• Title/Summary/Keyword: Thoracic wall

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SVC Syndrome Caused by Leiomyosarcoma of SVC - A Case Report - (상대정맥에 발생한 평활근육종의 수술 - 1례 보고 -)

  • 손영상;류세민;손호성;조원민;황재준;최영호;김학제;심재정;조성준
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.235-238
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    • 2002
  • Among the causes of SVC syndrome, intraluminal tumor, especially the leiomyosarcoma is very rare. We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission. On physical examination, facial edema and venous engorgement on upper extermities and upper chast wall were showed. The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC Surgery was performed through median sternotomy. For complete resection of the tumor and thrombus, we used partial and total CPB. The follow up SVC cavogram revealed no abnormality 14 months after the operation.

Automated Detection and Volume Calculation of Nodular Lung Cancer on CT Scans (CT 영상에서 결절성 폐암의 자동추출 및 체적계산)

  • Kim, Do-Yeon;Kim, Jin-Hwan;Noh, Seung-Moo;Park, Jong-Won
    • Journal of KIISE:Computing Practices and Letters
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    • v.7 no.5
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    • pp.451-457
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    • 2001
  • This paper describes automated methods for the detection of lung nodules and their volume calculation on CT scans. Gray-level threshold methods were used to segment the thorax from the background and then the lung parenchymes from the thoracic wall and mediastinum. A scanning-ball algorithm was applied to more accurately delineate the lung boundaries, thereby incorporating peripheral nodules contiguous to pleural surface within the segmented lung parenchymes. The lesions which have the high gray value were extracted from the segmented lung parenchymes. The selected lesions include nodules, blood vessels and partial volume effects. The discriminating features such as size, solid-shape, average, standard deviation and correlation coefficient of selected lesions were used to distinguish true nodules from pseudo-lesions. Volume and circularity calculation were performed for each identified nodules. The identified nodules were sorted in descending order of the volume. These method were applied to 621 image slices of 19 cases. The sensitivity was 95% and there was no false-positive result.

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A Rare Case of Primary Squamous Cell Carcinoma of the Stomach and a Review of the 56 Cases Reported in Japan

  • Wakabayashi, Hideyuki;Matsutani, Takeshi;Fujita, Itsurou;Kanazawa, Yoshikazu;Nomura, Tsutomu;Hagiwara, Nobutoshi;Hosone, Masaru;Katayama, Hironori;Uchida, Eiji
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.58-62
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    • 2014
  • We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy, and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristics of 56 cases of gastric squamous cell carcinoma reported in Japan.

Effect of the Abdominal Drawing-in Maneuver on the Scapular Stabilizer Muscle Activities and Scapular Winging During Push-up Plus Exercise in Subjects With Scapular Winging

  • Kim, Da-eun;Shin, A-reum;Lee, Ji-hyun;Cynn, Heon-seock
    • Physical Therapy Korea
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    • v.24 no.1
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    • pp.61-70
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    • 2017
  • Background: Scapular winging is a prominence of the entire scapular medial border, mainly caused by insufficient activity of the serratus anterior (SA) and imbalance of scapulothoracic muscles. Push-up plus (PUP) exercise has been commonly used to increase SA muscle activity. The facilitation of abdominal muscle may affect scapular muscle activity by myofascial connections. Thus, the sequential activation of the turnk muscles is suggested to facilitate the transition of proper force from upper limb and restore force couple of scapular muscles. The abdominal drawing-in maneuver (ADIM) has been effective in improving activation of the deep trunk muscles during movement. Objects: The aim of this study was to determine the effect of ADIM on the activity of the upper trapezius (UT), lower trapezius (LT), and SA during PUP exercises in subjects with scapular winging. Methods: Fourteen men with scapular winging (determined as a of distance between the scapular medial border and thoracic wall over 3 cm) volunteered for our study. The subjects performed the PUP exercise with and without ADIM. Surface electromyography was used to collect the electromyography data of the UT, LT, and SA. A scapulometer was used to measure the amount of scapular winging. Results: SA activity was significantly greater and scapular winging significantly lower during the PUP exercise with ADIM than during those without ADIM. Conclusion: PUP exercise with ADIM can be used as an beneficial method to improve SA activation and to reduce the amount of scapular winging in subjects with scapular winging.

