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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 1. Introduction
박성우,백애린,이홍렬,정성환,양세훈,김용현,정만표,behalf of the Korean Interstitial Lung Diseases Study Group 대한결핵및호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4
Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis–interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.
Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 1. Introduction
Park, Sung-Woo,Baek, Ae Rin,Lee, Hong Lyeol,Jeong, Sung Whan,Yang, Sei-Hoon,Kim, Yong Hyun,Chung, Man Pyo,Korean Interstitial Lung Diseases Study Group The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4
Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.
Koo, So-My,Kim, Song Yee,Choi, Sun Mi,Lee, Hyun-Kyung,Korean Interstitial Lung Diseases Study Group The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4
Connective tissue disease (CTD) is a collection of disorders characterized by various signs and symptoms such as circulation of autoantibodies in the entire system causing damage to internal organs. Interstitial lung disease (ILD) which is associated with CTD is referred to as CTD-ILD. Patients diagnosed with ILD should be thoroughly examined for the cooccurrence of CTD, since the treatment procedures and prognosis of CTD-ILD are vary from those of idiopathic interstitial pneumonia. The representative types of CTD which may accompany ILD include rheumatoid arthritis, systemic sclerosis (SSc), Sjogren's syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematous. Of these, ILD most frequently co-exists with SSc. If an ILD is observed in the chest, high resolution computed tomography and specific diagnostic criteria for any type of CTD are met, then a diagnosis of CTD-ILD is made. It is challenging to conduct a properly designed randomized study on CTD-ILD, due to low incidence. Therefore, CTD-ILD treatment approach is yet to been established in absence of randomized controlled clinical trials, with the exception of SSc-ILD. When a patient is presented with acute CTD-ILD or if symptoms occur due to progression of the disease, steroid and immunosuppressive therapy are generally considered.
구소미,김송이,최선미,이현경,on behalf of Korean Interstitial Lung Diseases Study Group 대한결핵및호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4
Connective tissue disease (CTD) is a collection of disorders characterized by various signs and symptoms such as circulation of autoantibodies in the entire system causing damage to internal organs. Interstitial lung disease (ILD) which is associated with CTD is referred to as CTD-ILD. Patients diagnosed with ILD should be thoroughly examined for the co-occurrence of CTD, since the treatment procedures and prognosis of CTD-ILD are vary from those of idiopathic interstitial pneumonia. The representative types of CTD which may accompany ILD include rheumatoid arthritis, systemic sclerosis (SSc), Sjögren’s syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematous. Of these, ILD most frequently co-exists with SSc. If an ILD is observed in the chest, high resolution computed tomography and specific diagnostic criteria for any type of CTD are met, then a diagnosis of CTD-ILD is made. It is challenging to conduct a properly designed randomized study on CTD-ILD, due to low incidence. Therefore, CTD-ILD treatment approach is yet to been established in absence of randomized controlled clinical trials, with the exception of SSc-ILD. When a patient is presented with acute CTD-ILD or if symptoms occur due to progression of the disease, steroid and immunosuppressive therapy are generally considered.
이종민,김용현,강지영,제갈양진,박소영,on behalf of Korean Interstitial Lung Diseases Study Group 대한결핵및호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4
Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.
Lee, Jongmin,Kim, Yong Hyun,Kang, Ji Young,Jegal, Yangjin,Park, So Young,Korean Interstitial Lung Diseases Study Group The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.4
Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.
이상훈,여유미,김태형,이홍렬,이진화,박용범,박종선,김이형,송진우,전병우,김현정,박진경,어수택,김영환,김동순,박무석,on behalf of Korean Interstitial Lung Diseases Study Group 대한결핵및호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.2
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.
Korean Society of Infectious Diseases,Korean Society of Pediatric Infectious Diseases,Korean Society of Epidemiology,Korean Society for Antimicrobial Therapy,Korean Society for Healthcare-associated I 대한의학회 2020 Journal of Korean medical science Vol.35 No.10
Since the first case of coronavirus disease19 (COVID-19) was reported in Wuhan, China, as of March 2, 2020, the total number of confirmed cases of COVID-19 was 89,069 cases in 67 countries and regions. As of 0 AM, March 2, 2020, the Republic of Korea had the second-largest number of confirmed cases (n = 4,212) after China (n = 80,026). This report summarizes the epidemiologic features and the snapshots of the outbreak in the Republic of Korea from January 19 and March 2, 2020.
