Constrictive bronchiolitis, one of small airway diseases, is very rare and occupies one of the two arms of bronchiolitis obliterans together with proliferative bronchiolitis. Proliferative bronchiolitis, presenting the prototype with bronchiolitis obliterans with organizing pneumonia(BOOP), can be easily taken into diagnostic consideration in terms of relatively rapid clinical course and radiologic presentation as if atypical pneumonia with interstitial and alveolar infiltrations. Meanwhile constrictive bronchiolitis is not only very rare but also easily overlooked as chronic obstructive pulmonary diseases such as emphysema, because it usually shows normal chest radiographic finding and obstructive pattern in pulmonary function test. In the aspects of the reponse to treatment, proliferative bronchiolitis showed dramatic response to the corticosteroid while constrictive bronchiolitis is intractable, which is easily explained on the basis of the pathologic characteristics of cicartrical replacement of bronchiolar walls. The bronchiolitis, both proliferative and constrictive, can be associated with diverse conditions such as inhalational injury, postinfectious process, drug or chemical induced reactions, connective tissue diseases, and organ trasplantation. And there is idiopathic type which has no associated condition. There is one explanation that both types of bronchiolitis lie on the same disease spectrum because the different disease pattern can be evoked from the same etiology. In contrast, another explanation is suggested that both types of bronchiolitis are one of nonspecific tissue reaction rather than a disease specific histologic finding because the various types of causes can provoke the same histologic findings. These dilemma remains for further investigation. With literature investigation, the authors report a case of constrictive bronchiolitis proven by open lung biopsy in 47 year old female who was diagnosed as non-Hodgkin's lymphoma and simultaneously had relatively rapid progression of airflow obstruction and showed negative radiographic finding without the risk factors for the development of chronic obstructive lung disease. We consider it as idiopathic because we could not find any relationship between constrictive bronchiolitis and non-Hodgkin's lymphoma on the literature search and it requires further investigation.
Arm ; Biopsy ; Bronchiolitis ; Bronchiolitis Obliterans* ; Connective Tissue Diseases ; Cryptogenic Organizing Pneumonia ; Emphysema ; Female ; Humans ; Lung ; Lung Diseases, Obstructive ; Lymphoma, Non-Hodgkin* ; Pneumonia ; Pulmonary Disease, Chronic Obstructive ; Radiography, Thoracic ; Respiratory Function Tests ; Risk Factors

PURPOSE: To determine the utility of HRCT in the diagnosis of chronic airflow obstruction and to correlate the morphologic abnormalities revealed by this modality with functional impairment in patients with chronic air-flow obstruction. MATERIALS AND METHODS:This study involved 80 patients with chronic airflow obstruction who underwent HRCT and a pulmonary function test. Final clinical diagnosis in these patients was determined by a chest physician on the basis of clinical features, bronchoscopy, pulmonary function test, and HRCT. In order to diagnose and determine the extent of areas of decreased attenuation revealed by HRCT (the CT score), the find-ings of HRCT were retrospectively reviewed by two radiologists, who reached a consensus. Clinical and HRCT diagnoses were then compared, and the rate of agreement between them was calculated. The relation-ship between the extent of areas of decreased attenuation revealed by HRCT and by FEV1/FVC was evaluated using Correl 's account and Student 's unpaired t-test. RESULTS: The agreement rate between clinical and HRCT diagnoses was 77.5% (62/80). The rates for bronchiec-tasis (88.9%, 24/27), emphysema (93.9%, 31/33), and bronchiolitis obliterans (100%, 6/6) were considerably higher than those for chronic bronchitis and bronchial asthma. The correlation rate between CT score and FEV1/FVC was significant in bronchiectasis (p<0.05; r: -0.76) and bronchiolitis obliterans (p<0.01; r:-0.66), but not in cases involving emphysema, bronchial asthma, or chronic bronchitis (p>0.05). CONCLUSION: HRCT is valuable in the diagnosis and prediction of physiologic impairment in patients with bronchiectasis and bronchiolitis obliterans, but has limited value in those with emphysema, chronic bronchitis or asthma.
Asthma ; Bronchiectasis ; Bronchiolitis Obliterans ; Bronchitis, Chronic ; Bronchoscopy ; Consensus ; Diagnosis* ; Emphysema ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Pulmonary Emphysema ; Respiratory Function Tests* ; Retrospective Studies ; Thorax

Chronic obstructive pulmonary disease (COPD) is commonly a combination of pulmonary emphysema and chronic bronchitis. Emphysema is a pathologically defined disease that can be accurately diagnosed using CT. Furthermore, CT is useful for determination of the subtypes, extent and distribution of emphysema. Objective quantification of emphysema is feasible using CT densitometry of lung parenchyma, that can be used for selection of adequate candidates and monitoring clinical results of various therapeutic measures for severe emphysema. Imaging parameters in CT densitometry should be kept constant in follow up examination for an effective comparison of the results. Chronic bronchitis is diagnosed by symptomatic criteria with nonspecific CT findings. Airway dimensions can be objectively measured using CT, enabling further understanding of pathophysiology of COPD.
Bronchitis, Chronic ; Densitometry ; Emphysema ; Follow-Up Studies ; Lung ; Lung Diseases, Obstructive ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Emphysema ; Thorax

