• Title/Summary/Keyword: Chest Radiography

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Mediastinal Emphysema, Giant Bulla, and Pneumothorax Developed during the Course of COVID-19 Pneumonia

  • Ruihong Sun;Hongyuan Liu;Xiang Wang
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.541-544
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    • 2020
  • The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiple countries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few cases have reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computed tomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance, thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, and pneumothorax were also observed during the course of the disease.

Using Rib Bone Turnover Technique, Prevention of Chest Wall Depression after Microtia Reconstruction (늑골 Turnover 방법을 이용한 소이증 재건 시 흉벽 함몰 예방술)

  • Park, Chan Young;Lee, Yoon Ho
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.214-218
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    • 2008
  • Purpose: Reconstruction of microtia using costal cartilage graft is commonly used technique nowadays. The chest wall depression at the donor site after the graft, however, has been noticed in many articles. Prevention or correction technique for the depression at the donor site also has been reported and we also have been concerned about the problem. This article is a case report about a new technique preventing chest wall depression after costal cartilage graft. Methods: We selected total 15 microtia patients who visited our clinic, from December 2005 to July 2007. They were 10 male and 5 female patients and the mean age was 11.9 years. The average follow up period was 9.2 months(2 to 15 months). We used 6, 7, and $8^{th}$ costal cartilage for microtia reconstruction. And then we turned over pivot of cartilage resection margin, after bihalving costal cartilage involving about 5-6 cm of $6^{th}$ and $7^{th}$ rib bone. After microtia reconstruction, chest donor sites were evaluated by physical examination and radiography. Results: Postoperative depression at the donor site was much less when the costal cartilage turnover technique was performed. Postoperative physical examination and three dimensional reconstruction CT showed that the rest part of rib bone was turned over and it supported the soft tissue defect during respiration. Conclusion: We expect that the turnover rib bone will not be absorbed after graft, as well as offering mechanical support, compared to the other reports.

Diagnostic Strategy of Primary Site in Metastatic Bone Tumor (전이성 골종양에서 원발병소의 진단)

  • Shin, Kyoo-Ho;Suh, Ki-Won;Jahng, Jun-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.98-104
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    • 1997
  • We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

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Evolution of Interferon-Gamma Release Assay Results and Submillisievert Chest CT Findings among Close Contacts of Active Pulmonary Tuberculosis Patients

  • Yoon, Soonho;Mihn, Do-CiC;Song, Jin-Wha;Kim, Sung A;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.4
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    • pp.283-288
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    • 2020
  • Background: Latent tuberculosis (TB) infection among TB contacts is diagnosed using plain chest radiography and interferon-gamma release assays (IGRAs). However, plain chest radiographs often miss active TB, and the results of IGRA could fluctuate over time. The purpose of this study was to elucidate changes in the results of the serial IGRAs and in the findings of the serial submillisievert chest computed tomography (CT) scans among the close contacts of active pulmonary TB patients. Methods: Patients age 20 or older with active pulmonary TB and their close contacts were invited to participate in this study. Two types of IGRA (QuantiFERON-TB Gold In-Tube assay [QFT-GIT] and the T-SPOT.TB test [T-SPOT]) and submillisievert chest CT scanning were performed at baseline and at 3 and 12 months after enrollment. Results: In total, 19 close contacts participated in this study. One was diagnosed with active pulmonary TB and was excluded from further analysis. At baseline, four of 18 contacts (22.2%) showed positive results for QFT-GIT and T-SPOT; there were no discordant results. During the follow-up, transient and permanent positive or negative conversions and discordant results between the two types of IGRAs were observed in some patients. Among the 17 contacts who underwent submillisievert chest CT scanning, calcified nodules were identified in seven (41.2%), noncalcified nodules in 14 (82.4%), and bronchiectasis in four (23.5%). Some nodules disappeared over time. Conclusion: The results of the QFT-GIT and T-SPOT assays and the CT images may change during 1 year of observation of close contacts of the active TB patients.

One Case of Video-Assisted Thoracoscopic Removal of Acupuncture Needle in Lung Parenchyma (폐실질 내 침술 침의 비디오 흉강경 제거 1예)

  • Jeong, Yeong-Gyu;Lee, Ho-Sung;Choi, Jae-Sung;Na, Joo-Ock;Seo, Ki-Hyun;Kim, Yong-Hoon;Lee, Seung-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.450-453
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    • 2011
  • We report the case of a 32-year-old woman presenting with intermittent chest pain resulted from a migratory acupuncture needle. The patient received acupuncture treatment approximately 3 years prior to this presentation, for the treatment of chronic left shoulder and lumbar pain after delivery. Chest radiography revealed a retained needle in the lingular segmental area. Video-assisted thoracoscopy was then used to remove the migratory acupuncture needle attached between the lingular segmental lobe and the pericardial fat. The patient recovered without complications and was discharged home.

