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Surgical Treatment of Main Pulmonary Artery Aneurysm with Patent Ductus Arteriosus -A Case Report- (동맥관개존증에 동반된 주폐동맥류의 수술치험 - 수술치험 1례)

  • 김대식;이성주;권오우;김창회;채성수;오성철
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1270-1275
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    • 1996
  • Pulmonary artery aneurysms are extremely rare conditions usually associated with congenital cardiac defects that cause increased pulmonary blood flow and pulmonary hypertension. The prognosis of pulmonary artery aneurysms is fatal due to the potential for rupture of the aneurysm and the underlying severe pulmonary hypertension. A 40-year old woman was admitted to our hospital with headache following traffic accident. On admission a continuous murmur was heard over the 2nd to 3rd intercostal space along left sternal border and a calcified cystic mass at left hilar portion was incidentally discoverd on chest reontgenogram. Cardiac catherization was diagnostic of a left to right shunt at main pulmoanry artery level and pulmonary hypertension. Pulmonary angiogram demonstrated a large aneurysm of main pulmonary artery extending into proximal left pulmonary artery. The pulmonary artery aneurysm associated with patent ductus arteriosus was diagnosed definitively and the patient was underwent resection of pulmonary artery aneurysm, closure of PDA and Dacron prosthetic graft replacement under cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged without any problem.

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Seasonal survey on the respiratory diseases of slaughtered pigs in Jeonbuk, Korea (전북지역 도축돈 호흡기질병 조사)

  • Lim, Mi-Na;Kim, Chul-Min;Park, Young-Min;Song, Ju-Tae;Jin, Jae-Kwon;Cho, Hyun-Ung
    • Korean Journal of Veterinary Service
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    • v.39 no.4
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    • pp.231-237
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    • 2016
  • The present study was conducted to investigate the lesion of red internal organs in slaughtered pigs and provided assistant data for pig farms. During March to December 2015, a total of 1,160 lung samples out of 58 herds were collected randomly from pigs slaughtered in Jeonbuk province. In addition, 290 hilar lymph nodes from pig with pneumonic lung lesion (5 samples per herd) were screened for selected viral and bacterial pathogens. Gross lesions of lungs such as swine enzootic pneumonia (SEP), pleuritis, pleuropneumonia, pericarditis and liver white spots were examined. The overall prevalence of SEP was 64.3% (746/1,160). In the analysis of seasonal prevalence, there was an increase of occurrence during the spring months (287/400, 71.8%) and decrease during the fall months (93/200, 46.5%) among the whole herds. The mean number of SEP score per pig was $1.20{\pm}1.28$. The prevalence of pleuropneumonia, pleuritis, pericarditis, and milk spot was 25.5% (296/1,160), 44.1% (512/1,160), 3.8% (44/1,160) and 17.6% (204/1,160), respectively. The most frequent region with lung lesion was diaphragmatic lobes (left 17.1%, right 17.3%). In the detection of viral pathogens by PCR, porcine circovirus type2 (PCV2) was positive in 86.9% (252/290), while porcine reproductive and respiratory syndrome virus (PRRSV) was not detected, In the case of bacterial pathogens, 50 microorganisms were isolated by PCR and/or microbiological test. The most frequently isolated bacteria was Streptococcus suis (20, 34.4%), followed by Pasteurella multocida (17, 29.3%), Streptococcus spp. (11, 3.4%), Actinobacillus pleuropneumoniae (2, 8.9%).

A Case of Scar Sarcoidosis (피부반흔에서 발생한 유육종증 1례)

