Radiologic assessment in pulmonary lobar transplantation

Pulmonary lobar transplantation provides a clue to the acute donor shortage. To examine the experimental and clinical applicability of lobar transplantation, the authors observed the extent of lung expansion and infiltrate in the allografted lobe through the sequential analysis of the early chest roentgenograms. MATERIALS AND METHODS: Twenty two mongrel dogs weighting 17 kg on average were used. Donor lung bloc was taken and flushed with Euro-Collins solution. The left lower lobar bloc was procured and implanted in the pneumonectomized recipient dog. The anastomosis was performed in the order of the pulmonary vein, artery, and bronchus. To assess the radiological pattern in the lobar allograft, a grading system was designed according to the extent of lung expansion and infiltrate. RESULTS: A) Expansion pattern: Good to excellent lung expansion was seen on postoperative day 0 in 6 out of 10 dogs; on day 1, 4/7; day 2, 3/12; day 3, 1/1; and day 4, 1/3, respectively. Radiographs on day 6, 7, and 12 also showed good expansion in one dog. B) Lung opacity pattern: Clear to minimal infiltrates were seen on day 0 in 8 out of 10 dogs; day 1, 7/17; day 2, 2/12; and day 4, 1/3. The same appearances were detected in a single dog on day 6, 7, and 12. C) Expansion-opacity correlation pattern: Radiographs on postoperative day 0 showed good expansion with mild infiltrates, and excellent expansion with minimal infiltrates were observed on day 1 in 3 out of 17 dogs, day 2, 1/12; and day 4, 1/3, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Benign solitary pulmonary nodule: Value of high-resolution CT

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.

Benign solitary pulmonary nodule: Value of high-resolution CT

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.

Early allograft function in canine single lung transplant

An assessment of early graft function in canine single lung transplant recipients was made by analysing early postoperative radiographic progression, lung perfusion, bronchial patency and bronchial anastomotic wound healing and histopathology of the allografted lung. Eighteen mongrel dogs weighing 15kg on average were used. Donor lung bloc with a generous atrial cuff, the pulmonary artery and left bronchus were taken and flushed with Euro-Collins solution which implanted in the pneumonectomized recipient dog. Anastomosis was done with the atrium, pulmonary artery and bronchus in that order. To assess an early graft function, a protocol for a grading system was designed into the chest roentgenogram, lung perfusion scan, bronchial patency and histopathologic progression of the bronchial anastomosis and allografted lung (Table 1). The results were obtained as follows: Radiographically, clear to infiltrate was seen in 67% (8/12), 33% (5/15), 30% (3/10) and 33% (2/6) on postoperative day 0, 1, 2 and 3 respectively. Lobar to total opacification was 33% (4/12), 67% (10/15), 70% (7/10) and 67% (4/6) on days 0 to 3 (Table 2). Perfusion scan showed normal to mild defect in 43% (3/7) and moderate to severe defect in 57% (4/7) on day 0 and 100% (5/5) on day 2 (Table 3). The bronchial anastomotic site showed patent to mild stenosis in 100% (8/8) on day 0 and mild stenosis in 2/2 on day 9 bronchofiberscopically, and showed normal wound healing in 38% (3/8), cellular infiltration in 38% (3/8) and infarction in 25% (2/8) up to day 9 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Plain film findings of acute appendicitis -complicated vs. uncompli- cated cases-

No abstract available.

Post-ESWL(Extracorporeal Shock Wave Lithotripsy) Renal Hematoma: CT Evaluation / 대한비뇨기과학회지

Morphological changes of the kidney after ESWL in 130 patients are analyzed with CT at Dept. of Urology, Chung-Ang University Hospital from March 1987 to May 1987. Of 130 patients, 9 patients(6.9%) showed renal hematoma. Among 9 patients, 5 patients (3.8%) had subcapsular hematoma and 4 patients(3.1%) had parenchymal hematoma. We analyzed these 9 patients radiologically and clinically. These hematoma were clinically insignificant and self-limited in all cases. So ESWL can be regarded as a safe modality for treatment of the renal and ureteral calculi.

