Truncus arteriosus is characterized by a single arterial vessel arising from the base of the heart and giving origin to the systemic, pulmonary and coronary circulation. To evaluate the incidence, types, and associated anomalies, 18cases of truncus arteriosus diagnosed by angiocardiography, were reviewed and were compared with other reports. Ten of them were confirmed by operation. The overall incidence of truncus arteriosus was 0.127%. Accordin to Collett and Edwards classification. Type I was encountered in 11cases(61%), type II in 4cases(22%), and type III in 3cases(17%), All the patients had subtruncal ventricular septal defects. Eight patients showed truncal valve regurgitation and valve stenosis was noted in one case. A right aortic arch was present in 9 cases. Associated anomalies were atrial septal defect(8cases), patent ductus arteriosus(3cases), coarctation of the aorta(2cases), isolation of the left subclavian artery(2 cases), and right aortic arch with an aberrant left subclavian artery(1case). Truncus arteriosus is an uncommon congenital cardio vascular malformation. In the group of cases which we encountered, type I was the most common anomaly. Frequently associated anomalies were right aortic arch, incompetent truncal valve and atrial septal defect.
Angiocardiography ; Aorta, Thoracic ; Classification ; Constriction, Pathologic ; Coronary Circulation ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence* ; Truncus Arteriosus* ; Vascular Malformations

PURPOSE: The purpose of our study was to identify the CT findings that help detect pleural dissemination from lung cancer and to evaluate the usefulness of selected diagnostic criteria. MATERIALS AND METHODS: After a computerized database search of 606 patients who had undergone thoracotomy for primary lung cancer, 23 patients were identified as h aving surgically documented pleural dissemination. From the same database, 50 patients without pleural dissemination during thoracotomy were randomly selected as controls. Preoperative CT scans and medical records were rev i ewed retrospectively, and findings were compared between the two groups. RESULT: One or more of three types of pleural thickening (plaque-like, nodular, and fissural) were identified on CT as the most discriminating finding (sensitivity, 74 % ; specificity, 60 %; p = 0.007). The following findings were also significantly discriminating (p<0.05): contiguity of primary tumor with the pleural surface as seen on CT; adenocarcinoma in cell type; and a peripheral tumor defined as one in which bronchoscopy revealed no endobronchial lesion. The use of combinations of these findings in addition to pleural thickening rendered diagnostic criteria more specific at the cost of the sensitivity. CONCLUSION: During preoperative CT evaluation of lung cancer, the recognition of subtle pleural thickening helps detect pleural dissemination. The likelihood that subtle pleural thickening represents pleural dissemination is increased when a primary tumor is contiguous with the pleural surface, is an adenocarcinoma, or is peripherally located.
Adenocarcinoma ; Bronchoscopy ; Humans ; Lung Neoplasms* ; Lung* ; Medical Records ; Retrospective Studies ; Sensitivity and Specificity ; Thoracotomy ; Tomography, X-Ray Computed

The pseudoaneurysms are resulted from complication of vascular catheterization, trauma, etc. and recently, the reports on pseudoaneurysms have been increasing. Successful treatment of pseudoaneurysms have been described usingdirect compression guided by color doppler ultrasound, instead of invasive surgical treatment. Authors experienced three cases of pseudoaneurysm ; two resulted from post-catheterization and one from trauma. We successfully treated two post-catheterization cases using C-clamp compression under the color doppler US-guidance. The traumatic case was treated by embolization instead of US-guided compression. We suggest that the compression of pseudoaneurysm using C-clamp under the US-guidance is more useful than hand or probe compression method.
Aneurysm, False* ; Arteries* ; Hand ; Ultrasonography ; Vascular Access Devices

PURPOSE: To evaluate factors influencing the CT assessment of mediastinal lymph node metastasis in patientswith non-small cell lung cancer. MATERIALS AND METHODS: CT scans of 198 patients who had undergone thoracotomyand mediastinal lymph node dissection for non-small cell lung cancer were retrospectively evaluated using a sizecriterion of > or = 10mm in the short axis. To evaluate the accuracy of CT in diagnosing lymph node metastasis on anodal station-by-station basis, CT and pathological results were correlated. Analysis included a comparison of thesensitivity and specificity of CT according to 1) cell type of tumor, squamous cell carcinoma versusadenocarcinoma (excluding bronchioloalveolar cell carcinoma) ; 2) histologic differentiation;3) tumor size;4)central and peripheral of the tumor;5) the presence or absence of obstructive pneumonitis and/or atelectasis;6)the presence or absence of prior granulomatous disease. RESULTS: The overall sensitivity, Specificity, positive predictive value, and negative predictive value of CT in diagnosing mediastinal lymph node metastasis were 65%,84%, 43%, and 93%, respectively. Sensitivity for squamous cell carcinoma (72%) was significantly higher than thatfor adenocarcinoma(44%)(p<0.01). Higher specificities were noted in patients without obstructive pneumonitisand/or atelectasis(91% versus 75%)(P<0.01), and with a peripherally located tumor (90% versus 82%)(P<0.01).sensitivity and specificity were not appreciably altered by other variables. CONCLUSION: In the CT assessment ofmediastinal lymph node metastasis the cell type of adenocarcinoma adversely affected sensitivity, with a highfrequency of normal-sized metastatic nodes. Obstructive pneumonitis caused by central tumor adversely affectedspecificity with the frequent occurrence of hyperplastc nodes.
Adenocarcinoma ; Axis, Cervical Vertebra ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Intravascular extension of malignancy is rare. Some cases of this have been reported, and these have mostly been seen in cases of lung cancer with extension into the pulmonary vein and left atrium. This is the first case of tumor involvement from the right atrium through the SVC to the azygous vein of the diaphragm level and all this was clearly visualized on 18FDG-PET/CT. A 68-year-old man was admitted for evaluation of SVC syndrome. Chest CT showed that the SVC was near completely obstructed by extension of tumor that had first invaded the thoracic spine and azygous vein. Multiple enlarged mediastinal lymph nodes were also noted. The pathologic examination of the biopsied tissues made the diagnosis of sarcomatoid carcinoma. The high metabolic activity within a thrombus on 18FDG-PET/CT has been suggested to indicate tumor thrombus because a blood thrombus typically shows lower metabolic activity that's caused by incorporated fibroblasts and endothelial cells within the thrombus (1). However, because some reports demonstrated that a high FDG uptake could also occur in a blood thrombus (2), the exact differentiation of the two by 18FDG-PET/CT seems to be difficult.
Aged ; Diaphragm ; Endothelial Cells ; Fibroblasts ; Heart Atria ; Humans ; Lung Neoplasms ; Lymph Nodes ; Positron-Emission Tomography ; Pulmonary Veins ; Spine ; Thorax ; Thrombosis ; Veins

