Tuberculosis and Respiratory Diseases最新文献

{"title":"Integration of Liquid Biopsy for Optimal Management of NSCLC.","authors":"Yuko Oya, Ichidai Tanaka, Ross A Soo","doi":"10.4046/trd.2024.0146","DOIUrl":"https://doi.org/10.4046/trd.2024.0146","url":null,"abstract":"<p><p>Molecular profiling of tumours from patients plays a crucial role in precision oncology. While tumour tissue-based genomic testing remains the gold standard in clinical management of patients with non-small cell lung cancer, advances in genomic technologies, the analysis of various bodily fluids, mainly blood but also saliva, pleural/ pericardial effusions, urine, and cerebrospinal fluid is now feasible and readily available. In this review, we will focus on the clinical application of circulating tumour DNA in patients with non-small cell lung cancer in the setting of early-stage disease, locally advanced disease with attention to the potential of ctDNA in prognostication, risk stratification, minimal residual disease, and in advanced disease, its role in the detection of genomic markers and mechanisms of acquired resistance. The role of ctDNA and liquid biopsies in lung cancer screening will also be discussed.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes using EBUS-guided Miniforcep Biopsy vs. EBUS-guided TBNA.","authors":"Pipu Tavornshevin, Poonchavist Chantranuwatana, Vorawut Thanthitaweewat, Virissorn Wongsrichanalai, Thitiwat Sriprasart, Nophol Leelayuwatanakul","doi":"10.4046/trd.2024.0134","DOIUrl":"https://doi.org/10.4046/trd.2024.0134","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a predominantly used method for lymph node (LN) metastasis assessment. This study aims to identify tissue adequacy improvement with the addition of EBUS-guided miniforcep biopsy (EBUS-MFB) to EBUS-TBNA in sampling LNs.</p><p><strong>Methods: </strong>We assessed tissue adequacy in patients with mediastinal and hilar lymphadenopathy, comparing the combination of EBUS-MFB and EBUS-TBNA with EBUS-TBNA alone. EBUS-MFB was performed with the guide sheath (GS) dilatation technique. Tissue adequacy was a tumor cell count (TCC) of >100 and neoplastic cell % (NCP) estimate of >25%. Further, we reported the diagnostic yield, tumor cell characteristics, and safety outcomes.</p><p><strong>Results: </strong>Among 69 patients (74 nodes), malignant diseases were diagnosed in 41 nodes using both techniques. Tissue adequacy with EBUS-TBNA (93.8% in 30/32 nodes) was comparable with the combined group (96.9% in 31/32 nodes, P = 0.317). EBUS-TBNA yielded higher TCC (84.4% with >1,000 cells) than EBUS-MFB (53.1%, P = 0.004). The combined approach significantly improved the diagnostic yield in nonmalignant diseases compared with EBUS-TBNA alone (97% vs. 78.8%, P = 0.014). Of the 32 nodes, 20 demonstrated discordant results between EBUS-TBNA and EBUS-MFB, with EBUS-MFB correctly diagnosing six nodes that EBUS-TBNA misdiagnosed. The complication rate was low (2.9%) with only minor bleeding reported.</p><p><strong>Conclusion: </strong>EBUS-TBNA alone and the combination of EBUS-MFB and EBUS-TBNA demonstrated comparable tissue adequacy, with EBUS-TBNA exhibiting better specimen characteristics, potentially sufficient for various molecular analyses. The addition of EBUS-MFB, performed using the GS-dilatation technique, to EBUS-TBNA improved the diagnostic yield and proved to be a safe and efficient approach, particularly in nonmalignant diseases.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The quality changes in intensive care units in South Korea since the initiation of ICU quality assessments.","authors":"Su Hwan Lee, Sunghoon Park","doi":"10.4046/trd.2025.0039","DOIUrl":"https://doi.org/10.4046/trd.2025.0039","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Park 7. Sarcoidosis.","authors":"Eun Joo Lee, Yangjin Jegal, Dong Won Park, Jimyung Park, Jun-Pyo Myong, Ji-Hyun Lee, Bo Hyoung Kang","doi":"10.4046/trd.2024.0202","DOIUrl":"https://doi.org/10.4046/trd.2024.0202","url":null,"abstract":"<p><p>Sarcoidosis is a granulomatous inflammatory disease of unknown etiology that can affect the entire body, but respiratory tract involvement is most common. In radiological findings, bilateral hilar and mediastinal lymph node enlargement is the most common finding, and when lung parenchyma is involved, findings such as micronodules, ground-glass shadows, reticular shadows, and fibrosis are seen. Biopsies for histological diagnosis are mainly performed on lymph nodes or lungs, and mediastinal lymph node biopsies are done via endobronchochial ultrasound-guided fine needle aspiration. Pathological findings are characterized by non-caseating, non-necrotizing granulomas, and in Korea, differentiation from tuberculosis is especially important. The natural history of sarcoidosis is very variable, with approximately two-thirds of subjects showing spontaneous remission and only 10-30% of patients showing a chronic or progressive form. The most important factor in determining treatment is whether there is a risk of death, organ failure, or loss of quality of life. Glucocorticosteroids are the mainstay of treatment, and if the disease progresses despite treatment, or if glucocorticosteroids cannot be reduced or cannot be used, immunosuppressants such as methotrexate and azathioprine can be considered. Response to glucocorticosteroids treatment is good, and most of the patients stabilize or improve, with a low mortality rate around 3-5%.