• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.2
• /
• pp.91-96
• /
• 2007

The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

• Korean Journal of Radiology
• /
• v.24 no.8
• /
• pp.752-760
• /
• 2023

Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.659-662
• /
• 2008

Video-assisted pulmonary lobectomy was introduced in the early 1990's by several authors, and the frequency of video-assisted thoracic surgery (VATS) lobectomy for lung cancer has been slowly increasing because of its safety and oncologic acceptability in patients with early stage lung cancer However, VATS is limited by 2D imaging, an unsteady camera platform, and limited maneuverability of its instruments. The da Vinci Surgical System was recently introduced to overcome these limitations. It has a 3D endoscopic system with high resolution and magnified binocular views and EndoWrist instruments. We report three cases of da Vinci robot system-assisted pulmonary lobectomy in patients with early stage lung cancer.

• Journal of Chest Surgery
• /
• v.46 no.2
• /
• pp.150-152
• /
• 2013

Arterial adventitial cystic disease is an uncommon type of non-atherosclerotic peripheral vessel disease. Most cases of arterial adventitial cystic disease occur in the popliteal arteries; however, fewer cases have been reported in the femoral arteries. A 59-year-old male patient visited the hospital with a complaint of a swelling on the lower extremity that had begun two months earlier. Suspecting deep vein thrombosis based on a physical examination and ultrasonography from another hospital, tests were performed. Magnetic resonance imaging (MRI) was performed for exact diagnosis because venous adventitial cystic disease was suspected by computed tomography venography. The MRI indicated venous adventitial cystic disease as well. Thus, a cystic mass excision was performed. In the end, a cystic mass compressing the common femoral vein that originated from the common femoral artery was diagnosed based on the macroscopic findings. This case is reported because blood circulation in the vein was impeded due to arterial adventitial cystic disease, and the symptoms improved after the cystic mass excision and polytetrafluoroethylene roofing angioplasty.

• Journal of Chest Surgery
• /
• v.56 no.1
• /
• pp.42-48
• /
• 2023

Background: With recent advances in cardiac surgery through minimal access, mini-thoracotomy has emerged as an excellent alternative for cardiac myxoma resection. This study analyzed the surgical results of this approach, focusing on postoperative cerebral embolism and tumor recurrence. Methods: We retrospectively reviewed 64 patients (mean age, 56.0±12.1 years; 40 women) who underwent myxoma resection through mini-thoracotomy from October 2008 to July 2020. We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. Patient characteristics and perioperative data, including brain diffusion-weighted magnetic resonance imaging (DWI) findings, were collected. Medium-term echocardiographic follow-up was performed. Results: Thirteen patients (20.3%) had a history of preoperative stroke, and 7 (11.7%) had dyspnea with New York Heart Association functional class III or IV. Sixty-one cases (95.3%) had myxomas in the left atrium. The mean cardiopulmonary bypass and cardiac ischemic times were 69.0±28.6 and 34.1±15.0 minutes, respectively. Sternotomy conversion was not performed in any case, and 50 patients (78.1%) were extubated in the operating room. No early mortality or postoperative clinical stroke occurred. Postoperative DWI was performed in 32 (53%) patients, and 7 (22%) showed silent cerebral embolisms. One patient underwent reoperation for tumor recurrence during the study period; in that patient, a genetic study confirmed the Carney complex. Conclusion: Mini-thoracotomy for cardiac myxoma resection showed acceptable clinical and neurological outcomes. In the medium-term echocardiographic follow-up, reliable resection was proven, with few recurrences. This approach is a promising alternative for cardiac myxoma resection.

• Investigative Magnetic Resonance Imaging
• /
• v.7 no.1
• /
• pp.22-30
• /
• 2003

Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.176-179
• /
• 2016

Delayed posttraumatic spinal epidural hematoma is an extremely rare disease, and it remains a challenge for surgical teams of trauma centers. Magnetic resonance imaging is an essential tool for early diagnosis, and emergent evacuation of the hematoma is the best choice of treatment. We report the case of a 33-year old man with posttraumatic epidural hematoma in the thoracic spine (T10 and T11 levels), who developed an abrupt-onset paraplegia 5 days after the trauma.

• Korean Journal of Bronchoesophagology
• /
• v.16 no.1
• /
• pp.51-54
• /
• 2010

Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. Occult bronchial foreign bodies arc rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. A 65-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobc collapse and obstructive pneumonitis as evidenced by imaging studies. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. We report this case with review of literatures.

• Journal of Chest Surgery
• /
• v.51 no.1
• /
• pp.72-75
• /
• 2018

Pericardial cysts are rare benign anomalies generally discovered as incidental findings on radiographic images. Rarely, pericardial cysts cause symptoms and may lead to complications. A 56-year-old woman presented to the emergency department for mild chest pain. A cardiovascular and respiratory examination revealed no abnormalities, while a chest X-ray and subsequent thoracic computed tomography (CT) showed a pericardial cyst. The patient refused both percutaneous treatment and thoracic surgery. Three years later, a thoracic CT scan showed that the pericardial cyst had disappeared. Although the spontaneous resolution of these lesions is rare, this article highlights the possibility of conservative management in select cases.

• Journal of Chest Surgery
• /
• v.42 no.5
• /
• pp.674-676
• /
• 2009

Isolated stress fracture of the first rib is rare, and repeated muscular pulling and fatigue of bone is thought to be responsible for this fracture. The diagnosis can be made by taking a thorough history and performing chest roentgenography, computed tomography or magnetic resonance imaging. Conservative treatment generally cures this condition. We report here on a case of exercise-induced isolated stress fracture of the first rib in a non-athlete college student and we review the related articles.