  • Kim, Sun Goo;Yi, Tae Min;Kim, Yu Jin;Lee, Se Il
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.71-74
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    • 2011
  • Purpose: Sarcoidosis is a systemic noncaseating granulomatous disease of an unknown origin, and can involve any organ including the skin. The infiltration of sarcoid granuloma in an old cutaneous scar is an uncommon cutaneous manifestation of sarcoidosis. This paper reports a 35-year old female who presented with cutanesous nodules in previous facial scars. Methods: A 35-year-old female presented with cutaneous nodules for 2 months in previous scars of the forehead and lower lip that she had acquired in the childhood. An excisional biopsy of the lower lip mass, serologic examinations and radiologic studies were performed. Results: The excisional biopsy revealed noncaseating granulomas consistent with sarcoidosis. Chest CT revealed both hilar and paratracheal lymphadenopathy with nodular densities in both lung fields. Routine laboratory tests, serologic tests, serum angiotensin converting enzyme level, sputum for acid-fast bacilli, ophthalmoscopic examination, TB-PCR and NTM-PCR showed normal findings. Therefore, the patient was diagnosed with sarcoidosis. The patient refused fiberoptic bronchoscopy and medication with oral steroid. Currently, the clinical manifestation and progress are being monitored closely, and treatment is expected to start with oral steroid according to the progress. Conclusion: For the proper management of cutaneous sarcoidosis, particularly scar sarcoidosis, plastic surgeons should be aware of the many clinical and histopathological features of sarcoidosis and recommend a systemic evaluation for early diagnosis and proper treatment.

Pathologic characteristics for the Rhodococcus equi infection in foals in Jeju (제주지역 망아지에서 Rhodococcus equi 감염증의 병리학적 특징)

  • Song, Kyung-Ok;Yang, Hyoung-Seok;Son, Won-Geun;Kim, Jae-Hoon
    • Korean Journal of Veterinary Research
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    • v.59 no.3
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    • pp.141-149
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    • 2019
  • From 1996 to 2014, 14 foals from nine farms in Jeju were diagnosed with a Rhodococcus equi infection. Clinically, most foals showed characteristic respiratory signs, including hyperthermia and dyspnea. The seasonal occurrence of R. equi infection in foals was higher in summer, such as June (eight foals; 57.1%) and July (four foals; 28.6%), than in the other seasons. The major cases of R. equi infections were observed among two-month-old (eight foals; 57.1%) and three-month-old (three foals; 21.4%) foals. Histopathologically, bronchopneumonia, abscess, and granulomatous pneumonia were the most prevalent lesions in the lungs of foals. Colonic ulcers and submucosal abscesses were found in a foal. Some foals showed granulomatous lymphadenitis and abscesses in the mesenteric and other lymph nodes. According to the polymerase chain reaction using 10 tissue samples of foals and nine R. equi isolates, the vapA gene was detected in 11/11 (100%) foals. Immunohistochemical staining using the anti-VapA monoclonal antibody was applied to detect the R. equi VapA antigen in the organs of foals. R. equi VapA antigens were demonstrated in most lungs and some mesenteric and hilar lymph nodes of 13 foals. Isolated virulent R. equi VapA bacteria showed high sensitivity to gentamicin, quinolones, rifampin, and vancomycin.

Sequential CT Findings in Two Cases of Immunoglobulin G4-Related Lung Disease: Focused on Disease Progression (Immunoglobulin G4 관련 폐 질환의 질병 경과에 따른 순차적 CT 소견: 증례 보고)

  • Lee, Dong-Kyu;Ham, Soo-Youn
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.276-281
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    • 2018
  • Immunoglobulin G4 (IgG4)-related lung disease has been actively studied over the past few years. Radiologic findings of IgG4-related lung disease vary among patients, but there are no long-term follow up studies regarding variations in imaging features over the course of disease progression. In two cases with relatively long-term follow up, diverse early and late computed tomography (CT) findings of IgG4-related lung disease are reviewed in this report. In contrast to nodular or diffuse ground-glass opacity, which was predominantly noted in CT scans at earlier stages of disease, honeycombing and traction bronchiectasis were regarded as late radiologic manifestations. Solid nodules might be visible in both early and late stages; however, development of new solid nodules and enlargement of preexisting nodules could occur during disease progression. Interlobular septal thickening and mediastinal/hilar lymphadenopathy were persistent, even in later stages of the disease. These findings might be useful in making an accurate and timely diagnosis of IgG4-related lung disease.

