• Title/Summary/Keyword: effusion

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Tuberculous Pericarditis Mimicking a Malignant Pericardial Tumor: A Case Report (악성 심막 종양으로 오인한 결핵성 심막염: 증례 보고)

  • Ji Young Park;Ji-Yeon Han;Jinyoung Park;Gi Won Shin;Su Young Yun;Mi Seon Kang;Da Som Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.197-203
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    • 2024
  • Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

Electronic Cigarette or Vaping-Associated Lung Injury Manifested as Acute Eosinophilic Pneumonia: A Case Report (급성호산구성폐렴으로 발현된 전자담배 관련 폐 손상: 증례 보고)

  • Thomas J Kwack;Cherry Kim;Sung Ho Hwang;Hwan Seok Yong;Yu‑Whan Oh;Eun‑Young Kang
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.298-303
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    • 2023
  • Electronic cigarette or vaping-associated lung injury (EVALI) is a disease defined by lung injuries caused by e-cigarette use. It predominantly manifests in forms of organized pneumonia or diffuse alveolar damage but rarely as acute eosinophilic pneumonia (AEP). This report describes a 34-year-old male with acute respiratory symptoms and a vaping history of only nicotine. Chest CT revealed peripheral distributing multiple patchy consolidations and ground-glass opacities dominant in both lower lobes, bilateral diffuse interlobular septal thickening, and bilateral pleural effusion without cardiomegaly. Bronchoalveolar lavage fluids showed increased eosinophilia levels, while infectious laboratory results were all negative, enabling the diagnosis of both AEP and EVALI. Herein, we report a rare case of only-nicotine vaping EVALI manifested as AEP.

Surgical Resection of Cardiac Hemangiosarcoma Using Articulated Surgical Stapler in a Dog

  • Woo-Jin Kim;Kyung-Min Kim;Won-Jong Lee;Chang-Hwan Moon;Hae-Beom Lee;Seong-Mok Jeong;Dae-Hyun Kim
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.37-42
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    • 2024
  • This case report discusses the successful surgical resection of cardiac hemangiosarcoma in a dog using an articulated surgical stapler. Cardiac tumors, particularly hemangiosarcomas, have a poor prognosis. Recommended treatment involves surgical removal of the primary tumor, along with chemotherapy. However, the use of staples for cardiac tumor resection has not yet been extensively documented in the veterinary literature. A 10-year-old dachshund with pericardial effusion underwent surgery to remove a right atrial mass. An articulated linear cutting stapler was used for tumor resection. The patient experienced chylothorax as a complication but recovered well. However, the patient later developed respiratory symptoms and died, most likely due to aspiration pneumonia. The surgical stapler provided stability, convenience, and a shorter surgical time during tumor resection. Surgical resection combined with chemotherapy improves the survival of dogs with cardiac hemangiosarcoma. The stability and adjustability of the stapling device make it advantageous for cardiac tumor resection. Although complications, such as chylothorax, can arise, appropriate management can lead to positive outcomes. This case report demonstrates the feasibility and safety of using an articulated surgical stapler for cardiac tumor resection in dogs. Insights from this case can guide future research and clinical practice.

Analysis of Description of Diffusion Phenomena in the 7th Grade Textbook and Diagnosis of Science Teachers' Understanding of the Diffusion Concepts (7학년 교과서의 확산현상 기술에 대한 분석과 과학교사들의 확산개념에 대한 이해도 조사)

  • Koo, Sun-Ah;Chae, Hee-K.
    • Journal of The Korean Association For Science Education
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    • v.28 no.5
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    • pp.383-394
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    • 2008
  • We analyzed the description of diffusion phenomena in a 7th-grade textbook, and investigated teachers' understanding and teaching methods on diffusion concepts. The data were collected from textbook analysis and questionnaires from 46 science teachers and interviews with 5 teachers. Based on texts' analysis by definition, example, and representation of the diffusion, we found that most of the representations were macroscopically explained by observing the movement of ink in water and smelling the fragrance of perfume in the air. The analysis of questionnaire and interviews also revealed that the definition and the explanation of the diffusion were too abstract for teachers to understand and teach the concept without further information about the microscopic concept of collision of the matter with the medium. Such examples and models lead science teachers to form indistinctive concepts such as dissolution, effusion, and evaporation. Furthermore, the analytical data showed that teachers' understanding of the diffusion concept has been heavily dependent upon the textbook and the level of the understanding was very similar with that of textual description.

Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements

  • Hend M. Esmaeel;Kamal A. Atta;Safiya Khalaf;Doaa Gadallah
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.80-90
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    • 2024
  • Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.

Large Cell Carcinoma of the Lung - An analysis of clinical features and survival (대세포 폐암의 임상적 양상과 생존률에 대한 분석)

  • Yang Jin Yeong;Lee Hyung Sik;Moon Sun Rock;Kim Gwi Eon;Suh Chang Ok;Loh Jojn J.K;Oh Won Yong;Whang In Soon
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.219-223
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    • 1990
  • This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan.1985 and Dec.1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, $78.8\%$. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor,19($57.6\%$) appeared in the right lung and 14 ($42.4\%$) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs.16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.),2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was $14.3\%$ while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).

