Case 1 C C 78 M LAP for

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Case 1 C. C. : 78 / M LAP (for EBUS TBLB) History: Dyspnea

Case 1 C. C. : 78 / M LAP (for EBUS TBLB) History: Dyspnea (onset 2 YA, MRC grade 2 -3) Adm. : 2013 -10 -16

2013 -10 -16

2013 -10 -16

2013 -10 -23

2013 -10 -23

2013 -10 -23

2013 -10 -23

Clinical course C. C. LAP (for EBUS TBLB), COPD 2013 -10 -17 TBNA: LN,

Clinical course C. C. LAP (for EBUS TBLB), COPD 2013 -10 -17 TBNA: LN, reactive hyperplasia. 2013 -10 -24 Wedge resection, RML, RLL: Cellular and fibrosing interstitial pneumonia, suggestive of nonspecific interstitial pneumonia, mixed pattern. 2014 -02 -06 Ig. G and Ig. G 4 immunohistochemical stainings: Ig. G 4 -related lung disease

Clinical course C. C. LAP (for EBUS TBLB), COPD, Ig. G 4 -RLD serum

Clinical course C. C. LAP (for EBUS TBLB), COPD, Ig. G 4 -RLD serum Ig. G 4 ( 2013 -11 -12: 2014 -8 -8: > 140 mg/d. L) 255 mg/d. L 35 mg/d. L. No evidence of involvement of other organs Autoantibodies related to CTD: all negative Mx: 2013 -11 ~ prednisolone, azathioprine 2014 -2 ~ prednisolone

2013 -10 -16 2014 -08 -08

2013 -10 -16 2014 -08 -08

2013 -10 -23 2014 -08 -08

2013 -10 -23 2014 -08 -08

Case 2 C. C. : 75 / M Dyspnea (onset 3 MA) History: ILD,

Case 2 C. C. : 75 / M Dyspnea (onset 3 MA) History: ILD, emphysema (외부 병원) Adm. : 2014 -02 -05

2014 -02 -05

2014 -02 -05

2014 -02 -05

2014 -02 -05

2014 -02 -05

2014 -02 -05

Clinical course C. C. Dsypnea, ILD 2014 -2 -7 Wedge resection, LUL, LLL: Cellular

Clinical course C. C. Dsypnea, ILD 2014 -2 -7 Wedge resection, LUL, LLL: Cellular and fibrosing interstitial pneumonia, suggestive of nonspecific interstitial pneumonia, mixed pattern. Ig. G and Ig. G 4 immunohistochemical stainings: Ig. G 4 -related lung disease (more than 50 positive cells/HPF)

Clinical course C. C. Dsypnea, Ig. G 4 RLD serum Ig. G 4 (

Clinical course C. C. Dsypnea, Ig. G 4 RLD serum Ig. G 4 ( 2014 -3 -6: 2014 -7 -30: > 140 mg/d. L) 69 mg/d. L 57 mg/d. L. No evidence of involvement of other organs Autoantibodies related to CTD: all negative Mx: 2014 -2 ~ prednisolone, azathioprine

2014 -02 -05 2014 -07 -30

2014 -02 -05 2014 -07 -30

Most common: up to 80% Ryu et al. Eur Respir J 2012

Most common: up to 80% Ryu et al. Eur Respir J 2012

ILD presentation: Radiological features Widening array of radiological patterns Patchy ground-glass opacities or consolidation

ILD presentation: Radiological features Widening array of radiological patterns Patchy ground-glass opacities or consolidation Reticular opacities (irregular lines) Honeycombing Thickening of the bronchovascular bundles & interlobular septa Pulmonary function testing: reduced diffusing capacity restrictive impairment particularly, extensive parenchymal infiltrates

ILD presentation: Radiological features DDx: Idiopathic interstitial pneumonias, such as idiopathic pulmonary fibrosis (usual

ILD presentation: Radiological features DDx: Idiopathic interstitial pneumonias, such as idiopathic pulmonary fibrosis (usual interstitial pneumonia) idiopathic nonspecific interstitial pneumonia, cryptogenic organising pneumonia Sarcoidosis

Figure 1 Chart shows the clinical course and progression of pulmonary hypertension, the morphologic

