• Title/Summary/Keyword: ChestCT

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A Case of Bronchial Artery Aneurysm with Bronchiectasis and Successful Coil Embolization (금속 코일 색전술로 치료된 기관지 확장증이 동반된 기관지 동맥류 1예)

  • Chung, Hyun Jung;Cho, Jae Hwa;Park, Byoung Do;Ryu, Jeong Seon;Kwak, Seung Min;Lee, Hong Lyeol;Jeon, Yong Sun
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.546-549
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    • 2008
  • Bronchial artery aneurysm (BAA) is a rare entity that requires early diagnosis and immediate treatment due to the possibility of a life-threatening massive hemorrhage through rupture. The standard treatment is a surgical resection of the aneurismal artery. However, various embolization techniques, including coil embolization, are currently used as the optimal treatment because they are less invasive. A 65-year-old woman was referred for the treatment of intermittent hemoptysis. A chest CT scan showed an approximately 2 cm sized vascular mass with strong contrast enhancement originating from the right bronchial artery on the bronchiectatic parenchyma. On the angiogram, the inferior portion of the bronchial artery with a hypertrophic aspect and a huge bronchial artery aneurysm was detected on the left side branch. The bronchial artery aneurysm was embolized successfully with coils at the proximal and distal portion of the aneurysm. After coil embolization, the selective bronchial angiogram confirmed complete occlusion. We report this case of a bronchial artery aneurysm that was treated successfully with coil embolization.

A Case of Amiodarone-induced Interstitial Lung Disease (Amiodarone의 투여로 야기된 간질성 폐 질환의 1례)

  • Kim, Byeong-Hun;Park, Jong-Won;Jung, Jin-Hong;Lee, Kwan-Ho;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.186-192
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    • 1994
  • Amiodarone has a potent suppressive effect on supraventricular and ventricular dysrhythmias, so has widely used as a class III antiarrhythmic agent. However, significant side effects were noted in over 50% of patients treated. Pulmonary toxicity represents the most serious adverse raeaction limiting the clinical efficacy of this new antidysrhythmic drug. A 66-year-old male had received amiodarone 200mg/day for 7 months to control high grade ventricular premature contraction and was admitted due to dyspnea on exertion for 1 week. At the time of admission end-inspiratory crepitant rale was heard on auscultation. The roentgenogram of his chest revealed reticular and granular radioopaque densities on both lower lung fields and high resonance CT revealed interstitial fibrosis and pneumonic consolidations on the periphery of the both middle and lower lobes. Trans-bronchoscopic lung biopsy revealed nonspecific intersitial fibrosis. The laboratory findings were non-specific. We present a case of amiodarone-induced interstitial pulmonary disease clinically improved by cortico-steroid therapy.

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The Usefulness of Bolus of Radiation Therapy in Patients with Whole Breast Cancer

  • Min, Jung-Whan;Son, Jin-Hyun;Park, Hoon-Hee;Dong, Kyung-Rae
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.3
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    • pp.99-103
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    • 2011
  • Radiation Therapy has been used in the treatment of breast cancer for over 80 years. Technically, it should include a part or all of such areas as chest wall or breast, axilla, internam mammary nodes and supraclavicular nodes. The purpose of this study is treated breast cancer patient to use 6 MV, 10 MV with bolus so that we observe changing of skin dose and evaluate those usefulness. Using woman's phantom, after CT simulate scanning, Through RTP system to make treatment plan, select three any place. And then, we measure that dose rate. After moving the phantom to linac, we put for TLD to three point same as RTP system which we put on the phantom. We exposed 6 MV, 10 MV with bolus and without so that it is measured dose by TLD device(4000 Harshaw). As a reult expose 6 MV,10 MV, it differences 10%, 15% according to bolus and withoout bolus where lateral point from RAO, LPO beam, other one is 20% where the furthest from both beams. To use bolus in the hospital is material to include closely part at skin among tissue of breast cancer. Acquired skin dose from RTP system is uncertainity. So it has to test another system likely TLD or other dosimetry system. Also exposed field of breast cancer is included inhomogeneity such as lung, bone and so on. Therefore it has to be accomplished a dose calculating of inhomogeneity part from treatment plan.

