RESUMEN
A three-dimensional (3D) segmentation and model reconstruction is a specialized tool to reveal spatial interrelationship between multiple internal organs by generating images without overlapping structures. This technique can also be applicable to mummy studies, but related reports have so far been very rare. In this study, we applied 3D segmentation and model reconstruction to computed tomography images of a Korean mummy with congenital diaphragmatic hernia. As originally revealed by the autopsy in 2013, the current 3D reconstruction reveals that the mummy’s heart is shifted to the left due to the liver pushing up to thoracic cavity thorough diaphragmatic hernial defect. We can generate 3D images by calling up the data exclusively from mummy’s target organs, thus minimizing the confusion of diagnosis that could be caused by overlapping organs.
RESUMEN
We found calcified pulmonary nodules in a middle-aged female mummy discovered from 350-yr-old Joseon tomb of Korea. In the CT scan, we found six radiopaque nodules in right lung, through the levels of thoracic vertebrae 1 to 6. We also found presumptive pleural adhesions in right thoracic cavity of CT images. We re-confirmed radiological findings by our post-factum dissection on the same mummy. By the differential diagnosis, we speculate that the radiopaque calcification nodules and associated pleural adhesion could have been caused by tuberculosis. This is the first-ever report on the pulmonary tuberculosis identified in archaeologically obtained, pre-modern Korean samples.
Asunto(s)
Adulto , Femenino , Humanos , Momias/diagnóstico por imagen , República de Corea , Tomografía Computarizada por Rayos X , Tuberculosis Pulmonar/diagnósticoRESUMEN
To date, there are still very few reports on benign-tumor cases based on East Asian skeletal series, even though other regions and continents have been well represented. In our study on the Joseon Human Skeletal Series, we identified benign bone tumors in two skeletons (cases Nos. 75 and 96). Our radiological analyses showed both cases to be homogeneous sclerotic bone masses aligned with the cranial vault suture. In a subsequent series of differential diagnoses, we determined both cases to be osteoma, the most common bone-tumor type reported for archaeological samples. Our study is the osteoarchaeological basis for this, the first-ever report on benign bone neoplasm in a pre-modern East Asian population.
Asunto(s)
Humanos , Pueblo Asiatico , Neoplasias Óseas , Diagnóstico Diferencial , Corea (Geográfico) , Osteoma , Paleopatología , Esqueleto , Cráneo , SuturasRESUMEN
The Harris line (HL), caused by bone-growth arrest and manifesting on X-rays as a radiopaque transverse line in the metaphysis of the long bones, is an indicator reflecting stress conditions such as disease or malnutrition. HL frequency has been assumed to differ between pre-modern and modern societies, as reflective of increased caloric intake and overall nutritional improvements attendant on industrialization. To determine if such a change occurred in Korea, in the present study we compared the respective HL statuses in medieval Joseon and modern Korean population samples. HLs were found in 39.4% (28/71) of the Joseon Koreans. Whereas only 27.5% (11/40) of the males showed an HL, fully 54.8% (17/31) of the females exhibited it. Notably, HLs were observed in only 16.4% (35/213) of the modern Koreans; more remarkably still, the HL rate was almost the same between the sexes, 16.7% (20/120) for the males and 16.1% (15/93) for the females. The HL frequency was much higher in the Joseon Koreans than in their modern counterparts, reflecting the improvement of nutritional status that had been achieved in the course of South Korea's modernization. This HL-frequency decrease was much more obvious in the female populations. The higher HL frequency among the Joseon females might reflect the relatively poor nutritional condition of females in pre-modern Korean society.
Asunto(s)
Femenino , Humanos , Masculino , Ingestión de Energía , Corea (Geográfico) , Desnutrición , Estado Nutricional , República de Corea , Esqueleto , Cambio Social , TibiaRESUMEN
Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.
