PURPOSE: To describe CT findings and differential points of cystic thymic lesions. MATERIAL AND METHOD: We evaluated retrospectively total 19 masses with well marginated cystic lesions at thymic area on CT scans. They were 10 teratomas, 3 congenital thymic cysts, 2 multilocular thymic cysts(associated with thymoma and myasthenia gravis in each), 2 cysts Assciated with thymic Hodgkin's lymphomas an ectopic parathyroid cyst, and an infected thymic cyst. The radiological abnormalities evaluated were thickness of the wall, presence or abscene of septa, mural nodule, solid component, calcification and fat component. RESULTS: All three cases of congenital thymic cysts and an ectopic parathyroid cyst appeared as thin-walled unilocular cyst with homogeneous internal density and without identifiable solid component. In multilocular thymic cyst, there were thick wall and solid components(n=2), thick internal septa and calcifications(n=l). The cysts of teratomas manifested thick walls(n=9), internal septa(n=4), calcifications(n=6), fat components(n=4), and solid components(n=4). Cysts in Hodgkin's diseases appeared as multilocular or unilocular and had thick wall and septa without calcification. infected thymic cyst presented with multilocular cystic mass with identifiable wall and septa, calcification, and solid components. CONCLUSION: The thymic diseases with cystic lesion include teratomas, congenital thymic cysts, multilocular thymic cysts, parathyroid cyst, .and Hodgkin's disease. Congenital thymic cyst and ectopic parathyroid cyst are thin-walled unilocular cystic lesions. Cystic lesions associated with teratoma, Hodgkin's disease, and multilocular thymic cyst are thick-walled cystic lesions with or without solid component.
Hodgkin Disease ; Mediastinal Cyst ; Myasthenia Gravis ; Retrospective Studies ; Teratoma ; Thymoma ; Tomography, X-Ray Computed

A 21-year-old woman presented with productive cough and hemoptysis. Chest radiograph shows a large thin-walled cystic lesion with an air-fluid level in medial portion of the left lower lung zone and opacity in paravertebral area of the right lower lung zone. Chest CT scan shows a thin-walled cavitary lesion in the posterior basal segment of left lower lobe with an air-fluid level. Area of consolidation containing air-filled cysts was also observed in medial aspect of right lower lobe. Selective angiogram obtained from aberrant artery arising from descending abdominal aorta showed two main branches of the artery supplying bilateral pulmonary lesions.
Aorta, Abdominal ; Arteries ; Bronchopulmonary Sequestration* ; Cough ; Female ; Hemoptysis ; Humans ; Lung ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Young Adult

PURPOSE: To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. MATERIALS AND METHODS: Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidence, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. RESULTS: Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. CONCLUSION: Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion.
Adenocarcinoma ; Biopsy* ; Biopsy, Fine-Needle* ; Bronchi ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chest Tubes ; Diagnosis ; Drainage ; Hemoptysis ; Humans ; Lymph Nodes ; Needles ; Neoplasm Metastasis ; Pneumothorax ; Spine ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

No abstract available.
Down Syndrome* ; Leukemia, Megakaryoblastic, Acute*

Body fluid Lactate dehydrogenase and its isoenzyme Measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudates in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudates and the activity of LD4 isoenzyme was also incereased compared with that of serum (P<0.05). 3. The inflammatory exudates of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity statistically compared with that of serum and malignant exudates (P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.
Ascites ; Ascitic Fluid ; Body Fluids* ; Erythrocyte Count ; Exudates and Transudates ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid* ; Leukocyte Count ; Leukocytes ; Liver Cirrhosis ; Peritonitis ; Pleural Effusion, Malignant ; Pleurisy

Antimicrobial susceptibility of the bacterial strains isolated from clinical specimens during the period from June, 1983 to June, 1986 in Yeungnam Medical Center was studied and the following results were obtained. 1. Staphylococcus aureus was highly susceptible to cephalothin and its susceptibility to methicillin was gradually reduced. 2. Streptococcus strains except enterococcus were generally susceptible to penicillin, while most enterococci were susceptible to only ampicillin. 3. Gram-negative rods including Escherichia coli were highly susceptible to amikacin and tobramycin. 4. Serratia were generally less susceptible to the amtimicrobials tested than other Enterobacteriaceae. Among them, Serratia marcescens showed the highest susceptibility to amikacin and chloramphenicol. 5. Pseudomonas aeruginosa revealed the highest susceptibility to amikacin and tobramycin and moderate susceptibility to carbenicillin and gentamycin. 6. Acinetobacter calcoaceticus revealed low susceptibility to most antimicrobials tested, showing only 30% susceptibility to amikacin, tobramycin and gentamycin in 1986.
Acinetobacter calcoaceticus ; Amikacin ; Ampicillin ; Bacteria* ; Carbenicillin ; Cephalothin ; Chloramphenicol ; Enterobacteriaceae ; Enterococcus ; Escherichia coli ; Gentamicins ; Methicillin ; Penicillins ; Pseudomonas aeruginosa ; Serratia ; Serratia marcescens ; Staphylococcus aureus ; Streptococcus ; Tobramycin

