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Surgical Management of Trachea Stenosis (기관협착증에 대한 기관 성형술)

  • 김치경
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1508-1515
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    • 1992
  • Between 1975 and 1992, forty five patients with trachea stenosis received tracheoplasty for relief of obstruction. The causes of airway problem are brain contusion[19 cases, 40%], cerebrovascular disease[3 cases, 7%], drug intoxication[8 cases, 18%], psychotic problem[2 cases, 4%], trachea tumor[3 cases, 7%], adult respiratory distress syndrome[9 cases, 20%] and direct trauma[1 case, 2%]. Direct causes of trachea stenosis were complications of tracheostomy[36 cases, 80%], complications of nasotracheal intubation[5 cases, 11%], tumor[3 cases, 6%] and trauma[1 case, 2%]. Thirty one patients underwent the sleeve resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Forteen patients received the Montgomery T-tube for relief of airway obstruction. Four patients have done simple excision of granulation tissue. Two, subglottic stenosis patients were received Rethi procedure[anterior division of cricoid cartilage, wedge partial resection of lower thyroid cartilage and Montgomery T-tube molding] and the other subglottic stenosis patient underwent permanent trachea fenestration. Including cervical flexion in all patients postoperatively, additional surgical techniques for obtain tension-free anastomosis were hyoid bone release technique in two cases, and hilar mobilization, division of inferior pulmonary ligament and mobilization of pulmonary vessel at the pericardium were performed in one case. Cervical approach was used in 39 cases, cervicomediastinal in 12 cases and transthoracic in one case. Complications of tracheoplasty were formation of granulation tissue at the anastomosis site[3 cases], restenosis[9 cases], trachea-innominate artery fistula[2 cases], wound infection[2 cases], separation of anastomosis[2 cases], air leakage[3 cases], injury to a recurrent laryngeal nerve[temporary 8 cases, permanent 2 cases] and hypoxemia[1 case]. Surgical mortality for resection with primary reconstruction was 6.7%, with one death due to postoperative respiratory failure and two deaths due to tracheo-innominate artery fistula.

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Evaluation of the Space Scattered Dose According to the Position of the Radiation Workers in Mammography Room (유방촬영 시 방사선관계종사자의 위치에 따른 공간선량평가)

  • Lee, Dong-Yeon;Lee, Jin-Soo
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.297-303
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    • 2016
  • This study was conducted to evaluate the dose of the space to the controller located within the mammography room conducted a research on ways to the reduction exposure to the radiation workers. Results, the dose of 6.18 mGy/year was measured when there is no difference in the hilar area of the controller position, the dose of 2.35E-11 mGy/year was measured when installing the Shielding door. In addition, when the direction of the X-ray tube anode be heading this direction controller, low average level measured was 0.30 mGy/year. Based on this study, the mammography should be considered when installing the anode and cathod directions. And, by installing the shielding door, it must be able to completely separate shooting space and control room. This is the best way radiation protection method in radiation workers.

Disseminated Coccidioidomycosis Presenting with Miliary Nodules (속립성 폐결절로 발현된 파종성 콕시디오이데스 진균증)

  • Kim, Jung Ha;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hae Chul;Park, Dae Won;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shon, Jang Uk;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.97-101
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    • 2006
  • Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

Imaging Diagnosis: Heartbase Tumor in a Dog (개의 심기저부 종양의 영상진단학적 특징)

  • Chang, Jin-Hwa;Jung, Joo-Hyun;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.48-51
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    • 2008
  • A ten-year-old Yorkshire Terrier developed serious abdominal distension and respiratory distress. Radiography and ultrasonography revealed a hyperechoic mass around the aorta that was contiguous with the right atrium and main pulmonary artery. It was resulted in failure of the right side of the heart including tricuspid regurgitation, hepatomegaly with dilation of the hepatic vein and severe ascites due to a large, expansile mass. Computed tomography(CT) identified a large mass originating at the cardiac hilar region and spanning from the cranial vena cava to the caudal vena cava. The tumor had invaded the cranial vena cava, caudal vena cava, heart and pleural wall. A tentative diagnosis of chemodectoma was assigned to the tumor through a fine needle aspiration. This report focuses on the typical features of imaging diagnosis of heartbase tumors by radiography, ultrasonography and CT.