Esophageal Foreign Bodies with Periesophageal Abscess (식도주위농양을 병발한 식도이물 2례)

  • 김춘환;김주용;김영홍;강주원;김병우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.9.3-9
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    • 1979
  • Foreign bodies in air and food passages are not uncommon problems in the otolaryngological fields and its etiological factors are closely related to the social environment and mode of life. It may complicate of esophageal perforation, periesphagitis, periesophageal abscess, mediastinitis, pneumothorax, pyothorax and lung abscess which may lead to the problems of life and death. The majority of esophageal foreign bodies which lodge in the esophagus can be removed endoscopically, but the following types of foreign bodies may require removal by the external route: 1. an impacted foreign body, 2. a foreign body producing periesophagitis after unsuccessful attempts at removal through the esophagoscope, and 3. a periesophageal abscess with a foreign body lodging in the abscess itself. Many interesting cases and statistical analysis of esophageal foreign bodies were reported by many authors, but only a few complicated cases were reported. Recently, we experienced 2 cases of esophageal foreign bodies which penetrate the cervical and thoracic esophageal wall and formed periesophageal abscess in 12 and 40 years-old males who swallowed of wire accidentally. The foreign bodies are successfully removed by the external routes through the lateral neck and chest. The postoperative courses were uneventful.

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Stomach Cancer Surgery after Coronary Artery Bypass Surgery with in situ Right Gastroepiploic Artery Graft (정위 우위대망동맥을 이용하여 관상동맥우회술을 시행한 환자에서의 위암수술)

  • 황호영;김기봉
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.444-447
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    • 2004
  • A 59 year-old male diagnosed as unstable angina underwent off-pump coronary artery bypass surgery using in situ left internal mammary and right gastroepiploic artery grafts. During harvesting the right gastroepiploic artery, there was no abnormal finding in intraabdominal organs including stomach and liver. He was discharged at the 3rd postoperative day without complication. In case of using in situ right gastroepiploic artery, we recommend gastrofberscopic study at regular follow-up, The patient underwent the gastrofiberscopic study at postoperative 3rd month and diagnosed as advanced gastric cancer on the posterior wall of gastric fundus. At 5th postoperative month, total gastrectomy without intraoperative injury of the right gastroepiploic artery was performed at the department of general surgery. He was discharged at the 9th postoperative day. Follow-up coronary angiography performed at the 1st postoperative year demonstrated patent grafts including right gastroepiploic artery.

Transforming Growth Factor β Receptor Type I Inhibitor, Galunisertib, Has No Beneficial Effects on Aneurysmal Pathological Changes in Marfan Mice

  • Park, Jeong-Ho;Kim, Min-Seob;Ham, Seokran;Park, Eon Sub;Kim, Koung Li;Suh, Wonhee
    • Biomolecules & Therapeutics
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    • v.28 no.1
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    • pp.98-103
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    • 2020
  • Marfan syndrome (MFS), a connective tissue disorder caused by mutations in the fibrillin-1 (Fbn1) gene, has vascular manifestations including aortic aneurysm, dissection, and rupture. Its vascular pathogenesis is assumed to be attributed to increased transforming growth factor β (TGFβ) signaling and blockade of excessive TGFβ signaling has been thought to prevent dissection and aneurysm formation. Here, we investigated whether galunisertib, a potent small-molecule inhibitor of TGFβ receptor I (TβRI), attenuates aneurysmal disease in a murine model of MFS (Fbn1C1039G/+) and compared the impact of galuninsertib on the MFS-related vascular pathogenesis with that of losartan, a prophylactic agent routinely used for patients with MFS. Fbn1C1039G/+ mice were administered galunisertib or losartan for 8 weeks, and their ascending aortas were assessed for histopathological changes and phosphorylation of Smad2 and extracellular signal-regulated kinase 1/2 (Erk1/2). Mice treated with galunisertib or losartan barely exhibited phosphorylated Smad2, suggesting that both drugs effectively blocked overactivated canonical TGFβ signaling in Fbn1C1039G/+ mice. However, galunisertib treatment did not attenuate disrupted medial wall architecture and only partially decreased Erk1/2 phosphorylation, whereas losartan significantly inhibited MFS-associated aortopathy and markedly decreased Erk1/2 phosphorylation in Fbn1C1039G/+ mice. These data unexpectedly revealed that galunisertib, a TβRI inhibitor, showed no benefits in aneurysmal disease in MFS mice although it completely blocked Smad2 phosphorylation. The significant losartan-induced inhibition of both aortic vascular pathogenesis and Smad2 phosphorylation implied that canonical TGFβ signaling might not prominently drive aneurysmal diseases in MFS mice.

