• Title/Summary/Keyword: Thorax CT

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Correlation between High-Resolution CT and Pulmonary Function Tests in Patients with Emphysema (폐기종환자에서 고해상도 CT와 폐기능검사와의 상관관계)

  • Ahn, Joong-Hyun;Park, Jeong-Mee;Ko, Seung-Hyeon;Yoon, Jong-Goo;Kwon, Soon-Seug;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.367-376
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    • 1996
  • Background : The diagnosis of emphysema during life is based on a combination of clinical, functional, and radiographic findings, but this combination is relatively insensitive and nonspecific. The development of rapid, high-resolution third and fourth generation CT scanners has enabled us to resolve pulmonary parenchymal abnormalities with great precision. We compared the chest HRCT findings to the pulmonary function test and arterial blood gas analysis in pulmonary emphysema patients to test the ability of HRCT to quantify the degree of pulmonary emphysema. Methods : From october 1994 to october 1995, the study group consisted of 20 subjects in whom HRCT of the thorax and pulmonary function studies had been obtained at St. Mary's hospital. The analysis was from scans at preselected anatomic levels and incorporated both lungs. On each HRCT slice the lung parenchyma was assessed for two aspects of emphysema: severity and extent. The five levels were graded and scored separately for the left and right lung giving a total of 10 lung fields. A combination of severity and extent gave the degree of emphysema. We compared the HRCT quantitation of emphysema, pulmonary function tests, ABGA, CBC, and patients characteristics(age, sex, height, weight, smoking amounts etc.) in 20 patients. Results : 1) There was a significant inverse correlation between HRCT scores for emphysema and percentage predicted values of DLco(r = -0.68, p < 0.05), DLco/VA(r = -0.49, p < 0.05), FEV1(r = -0.53, p < 0.05), and FVC(r = -0.47, p < 0.05). 2) There was a significant correlation between the HRCT scores and percentage predicted values of TLC(r = 0.50, p < 0.05), RV(r = 0.64, p < 0.05). 3) There was a significant inverse correlation between the HRCT scores and PaO2(r = -0.48, p < 0.05) and significant correlation with D(A-a)O2(r = -0.48, p < 0.05) but no significant correlation between the HRCT scores and PaCO2. 4) There was no significant correlation between the HRCT scores and age, sex, height, weight, smoking amounts in patients, hemoglobin, hematocrit, and wbc counts. Conclusion : High-Resolution CT provides a useful method for early detection and quantitating emphysema in life and correlates significantly with pulmonary function tests and arterial blood gas analysis.

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Two Cases of Cerebral Cysticercosis Treated with Albendazole (Albendazole을 이용한 뇌낭미충증(腦囊尾蟲症) 치험(治驗) 2예)

  • Joo, Kyoung-Hwan;Rim, Han-Jong
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.165-171
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    • 1991
  • Two patients with confirmed cerebral cysticercosis were treated with Albendazole(Zentel$^{(R)}$) at a daily dose of 1.200mg t.i.d. for 14 consecutive days and evaluated for tolerance and therapeutic effects. First case was 29 year old male, who had experience of 4 times of grand mal seizures during 1 year period before administration in Korea University Hospital. His chief complaints were seizure and moderate degree headache. He also had 4 subcutaneous nodules on the thorax, right and left upper arms. Among them one nodule was biopsied and confirmed microscopically as Cysticercus cellulosae hominis. Computed tomography of the brain showed four round low density lesions in right postero-frontal area, sylvian area, intra-occipital area and left parietal area. Second case was 48 year old male, who also had experience of seizures at 3 years, 5 months and 3 months before administration. In this case, no subcutaneous nodules and no headaches were noted. Brain CT showed four round low density lesions in right postero-parietal area and temporo-parietal area, and left temporo-parietal and parietal area. Serum antibody against cystic fluid antigen was detected by ELISA in both cases. The efficacy of the treatment of cerebral cysticercosis was assessed by the frequency of convulsions after treatment for 22 months follow-up. by the disappearance of the densities in cystic lesions at brain CT for 6 months follow-up, and disappearance of subcutaneous nodules, headache and so on. As the results, all low density lesions in both cases were disappeared in films of brain CT, and 4 nodules in first case were also disappeared. No more seizure and complain of headache occurred during the last 22 months after treatment in both cases. Post-treatment complete blood count and liver function test revealed no remarkable change compared to pre-treatment test. In the nations of Latin America, the physicians do not initially recommended the simultaneous administrations of steroids, reserving them only for patients whom the adverse reactions such as severe headache and/or seizures are occurred. According to them, in most patients these symptoms are controlled with aspirin and symptomatic drugs. But our experience using praziquantel is different, and most cerebral cysticercosis patients who takes PZQ had complaint of severe headache and sometimes seizure. So we simultaneously used dexamethasone as 6mg q.i.d. for 14 consecutive days and 6 days tapering thereafter in both cases for prevention of reactions produced by the host in response to the deaths of the parasites. As the conclusion, albendazole is effective in patients who presented cerebral cysticercosis and albendazole may help in the control of cysticercosis.

