• Title/Summary/Keyword: 늑막

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Pulmonary Cryptococcosis in Immunocompetent Patients: CT Findings

  • Lee, Jae-Kyo
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.74-81
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    • 2004
  • Purpose: To evaluate the computed tomography (CT) findings of pulmonary cryptococcosis in immunocompetent patients. Materials and Methods: CT scans of 25 patients with biopsy-proven cryptococcosis [surgery (n=3), percutaneous needle biopsy (n=21), and bronchoscopic biopsy (n=1)] were analyzed. Thirteen patients were men and 12 patients were women, with a mean age of 53.7 years. Presenting symptoms were cough, sputum, and dyspnea and 12 patients presented with incidentally found chest radiographic abnormalities. Results: Nodule or multiple conglomerate nodules (n=10, 40%) and segmental or lobular consolidation (n=9, 36%) were most common, followed by mixed patterns (n=5, 20%). Predilection sites were lower lobe (n=21/37, 57%) and subpleural areas (n=23, 92%). Air bronchograms within consolidations (n=11/14, 79%) with mild volume loss (n=10/14, 71%) were common. While interlobular septal thickening (n=11, 44%) and cavitation or central low-attenuations (n=11, 44%) were relatively common, lymphadenopathy (n=2, 8%) or free pleural effusions (n=1, 4%) were uncommon. Conclusion: Nodules or airspace consolidation with a predilection of lower lobe and subpleural area are the most common appearances of pulmonary cryptococcosis in immunocompetent patients.

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Extrapleural Pneumonectomy for Diffuse Malignant Mesothelioma -A Case Report- (미만형 악성 중퍼세포종의 늑막폐절제술 -1례 보고-)

  • Kim, Byeong-Gu;Bae, Sang-Il;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.664-668
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    • 1996
  • Malignant mesothelioma has been considered a uniformly fatal disease associated with a median survival of 4 to 18 months. However, a multimodality approach toward therapy may Increase the length of palliation when a maximal resection of tumor is achieved. Recently we have experienced a 49 years-old male patient who had d ffuse malignant mesothelioma. The patient has complained of blood-tinged sputum and right chest pain for several months. Chest x-rays and CT scans showed compact haziness in the right entire thorax with massive bloody elusion, diffuse pleural thickening and collapsed underlying lung. We performed extrapleural pneumonectomy, and postoperative chemotherapy with cisplatin and mltomycin (Memorial Sloan-fettering Cancer Center method) was done. We are observing him for months now and there is no evidence of local recurrence.

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Significance of Pleural Fluid PCR and ADA Activity in the Diagnosis of Tuberculous Pleurisy (결핵성 늑막염의 진단시 늑막액의 Tb PCR 및 ADA활성도에 관한 연구)

  • 황재준;최영호;김욱진;신재승;손영상;김학제
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.669-675
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    • 2000
  • Background: Tuberculous pleurisy is the leading cause of pleural effusion in Korea. And differential diagnosis of tuberculous pleurisy with other cause is clinically very important. Traditional diagnostic methods such as routine analysis of pleural fluid, staining for acid-fast bacilli or pleural biopsy have major inherent limitaion. This study was designed to evaluate the significance of pleural fluid polymerase chain reaction(PCR) and adenosine deaminase (ADA) activity in early diagnosis of tuberculous pleurisy. Material and Method: Between March 1996 and July 1997, 198 patients with pleural effusion reviewed retrospectively. The study group included 112 cases with tuberculous effusion and 86 cases with non-tuberculous effusions, whose diagnoses were confirmed by pleural biopsy, microbiological methods, or cytology. We compared the results of PCR and pleural fluid levels of ADA between tuberculous and non-tuberculous effusions. Result: Mean age was 47.54$\pm$19.52 years(range 2 to 85 years). The positive rate of PCR was significantly higher in tuberculous group than non-tuberculous group(p<0.05). The sensitivty, specificity, positive predictive value(PPV), and negative predictive value(NPV) for PCR were 31.7, 90.9, 83.0, and 48.8%, respectively. Mean ADA activity was significantly higher in tuberculous group than non-tuberculous group(83.2 U/L vs 49.8 U/L)(p<0.05). With diagnostic thresholds of 40 U/L, the sensitivity, specificity, PPV, and NPV of ADA for tuberculosis were 75.9, 70.9, 77.3, and 69.3% respectively. At a level of 70 U/L, the sensitivity, specificity, PPV, and NPV of ADA for tuberculosis were 70.1, 75.9, 82.9, and 60.3% respectively. Conclusion: PCR is very highly specific, but less sensitive methods in diagnosis of tuberculous pleurisy. But ADA level of pleural fluid has acceptable sensitivity and specificity in diagnosis of tuberculous pleurisy. ADA activity is more useful test in the evaluation of pleural effusions.

