Acute Pulmonary Oxygen Toxicity in Rats: Findings and Lung Density Changes in High Resolution Computed Tomography

PURPOSE: To evaluate imaging findings and lung density changes after 95% oxygen inhalation in rat. MATERIALS AND METHODS: A total of 18 rats were divided into three groups on the basis of inhalation time: group I(n=6) inhaled 95 % oxygen for 24 hours, and group II(n=6) for 48 hours, group III(n=6) for 60 hours. A control group(n=6) inhaled room air(21% oxygen). Chest radiograph and high resolution computed tomography were performed, and pathologic and imaging findings were compared. RESULTS: Chest radiograph showed abnormality only in group III. High resolution CT, however, revealed abnormal findings in all three groups : diffuse ground glass opacity in groups I, II and III, additional focal patchy consolidation at the peripheral portion in group II, and diffuse consolidation in group III. Lung density was sig-nificantly higher in group I than in controls(p 0.05). In group III, density was significantly higher than in group II. The lung density changes seen in all groups showed a bilateral diffuse increased pattern. but, in group III, changes were more severe in the central, peripheral and posterior portion of the lower lung. Ground glass opacity and focal patchy consolidaton seen on HRCT were found on pathologic examination to be due to alveolar cell hyperplasia and septal thickening. Consolidation was caused by alveolar edema and hemorrage. Pathologic lesions were randomly distributed in both lungs. CONCLUSION: One HRCT images, rat exposed to hyperoxia showed ground glass opacity, patchy consolidation and diffuse consolidation. Depending on exposure time, the pathologic findings also indicated increased lung density and a bilateral, diffuse distribution pattern, as well as alveolar cell hyperplasia and septal thickening, alveolar edema and hemorrage. HRCT may be more helpful than simple X-rays for the early detection of pulmonary oxygen toxicity.

CT and MR Findings of Bronchial Anthra cofibrosis

PURPOSE: To evaluate the CT and MR findings of bronchial anthracofibrosis. MATERIALS AND METHODS: Forty-one patients with ronchoscopically confirmed bronchial anthracofibrosis were included in this study. Thirty-six were female and five were male, and all were aged between 53 and 89 (mean, 70) years. The CT (n=41) and MR findings (n=5) were retrospectively analysed with regard to bron-chostenosis, atelectasis, air-space consolidation, lymph node enlargement, calcified lymph node, mass and bronchial wall thickening, as seen on CT, and signal intensity of the mass and lymph nodes, as seen on MR. RESULTS: CT scans revealed the presence of bronchostenosis (n=34, 83%), atelectasis (n=24, 59%), pneumonic consolidation (n=26, 63%), enlarged mediastinal lymph node (n=39, 95%), calcified lymph node (n=22, 54%), mass (n=4,10%), and thickening of bronchial wall (n=1, 2.4%). Multifocal involvement of bron-chostenosis, atelectasis, and air-space consolidation occurred in 61%, 50% and 30% of cases, retrospectively. MR imaging showed low signal intensity of mass (n=3) and lymph nodes (n=10) on T1WI and T2WI. but in one case, mass and lymph node showed central high signal intensity on T2WI. CONCLUSION: A multiplicity of bronchostenosis, atelectasis, air-space consolidation and enlarged mediastinal lymph nodes were characteristic CT findings of bronchial anthracofibrosis. Most MR findings included relatively low signal intensity of masses and lymph nodes on T2WI, possibly indicating the benign nature of the diseases

Evaluation of the Embolic Effect of Polyvinyl Alcohol Foam particles According to Particle Size on the Cerebral Artery of a Cat, Focusing on T2 Weighted MR Images and Pathologic Study After 24 Hours

PURPOSE: This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. MATERIALS AND METHODS: A total of 21 cats were divided into three groups according to the PVA particle size injected: group I(n=7), embolized with 45-150 micrometer PVA; group II(n=7), with 150-250 micrometer PVA; and group III(n=7), with 350-500 micrometer PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. RESULTS: On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group Iand in two of the seven (29%) in group II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 +/-1 . 37 % in group Iand 5.18 +/-1 . 77% in group II( P <0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries(MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II. No group IIIcat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175 micrometer in Group Iand 258 micrometer in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. CONCLUSION: Small PVA particles had a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150 micrometer in size are appropriate.

