• Korean Journal of Radiology
• /
• v.22 no.11
• /
• pp.1918-1928
• /
• 2021

Objective: With the recent development of various MRI-conditional cardiac implantable electronic devices (CIEDs), the accurate identification and characterization of CIEDs have become critical when performing MRI in patients with CIEDs. We aimed to develop and evaluate a deep learning-based algorithm (DLA) that performs the detection and characterization of parameters, including MRI safety, of CIEDs on chest radiograph (CR) in a single step and compare its performance with other related algorithms that were recently developed. Materials and Methods: We developed a DLA (X-ray CIED identification [XCID]) using 9912 CRs of 958 patients with 968 CIEDs comprising 26 model groups from 4 manufacturers obtained between 2014 and 2019 from one hospital. The performance of XCID was tested with an external dataset consisting of 2122 CRs obtained from a different hospital and compared with the performance of two other related algorithms recently reported, including PacemakerID (PID) and Pacemaker identification with neural networks (PPMnn). Results: The overall accuracies of XCID for the manufacturer classification, model group identification, and MRI safety characterization using the internal test dataset were 99.7% (992/995), 97.2% (967/995), and 98.9% (984/995), respectively. These were 95.8% (2033/2122), 85.4% (1813/2122), and 92.2% (1956/2122), respectively, with the external test dataset. In the comparative study, the accuracy for the manufacturer classification was 95.0% (152/160) for XCID and 91.3% for PPMnn (146/160), which was significantly higher than that for PID (80.0%,128/160; p < 0.001 for both). XCID demonstrated a higher accuracy (88.1%; 141/160) than PPMnn (80.0%; 128/160) in identifying model groups (p < 0.001). Conclusion: The remarkable and consistent performance of XCID suggests its applicability for detection, manufacturer and model identification, as well as MRI safety characterization of CIED on CRs. Further studies are warranted to guarantee the safe use of XCID in clinical practice.

• Journal of the Korean Society of Radiology
• /
• v.82 no.4
• /
• pp.994-999
• /
• 2021

Late recurrence over 10 years after surgery and endobronchial metastasis are some of the specific biological behaviors of renal cell carcinoma (RCC). The current report describes a case of solitary endobronchial metastasis at a subsegmental bronchus that developed 20 years after curative nephrectomy for RCC. A 71-year-old male was admitted to our hospital for pneumonia. Chest radiography showed multifocal ill-defined nodular opacities in the right lower lung zone, suggesting pneumonia. Subsequent chest CT confirmed pneumonic infiltration in the right lung. However, a 4.3-cm, well-defined, elongated mass with a branching pattern was also identified in the right lower lobe, and a right nephrectomy scar was detected on the covered upper abdomen. The patient had undergone right nephrectomy 20 years ago due to clear cell RCC. After right lower lobectomy, the postoperative pathological diagnosis was endobronchial metastatic clear cell RCC. Endobronchial metastasis should be considered in a patient with a history of RCC who presents with a suspected endobronchial tumor, even decades after curative surgery.

• Journal of Chest Surgery
• /
• v.47 no.4
• /
• pp.333-343
• /
• 2014

Background: A preclinical study was conducted for evaluating a valved conduit manufactured with a glutaraldehyde (GA)-fixed bovine pericardium treated using an anticalcification protocol. Methods: Bovine pericardia were decellularized, fixed with GA in an organic solvent, and detoxified. We prepared a valved conduit using these bovine pericardia and a specially designed mold. The valved conduit was placed under in vitro circulation by using a mock circulation model, and the durability under mechanical stress was evaluated for 2 months. The valved conduit was implanted into the right ventricular outflow tract of a goat, and the hemodynamic, radiologic, histopathologic, and biochemical results were obtained for 6 months after the implantation. Results: The in vitro mock circulation demonstrated that valve motion was good and that the valved conduit had good gross and microscopic findings. The evaluation of echocardiography and cardiac catheterization demonstrated the good hemodynamic status and function of the pulmonary xenograft valve 6 months after the implantation. According to specimen radiography and a histopathologic examination, the durability of the xenografts was well preserved without calcification at 6 months after the implantation. The calcium and inorganic phosphorus concentrations of the explanted xenografts were low at 6 months after the implantation. Conclusion: This study demonstrated that our synergistic employment of multiple anticalcification therapies has promising safety and efficacy in the future clinical study.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.4
• /
• pp.359-363
• /
• 2009

Immunoglobulin G4 (IgG4) related autoimmune diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation of numerous IgG4-positive lymphoplasma cells of varying origin, and a positive response to steroid treatment. Autoimmune pancreatitis, sclerosing cholangitis, and retroperitoneal fibrosis are representative presentations of IgG4 related autoimmune disease. Herein, we describe 2 patients (40-years-old woman and 47-years-old man) diagnosed with pulmonary involvement of IgG4-related autoimmune disease. The patients were admitted for an evaluation of the lung mass or multiple lung nodules found on chest radiography. Surgical lung biopsies were performed and pathologic finding revealed lymphoplasmacytic sclerosing inflammation with numerous IgG4 positive cells. The patients had elevated serum total IgG and IgG4 levels. Treatment consisted of high dose methylpredinisolone (1 mg/kg/day) and demonstrated good responsiveness. However, one patient experienced 2 relapses while being tapered off of steroid treatment.

