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CT Findings and Accuracy of Preoperative Pathologic Diagnosis in Bronchial Carcinoid According to Subtype (기관지 유암종의 아형에 따른 CT 소견과 수술전 병리학적 진단의 정확성)

  • 임준석;홍용국;정경영;최규옥
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.380-387
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    • 1998
  • We evaluated CT findings of bronchial carcinoid and accuracy of preoperative pathological diagnosis according to two subtypes. The subjects were 10 cases(typical;5, atypical;5), confirmed by surgery and tissue pathology. Sputum cytology(n=10), percutaneous aspiration(n=1) and bronchoscopic biopsy (n=8) were performed, preoperatively. The CT findings were analysed according to two subtypes. Typical carcinoid shows central location in all, and bronchial lumens just proximal to tumor were widened in two, whereas atypical carcinoid presented as peripheral leison in two. Among central atypical carcinoid, two cases showed flat meniscus appearance of lumen. Remaining one showed diffuse wall thickening. Intratumoral low density by necrosis was noted in one. Both subtypes show contrast enhancement. For preoperative diagnosis, sputum cytology & percutaneous aspiration were not conclusive at all. As for bronchoscopic biopsy, only 3 cases were accurately diagnosed as typical carcinoid. Typical carcinoid presented as endobronchial mass in all, whereas atypical carcinoid presented in various appearance. In all atypical & some typical carcinoid were misdiagnosed as primary lung cancer, preoperatively. However, in typical carcinoid, conservative surgery was possible. In conclusion, if there is discrepancy between CT findings & preoperative pathological diagnosis, full understanding of CT findings of bronchial carcinoid is imperative to choose appropriate surgical modality.

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Blood Gas Analysis and Lung Histopathology in Waterston Operation (Waterston 수술이 Gas 값과 폐조직에 미치는 영향)

  • 김세화;이홍균
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.87-96
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    • 1972
  • Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.

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Effect of Scutellaria Baicalensis Georgi. Extract on Cisplatin-Induced Acute Renal Failure in Rabbits (토끼에서 cisplatin에 의해 유도된 급성 신부전시 황금(黃芩; Scutellaria Baicalensis Georgi.) 추출물의 효과)

  • Kim, Soo-Chang;Song, Yeong-Min;Lee, Sung-Dae;Song, Seung-Hee;Koh, Phil-Ok;Kim, Jong-Su;Kim, Chung-Hui;Kang, Chung-Boo
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.392-399
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    • 2007
  • Scutellaria baicalensis Georgi. (SBGE) is known to be antioxidant effect. In addition of the effects, we further investigated the SBGE on the antioxidant effect on a renal cortical slices cell and kidney protecting effects. The results were as follows. 1 When renal cortical slices separated from a rabbit's kidney were treated with 1mM tert-Butylhydroperoxide (t-BHP) in the presence of SBGE. SBGE significant prevented t-BHP induced increase in lactate dehydrogenase (LDH) release and lipid peroxidation. 2. When renal cortical slices separated from a rabbit's kidney were treated with oxidant $300{\mu}M$ cisplatin in the presence of SBGE. SBGE significant prevented cisplatin-induced increase in LDH release and lipid peroxidation. 3. Pretreatment with 0.1g/kg SBGE for seven day and treatment with 5 mg/kg cisplatin by the intraperitoneal injection The results were that the pretreatment group with SBGE showed a significant decrease in lipid peroxidation, increase in clearance rate of blood urea nitrogen (BUN) and creatinine in the kidney than the administering single agent group of cisplatin. and pretreatment group with SBGE showed intact microvillus of proximal tubule and no contraction of rumen, it was a similar result with normal group. With the results SBGE showed to be highly effective on antioxidant effect and cellular protection activity against cisplatin that was a toxic agent on a kidney. Therefore, SBGE is considered to have protective effective on a disordered kidney or kidney diseases such as nephritis or renal failure that cause tissue damages in a kidney.