Evaluation of the Embolic Effect of Polyvinyl Alcohol Foam particles According to Particle Size on the Cerebral Artery of a Cat, Focusing on T2 Weighted MR Images and Pathologic Study After 24 Hours

PURPOSE: This study was designed to determine the embolic effect of PVA particles of various sizes on the cerebral artery of a cat and to determine the appropriate particle size for embolization. MATERIALS AND METHODS: A total of 21 cats were divided into three groups according to the PVA particle size injected: group I(n=7), embolized with 45-150 micrometer PVA; group II(n=7), with 150-250 micrometer PVA; and group III(n=7), with 350-500 micrometer PVA. PVA particles were slowly injected into the left common carotid artery of each cat, and T2-weighted coronal MR images were obtained 24 hours after injection. During histologic examination of brain sections we analyzed the size, number of occluded vessels, and the ischemic changes caused by the particles. RESULTS: On T2 weighted images, areas of high signal intensity (infarction) were observed in four of the seven cats (57%) in group Iand in two of the seven (29%) in group II. High signal intensity was not found in group III. The mean percentage of areas of high signal intensity was 11.86 +/-1 . 37 % in group Iand 5.18 +/-1 . 77% in group II( P <0.05). During histologic examination, occlusion of the distal branches of the anterior cerebral (ACA) and/or the middle cerebral arteries(MCA) by PVA particles was observed in all seven cats (100%) in group I, and in four of the seven cats (57%) in group II. No group IIIcat showed occlusion of the distal branches of the ACA and/or MCA. The mean caliber of occluded vessels was 175 micrometer in Group Iand 258 micrometer in Group II. The mean number of occluded vessels seen on all slide sections was 14 in Group I and 5 in Group II. CONCLUSION: Small PVA particles had a greater cerebral embolic effect than did those which were medium or large. For the induction of embolic infarction in cat brain, PVA particles 45-150 micrometer in size are appropriate.

Rhabdomyolysis and localized myositis associated with amitiptyline overdose / 대한내과학회지

Widespread use of amitriptyline in clinical practice has led to extensive knowledge of its therapeutic and toxic effects. In cases of amitriptyline overdose, delirium, arrhythmia, convulsion, and adult respiratory distress syndrome have been reported, but amitriptyline-associated rhabdomyolysis has been rarely reported in the literature. Several drugs are associated with myositis or myopathy, but amitriptyline-related myositis has not been reported. We describe a 40-year-old woman with rhabdomyolysis and localized myositis in left proximal thigh after she had taken 625mg of amitriptyline.

New Film-Cassette System to Obtain Wider Field of Craniocaudal View Compared with Conventional Technique in Screening Mammography

PURPOSE: To evaluate the efficacy of a newly designed cassette and film system used to obtain a craniocaudal(CC) image during mammographic examination. MATERIALS AND METHODS: We designed a film-cassette system for use inobtaining a CC image. The merit of this system is that the contact plane between the film and film cassette andthe thoracic wall of the examinee changed from linear to concave, thus including more tissue on the image. Twentywomen examined by screening mammography underwent conventional and new CC plane examinations. The distance fromthe nipple to the posterior margin of the included breast tissue, as seen on CC mammograms, was measured using thetwo techniques, and the difference between the respective results was analyzed by paired t-test. RESULTS: Thedistance from the nipple to the posterior margin was 12.9 +/-1.7cm and 14.5 +/-1.4cm at the lateral portion of theconventional and new CC image, respectively. This distance was thus significantly greater on the new than on theconventional image (p<0.001), but there was no significant difference between their me-dial portions. CONCLUSION:The newly designed cassette and film system used to obtain a craniocaudal image during mam-mography includes morebreast tissue than the conventional system and may be helpful for the mammograph-ic screening and diagnosis ofperipheral breast lesions.

A comparison of Bone SPECT, MRI, and Arthroscopy for the Evaluation of Chronic Knee Pain / 대한류마티스학회지