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Influences of Anesthetics in term of Computed Tomography Bronchial Lumen to Pulmonary Artery Diameter Ratio in Beagle Dogs (비글견의 컴퓨터단층영상에서 기관내강과 폐동맥 직경비율의 마취제에 따른 영향평가)

  • Lim, Jong-su;Hwang, Tae-sung;Yoon, Young-min;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.6-9
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    • 2016
  • Bronchoarterial (BA) ratio is a commonly used criterion to define airway dilatation despite the lack of normative human and animals. The objective of our study was to compare the range of normal bronchial to accompanying arterial diameter ratio with previous reports on CT scan of the thorax in dogs and assess influence anesthetics on BA ratio in dogs. Dogs undergoing multidetector CT scan of the chest for nonpulmonary conditions at a single center were prospectively identified. High-resolution reconstruction was performed on those included and both airway lumen and vessel diameters were measured in the lobar bronchi of the left cranial (cranial and caudal parts), right cranial, right middle, left caudal, and right caudal lung lobes. Eight dog were included; Mean of the mean BA ratios was $1.43{\pm}0.24$ (95% CI = 1.36 - 1.50) in inhalation anesthetic group. In propofol group, the mean of the mean BA ratios was $1.13{\pm}0.29$ (95% CI = 1.04 - 1.22). In medetomidine group, the mean of the mean BA ratios was $0.89{\pm}0.19$ (95% CI = 0.83 - 0.95). Comparing individual lobes within anesthetic category, there was no signicant difference in mean BA ratio between lung lobes or between dog according to inhalation, propofol, and medetomidine group (P = 0.630, P = 0.878, and P = 0.508, respectively). The BA ratio in these clinically normal dogs was consistent and may be a useful tool in evaluating for bronchiectasis on CT images. However, some different criteria for bronchiectasis were applied by the anesthetic methods.

Thymus Size and Its Relationship to Perinatal Diseases; Respiratory Distress Syndrome and Intrauterine Growth Retardation (흉선의 크기와 주산기 질환들과의 관계)

  • Chung, Sun Mi;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.855-861
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    • 2002
  • Purpose : Thymus size can be affected by several factors and perinatal diseases can be estimated by its size. The purpose of this study was to search for a relationship between cardiothymic/thoracic(CT/T) ratio and perinatal diseases such as neonatal respiratory distress syndrome(RDS) and intrauterine growth retardation(IUGR) by measuring the width of the cardiothymic shadow at the level of the carina and dividing it by the width of the thorax at the costophrenic angles. Methods : A clinical study was conducted on newborn infants with RDS(n=51), IUGR(n=27), and premature rupture of membranes(PROM, n=48), who were admitted at NICU of Catholic University of Daegu from June 2000 to Oct. 2001. CT/T ratio was measured within six hrs of age, at 2-3 days of age, and at 5-7 days of age. Results : CT/T ratios of RDS group, IUGR group, and PROM group were $0.46{\pm}0.07$, $0.32{\pm}0.04$. $0.36{\pm}0.06$, respectively. CT/T ratios of RDS group within 6hrs of age, at 2-3 days of age, and at 5-7 days of age were $0.43{\pm}0.07$, $0.34{\pm}0.06$, $0.25{\pm}0.04$, respectively. There were statistically significances among the RDS group, the IUGR group, and the PROM group and in the RDS group at different times. Regression for gestational age among three groups was not statistically significant but correlation for gestational age in the entire groups was statistically significant. CT/T ratio between normal spontaneous vaginal delivery and c-section among three groups was not statistically significant. CT/T ratios with dexamethasone-treated group and untreated group was not statistically significant. Conclusion : We concluded that thymus size differed significantly in the perinatal diseases such as RDS and IUGR, and so can be used as an early diagnostic tool for perinatal diseases.