The effect of Lower Extremity Selective Voluntary Motor Control for joint motion during Gait in Children with Spastic Diplegia (경직성 양하지 마비아의 하지의 선택적 운동 조절 능력이 보행 시 관절 움직임에 미치는 영향)

  • Seo, Hye-Jung;Seo, Mu-Jung;Shin, Hyun-Hee;Oh, Tae-Young
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.3
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    • pp.293-302
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    • 2012
  • Background & Purpose : The purpose of this study is to evaluate the impairment of SVMC(selective voluntary motor control) of the lower extremity by assessing each joints of lower limb and to analyze the motional relationship between each joints of lower limb using SCALE(Selective Control Assessment of the Lower Extremity) during the swing phase of gait cycle in children with spastic diplegia. Method : 11 children with spastic diplegia CP who could walk independently and 10 normal developing children were participated. SCALE(Selective Control Assessment of the Lower Extremity) assessments were conducted for 11 children with CP. Gait analysis were accomplished in all participants. Qualisys motion analysis was used as a statistical tool to assess the motional relationship between hip joint, knee joint and ankle joint in each limb. We used descriptive statistics, cross-tabulation, independent t-test, linear regression to analysis motional relationship between each joints of lower limb using by SPSS ver.17.0. Result : Firstly, there were significant differences in SCALE scores between the cerebal palsy group and the control group in knee joint(p<0.05), but no significant difference in hip and ankle joints during the swing phase of gait cycle. Secondly, the difference of SCALE scores showed no statistical motional difference in knee and ankle joints during the swing phase, and showed significant motional difference in hip joints during the swing phase(p<0.05). Thirdly, there was a liner relationship between the motion of hip and ankle joints during the swing phase. Conclusion : The nature of SVMC(selective voluntary motor control) in each joints of the lower limb may reflect the ability of gait, thus SCALE may be used for assessing and for treating the cerebal palsy patients who are able to walk independently. Also we knew that the impairment of SVMC(selective voluntary motor control) increases from the proximal to the distal joints.

Glutathione S-transferases (GSTM1, GSTT1 and GSTP1) and N-acetyltransferase 2 Polymorphisms and the Risk of Gastric Cancer (위암 환자에서 Glutathione S-transferases (GSTM1, GSTT1, GSTP1) 및 N-acetyltransferase 2 유전자 다형성 분포)

  • Hong, Su-Hyung;Kim, Jung-Wan;Kim, Ho-Gak;Park, In-Kyu;Ryoo, Jun-Wook;Lee, Chang-Hyeong;Sohn, Yoon-Kyung;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.2
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    • pp.135-140
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    • 2006
  • Objectives : Polymorphisms of genes from glutathione Stransferases (GSTs) and N-acetyltransferase 2 (NAT2) have been associated with increased susceptibility to various cancers. Previous results showed that East Asians such as Koreans, Japanese and Chinese have a much higher frequency of the GSTM1 and GSTT1 null genotypes and NAT2 rapid acetylator type. Therefore, we investigated the association between the polymorphic types of GSTs (GSTM1, GSTT1, GSTP1) and NAT2 and the incidence of gastric cancer which is one of the most prevalent cancers among the East Asians. Methods : It was performed in a case-control study consisting of 238 healthy subjects and 108 cancer patients (54 distal and 54 proximal carcinomas). We also evaluated the association between GSTs and NAT2 and the risk factors for gastric cancer such as alcohol consumption, smoking, H. pylori infection, family history of gastric cancer, and tumor location. Results : In our study, the percentage of cases whose hometown was rural was higher than those of controls (odds ratio (OR) =2.88; 95% CI=1.72-4.76), and the frequency of the lower socio-economic status increased significantly in patients (OR=2.53; 95% CI=1.59-4.02). There was no significant difference in the GST polymorphic types between the cases and controls. However, NAT2 rapid or intermediate acetylator types were frequently detected in the cases with family history of gastric cancer (OR=1.92; 95% CI=1.79-26.0). Conclusions : These results suggest that the hometown and socio-economic status are important environmental factors for gastric carcinogenesis, and NAT2 polymorphic types could be associated with familial gastric carcinoma.

A Case of Cystinuria with Multiple Renal Stones in an 8-month-old Girl (8개월 여아에서 다발성 결석으로 진단된 시스틴뇨증 1례)

  • Kang, Eun Gu;Lee, Joo Hoon;Lee, Beom Hee;Kim, Gu-Hwan;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.122-126
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    • 2013
  • Cystinuria is an autosomal recessive disease characterized by impaired transport of cystine and dibasic amino acids in the proximal renal tubule, resulting in the formation of cystine stones. It is believed to account for about 1% of all kidney stones and up to 10% of pediatric stones. Here we report a case of cystinuria with multiple renal stones confirmed by genetic mutational analysis. An 8-month-old girl was admitted to AMC with persistent fever and multiple renal stones. A renal sonogram showed multiple stones at the right renal pelvis, right distal ureter, and left renal medullary portion. An approximately 1 cm renal stone was extracted spontaneously, and stone analysis revealed it to be composed entirely of cystine. Cystinuria was confirmed by increased urine dibasic amino acid levels, including cysteine, and genetic mutational analysis showed the patient to be a homozygote for the pathogenic c. 1820del (p.L607fs) of SLC3A1. Despite treatment with oral hydration and urinary alkalinization, and restricted intake of animal protein, the stones increased in size and number. The patient has since been treated with tiopronin.