MONTANI, VALERIA,TANIGUCHI, SHIN-ICHI,SHONG, MINHO,SUZUKI, KOICHI,OHMORI, MASAYUKI,GIULIANI, CESIDIO,NAPOLITANO, GIORGIO,SAJI, MOTOYASU,FIORENTINO, BRUNO,REIMOLD, ANDREAS M.,TING, JENNY P.-Y,KOHN, LEO 충남대학교 생물공학연구소 1999 생물공학연구지 Vol.7 No.-
Aberrant expression of major histocompatibility complex(MHC) classⅡ proteins on thyrocytes, which is associated with autoimmune thyroid disease, is mimicked by γ-interferon (γ-IFN). To define elements and factors that regulate classⅡ gene expression in thyrocytes and that might be involved in aberrant expression, we have studied γ-IFN-induced HLA-DRα gene expression in rat FRTL-5 thyroid cells. The present report shows that classⅡ expression in FRTL-5 thyrocytes is positively regulated by the classⅡ transactivator (CIITA), and that CIITA mimics the action of γ-IFN. Thus as is the case for γ-IFN, several distinct and highly conserved elements on the 5'-flanking region of the HLA-DRα gene, the S, X_1, X_2, and Y boxes between -137 to -65 bp, are required for classⅡ gene expression induced by pCIITA transfection in FRTL-5 thyroid cells. CIITA and γ-IFN do not cause additive increases in HLA-DRα gene expression in FRTL-5 cells, consistent with the possibility that CIITA is an intermediate factor in the γ-IFN pathway to increased classⅡ gene expression. Additionally, γ-IFN treatment of FRTL-5 cells induces an endogenous CIITA transcript; pCIITA transfection mimics the ability of γ-IFN treatment of FRTL-5 thyroid cells to increase the formation of a specific and novel protein/DNA complex containing CBP, a coactivator of CRE binding proteins important for cAMP-induced gene expression; and the action of both γ-IFN and CIITA to increase classⅡ gene expression and increase complex formation is reduced by cotransfection of a thyroid Y box protein, which suppresses MHC classⅠ gene expression in FRTL-5 thyroid cells and is a homolog of human YB-1, which suppresses MHC classⅡ expression in human glioma cells. we conclude that CIITA and TSH receptor suppressor element binding protein-1 are components of the γ-IFN-regulated transduction system which, respectively, increase or decrease classⅡ gene expression in thyrocytes and may, therefore, be involved in aberrant classⅡ expression associated with autoimmune thyroid disease. (Endocrinology 139: 280-289, 1998)
Bongyoung Kim,박세윤,정동식,Sook In Jung,오원섭,김신우,Kyong Ran Peck,장현하,The Korean Society of Infectious Diseases 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.6
Background/Aims: This study aimed to collect information on the opinions of Korean infectious disease (ID) experts on coronavirus disease 2019 (COVID-19) and related issues in preparation for a future outbreak. Methods: A survey was conducted over the course of 5 days (from April 21 to 25, 2020), targeting all adult ID specialists currently in the medical field in South Korea (n = 265). An online-based survey was forwarded via text message and e-mail. Only one response was accepted from each participant. Results: Of these 265 ID specialists gotten to, 132 (49.8%) responded. The highest proportion of the respondents envisaged the current COVID-19 outbreak to end after December 2020 (47.7% for the domestic Korean outbreak and 70.5% for the global pandemic); moreover, 60.7% of them stated that a second nationwide wave is likely to occur between September and December 2020 in South Korea. N95 respirators were considered to be the most important item in hospitals in preparation for a second wave. The most important policy to be implemented at the national level was securing national hospitals designated for the treatment of ID (67.4%). Conclusions: ID experts in South Korea believe that the COVID-19 pandemic may not be easily controlled and that a second nationwide wave is likely to occur in South Korea. Our results indicate that Korean ID specialists believe that a high level of preparation is needed in various aspects, including the procurement of personal protective equipment, to respond efficiently to a second outbreak.