Familial Sarcoidosis, The First Report in Korea (가족형 폐유육종증)

  • Uhm, Wan-Sik;Lim, Chae-Man;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.644-650
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    • 1994
  • Sarcoidosis can affect two or more members of the same family, and the reported occurrence of such familial sarcoidosis is variable from 0.5 to 14%. Recent1y we have experienced familial sarcoidosis affected mother and daughter, for the first time in Korea. Mother was diagnosed as Stage 11 sarcoidosis 4 years ago by transbronchial lung biopsy and cervical lymph node biopsy with compatible BAL finding in our hospital. This time, the daughter was admitted with bilateral hilar enlargement and anterior uveitis. Even though she had positive tuberculin skin test and atypical BAL finding(lymphocyte: 61%, CD4/CD8: 1.22). Transbronchial lung biopsy and mediastinal lymph node biopsy revealed noncaseating epithelioid granuloma without AFB. Slit lamp examination of the eyes showed severe anterior uveitis. Systemic steroid therapy was started due to progressive uveitis with antituberculous medication.

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The Natural Course of Endobronchial Inflammatory Polyps as a Complication after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

  • Lee, Kyu Min;Jang, Sun Mi;Oh, Seo Young;Kim, Do Young;Lee, Geewon;Kim, Ahrong;Kim, Min Ji;Kim, Tae Hwa;Park, Joon Woo;Lee, Kwangha;Kim, Ki Uk;Lee, Min Ki;Eom, Jung Seop
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.419-422
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    • 2015
  • We presented a case of unusual endobronchial inflammatory polyps as a complication following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a patient with tuberculous lymphadenitis. EBUSTBNA of the right hilar lymph node was performed in a 29-year-old, previously healthy man. The patient was confirmed with tuberculous lymphadenitis and received antituberculosis medication over the course of 6 months. Chest computed tomography, after 6 months of antituberculosis therapy following the EBUS-TBNA showed nodular bronchial wall thickening of the right main bronchus. Histological and microbiological examinations revealed inflammatory polyps. After 7 months, the inflammatory polyps regressed almost completely without need for removal.

Pulmonary Involvement of T-cell type Lymphoma with Rapid, Bilateral Infiltration and High Fever Simulating Pueumonia (고열과 급속한 진행성 양측 폐침윤으로 폐렴이 의심되었던 T세포 임파종)

  • Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1440-1446
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    • 1997
  • The radiologically detectable pulmonary involvement of NHL at diagnosis is about 4%. The commonest intrathoracic manifestations of secondary pulmonary lymphoma are mediastinal or hilar lymph node enlargement And the most frequent manifestations of pulmonary parenchymal lymphoma are lymphomatous nodules. But, when patients with newly diagnosed lymphoma exhibit rapidly progressive parenchymal lesions, an infection, such as pneumonia, is usually suspected. We present a report of a patient who developed rapidly progressive pulmonary involvement with T cell lymphoma, which was considered to be pneumonia because of high fever and rapidly progressive radiologic findings.

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Surgical Treatment of Main Pulmonary Artery Aneurysm with Patent Ductus Arteriosus -A Case Report- (동맥관개존증에 동반된 주폐동맥류의 수술치험 - 수술치험 1례)

  • 김대식;이성주;권오우;김창회;채성수;오성철
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1270-1275
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    • 1996
  • Pulmonary artery aneurysms are extremely rare conditions usually associated with congenital cardiac defects that cause increased pulmonary blood flow and pulmonary hypertension. The prognosis of pulmonary artery aneurysms is fatal due to the potential for rupture of the aneurysm and the underlying severe pulmonary hypertension. A 40-year old woman was admitted to our hospital with headache following traffic accident. On admission a continuous murmur was heard over the 2nd to 3rd intercostal space along left sternal border and a calcified cystic mass at left hilar portion was incidentally discoverd on chest reontgenogram. Cardiac catherization was diagnostic of a left to right shunt at main pulmoanry artery level and pulmonary hypertension. Pulmonary angiogram demonstrated a large aneurysm of main pulmonary artery extending into proximal left pulmonary artery. The pulmonary artery aneurysm associated with patent ductus arteriosus was diagnosed definitively and the patient was underwent resection of pulmonary artery aneurysm, closure of PDA and Dacron prosthetic graft replacement under cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged without any problem.