The metrizamide study in neuroradiologic diagnosis

The retrospective analysis on the clinical utility and side effects of the metrizamide myelography andmetrizamide CT-cisternography were made in 292 patients. Metrizamide CT proved valuable in the diagnosis ofintraspinal neoplasms with total block in myelography, demonstrating the upper margin of the neoplasms in a largenumber(75%) of the cases with neoplasm. Metrizamide study also clearly showed the nature and extent of thesyringomyelia, and arachnoid cyst. Metrizamide CT was also helpful in the diagnosis of spinal stenosis, spinaltrauma and infectious disease of the spine. The most common side effects were transient minor meningealirritations (headache, nausea, vomiting and dizziness)which persisted no more than 48 hours in most of thepatients. Five patients developed major complications such as grand mal seizure, toxic psychosis or asepticmeningits.

Radiological findings of the estragonadal endodermal sinus tumors in children

Endodernal sinus tumors(EST) are generally recognized as a germ cell tumors with extraembryonicdifferentiation that resemble the endodermal sinus of the rat placenta. Like other germ cell tumors the primaryEST may either occur in the gonads or in specific extragonadal sites. CT is the most accurate study in delineatingthe extent of primary and metastatic lesions particularly in the pelvis. Recently authors experienced six cases ofthe pathologically proven extragonadal endodermal sinus tumors in children and retrospectively analyzed theradiological findings including the CT. The results were as follows: 1 Of the 6 cases of extragonadal EST, theprimary lesion presented in the sacrococcygeal region in 5 patients and liver in one patient. 2. There were 4females and 2 males. Of the sacrococcygeal lesions 3 were females and 2 were males. 3. The age of presentationranged from 9 months to 3 years of age(mean age=21 months) 4. Conventional radiographic study of thesacrococcygeal lesion showed presacral, retrorectal soft tissue mass without calcification which extended into thebuttock. CT revealed well circumscribed enhancing soft tissue mass with irregular central low density areas. 5.Primay EST of the liver revealed ill-defined inhomogeneous mixed echogenic mass( ultrasound) and ill-defined lowdensity mass(CT). Angiography showed hypervascular mass with areas of necrosis and no evidence portal veininvasion. A-V shunting was not present. 6. Reginal lymph node metastasis was present at the time of diagnosis in 2cases of sacrococcygeal EST. 7. Local recurrence of tumor was noted in 2 patients with sacrococcygeal lesion aftersurgery and chemotherapy.

Radiological Findings of Pulmonary Aspergillosis

The pulmonary aspergillosis is a group of three separate diseases, comprising invasive aspergillosis, aspergilloma, and allergic bronchopulmonary aspergillosis, or a disease process in which one of three entities overlap with another process such as mucoid impaction, pulmonary infil t ration with eosinophilia, bronchocentric granulomatosis, microgranulomatous hypersensitivity, or asthma. The radiological findings of 24 cases of pulmonary aspergilloss diagnosed and treated at Seoul National University Hospital during the past 7 years were analyzed retrospectively. The results were as follows: 1. Final diagnosis of 24 cases of pulmonary aspergillosis was aspergilloma in 16 cases, invasive aspergillosis in 2 cases, variant form of allergic bronchopulmonary aspergillosis in 3 cases, and endobroncnial aspergillosis in 3 cases. 2. The underlying causes of the aspergilloma were healed tuberculous cavity in 6 cases, bronchiectasis in 8 cases, and no underlying cause were found in 2 cases. All the 16 cases of aspergilloma were correctly diagnosed without difficultly by demonstrating the intracavitary mass or air meniscus. 3. Radiological findings of the invasive aspergillosis in kidney transplant patients were multiple round nodules with early cavitation and formation of aspergilloma which shows slowly progressive cavitation over 13 months in one case, and diffusely scattered miliary nodules with occasional cavitation in the other case. 4. Classic allergic bronchopulmonary aspergillosis were not found in our series but variant form of ABPA was found in 3 young female patients. AII the three patients shows some degree of central bronchiectasis and combined aspergilloma was found in 2 cases. 5. Three patients diagnosed as endobronchial aspergillosis-saprophytic infection of aspergillus in the bronchial tree-by bronchoscopic biopsy shows nonspecific radiological findings.