OBJECTIVE: This study was undertaken to evaluate the value of bone single photon emission computed tomography(SPECT), simply radiography, magnetic resonance imaging(MRI), and arthroscopy to see the severity of osteoarthritis(OA) and the meniscal tear in patients with chronic knee pain. METHOD: Total 25 patients who had chronic knee pain and suspected meniscal tear during the period from May 1997 through June 1998 were included in the study. The simple radiography, bone SPECT and MRI were performed in all 25 patients. The arthroscopy was done in 17 patients and arthroplasty in four. In order to see the severity of OA, the arbitrary grading was done by SPECT, and kellgren-Lawrence grading by simple radiography and Outerbridge grading by arthroscopy were used. RESULTS: In 21 patients, bone SPECT and MRI with either arthroscopy or arthroplasty were done. Among the seventeen of these 21 patients who had a meniscal tear either by arthroscopy or arthroplasty, the meniscal tears were found in 15 patients by SPECT, and 14 patients by MRI. Spearman rank correlation coefficient between SPECT grading and arthroscopic grading was 0.814, and the coefficient between simple radiographic grading and arthroscopid grading was 0.360. CONCLUSION: The bone SPECT of the knee seems to be more cost-effective in comparison to MRI and arthroscopy to see the severity of OA and the meniscal tear in patients who has chronic knee pain.

Sclerosing mesenteritis associated with skin panniculitis and pleural thickening / 대한내과학회지

Sclerosinng mesenteritis is a rare disease that occurs most often among middle aged man. Fewer than 200 cases have been reported in the literature. It is a benign mesenteric lesion characterized by fat necrosis, fibrosis and chronic inflammation. The pathogenesis of this disease is unclear through an autoimmune origin has been proposed. The disease is generally localized and self- limiting. Fatal case is rare but has been reported. In patients with biopsy proven sclerosing mesenteritis having a relentless downhill course, treatment with prednisolone and oral cyclophosphamide in isolated case report has lead to evident clinical and radiological responses. This is a report of a case of sclerosing mesenteritis, who presented to us with history of colicky abdominal pain and weight loss. She was treated with prednisone and intravenous cyclophosphamide pulse therapy and resulted in radiological and clinical improvement. Interestingly this case has associated with skin panniculitis and pleural thickening. The skin panniculitis also showed good response to prednisolone. Our case is the first in which sclerosing mesenteritis was associated with pleural thickening.

CT and MR Findings of Meningioangiomatosis

PURPOSE: To characterize the CT and MR findings in patients with meningioangiomatosis(MA). MATERIALS AND METHODS: Four patients (18 to 53 years old, two females and two males) with MA were retrospectively reviewed. CTwas used in four cases and MR in three. Pathologic specimens were obtained from all four. RESULT: All lesions were located in the cortical and subcortical areas and showed spotty(n=1), popcornlike(n=2), or gyral(n=1) calcification. The mass were associated with surrounding edema and gliosis. In two patients, lesions were multiple and were accompanied by eccentric cysts. CONCLUSION: MA is a surgically correctable benign disease. Its radiologic characteristics are cortical or subcortical mass with various calcifications, associated peripheral edema and gliosis.

Mucocele in Concha Bullosa: A Case Report

Mucocele of concha bullosa is rare and can be misdiagnosed as an intranasal tumor mass. We report a case ofmucopyocele of the concha bullosa.

Esophageal Achalasia: Results of Balloon Dilation

PURPOSE: To evaluate the clinical effectiveness of fluoroscopically guided balloon dilation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Under fluoroscopic guidance, 21 balloon dilation procedures were performed in 14 patients with achalasia. A balloon with a diameter of 20mm was used for the initial attempt. Ifthe patient tolerated this well, the procedure was repeated with a 10-20 mm balloon, placed alongside at the same session. If, however, the patient complained of severe chest pain and/or a postprocedural esophagogram showed an improvement, the additional balloon was not used. For patients whose results were unsatisfactory, the dilation procedure was repeated at sessions three to seven days apart. RESULTS: Succesful dilation was achieved in 13 of 14patients(92.9%), who needed a total of 20 sessions of balloon dilation, ranging from one to three sessions perpatient(mean, 1.54 sessions). Esophageal rupture occured in one of 14 patients(7.1%) ; of the 13 patients who underwent a successful dilation procedure, 12(92.3%) were free of recurrent symptoms during the follow-up periodof 1-56(mean, 18.5) months. The remaning patient(7.7%) had a recurrence seven months after dilation. CONCLUSION: Fluoroscopically guided balloon dilation seems to be safe and effective in the treatment of esophageal achalasia.

