• Tuberculosis and Respiratory Diseases
• /
• 제57권6호
• /
• pp.515-521
• /
• 2004

With the increasing resolution of modern CT scanners, analysis of the larger numbers of images acquired in a lung screening exam or diagnostic study is necessary, which also needs high accuracy and reproducibility. Recent developments in the computerized analysis of medical images are expected to aid radiologists and other healthcare professional in various diagnostic tasks of medical image interpretation. This article is to provide a brief overview of some of computer-aided diagnosis schemes in chest CT.

• Journal of Chest Surgery
• /
• 제26권7호
• /
• pp.557-559
• /
• 1993

We report a case of 62-year-old female who had an aneurysm of the right subclavian artery developed due to atherosclerosis. The preoperative diagnosis was made by chest computed tomography and arteriography. After resection of a 10x10x7cm-diametered and round aneurysm, end to side anastomosis of the right subclavian artery to the right carotid artery was done. She is well for 2 years after surgery.

• Journal of Chest Surgery
• /
• 제32권10호
• /
• pp.951-953
• /
• 1999

Leiomyoma is extremely rare benign tumor of the trachea. A case of leiomyoma of the trachea is described in a 36-year-old man. The patient had a brief history of asthma-like symptoms. Computed tomography of the chest revealed the ovoid lower trachea mass, which was occupying about 80% of the tracheal lumen. At fiberoptic bronchoscopy highly vascularized round mass was seen on the membranous portion of the lower trachea. The tumor was excised by segmental sleeve resection and end-to-end anastomosis of the trachea was performed. Postoperative course was uneventful and bronchoscopic findings showed clear healing of the anastomotic site.

• Journal of Trauma and Injury
• /
• 제24권1호
• /
• pp.52-55
• /
• 2011

The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

• Journal of Chest Surgery
• /
• 제25권11호
• /
• pp.1180-1184
• /
• 1992

The use of computed tomography of the chest in mediastinal staging of lung carcinoma lies the premiss that malignant lymph nodes are larger than benign ones. We have studied the size of mediastinal lymph nodes & the malignancy rate in 55 lung carcinomas from March 1990 to July 1992 at the Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of medicine. The lack of relationship between the size of mediastinal lymph node and the probability of malignancy helps to clarify the limitations of the use of computed tomography in the staging of the mediastinum in lung carcinoma. There was no tendency for all malignant lymph nodes to be larger than benign nodes. To allow comparison with our data, malignancy rates for all lymph nodes larger than 10mm are 24.8% in sensitivity & benign rates for all lymph nodes less than 10mm are 96% in specificity. But all mediastinal lymph nodes larger than 30mm are metastatic lymph nodes in our cases. We are going to try to have thoracotomy for complete resection of lung carcinoma as possible as we can if there no evidence of contralateral mediastinal metastases of lymph nodes, even though there are large mediastinal lymph nodes in lung carcinoma.

• Journal of Chest Surgery
• /
• 제51권2호
• /
• pp.138-141
• /
• 2018

Herein, we describe the case of a 67-year-old female patient who presented with cough and haemoptysis. Chest computed tomography revealed destruction of the left lower lobe and multiple fungus balls in a bronchiectatic cavity. A left lower lobectomy was performed via thoracotomy. Histopathological examination of the lung showed a concomitant aspergilloma and multiple tumourlets in the large bronchiectatic cavity. Pulmonary intracavitary aspergilloma and concomitant tumourlets are quite rare. Our report presents this interesting case that manifested with haemoptysis.

• Journal of Chest Surgery
• /
• 제54권5호
• /
• pp.404-407
• /
• 2021

We present a case study of necrotizing fasciitis (NF), a very rare but dangerous complication of chest tube management. A 69-year-old man with shortness of breath underwent thoracostomy for chest tube placement and drainage with antibiotic treatment, followed by a computed tomography scan. He was diagnosed with thoracic empyema. Initially, a non-cardiovascular and thoracic surgeon managed the drainage, but the management was inappropriate. The patient developed NF at the tube site on the chest wall, requiring emergency fasciotomy and extensive surgical debridement. He was discharged without any complications after successful control of NF. A thoracic surgeon can perform both tube thoracostomy and tube management directly to avoid complications, as delayed drainage might result in severe complications.

• Journal of Trauma and Injury
• /
• 제31권3호
• /
• pp.135-142
• /
• 2018

Purpose: When hemodynamically unstable patients with blunt major trauma arrive at the emergency department (ED), the safety of performing early whole-body computed tomography (WBCT) is concerning. Some clinicians perform central venous catheterization (CVC) before WBCT (pre-computed tomography [CT] group) for hemodynamic stabilization. However, as no study has reported the factors affecting this decision, we compared clinical characteristics and outcomes of the pre- and post-CT groups and determined factors affecting this decision. Methods: This retrospective study included 70 hemodynamically unstable patients with chest or/and abdominal blunt injury who underwent WBCT and CVC between March 2013 and November 2017. Results: Univariate analysis revealed that the injury severity score, intubation, pulse pressure, focused assessment with sonography in trauma positivity score, and pH were different between the pre-CT (34 patients, 48.6%) and post-CT (all, p<0.05) groups. Multivariate analysis revealed that injury severity score (ISS) and intubation were factors affecting the decision to perform CVC before CT (p=0.003 and p=0.043). Regarding clinical outcomes, the interval from ED arrival to CT (p=0.011) and definite bleeding control (p=0.038), and hospital and intensive care unit lengths of stay (p=0.018 and p=0.053) were longer in the pre-CT group than in the post-CT group. Although not significant, the pre-CT group had lower survival rates at 24 hours and 28 days than the post-CT group (p=0.168 and p=0.226). Conclusions: Clinicians have a tendency to perform CVC before CT in patients with blunt major trauma and high ISS and intubation.

• 한국방사선학회논문지
• /
• 제16권5호
• /
• pp.619-625
• /
• 2022

영상의학 분야에서 컴퓨터단층촬영(Computed Tomography, CT) 검사는 가장 보편화된 검사 방법 중의 하나이고 병원에서 이용 빈도가 매우 높은 검사 방법 중의 하나이다. 그러나 다른 검사 방법에 비해 매우 높은 방사선 피폭을 동반한다. 피폭 저감화를 위해서 CT 검사가 꼭 필요한 경우만 검사를 시행하는 방법과 꼭 필요해서 검사를 시행하는 경우에도 검사의 목적에 부합하고 적은 선량으로 검사를 시행할 수 있는 프로토콜을 사용해야 한다. 본 연구에서는 지역의 대표적 종합병원에서 사용하고 있는 가장 최신의 방사선량 사용정보를 알아보고 진단기준수준(Dignostic Reference Level, DRL)을 개발하고자 하였다. 실험결과 두부 CT, 복부 CT검사에서 DLP는 NRPB(U.K) 와 Korea DRL보다 높게 나타났다. 흉부 CT의 사용 DLP 값은 CT장치 3종 모두 낮게 나타났다. 해당 병원에서는 CT 검사 시 피폭 저감화를 위한 노력을 해야 하는 것을 알 수 있었고 특히 두부 CT, 복부 CT에서 피폭 저감의 노력이 필요하다고 판단한다.

• Journal of Korean Neurosurgical Society
• /
• 제51권5호
• /
• pp.316-319
• /
• 2012

A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.