Diagnostic Imaging of Nasal Lymphoma in a Cat (고양이에서 비강 림프종의 영상 진단 증례)

  • Jung, Joo-Hyun;Seo, Kyoung-Won;Chang, Jin-Hwa;Bae, Il-Hong;Kim, Dae-Yong;Yoon, Hwa-Young;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.361-365
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    • 2006
  • A spayed female, 5-year-old, weighing 2.7 kg, domestic short hair cat was referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs of this patient were weight loss, sneezing, respiratory distress, nasal discharge, epistaxis, ocular discharge, left exophthalmos, and left facial edema and deformity. The laboratory tests represented mild leukocytosis. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail was found. Destructive and lytic changes of the left nasal bone with soft tissue swelling were identified. On the thorax radiographs, there were a tracheobronchial lymph node swelling and a soft tissue round mass in the left caudal lung field. On computed tomographic scan images, asymmetrical destruction of turbinate and nasal septum and increased soft tissue opacity in the nasal cavity were identified. Destruction of the lateral maxillary bone, invasion to the left retrobulbar region, and craniodorsal deviation of the left eye were seen. Also, there was lysis of hard palate and cribriform plate. Invasion to the brain was found. The patient was diagnosed as nasal lymphoma by cytology and histopathology.

One Case of Alveolar Rhabdomyosareoma arising from Intercostal Muscle (늑간근에 발생한 폐포성 횡문 근육종 1례 보고)

  • 김선한
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.598-604
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    • 1992
  • Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and acounts for 6% to 15% of all cases of childhood cancer, Rhabdomyosarcoma in seventh most common form of childhood neoplasms, following acute leukemia, tumors of the central nervous system, lymphoma neuroblastoma, Wilm`s tumor, bone tumor. Rhabdomyosarcoma can arise anywhere in the body, but primary site in the thorax is relatively rare. We experienced a case of aveolar rhabdomyosarcoma arising from intercostal muscle, A 12 year-old woman was suffered from the intermittent left chest pain radiating to the scapular area and dyspnea, On physical examination, pulmonary friction rub was heard on the left upper lobe area. Qn adimission, the chest simple radiography revealed a 7 x 6, 5cm sized radio-opaque mass with pleural effusion in the superior mediastinum and the CT showed a well difined radio-opaque mass including the destructed 2nd rib and pleural effusion. The percutaneous tra-nsthoracic needle aspiration biopsy was likely to show blastoma. After the chemotherapy[vincristine, actinomycin-D, cyclophosphamde] was done to treat blastoma, the pleural effussion was subsided and the mass was slightly decreased by 4.5x 4. 5cm. For treatment and diagnosis, we performed en-bloc resection and the defected chest was reconstucted with Gortex patch. Grossly, the specimen was colored graysh-white and arised in between two ribs The microscopic findings showed that the tumor cells were small round with scant pinkish cytoplasm on the H-E stain and the tumor cell nests were grouped by reticulum fibers and showed alveolar pattern on the silver stain The electromicroscopic finding presented that the cytoplasm contained tangled fibrillar and flocculent materials. The histopathologic findings were compatable with laveolar rhabdomyosarcoma. She was discharged without any complication. After discharge, she has been treated with radiation theraphy and chemotheraphy, and not recurred untill last follow-up We report a case of alveolar rhabdomyosarcoma arising to intercostal muscle, developed in 12 year-old waman, with brief review of literatures.

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Extrapleural Pneumonectomy for Diffuse Malignant Mesothelioma -A Case Report- (미만형 악성 중퍼세포종의 늑막폐절제술 -1례 보고-)

  • Kim, Byeong-Gu;Bae, Sang-Il;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.664-668
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    • 1996
  • Malignant mesothelioma has been considered a uniformly fatal disease associated with a median survival of 4 to 18 months. However, a multimodality approach toward therapy may Increase the length of palliation when a maximal resection of tumor is achieved. Recently we have experienced a 49 years-old male patient who had d ffuse malignant mesothelioma. The patient has complained of blood-tinged sputum and right chest pain for several months. Chest x-rays and CT scans showed compact haziness in the right entire thorax with massive bloody elusion, diffuse pleural thickening and collapsed underlying lung. We performed extrapleural pneumonectomy, and postoperative chemotherapy with cisplatin and mltomycin (Memorial Sloan-fettering Cancer Center method) was done. We are observing him for months now and there is no evidence of local recurrence.

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Multiple Congenital Vascular Anomalies In a Lakeland Terrier: Computed Tomographic Angiographic Evaluation

  • JANG, Moonjung;CHEON, Sangkyung;KIM, Wanhee;CHOI, Mincheol;YOON, Junghee
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.114-118
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    • 2018
  • A 3-month-old intact male Lakeland terrier was presented with recurring regurgitation after removing cervical esophageal foreign body by endoscopy. Blood and urine analysis, radiography, ultrasonography, fluoroscopic esophagography, computed tomographic angiography (CTA) were performed. In radiography and fluoroscopic esophagography, vascular ring anomaly was considered as the primary cause of megaesophagus, and CTA with gas-inflation of the esophagus was performed. Compressed esophagus, persistent right aortic arch (PRAA), aberrant left subclavian artery (LSA), and a venous structure which was confirmed in surgery to be incomplete type persistent left cranial vena cava (PLCVC) connected with the left side azygos vein were observed. Left deviation of the trachea was also revealed in CT, which implies the compression by left ligamentum arteriosum. Therefore, type 3 PRAA with left ligamentum arteriosum and aberrant LSA, was considered as a prior differential diagnosis. Surgical repair was performed and the clinical signs improved. This report describes CTA characteristics of combination of PRAA with aberrant LSA, incomplete PLCVC and Lt. azygos vein in a dog. Although not every vascular anomaly does induce clinical sign, some types can complicate the surgical procedure, and cause clinical signs. Therefore, thorough evaluation of vascular anomalies in the thorax is important, and CTA is a useful method in identifying multiple vascular anomalies in dogs.

