• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.742-755
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• 1997

Background : Endobronchial tuberculosis(ET) is still relatively common disease in Korea. We intended to evaluate the length of endobronchial lesion, peribronchial thickness, luminal irregularity and associated mediastinal lymph node enlargement with Chest CT to get information for such aggressive treatment as electrocautery, laser therapy and so on of bronchial stricture in ET, and also to compare the change of Chest CT finding with that of bronchoscopic finding after one month of anti-tuberculosis treatment. Method : We performed CT in 26 patients who were diagnosed as ET by bronchoscopy at Boramae Hospital from November 1991 to March 1996. After classifying ET into seven subtypes according to bronchoscopic finding, we analyzed the CT finding of each subtype. And we followed up the bronchoscopy, CT, and PIT after one month of anti-tuberculosis treatment, and compared the change of CT findings with those of bronchoscopic findings in nine patients. Results : Age of the patients was from 17 to 73 years old, and the ratio of male to female was 1 : 25 with absolute female predominance. The site(s) of bronchial involvement by tuberculosis is one in 14 cases, two in nine cases and three in one case, respectively, and the left main bronchus was the most frequently involved site (13 cases for multiple involvements and 7 cases for single involvement among 26 cases). The length of bronchial involvement by tuberculosis which was measured by CT was from 10 to 55 mm, and there was a tendency that the length of involved lesion in fibrostenotic type was shorter than that of actively caseating type. Bronchial stricture on CT was noticed in 25 (96%) cases and the range of severity was from total occlusion to near-normal and also showed wide variation even though the subtype of ET was same. The increase of peribronchial thickness which was measured by CT, was noticed in 21 cases (91%) among 23 cases (in which the measurement was possible), and there was no improvement of peribronchial thickness in those cases which showed little improvement in bronchial stricture despite anti-tuberculosis treatment. There was no difference in the luminal irregularity of involved bronchi on CT in relation to bronchoscopic subtypes. The mediastinal lymph node enlargement, defined as the diameter of lymph node was larger than 1cm on CT, was detected in 20 cases (77%), and right side was more frequently involved (L : R = 1 : 5.2). The CT finding usually showed extrinsic bronchial compression but showed direct invasion in two cases which were bronchoscopically classified as tumorous type. When follow-up bronchoscopy and CT was performed after one month of anti-tuberculosis treatment in nine patients, CT showed significant improvement in peribronchial thickness and mediastinal lymph node enlargement. Bronchial stricture was also improved in 6 cases but aggravated in 3 cases despite anti-tuberculosis therapy. In two cases which were classified as fibrostenotic type by bronchoscopy, CT showed significant improvement in bronchial stricture, interestingly. Conclusion : We concluded that the role of Chest CT was complimentary to bronchoscopy in ET, since CT was useful in evaluating the length of bronchial involvement, peribronchial thickness, and mediastinal lymph node enlargement.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.369-375
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• 2007

Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

• Progress in Medical Physics
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• v.23 no.4
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• pp.269-278
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• 2012

Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.