• Title/Summary/Keyword: thoracic imaging

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Long Term Management of Congenital Ventricular Tachyarrhythmia in a Dog

  • Lee, Geonyoung;Kang, Jooyeon;Ko, Minho;Cho, Hyunkee;Choi, Sooyoung;Park, In-Chul;Chung, Jin-Young
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.353-355
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    • 2017
  • A four month old, intact female Jindo dog presented to the Veterinary Teaching Hospital of Kangwon National University with collapse. Physical examination revealed a heart rate of more than 200 beats per minute. Blood tests showed mild anemia and mild neutrophilia, while thoracic radiography and ultrasonography revealed no remarkable findings. Electrocardiography showed ventricular premature complexes (VPCs). The dog was diagnosed with congenital ventricular tachyarrhythmia. The condition was improved by lidocaine infusion. After 10 days, the dog was discharged from the hospital with a prescription of atenolol, pimobendan, diltiazem, furosemide, spironolactone, and L-carnitine. This dog is still alive after 31 months. However, progressive cardiac remodeling was confirmed on radiography and ultrasonography. Congenital ventricular tachyarrhythmia is rare in dogs, and the prognosis of reported cases is poor. This report describes the long-term successful management of a dog with congenital ventricular tachyarrhythmia.

Two cases of familial cerebral cavernous malformation caused by mutations in the CCM1 gene

  • Yang, Im-Yong;Yum, Mi-Sun;Kim, Eun-Hee;Choi, Hae-Won;Yoo, Han-Wook;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.59 no.6
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    • pp.280-284
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    • 2016
  • Cerebral cavernous malformation (CCM) is a vascular malformation characterized by abnormally enlarged capillary cavities without any intervening neural tissue. We report 2 cases of familial CCMs diagnosed with the CCM1 mutation by using a genetic assay. A 5-year-old boy presented with headache, vomiting, and seizure-like movements. Brain magnetic resonance imaging (MRI) revealed multiple CCM lesions in the cerebral hemispheres. Subsequent mutation analysis of his father and other family members revealed c.940_943 del (p.Val314 Asn315delinsThrfsX3) mutations of the CCM1 gene. A 10-month-old boy who presented with seizure-like movements was reported to have had no perinatal event. His aunt was diagnosed with cerebral angioma. Brain and spine MRI revealed multiple angiomas in the cerebral hemisphere and thoracic spinal cord. Mutation analysis of his father was normal, although that of the patient and his mother revealed c.535C>T (p.Arg179X) mutations of the CCM1 gene. Based on these studies, we suggest that when a child with a familial history of CCMs exhibits neurological symptoms, the physician should suspect familial CCMs and consider brain imaging or a genetic assay.

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.

Clinical Usefulness of Chest Wall Ultrasonography for Detecting Fractures of Costal Cartilage due to Minor Blunt Chest Trauma (경미한 둔상에 의하여 야기되는 늑연골 골절 진단에 있어서 흉벽 초음파 검사의 임상적 유용성)

