• Title/Summary/Keyword: Thoracic Diseases/diagnosis

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Magnetic Resonance Imaging in Thorax (흉부의 자기공명영상)

  • Choi, Byoung Wook
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.571-584
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    • 2004
  • Magnetic Resonance Imaging (MRI) is one of the most advanced imaging techniques in clinical and research medicine. However, clinical application of MRI to the lung or thorax has been limited due to various drawbacks. Low signal intensity of the lung and cardiac and respiratory movements are the most serious problems with MRI in thorax. Nevertheless, MRI is superior to CT in some selected patients with thoracic diseases. The role of clinical MRI in thoracic disease has been widened with improvement of MR equipments and development of new pulse sequences. Otherwise, functional assessment of lung by MRI has been studied for the last decade. These include perfusion MRI with or without contrast enhancement and ventilation MRI with oxygen-enhancement or hyperpolarized noble gas, $^3He$ and $^{129}Xe$.

Clinical evaluation of thoracoscopy (흉강경검사의 임상적 고찰)

  • Kim, Yeong-Ho;Jo, Jung-Gu
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.522-530
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    • 1984
  • During a 12-month period, 31 patients underwent diagnostic and therapeutic thoracoscopy for previously undiagnosed thoracic diseases. In all patient, the diagnosis had been unobtainable by the usual diagnostic modalities of thoracentesis, closed pleural biopsy, bronchoscopy, or mediastinoscopy. The patients ranged from 4 years to 84 years old. One procedure was performed for mediastinal mass, 8 for parenchymal lesions, 21 for pleural diseases, and 1 for diaphragmatic disease. A correct diagnosis was obtained by thoracoscopy in 31 procedures for a 90% overall accuracy rate. There was no clinically significant morbidity in this series and no procedure-related mortality. Thoracoscopy, performed under intercostal nerve block and regional anesthesia, has proved to be a very attractive method of the diagnosis of thoracic disease.

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Successful Diagnosis and Treatment of a Pancreaticopleural Fistula in a Patient Presenting with Unusual Empyema and Hemoptysis

  • Kim, Eunji;Ahn, Hyo Yeong;Kim, Yeong Dae;I, Hoseok;Cho, Jeong Su
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.174-177
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    • 2019
  • Pancreaticopleural fistula (PPF) is a rare complication in patients with pancreatitis. Its symptoms are similar to those of empyema or pleural effusion; therefore, it is important to consider PPF in the differential diagnosis. Herein, we describe the diagnosis and treatment of PPF in a patient presenting with unusual empyema and delayed hemoptysis.

The Review of Misdiagnosis in Surgical Chest Diseases (진단 곤란했던 흉부질환에 대한 검토)

  • 손말현;조광현;김진식
    • Journal of Chest Surgery
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    • v.8 no.1
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    • pp.1-8
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    • 1975
  • The author reviewed 36 cases of misdiagnosis in 533 cases of Surgical chest diseases which were operated during past 5 years in Department of Thoracic Surgery in Busan University Hospital. The detail of cases are as follows; 11 of 162 cases in pulmonary tuberculosis, 5 of 133 cases in empyema, 3 of 29 cases of mediastinal tumor and 7 of 155 cases of miscellaneous. rate of misdiagnosis in all cases was 6.5%. The author further discussed the factor of misdiagnosis in these cases and some diseases which were needed differential diagnosis.

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Coarctation of Aorta: A Report of 4 Cases (대동맥교약증 수술치험 4예)

  • 김용진
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.529-534
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    • 1978
  • Recent advances in the surgical treatment of congenital disorders of the heart have necessitated an accurate preoperative diagnosis. Right heart catheterization has become widely accepted as a research tool and diagnostic test to detect the heart diseases, especially in the congenital heart anomalies. Right heart catheterizations were carried out in 50 cases of congenital heart diseases at Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, during the period of June, 1975 through September 1978. In age distribution, 27cases were below 10 years of age, 18 cases between 11 and 20, and 5 cases above 20 male to female ratio was 2.8:1. The distribution of congenital heart diseases was VSD [42%], TOF [36%], PDA [10%], ASD [8%], and PS[4%]. Of these, 44 cases [88%], were compatible with the clinical impressions that were made preliminarily before cardiac catheterization, and all the cases except 1 case of VSD was correlated well with the postoperative diagnosis. The right heart catheterization is considered to be reliable and accurate toll in the preoperative diagnosis of congenital heart diseases. These procedures caused complications such as left side hemiplegia [lcase], occlusion of the femoral artery [lcase], and transient ventricular tachycardia [1case], and so the complication rate of right heart catheterization was 6% [3 cases]. None of patients who have undergone right heart catheterization was died.

