Evaluation of acute aortic dissection by intravascular ultrasonography.
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Acute Disease↗
Biomedical subjects
O J Kwon
Publications and source records attributed to O J Kwon.
Pulmonary diffuse alveolar septal amyloidosis--diagnosed by transbronchial lung biopsy.
Diffuse alveolar septal involvement is a rare form of pulmonary amyloidosis. Antemortem diagnosis is unusual, and most of the reported cases were diagnosed at autopsy. It has recently been reported that transbronchial lung biopsy via a flexible fiberoptic bronchoscope was a relatively safe method to confirm diffuse alveolar septal amyloidosis. We report a case of pulmonary diffuse alveolar septal amyloidosis confirmed by transbronchial lung biopsy. The patient's chief complaints were dyspnea on exertion and epigastric pain aggravated over a one-year period, while a chest roentgenogram showed bilateral diffuse interstitial infiltration. This case also showed nephrotic syndrome, cardiac arrhythmia, congestive heart failure, a tingling sensation in both hands and multiple nodules in the gastrointestinal tracts, suggesting involvement of the kidney, heart, peripheral nerves and gastrointestinal tracts. We propose that when diffuse interstitial lung disease is present with systemic signs such as nephrotic syndrome or cardiac arrhythmia, amyloidosis should be considered as a possible diagnosis. Also, transbronchial lung biopsy may be a useful confirmative diagnostic tool.
Amyloidosis↗
Translumbar carotid arteriography.
In seven patients, carotid arteriography and arch aortography were performed using a translumbar catheter exchange sheath which facilitated selective catheterization. No significant complications occurred. The translumbar approach is easier than the axillary approach, will result in fewer complications, and should be considered whenever a femoral arterial access is unavailable.
Aged↗
Percutaneous transluminal renal angioplasty. A potentially effective treatment for preservation of renal function.
Percutaneous transluminal renal angioplasty (PTRA) was performed in a group of 12 patients with marked renal functional impairment, severe hypertension, and critical renovascular stenoses in a solitary functioning kidney (ten patients) or bilaterally (two patients). The procedure led to least partial dilation in 11 of the 13 stenoses acted on and stabilization or modest improvement in renal function in seven of the 11 patients in whom some technical success had been achieved. Moreover, the severity of the patients' hypertension appeared to be favorably affected following PTRA. Complications that were encountered included three episodes of nonoliguric acute renal failure, a thrombotic occlusion of a renal artery, a tear of the balloon segment of the catheter requiring femoral arteriotomy, and an episode of gastrointestinal tract bleeding. Percutaneous transluminal renal angioplasty may be an effective modality in the treatment of patients with severe renovascular stenosis, renal functional impairment, and hypertension.
Acute Kidney Injury↗
Percutaneous replacement of biliary T tubes.
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Biliary Tract↗
The heparin-induced thrombocytopenia and thrombosis syndrome: treatment with intraarterial urokinase and systemic platelet aggregation inhibitors.
We report a case of the heparin-induced thrombocytopenia and thrombosis syndrome presenting with acute ischemia of a lower limb. The patient was successfully treated by withdrawal of heparin products, intraarterial urokinase, and platelet anti-aggregation therapy consisting of Dextran and aspirin.
Angiography↗
Exchange-donor program in renal transplantation: a single-center experience.
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Family↗
Conjoined gastric and mediastinal benign cystic teratomas. Case report of a rare occurrence and review of literature.
Teratomas are embryonal neoplasms which arise from totipotential cells and contain elements from all three germ layers (ectoderm, mesoderm, and the endoderm). Simultaneous occurrence of mediastinal and gastric teratomas in infants has not been reported, although gastric teratomas extending into the mediastinum have been reported twice in literature. We report here a case in which a gastric cystic teratoma was connected to its mediastinal counterpart with a pedicle. The pertinent literature is reviewed.
Diagnostic Imaging↗
Bronchiolitis in adults: pathology and imaging.
The most common high resolution CT (HRCT) findings of bronchiolitis are centrilobular nodules and branching linear structures in the secondary pulmonary lobules or areas of air trapping. These findings can be helpful in suggesting the presence of bronchiolitis. However, they are nonspecific because there are overlapping features among various kinds of bronchiolitis. Bronchiolar or peribronchiolar inflammation appears as centrilobular nodule, while bronchiolectasis filled with secretions manifests with branching linear structure on HRCT. Air trapping is secondary to bronchiolitis. Proliferative bronchiolitis with the findings of patchy areas of consolidation or ground-glass opacity can be distinguished from other bronchiolitis. Mineral dust-induced bronchiolitis and peribronchiolar lesions in sarcoidosis present with perilymphatic (centrilobular plus perilobular) micronodules in the secondary pulmonary lobule. Bronchiolitis in hypersensitivity pneumonia appears with poorly defined centrilobular nodules, associated with ground-glass opacity and air trapping.