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximal forced inspiratory flow dynamics and acute exacerbation in COPD patients with exacerbation history.","authors":"Heemoon Park, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Hyun Woo Lee","doi":"10.4046/trd.2024.0156","DOIUrl":"https://doi.org/10.4046/trd.2024.0156","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a significant global health burden characterized by progressive airflow obstruction and frequent exacerbations. Traditionally, COPD severity has been assessed using expiratory flow measurements like FEV1. However, the role of inspiratory flow, specifically maximal forced inspiratory flow (FIFmax), in predicting exacerbation risk is gaining attention.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated COPD patients with a history of exacerbations, receiving inhaled therapy. The eligible patients were followed up for 3 years with spirometric assessments. Patients were categorized into quartiles based on the annual change in FIFmax, from the greatest decrease (Q1) to the greatest increase (Q4). Primary outcome was acute exacerbation, stratified by severity as moderate-to-severe and severe exacerbation.</p><p><strong>Results: </strong>A total of 180 patients were followed up for 3 years. While a greater increase in FIFmax was linearly associated with lower rates of both moderate-to-severe and severe exacerbations (P-value for trend <0.001 for both), time-to-event analysis revealed no significant association between FIFmax changes and moderate-to-severe exacerbations. In contrast, a significant association was observed with severe exacerbations (Log-Rank P-value=0.005). Even after adjusting for confounders, FIFmax remained an independent predictor of severe exacerbations (Q3: hazard ratio=0.506 [95% confidence interval=0.306-0.836], P-value=0.008; Q4: hazard ratio=0.491 [95% confidence interval=0.291-0.830], P-value=0.008).</p><p><strong>Conclusions: </strong>Changes in FIFmax were not significantly associated with moderate-to-severe exacerbations but were related with a reduced risk of severe exacerbations in COPD patients receiving inhaled therapy. These findings suggest that FIFmax may serve as a valuable prognostic marker for severe exacerbations in high-risk COPD patients.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Role of Molecular Testing in the Management of Non-Metastatic Non-Small Cell Lung Cancer.","authors":"Hidenori Kage","doi":"10.4046/trd.2024.0159","DOIUrl":"https://doi.org/10.4046/trd.2024.0159","url":null,"abstract":"<p><p>Advances in targeted therapies and immune checkpoint inhibitors have significantly enhanced survival rates for patients with metastatic non-small cell lung cancer (NSCLC). For non-metastatic NSCLC, addition of immune checkpoint inhibitors post-chemoradiotherapy has improved outcomes in stage III disease and during the perioperative phase for stages IB-IIIA. Recently, adjuvant osimertinib and alectinib therapy have demonstrated improved survival for patients with EGFR or ALK alterations, respectively, and they have been established as standard therapies. Furthermore, osimertinib has proven effective when administered following chemoradiotherapy in stage III NSCLC. These studies highlight the necessity to assess EGFR and ALK status to guide treatment decisions for almost all NSCLC patients, regardless of whether they will undergo curative surgery, chemoradiotherapy, or as palliative chemotherapy. This review summarizes recent trials on perioperative and post-chemoradiation therapy and argues that molecular testing is required for non-metastatic NSCLC to improve patient outcomes.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and the Future of Pulmonary Function Testing in COPD: Toward Earlier Diagnosis of COPD.","authors":"Sang Hyuk Kim, MeiLan K Han","doi":"10.4046/trd.2025.0009","DOIUrl":"https://doi.org/10.4046/trd.2025.0009","url":null,"abstract":"<p><p>In the field of chronic obstructive pulmonary disease (COPD), there is growing interest in methods for early detection with the goal of altering disease progression. At the same time, pulmonary function testing (PFT) remains central to the diagnosis and management of COPD. Yet, spirometry remains underused, particularly in primary care, contributing to the underdiagnosis and misdiagnosis of COPD. Challenges hindering more active use of spirometry include a lack of access in primary care clinics or public venues, the complexity of performing spirometry and a lack of comfort with interpretation. Enhancing PFT utilization will require new approaches including broadening availability and adopting different approaches to interpretation.