Asunto(s)
Humanos , Masculino , Broncoscopía , Electrones , Eritrocitos , Explosiones , Nitroglicerina , Cavidad Peritoneal , Bazo , Esplenectomía , Rotura del Bazo , EsplenosisRESUMEN
Entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities in young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomical relationships between vascular and musculotendinous structures in the popliteal fossa. A 55-year-old male patient visited Yonsei University College of Medicine with the chief complaint of claudication in his right calf. He had undergone stent insertion in the right popliteal artery for peripheral artery occlusive disease 2 years earlier. Lower extremity CT angiography showed stent fracture and in-stent thrombosis. He underwent femoral-to-popliteal artery bypass surgery. Postoperative lower extremity CT angiography showed that the vein graft was compressed between the medial head of the gastrocnemius and the semimembranosus muscle. However, the blood flow was normal and his pain was relieved.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Aneurisma , Angiografía , Arterias , Cabeza , Isquemia , Extremidad Inferior , Músculos , Arteria Poplítea , Stents , Trombosis , Trasplantes , VenasRESUMEN
Systemic lupus erythematosus (SLE) is a chronic and multisystemic disease. Pleuropulmonary disease in SLE has various clinical manifestations, such as immunologic pneumonia, infectious pneumonia, interstitial lung disease, pulmonary hypertension, pulmonary hemorrhage, pleuritis and pleural effusion. It can manifest as an initial clinical finding of SLE. We experienced two cases; one case of pulmonary hemorrhage and one case of atypical pneumonia as an initial clinical manifestation of SLE.
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Hemorragia , Hipertensión Pulmonar , Enfermedades Pulmonares , Enfermedades Pulmonares Intersticiales , Lupus Eritematoso Sistémico , Derrame Pleural , Pleuresia , NeumoníaRESUMEN
PURPOSE: To evaluate the HRCT findings and to correlate the findings with the results of a pulmonary function test (PFT) in patients with reactive airway dysfunction syndrome (RADS). MATERIALS AND METHODS: On March 2003, a fire at a boarding house of primary school soccer players caused a multiple casualty disaster. After 8 months, nine boys that presented with chronic cough and dyspnea were treated, and were subjected to follow-up evaluations. Eight patients underwent a chest radiograph, HRCT, and a PFT. Two patients with severe symptoms received extended follow-up after 1 year. Two radiologists retrospectively reviewed the chest radiographs and the follow-up HRCT scans. We correlated the HRCT findings with the results of the PFT. RESULTS: Six patients with an inhalation injury were diagnosed with RADS. On the chest radiographs, eight patients showed no abnormal findings. On an HRCT scan, four patients showed abnormal findings. The abnormal findings were mosaic air trapping (n = 4), bronchial wall thickening (n = 1), and parenchymal consolidation (n = 1). In all four patients that showed abnormal findings in the HRCT scan, abnormal results of the PFT were also seen. The two patients that received extended follow-up showed an improvement of the clinical symptoms, as seen by the PFT, and had a decreased extent and degree of mosaic air trapping, as seen on HRCT. CONCLUSION: An HRCT scan is an essential modality for the diagnosis and follow-up of patients with RADS. Both a full expiratory and inspiratory HRCT scan must be performed for an accurate diagnosis.
Asunto(s)
Humanos , Hiperreactividad Bronquial , Tos , Diagnóstico , Desastres , Disnea , Incendios , Estudios de Seguimiento , Inhalación , Pulmón , Radiografía Torácica , Pruebas de Función Respiratoria , Estudios Retrospectivos , Lesión por Inhalación de Humo , Fútbol , TóraxRESUMEN
Botryomycosis is a chronic supprative disease with characteristic granules formation in the pus caused by bacteria and frequently is mistaken for a fungal infection. Pulmonary botryomycosis can resemble actinomycosis, tuberculosis, or invasive carcinoma by causing a mass lesion with constitutional symptoms. We report a case of pulmonary botryomycosis in a 43 years old man. He had a cavitary lesion of the right upper lobe and diagnosis was confirmed by percutaneous needle aspiration. The specimen demonstrated multiple clusters of bacteria within abscess that best were visualized by gram staining. Cultures of the biopsy materials yielded pure growth of Gemella morbilium. The patient recovered quickly after antibiotics treatment for 3 weeks.
