Biomedical subjects
Publications and source records attributed to Y W Bahk.
Two cases of segmental collapse of the upper lobe simulating an apical pleural effusion in association with pneumothorax are reported. Our cases differ from previously reported ones in that the peripheral collapse occurred in association with a pneumothorax without pleural adhesions, it was segmental rather than lobar, and was observed in adults.
A case report is presented in which there were computed tomographic (CT) findings of struma ovarii (SO) simulating a teratodermoid cyst. The patient was a 73-year-old woman with a painful mass in the lower abdomen. CT revealed a large complex mass with multiple cystic and solid components. One of the cysts had fat-fluid level and minor calcification in the wall. The histological findings were struma ovarii. To our knowledge, these CT findings have not been described previously. Our case demonstrates the importance of including struma ovarii in the CT differential diagnosis of teratodermoid cysts.
The present study has been carried out to enhance the specificity of computed tomography (CT) in diagnosing herniated nucleus pulposus (HNP) of the lumbar spine by the application of measure-set (MS) technic. MSCT scans of 20 patients with proven diagnosis of HNP were reviewed prospectively to sort out features of diagnostic value. Eleven were men and 9 were women with the mean age being 40 years. MSCT scan revealed dislocation of the center of the nucleus pulposus (NP) in direction of herniation in 75%, "permeation" of the annulus fibrosus (AF) by HNP material and a clear disruption of the outermost layer of AF in all patients. The site and grade of the protrusion of HNP beyond the normal saliancy of AF could be easily evaluated in 90%. The present study saliancy of AF could be easily evaluated in 90%. The present study revealed that MSCT can demonstrate four characteristic findings of HNP enabling one to directly and semiquantitatively assess the pathologic changes of NP.
Measure-set computed tomography (MSCT) scan was performed in 30 adult subjects (17 men and 13 women, mean age 42 years) and eight cadavers (five men and three women, mean age 42 years) to establish prospectively a normal CT pattern of the internal architectures of the lumbar disc. Based on the uniformity or nonuniformity of MSCT composition of the nucleus pulposus (NP) and annulus fibrosus (AF), and also on how well NP was discerned from the surrounding AF, the internal architecture could be categorized into well-defined (WD), intermediate (IM), and ill-defined (ID) types. An age and prevalence study of the categorized disc showed that, with age, the disc undergoes an architectural transformation from WD through IM to ID. In addition, 72.5% of WD-type discs and 72.1% of ID-type discs occurred in the third and fourth decades and in the sixth and seventh decades, respectively, suggesting that the former is a young form with mild degeneration and the latter an old form with advanced degeneration. Fifty-eight percent of WD-type discs and 60.4% of ID-type discs occurred at L1-3 and L4-S1 levels, respectively, regardless of age. This finding suggests the old form tends to occur at the lumbosacral junction, which is the site of maximum weight bearing in humans. The correlation of water content and histologic findings of degeneration with the three categorized disc types in cadavers showed that WD, IM, and ID discs were associated with the largest, intermediary, and least amount of water of NP, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
A patient with past history of esophageal stenosis complained of sudden dysphagia in the erect position which was relieved transiently in the supine position. Initial esophagoscopy failed to detect any mass in the lumen. Esophagogram revealed shifting foreign body from lower stenotic site to upper dilated area with postural change from the erect to the supine position. A French bean was detected and removed during the second esophagoscopy.
The informational gains obtained by the use of pinhole collimator scintigraphy (PCS) have been well documented. The present study has been undertaken to prospectively investigate its efficacy in diagnosing several commonly occurring spinal diseases. Patient material consisted of metastatic cancer (39 vertebrae), compression fractures (33 vertebrae), tuberculous spondylitis (17 vertebrae), and pyogenic spondylitis (six vertebrae). PCS findings were characterized in terms of localization, appearance, and homogeneity of abnormal radionuclide accumulation. Thus, metastatic cancer manifested as diffusely or focally homogeneous accumulation within the vertebral body or as a typical short-segmental accumulation along the end-plate, whereas compression fracture manifested as characteristic board-like accumulation along the entire length of end-plates. Tuberculous spondylitis, on the other hand, revealed homogeneous accumulation throughout the vertebral body, and pyogenic spondylitis revealed accumulation at the end-zone of opposing vertebral bodies giving sandwich-like appearance. The disk space at the affected level was not narrowed in the former two diseases but it was narrowed in the latter two. It was concluded that PCS may be useful in differentiating metastatic cancer, compression fracture, tuberculous spondylitis, and pyogenic spondylitis.
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The air meniscus sign occurs in a number of lung conditions, including infection, benign and malignant tumors, and hematoma. Sclerosing hemangioma does not appear to have been implicated previously in this connection. Two such cases are described. Possible mechanisms of air meniscus formation and its diagnostic value in sclerosing hemangioma are discussed.
Epidemic haemorrhagic fever is a viral disease characterized by acute febrile onset followed by profound renal dysfunction. The endemic areas are widespread throughout the Eurasian continent and the Japanese islands. The patient with EHF usually seeks medical care as an emergency for an "acute abdomen". Consequently the X-ray examination becomes an essential part of the clinical study. We analysed the plain abdomen and chest films of 62 patients with this disease. The radiologic manifestations represented diffuse capillary damage with resultant oedema and haemorrhage, particularly in the retro-peritoneal space. Abnormal findings were seen in 94% of the patients on the plain abdomen, and in 63% on the chest film. The most significant finding was obliteration and blurring of anatomical detail in both intra- and retro-peritoneal cavities and renal enlargement. We believe that simultaneous presence of oedema and effusion in both intra- and retro-peritoneal cavities along with renal enlargement is in practice pathognomic of EHF. Obliteration of the renal outline and cardiomegaly with overt lung oedema was associated with the most severe renal dysfunction.
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A case is presented in which massive retroperitoneal hemorrhage from the left first lumbar artery complicating a percutaneous renal biopsy was successfully controlled by superselective embolization with microcoils. An anterior radiculomedullary artery (artery of Adamkiewicz) originated from the lumbar artery. To minimize the risk of ischemic damage to the spinal cord from embolization, the extravasating branch of the lumbar artery had to be superselectively catheterized using a 3-F coaxial catheter system. Computed tomography (CT) scan localized the hematoma within the left posterior pararenal space in the retroperitoneal space.
We evaluated the CT of intestinal obstruction due to adhesions in 20 postoperative patients, with emphasis on early detection of strangulation. Ten patients with surgically proven strangulated obstruction (strangulation group) were compared with another ten patients (nonstrangulation group) in whom seven improved with conservative management and three had confirmed simple obstruction on surgical exploration. Beak-like luminal narrowing ("beak") was the most common CT finding at the obstructed site in both groups. The CT findings that suggested strangulated obstruction were serrated beaks, mesenteric edema or vascular engorgement, and moderate to severe bowel wall thickening. In contrast, simple obstruction could be assumed when the beak was smooth, there were no mesenteric changes, and the bowel wall was normal or mildly thickened. Computed tomography is a useful tool for detecting strangulation in patients with postoperative adhesive intestinal obstruction.
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