• Tuberculosis and Respiratory Diseases
• /
• v.77 no.4
• /
• pp.193-196
• /
• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• Journal of Veterinary Clinics
• /
• v.25 no.3
• /
• pp.187-191
• /
• 2008

A 7-year-old, intact female Yorkshire terrier dog was presented for coughing, anorexia, chest pain and dyspnea. Right lateral thoracic radiograph demonstrated a large mass shape on the heart base with decreased cardiac silhouette and severe right deviation of the trachea with the heart shifted to the left thoracic wall was observed on the ventrodorsal thoracic projection. Echocardiographic examination revealed a large rounded mass compressing left atrium around the heart base without signs of pericardial effusion. On computed tomographic (CT) findings, sagittal CT images depicted the possibility of cranial vena caval invasion and heart base involvement of the mass associated with biatrial compression. Dorsal CT image revealed the right deviation of trachea due to the heart base mass and markedly shrunk lung space was detected on the transverse CT image. Because the dog suddenly had died during the recovery from anesthesia after finishing CT scan, necropsy was performed. On gross findings, a large and lobulated mass was located at the base of the heart. A poorly-demarcated, infiltrative, multilobulated tumor composed of polyhedral cells in solid cellular sheets was confirmed based on histopathologic examination. This dog was diagnosed as a chemodectoma. This case report describes the clinical findings, diagnostic consistency of thoracic radiography, echocardiography and CT, and histopathologic confirmation in a spontaneously occurring chemodectoma with a Yorkshire terrier dog.

• Journal of Oriental Neuropsychiatry
• /
• v.16 no.2
• /
• pp.35-42
• /
• 2005

Objective : The relations of the heart size and seven emotions were described in Dong Yi Bo Gam, and we aimed to identify the correlations of the patients with anxiety disorder and their heart sizes. Methods : The subjects were 15 patients with anxiety disorder and 20 control groups. Chest radiography were performed. We measured patients' heart sizes and compared with control groups. Results : 1. The signigicant difference of somatization, anxiety, depression scale and Panic anxiety scale in SCL-90-R in patients with anxiety disorder from controls was confirmed. 2. The difference of thoracic sizes in patients with anxiety disorder and controls had no correlations. 3. The difference of heart sizes in patients with anxiety disorder and controls had no correlations. 4. The difference of cardiothoracic ratio in patients with anxiety disorder and controls had negative correlations. Conclusions : Based on these results, the patients with anxiety disorders and their heart sizes had no correlations. But in cardiothoracic ratio had negative correlations. So heart size and seven emotions have significant correlation.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.3
• /
• pp.636-642
• /
• 1998

The frequency of fulminant peumonia due to Mycoplasma pneumoniae is relatively rare despite the high prevalence of Mycoplasma species infection in the general population. We report a case of mycoplasma pneumonia complicated with severe ARDS, overt hemolytic anemia and hepatitis. He had high titers of antimycoplasma antibody and cold agglutinin. Despite erythromycin administration, the pneumonic infiltration on chest radiography was not resolved, and mechanical ventilation was needed for 16 days. During the therapeutic course, his hemoglobin decreased. After the administration of prednisolone, his hemoglobin increased and pneumonic infiltration was totally resolved. He had a progressively favorable course and could be discharged in relatively good clinical condition.

• Journal of radiological science and technology
• /
• v.1 no.1
• /
• pp.44-54
• /
• 1978

This study was carried out with statistical materials during the last two years of period from Jan. 1975 to Dec. 1976 which presented at radiologic department of 5 hospitals in Seoul City. The primary purpose of this study was to obtained more detailed informations related to the activities of radiologic technologists in diagnostic X-Ray examinations part and to provide some basic materials for managements in activities of then and manpower managements of their organization and practice. From the results of this study, the following conclusions were obtained [1] During two year from the January of 1975 to the December of 1976, total number of case in X-ray examinations were 464,830 case and 22,029 case in 1975 and 24,461 in 1976. And ratio of icreased in X-Ray examinations by year was 11.09 per cent. [2] Regarding the examined portion of X-Ray examination, a great propotion was chest examination as 56.88 per cent. [3] An average, the required time per case in X-Ray exam. was 9.28 minutes and make used of 1.94 sheets of X-Ray film per case in radiography. [4] An average, ratio of increased in X-Ray film by year was 12.71 per cent and ratio of failed film in it was 2.23 per cent. [5] The frequency rate of film size showed the highest distribution of $8"{\times}10"$(28.17%) and the highest distribution of X-Ray film by month was July(8.93%). [6] An average, the amount of activities per a diagnostic X-Ray equipment was 34.92 case and make used of 67.81 sheets of X-Ray film in a day. [7] The mean number of case in X-Ray examinations by radiologic technologists was 29.29 cases and make used of 56.87 sheets of X-Ray film in a day. Also, the average number of case was reading by radiologists was 32.42 case and 62.97 sheets of X-Ray film in a day.

• Journal of radiological science and technology
• /
• v.32 no.2
• /
• pp.147-151
• /
• 2009

In general, the discrete confidence judgments that use five-step assessment method have been used to assess the medical images by ROC. TPF or FPF can be computed easily with this independent reading test. However, during experiments, it happens frequently that adequate distribution for observers is required to smoothly estimate the ROC curve. In addition, data becomes invalid for distribution of the created categories. To solve such problems or to apply the ROC interpretation to data that is not obtained from the experimental observation, the continuous confidence judgements (CCJ) has been proposed, which implements ROC interpretation using continuously-distributed experimental results without category classification has been used. As the use of CCJ to assess medical images was barely reported in Korea, we applied it to the assessment of chest digital images in this study. The results showed that a smooth ROC curve was obtained conveniently by the commercialized program and the characteristic value was measured easily. Therefore, it is recommended that this method can be applied to the assessment of digital medical images.