• Journal of the Korean Society of Radiology
• /
• v.84 no.1
• /
• pp.253-262
• /
• 2023

Purpose To assess the clinicoradiological features of pulmonary cryptococcosis in immunocompetent patients. Materials and Methods This retrospective study included immunocompetent patients who had been diagnosed with pulmonary cryptococcosis on the histopathologic exam and underwent chest CT between January 2008 and November 2019. Imaging features were divided into major imaging patterns, distributions, and ancillary imaging findings. Univariable analysis was performed to evaluate clinicoradiological features according to the presence of serum cryptococcal antigen. Results Thirty-one patients were evaluated (mean age: 60 years, range: 19-78 years). A single nodular lesion confined to a single lobe was the most common imaging pattern (14/31, 45.2%). Serum cryptococcal antigen tests were performed in 19 patients (19/31, 61.3%). The presence of serum cryptococcal antigen was observed in six patients (6/19, 31.6%), all of whom showed a consolidation-dominant pattern. The presence of serum cryptococcal antigen was significantly associated with the consolidationdominant pattern compared to those associated with a nodule-dominant pattern (p = 0.011). Conclusion A combination of CT findings of consolidation and a positive serum cryptococcal antigen test may be helpful for diagnosing pulmonary cryptococcosis in immunocompetent patients.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.5
• /
• pp.677-684
• /
• 1995

Background: Broncholithiasis is uncommon but clinically important because it may cause a variety of nonspecific symptoms and signs prior to the onset of lithoptysis, and rarely massive hemoptysis. Method: A retrospective clinical study was done on 11 case of broncholithiasis diagnosed at Kyungpook National University Hospital from Jan. 1985 to Dec. 1993. The study investigated the clinical features, radiologic findings, bronchoscopic findings and management. Results: 1) The common symptoms included cough, dyspnea, hemoptysis, fever and purulent sputum. Lithoptysis occurred in 3 patients. 2) The radiologic findings were variable and nonspecific. Hilar calcification and parenchymal calcification were the most common findings. 3) The bronchoscopy was performed in 10 patients and revealed broncholiths in 9 patients. 4) Chemical composition of broncholiths was analyzed in 2 patients. Calcium carbonate was main component. 5) In 6 out of 9 patients in whom broncholiths was revealed by bronchoscopy, broncholiths were successfully extracted through the flexible bronchoscope. 6) In 9 patients, broncholithiasis was related to tuberculosis and in 1 case, related to silicosis. Conclusion: Broncholithiasis shows a variable clinical spectrum. Tuberculosis is the most common cause of broncholithiasis. In the case of no accompanied complication, nonsurgical management such as bronchoscopic removal and conservative therapy is an effective measure.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.4 no.2
• /
• pp.66-71
• /
• 2011

Purpose: This study was conducted to determine the usefulness of ultrasonography in evaluating callus formation in radiologically suspected nonunion or delayed union of clavicle fractures during conservative management. Materials and Methods: Six male patients and one female patient (average age: 38.3 years; range: 7 to 70 years), whose conservatively managed clavicle fractures were suspected of nonunion or delayed union, were examined with ultrasonography. If callus formation was detected, the patient continued to receive conservative management. If callus formation was not detected, the patient received operative management. Results: Six patients, in whom callus formation was observed ultrasonographically, continued to receive conservative management. The final simple radiographies of their fractures showed complete unions. One patient, in whom no callus formation was observed ultrasonographically, received operative management. In that patient, there was no operative finding of any fracture healing. Conclusion: Ultrasonography is a useful tool for evaluating callus formation in clavicle fractures suspected of nonunion or delayed union during conservative management. Ultrasonography can be used to avoid unnecessary surgery.