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Adulto , Humanos , Absceso , Actinomicosis , Antibacterianos , Bacterias , Biopsia , Diagnóstico , Gemella , Agujas , Supuración , TuberculosisRESUMEN
PURPOSE: Reactive airways dysfunction syndrome (RADS) is characterized by the appearance of asthma-like symptoms and an increase in nonspecific bronchial hyperresponsiveness in previously healthy individuals after a single large exposure to irritating gas, fume, or vapor, usually as a result of an accident. The purpose of this study is to evaluate the incidence of RADS and clinical characteristics after inhalation injury in children. METHODS: We analyzed nine male children with inhalation injuries from an elementary school fire accident. Clinical manifestations, PFTs including provocation test by methacholine and exercise, radiologic evaluations, skin test and serologic test for evidence of allergy were evaluated at 8 months after the inhalation injury. RESULTS: No documented preexisting respiratory illness was identified, nor did subjects relate past respiratory problems. All subjects suffered from the persistence of respiratory symptoms (cough on exertion, dyspnea on exertion or voice change in five subjects). All subjects showed normal chest X-rays, but a mosaic pattern was documented in the HRCT of three subjects. Basal FEV1 (%predicted) was decreased in one subject and FEF25-75% was decreased significantly in two subjects. Methacholine challenge test was positive in four subject and Exercise provocation tests showed significant decreases of FEV1 and FEF25-75% in three subjects. In four subjects, atopy was documented and but in all others, no evidence of atopy was identified. CONCLUSION: This study showed that RADS could develop after inhalation of irritants, and might persist. Inhalation injury patients should be closely monitored on respiratory symptoms and PFT.
Asunto(s)
Niño , Humanos , Masculino , Hiperreactividad Bronquial , Quemaduras , Disnea , Incendios , Hipersensibilidad , Incidencia , Inhalación , Irritantes , Cloruro de Metacolina , Pruebas Serológicas , Pruebas Cutáneas , Tórax , VozRESUMEN
Sarcoidosis is a rare systemic disorder with unknown cause that is characterized pathologically by non-caseating granuloma. The lung and mediastinal lymph nodes are almost always involved, and most patients experience acute or insidious respiratory symptom. Because sarcoidosis is an interstitial lung disorder involving the alveoli and bronchioles, the most common radiological finding is a reticularnodular lesion with lymphatic distribution. However, cavitation is quite rare. Sarcoidosis is also a major cause of hepatic granuloma in Western countries, accounting for 12% to 30% of cases. In most patients, the course of hepatic sarcoidosis is benign. However, chronic intrahepatic cholestasis or portal hypertension may develop in some patients. We report a case of sarcoidosis with cavitation and hepatic involvement.
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Humanos , Bronquiolos , Colestasis Intrahepática , Granuloma , Hipertensión Portal , Pulmón , Ganglios Linfáticos , SarcoidosisRESUMEN
The most common surgically retained foreign body is t506e laparotomy sponge, and since cotton sponges are inert, they do not undergo any specific decomposition or biochemical reaction. Pathologically, however, two types of foreign body reaction occur: either type there is an aseptic fibrinous response that creates adhesions and encapsulation, resulting in a foreign-body granuloma, or the response is exudative in nature and leads to abscess formation with or without secondary bacterial invasion. We describe the case of a 52-year-old woman with a past history of cholecystectomy in whom a foreign-body abscess mimicked a hepatic tumor. Index words : Peritoneum, abscess Foreign bodies
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Femenino , Humanos , Persona de Mediana Edad , Absceso , Colecistectomía , Fibrina , Cuerpos Extraños , Reacción a Cuerpo Extraño , Granuloma de Cuerpo Extraño , Laparotomía , Peritoneo , PoríferosRESUMEN
Diffuse telangiectatic type of pulmonary arteriovenous malformation (AVM) is an uncommon disease entity in which numerous small arteriovenous connections occur throughout the lungs. It has rarely been confirmed by pulmonary angiography. We report a case of diffuse telangiectatic pulmonary AVM occurring in a patient with dyspnea and confirmed by CT using the slab maximum intensity projection (MIP) technique and conventional direct pulmonary angiography.