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The Effect of Pleurodesis with Doxycycline in the Rabbit (토끼에서 Doxycycline을 이용한 흉막유착 효과)

  • Won, Kyoung-Sook;Park, Keon-Uk;Jeon, Won-Ho;Baik, Jae-Jung;Jeong, Yeon-Tae;Suh, Jung-Il;Son, Jin-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.531-536
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    • 1994
  • Background: The intrapleural instillation of tetracycline for pleural sclerosis had been most commonly used in patients with symptomatic malignant pleural effusion or recurrent pneumothorax for a long time. Unfortunately, at a time of expanding use of this agent, the production of injectable tetracycline hydrochloride used for pleurodesis was discontinued by its sole manufacturer in mid-1991 because the manufacturer was unable to meet US Food and Drug Administration purity standards. So we performed a preliminary study of doxycycline, as a alternative pleural sclerosant on rabbit pleura and compared its efficacy with that of tetracycline. Method: Eighteen New Zealand white rabbits weighing 2 to 3kg(mean 2.6kg) were devided into three groups. In each groups, one tetracycline(20 mg/ml/kg) and two doxycycline solutions(7 mg/ml/kg and 20 mg/ml/kg) instillated into the right pleural space through an 18-gauge angiocath with care to prevent pneumothorax. All rabbits were sacrificed after 28 days. Results: 1) In the group of tetracycline 20 mg/ml/kg(six rabbits), five rabbits showed partial pleural symphysis with several fibrous bands, and one rabbit died on 22th day. 2) In the group of doxycycline 7 mg/ml/kg(six rabbits), three rabbits showed partial pleural symphysis and the other three rabbits showed complete pleural symphysis without necrosis of underlying parenchymal lung tissue. 3) In the group of doxycycline 20 mg/ml/kg(six rabbits), two rabbits showed complete pleural symphysis without lung necrosis, another two rabbits showed complete pleural symphysis with lung necrosis, and the other two rabbits died on 4th and 13th day, respectively. Conclusion: We concluded that doxycycline is a highly effective sclerosing agent having stronger pleurodesis effect with that of tetracycline by dose base and its optimal dosage was considered as 7 mg/ml/kg with minimal complications.

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The Clinical Usefulness of Spiral CT Angiography in the Diagnosis of Pulmonary Thromboembolism (폐색전증 진단에서 나선식 전산화 단층촬영 혈관조영술의 임상적 유용성)

  • Kim, Woo-Gyu;Lim, Byung-Sung;Kim, Mi-Young;Hwang, Hweung-Kon
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.669-680
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    • 1999
  • Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

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A Nested Cauldron Structure in the Tertiary Miocene Eoil Basin, Southeastern Korea (한반도 동남부 제3기 마이오세 어일분지내 둥지형 화산함몰구조)

  • Son, Moon;Kim, In-Soo;Ock, Soo-Seok
    • The Journal of the Petrological Society of Korea
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    • v.10 no.2
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    • pp.121-131
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    • 2001
  • The combination of geological, structural and satellite image studies is used to make an examination of the Miocene eruptive type in the Eoil Basin, SE Korea. The basin subsided by the NW-SE extension due to NNW dextral shearing during the East Sea opening. Based on geological structures as well as lithofacies and ages of the basin-fills, it is divided into the NE subbasin and the SW subbasin which were abundantly filled with basaltic volcanics and marine sediments without volcanic materials, respectively: Syndeposional synclines and anticlines are characteristically developed in the NE subbasin, which amplitudes decrease away from the adjacent normal faults to make them into a homoclinal structure. The thicker lavas as well as the younger agglomerates and lacustrine sediments, which show circular distributions, are distributed around the axial zones of major synclines. The satellite image shows four remarkable circular structures within the NE subbasin. They are located adjacent to and along the normal faults, and they are laid almost exactly on the axial zones of the synclines as well as on the distribution area of the agglomerates and lacustrine sediments. These facts indicate that the basaltic lava effusion were conducted by the normal faults like a kind of fissure-eruption and its activity was more predominant at the sites in where the synclines are developed. More active effusion of lava became a reason for deeper subsidence to make differential subsidence and syndepositional folding adjacent to and along the normal faults. Hence, we suggest that a nested cauldron structure was formed in the NE subbasin of the Eoil Basin, and that the volcanism made the subbasin to be a lava pond and controlled the process of filling and sedimentation in the subbasin.

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The Role of Chest CT Scans in the Management of Empyema (농흉에서 전산화 단층촬영의 의의)

  • Heo, Jeong-Suk;Kwun, Oh-Yong;Sohn, Jeong-Ho;Choi, Won-Il;Hwang, Jae-Seok;Han, Seung-Beom;Jeon, Young-June;Kim, Jung-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.397-404
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    • 1994
  • Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

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