Adult↗
Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings.
PURPOSE: The purpose of this work was to describe the radiologic findings of pulmonary tuberculosis in patients who presented with acute respiratory failure. METHODS: We included patients who had newly diagnosed active pulmonary tuberculosis and who presented with acute respiratory failure. Initial chest radiographic (n = 17) and high-resolution CT (n = 11) findings of each patient were analyzed retrospectively. RESULTS: Of 1,010 patients with active pulmonary tuberculosis, 17 patients (1.7%) presented with acute respiratory failure. Nine (53%) of the 17 patients died. The most common initial chest radiographic findings were small nodular lesions (16/17; 94%), consolidation (13/17; 76%), and ground-glass opacity (12/17; 70%). Eleven (69%) of 16 nodular lesions, 9 of 13 (69%) consolidations, and 10 of 12 (83%) ground-glass opacities were bilateral. On HRCT (n = 11), miliary micronodular lesions were seen in 6 patients (55%), whereas bronchogenic spread of tuberculosis with disseminated centrilobular nodules and tree-in-bud appearance was seen in 5 patients (45%). Diffuse areas of ground-glass attenuation were seen in all six patients with miliary nodules and four of five patients with bronchogenic spread of tuberculosis. CONCLUSION: Patients with pulmonary tuberculosis occasionally present with acute respiratory failure. In this condition, chest radiograph most commonly shows bilateral small nodular lesions mixed with consolidation or ground-glass opacity, whereas HRCT demonstrates findings of miliary or bronchogenic disseminated tuberculosis with diffuse areas of ground-glass attenuation.
Acute Disease↗
Squalene-induced extrinsic lipoid pneumonia: serial radiologic findings in nine patients.
PURPOSE: The purpose of this work was to demonstrate the initial and follow-up radiologic findings of squalene-induced extrinsic lipoid pneumonia. METHOD: Follow-up chest radiographs (n = 9) and high-resolution CT scans (n = 3) as well as initial radiographs (n = 9) and CT scans (n = 8) were obtained in nine patients with squalene-induced extrinsic lipoid pneumonia. The serial radiologic findings were analyzed retrospectively by three chest radiologists, focusing on the pattern and distribution of parenchymal abnormalities. RESULTS: The most frequent pattern of parenchymal abnormalities on chest radiograph was areas of ground-glass opacity (n = 9, bilateral 6), followed by consolidation (n = 7, bilateral 3) and poorly defined small nodules (n = 4, bilateral 2). The abnormalities were distributed in the right lower lung (n = 9), left lower lung (n = 6), and right middle lung (n = 6) zones. Initial CT scans (n = 8) demonstrated bilateral areas of ground-glass attenuation (n = 8), poorly defined centrilobular nodules (n = 8), crazy paving (n = 6), and consolidation (n = 3). The abnormalities were distributed in the right middle lobe (n = 8) and in both lower lobes (n = 5). Follow-up chest radiograph (n = 9) showed complete disappearance (n = 2) and decrease (n = 7) in the extent of the parenchymal abnormalities. Follow-up CT scans (n = 3) demonstrated decrease (n = 2) and no change (n = 1) in the extent of the abnormalities. CONCLUSION: Squalene-induced extrinsic lipoid pneumonia most commonly appears as areas of ground-glass attenuation mixed with poorly defined centrilobular nodules and crazy paving on CT, being distributed mainly in the right middle and both lower lobes. The lesions are indolent and remain after cessation of squalene ingestion.
Adolescent↗
Pulmonary tuberculosis: CT and pathologic correlation.
