We describe the characteristic clinical and pathologic findings of three cases of constrictive bronchiolitis. All three patients were middle-aged women with chronic respiratory illness characterized by chronic cough, dyspnea, mild to severe obstructive pulmonary dysfunction, relatively normal chest radiographs with occasional peribronchial infiltration, and lack of response to bronchodilators or prednisolone. The patients also had medical diseases such as non-Hodgkin's lymphoma and hyperprolactinemia in case 1 and 3, respectively. None of the patients smoked cigarettes and had clinical evidence of recent viral lower respiratory tract infection. Histologic study by open lung biopsy revealed a spectrum of changes ranging from active cellular bronchiolitis to obliterative peribronchiolar fibrosis. The intervening interstitial and alveolar areas showed no remarkable lesion. Immunohistochemically, the bronchiolar or peribronchiolar inflammatory infiltrates mainly comprised of mixed T- and B-lymphocytes. It may be possible that the active form of constrictive bronchiolitis is initiated by attendant lymphocytic inflammation of the airways, which is followed by fibrous obliteration of bronchioles.
Adult ; Biopsy ; Bronchiolitis/immunology/*pathology ; Bronchoconstriction/*immunology ; Female ; Human ; Middle Age ; Pulmonary Fibrosis/immunology/pathology ; T-Lymphocytes/immunology

The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is an ultrasound-based risk stratification system for thyroid nodules that has been widely applied for the diagnosis and management of thyroid nodules since 2016. This review article provides an overview of the use of the K-TIRADS compared with other risk stratification systems. Moreover, this review describes the challenges in the clinical application of the K-TIRADS, as well as future development directions toward the personalized management of patients with thyroid nodules.

The Korean Society of Thyroid Radiology (KSThR) was founded as an affiliated subspecialty society of Korean Society of Radiology in 2010. The KSThR was originated from the thyroid radiology research committee which had started within the Korean Society of Neuroradiology in 2005. In the beginning, the research committee was organized to make a clinical guideline for ultrasonography (US) diagnosis and US-guided biopsy of thyroid nodules to cope with the rapidly increasing role of US imaging and the increasing burden of US-guided biopsy for thyroid nodules in the early 2000s. The KSThR proposed a subspecialty of thyroid radiology which is a medical subspecialty dealing with the imaging-based diagnosis and interventional treatment of thyroid disease. The KSThR has made an effort to make an advance in the research of thyroid imaging and intervention, which could provide scientific evidences for imaging-based management of nodular thyroid disease and thyroid cancers. The KSThR has published clinical guidelines of diagnostic imaging and interventional management of thyroid nodules, which included the US diagnosis and imaging-based management, fine-needle aspiration, core needle biopsy, and radiofrequency ablation therapy in thyroid nodules. The KSThR has a mission to play a leading role in the research and clinical practice of imaging-based management of thyroid disease, and the KSThR will make an advance in collaboration with Korean Thyroid Association.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Catheter Ablation ; Cooperative Behavior ; Diagnosis ; Diagnostic Imaging ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

Radiofrequency ablation (RFA) is a new, minimally invasive modality that serves as an alternative to surgery in patients with thyroid tumors. The Task Force Committee of the Korean Society of Thyroid Radiology developed recommendations for the optimal use of RFA for thyroid tumors in 2012 and revised them in 2017. Herein, we review and summarize the 2017 thyroid RFA guideline and compare it with the 2012 thyroid RFA guideline.
Advisory Committees ; Catheter Ablation ; Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is an ultrasound-based risk stratification system for thyroid nodules that has been widely applied for the diagnosis and management of thyroid nodules since 2016. This review article provides an overview of the use of the K-TIRADS compared with other risk stratification systems. Moreover, this review describes the challenges in the clinical application of the K-TIRADS, as well as future development directions toward the personalized management of patients with thyroid nodules.

A 61-year-old woman with a history of asthma and pulmonary tuberculosis was presented with purulent bloody sputum. She was treated as having lung abscess initially, but her signs and symptoms did not improve with traditional therapy. Finally, in the clinical course and laboratory data during hospitalization, she was diagnosed as ABPA with coexistent aspergilloma. Thereafter she was treated with itraconazole for aspergilloma, and corticosteroid for ABPA. The symptoms of hemoptysis and dyspnea were improved. A case of ABPA with coexistent aspergilloma and a brief review of the literature were presented.
Aspergillosis, Allergic Bronchopulmonary* ; Asthma ; Dyspnea ; Female ; Hemoptysis ; Hospitalization ; Humans ; Itraconazole ; Lung Abscess ; Middle Aged ; Sputum ; Tuberculosis, Pulmonary