Renal Manifestations and Imaging Studies of Kawasaki Disease (가와사키 질환에서의 신증상과 영상 검사 소견)

  • Oh, Ji Young;Park, Se Jin;Kim, Sun Jung;Jang, Gwang-Cheon;Kim, Uria;Shin, Jae Il;Kim, Kee Hyuck
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.86-91
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    • 2013
  • Purpose: The aim of this study was to verify renal inflammation following Kawasaki disease (KD) using single photon emission computed tomography along with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT). Methods: From March 2011 to October 2011, 15 patients diagnosed with KD at the National Health Insurance System Ilsan Hospital were enrolled in the study. All patients underwent DMSA renal SPECT to evaluate renal involvement during the acute phase of KD. Urine ${\beta}2$-microglobulin (${\beta}2$-MG), a marker of renal proximal tubular dysfunction, was also measured to assess renal damage. Results: All 15 patients had normal renal function test results. However, microscopic hematuria and pyuria were observed in 13% and 33% of the patients, respectively. Moreover, urine ${\beta}2$-MG was elevated in 46% of the patients. In addition, patients were divided into two groups based on ${\beta}2$-MG level: those with an increased ${\beta}2$-MG level, and those with a normal ${\beta}2$-MG level. No significant differences were found between these two groups in clinical characteristics, laboratory, sonography, and echocardiography findings. All patients' DMSA renal SPECT scans were normal. Conclusion: Our study showed that mild abnormalities in the urinalysis and elevated urine ${\beta}2$-MG were the only findings of renal involvement in KD. However, no aggressive renal manifestations were detected on DMSA renal SPECT.

Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density (골다공증 진단을 위한 초음파 변수의 골밀도에 대한 의존성)

  • Hwang, Kyo Seung;Kim, Yoon Mi;Park, Jong Chan;Choi, Min Joo;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.502-508
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    • 2012
  • Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

Acute toxicity effets of formaline to flounder, Paralichthys olivaceus (넙치 (Paralichthys olivaceus)에 대한 포르말린의 급성독성 효과)

  • Park, In-Seok;Kim, Hyung-Bae;Kim, Min-Suk;Park, Chul-Won
    • Journal of fish pathology
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    • v.8 no.1
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    • pp.57-67
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    • 1995
  • Twenty-four hours, acute toxicity and the histopathological effect of formaline to flounder, Paralichthys olivaceus larvae were examined. The $LC_{50}$ values obtained to farmaline were 2,520 ppm in 1 hour treatment. 1.610 ppm in 2 hours treatment, 868 ppm in 4 hours treatment and 141 ppm in 24 hours treatment. Many pathological features such as hypertrophy of mucous and epithelial cells in secondary gill lamella, hyaline droplet degeneration of tubular epithelial cells in the proximal convoluted segment of renal tubules, focal or massive necrosis in liver cells and pycnotic nucleus in heart cells were recognized. The above results were discussed in relation to the application of formaline as therapeutic agent in flounder disease.

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Effect of Titanium Prosthesis on Computed Tomography Measurements of Bone Mineral Density

  • Han, S.M.;Zude Feng
    • Journal of Biomedical Engineering Research
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    • v.19 no.2
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    • pp.177-182
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    • 1998
  • This study investigated the effects of a titanium prosthesis, malalignment, field of view, and distal flare of titanium prosthesis on computed tomography( CT) measurements of home mineral density. Eight femora and eight tibiae from fresh male cadavers were used. Fifteen pieces of cancellous bone from the proximal tibiae were milled into rectangular parallelepipeds. Parallelepipeds and femors were scanned with and without titanium prosthesis when centered in the gantry of the CT scanner and malaligned, respectively. Image data were then reconstructed with field of view of 10 and 30 cm. Bone mineral density(BMD) values were obtained from CT images using C-MED software. The effects of titanium prosthesis, malalignmetn, and field of view were investigated. When bone was centered in the gantry of the CT scanner, the mean relative difference of BMD measurements caused by a titanium prosthesis was less than 1% for both cortical and cancellous bone. Field of view had negligible effect on BMD measurements as well. Malalignment and distal flare of prosthesis, however, caused a significant difference in BMD measurements(p<0.0001). The titanium prosthesis did not interfere with malalignment combining the existence of a titnium prosthesis on BMD measurements was significant.

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