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Humanos , Angiografía , Malformaciones Arteriovenosas , Disnea , Pulmón , Tomografía Computarizada por Rayos XRESUMEN
Purpose: To determine the differences in the radiographic findings of miliary tuberculosis between patients with and without associated acute respiratory failure (ARF). MATERIALS AND METHODS: We retrospectively reviewed 32 patients in whom miliary tuberculosis had been diagnosed, and assigned them to one of two groups: with ARF (n=10), and without ARF (n=22). Chest radiographic findings such as the presence of miliary nodules, cosolidation, ground-glass opacity (GGO), pleural effusion, small calcified nodules and linear opacities were assessed, the size and profusion of nodules in each of four zones were analyzed and scored using the standard radiographs of the International Labor Organization, and the extent of consolidation and GGO were scored according to the percentage of involved lung. We compared the radiologic findings between the two groups. RESULTS: Ground-glass opacity, consolidation, and pleural effusion were seen more frequently in miliary tuberculosis patients with ARF than in those without ARF. Although the size and profusion of nodules were similar in both groups (p>0.05), consolidation and ground-glass opacity in cases of miliary tuberculosis with ARF were significantly more extensive than in those without ARF (p<0.005). CONCLUSION: GGO and consolidation were more extensive in miliary tuberculosis patients with ARF. A finding of ground-glass opacity in miliary tuberculosis patients might be an early indication of developing ARF.
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Humanos , Pulmón , Derrame Pleural , Radiografía Torácica , Insuficiencia Respiratoria , Estudios Retrospectivos , Tuberculosis Miliar , Tuberculosis PulmonarRESUMEN
OBJECTIVE : The sperm acrosome reaction is a Ca2+ -dependent exocytotic event that is triggered by adhesion to the mammalian egg's zona pellucida. Previous studies suggested a role of Ca2+ channels in acrosome reactions. This study was conducted to investigate the T-type calcium channel is operated in acrosome reaction of human spermatozoa. METHOD : Human semen samples were obtained from healthy donors with nomal criteria. The spermatozoa were divided into five groups: Group 1 were non-treated as a control; Group 2 where spermatozoa were exposed to 5 micrometer Ca2+ A23187 (Ca2+i); Group 3 where spermatozoa were exposed 5 micrometer Ca2+i and mibefradil; Group 4 where spermatozoa were exposed 5 micrometer Ca2+i and nifedipine, and Group 5 where spermatozoa were treated with 5 micrometer Ca2+i and both of mibefradil and nifedipine. Spermatozoa in all groups were retrieved after incubation for 15 and 30 minutes at 37degrees C. After staining with PSA-FITC, fluorescence was observed under a fluorescence microscope, and AR was evaluated on a total >100 spermatozoa/side. RESULT AND CONCLUSION : We observed on acrosome reaction inhibition rate in human spermatozoa the various of concentration of mibefradil, nifedipine. Maximum response was noted with 1.0 micrometer mibefradil and the decrease of acrosome reaction inhibition rate 45%. Nifedipine in acrosome reaction inhibition rate was only about 25%. The Ca2+i-induced AR of spermatozoa was significantly suppressed by mibefradil. Incidence of the suppression was depending on concentration of mibefradil. Results from the present study suggest that the human spermatozoa possess T-type channel. The observation that reversible inhibitor of T channels in male germ cells provides a new mechanism of contraceptive action.
Asunto(s)
Humanos , Masculino , Reacción Acrosómica , Acrosoma , Calcimicina , Canales de Calcio Tipo T , Fluorescencia , Células Germinativas , Incidencia , Mibefradil , Nifedipino , Semen , Espermatozoides , Donantes de Tejidos , Zona PelúcidaRESUMEN
We report the CT findings of diffuse esophageal spasm (DES) in a patient with dysphagia. Although an uncommon condition, DES should be included in the differential diagnosis if relatively long and symmetric segmental esophageal wall thickening and an epiphrenic esophageal diverticulum are noted at CT.
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Humanos , Trastornos de Deglución , Diagnóstico Diferencial , Divertículo Esofágico , Espasmo Esofágico DifusoRESUMEN
PURPOSE: To evaluate the usefulness of cardiac MRI in the diagnosis of clinically suspected arrhythmogenic right ventricular dysplasia (ARVD). MATERIALS AND METHODS: Between February 1991 and January 1999, 15 patients [M:F=13:2, aged 2 -60 (mean, 37 -7) years] with clinically suspected ventricular arrhythmia due to unknown causes underwent MR imaging. Using a CP body array coil and the single slice breath hold technique, ECG-gated T1-weighted images were obtained. In all patients, these were acquired transaxially from the diaphragm to the aortic arch and along the true short and long axis, and in two, coronal images were obtained. On the basis of clinical and MRI diagnostic criteria, ARVD was classified as one of four types. The significance of differences in diagnostic grades between clinical and MRI criteria was determined using Wilcoxon's signed rank test. RESULTS: According to both clinical and MRI criteria, it was highly probable that three of the 15 patients had ARVD. In eleven, both sets of criteria indicated the same diagnostic grade. Wilcoxon's signed rank test indicated no significant differences in diagnostic grades between clinical and MRI criteria (p > 0.05). CONCLUSION: For the diagnosis or exclusion of ARVD, MR imaging is a useful modality.