• Journal of Oral Medicine and Pain
• /
• v.26 no.3
• /
• pp.277-290
• /
• 2001

영상촬영술은 개방형 외과적 관절수술이나 관절경 검사법을 할 수 없는 상태에서 관절의 상태에 대한 시각적 정보를 확보할 수 있는 유일한 방법이다. 이것의 주된 목적은 진단과 치료계획과정을 도와주는 정보를 제공하는데 있다. 그중 방사선 촬영술은 턱관절의 구조적 질병을 진단하는데 기본적인 수단으로서 오래동안 사용되어 왔 다. 그러나 어떠한 방사선 소견이 개별 관절질환의 특징적 소견인지는 찾아내기가 어려운 실정이다. 그러나 통상적 턱관절 방사선 촬영술로서도 구조적 골변화를 찾아낼 수 있으며 특히 시상 단층촬영술은 턱관절에서 가장 유익한 정보를 보여준다고 한다. 또한 보고에 의하면 턱관절 장애는 다양한 해부학적 요인들과 관련이 있다고 한다. 따라서 본 연구에서는 통상적인 방사선 단층촬영술을 이용하여 턱관절 장애환자의 턱관절에서 나타나는 골변화를 찾아내고 이러한 골변화가 하악과두 수평각, 하악과두 형태, 과두위치 등과 같은 여러 요인들과 서로 관련이 있는 지 찾아보고저 하였다. 단국치대 구강내과 안면동통진료실에 내원한 256명의 환자 중, 턱관절장애를 편측으로만 호소하는 환자 73명을 대상으로 SCANORA를 이용하여 방사선 단층촬영을 시행하였다. 먼저 악하두정위 촬영을 통해 정중선에 대한 하악과두의 방향을 찾아내고 단층촬영 부위를 계산하였으며, 모든 촬영면은 4 mm 두께로 하고 턱관절 부위에만 국한되도록 조준하였다. 폐구 시 4개의 시상 촬영과 개구 시 한개의 시상 및 전두촬영상을 구한 후, 하악과두, 과두 형태 및 하악과두위치 등과 같은 요인들에 대한 골변화간의 관련성을 조사하고저 자료를 측정한 후 Contengency table analyses를 시행하였다. 본 연구의 결과에 따르면 결론적으로 하악과두의 형태, 하악과두의 수평각 및 하악과두의 위치 등은 턱관절의 골변화와 상호 관련이 있다는 가설을 확인할 수 있었다. 즉 하악과두상의 골변화는 과두가 후방위치되고 과두각이 25도 이상 크며, 특히 20대에서는 flat type, 40대에서는 angled type의 과두형태를 가지며 두 과두각의 차이가 9도에서 12도 정도로 큰 차이가 있는 남성환자에서 증가한다.

• Radiation Oncology Journal
• /
• v.22 no.1
• /
• pp.40-54
• /
• 2004

Purpose : Captopril (angiotension converting enzyme inhibitor) is known to have a radioproptective effect in the lungs, intestines and skin, but its effect in the heart is unclear. To investigate the radioprotectlve efiect and mechanism of captopril on the heart, the histopathological changes and immunohistochemical stains were compared with radiation alone, and radiation combined with captopril, in the rats. Materials and Methods : The histopathological changes and immunohistochemical stains ($TNF{\alpha}$, $TGF{\beta}1$, PDGF and FGF2) were examined in the radiation alone and the combined captopril and radiation groups, 2 and 8 weeks after irradiation. Each group consisted of 8 to 10 rats (Sprague-Dawley). Irradiation (12.5 Gy) was given to the left hemithorax in a single fraction. Captopril (50 mg/Kg/d) mixed with water, was given orally and continuously from the first week prior to, up to the 8th week of the experiment. Results : In the radiation alone group, the ventricle at 2 weeks after irradiation showed prominent edema (p=0.082) and fibrin deposit (p=0.018) compared to the control group. At 8 weeks, the edema was decreased and fibrosis increased compared to those at 2 weeks. The histopathological changes of the combined group were similar to those of the control group, due to the reduced radiation toxicity at 2 and 8 weeks. The endocardial fibrin deposit (p=0.047) in the atrium, and the interstitial fibrin deposit (p=0.019) and edema (p=0.042) of the ventricle were reduced significantly in the combined group compared to those in the radiation alone group at 2 weeks. The expressions of $TNF-{\alpha}$, $TGF-{\beta}1$, PDGF and FGF-2 in the radiation alone group were more increased than in the control group, especially in the pericardium and endocardium of the atrium at 2 weeks. At 8 weeks, the pericardial $TNF-{\alpha}$ and $TGF-{\beta}1$ in the radiation alone group continuously increased. The expressions of $TNF-{\alpha}$, $TGF-{\beta}1$ and PDGF were decreased in the combined group at 2 weeks. At 8 weeks, the expressions of $TNF-{\alpha}$ in the atrial and ventricular pericardia were markedly reduced (p=0.049, p=0.009). Conclusion : This study revealed that the early heart damage induced by radiation can be reduced by the addition of captopril in a rat model. The expressions of $TNF-{\alpha}$, $TGF-{\beta}1$ and PDGF were further decreased in the combined compared to the radiation alone group at both 2 and 8 weeks. From these results, it may be concluded that these cytokines probably play roles in the radioprotective mechanism of captopril from the radiation-induced heart toxicity, similarly to in other organs.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.2
• /
• pp.311-321
• /
• 1998