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Interventional Treatment of Chemical Pleuritis and Hemothorax Caused by Iatrogenic Internal Jugular Vein Perforation after Central Venous Port System Implantation: A Case Report (중심정맥포트 삽입 후 의인성 속목정맥 천공에 의한 화학적 늑막염과 혈흉의 중재적 치료: 증례 보고)

  • Do Woo Kim;Young Hwan Kim;Ung Rae Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1459-1465
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    • 2020
  • The perforation of the intrathoracic internal jugular vein during the placement of an implantable central venous chemoport is a rare complication that is manifested by hemothorax or hemorrhagic shock. Furthermore, inappropriate instillation of a chemotherapeutic agent in the chemoport can cause chemical pleuritis, and the diagnosis of these complications prior to the instillation of chemotherapeutic agents and open thoracic surgery is mandatory. We report a patient with chemical pleuritis and hemothorax following an inappropriate instillation of a chemotherapeutic agent, through the perforated right internal jugular vein after placement of an implantable central venous chemoport. Treatment by embolization using coils and N-butyl cyanoacrylate, after percutaneous drainage, was successful.

Diagnostic Significance of Total Lactate Dehydrogenase(LD) and LD Isoenzyme Measurement in the Body Fluids (체강액에서 총 Lactate dehydrogenase 및 Lactate dehydrogenase 동위효소 측정의 진단학적 의의)

  • Jeon, Chang-Ho;Bae, Eun-Kyung;Hong, Seok-Il;Kim, Chung-Sook;Lee, Young-Hyun
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.193-199
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    • 1986
  • Body fluid Lactate dehydrogenase and its isoenzyme measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudate in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudate and the activity of LD4 isoenzyme was also increased compared with that of serum(P<0.05). 3. The inflammatory exudate of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity stastistically compared with that of serum and malignant exudate(P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.

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Effects of Cyclobuxine D on Carrageenin-induced Pleurisy and Croton Oil-induced Granuloma Pouch in Rats (흰쥐의 Carrageenin 유발 늑막염과 Croton oil 유발 육아종양에 미치는 Cyclobuxine D의 영향)

  • Lee, Jong-Hwoa;Park, Young-Hyun;Cho, Byung-Heon;Kim, Yu-Jae;Kim, Jong-Bae;Kim, Chung-Mok;Kim, Chun-Sook;Cha, Young-Deog;Kim, Young-Suk
    • The Korean Journal of Pharmacology
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    • v.23 no.2
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    • pp.151-157
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    • 1987
  • Cyclobuxine D, a steroidal alkaloid, was extracted from Buxus microphylla var. koreana Nakai. The effects of cyclobuxine D on carrageenin-induced pleurisy and croton oil-induced granuloma pouch in rats was investigated and compared with those of aspirin, hydrocortisone ana dexamethasone. Intrapleural injection of 2% carrageenin caused the accumulation of exudate. The rate of plasma exudation, measured by the exuded dye amounts for 20 min in the pleural cavity after intravenous injection of pontamine sky blue, showed a peak at 5 hr. Cyclobuxine D (5, 20 and 50 mg/kg, i.p.) suppressed dose-dependently the accumulation of the pleural exudate and the exudation of dye. Among several methods used for screening and evaluation anti-inflammatory agents, granuloma pouch technic introduced by Hans Selye (Hans seyle, 1953) is considered as a simple and reliable method. An air pocket was produced in the subcutaneous tissue of the interscapular region by injection of 1 ml of 1% croton oil as irritant. Inflammatory exudate accumulated in the pouch during the succeding 14 days. Cyclobuxine D (5 and 20 mg/kg) decreased fluid volume in pouch and weight of pouch wall in granulomatous inflammation.

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Pleural hyaline plaque -A case report- (다발성 늑막반 -1례 보고-)

  • 이홍렬
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.507-509
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    • 1995
  • Pleural hyaline plaques are discrete, multiple, usually bilateral, irregular thickenings involving the parietal pleura. The association of pleural plaques with occupational and environmental exposure to asbestos has been shown convincingly. We have experienced a case of pleural plaques involving bilateral parietal pleura which was exposed to asbestos for thirty years.

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Empyema Thoracis Resulting from Migrated Acupuncture Needle -Two Cases- (침(acupuncture needle)에 의한 농흉 -2례 보고-)

  • 황은구;김범식;조규석;박주철
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.101-103
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    • 2001
  • 한방용 침술은 비교적 광범위하게 이용되나 해부학적지식부족이나 소독이 불량할 때 여러 가지 합병증을 유발할 수 있다. 두 명의 환자에서 시술된 침이 피부와 근육을 관통하여 흉강내에 들어가 농흉을 발생시켜 늑막박피술과 침을 제거하였다.

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