PURPOSE: The purposes of this study are to discribe the high-resolution computed tomographic (HRCT) findings of pulmonary histiocytosis X and to evaluate the relationship between the extent of the lesion on HRCT and pulmonary function test (PFT). MATERIALS AND METHODS: We retrospectively analyzed the HRCT findings of 8 patients with pathologically proved pulmonary histiocytosis X. The morphological pattern and incidence of the lesions were evaluated. The extent of the lesions were correlated with the results of PFT by calculating Spearman correlation. RESULTS: The most common HRCT findings were thick-walled cysts (n=8) followed by nodules (n=7). Other associated findings were reticulation, ground-glass opacification, and conglomerate nodules. The extent of the disease on HRCT was correlated inversely with percent predicted value of functional vital capacity. CONCLUSION: Common HRCT findings of pulmonary histiocytosis X were cysts with irregular wall thickening and nodules. The extent of the disease on HRCT correlated with the severity of restrictive pattern of PFT.
Histiocytosis, Langerhans-Cell* ; Humans ; Incidence ; Respiratory Function Tests ; Retrospective Studies ; Vital Capacity

Galeazzis frature has been described as a fracture of the radius complicated by a dislocation of the distal radioulnar joint. This fracture, with angulation of the distal radius and dislocation of the distal radioulnar joint, shows the tendency to redisplacement after reduction due to a variety of factors including the brachioradialis muscle, the pronator quadratus muscle and the thumb abductors and extensors. Because of these factors, this fracture may rarely be treated by manipulation and plaster immobilization alone. The treatment of choice for Galeazzis fracture is open reduction and internal fixation. The author reviewed the cases of 28 patients with Galeazzis fracture who had been treated at the Department of Orthopedic Surgery, Yonsei University Wonju College of Medicie from January 1978 to December 1986. This study emphasized the nature of the injury, the level of the radial fracture, treatment and results. The results were as follows ; 1. The subjects included 2 children and 26 adults. Males were affected more frequently than females, and the sex ratio was 6: 1 2. The causes of injury included car accidents in ten cases(36%), falls in eight cases(29%), injuries from machinery in five cases(18%), direct blows in four cases(14%) and explosion in one case(3%). 3. The fracture occured most often at the junction of the middle and distal thirds of the radial shaft in thirteen cases(47%), and less often in the middle third of the radial shat, eitht cases(29%). Infrequent sites of fracture included the junction of the proximal and middle thirds in four cases(14%), the distal third in two cases(7%) and the proximal third of the radius in one case(3%). 4. Twenty-two cases(78%) experienced fracture composed of only two fragmented, but six cases(22%) were multifragment fractures. The frature was oblique and in one case, spiral. In twenty-two cases, the fractures were closed and in six cases, open. Three cases of open fractures had grade III soft tissue injuries. 5. Roentgenograpghic diagnosis of the distal radioulnar joint disruption was possible in 82% of the cases. 6. Associated injuries were noted in 57% of the cases including six cases of head injuries, four cases of head injuries, two cases of injury to the lower extremities, two cases of spinal injury, one cases of a fractured humerus. 7. Conservative treatment was given in five cases and operative treatment twenty-two cases. Conservative treatment gave excellent results in one case, fair results in two cases, while operative treatment resulted in an excellent outcome in thirteen cases, a fair outcome in eight cases and poor in one case. 8. Six cases experienced complications including delayed union in two cases, subluxation of the distal radioulnar joint in two cases, ahgulation in one case and infection in one case.
Accidental Falls ; Adult ; Child ; Clinical Study ; Craniocerebral Trauma ; Diagnosis ; Dislocations ; Explosions ; Female ; Fractures, Open ; Gangwon-do ; Humans ; Humerus ; Immobilization ; Joints ; Lower Extremity ; Male ; Orthopedics ; Radius ; Sex Ratio ; Soft Tissue Injuries ; Spinal Injuries ; Thumb

PURPOSE: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(IPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. MATERIALS AND METHODS: We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40--85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. RESULTS: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower Iobe;10/19, left lower Iobe;5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). CONCLUSION: The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the [ocatiaon where the most advanced fibrosis occur.
Carcinoma, Squamous Cell ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Retrospective Studies