Genotypic diversity and prevalence of Porcine circoviruses for slaughter pigs in Korea (도축장 출하돈의 돼지써코바이러스 발생율과 유전형 분석)

  • Bo-Mi Moon;Keum-Sook Chu;Seung-Chai Kim;Hwan-Ju Kim;Da-Jeong Kim;Won-Il Kim
    • Korean Journal of Veterinary Service
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    • v.46 no.4
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    • pp.315-324
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    • 2023
  • This study was carried out to investigate the genotypic diversity of PCV2 and co-infection of PCV3 in the hilar lymph nodes of 700 randomly-selected slaughter pigs. Fourteen samples per each farm were obtained from 50 farms between February and August in 2022. Of the 50 farms, 44 farms that had been positive for PCV2 by RT-PCR were genotyped. As a result of PCV2 genotyping, positive rate of PCV2 DNA was 62.3% (436/700). Among the PCV2 DNA-positive samples, positive rate of a single PCV2 genotype was 79.1% (345/436), while multiple PCV2 genotypes were only detected in 20.9% (91/436). Of the 436 single infection cases, PCV2d genotype was most prevalent. Positive rates of PCV2 and PCV3 were 53.6% and 26.0% at the sample level, 5.1% and 8.0% at the farm level, respectively. And the co-positive rate of two viruses was 8.7% (61/700) at the sample level, 62.0% (31/50) at the farm level. These results demonstrate that PCV2 prevalence in slaughter pigs is very high and co-infection between different PCV2 genotypes and between PCV2 and PCV3 is relatively common. Therefore, genetic diversity and co-infection between other porcine circoviruses should be consistently monitored in the future.

Ultrasonographic Indeterminate Lymph Nodes in Preoperative Thyroid Cancer Patients: Malignancy Risk and Ultrasonographic Findings Predictive of Malignancy

  • Roh-Eul Yoo;Ji-hoon Kim;Jeong Mo Bae;Inpyeong Hwang;Koung Mi Kang;Tae Jin Yun;Seung Hong Choi;Chul-Ho Sohn;Jung Hyo Rhim;Sun-Won Park
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.598-604
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    • 2020
  • Objective: Proper management of lymph nodes (LNs) with ultrasonographic (US) indeterminate features in thyroid cancer patients remains elusive. We aimed to evaluate the malignancy risk and US findings predictive of malignancy for US indeterminate LNs in preoperative thyroid cancer patients through node-by-node correlation. Materials and Methods: A total of 348 LNs in 284 thyroid cancer patients, who underwent fine-needle aspiration or core-needle biopsy between December 2006 and June 2015, were included. We determined the malignancy risks for US probably benign, indeterminate, and suspicious categories. For US indeterminate LNs, which had neither echogenic hilum nor hilar vascularity in the absence of any suspicious finding, US findings were compared between benign and metastatic LNs using Mann-Whitney U test and Fisher's exact test. Results: US imaging diagnoses were probably benign in 20.7% (n = 72) cases, indeterminate in 23.6% (n = 82), and suspicious in 55.7% (n = 194). Malignancy risk of US indeterminate LNs (19.5% [16/82]) differed from those of the US probably benign (2.8% [2/72]) (p = 0.002) and US suspicious LNs (78.4% [152/194]) (p < 0.001). Among US indeterminate LNs, there were no significant differences in short, long, and long-to-short diameter (L/S) ratios between benign and metastatic LNs (3.9 vs. 3.8 mm, p = 0.619; 7.3 vs. 7.3 mm, p = 0.590; 1.9 vs. 1.9, p = 0.652). Conclusion: US indeterminate LNs were frequently encountered during preoperative evaluation and had intermediate malignancy risk. Given the lack of discriminative power of size criteria and L/S ratio, clinical factors such as surgical strategy and node size should be considered for proper triage of US indeterminate LNs in thyroid cancer.

