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[en] Chylothorax carries significant mortality and morbidity. Patients with high-output chylothorax have traditionally been managed by surgical treatment if nonoperative management has proved unsuccessful. Newer, more recent percutaneous techniques used to treat chylothorax are safer and less invasive than surgery. We present three cases that have been successfully managed using these percutaneous techniques.
[en] A routine chest radiograph is mandatory in many institutions as a part of pre-employment screening. The usefulness of this has been studied over the years keeping in mind the added time, cost, and radiation concerns. Studies conducted outside India have shown different results, some for and some against it. To our knowledge, there is no published data from India on this issue. A retrospective review of the reports of 4113 pre-employment chest radiographs done between 2007 and 2009 was conducted. Out of 4113 radiographs, 24 (0.58%) candidates required further evaluation based on findings from the screening chest radiograph. Out of these, 7 (0.17%) candidates required appropriate further treatment. The percentage of significant abnormalities detected which needed further medical intervention was small (0.17%). Although the individual radiation exposure is very small, the large numbers done nation-wide would significantly add to the community radiation, with added significant cost and time implications. We believe that pre-employment chest radiographs should be restricted to candidates in whom there is relevant history and/or clinical findings suggestive of cardiopulmonary disease.
[en] To determine value of inclined coronal MR in diagnostic thoracic abnormalities, the multiscan coronal and inclined coronal spin echo MR images of 4 normal subjects and 10 patients with thoracic abnormalities were reviewed. The major airway such as trachea, main bronchi and lobar bronchi, left atrium and its junctions with pulmonary veins required less slices for visualization on inclined coronal images than on standard coronal images, and these normal structures and the lesions located in this region were easy to evaluate in several cases. The left pulmonary artery, especially the upper and lower lobe branches were better visualized on inclined coronal images. There was no case in which normal structures of lesions were more difficult to demonstrate or inclined coronal images compared with standard coronal images. It is concluded that an inclined coronal MR scan of the thorax is valuable to evaluate the mediastinal structures and lesions, especially in diagnosing the abnormalities of the airway, left atrium and its junctions with pulmonary veins. (author). 13 refs.; 5 figs
[en] A computerized scheme was developed for automated identification of erect posteroanterior (PA) and supine anteroposterior (AP) chest radiographs. The method was based on three features, the tilt angle of the scapula superior border, the tilt angle of the clavicle and the extent of radiolucence in lung fields, to identify the view of a chest radiograph. The three indices Ascapula, Aclavicle and Clung were determined from a chest image for the three features. Linear discriminant analysis was used to classify PA and AP chest images based on the three indices. The performance of the method was evaluated by receiver operating characteristic analysis. The proposed method was evaluated using a database of 600 PA and 600 AP chest radiographs. The discriminant performances Az of Ascapula, Aclavicle and Clung were 0.878 ± 0.010, 0.683 ± 0.015 and 0.962 ± 0.006, respectively. The combination of the three indices obtained an Az value of 0.979 ± 0.004. The results indicate that the combination of the three indices could yield high discriminant performance. The proposed method could provide radiologists with information about the view of chest radiographs for interpretation or could be used as a preprocessing step for analyzing chest images.
[en] This study analyzed decade-based statistic data which had been collected from the reports of annual radiographic pulmonary tuberculosis screening program initiated by the Korean National Tuberculosis Association (KNTA) for last 5 decades (from 1956 to 2005). We analyzed only the content of annual statistic report to preserve the characteristic of statistic data and the contents of original copy by focusing on the analysis of tuberculosis cases where age and sex were excluded. The results of the disease-based analysis on the tuberculosis cases from cumulative subjects of chest radiography (CXR) from 1956 to 2005 are summarized as follows. 1. The cumulative number of subjects who were examined under annual chest radiography over last 5 decades totaled 54,938,875 persons. 2. The cumulative number of pulmonary tuberculosis cases during same period totaled 958,251 persons (1.74%). 3. The cumulative number of subjects treated during same period totaled 465,082 persons (0.85%). 4. The cumulative number of mild pulmonary tuberculosis cases during same period totaled 229,615 persons (0.42%). 5. The cumulative number of moderate pulmonary tuberculosis cases during same period totaled 144,247 persons (0.26%). 6. The cumulative number of severe pulmonary tuberculosis cases during same period totaled 74,066 persons (0.13%). 7. The cumulative number of exudative pleurisy cases during same period totaled 17,154 persons (0.03%). 8. The cumulative number of subjects under monitoring during same period totaled 493,169 persons (0.90%). 9. The cumulative number of uncertain activity cases during same period totaled 78,214 persons (0.14%). 10. The cumulative number of pseudo-pulmonary tuberculosis cases during same period totaled 272,349 persons (0.50%).
[en] We present a case of an uneventful dual chamber permanent pacemaker (PPM) implantation which, on the follow-up chest radiograph (CXR), was reported as good lead tip placement and no complications. The patient was re-admitted 7 months later. The PA CXR appearances were unchanged but, in the lateral projection, the ventricular lead tip was projected posteriorly within the heart, most likely within the LV. This was confirmed by CT showing the ventricular lead tip within the LV having passed through a patent foramen ovale (PFO).
[en] Aim: To investigate cardiac magnetic resonance (CMR)-derived parameters to determine a convenient index reflecting the degree of pulmonary regurgitation (PR) after Tetralogy of Fallot (TOF) repair. Materials and methodS: Sixty-three patients (age at CMR study, 23.6 [10.2–34.7] years, 55.6% male) underwent CMR after TOF repair. PR was quantified using ventricular stroke volume difference and phase-contrast mapping of the main pulmonary artery flow. In both approaches, the PRV index (PRVI) and the PR fraction (PRF) were calculated and correlated to the right ventricle end-diastolic volume index (RVEDVI) and the right ventricle end-systolic volume index (RVESVI). Results: No statistically significant difference was observed between the PR volumes and the PRF measured by the stroke volume difference or the phase-contrast method. The PRVI was better correlated to RVEDVI and RVESVI than the PRF. Conclusion: The PRVI exhibits more correlation to the RVEDVI than PRF. Thus, it could be a preferable parameter to reflect the PR burden. - Highlights: • Pulmonary regurgitation (PR) after surgical repair of TOF is common and the proper quantification of which is essential. • Stroke volume difference or phase-contrast approach has no significant difference in the quantification of PR after TOF repair. • Pulmonary regurgitation volume index (PRVI) shows statistically significant more correlation with RVEDVI. Thus, it could be preferable in determining the pulmonary regurgitation burden more than pulmonary regurgitation fraction (PRF).
[en] Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction
[en] In application of wide latitude HR-C film to chest x-ray examination, former x-ray diagnosis area is larger and diagnostic information has great deal of promotion. HR-C film is compare to former x-ray film is larger latitude and density level is small, reading is very easily. Especially, high estimate that is in characteristic curve linearity of toe part is good, contrast of low density made good shape and not good describe to overlap is diagnostic information increase mediastinum portion etc