• Journal of Medicine and Life Science
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• v.17 no.1
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• pp.21-24
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• 2020

Intramural esophageal dissection is a rare disorder characterized by a separation of the mucosa and/or submucosa from deeper muscular layers of the esophagus, with or without perforation. Iatrogenic instrumentation such as endoscopy is one of the major causes of IED. We report a case of IED after endoscopy in a patient with hypopharyngeal cancer treated with concurrent chemoradiotherapy, and suggest that a history of chemoradiotherapy can be a risk factor of IED on endoscopy. In this case, chest computed tomography scans show not only typical esophageal double lumen but also eccentric esophageal wall thickening and abnormally thin the other side esophageal wall, and this CT finding may also be important to diagnose IED.

• Tuberculosis and Respiratory Diseases
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• v.77 no.2
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• pp.55-59
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• 2014

The US National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality and a 6.7% decrease in all-cause mortality. The NLST is the only trial showing positive results in a high-risk population, such as in patients with old age and heavy ever smokers. Lung cancer screening using a low-dose chest computed tomography might be beneficial for the high-risk group. However, there may also be potential adverse outcomes in terms of over diagnosis, bias and cost-effectiveness. Until now, lung cancer screening remains controversial. In this review, we wish to discuss the evolution of lung cancer screening and summarize existing evidences and recommendations.

• Journal of Chest Surgery
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• v.44 no.5
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• pp.368-372
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• 2011

This study was conducted to investigate the clinical application of three-dimensional (3D) reconstructed computed tomography (CT) images in detecting and gaining information on esophageal foreign bodies (FBs). Two patients with esophageal FBs were enrolled for analysis. In both cases, 3D reconstructed images were compared with the FB that was removed according to the object shape, size, location, and orientation in the esophagus. The results indicate the usefulness of conversion of CT data to 3D images to help in diagnosis and treatment. Use of 3D images prior to treatment allows for rapid prototyping and surgery simulation.

• Tuberculosis and Respiratory Diseases
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• v.84 no.3
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• pp.171-175
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• 2021

Cryptogenic organizing pneumonia (COP) is a type of idiopathic interstitial pneumonia with an acute or subacute clinical course. Bilateral lung consolidations located in the subpleural area and bronchovascular bundle are the most common findings on chest high-resolution computed tomography. The pathologic manifestations include granulation tissue in the alveoli, alveolar ducts, and bronchioles. COP responds fairly well to glucocorticoid monotherapy with rapid clinical improvement, but recurrence is common. However, treatment with combined immunosuppressant agents is not recommended, even if the COP patient does not respond to glucocorticoid monotherapy with expert opinion.

• Journal of Trauma and Injury
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• v.32 no.2
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• pp.122-125
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• 2019

A 73-year-old man, who, in an inebriated state, had slipped in a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. Based on the chest and abdominopelvic computed tomography, he was diagnosed with multiple rib fractures and hemopneumothorax on the left hemithorax and was found to have a bony fragment in the spleen. He had not presented peritonitis and exsanguinous symptoms during the observation period. Seven days later, computed tomography of the abdomen showed suspected diaphragmatic injury and a retained foreign body in the spleen. On exploration by video assisted thoracoc surgery (VATS), a herniated omentum through the lacerated site of the diaphragm was observed. After omentectomy using Endo Gia, the foreign body in the spleen was observed through the lacerated site of the diaphragm. Traumatic diaphragm rupture with a foreign body, in the spleen, was successfully managed by video assisted thoracic surgery via the lacerated site of the diaphragm.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.140-142
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• 2023

The azygos vein sometimes merges abnormally across the right upper lobe of the lung and it hangs at the lower edge of a membranous septum, called the meso-azygos. The septum invaginates the lobe and makes a fissure. The smaller medial part of the right upper lobe is called an azygos lobe. A 16-year-old male patient was diagnosed with right-sided pneumothorax, and a closed thoracostomy was done in the emergency room. During elective wedge resection including the bulla, the meso-azygos, abnormal azygos vein, and azygos lobe were detected. We reviewed the computed tomography images and found that the azygos lobe had re-expanded laterally, not medially, to the meso-azygos after the closed thoracostomy in the emergency room. The patient had been diagnosed with left-sided pneumothorax a year ago, and no one noticed the azygos lobe at that time. We report the intraoperative findings and comparative images of a migratory azygos lobe.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.353-356
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• 1993

Advent of new imaging modalities such as computed tomography, magnetic resonance imaging and ultrasound contributed greately to the specific imaging diagnosis. However plain chest X-ray is still most prequently used for imaging diagnosis of respiratory disease in clinical pratic and it is important to make a good quality of X-ray film and good interpretation. The optimal chest X-ray should be taken with full inspiration without rotation and motion and the exposure is at the level of barely demonstrable thoracic vertebral disc space. It is recommended that higk KVP technique for detection of lesions which is overlaped by mediastinum, heart and rib cage. It is better to examine chest X-ray film start at some distance(6-8 feet) and closer to the film later on and the reader should not read a film in fatigue condition. The reading room should be quiet and relately dark illumination. It is important, to make a good X-ray film and good interpretation to reduce the observer error.

