as a query from the database by comparing six image patterns (honeycombing, reticular opacity, emphysema, ground-glass opacity, consolidation and normal lung) of DILD, which were automatically quantified and classified by a convolutional neural network. We assessed the rates of retrieving the same pairs of query CTs, and the number of CTs with the same disease class as query CTs in top 1-5 retrievals. Chest radiologists evaluated the similarity between retrieved CTs and queries using a 5-scale grading system (5-almost identical; 4-same disease; 3-likelihood of same disease is half; 2-likely different; and 1-different disease). Results: The rate of retrieving the same pairs of query CTs in top 1 retrieval was 61.7% (37/60) and in top 1-5 retrievals was 81.7% (49/60). The CBIR retrieved the same pairs of query CTs more in UIP compared to NSIP and COP (p = 0.008 and 0.002). On average, it retrieved 4.17 of five similar CTs from the same disease class. Radiologists rated 71.3% to 73.0% of the retrieved CTs with a similarity score of 4 or 5. Conclusion: The proposed CBIR system showed good performance for retrieving chest CTs showing similar patterns for DILD.

• Korean Journal of Veterinary Research
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• v.47 no.3
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• pp.321-324
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• 2007

Pneumocystis (P.) carinii is an opportunistic fungal pathogen of many animal species and human, which can cause fatal pneumonia in immunocompromised individuals. Three 100-day-old pigs with progressive atrophy, anorexia and respiratory distress were submitted to the Cheju National University for diagnosis. Grossly, the lungs were enlarged with rubbery consistency. Histopathologically, the lungs were characterized by diffuse interstitial pneumonia with thickening of alveolar septa due to infiltration of macrophages and lymphocytes. Alveolar lumens were filled with a foamy eosinophilic proteinaceous material in which numerous punctiform organisms. The organisms were demonstrated as P. carinii by Grocott-methenamine-silver staining and immunohistochemistry in lungs of two pigs. In our best knowledge, this is believed to be the first report of P. carinii pneumonia in pigs in Korea.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.251-259
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• 2003

• Korean Journal of Clinical Pharmacy
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• v.22 no.2
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• pp.181-186
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• 2012

Objective: To report a fatal case of Multidrug-resistant Acinetobacter baumannii (MDR-AB) in a patient with interstitial lung disease (ILD) on high-dose glucocorticoids. Case Summary: A 66-year-old man with a history of coniosis was transferred to the hospital with progressive cough and sputum production. This patient has been diagnosed with pneumonia and ILD on admission, requires antimicrobial therapy and systemic immunosuppressants. He received high dose of methylprednisolone and cyclophosphamide for ILD as well as ceftriaxone and azithromycin for pneumonia. On day 7 in the intensive care units (ICUs), patient had fever and leukocytosis, thus antimicrobials were switched to piperacillin. After 13 days in the ICU, Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA) were isolated on transtracheal aspirate (TTA) and meropenem was initiated. However, it was revealed a multidrug-resistant Acinetobacter baumannii (MDR-AB) species, resistant to carbapenem. Patient was administered colistin but expired due to septic shock on day 84. Discussion: Systemic immunosuppressive therapy can result in infections that may compromise patient's survival. MDR-AB has emerged as a serious cause of nosocomial infections in immunocompromised patients. MDR-AB is resistant to most standard antimicrobials and therapeutic options are limited. Conclusion: We report our recent experience with a fatal MDR-AB pneumonia in a patient with ILD, who had to be treated with high dose glucocorticoids and immunosuppressnts.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.255-262
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• 2021

Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated necrotizing vasculitis, which mainly affects small vessels in various organs, especially the lungs. The two key pulmonary manifestations, interstitial lung disease (ILD) and diffuse alveolar hemorrhage (DAH), increase the morbidity and death rate of patients with MPA. ILD is more common in MPA than in other ANCA-associated vasculitis subsets and is primarily associated with myeloperoxidase-ANCA. Unlike alveolar hemorrhage due to pulmonary capillaritis, ILD can initially manifest as isolated pulmonary fibrosis. Of note, its most frequent radiographic pattern is the usual interstitial pneumonia pattern, similar to the characteristic pattern seen in idiopathic pulmonary fibrosis. In this review we present the pathogenesis, clinical manifestations, and radiographic and histopathologic features of ILD and DAH in MPA. We also briefly summarize the outcome and therapeutic options for the two conditions.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.112-115
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• 2016

Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder characterized by diffuse infiltration of the pulmonary parenchymal interstitium by polyclonal lymphocytes and plasma cells. LIP has been associated with a variety of clinical conditions; such as connective tissue disorders and other immune system abnormalities. Treatment usually involves administration of corticosteroids and other immunosuppressants. We report on a 38-year-old female patient who complained of shortness of breath, dry mouth, and dry eyes for more than 1 month, and was positive for Raynaud's phenomenon. Based on surgical biopsy, she was diagnosed as having LIP accompanied by $Sj{\ddot{o}}gren^{\prime}s$ syndrome. The patient was treated with high-dose steroids followed by maintenance therapy for approximately 2 years, and her condition improved.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.383-390
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• 2008

Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

• Proceedings of the Korean Society of Veterinary Pathology Conference
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• 2003.10a
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• pp.49-49
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• 2003

PMWS is characterised by weight loss and dyspnea combined with pathological findings of interstitial pneumonia and generalized enlarged lymph nodes. Typical histological lesions include multifocal granulomatous pneumonia, and lymphocyte depletion and multinucleated giant cell formation in lymph nodes[1,2]. (omitted)