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Seasonal survey on the respiratory diseases of slaughtered pigs in Jeonbuk, Korea (전북지역 도축돈 호흡기질병 조사)

  • Lim, Mi-Na;Kim, Chul-Min;Park, Young-Min;Song, Ju-Tae;Jin, Jae-Kwon;Cho, Hyun-Ung
    • Korean Journal of Veterinary Service
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    • v.39 no.4
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    • pp.231-237
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    • 2016
  • The present study was conducted to investigate the lesion of red internal organs in slaughtered pigs and provided assistant data for pig farms. During March to December 2015, a total of 1,160 lung samples out of 58 herds were collected randomly from pigs slaughtered in Jeonbuk province. In addition, 290 hilar lymph nodes from pig with pneumonic lung lesion (5 samples per herd) were screened for selected viral and bacterial pathogens. Gross lesions of lungs such as swine enzootic pneumonia (SEP), pleuritis, pleuropneumonia, pericarditis and liver white spots were examined. The overall prevalence of SEP was 64.3% (746/1,160). In the analysis of seasonal prevalence, there was an increase of occurrence during the spring months (287/400, 71.8%) and decrease during the fall months (93/200, 46.5%) among the whole herds. The mean number of SEP score per pig was $1.20{\pm}1.28$. The prevalence of pleuropneumonia, pleuritis, pericarditis, and milk spot was 25.5% (296/1,160), 44.1% (512/1,160), 3.8% (44/1,160) and 17.6% (204/1,160), respectively. The most frequent region with lung lesion was diaphragmatic lobes (left 17.1%, right 17.3%). In the detection of viral pathogens by PCR, porcine circovirus type2 (PCV2) was positive in 86.9% (252/290), while porcine reproductive and respiratory syndrome virus (PRRSV) was not detected, In the case of bacterial pathogens, 50 microorganisms were isolated by PCR and/or microbiological test. The most frequently isolated bacteria was Streptococcus suis (20, 34.4%), followed by Pasteurella multocida (17, 29.3%), Streptococcus spp. (11, 3.4%), Actinobacillus pleuropneumoniae (2, 8.9%).

A Case of Scar Sarcoidosis (피부반흔에서 발생한 유육종증 1례)

  • Kim, Sun Goo;Yi, Tae Min;Kim, Yu Jin;Lee, Se Il
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.71-74
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    • 2011
  • Purpose: Sarcoidosis is a systemic noncaseating granulomatous disease of an unknown origin, and can involve any organ including the skin. The infiltration of sarcoid granuloma in an old cutaneous scar is an uncommon cutaneous manifestation of sarcoidosis. This paper reports a 35-year old female who presented with cutanesous nodules in previous facial scars. Methods: A 35-year-old female presented with cutaneous nodules for 2 months in previous scars of the forehead and lower lip that she had acquired in the childhood. An excisional biopsy of the lower lip mass, serologic examinations and radiologic studies were performed. Results: The excisional biopsy revealed noncaseating granulomas consistent with sarcoidosis. Chest CT revealed both hilar and paratracheal lymphadenopathy with nodular densities in both lung fields. Routine laboratory tests, serologic tests, serum angiotensin converting enzyme level, sputum for acid-fast bacilli, ophthalmoscopic examination, TB-PCR and NTM-PCR showed normal findings. Therefore, the patient was diagnosed with sarcoidosis. The patient refused fiberoptic bronchoscopy and medication with oral steroid. Currently, the clinical manifestation and progress are being monitored closely, and treatment is expected to start with oral steroid according to the progress. Conclusion: For the proper management of cutaneous sarcoidosis, particularly scar sarcoidosis, plastic surgeons should be aware of the many clinical and histopathological features of sarcoidosis and recommend a systemic evaluation for early diagnosis and proper treatment.