PURPOSE: To describe the radiological differences between tuberculous(TBB) and non-tuberculous bronchiectasis(NTBB). MATERIALS AND METHODS: Chest radiographs(n=62), bronchograms(n=18), and CT scans(n=52) of 37 patients with TBB and 25 patients with NTBB were reviewed retrospectively. Diagnostic basis for TBB were positive sputum AFB with or without history of anti-tuberculous chemotherapy(n=35), and radiological findings of pulmonary tuberculosis (n=2). Four of NTBB had a history of severe respiratory tract infection in childhood. RESULTS: Air-fluid levels on chest radiographs were seen in 2% of TBB, and 20% of NTBB. On bronchograms, all patients with TBB had combined focal bronchostenosis, whereas patients with NTBB had tubular(50%), cystic(17%), or mixed(33%) pattern of dilatation without stenosis. On CT scans, focal emphysema was seen in 86% of the patients with TBB, and 38% of the patients with NTBB. Peribronchiolar infiltration were seen in 78% and 44% of patients with TBB and NTBB, retrospectively. CONCLUSION: Basic radiological difference between TBB and NTBB was that the former had coexistent sten.
Bronchiectasis* ; Constriction, Pathologic ; Dilatation ; Humans ; Pulmonary Emphysema ; Radiography, Thoracic ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The characteristic radiographic and CT findings of Iobar atelectasis are well known. However, Iobar atelectasis is a dynamic process, and atypical presentations may occur due to a number of different causes. Familiarity with the various typical and atypical radiographic findings of Iobar atelectasis is important for correct diagnosis. The aim of this manuscript is to illustrate the spectrum of radiographic findings of Iobar atelectasis and to correlate the radiographic findings with the CT findings. The review will illustrate examples of typical and atypical Iobar atelectasis, including combined Iobar atelectasis, peripheral Iobar atelectasis, migrating Iobar atelectasis, rounded atelectasis involving the entire lobe and Iobar atelectasis mimicking paravertebral and mediastinal masses.
Diagnosis ; Pulmonary Atelectasis* ; Recognition (Psychology)

The characteristic radiographic and CT findings of Iobar atelectasis are well known. However, Iobar atelectasis is a dynamic process, and atypical presentations may occur due to a number of different causes. Familiarity with the various typical and atypical radiographic findings of Iobar atelectasis is important for correct diagnosis. The aim of this manuscript is to illustrate the spectrum of radiographic findings of Iobar atelectasis and to correlate the radiographic findings with the CT findings. The review will illustrate examples of typical and atypical Iobar atelectasis, including combined Iobar atelectasis, peripheral Iobar atelectasis, migrating Iobar atelectasis, rounded atelectasis involving the entire lobe and Iobar atelectasis mimicking paravertebral and mediastinal masses.
Diagnosis ; Pulmonary Atelectasis* ; Recognition (Psychology)

Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease(CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15mm in long diameter and 3mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (P=0.002), Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (P=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.
Collagen* ; Female ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Lymph Nodes ; Male ; Pleural Effusion ; Pulmonary Fibrosis

PURPOSE:We performed this study to evaluate the clinical significance and temporal changes of pleural effusion developed after the resection of hepatoma. MATERIALS AND METHODS: We reviewed retrospectively follow-up chest radiographs of 97 patients who had undergone operation for hepatoma and had no radiologically demonstrable postoperative complications. The duration of pleural effusion was classified into five groups and the amount of pleural effusion at one week after operation was graded into four groups. Statistical significance of the relationship between the duration, amount of pleural effusion and five factors, which are location and size of tumor, age of the patients, methods of operation, and preoperative liver function, was studied respectively. RESULTS:Pleural effusion was developed in 63.9% (62/97) and the mean duration was 2.5 weeks. In 92% (52/56), pleural effusion disappeared spontaneously within four weeks. Patients who had hepatoma in upper portion of the right lobe developed more frequent pleural effusion which persisted longer, and was larger in amount at one week after operation(p<0.05). There were no statistically significant differences between pleural effusion and the other four factors. CONCLUSION:Pleural effusion following hepatoma surgery should not be regarded as a sign of post-operative complication, as it invariably disappears spontaneously within four weeks. Development of pleural effusion is considered to be caused by local irritation and disturbance of lymphatic flow at the diaphragm.
Carcinoma, Hepatocellular* ; Diaphragm ; Follow-Up Studies ; Humans ; Incidence* ; Liver ; Pleural Effusion* ; Postoperative Complications ; Radiography, Thoracic ; Retrospective Studies