  • Lee, Woo-Surng;Kim, Yo-Han;Chee, Hyun-Keun;Hwang, Jae-Joon;Lee, Song-Am;Jung, Ho-Sung;Shin, Hyun-Joon;Choi, Young-Chill
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.502-508
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    • 2009
  • Background: Rib fractures are the most common injuries that are caused by blunt chest trauma. However, fractures of the costal cartilage generally go unnoticed on chest X-rays unless they involve a calcified cartilage. For this reason, the sensitivity of conventional radiography for detecting rib fractures is low, and especially those involving the cartilaginous part of the rib. Thus, we have evaluated the usefulness of ultrasonography for detecting fractures of the costal cartilage that were overlooked on the conventional radiographs of patients who suffered minor blunt chest traumas. Material and Method: A total of 45 patients who suffered minor blunt chest trauma and who had no evidence of rib fractures or other major fractures on conventional radiographs were admitted for ultrasonography between April 2008 and March 2009. There were 24 women and 21 men, and the mean age of the patients was 50.4$\pm$15.91 years (range: 17$\sim$76 years). They were examined for the detection of fractures of the costal cartilage by performing ultrasonography with a 7.5-MHz linear transducer. Result: A total of 30 patients (67%) had fractures of the costal cartilage, whereas 15 patients (33%) had no evidence of chondral rib fractures. The mean number of fracture sites of the fractured costal cartilage was 1.6$\pm$0.81 (range: 1$\sim$4 sites) in 30 patients. Periosteal hematoma was the most common finding associated with fractures of the costal cartilage (n=7, 17%), followed by sternum fracture (n=5, 12%). However, periosteal hematoma was noticed in 1 patient (2%) who was without fracture of the costal cartilage, and sternum fracture was noticed in 1 patient (2%) who was without fractures of the costal cartilage. Conclusion: The results of this study suggest that ultrasonography may be a useful imaging modality for detecting fractures of the costal cartilage that are overlooked on the conventional radiographs of patients who suffer minor blunt chest trauma.

The Ability of FDG Uptake Ratio and Glut-1 Expression to Predict Mediastinal Lymph Node Metastasis in Resected Non-small Cell Lung Cancer (절제된 비소세포암에서 FDG 섭취비와 Glut-1 발현 정도를 이용한 종격동 림프선 전이 여부 예측)

  • Cho, Suk-Ki;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.506-512
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    • 2010
  • Background: This study was designed to evaluate the FDG uptake ratio of mediastinal node and primary tumors using integrated PET/CT imaging combined with Glut-1 expression of the primary tumor in order to predict the N2 status more accurately in NSCLC patients. Material and Method: Patients who underwent integrated PET/CT scanning with a detectable mSUV for both primary tumors and mediastinal lymph nodes were eligible for this study. The FDG uptake ratio between the mediastinal node and the primary tumor was calculated. Result: The average mSUV of primary tumors and mediastinal nodes were, respectively, $7.4{\pm}2.2$ and $4.2{\pm}2.2$ in N2-positive patients and $7.6{\pm}3.7$ and $2.8{\pm}6.9$ in N2-negative patients. The mean FDG uptake ratio of mediastinal node to primary tumor were $0.58{\pm}0.23$ for malignant N2 lymph nodes and $0.45{\pm}0.20$ for benign lymph nodes (p<0.05). Models which combined Glut-1 expression with an FDG ratio have better diagnostic power than models that use the FDG uptake ratio alone. Conclusion: In some patients with a previous history of pulmonary tuberculosis or other inflammatory lung diseases, an FDG uptake ratio combined with Glut-1 expression may be useful in diagnosing mediastinal node metastasis more exactly.

Application of Three-Dimensional Printed Models in Congenital Heart Surgery: Surgeon's Perspective (선천성 심기형의 수술에 있어서 삼차원 프린팅 모델의 적용: 심장외과의사의 관점)

  • Hyungtae Kim;Ki Seok Choo;Si Chan Sung;Kwang Ho Choi;Hyoung Doo Lee;Hoon Ko;Joung-Hee Byun;Byung Hee Cho
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.310-323
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    • 2020
  • To treat congenital heart disease, it is important to understand the anatomical structure correctly. Three-dimensional (3D) printed models of the heart effectively demonstrate the structural features of congenital heart disease. Occasionally, the exact characteristics of complex cardiac malformations are difficult to identify on conventional computed tomography, magnetic resonance imaging, and echocardiography, and the use of 3D printed models can help overcome their limitations. Recently, 3D printed models have been used for congenital heart disease education, preoperative simulation, and decision-making processes. In addition, we will pave the way for the development of this technology in the future and discuss various aspects of its use, such as the development of surgical techniques and training of cardiac surgeons.