PURPOSE: We performed this study to evaluate the most common site of the nasolacrimal systemic obstruction and causes of the nasolacrimal stent insertion failure and reobstruction following the insertion of the stent. MATERIAL AND METHODS: Nasolacrimal stent insertion was attempted in 26 cases(24 patients) of 30 cases (25 patients) with complete obstruction of the nasolacrimal system at the dacryocystography. We retrospectively assessed the obstruction site of nasolacrimal system, and evaluated the rate and causes of stent insertion failure and reobstruction following insertion of the stent on follow-up. RESULT: The obstructive sites of then asolacrimal system were junction level of the lacrimal sac and nasolacrimal duct(80%), common canaliculi(10%),and nasolacrimal duct(10%). In seven cases, we failed to insert the nasolacrimal stent. Four of the seven cases had a history of previous operation on paranasal sinus or nasolacrimal system. At 4 weeks follow up, epiphorare developed in four of 10 cases(reobstruction rate, 40%). Inflammatory process around the nasolacrimal duct stent was conndered to be the cause of reobstruction in two of the four reobstructed cases. CONCLUSION: Success rate of nasolacrimal duct stent insertion was 73%, and failure rate was 27%. The causes of the stent insertion failure included fibrosis and granulation tissue due to the previous operation around nasolacrimal duct system and paranasal sinus area. Inflammatory process around the stent caused recurrent obstruction.
Fibrosis ; Follow-Up Studies ; Granulation Tissue ; Nasolacrimal Duct* ; Stents*

No abstract available.
Lung ; Thorax

PURPOSE: We assessed the usefulness of resistive index(RI) on spectral analysis of Doppler sonography for differential diagnosis of benign and malignant breast lesions. MATERIALS AND METHODS: We retrospectively reviewed 29 benign and 22 malignant lesions of breast, which were examined preoperatively with color and duplex Doppler andwere confirmed by histopathologically after operation. We analyzed the average and distribution of RI in benignand malignant lesions. RESULTS: Although, there was no difference in the average values of RI in benign and malignant breast lesions, the distribution of RI was below 0.7 in eighteen cases (62%) of benign lesions, and above 0.7 in eighteen cases (82%) of malignant lesions. Thus, RI is valuable for differentiation between benignand malignant lesions of breast. CONCLUSIONS: Measurement of RI in breast disease using color and duplex Dopplerstudy is useful modality adjunct to the conventional ultrasonographic differentiation of benign and malignantlesions.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies

No abstract available.
Intestinal Obstruction ; Lung ; Lung Neoplasms ; Superior Mesenteric Artery Syndrome

Actinomycosis is an indolent infectious disease characterized by pyogenic response and necrosis, followed by intense fibrosis. The main forms of human actinomycosis are cervicofacial, pulmonary, and abdominopelvic type. Pulmonary actinomycosis accounts for 15% to 20% of total cases and unfortunately, clinical manifestations and radiologic findings are nonspecific. Small pleural effusion or empyema may develop in advanced disease but massive empyema is infrequent and rarely reported. We report a case of huge empyema caused by pulmonary actinomycosis in a 55 year-old man, presented with one-month history of productive cough and fever. The CT scan revealed a huge cavity with air-fluid level occupying the left hemithorax. Empyema caused by actinomycosis was confirmed microscopically by demonstration of sulfur granules in empyema sac through thracotomy. Decortication and surgical resection of empyema sac and destructed lung was accomplished and followed by intravenous infusion of penicillin G.
Actinomycosis* ; Communicable Diseases ; Cough ; Empyema* ; Fever ; Fibrosis ; Humans ; Infusions, Intravenous ; Lung ; Middle Aged ; Necrosis ; Penicillin G ; Pleural Effusion ; Sulfur ; Tomography, X-Ray Computed