Ischemic Colitis Proximal to Obstructing Colonic Carcinoma: Values of CT in Its Detection

PURPOSE: To determine the value of the CT scan in distinguishing an ischemic and a tumoral segment in coloniccarcinoma complicated by proximal bowel ischemia. MATERIALS AND METHODS: CT scans of twenty patients with ischemic colitis proximal to obstructing colonic carcinoma were reviewed retrospectively. The presence of anischemic segment proximal to colonic carcinoma were patho-logically confirmed in 12 patients, and the remaining eight patients showed typical radiologic findings of bowel ischemia on barium enema but on pathologic review showed only colonic carcinoma. CT scans were analyzed for the location, wall thickness, length, and enhancing pattern of both tumoral and ischemic segments in correlation with barium enema or surgico-pathologic results. Theresults of tumor staging shown on CT scan were compared with those of pathologic findings. RESULTS: On CT scan adistinction between ischemic and tumoral segments could be made in 15 patients (75%). The ischemic segments were contiguously proximal to the tumoral segment in 18 patients. In two patients, however, there was an intervening segment of normal bowel between the two segments and this was confirmed by pathology. Maximvm bowel wall thickness ranged from 0.8 to 4.5cm (mean, 2.0cm) in tumoral segments and from 0.6 to 1.5 cm (mean, 1.0cm) in ischemic segments (p<0.05). Tumoral segments were enhanced heterogeneously in 12 patients (60%) and homogeneously in the remaining eight, while ischemic segments were enhanced homogeneously in 14 patients (70%) and heterogeneously insix. Peripheral rim enhancement was seen only in the ischemic segments of four patients (20%). Comparing TNM tumorstaging of the CT scan with that of pathology, CT scan overstaged in two patients (10%) and understaged in one(5%). CONCLUSION: CT is a valuable tool for distinguishing an ischemic from a tumoral segment in patients with ischemic colitis proximal to colonic carcinoma. An understanding of this pathologic entity could reduce the possibility of over or understaging in cases of colonic carcinoma.

Use of methylcellulose in Small-Bowel Follow-Through Examination: Comparison with Enteroclysis and Conventional Series in Normal Subjects

PURPOSE: To evaluate the efficacy of a modified small bowel follow-through (SBFT) and to optimize this technique. MATERIALS AND METHODS: Ninety-nine subjects without small bowel pathology underwent modified SBFT using oral administration of methylcellulose after taking 100ml of 120% or 100, 150, or 200ml of 70% barium. Thirty-three and 39 normal subjects undergoing enteroclysis or conventional SBFT, respectively, were also evaluated for comparison of image qualities and transit time. RESULTS: Enteroclysis was the most successful ofthree types of small bowel examination for obtaining the best quality of bowel transradiency and distension. Modified SBFT was, however much superior to the conventional series for obtaining good bowel transradiency and rapid transity time (mean, 37-49 minutes). The use of 150ml of 70% barium was better than the other three modified techniques in achieving good bowel transradiency, rapid transit time, and less flocculation. CONCLUSION: Our modified SBFT is a simple and safe method for easily improving bowel transradiency and transit time.

Hyperdense Dots Mimicking Microcalcifications: Mammographic Findings

PURPOSE: To differentiate fine hyperdense dots mimicking microcalcifications from true microcalcifications on mammography. SUBJECTS AND METHODS: Mammograms showing hyperdense dots in ten patients (mean age, 59 years) were evalvated. Two radiologists were asked to differentiate with the naked eye the hyperdense dots seen on tenmammograms and proven microcalcifications seen on ten mammograms. Densitometry was also performed for all lesions and the contrast index was calculated. The shape and distribution of the hyperdense dots were evaluated and enquiries were made regarding any history of breast disease and corresponding treatment. Biopsies were performed for two patients with hyperdense dots. RESULTS: Two radiologists made correct diagnoses in 19/20 cases(95%). The contrast index was 0.10-0.88 (mean 0.58) for hyperdense dots and 0.02-0.45 (mean 0.17) for truemicrocalcifications. The hyperdense dots were finer and homogeneously rounder than the microcalcifications. Distribution of the hypendense dots was more superficial in subcutaneous fat (seven cases) and subareolar area(six cases). All ten patients with hyperdense dots had history of mastitis and abscesses and had been treated byopen drainage (six cases) and/or folk remedy (four cases). In eight patients, herb patches had been attached. Biopsies of hyperdense dots did not show any microcalcification or evidence of malignancy. CONCLUSION: These hyperdense dots were seen mainly in older patients. Their characteristic density, shape, distribution and clinical history makes differential diagnosis from true microcalcifications easy and could reduce unnecessary diagnostic procedures such as surgical biopsy.

An operative treatment of osteogenic sarcoma / 대한정형외과학회잡지

No abstract available.