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A Case of Late Presenting Congenital Diaphragmatic Hernia (늦게 발현된 선천성 횡경막 탈장 1예)

  • Song, Ji-Eun;Kwon, Oh-Kun;Kim, Young-Ho;Lee, Hae-Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.246-250
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    • 2009
  • Congenital diaphragmatic hernias (CDH) usually cause respiratory distress soon after birth and are associated with a high mortality rate in the early postnatal period. However, there is a milder form of CDH that does not manifest during the neonatal period. The late presenting CDH is characterized by a variable clinical picture. We present the case of an otherwise healthy 5-month-old girl, who was referred for evaluation of an 1-day history of vomiting and irritability. Chest simple X-ray and CT showed bowel loops in the left thoracic cavity, which was consistent with diaphragmatic hernia. At operation, she was found to have a small left posterolateral diaphagmatic defect with viable small bowel loops in the left thoracic cavity. After surgical reposition of the hernia, the symptoms such as vomiting and irritability subsided. The lack of typical manifestation of CDH such as respiratory distress may lead to delayed diagnosis. The possibility of late presenting CDH should not be overlooked even after the neonatal period.

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Popliteal Artery Entrapment Syndrome -One case report - (슬와동맥 포착증후군 - 1예 보고 -)

  • Oh Jae-Yun;Lee Seock-Yeol;Lee Chol-Sae;Lee Seung-Jin
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.791-794
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    • 2006
  • Popliteal artery entrapment syndrome is a rare disorder and lead to claudication and disturbance of blood flow from the results of an abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in a young male population. The specific diagnosis is difficult, In most cases, surgical treatment provides a definitive diagnosis of the lesion and is necessary for the patient's recovery. A 34-years-old male was admitted complaining of claudication and pain on left leg. Ankle-brachial index, vascular sonography, CT-angiogram and MRI revealed an occlusion of proximal popliteal artery of left leg. The patient was confirmed as a popliteal artery entrapment syndrome (type IV) that the popliteal artery was entrapped by a fibrous band around the popliteus muscle in the operative fold. Completely occluded fibrotic popliteal artery was removed, and interposition with ipsilateral greater saphenous vein graft was done. After surgery, symptoms of the patient have improved.

Clinical Experience with Vascular Surgery (혈관수술에 대한 임상적 고찰)

  • 김현경
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1570-1577
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    • 1992
  • The vascular surgery is the field that has developed in early 20 century and is progressing nowadays. Recent advance in surgical technique accompanying with excellent medical diagnosis and treatment, prompt angiographic usage, development of variable prosthetic material, and concomitant use of anti-coagulant have made remarkable results of vascular surgery. 83 cases of vascular surgery have been performed at Thoracic and Cardiovascular Surgery Department of Pusan National Unversity Hosaital since 1971 till 1990, for 20 years and their results are followed. Patient ductus arteriosus and Buerger`s disease were omited in this study. 1. The age distribution shows that the fifth and sixth decades are most frequently affected and mean age was 56.1 years old. Male to female ratio is 1: 2.32. 2. Among the 83 cases of all, number of occlusive vascular disease is 46 and that of aneurysmal disease is 33. 3. In clinical manifestation, most common symptom of occlusive disease is pulselessness and pain was next. Mass sensation is most commonly complained by patients of aneurysmal disease. 4. CT scan was more important in diagnosis of aneurysmal diseases and angiogram was more commonly used in occlusive diseases. 5. The common site of arterial occlusion was common iliac artery, femoral artery, aortic bifurcation, and external iliac artery, as its frequency rate. The most commonly affecting portion of aortic aneurysm was abdminal aorta, and descending thoracic aorta and femoral artery were next 6. Preoperative associated diseases were atherosclerosis[41 cases], hypertension[21 cases], valvular heart disease[11 cases], and diabetes mellitus[9 cases], etc, 7. Operative methods in ocllusive diseases were thrombectomy[36.9%], endarterectomy [10.9%], and bypass graft insertion[52.7%]. Among the bypass graft, Y-graft was used in 7 case, straight graft was used in 17 cases, and saphenous venous graft was used in 2 cases. 8. Postoperative complications were developed in 17 cases, and morbidity rate was 36. 9. Eleven patient were died within 1 month after operation, so operative mortality rate was 13.3%. 10. Duration of patency was beteween 7 and 58 months[average 27.5 months] in occlusive diseases and their 5-year patency rate was 56.3%. Duration of patency of aneurysmal disease was 20 months in aveage and their 5-year patency rate was 51.3%. 11. Patients of eleven cases of occlusive disease and two cases of aneurysmal disease required reoperation for variable reason. 12. 35 cases of patient have used anticoagulants: coumadin, ticlid, and persanthin-ASA combination.