BACKGROUND: Cerebral protection is one of the most important procedures during aortic arch surgery. We can minimize neurological complications through short period of total circulatory arrest and resuming of brain perfusion. We evaluated 11 patients who underwent arch replacement using antegrade brain perfusion via right axillary artery. MATERIAL AND METHOD: Between July 2004 and July 2006, 11 patients (male 9, female 2) underwent aortic arch replacement with antegrade brain perfusion via right axillary artery. Preoperative diagnosis was listed; 5 type A aortic dissections (5/11, 45.5%), 5 aortic aneurysms (5/11, 45.5%) and 1 type A IMH (intramural hematoma, 1/11, 9%). The mean age at the time of operation was 60.3+/-12.8 years. For antegrade brain perfusion, we performed right axillary artery cannulation in all patients. Retrograde brain perfusion was used briefly during total circulatory arrest. RESULT: The mean total circulatory arrest time was 31.1+/-16.9 minutes and the mean retrograde brain perfusion time was 21+/-17.8 minutes. Mean antegrade brain perfusion time was 77.9+/-17.5 (43~101) minutes. We had neither operative mortality nor permanent neurological complications. CONCLUSION: By means of antegrade brain perfusion via right axillary artery, that could lead to decrease circulatory arrest time and minimize damages to severely atheromatous arch vessels, we can expect to reduce neurological complications after aortic arch replacement. Further investigation with large patient populations will be required.
Aorta, Thoracic* ; Aortic Aneurysm ; Axillary Artery* ; Brain* ; Catheterization ; Diagnosis ; Female ; Hematoma ; Humans ; Mortality ; Perfusion*

Virginia creeper (or five-leaved ivy; Parthenocissus quinquefolia) is one of the most popular and widely grown climbers worldwide. In September 2021, Virginia creeper leaves with typical rust symptom were found in an arboretum in Korea, with severe damage. Globally, there is no record of a rust disease on Virginia creeper. Using morphological investigation and molecular phylogenetic inferences, the rust agent was identified as Neophysopella vitis, which is a rust pathogen of other Parthenocissus spp. including Boston ivy (P. tricuspidata). Given that the two ivy plants, Virginia creeper and Boston ivy, have common habitats, especially on buildings and walls, throughout Korea, and that N. vitis is a ubiquitous rust species affecting Boston ivy in Korea, it is speculated that the host range of N. vitis may recently have expanded from Boston ivy to Virginia creeper. The present study reports a globally new rust disease on Virginia creeper, which could be a major threat to the ornamental creeper.

PURPOSE: Since the laparoscopic cholecystectomy became an usual procedure, operative indications of the gallbladder polyps have had the tendency to enlarge. There are no precise management plan about the gallbladder polyps which is not included in the accepted operative indications. Therefore a management plan may be required for the patients who has gallbladder polyps which is not accepted operative indications. METHODS: We retrospectively analysed 106 patients with gallbladder polyps who were diagnosed preoperatively by ultrasound and CT from January 1991 to January 2005. Our operation indications are polyp above 10 mm, symptomatic polyp, sessile polyp, coincidence of stone, focal thickening of gallbladder wall, diffuse wall thickening and detection during other operations. The gallbladder polyps which were suspected to the gallbladder cancer strongly on radiologic studies and polyps above 20 mm size were excluded in this studies. RESULTS: Among the 106 patients, 87 patients underwent operation, and polypoid lesions disappeared during the follow-up period in 3 patients, and 16 patients are on regular follow up. Fifty-six cases received operation with accepted operative indications, and the thirty-one cases underwent operation by the patient's demand. Two groups showed significant difference in true polyp on pathological diagnosis (P < 0.001). There was 16.07% true polyp in opertive indication based 56 patients and no true polyp in patient's demanded 31 cases. The pathologic diagnoses were cholesterol polyp in 27 patients (87.15%), no polyp in 2 patients, adenomatous hyperplasia in 2 patients. The correlation of the polyp size and pathologic diagnosis was an inverse relation to the polyp size and incidence of pseudopolyp (P=0.014). CONCLUSION: We propose that the 6-month-interval follow-up observation is fully safe for polyps sized below 10 mm and not included in accepted operative indications.
Cholecystectomy, Laparoscopic ; Cholesterol ; Diagnosis ; Follow-Up Studies ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Hyperplasia ; Incidence ; Polyps ; Retrospective Studies ; Surgical Procedures, Operative ; Ultrasonography