Asunto(s)
Humanos , Aorta Torácica , Arritmias Cardíacas , Displasia Ventricular Derecha Arritmogénica , Vértebra Cervical Axis , Diagnóstico , Diafragma , Imagen por Resonancia MagnéticaRESUMEN
PURPOSE: To evaluate the usefulness of cardiac MRI in the diagnosis of clinically suspected arrhythmogenic right ventricular dysplasia (ARVD). MATERIALS AND METHODS: Between February 1991 and January 1999, 15 patients [M:F=13:2, aged 2 -60 (mean, 37 -7) years] with clinically suspected ventricular arrhythmia due to unknown causes underwent MR imaging. Using a CP body array coil and the single slice breath hold technique, ECG-gated T1-weighted images were obtained. In all patients, these were acquired transaxially from the diaphragm to the aortic arch and along the true short and long axis, and in two, coronal images were obtained. On the basis of clinical and MRI diagnostic criteria, ARVD was classified as one of four types. The significance of differences in diagnostic grades between clinical and MRI criteria was determined using Wilcoxon's signed rank test. RESULTS: According to both clinical and MRI criteria, it was highly probable that three of the 15 patients had ARVD. In eleven, both sets of criteria indicated the same diagnostic grade. Wilcoxon's signed rank test indicated no significant differences in diagnostic grades between clinical and MRI criteria (p > 0.05). CONCLUSION: For the diagnosis or exclusion of ARVD, MR imaging is a useful modality.
Asunto(s)
Humanos , Aorta Torácica , Arritmias Cardíacas , Displasia Ventricular Derecha Arritmogénica , Vértebra Cervical Axis , Diagnóstico , Diafragma , Imagen por Resonancia MagnéticaRESUMEN
PURPOSE: To study the impact of inversion of soft-copy chest radiographs on the detection of small solitary pulmonary nodules using a high-resolution monitor. MATERIALS AND METHODS: The study group consisted of 80 patients who had undergone posterior chest radiography; 40 had a solitary noncalcified pulmonary nodule approximately 1 cm in diameter, and 40 were control subjects. Standard and inverse digital images using the inversion tool on a PACS system were displayed on high-resolution monitors (2048x2560x8 bit). Ten radiologists were requested to rank each image using a five-point scale (1=definitely negative, 3=equivocal or indeterminate, 5=definite nodule), and the data were interpreted using receiver operating characteristic (ROC) analysis. RESULTS: The area under the ROC curve for pooled data of standard image sets was significantly larger than that of inverse image sets (0.8893 and 0.8095, respectively; p0.05). CONCLUSION: For detecting small solitary pulmonary nodules, inverse digital images were significantly inferior to standard digital images.
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Humanos , Diagnóstico , Intensificación de Imagen Radiográfica , Radiografía , Radiografía Torácica , Curva ROC , Nódulo Pulmonar Solitario , TóraxRESUMEN
PURPOSE: To assess the efficacy of two-dimensional breath-hold coronary magnetic resonance angiography (coronary MRA) in normal rolunteers. MATERIALS AND METHODS: During a four-month period, 11 volunteers underwent MRA of the major coronary branches using a 2-D multiphase breath-hold spiral fast-gradient echo sequence. The proximal diameter of each visualized coronary artery was measured, and visibility and image quality were also determined. RESULTS: Adequate visualization was achieved in 82-100% of proximal coronary arterial branches and in 36-55% of the middle, distal branches. In general, the diameter of the proximal coronary artery correlated closely with that measured from conventional coronary angiography and using previous coronary MRA data. However, visibility and image quality in the left circumflex coronary artery were limited. CONCLUSION: In the majority of subjects, 2-D coronary MRA provides adequate visualization of the proximal segments of the major coronary arterial branches.