Figure 1 Chart shows the clinical course and progression of pulmonary hypertension, the morphologic changes that occur, and the functional parameters. c. MRI = cardiac MR imaging, CO = cardiac output, COPD = chronic obstructive pulmonary disease, LV = left ventricle, MDCTA = multidetector CT angiography, RV = right ventricle. Radio. Graphics, http: //pubs. rsna. org/doi/abs/10. 1148/rg. 321105232 Published in: Elena Peña; Carole Dennie; John Veinot; Susana Hernández Muñiz; Radio. Graphics 2012, 32, 9 -32. DOI: 10. 1148/rg. 321105232 © RSNA, 2012 One Power. Point slide of each figure may be downloaded and used for educational not promotional purposes by an author for slide presentations only. The ATS citation line must appear in at least 10 -point type on all figures in all presentations. Pharmaceutical and Medical Education companies must request permission to download and use slides, and authors and/or publishing companies using the slides for new article creations for books or journals must apply for permission. For permission requests, please contact the Publisher at.

Case 1 C. C. : 78 / M LAP (for EBUS TBLB) History: Dyspnea

Case 1 C. C. : 78 / M LAP (for EBUS TBLB) History: Dyspnea (onset 2 YA, MRC grade 2 -3) Adm. : 2013 -10 -16

2011 -11 -25 2013 -06 -05

2011 -11 -25 2013 -06 -05

2011 -11 -25 2013 -06 -08

2011 -11 -25 2013 -06 -08

Case 2 C. C. : 75 / M Dyspnea (onset 3 MA) History: ILD,

Case 2 C. C. : 75 / M Dyspnea (onset 3 MA) History: ILD, emphysema (외부 병원) Adm. : 2014 -02 -05

2006 -03 -23 2011 -05 -23

2006 -03 -23 2011 -05 -23

Pulmonary arterial hypertension Right ventricular function : major determinant of functional capacity and prognosis

Pulmonary arterial hypertension Right ventricular function : major determinant of functional capacity and prognosis

4 D Phase-Contrast MR Imaging Appearance of vortex coincides with pulmonary arterial hypertension Period

4 D Phase-Contrast MR Imaging Appearance of vortex coincides with pulmonary arterial hypertension Period of existence of vortex ∝ Mean PAP (= 16. 7 + 58 x tvortex) Reiter G. et al. Circ Cardiovasc Imaging. 2008; 1: 23 -30

2005 -02 -18 2005 -08 -19

2005 -02 -18 2005 -08 -19

2012 -04 -09 2014 -03 -13

2012 -04 -09 2014 -03 -13

2014 -05 -13 CT

2014 -05 -13 CT

2014 -05 -13 MIP

2014 -05 -13 MIP

2014 -05 -13 MIP

2014 -05 -13 MIP

2014 -05 -13 MIP thin

2014 -05 -13 MIP thin

2014 -05 -13 MIP thin

2014 -05 -13 MIP thin

Valve-sparing aortic root reconstruction modified David procedure

Valve-sparing aortic root reconstruction modified David procedure

Valve-sparing aortic root reconstruction modified David procedure Commissural posts and associated leaflets are inserted

Valve-sparing aortic root reconstruction modified David procedure Commissural posts and associated leaflets are inserted within the cylinder of the aortic graft (“reimplantation technique”). Coronary buttons are reimplanted in between the commissural posts. Preserved aortic leaflets - Patel H J , and Deeb G M Circulation. 2008; 118: 188 -195

Magnetic resonance angiography Parallel imaging or time-resolved techniques Reduce scan time Improve spatial resolution

Magnetic resonance angiography Parallel imaging or time-resolved techniques Reduce scan time Improve spatial resolution by improving anatomic coverage and removing aliasing artifact with the use of multiple channel coils The individual coils, which have varying spatial sensitivities, are used to simultaneously receive MR signal following a single radiofrequency (RF) puls. Reduction in exogenous contrast dose

Large field of view CE MRA using parallel imaging Hartung et al. Journal of

Large field of view CE MRA using parallel imaging Hartung et al. Journal of Cardiovascular Magnetic Resonance 2011, 13: 19

Rapid whole chest CE MRA using parallel imaging Hartung et al. Journal of Cardiovascular

Rapid whole chest CE MRA using parallel imaging Hartung et al. Journal of Cardiovascular Magnetic Resonance 2011, 13: 19