No abstract availble.

Drug-induced interstitial lung disease (DILD) is a group of adverse drug reactions that is rare but fatally toxic. Pulmonary toxicity causes inflammation and subsequent interstitial fibrosis. As novel drugs with a variety of purposes are introduced into the medical field, the number of culprit medications that are suspected to cause lung complications is accordingly increasing. In this review, DILD will be discussed from several aspects such as causality by numerous drugs, check points for a timely diagnosis, alongside some contemporary treatment options. The exact mechanism of DILD has not been elucidated, and a useful clinical, radiological, or pathological confirmation process is still lacking. Common drugs which casue DILD include bleomycin, amiodarone, epidermal growth factor receptor-targeted agents, and immune checkpoint inhibitors. Diagnosis is based on a suspicious drug administration history, somewhat inconsistent clinical symptoms and signs, radiological hints, and histopathological assistance, together with the exclusion of other lung-injuring etiologies. Cessation of the suspected drug, meticulous corticosteroid usage, and ancillary supportive management are the mainstay therapeutic strategy for DILD. Most cases of DILD respond to these countermeasures and reductions, but in some cases the fibrotic process worsens, leading to irreversible sequelae on the affected lung.

Drug-induced interstitial lung disease (DILD) is a group of adverse drug reactions that is rare but fatally toxic. Pulmonary toxicity causes inflammation and subsequent interstitial fibrosis. As novel drugs with a variety of purposes are introduced into the medical field, the number of culprit medications that are suspected to cause lung complications is accordingly increasing. In this review, DILD will be discussed from several aspects such as causality by numerous drugs, check points for a timely diagnosis, alongside some contemporary treatment options. The exact mechanism of DILD has not been elucidated, and a useful clinical, radiological, or pathological confirmation process is still lacking. Common drugs which casue DILD include bleomycin, amiodarone, epidermal growth factor receptor-targeted agents, and immune checkpoint inhibitors. Diagnosis is based on a suspicious drug administration history, somewhat inconsistent clinical symptoms and signs, radiological hints, and histopathological assistance, together with the exclusion of other lung-injuring etiologies. Cessation of the suspected drug, meticulous corticosteroid usage, and ancillary supportive management are the mainstay therapeutic strategy for DILD. Most cases of DILD respond to these countermeasures and reductions, but in some cases the fibrotic process worsens, leading to irreversible sequelae on the affected lung.

Cystic lung disease (CLD) is a group of lung disorders characterized by the presence of multiple cysts, defined as air-filled lucencies or low-attenuating areas, bordered by a thin wall (usually < 2 mm). The recognition of CLDs has increased with the widespread use of computed tomography. This article addresses the mechanisms of cyst formation and the diagnostic approaches to CLDs. A number of assessment methods that can be used to confirm CLDs are discussed, including high-resolution computed tomography, pathologic approaches, and genetic/serologic markers, together with treatment modalities, including new therapeutic drugs currently being evaluated. The CLDs covered by this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, Birt-Hogg-Dube syndrome, lymphocytic interstitial pneumonia/follicular bronchiolitis, and amyloidosis.
Amyloidosis ; Birt-Hogg-Dube Syndrome ; Bronchiolitis ; Diagnosis* ; Histiocytosis, Langerhans-Cell ; Lung Diseases* ; Lung* ; Lymphangioleiomyomatosis

Management of diabetic foot ulcer is a multi-disciplinary, time-consuming work. In order to obtain a proper recording, better communication, and fair comparative study, effective method of recording system for diabetic foot ulcer is required. Wagner classification and NPUAP (National Pressure Ulcer Advisory Panel) chronic ulcer staging are widely used but have a drawback that they only consider the depth of the ulcer. Authors devised a recording system for the diabetic foot ulcer and applied it to the patients to examine any problems associated with its use. From September 1999 to January 2001, diabetic foot ulcer recording form was applied to 92 patients with diabetic foot ulcer. The form has 8 fields of recording: date, location, depth, size, status of ulcer, status of margin, interval change, recorder. These fields are for recording itself, treatment plan, or prognostic value. The data were collected and analyzed in detail. Authors proposed criteria for the ideal recording system in the management of diabetic foot ulcer. In conclusion, the diabetic foot ulcer recording system proved to be highly efficient, simple and easy to document the ulcer. In addition, it could help surgeons decide the treatment plan and predict the outcome.
Classification ; Diabetic Foot* ; Humans ; Pressure Ulcer ; Ulcer* ; Wounds and Injuries*

HAV is a small, non-enveloped, and single-stranded RNA virus. The virus is transmitted from person to person through the fecal-oral route and through the ingestion of contaminated food. HAV infection normally affects children without producing symptoms but in adults it causes clinically apparent disease. The virus can spread easily from asymptomatic children to other children and to adult contacts. Children are thus considered to be a principal reservoir and dominant source of transmission in the community. Infection is maintained by serial transmission from infected individuals to those who are susceptible. While almost acute hepatitis A patients subside without progress to chronic liver disease, some patients may have relapsing, prolonged, cholestatic and fulminant hepatitis. Hepatitis A vaccine has been used successfully to prevent hepatitis A infection worldwide since mid-1990s. The sero-positivity pattern of anti-hepatitis A virus antibody (anti-HAV) has been changing rapidly from the intermediate to the low during the past 30 years in Korea. Thus adulthood acute hepatitis A became widespread in last 10 years in Korea due to decreased seroprevalence of anti-HAV. It can be recognized that acute hepatitis A is a "growing and living", not a "fading and dying" disease. The changes in seroepidemiologic pattern may cause sporadic and large community outbreaks and lead to increased healthcare cost. In this situation, we should have our own vaccination strategy to prevent and future eradication of hepatitis A infection.
Adult ; Child ; Disease Outbreaks ; Eating ; Health Care Costs ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Korea ; Liver Diseases ; RNA Viruses ; Seroepidemiologic Studies ; Vaccination ; Viruses