Typical CT findings of active postprimary pulmonary tuberculosis include centrilobular nodules and branching linear structures (tree-in-bud appearance), lobular consolidation, cavitation, and bronchial wall thickening. The CT findings of inactive pulmonary tuberculosis include calcified nodules or consolidation, irregular linear opacity, parenchymal bands, and pericicatricial emphysema. The typical appearance of primary tuberculosis on CT scans is homogeneous, dense, well-defined segmental or lobar consolidation with enlargement of lymph nodes in the hilum or the mediastinum. Miliary nodules may be seen in primary and postprimary tuberculosis. On CT, tuberculomas appear as a nodule with surrounding satellite nodules and internal cavitation on CT. Atypical radiologic manifestations of tuberculosis, encountered in as many as one third of the cases of adult-onset tuberculosis, are single or multiple nodules or masses, basilar infiltrates, miliary tuberculosis with diffuse bilateral areas of ground-glass opacity, and reversible multiple cysts. Underlying histopathologic findings of typical and atypical CT findings of tuberculosis are caseating granulomas or pneumonia in the active phase and fibrosis and dystrophic calcification in the inactive phase.
Adult↗
T1 lung cancer on CT: frequency of extrathoracic metastases.
PURPOSE: To determine the frequency of extrathoracic metastases in T1 non-small-cell lung cancer. METHOD: Ninety patients with T1 lung cancer identified on CT were included. Extrathoracic metastases were evaluated at the time of initial diagnosis and during a 1-year follow-up study. The frequency of metastases was compared in terms of cell type (squamous or nonsquamous), size (<2 cm or >2 cm), and the initial CT findings of the tumor. RESULTS: Extrathoracic metastases were identified in 12 (13%) of 90 patients at the time of diagnosis and in 10 patients at the 1-year follow-up study (total, 22 of 90 [24%] patients). Tumors with ground-glass opacity on CT were associated with a significantly lower prevalence of metastases (p = 0.042). The area of ground-glass opacity was seen in 1 of 13 (85%) patients with bronchioloalveolar carcinoma and in 12 of 53 (23%) patients with adenocarcinoma other than bronchioloalveolar carcinoma (p < 0.001). There was no significant difference in the prevalence of metastases between squamous and nonsquamous cell carcinoma, between tumors smaller than 2 cm (n = 17) and larger than 2 cm in diameter (n = 73) and between tumors with or without mediastinal nodal metastases (p>0.05). CONCLUSION: Extrathoracic metastases were apparent at the initial examination in 13% of patients and at the 1-year follow-up examination in 11% of patients. The prevalence is significantly lower in tumors with ground-glass opacity.
Carcinoma, Non-Small-Cell Lung↗
Evaluation of tracheobronchial disease with helical CT with multiplanar and three-dimensional reconstruction: correlation with bronchoscopy.
The advantage of volumetric computed tomography in the thorax is the possibility of acquiring both multiplanar and three-dimensional (3D) images, thus enabling precise diagnosis and evaluation of extent of disease involving the airways. Multiplanar and 3D images appear to be useful for global understanding of the status of the tracheobronchial tree, particularly for evaluation of focal stenosis of the airways. Such images seem to be especially useful in evaluating the longitudinal extent of airway lesions, thus providing valuable information for preparing a road map for bronchoscopy, for surgical planning, and for follow-up of treatment response. However, multiplanar and 3D images do not appear to be useful in lesion detection or evaluation of transaxial extension. Multiplanar and 3D images also seem to be helpful in demonstrating whether a lesion is endobronchial, submucosal, or peribronchial. The quality of such images appears to be excellent or good in almost all patients.
Adult↗
The loss of p27 protein has an independent prognostic significance in gastric cancer.
BACKGROUND: p27 and cyclin E are regulators of the G1 to S phase transition. This study was performed to determine whether two cell cycle regulators--p27 and cyclin E--provided prognostic information in gastric cancer patients. MATERIALS AND METHODS: A total of 115 gastric cancer patients were eligible for this study from Jan. 1988 through Dec. 1994, and their paraffin blocks were chosen for immunohistochemical staining against p27 and cyclin E. RESULTS: Consequently, 35 patients were stained positively for p27 (30.4%) and 24 for cyclin E (20.9%). A high level of p27 expression was more frequently observed in intestinal type (43.9%) than in diffuse (23.0%) (p = 0.019). Concerning patients' survival, univariate analysis showed that the depth of invasion (p = 0.043), the number of metastatic nodes (p = 0.024) and the expression of p27 (p = 0.031) were significant prognostic factors. In particular, p27 negative group showed a worse overall survival than their counterpart (42.42 +/- 9.63% Vs 26.63 +/- 4.17%). On multivariate analysis by Cox regression model, the expression of p27 (p = 0.048) and number of metastatic nodes (p = 0.026) were significant prognostic factors on overall survival. CONCLUSIONS: Loss of the p27 protein has independent prognostic significance in gastric carcinomas, and whether p27 negative gastric cancer requires more radical therapies can be elucidated by future clinical trials.
Adult↗