Background: Mucoepidermoid carcinoma of the lung arises from submucosal gland of tracheobronchial tree. Histologically, the tumor is composed of mucin-secreting cells, squamous cells, and intermediated cells, which show no particular differentiating characteristics, in varying proportions. The tumor is divided into low grade and high grade depending on the proportion of cells, and the degree of the mitotic activity, cellular necrosis and nuclear pleomorphism. While favorable prognosis of low grade tumor, high grade tumor, which is very difficult to differentiate from adenosquamous carcinoma, has an aggressive clinical course. The tumor is rare, comprising 0.1 to 0.2% of primary lung cancers and 1 to 5% of bronchial adenomas. Method: A retrospective clinical study was done on 17 cases of mucoepidermoid carcinoma. The study investigated the clinical features, radiologic findings, bronchoscopic findings, histology and clinical courses. Results: Age ranged between second to seventh decade with a mean age of 42 years. Twelve out of 17 cases were male. Five out of 17 cases were smokers with a mean 11 pack-years. Common symptoms included dyspnea, cough, hemoptysis, and wheezing. Two out of 17 cases was asymptomatic. Atelectasis or mass was common radiologic finding. Plain chest radiography was normal in one patient whom the tumor was located in upper trachea. Bonchoscopy revealed exophytic mass in 12 cases and nodular infiltrations in 4 cases. One case having solitary pulmonary nodule in the right lower lung was normal on bronchoscopy. Histologically, ten out of 17 cases were low grade, and seven out of 17 cases were high grade. Among 10 patients with low grade tumor,9 patients were performed operation and have been alive without recurrence during a mean follow-up of 30 months. Two out of 7 patients with high grade tumor were performed pneumonectomy and have been alive during a follow-up of 3 and 8 months, respectively. Conclusion: Most of mucoepidermoid carcinoma is located at central airway and is presented symptoms by mucosal irirtation. Although atelectasis or mass is common radiologic finding. chest X -ray can be normal. The histologic grading and the extent of tumor are two most important factors for prognosis.

• Clinical and Experimental Pediatrics
• /
• v.45 no.4
• /
• pp.519-523
• /
• 2002

Purpose : We aimed to evaluate the abnormalities of chest radiographs including atelectasis in children who were admitted with bronchial asthma. Methods : We retrospectively analyzed the 357 chest radiographs and the clinical and laboratory features of the 144 children with asthma, who were admitted at Daejoen St. Mary's Hospital from April 1994 to May 1998. Results : Clinical and laboratory characteristics were as follows : male to female ratio, 2.1 : 1; mean age, 4.8 years of age; mean numbers of admission, 2.5; mean hospitalization, 5.0 days; mean IgE, 387 IU/mL; mean eosinophil count, $362/mm^3$. In the abnormal findings of the 357 radiographs, there were 314 cases(88.0%) of hyperinflation, pulmonary infiltration 35.0%, atelectasis 5.3% and pneumomediastinum 0.3%. All(19) cases of atelectasis were observed in the right lung field with mostly segmental and lobular distribution, except one with lobar involvement. Atelectasis was predominant in males and those under 2 years of age. There was a tendency that the right upper lung was more involved under two years while the right lower lung was more involved over seven years of age. Conclusion : Radiographs of children admitted to hospital with bronchial asthma showed abnormal findings including pneumonia or atelectasis(5.3%). These abnormal findings can help to determine other therapeutic modalities in addition to asthma treatment.