• Journal of Chest Surgery
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• v.52 no.4
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• pp.221-226
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• 2019

Background: Accurate mediastinal lymph node staging is vital for the optimal therapy and prognostication of patients with lung cancer. This study aimed to determine the preoperative risk factors for pN2 disease, as well as its incidence and long-term outcomes, in patients with clinical N0-1 non-small cell lung cancer. Methods: We retrospectively analyzed patients who were treated surgically for primary non-small cell lung cancer from November 2005 to December 2014. Patients staged as clinical N0-1 via chest computed tomography (CT) and positron emission tomography (PET)-CT were divided into two groups (pN0-1 and pN2) and compared. Results: In a univariate analysis, the significant preoperative risk factors for pN2 included a large tumor size (p=0.083), high maximum standard uptake value on PET (p<0.001), and central location of the tumor (p<0.001). In a multivariate analysis, central location of the tumor (p<0.001) remained a significant preoperative risk factor for pN2 status. The 5-year overall survival rates were 75% and 22.9% in the pN0-1 and pN2 groups, respectively, and 50% and 78.2% in the patients with centrally located and peripherally located tumors, respectively. In a Cox proportional hazard model, central location of the tumor increased the risk of death by 3.4-fold (p<0.001). Conclusion: More invasive procedures should be considered when preoperative risk factors are identified in order to improve the efficacy of diagnostic and therapeutic plans and, consequently, the patient's prognosis.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.229-235
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• 2017

In abdominal Ultrasonography, the fatty liver is diagnosed through hepatic parenchymal echo increased parenchymal density and unclear blood vessel boundary, and according to many studies, abdominal Ultrasonography has 60~90% of sensitivity and 84~95% of specificity in diagnosis of fatty liver, but the result of Ultrasonography is dependent on operators, so there can be difference among operators, and quantitative measurement of fatty infiltration is impossible. Among examinees who same day received abdominal Ultrasonography and chest computed tomography (CT), patients who were diagnosed with a fatty liver in the Ultrasonography were measured with liver Hounsfield Units (HU) of chest CT imaging to analyze the accuracy of the fatty liver diagnosis. Among 720 subject examinees, those who were diagnosed with a fatty liver through abdominal Ultrasonography by family physicians were 448, which is 62.2%. The result of Liver HU measurement in the chest CT imaging of those who were diagnosed with a fatty liver showed that 175 out of 720 had the measured value of less than 40 HU, which is 24.3%, and 173 were included to the 175 among 448 who were diagnosed through Ultrasonography, so 98.9% corresponded. This indicates that the operators' subjective ability has a great impact on diagnosis of lesion in Ultrasonography diagnosis of a fatty liver, and that in check up chest CT, under 40 HU in the measurement of Liver HU can be used for reference materials in diagnosis of a fatty liver.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.476-488
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• 2021

Objective: We aimed to develop a deep neural network for segmenting lung parenchyma with extensive pathological conditions on non-contrast chest computed tomography (CT) images. Materials and Methods: Thin-section non-contrast chest CT images from 203 patients (115 males, 88 females; age range, 31-89 years) between January 2017 and May 2017 were included in the study, of which 150 cases had extensive lung parenchymal disease involving more than 40% of the parenchymal area. Parenchymal diseases included interstitial lung disease (ILD), emphysema, nontuberculous mycobacterial lung disease, tuberculous destroyed lung, pneumonia, lung cancer, and other diseases. Five experienced radiologists manually drew the margin of the lungs, slice by slice, on CT images. The dataset used to develop the network consisted of 157 cases for training, 20 cases for development, and 26 cases for internal validation. Two-dimensional (2D) U-Net and three-dimensional (3D) U-Net models were used for the task. The network was trained to segment the lung parenchyma as a whole and segment the right and left lung separately. The University Hospitals of Geneva ILD dataset, which contained high-resolution CT images of ILD, was used for external validation. Results: The Dice similarity coefficients for internal validation were 99.6 ± 0.3% (2D U-Net whole lung model), 99.5 ± 0.3% (2D U-Net separate lung model), 99.4 ± 0.5% (3D U-Net whole lung model), and 99.4 ± 0.5% (3D U-Net separate lung model). The Dice similarity coefficients for the external validation dataset were 98.4 ± 1.0% (2D U-Net whole lung model) and 98.4 ± 1.0% (2D U-Net separate lung model). In 31 cases, where the extent of ILD was larger than 75% of the lung parenchymal area, the Dice similarity coefficients were 97.9 ± 1.3% (2D U-Net whole lung model) and 98.0 ± 1.2% (2D U-Net separate lung model). Conclusion: The deep neural network achieved excellent performance in automatically delineating the boundaries of lung parenchyma with extensive pathological conditions on non-contrast chest CT images.