Differentiation between Morgagni Hernia and Pleuropericardial Fat with Using CT Findings / 대한흉부외과학회지

BACKGROUND: Generally hernia is diagnosed with simple chest or gastrointestinal x-ray. Sometimes CT or MRI can give lots of information for the diagnosis. However, there was no study for the differentiation with using CT findings between Morgagni hernia and pleuropericardial fat. The aim of this study was to evaluate the useful CT findings for differentiating Morgagni hernia from pleuropericardial fat. MATERIAL AND METHOD: We retrospectively analyzed CT scans of eight patients with Morgagni hernia and 20 patients with abundant pleuropericardial fat without peridiaphragmatic lesions. All CT scans were performed with coverage of the whole diaphragm in the inspiration state. We evaluated 1) the presence of the defect of the anterior diaphragm, 2) the interface between the lung and fat, 3) the angle between the chest wall and fat, 4) the continuity between the extrapleural fat and fat, 5) the presence of the vessels within fat, and 6) the presence of a thin line surrounding fat. RESULT: In all cases with Morgagni hernia, the defect of the anterior diaphragm was seen. The interface was well-defined, smooth, and convex to the lung. The angle with the chest wall was acute. The continuity with the extrapleural fat was not seen. In the cases with abundant pleuropericardial fat, the defect of the anterior diaphragm was seen in three (15%). The interface was usually irregular (n=10) and flat (n=17). The angle with the chest wall was variable. The continuity with the extrapleural fat, that was markedly increased in amount, was usually seen (n=16). The thin line surrounding fat was seen in four cases with Morgagni hernia, however, not seen in all cases with pleuropericardial fat. All of the above findings were statistically significant, however, vessels within fat was not significant to differentiate Morgagni hernia (n=8/8) from pleuropericardial fat (n=14/20). CONCLUSION: The useful CT findings of Morgagni hernia were fatty mass with sharp margin, convexity toward lung, acute angle with chest wall, and thin line surrounding hernia. Branching structure within fatty mass representing omental vessels that has been known as a characteristic finding of Morgagni hernia was not useful for differentiating Morgagni hernia from pleuropericardial fat.

Effect of Hot Pack Therapy on the Blood Flow of Lower Extremities

OBJECTIVE: To evaluate quantitative changes in arterial blood flow in the legs and systemic changes in blood flow after hot pack therapy on a leg. METHOD: It was conducted on 60 legs of 30 adults without the symptom of peripheral vascular disease. The blood flow of both popliteal arteries were recorded before and after hot pack therapy on a leg. Also, the blood pressure and pulse rate were recorded every two minutes using a pulsimeter. T-test was done to examine differences between blood flow of the popliteal artery on both legs before and after hot pack therapy. Paired t-test was used to examine differences in each leg before and after hot pack therapy and systemic effect after hot pack therapy. RESULTS: After hot pack therapy, there were statistically meaningful changes in all the variables except the popliteal arterial diameter in a leg with hot pack therapy, whereas there were no significantly meaningful changes in a leg without therapy. Pulse rate was changed significantly, but blood pressures were not. CONCLUSION: There were an increase in regional arterial blood velocity and blood flow, skin temperature, and a reduction in peripheral resistance in a leg with hot pack therapy, but no meaningful changes without thrapy. There is no evidence of reflex vasodilatation. There is no meaningful changes in blood pressure, but an increase in pulse rate.

A Case of Spontaneous Renal Artery Dissection Causing Renal Infarction in a Previously Healthy Man / 대한신장학회잡지

Spontaneous renal artery dissection is an uncommon cause of renal infarction. Previous reports of spontaneous renal artery dissection has been associated with hypertension or fibromuscular dysplasia. We report herein the case of a previously healthy, normotensive patient with renal infarction due to spontaneous renal artery dissection who remained normotensive throughout his course without therapy. A previously healthy 31-year-old man with well- documented normotension had a sudden onset of right flank pain and delayed onset of elevation of lactic dehydrogenase, hematuria, and proteinuria. Thin section spiral computerized tomogram shows linear intraluminal filling defect suggesting intimal flap. Angiography shows dissection of main right renal artery. Six months later, he has remained well and normotensive without therapy. To our knowledge, this is the first case of spontaneous renal artery dissection in normotensive patients in Korea.

The abnormalities of immune function ib schizophrenics(III) / 신경정신의학

No abstract available.

Psychoneuroimmunology: stress, depression, schizophrenia and the immune system / 신경정신의학

No abstract available.