The concept on idiopathic pulmonary fibrosis (IPF) pathogenesis has progressed from chronic inflammation to aberrant wounding healing and even more to the current paradigms of a multifactorial and heterogeneous disease process. Despite the growth of clinical trials for IPF, most of the results, including N-acetylcysteine combination, warfarin, and bosentan, were disappointing. On the other hand, there have been a number of important developments; the foremost is the licensing of pirfenidone in Europe and Asia. In this article, we briefly review the recent knowledge of pathogenesis of IPF. We also summarize the recent clinical trials regarding the management of IPF.
Acetylcysteine ; Asia ; Europe ; Hand ; Idiopathic Pulmonary Fibrosis ; Inflammation ; Licensure ; Pyridones ; Sulfonamides ; Warfarin

Nonalcoholic fatty liver disease (NAFLD) is characterized by a wide spectrum of liver damage spanning steatosis, nonalcoholic steatohepatitis (NASH), cryptogenic liver cirrhosis, and even to hepatocellular carcinoma. Investigations in the last few years have focused on NASH, a relatively aggressive form of liver disease, due largely to the explosion of information provided by clinical and basic science studies related to the widespread presence of risk factors, such as obesity, type II diabetes mellitus, and dyslipidemia. This is especially important given that obesity and type II diabetes mellitus have recently reached epidemic proportions in Korea. The pathogenesis of NASH is multifactorial, with insulin resistance and increased fatty acid possibly being important factors in the accumulation of hepatocellular fat, and oxidant stress, lipid peroxidation, mitochondrial dysfunction, and dysregulation of variable cytokines possibly being important causes of hepatocellular injury in steatotic liver. Because not all steatotic livers progress to NASH, some other environmental factors or a combination of genetic factors are thought to be required for progression to NASH and fibrosis. Lifestyle modifications continue to be the cornerstone therapy in NAFLD, but some insulin-sensitizing drugs might be more effective in treating NASH. Many pilot trials for antioxidants and lipid-lowering and hepatic protective agents have yielded promising initial results in improving liver enzymes or features of liver histology. However, the efficacy of these agents remains questionable. Despite recent gains in understanding NASH, several issues related to its natural history, pathogenesis, and treatment remain unresolved.
Adipose Tissue/metabolism ; Antilipemic Agents/therapeutic use ; Antioxidants/therapeutic use ; Fatty Liver/*etiology/*therapy ; Hepatitis/*etiology/therapy ; Humans ; Insulin Resistance ; Life Style ; Lipid Peroxidation ; Mitochondria/metabolism ; Obesity/diet therapy/etiology ; Oxidative Stress ; Risk Factors

Recent progress in medical informatics enables us to use medical information regardless of time or place, to make a diagnostic and therapeutic plan, according to increasing need about health of general population. There are many homepages on the web, which provides medical common senses, hospital information, and medical counselling on the web. Virtual Hospital, which offers comprehensive media information, has medical counselling program with various programs such as self-diagnosis, emergency information, drug information, Q and A, and so on. The aim of this study is to examine the content and purpose of medical counselling on the web. The subjects consisted of 150 counselings which were called 'Medical Counselling' in the Virtual Hospital for December 1996 through March 1997. Many questioners wanted to know treatment principles. to make a diagnosis, and to know specific medical knowledge, The most common questions are as follows; general and unspecified, digestive, skin, musculoskeletal problems. These findings suggests that medical counselling may be used to supplement the lack of direct medical interviews with doctors.
Counseling* ; Diagnosis ; Emergencies ; Internet* ; Medical Informatics ; Skin

Objectives: This study investigated the 24-hour ambulatory blood pressure monitoring (ABPM) and Holter parameters for evaluating their prognostic significance of cardiovascular events including stroke in population without atrial fibrillation (AF). Methods: Among 3,199 patients that underwent ABPM, 335 who also underwent Holter recordings were selected in a tertiary hospital. Seventeen patients who had been documented with AF on Holter monitoring or diagnosed with AF were excluded, and finally 318 patients were analyzed. The association between cardiovascular events and ABPM/Holter parameters was analyzed by a logistic regression model, and the risk factors were estimated by a Cox hazard model. Age, sex, and histories of cardiovascular disease were adjusted by a multivariable analysis, and the cut-off values were suggested by a Kaplan-Meyer analysis. Results: During the total follow-up (28.5±1.7 months), 13 (4.1%) stroke, 6 (1.9%) heart failure, and 12 (3.8%) acute coronary syndrome incidences were observed. In the univariate analysis of the ABPM parameters, an increment in the night systolic BP (hazard ratio=1.034, P=0.020) and night diastolic BP (hazard ratio=1.063, P=0.031) significantly elevated the risk of a stroke occurrence. According to the Kaplan-Meyer analysis, there was a significant difference in the stroke incidence between the groups divided by a cut-off value of the night systolic BP of 120 mmHg (P=0.014) and night diastolic BP of 75 mmHg (P=0.023). Conclusion In a population without AF, the nocturnal BP was a significant predictor of a stroke incidence. At this point, the cut-off value of mean 120/75 mmHg in 24 ABPM was advisable.