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Recurrent Malignant Thymoma Detected by Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA Scan (Tc-99m MIBI, Tc-99m Tetrofosmin, 그리고 Tc-99m (V) DMSA 스캔에 의해 발견된 재발성 악성 흉선종)

  • Seok, Ju-Won;Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.268-273
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    • 2001
  • Thymoma is the most common primary tumor of anterior mediastinum, accounting for 20% to 30% of all mediastinal tumors. The recurrence rate after total resection of the thymoma ranges 8% to 18%. We reported one patient of recurrent malignant thymoma imaged with Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA. Early and delayed Tc-99m MIBI and Tc-99m Tetrofosmin scintigraphies showed an increased uptake in the mediastinal area. Also, Tc-99m (V) DMSA scintigraphy revealed an increased uptake tn the corresponding area. Coronal SPECT images of Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA revealed increased uptake of each radiopharmaceutical in the tumor lesion corresponding to the mediastinal lesion on the chest CT. However, the normal blood pool activities of the heart and great vessels of Tc-99m (V) DMSA obscured the recurrent malignant thymoma. Although Tc-99m (V) DMSA is a useful tumor seeking agent, we recommend Tc-99m MIBI and Tc-99m Tetrofosmin SPECT rather than Tc-99m (V) DMSA to detect primary and recurrent malignant thymoma.

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A Case Report of Synovial Sarcoma of the Face (우측 협부에 발생한 윤활막육종 증례보고)

  • Heo, Jung;Lee, Keun Cheol;Park, Jung Min;Kim, Seok Kwun;Roh, Mee Sook;Lee, Jin Hwa
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.760-762
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    • 2005
  • Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.

A Case of Right Atrial Mass Associated with Hepatocellular Carcinoma (간세포암에 동반된 우심방 종괴 1례)

  • Park, Chan-Won;Choi, Jin-Soo;Kwon, Soon-Uk;Song, Young-Doo;Kim, Jun-Hwan;Lee, Heun-Joo
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.119-124
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    • 1999
  • Right atrial metastasis occurs in 1 to 4% of patients with hepatoma, and the extension to intracavitary or metastasis of a tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographies findings. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating a massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.

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Mediastinal Lipoblastoma - A case report - (종격동 내 지방모세포종 - 1예 보고 -)

  • Oh, Se-Jin;Kang, Chang-Hyun;Kim, Joo-Hyun;Kim, Young-Tae
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.240-243
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    • 2007
  • Mediastinal lipoblastoma is a rare benign tumor originating from embryonic lipid cells and it almost always occurs during infanthood or early childhood. It is a tumor with a good prognosis despite its potential for local invasion and rapid growth. We report here on a three years old girl who was treated for a benign lipoblastoma in the anterior mediastinum. CT scanning showed a fat containing mass without internal calcification or fluid component, and the mass showed a compressive effect on the adjacent structures. The mass was located between the pericardium and right mediastinal pleura and it was removed completely without complication. Pathologic examination revealed a benign lipoblastoma. The patient showed no evidence of recurrence at the time of the report.