Fibrosing Mediastinits Causing Obstruction of Left Lower Lobar Bronchus: A Pediatric Case Report (좌하엽 기관지 폐쇄를 유발한 섬유성 종격동염: 소아 증례 보고)

  • Young Woo Sim;Young Seon Kim;Seung Eun Lee;Min Hye Jang
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.744-749
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    • 2022
  • Fibrosing mediastinitis is a rare benign disorder characterized by the proliferation of dense fibrous tissue within the mediastinum. It typically manifests as localized or infiltrative soft-tissue masses in the middle mediastinum or hilar area, which cause compression and encasement of adjacent mediastinal structures, such as the vessels or airway. Here, we report a rare case of fibrosing mediastinitis in a 13-year-old girl that presented as a middle mediastinal mass lesion on CT scan with obliterating left lower lobar bronchus. The patient's symptoms and follow-up chest CT showed significant improvement following systemic corticosteroid treatment. As fibrosing mediastinitis can improve with systemic steroid therapy, radiologists must be aware of its radiologic findings when discriminating between infiltrating soft tissue lesions in the mediastinum.

Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?

  • Shyam Vedantam;Sunil Amin;Ben Maher;Saqib Ahmad;Shanil Kadir;Saad Khalid Niaz;Mark Wright;Nadeem Tehami
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.426-433
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    • 2022
  • Background/Aims: Cholangiogram interpretation is not used as a key performance indicator (KPI) of endoscopic retrograde cholangiopancreatography (ERCP) training, and national societies recommend different minimum numbers per annum to maintain competence. This study aimed to determine the relationship between correct ERCP cholangiogram interpretation and experience. Methods: One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were three groups of 50 participants each: "Trainees," "Consultants group 1" (performed >75 ERCPs per year), and "Consultants group 2" (performed >100 ERCPs per year). Results: Trainees was inferior to Consultants groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepatic duct on the initial or completion/occlusion cholangiogram. Consultants group 1 was inferior to Consultants group 2 in identifying Strasberg type A bile leaks (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.77-0.96), Strasberg type B (OR, 0.84; 95% CI, 0.74-0.95), and Bismuth type 2 hilar strictures (OR, 0.81; 95% CI, 0.69-0.95). Conclusions: This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP case volumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficult findings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.

Identification of concurrent infection with Jaagsiekte sheep retrovirus and maedi-visna virus in China

  • Xujie Duan;Xiaona Shi;Pei Zhang;Xiaoyue Du;Sixu Chen;Liang Zhang;Huiping Li;Yufei Zhang;Jinling Wang;Yulin Ding;Shuying Liu
    • Journal of Veterinary Science
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    • v.25 no.5
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    • pp.61.1-61.13
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    • 2024
  • Importance: Ovine pulmonary adenomatosis (OPA) and maedi-visna disease (MVD) are chronic and progressive infectious diseases in sheep caused by Jaagsiekte sheep retrovirus (JSRV) and maedi-visna virus (MVV), respectively. Objective: To investigate the pathological changes and conduct viral gene analysis of OPA and MVD co-occurrence in Inner Mongolia, China. Methods: Using gross pathology, histopathology, immunohistochemistry, ultrastructural pathology, PCR, and sequence analysis, we investigated the concurrent infection of JSRV and MVV in 319 Dorper rams slaughtered in a private slaughterhouse in Inner Mongolia, in 2022. Results: Of the 319 rams included, 3 showed concurrent JSRV and MVV infection. Gross lung pathology showed diffuse enlargement, consolidation, and greyish-white miliary nodules on the lung surface; the trachea was filled with a white foamy fluid; hilar and mediastinal lymph nodes were significantly enlarged. Histopathology results revealed typical OPA and MVD lesions in the lung tissue. Immunohistochemical results were positive for JSRV envelope protein (Env) in the tumor cells and MVV CA in alveolar macrophages. Transmission electron microscopy showed several virions and autophagosomes in the lung tissue, severely damaged mitochondria, and the induced mitophagy. Nucleotide sequences obtained for JSRV env and MVV gag showed the highest homology with the Inner Mongolian strains of JSRV env (JQ837489) and MVV gag (MW248464). Conclusions and Relevance: Our study confirmed that OPA and MVD co-occurrence and identified the pathological changes in Inner Mongolia, China, thereby providing references for the identification of concurrent JSRV and MVV infections.