Immunoglobulin G4-Related Disease in the Thorax: Imaging Findings and Differential Diagnosis (흉부에서 발생한 IgG4 연관 질환: 영상 소견 및 감별진단)

  • Yookyung Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.826-837
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    • 2021
  • Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

The Usefulness of 4D Echocardiographic Modality for Assessing RV Affection in Uncontrolled Hypertensive Patients

  • Rehab M. Hamdy;Shaimaa A Habib;Layla A Mohamed;Ola H. Abd Elaziz
    • Journal of Cardiovascular Imaging
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    • v.30 no.4
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    • pp.279-289
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    • 2022
  • BACKGROUND: In many cardiovascular disorders, the contractile performance of the right ventricle (RV) is the primary determinant of prognosis. For evaluating RV volumes and function, 4 dimensional (4D)-echocardiography has become common. This research used 2D and 4D modalities to assess RV contractile performance in hypertensive patients. METHODS: A total of 150 patients with essential hypertension were enrolled in this study, along with 75 age and sex-matched volunteers. Clinical evaluation and echocardiographic examination (including M-mode, tissue Doppler imaging, and 2D speckle tracking) were conducted on all participants. RV volumes, 4D-ejection fraction (EF), 4D-fractional area change (FAC), 4D-tricuspid annular plane systolic excursion (TAPSE), 4D-septal and free wall (FW) strain were all measured using 4D-echocardiography. RESULTS: Hypertensive patients showed 2D-RV systolic and diastolic dysfunction (including TAPSE, 2D-right ventricular global longitudinal strain, RV-myocardial performance index and average E/EaRV) and 4D-RV impairment (including right ventricular EF, FAC, RV strain and TAPSE, right ventricular end-diastolic volume and right ventricular end-systolic volume) compared to the control group. We verified the prevalence of RV systolic dysfunction in hypertension patients using the following parameters: 1) 15% of them had 2D-TAPSE < 17 mm vs. 40% by 4D-TAPSE; 2) 25% of them had 2D-GLS < 19% vs. 42% by 4D-septal strain and 35% by 4D FW strain; 3) 35% of hypertensive patients had 4D-EF < 45%; and finally; 4) 25% of hypertensive patients had 2D-FAC < 35% compared to 45% by 4D-FAC. CONCLUSIONS: The incidence of RV involvement was greater in 4D than in 2D-modality trans-thoracic echocardiography. We speculated that 4D-echocardiography with 4D-strain imaging would be more beneficial for examining RV morphology and function in hypertensive patients than 2D-echocardiography, since 4D-echocardiography could estimate RV volumes and function without making geometric assumptions.

Imaging Findings of Pneumothorax Caused by Bronchial Cartilage Hypoplasia in a Dog (개에서 기관지 연골 저형성에 의해 발생한 기흉의 영상학적 진단 증례)

  • Kim, Su-yeon;Kim, Seong-soo;Lee, Jeo-soon;Yun, Soo-kyung;Oh, Hyun-jung;Shon, Jung-min;Kim, Bo-eun;Kim, Wan-hee;Yoon, Jung-hee;Choi, Min-cheol
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.469-472
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    • 2015
  • A 10-year-old, castrated poodle dog presented with a cough for 2 weeks, and the cough initially developed since very young age. On radiographs, pneumothorax was noticed by characteristics of radiolucent area without pulmonary markings along the thoracic wall and diaphragm, retracted lung lobes from the thoracic wall and severely decreased volume of the left cranial lung lobe with disconnected bronchus. Computed tomography (CT) findings identified several pulmonary air-filled cysts and collapsed lung with abnormal shape and non-tapered end of bronchus, bronchioles at the accessory lobe and left cranial lobe. Also, pneumothorax, pneumomediastinum and subcutaneous emphysema were found. Imaging diagnosis was the spontaneous pneumothorax caused by ruptured emphysematous bullae associated with congenital bronchial cartilage abnormality or bronchial tree malformation. On surgery, hypoplasia of the left cranial lobe, right middle lobe, and accessory lobe with a bulla where air was leaking was identified. The accessory lobe was partially resected and bronchial cartilage hypoplasia was confirmed by histopathologic examination.