PURPOSE: We analysed the role of modified Gianturco self-expandable stents in the treatment of tracheobronchial stenosis in 13 patients. MATERIALS AND METHODS: We inserted modified Gianturco self-expandable stents under the fluoroscopic and bronchoscopic guidance. There were stenosis in the trachea(n--2), the right main bronchus(n=2), and the left main bronchus(n=9). The causes of the stenosis were endobronchial tuberculosis(n=10), intubation granuloma (n=l), restenosis after surgical reconstruction(n=2). RESULTS: Dyspnea or wheezing was improved within 1 or 2 days following the procedure. There were 32% and 22% respective increase in average FEV1 and FVC. Lung perfusion scan showed 9.6% increase of perfusion in the involved lung. No complications related to the procedure were encountered. During follow-up period of up to 31 months, 2 patients showed tracheal or bronchial restenosis, at 3 and 6 months, retrospectively. There was a distal migration of the stents in one case. CONCLUSION: During the follow up period after stent insertion, improvement of the obstructive changes and dyspnea persisted in 10 out of 13 patients. The modified Gianturco self-expandable metallic stents may be a good choice for the treatment of tracheobronchial stenosis, either as a primary treatment, or when the reconstruction failed.
Constriction, Pathologic* ; Dyspnea ; Follow-Up Studies ; Granuloma ; Humans ; Intubation ; Lung ; Perfusion ; Respiratory Sounds ; Retrospective Studies ; Stents*

PURPOSE: The purpose of this study was to determine the following:the safety of fine needle aspiration biopsy in immunocompromized children with radiographic features of Pneumocystis car/nil pneumonia, its diagnostic rate in those groups and the appropriate radiographic stage for fine needle aspiration biopsy to prove the etiologic agent. METHODS AND MATERIALS: We retrospectively reviewed the patient records of 16 children with immune compromizing diseases who had undergone fine needle aspiration biopsy of the lung. They showed the infectious sign of the lung along with the radiographic pattern of diffuse pulmonary disease, suggesting Pneumocystis carlnil pneumonia. All patients had underlying lymphoreticular malignancies including 14 acute lymphocytic leukemia and 2 non Hodgkin's lymphoma. According to the radiographic pattern of biopsy site, parenchymal disease was categorized as fine reticulonodular density(n=4), ground-glass opacity(n=9) and compact consolidation(n=3). We assessed the diagnostic rate of Pneumocystis carinii pneumonia and complications in each of the three groups. RESULTS: A diagnosis of Pneumocystis carinii pneumonia was established by fine needle aspiration biopsy in 9 patients(56%) including 2 of 4 patients with fine reticulonodular density, 4 of 9 patients with ground-glass opacity, and all 3 patients with compact consolidation. Four patients(25%) developed pneumothorax, and three of them required tube insertion. There was no patient who developed hemoptysis. CONCLUSION: Fine needle aspiration biopsy is a safe and easy method that can yield Pneumocystis carinii organism at a relatively high rate in immunocompromized children with diffuse pulmonary lesions suopicions of Pneumocystis carinii pneumonia. We recommend performing fine needle aspiration biopsy regardlesss of radiographic patterns when Pneumocystis carinii pneumonia is suggested.
Biopsy* ; Biopsy, Fine-Needle* ; Child* ; Diagnosis ; Hemoptysis ; Humans ; Lung Diseases ; Lung* ; Lymphoma, Non-Hodgkin ; Pneumocystis ; Pneumocystis carinii ; Pneumonia* ; Pneumonia, Pneumocystis ; Pneumothorax ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies

13 cases of atypical meningioma were analysed, which were proven surgically S.N.U.H. for 3 years since Marach,1979. CT findings of atypical meningioma were central low density in 8 cases, large cyst in 4 cases, calcifiedmass in 1 case and non-specific scalp mass in 1 case. All the CT findings of atypical meningioma werepathologically proven as follows. Central low density was tissue necrosis in 5 cases, multiple cyts in 2 cases andhemorrhage in a case. Large cyst was arachnoid cyst in all 4 cases. Calcified mass was massive calcium depositionon tumor. Non-specific scalp mass on temporal area was meningioma involving soft tissue, bone and dura.
Arachnoid ; Bone and Bones ; Calcium ; Meningioma ; Necrosis ; Scalp

Popular use of intravascular catheterization of both diagnostic and therapeutic purposes led to increase in iatrogenic intravascular foreign bodies for which percutaneous removal has been accepted as the treatment of choice. The majority of percutaneously removed intravascular foreign bodies are located in the right side of the heart, large veins, and pulmonary arteries and intraarterial foreign body is rare. We recently experienced a case of intraarterial fragmented catheter which was removed with a basket percutaneously without any complication.
Catheterization ; Catheters ; Foreign Bodies* ; Heart ; Pulmonary Artery ; Veins