Successful Treatment of Left Atrial Auricular Abscess -A case report - (좌심방이-농양의 수술적 치료 -치험 1예 -)

  • 이정렬;김준성;배은정;노정일;안규리
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.272-274
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    • 2004
  • We report an unusual case of left atrial auricular abscess which was successfully treated by surgical resection, treatment with antibiotics and mediastinal irrigation. A 9-year-old female patient with previous history of urinary tract infection was admitted because of persistent fever. Echocardiography and magnetic resonance imaging revealed massive pericardial effusion and a mass lesion at the left upper cardiac border. Pericardiocentesis isolated Staphylococcus aureus on culture. The patient underwent mass removal under cardiopulmonary bypass. The mass was located within the left atrial auricular wall with fibropurulent abscess formation inside. Postoperative mediastinal irrigation was performed. Pathologic examination of the mass showed organized thrombi with chronic fibrosing mural endocarditis. She discharged on the 21st postoperative day without complication.

A Case of Atrial Septal Defect (ASD) in a Miniature Schunauzer Dog (Miniature Schunauzer Dog에서 발생한 심방중격 결손 증례)

  • Park, Chul;Choi, Chi-bong;Kim, Il-hwan;Park, Hee-myung
    • Korean Journal of Veterinary Research
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    • v.43 no.2
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    • pp.307-310
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    • 2003
  • An atrial septal defect (ASD) is congenital heart disease with a communication between the atria, which allows blood to shoot from the atrium with pressure. A 3-month-old female Miniature Schunauzer was referred to the Veterinary Teaching Hospital of Konkuk University for the evaluation of systolic heart murmur. At presentation, the mucous membrane was cyanotic. On physical examination, an ejection-type systolic murmur was auscultated at the pulmonic area. In addition, thoracic radiography showed enlargement of main pulmonary artery and right atrial/ventricular enlargement. Echocardiography revealed dilated right atrium and atrial septal defect. However, mitral and tricuspid valve were still intact and well tolerating. The presence of an ASD was confirmed by identifying flow across the defect with color Doppler imaging. Doppler echocardiography provides a means of non-invasive documentation and quantification of ASD. Complete blood count and serum chemistry were not remarkable. Although large defect was confirmed between the two atrium, the patient did not show any obvious clinical signs of heart failure at this time.

Idiopathic Pleuroparenchymal Fibroelastosis Presenting in Recurrent Pneumothorax: A Case Report

  • Noh, Hyun Jin;Seo, Yun;Huo, Sol Mi;Kim, Tae Jung;Kim, Hyo Lim;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.184-187
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    • 2014
  • Idiopathic pleuroparenchymal fibroelastosis (PPFE) is a rare, recently classified entity that consists of pleural and subjacent parenchymal fibrosis predominantly in the upper lungs. In an official American Thoracic Society/European Respiratory Society statement in 2013, this disease is introduced as a group of rare idiopathic interstitial pneumonias. We describe a case of a 76-year-old woman with cough and recurrent pneumothorax. She was admitted to our hospital with severe cough at first. High resolution computed tomography (HRCT) disclosed multifocal subpleural consolidations with reticular opacities in both lungs, primarily in the upper lobes, suggesting interstitial pneumonia. Rheumatoid lung was diagnosed initially through an elevated rheumatoid factor, HRCT and surgical biopsy at the right lower lobe. However, one month later, pneumothorax recurred. Surgical biopsy was performed at the right upper lobe at this time. The specimens revealed typical subpleural fibroelastosis. We report this as a first case of idiopathic PPFE in Korea after reviewing the symptoms, imaging and pathologic findings.

Type A Aortic Dissection with Aortocaval Fistula -Report of 1 case- (대동맥-상대정맥루를 동반한 A형 대동맥 해리증 수술 치험 -1례보고-)

  • 김흥수;양승인;정성운;김종원;이형렬
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.599-604
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    • 2002
  • Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.