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: 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 increase in size of lymph node on Ct scan is the single most important finding of lymphadenopathy. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with idiopathic pulmonary fibrosis with no evidence of malignancy or current infection. CT scans of 70 patients (16 with conventional CT and 54 with high-resolution CT) were assessed for lymph node size and locations. The duration of symptoms, and the extent and patterns of the parenchymal lung disease on CT scans were correlated with lymph node enlargement. In 54 of 70 patients, more than one lymph nodes were larger than 1-1.5cm. The prevalence of mnode enlargement increased significantly with a longer duration of symptom (p=0.001), larger extent of the disease (p=0.043), and with a greater proportion of honeycomb pattern (p=0.0344). Right paratracheal, subcarinal, right tracheobronchial, and paraesophageal nodes were the most common sites of nodes enlargement. In conclusion, mediastinal lymph node enlargement is common in patients with idiopathic pulmonary fibrosis and is more frequently seen in patients with a longer duration of clinical symptoms, greater extent of the disease, and with a larger proportion of honeycomb pattern.
Humans ; Idiopathic Pulmonary Fibrosis* ; Lung Diseases ; Lymph Nodes* ; Lymphatic Diseases ; Prevalence ; Tomography, X-Ray Computed*

OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients.SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

STUDY DESIGN: Retrospective study of prospectively-collected data. OBJECTIVES: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. SUMMARY OF LITERATURE REVIEW: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. MATERIALS AND METHODS: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. RESULTS: The average area of the spinal canal was 81.40±53.61 mm2 in the surgical group, compared to 127.75±82.55 mm2 in the nonsurgical group (p=0.042). The muscle area in the spinal canal was 5.17±1.30 cm2 in the surgical group, whereas it was 6.40±1.56 cm2 in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). CONCLUSIONS: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.
Fitness Centers ; Humans ; Lumbosacral Region ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spinal Stenosis ; Sprains and Strains

PURPOSE: To investigate the efficacy of a subconjunctival injection of alphaVbeta5 integrin antibody on corneal angiogenesis induced by chemical epithelial denudation in a rabbit eye model. METHODS: One week after debridement by heptanol, rabbits were treated with a subconjunctival injection of alphaVbeta5 integrin antibody or control immunoglobulin G weekly for 2 weeks. Rabbits that did not receive injection after debridement served as the untreated group. The percentage of neovascularized corneal area was calculated by biomicroscopy, and the sectioned area and number of new vessels were calculated by histological examinations. RESULTS: At 7 days after the first injection, alphaVbeta5 integrin antibody-treated eyes had 9.5% (P=0.02) and 6.8% (P=0.03) less neovascularized corneal area than vector-treated eyes and untreated eyes, respectively. At 7 days after the second injection, alphaVbeta5 integrin antibody-treated eyes had 21.1% (P=0.02) and 18.3% (P=0.02) less neovascularized corneal area than vector-treated eyes and untreated eyes, respectively. Light microscopic examination showed a smaller neovascularized corneal area and a reduced number of new vessels in the alphaVbeta5 integrin antibody-treated eyes compared to the control eyes. CONCLUSIONS: Subconjunctival injection of alphaVbeta5 integrin antibody effectively reduces experimental corneal neovascularization induced by chemical injury, and could be used as a corneal angiogenesis inhibitor in the future.
Corneal Neovascularization* ; Debridement ; Heptanol ; Immunoglobulin G ; Rabbits

PURPOSE: To determine the efficacy of photodynamic therapy (PDT) with verteporfin (Visudyne(R), Norvatis Ophthalmics AG, Hettingen, Switzerland), a benzoporphyrin derivative, in the treatment of corneal neo-vascularization (CN) in a rabbit eye model. METHODS: CN was induced by placing instrastromal sutures in the cornea. Two weeks after suturing, verteporfin was administrated intravenously and 1 hour later, the right eye (treated group) was exposed to a laser with a 689 nm wavelength, and the left eye was used as the control. The changes in CN were analyzed using biomicroscopy and optical microscopy in twelve rabbits. RESULTS: The mean percentages of the neovascular area in the control and treated groups were 96.4 +/- 1.9% and 90.3 +/- 3.5% (P=0.009) at three days after the PDT, 88.6 +/- 4.6% and 71.6 +/- 6.2% (P<0.001) at one week, and 76.8 +/- 4.4% and 43.6 +/- 15.1% (P<0.001) at two weeks, respectively. Optical microscopy showed significant differences between the control and treated group in terms of the area and number of CN (P<0.05). CONCLUSIONS: PDT with verteporfin is a safe and effective procedure for regressing CN. However, a further study will be necessary.
Animals* ; Cornea ; Corneal Neovascularization* ; Microscopy ; Photochemotherapy* ; Rabbits ; Sutures