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of YJP-40 in patients with acute bronchitis: a randomized, double-blind, parallel group study.","authors":"Chin Kook Rhee","doi":"10.4046/trd.2024.0177","DOIUrl":"https://doi.org/10.4046/trd.2024.0177","url":null,"abstract":"<p><p>Pelargonium sidoides has been known to be effective in treating respiratory diseases. Pelargonium sidoides extract (Umckamin®) was approved in Korea for acute bronchitis. YJP-40 (Umckamin plus®) is formulated with extract of Pelargonium sidoides and ivy leaf. Ivy leaf extract has an expectorant effect and has been used to treat bronchitis. The aim of this study was to compare the efficacy of YJP-40 syrup with Umckamin® syrup in patients with acute bronchitis. This was a multicenter, randomized, double-blind, active-controlled, non-inferiority, phase III clinical trial. Patients were randomized 1:1 to either the test (YJP-40) or the control (Umckamin®) group. The primary endpoint was the change in bronchitis severity score (BSS) total score 7 days after administration. A total of 240 subjects (test group: 121, control group: 119) from 7 hospitals were enrolled in this clinical trial. The average change in BSS total score 7 days after administration compared to before was -4.31±2.09 and -4.36±1.71 in the test group and the control group, respectively. The non-inferiority of the test group to the control group was demonstrated. The response rate at 7 days after administration was 87.16% (95/109) in the test group and 86.92% (93/107) in the control group (P = 0.9778). There was no statistically significant difference between the groups in the incidence of adverse events. YJP-40 can be a safe and effective treatment option for acute bronchitis.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Guidelines for Diagnosis and Management of Interstitial Lung Disease: Cryptogenic organizing pneumonia.","authors":"Yong Suk Jo, Jong Sun Park, Sun Hyo Park, Joon Sung Joh, Hye Jin Jang, Hyun-Kyung Lee","doi":"10.4046/trd.2024.0167","DOIUrl":"https://doi.org/10.4046/trd.2024.0167","url":null,"abstract":"<p><p>Cryptogenic organizing pneumonia (COP), one of the idiopathic interstitial pneumonias (IIP), exhibits an acute or subacute course. It can be diagnosed after excluding secondary causes or diseases. COP accounts for approximately 5-10% of IIPs, with the average age of diagnosis ranging from 50 to 60 years. Patients primarily present with dry cough and dyspnea. They often experience fever, fatigue, and weight loss. Common radiologic findings on high-resolution computed tomography (HRCT) include localized consolidations, which are typically subpleural or located in the lower zones, though they can occur in all regions of the lungs. While treatment can be initiated without histopathological diagnosis, tissue biopsy may be necessary when the diagnosis is unclear. Response to steroid therapy is generally good, with rapid clinical improvement and a favorable prognosis, although relapses are common.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Guidelines for the Diagnosis and Management of Interstitial Lung Disease: Part 5-Other Forms of Interstitial Lung Disease.","authors":"Hyung Koo Kang, Sun Mi Choi, Hong-Joon Shin, Hae In Jung, Uiri An, Sei Hoon Yang","doi":"10.4046/trd.2024.0181","DOIUrl":"https://doi.org/10.4046/trd.2024.0181","url":null,"abstract":"<p><p>Rare forms of interstitial lung diseases (ILDs) present with unique clinical features and require different treatment strategies. Respiratory bronchiolitis-associated ILD mainly affects smokers, showing ground-glass opacities on chest computed tomography (CT) scans and pigmented macrophages in the bronchoalveolar lavage fluid. Smoking cessation is essential for treatment, with corticosteroids used for severe cases. Desquamative interstitial pneumonia, also related to smoking, is characterized by exertional dyspnea, dry cough, restrictive lung function, and ground-glass opacities on high-resolution CT. Lymphoid interstitial pneumonia involves lymphocytic proliferation and is associated with autoimmune diseases or infections, treated with corticosteroids. Acute interstitial pneumonia resembles acute respiratory distress syndrome but occurs without a clear cause and is managed with supportive care. Idiopathic pleuroparenchymal fibroelastosis results in fibrosis in the upper lobes, primarily in nonsmokers, and is diagnosed through clinical and imaging findings, with no effective treatment to improve survival. Each condition has distinct pathological features, clinical presentations, and treatment approaches, along with variable prognoses.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}