Cough is one of the most common symptom of many respiratory diseases. The Korean Academy of Tuberculosis and Respiratory Diseases organized cough guideline committee and cough guideline was developed by this committee. The purpose of this guideline is to help clinicians to diagnose correctly and treat efficiently patients with cough. In this article, we have stated recommendation and summary of Korean cough guideline. We also provided algorithm for acute, subacute, and chronic cough. For chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered. If UACS is suspicious, first generation anti-histamine and nasal decongestant can be used empirically. In CVA, inhaled corticosteroid is recommended in order to improve cough. In GERD, proton pump inhibitor is recommended in order to improve cough. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, angiotensin converting enzyme inhibitor, habit, psychogenic cough, interstitial lung disease, environmental and occupational factor, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and idiopathic cough can be also considered as cause of chronic cough. Level of evidence for treatment is mostly low. Thus, in this guideline, many recommendations are based on expert opinion. Further study regarding treatment for cough is mandatory.
Asthma ; Bronchiectasis ; Bronchiolitis ; Bronchitis, Chronic ; Cough* ; Expert Testimony ; Gastroesophageal Reflux ; Humans ; Lung Diseases, Interstitial ; Lung Neoplasms ; Peptidyl-Dipeptidase A ; Peritoneal Dialysis ; Proton Pumps ; Sleep Apnea, Obstructive ; Tuberculosis

The topic of the extragastric manifestations of Helicobacter pylori infection continues to capture the attention of many researchers all over the world. Some extragastric diseases, possibly linked to H. pylori infection, have been largely investigated. Although evidence is emerging that the prevalence of H. pylori is declining in all age groups, the understanding of its disease spectrum continues to evolve. There are, in fact, several studies concerning cardiovascular diseases, pulmonary diseases, hematologic disease, eye and skin diseases, hepatobiliary disease, diabetes mellitus, and neurological disorders. Among them, this article reviews the literature published pertaining to H. pylori eradication and pulmonary disease such as bronchial asthma, chronic bronchitis, chronic obstructive pulmonary disease, and lung cancer.
Asthma ; Bronchitis, Chronic ; Cardiovascular Diseases ; Diabetes Mellitus ; Helicobacter pylori* ; Helicobacter* ; Hematologic Diseases ; Humans ; Lung Diseases* ; Lung Neoplasms ; Nervous System Diseases ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Skin Diseases

PURPOSE: To develop an automated classification system for the differentiation of obstructive lung diseases based on the textural analysis of HRCT images, and to evaluate the accuracy and usefulness of the system. MATERIALS AND METHODS: For textural analysis, histogram features, gradient features, run length encoding, and a co-occurrence matrix were employed. A Bayesian classifier was used for automated classification. The images (image number n=256) were selected from the HRCT images obtained from 17 healthy subjects (n=67), 26 patients with bronchiolitis obliterans (n=70), 28 patients with mild centrilobular emphysema (n=65), and 21 patients with panlobular emphysema or severe centrilobular emphysema (n=63). An five-fold cross-validation method was used to assess the performance of the system. Class-specific sensitivities were analyzed and the overall accuracy of the system was assessed with kappa statistics. RESULTS: The sensitivity of the system for each class was as follows: normal lung 84.9%, bronchiolitis obliterans 83.8%, mild centrilobular emphysema 77.0%, and panlobular emphysema or severe centrilobular emphysema 95.8%. The overall performance for differentiating each disease and the normal lung was satisfactory with a kappa value of 0.779. CONCLUSION: An automated classification system for the differentiation between obstructive lung diseases based on the textural analysis of HRCT images was developed. The proposed system discriminates well between the various obstructive lung diseases and the normal lung.
Bronchiolitis Obliterans ; Classification* ; Emphysema ; Humans ; Lung ; Lung Diseases, Obstructive* ; Pulmonary Emphysema

No abstract available.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia*

The typical radiographic findings of bronchiolitis obliterans organizing pneumonia (BOOP) are known to be patchy air-space consolidation that is often subpleural, and with or without ground-glass opacities. However, there are scant radiologic reports about the micronodular pattern of BOOP. We report here on a case of BOOP that manifested as diffusely scattered ill-defined centrilobular micronodules on HRCT.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia*

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.
Adult* ; Anxiety ; Asthma ; Biomass ; Bronchitis, Chronic ; Cohort Studies ; Cytokines ; Depression ; Diagnosis ; Hematologic Tests ; Humans ; India* ; Lung ; Lung Diseases ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vitamin D

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.
Adult ; Anxiety ; Asthma ; Biomass ; Bronchitis, Chronic ; Cohort Studies ; Cytokines ; Depression ; Diagnosis ; Hematologic Tests ; Humans ; India ; Lung ; Lung Diseases ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vitamin D