PURPOSE: A decline in the circulating levels of estrogen impairs vaginal engorgement, which leads to histopathological changes in the vaginal tissues. The aim of this study was to evaluate the effect of delayed estrogen replacement on the vagina structure in castrated rabbits. Materials and Methods: New Zealand White female rabbits were randomly divided into three groups; two groups (the castration and castration estrogen replacement groups) were castrated: the control group underwent sham operations. Nine weeks after surgery, the estrogen replacement group received subcutaneous injections of estrogen (50microgram/kg/day) for 4 weeks. Vaginal tissue was processed for histology with Masson's trichome stain. The expressions of e-NOS and n-NOS were examined by immunohistochemistry and Western blot. RESULTS: From the histology, marked thinning of the vaginal epithelial layers, and decreased smooth muscle content and submucosal microvasculatures were evident, but with no increase in the collagen fibers in the castrated group was noted. The vaginal tissue of the estrogen replaced animal showed similar morphological features to those in the control rabbits. From the histomorphometry, the percentage of vaginal smooth muscle in the castrated group was significantly decreased compared to those in the control and estrogen replaced groups. The expression and signal intensity of e-NOS were decreased in the vagina of the castrated animals compare to those in the control group. In the estrogen replaced group, the expression of e-NOS was normalized. CONCLUSIONS: Delayed estrogen replacement showed structural restoration of vaginal tissues. These results suggest that delayed estrogen replacement therapy could improve the sexual function in menopausal women.
Animals ; Blotting, Western ; Castration ; Collagen ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Immunohistochemistry ; Injections, Subcutaneous ; Menopause ; Muscle, Smooth ; New Zealand ; Rabbits ; Trichomes ; Vagina

The purpose of this study is to introduce a new method to reduce the donor morbidity of radial forearm free flap using ulnar forearm flap, and to evaluate its usefulness and results. 6 patients underwent radial forearm free flap designed by authors and we repaired radial forearm flap donor defect using ulnar forearm flap following ablative surgery for oropharyngeal cancers from June 1995 to February 1997. Radial forearm flap was designed just proximal to wrist crease, and its vascular pedicle was placed in the center of flap. Donor defect was repaired with V-Y fashion closure using ulnar artery axial pattern fasciocutaneous flap. Mean closing time of donor site was 30 minutes. and mean healing period of donor site was 10 days. There was no difficulty in closure. All donor sites healed completely without complication. Limitation of motion was not noticed in the wrist and forearm. We conclude that repair of radial forearm flap donor defect using ulnar forearm flap is new excellent method to prevent the prominent scar of forearm in cases of conventional skin graft for donor defect, and provide rapid healing of wound with low risk of complication
Cicatrix ; Forearm* ; Free Tissue Flaps* ; Humans ; Oropharyngeal Neoplasms ; Skin ; Tissue Donors* ; Transplants ; Ulnar Artery ; Wounds and Injuries ; Wrist

The purpose of this study is to introduce a new method to reduce the donor morbidity of radial forearm free flap using ulnar forearm flap, and to evaluate its usefulness and results. 6 patients underwent radial forearm free flap designed by authors and we repaired radial forearm flap donor defect using ulnar forearm flap following ablative surgery for oropharyngeal cancers from June 1995 to February 1997. Radial forearm flap was designed just proximal to wrist crease, and its vascular pedicle was placed in the center of flap. Donor defect was repaired with V-Y fashion closure using ulnar artery axial pattern fasciocutaneous flap. Mean closing time of donor site was 30 minutes. and mean healing period of donor site was 10 days. There was no difficulty in closure. All donor sites healed completely without complication. Limitation of motion was not noticed in the wrist and forearm. We conclude that repair of radial forearm flap donor defect using ulnar forearm flap is new excellent method to prevent the prominent scar of forearm in cases of conventional skin graft for donor defect, and provide rapid healing of wound with low risk of complication
Cicatrix ; Forearm* ; Free Tissue Flaps* ; Humans ; Oropharyngeal Neoplasms ; Skin ; Tissue Donors* ; Transplants ; Ulnar Artery ; Wounds and Injuries ; Wrist