Unilateral pleuroparenchymal fibroelastosis as a rare form of idiopathic interstitial pneumonia:A case report

BACKGROUND Pleuroparenchymal fibroelastosis(PPFE)is a rare idiopathic interstitial pneumonia characterized by predominantly upper lobe involvement with pleural fibrosis and subjacent parenchymal fibrosis.Recently,there have been increasing reports of PPFE,and PPFE might coexist with other interstitial lung diseases in the lower lobe and upper lobe.However,cases of unilateral PPFE are scarce.CASE SUMMARY A 75-year-old Korean male presented to our hospital with chronic dry cough and exertional dyspnea.The patient’s symptoms started 6 mo previously and had been gradually worsening.At the time of presentation,he felt dyspnea when walking at his own pace.Radiologic findings suggested PPFE,but the lesion was localized in the upper lobe of the right lung.After multidisciplinary discussion,a transbronchial lung biopsy in the right upper lobe revealed collapsed alveoli with parenchymal fibroelastosis,and elastic van Gieson staining demonstrated septal elastosis with intra-alveolar collagenosis,which met the histopathologic criteria of definite PPFE.After multidisciplinary discussion in an experienced interstitial lung disease center,we confirmed the diagnosis of unilateral PPFE.Furthermore,we confirmed the progression of PPFE on radiologic findings during the followup period.CONCLUSION Clinicians should consider PPFE,even in cases with unilateral,predominantly upper lung involvement in interstitial lung disease patients through multidisciplinary discussion.

Effects of Liuwei Dihuang Decoction(Yukmijihwang-tang)on Physical Fatigue by Regulating Neurotransmitters in Brain

Objective:To study the effect of Liuwei Dihuang Decoction(六味地黄汤)or Yukmijihwangtang(YJT)on endurance exercise by in vivo experiment.Methods:ICR mice were randomly divided into the control group(distilled water)and the YJT groups(1,10,100 mg/kg),5 animals per group.YJT and distilled water were orally administered.The anti-fatigue effect of YJT was evaluated by open fifiled test(OFT),forced swimming test(FST),and tail suspension test(TST).Results:In the OFT,YJT signifificantly increased the total movement distance in a dose-dependent manner.Additionally,treatment with YJT signifificantly decreased immobility time in the FST and the TST.Various neurotransmitters such as norepinephrine(NE),serotonin(5-HT),dopamine(DA)levels were increased by FST.Administration of YJT down-regulated the expression levels of NE,5-HT,5-hydroxyindole-acetic acid(5-HIAA),and DA in the brain stem and hypothalamus of mice.Moreover,protein expression of HSP70 in mice liver and heart muscles was signifificantly increased in the YJT groups.Conclusions:YJT could ameliorate fatigue and enhance exercise tolerance through suppressing of brain monoamines including NE,5-HT,5-HIAA,and DA in FST mice model.