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Right Heart Catheterization as Study of Congenital Heart Disease (선천성 심장질환에 있어서 우심도자법의 임상적 연구)

  • 김규태
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.523-528
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    • 1978
  • Recent advances in the surgical treatment of congenital disorders of the heart have necessitated an accurate preoperative diagnosis. Right heart catheterization has become widely accepted as a research tool and diagnostic test to detect the heart diseases, especially in the congenital heart anomalies. Right heart catheterizations were carried out in 50 cases of congenital heart diseases at Department of Thoracic and Cardiovascular Surgery, , Kyungpook National University Hospital, during the period of June, 1975 through September 1978. In age distribution, 27cases were below 10 years of age, 18 cases between 11 and 20, and 5 cases above 20 male to female ratio was 2.8:1. The distribution of congenital heart diseases was VSD [42%], TOF [36%], PDA [10%], ASD [8%], and PS[4%]. Of these, 44 cases [88%], were compatible with the clinical impressions that were made preliminarily before cardiac catheterization, and all the cases except 1 case of VSD was correlated well with the postoperative diagnosis. The right heart catheterization is considered to be reliable and accurate toll in the preoperative diagnosis of congenital heart diseases. These procedures caused complications such as left side hemiplegia [lcase], occlusion of the femoral artery [lcase], and transient ventricular tachycardia [1case], and so the complication rate of right heart catheterization was 6% [3 cases]. None of patients who have undergone right heart catheterization was died.

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A late onset solitary mediastinal cystic lymphangioma in a 66-year-old woman who underwent kidney transplantation

  • Lee, Jung Mo;Lee, Sang Hoon;Park, Youngmok;Kim, Chi Young;Goag, Eun Kyoung;Lee, Eun Hye;Park, Ji Eun;Lee, Chang Young;Kim, Se Kyu
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.155-158
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    • 2015
  • Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

Early Diagnosis and Intervention Are Needed for a Reasonable Prognosis of Thromboangiitis Obliterans

  • Miju Bae;Sung Woon Chung;Jonggeun Lee;Eunji Kim;Gayeon Kang;Moran Jin
    • Journal of Chest Surgery
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    • v.56 no.5
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    • pp.328-335
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    • 2023
  • Background: Thromboangiitis obliterans (TAO) poses a higher risk of amputation than atherosclerosis obliterans. It is characterized by onset at a relatively young age. There are currently no clear treatment guidelines for TAO other than smoking cessation. In this study, we aimed to identify factors that could influence a favorable prognosis of TAO. Methods: From January 2009 to December 2019, we retrospectively reviewed the initial symptoms, characteristics, treatments, and disease course of 37 patients (45 limbs) with TAO. Logistic regression analysis was performed to investigate factors affecting the course of symptoms that persisted or worsened despite treatment. Results: Patients' mean age was 37.2±11.4 years, and all patients were men. The mortality rate was 0% during the follow-up period (76.9±51.1 months). All patients were smokers at the time of diagnosis, and 19 patients (51.4%) successfully quit smoking during treatment. When comparing the Rutherford categories before and after treatment, 23 limbs (51.1%) showed improvement, the category was maintained in 11 limbs (24.4%), and 11 limbs (24.4%) worsened. Symptom persistence or exacerbation despite treatment was associated with a higher initial Rutherford category (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.04-2.42; p=0.03) and a higher score of the involved below-knee artery at the time of diagnosis (OR, 2.26; 95% CI, 1.10-4.67; p=0.03). Conclusion: The degree of disease progression at the time of diagnosis significantly affected patients' prognosis. Therefore, early diagnosis and intervention are important to improve the course of TAO.

Progression of NETs Correlating with Tumor-Related Diseases

  • Zhang, Le-Meng;Chen, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7431-7434
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    • 2015
  • As an important component of innate immune system, neutrophil has been involved in many other physiological processes, including tumor-related diseases. In 2004, the phenomenon of NETs was reported for the first time. Extracellular decondensed chromatin, released from activated neutrophils, forms a network structure, which is NETs. This review focuses on the function of NETs in tumor cell proliferation, metastasis, and tumor-associated thrombosis; it also explores the application of NETs specific markers in the diagnosis of pre-thrombotic state and tumor associated diseases; it also explores NETs inhibitor for the treatment of tumor-related diseases. In view of the rapid development of NETs, it may provide new therapeutic targets for tumor-associated thrombosis, and even tumor itself.

A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient (폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.372-377
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    • 2007
  • Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.