New-onset nontuberculous mycobacterial pulmonary disease in bronchiectasis: tracking the clinical and radiographic changes

Abstract Background The close association between bronchiectasis and nontuberculous mycobacterial pulmonary disease (NTM-PD) is well-known. However, the clinical impact of subsequent new-onset NTM-PD in bronchiectasis patients has not been elucidated. The aim of this study is to investigate the clinical courses and radiographic changes of patients with bronchiectasis in whom NTM-PD subsequently developed. Methods A total of 221 patients with bronchiectasis who had participated in a non-NTM bronchiectasis cohort between July 1st 2011 and August 31st 2019 at Seoul National University Hospital were included in this study. The data of patients in whom NTM-PD developed during this observation period were analyzed; specifically, changes in the Bronchiectasis Severity Index (BSI) and lesions on computerized tomography (CT) scan of the chest arising during the observation period. Results During the observation period, NTM was isolated from 35 patients. A total of 31 patients (14.0%) satisfied the diagnostic criteria of NTM-PD. The median time from enrollment in the cohort to the development of subsequent NTM-PD was 37 months (Interquartile range [IQR], 18–78 months). Mycobacterium avium complex was the most common pathogen (80.6%). Twelve patients underwent antibiotic treatment for NTM-PD with a median interval of 20 months (IQR, 13–30) from the time of NTM-PD diagnosis. When NTM-PD developed, the severity and extent of bronchiectasis, cellular bronchiolitis, and the extent of nodules worsened on CT scans, while BSI did not change. Conclusions NTM-PD can develop in previously negative bronchiectasis patients. It is associated with worsening radiographic lesions. Active screening of non-NTM bronchiectasis patients for new-onset NTM infection should be considered, especially if radiographic findings worsen. The BSI is not a reliable predictor of new-onset NTM-PD. Trial registration This study was performed at Seoul National University Hospital (NCT01616745).

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Clinical Implications of Size of Cavities in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Single-Center Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab087 ◽

2021 ◽

Vol 8 (3) ◽

Author(s):

Hye-Rin Kang ◽

Eui Jin Hwang ◽

Sung A Kim ◽

Sun Mi Choi ◽

Jinwoo Lee ◽

...

Keyword(s):

Treatment Outcomes ◽

Pulmonary Disease ◽

Clinical Outcomes ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

University Hospital ◽

Study Cohort ◽

National University ◽

Seoul National University ◽

The Impact

Abstract Background The presence of cavities is associated with unfavorable prognosis in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, little is known about the characteristics of such cavities and their impact on clinical outcomes. The aim of this study was to investigate the size of cavities and their implications on treatment outcomes and mortality in patients with NTM-PD. Methods We included patients diagnosed with NTM-PD at Seoul National University Hospital between January 1, 2007, and December 31, 2018. We measured the size of cavities on chest computed tomography scans performed at the time of diagnosis and used multivariable logistic regression and Cox proportional hazards regression analysis to investigate the impact of these measurements on treatment outcomes and mortality. Results The study cohort comprised 421 patients (noncavitary, n = 329; cavitary, n = 92) with NTM-PD. During a median follow-up period of 49 months, 118 (35.9%) of the 329 patients with noncavitary and 64 (69.6%) of the 92 patients with cavitary NTM-PD received antibiotic treatment. Cavities >2 cm were associated with worse treatment outcomes (adjusted odds ratio, 0.41; 95% CI, 0.17–0.96) and higher mortality (adjusted hazard ratio, 2.52; 95% CI, 1.09–5.84), while there was no difference in treatment outcomes or mortality between patients with cavities ≤2 cm and patients with noncavitary NTM-PD. Conclusions Clinical outcomes are different according to the size of cavities in patients with cavitary NTM-PD; thus, the measurement of the size of cavities could help in making clinical decisions.

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Screening for early detection of lung cancer: results from Seoul National University Hospital.

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.1991.38.2.119 ◽

1991 ◽

Vol 38 (2) ◽

pp. 119-127

Author(s):

Yong Chol Han ◽

Chul Gyu Yoo ◽

Young Whan Kim ◽

Sung Koo Han ◽

Young Soo Shim ◽

...

Keyword(s):

Lung Cancer ◽

Early Detection ◽

University Hospital ◽

National University ◽

Seoul National University

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Radioiodine Treatment of Differentiated Thyroid Carcinoma: The Experience at Seoul National University Hospital

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/157340510790694081 ◽

2010 ◽

Vol 6 (1) ◽

pp. 2-7

Author(s):

Ho Lee ◽

June-Key Chung ◽

Jong Lee ◽

So Oh ◽

Keon Kang ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

University Hospital ◽

Radioiodine Treatment ◽

National University ◽

Seoul National University

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Abstract TMP45: Usefulness of Susceptibility Vessel Sign With Bright Vessel Appearance in Acute Ischemic Stroke

Stroke ◽

10.1161/str.47.suppl_1.tmp45 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Han-Gil Jeong ◽

Beom-Joon Kim ◽

Chi Kyung Kim ◽

Jun Yup Kim ◽

Dong-Wan Kang ◽

...

Keyword(s):

Ischemic Stroke ◽

Arterial Occlusion ◽

University Hospital ◽

Large Artery ◽

Peripheral Arteries ◽

Inclusion Criteria ◽

Arterial Segment ◽

Susceptibility Effect ◽

National University ◽

Seoul National University

Background: Red thrombi, composed of fibrin and trapped erythrocytes, have magnetic susceptibility effect. Susceptibility vessel sign (SVS) is visualized more sensitively using susceptibility weighted imaging (SWI) than T2*-weighted imaging. Bright vessel appearance (BVA) on arterial spin labeling (ASL) imaging can visualize occluded arterial segment by arterial transit artifact, more sensitively in small and peripheral branches. We investigated the usefulness of SWI-SVS with BVA to visualize different thrombus and predict stroke mechanisms. Methods: From a total of 564 stroke cases who admitted to Seoul National University Hospital in 2014, the authors collected eligible cases with the following inclusion criteria; (1) Lesion-documented ischemic stroke (N=425); (2) SWI and ASL MRI performed (N=407); (3) Symptomatic arterial occlusion with BVA (N=141). All images were analyzed for the presence and location of SWI-SVS and BVA. The location of SWI-SVS and BVA were classified into (1) proximal, large arteries; distal ICA, M1/2, A1, P1, basilar artery, V4 and (2) peripheral, small arteries; M3/4, P2/3, A2/3, lenticulostriate arteries, three cerebellar arteries. The relationships between SWI-SVS in the presence of BVA and stroke etiologies are explored. Results: Male was 58.2% (n=82) and mean age was 65.7±14.3. Thirty-four percent (n=48/141) of BVA and 30.3% (n=30/99) of SVS was located within small, peripheral arteries. SWI-SVS was more commonly associated with other determined etiology (20.2% vs. 4.8%) and cardioembolism (39.4% vs. 14.3%), but less with large artery atherosclerosis (26.3% vs. 69.0%, P <0.01) compared to the patients without SWI-SVS. Cancer-related hypercoagulability (60%, n=12/20) was most common in other determined cases with SWI-SVS. Multivariate analysis showed that SWI-SVS was an independent predictor of other determined etiology (adjusted OR, 7.20; 95% CI, 1.48-34.99) and cardioembolism (adjusted OR, 5.76; 95% CI, 1.27-26.02) Conclusions: SWI-SVS with BVA may predict ischemic stroke of cardioembolism and other determined etiology. Occlusions of small, peripheral arteries are well visualized with BVA and composition of thrombus can be identified by SWI-SVS.

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