Evaluation of Chest Density in Insight Film (Insight film을 이용한 농도측정 평가)

  • Kwon, Lee-Seon;Park, Jang-Hwan;Lim, Oh-Soo;Jung, Kyong-Mo;Cheung, Hwan
    • Journal of radiological science and technology
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    • v.15 no.2
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    • pp.17-23
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    • 1992
  • Simple chest radiography is the most frequently performed examination in radiologic practice. However, with transmitted dose through chest which has the problem of wide variations in absorption, conventional Film/Screen Combinations Method make it difficult to delineate lung field mediastinum & cardia portion and subdiaphragmatic structures. In order to overcome this problem, we have been tried several methods as follows. High Kilovoltage Technique, Rare Earth Screen/Wide Lattitude Film, Use of Compensating Filter and Digital Beam Attenuator and recently Insigh System has been developed. In this paper, we'd like to discuss Insight film through apperciation by measuring the difference of contrast. In order to evaluate insight film. We have done experiments using Insight System with Simple Phase, Picker 550. We could get an result which was able to overcome the limitted dynamic range of conventional Film/Screen System remarkably.

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A Case Report on Pneumothorax Caused by Interscapular Area Acupuncture (견갑골 내측 부 자침으로 야기된 기흉 1례)

  • Sung, Hee Jin;Lim, Su Sie;Choi, Hyun Young;Lee, Eun Yong;Roh, Jung Du;Lee, Cham Kyul
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.213-218
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    • 2016
  • Objectives : The purpose of this study was to report the case prognosis and evaluate treatment and prevention of pneumothorax after acupuncture treatment. Methods : A 32-year-old slender male complained of pain in the interscapular area. As a result, acupuncture needling and manual technique were performed to trigger the points of trapezius and rhomboid muscles. After this, chest pain and dyspnea occurred. Pneumothorax was confirmed by chest radiography and symptom progression was observed for 14 days while high pressure oxygen was administered. Results : The chest pain disappeared after 4 days of pneumothorax, and most of the related symptoms disappeared after 14 days. Conclusion : For acupuncture treatment to the interscapular area, the depth and manual technique should be carefully performed.

Extraskeletal Osteosarcoma Arising from the Pleura

  • Lee, Chee-Hoon;Park, Chang Ryul;Kim, Jung Won;Suh, Jae-Hee;Lee, Yong Jik;Jung, Jong Phil
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.320-324
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    • 2014
  • A 37-year-old woman was referred to our institution for further management of a mass lesion located in the thoracic cavity. The mass had grown by more than 10 cm over the course of a year and was initially considered to be a scar from previous pulmonary tuberculosis at another hospital. The patient had complained of left-sided flank pain for a year and experienced dyspnea for one month. Chest radiography and chest computed tomography revealed an irregular-shaped mass in the left mid to lower pleural cavity. The mass was widely excised through left thoracotomy. Pathologic examination of the biopsy specimen revealed a malignant spindle cell tumor, which consisted of components of osteosarcoma, pleomorphic sarcoma, and leiomyosarcoma. The patient underwent adjuvant chemotherapy and has been doing well without any evidence of recurrence for 14 months.

Surgical Correction of Pseudo-flail Chest Using Interfragmentary Wiring, Latissimus Dorsi Flap, and External Splinting in a Dog

  • Min, Byong-Su;Jeong, Soon-Wuk;Yoon, Hun-Young
    • Journal of Veterinary Clinics
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    • v.33 no.2
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    • pp.124-128
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    • 2016
  • A 7-year-old intact female Maltese dog presented with a history of bite wounds. Physical examination revealed labored breathing, four puncture wounds with subcutaneous emphysema of the thorax, and paradoxical respiratory movement of the right thoracic wall. On radiography, a segmental fracture of the right 7th rib and a single fracture of the 8th rib were evident on the dorsal thorax. An inward displacement of the fractured segment and contusion of the right caudal lung lobe were identified with computed tomography. A diagnosis of pseudo-flail chest was made. Exploratory thoracotomy revealed a full-thickness muscular defect, a marked discoloration of the right caudal lung lobe, a segmental fracture of the right 7th rib, and a single fracture of the right 8th rib. Necrotic tissues were removed using surgical debridement. The fractured 7th and 8th ribs were corrected using a single interfragmentary wiring technique. The thoracic wall was reconstructed using the latissimus dorsi muscle flap. Additional thoracic stabilization using a thermoplastic splint was applied to correct paradoxical respiratory movement. The external splint was removed 4 weeks postoperatively. There was no evidence of respiratory abnormalities 18 months postoperatively.

Pneumocystis jiroveci Pneumonia Mimicking Miliary Tuberculosis in a Kidney Transplanted Patient

  • Jung, Ju Young;Rhee, Kyoung Hoon;Koo, Dong Hoe;Park, I-Nae;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.127-130
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    • 2009
  • Bilateral interstitial infiltration in chest radiography, which may be fine granular, reticular or of ground glass opacity, is the typical radiographic findings of Pneumocystis jiroveci pneumonia. Recently, atypical radiographic features, including cystic lung disease, spontaneous pneumothorax or nodular opacity, have been reported intermittently in patients with P. jiroveci pneumonia. We report the case of a 29-year-old woman with a transplanted kidney whose simple chest radiography and HRCT scan showed numerous miliary nodules in both lungs, mimicking miliary tuberculosis (TB). Under the presumptive diagnosis of miliary TB, empirical anti-TB medication was started. However, Grocott methenamine silver nitrate staining of a transbronchial lung biopsy tissue revealed P. jiroveci infection without evidence of TB. These findings suggest that even in TB-endemic area other etiology such as P. jiroveci as well as M. tuberculosis should be considered as an etiology of miliary lung nodules in mmunocompromised patients.