• Radiation Oncology Journal
• /
• v.29 no.1
• /
• pp.11-19
• /
• 2011

Purpose: To evaluate the pathological and clinical effects of preoperative chemoradiation (CCRT) in cases of locally advanced rectal cancer and to determine the predictive factors for tumor downstaging. Materials and Methods: From March 2004 to August 2008, 33 patients with locally advanced rectal cancer were treated with preoperative CCRT. Twenty-eight patients (84.8%) were treated using a concomitant boost technique while five (15.2%) patients were treated using a cone down boost technique. All patients received 50.4 Gy of irradiation and concurrent chemotherapy with 5-fluorouracil. The median follow-up duration was 24.2 months (range, 9.8 to 64.7 months). Results: Thirty-one (93.9%) patients underwent surgery. Twenty-four patients (72.7%) underwent anal sphincter-preserving surgery. The 3-year disease free survival (DFS) and overall survival rates were 63.4% and 78.8%, respectively. Post-operative factors were more important for DFS. Pathologic N stage, margin status, and pathologic differentiation were significant prognostic factors (p=0.001, 0.029, 0.030). Tumor size and lymphovascular invasion were also associated with marginal significance (p=0.081, 0.073). However, only pre-treatment T stage was a significant pre-operative factor (p=0.018). The complete pathological response rate was 9.1 %. T-downstaging was observed in ten (30.3%) patients, whereas N-downstaging was found in 24 (72.7%) patients. Pre-treatment T stage and the interval between CCRT and operation were the predictive factors for downstaging in a univariate analysis (p=0.029, 0.027). Pre-treatment carcinoembryogenic antigen was also associated with marginal significance (p=0.068). Conclusion: The survival of rectal cancer patients can be better determined based on post-operative findings. Therefore, pre-operative CCRT for downstaging of the tumor seems to be important. Pre-treatment T stage and the interval between CCRT and operation can be used to predict downstaging.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.2
• /
• pp.331-338
• /
• 1999

Chemoradiation therapy used on pediatric oncology patients often causes dental developmental anomalies that affect future dental care. Defects noted include tooth and root agenesis, root thining and shortening, and localized enamel defects. The effect of radiotherapy usually are confined to the radiation site, but the effects of chemotherapy may be more wide spread because of its systemic distribution and structures and organs unrelated to the primary tumor may be affected. Many pediatric cancers are treated with a combination of radiation and multiagent chemotherapy to create synergic and additive effects. Dental treatment affected by chemoradiation damage to developing teeth includes orthodontic tooth movement, prosthetic abutment considerations, periodontal health, space maintenance, requirements for home fluoride regimens to protect hypomineralized areas, restoration options for hypoplastic/hypomineralized teeth, and endodontic procedures. The following case demonstrate chemoradiation therapy effects on the dental development.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.123-126
• /
• 2010

Purpose: Poland syndrome is rare disease which is characterized by absence of unilateral pertoralis major muscle accompanied by ipsilateral syndactyly or brachydactyly, which was described first by Alfred Poland in 1841. Materials and Methods: We performed the physical examination, laboratory test and radiologic evaluation to 18 year old male, who complaint asymmetry of right anterior chest. Results: We diagnosed the Poland syndrome due to absence of right pectoralis major muscle and brachydactyly of right hand. Conclusion: Current authors report a patient who had hypopalsia of pectoralis muscles, which needed differential diagnosis with pectoralis major rupture.