Suggestion of the morphological characteristic parameters according to the Lee's physical constitution theory using X-ray computed tomography (X선 CT화상을 이용한 사상체질의 형태학적 특징 파라메타의 제안)

  • Jo, Bong-Kwan;Bae, Jong-Il;Ko, Byung-Hee;Saito, Masao
    • Proceedings of the KOSOMBE Conference
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    • v.1993 no.11
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    • pp.13-16
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    • 1993
  • In this paper the morphological characteristic parameters according to the Lee's physical constitution theory are suggested using the X-ray computed tomography. The Lee's physical constitution theory is classify into 4 physical constitutional types by the relative degree of visceral function: those are macro-negative(strong liver- weak lung), micro-negative(strong kidney- weak spleen), micro-positive(strong spleen- weak kidney) and macro-positive(string lung- weak liver). The morphological characteristic parameters are the following. The AA-line is the distance between Rt. & Lt. acupuncture point keug-cheun. The BB-line is the length of lung. The CC-line is the longest width of thorax. The DD-line is the vertical distance between the CC-line and the EE-line. The EE-line is the distance between the Rt. and Lt. anterior superior iliac spines. As the results macro-negative(strong liver-weak lung) has the longest CC-line and the short BB-line. Micro-negative(strong kidney-weak spleen) has the longest EE-line and the short CC-line. Micro-positive(strong spleen-weak kidney) has the longest DD-line and the short BB-line. And macro-positive(strong lung-weak kidney) has the longest BB-line and the short EE-line.

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Head and neck extra nodal NHL (HNENL) - Treatment Outcome and Pattern of failure - A Single Institution Experience

  • Giridhar, Prashanth;Mallick, Supriya;Bhasker, Suman;Pathy, Sushmita;Mohanti, Bidhu Kalyan;Biswas, Ahitagni;Sharma, Atul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6267-6272
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    • 2015
  • Background: Extra nodal lymphoma (ENL) constitutes about 33 % of all non-Hodgkin's lymphoma. 18-28% develops in the head and neck region. A multimodality treatment with multi-agent chemotherapy (CT) and radiotherapy (RT) is considered optimum. Materials and Methods: We retrieved the treatment charts of patients of HNENL treated in our institute from 2001-2012. The charts were reviewed and the demographic, treatment details and outcome of HNENL patients were retrieved using predesigned pro-forma. Results: We retrieved data of 75consecutive patients HNENL. Median age was 47years (Range: 8-76 years). Of the 75 patients 51 were male and 24 were female. 55patients were evaluable. The patient and tumor characteristics are summarized in Table 1. All patients were staged comprehensively with contrast enhanced computed tomography of head, neck, thorax, abdomen, pelvis and bone marrow aspiration and biopsy 66 patients received a combination multi-agent CT with CHOP being the commonest regimen. 42 patients received 4 or lesser number of cycles of chemotherapy whereas 24received more than 4 cycles chemotherapy. Post radiotherapy, 41 out of 42 patients had a complete response at 3 months. Only 21patients had a complete response after chemotherapy. All patients received radiation (mostly involved field radiation) as a part of the treatment. The median radiation dose was 45 Gray (Range: 36 Gray-50 Gray). The radiation was planned by 2D fluoro simulation based technique in 37cases and by 3 Dimensional conformal radiation therapy (3DCRT) in 36 cases. Two patients were planned by the intensity modulated radiation therapy (IMRT) technique. IMRT was planned for one thyroid and one nasal cavity primary. 5 patients experienced relapse after a median follow up of 19 months. The median survival was not reached. The estimated two and three year survival were 92.9% (95%CI- 68.6- 95.35) and 88% (95%CI- 60.82 - 92.66) respectively. Univariate analysis revealed higher stage and poorer baseline performance status to be significantly associated with worse progression free survival. 5 patients progressed (relapse or primary disease progression) after treatment. Of the 5 patients, two patients were primary orbital NHL, two patients had NHL nasal cavity and one was NHL thyroid. Conclusions: Combined modality treatment in HNENL confers excellent disease control with acceptable side effects.