• Title/Summary/Keyword: 자기공명영상(MRI)

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Postnatal Management of Antenatally Diagnosed Patent Urachus with Bladder Prolapse

  • Choi, Hyun-Shin;Kim, Hae-Eun;Kim, Eun-Sun;Oh, Soo-Young;Chang, Yun-Sil;Seo, Jeong-Meen;Park, Won-Soon
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.262-264
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    • 2010
  • A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

Preoperative Three Dimensional Ultrasonographic Evaluation of the Rotator Cuff Tear (회전근 개 파열에 대한 수술 전 3차원 초음파 검사의 유용성)

  • Yum, Jae-Kwang;Sin, Yong-Woon;Han, Jung-Il
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.24-28
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    • 2008
  • Purpose: We wanted to determine if preoperative three dimensional (3D) ultrasonographic evaluation for rotator cuff tear is useful to measure the real size of a torn rotator cuff for performing an operation Materials and Methods: This study included 15 cases (7 males and 8 female), and these patients were confirmed to have a full thickness tear of the rotator cuff by 3D ultrasonography and the operative findings, as well as on the magnetic resonance imaging (MRI). The average age of the patients was 55.4yrs. Results: The average difference between the 3D ultrasonographic and operative measurements of the full thickness tear of the rotator cuff was 0.7 mm in the transverse length and 2.0 mm in the longitudinal length. Conclusion: The low error between the 3D ultrasonographic and intraoperative measurements of rotator cuff tear shows the usefulness of preoperative 3D ultrasonographic evaluation for rotator cuff tear.

Using the Arthroscopic Remplissage of Anterior Shoulder Instability with Hill-Sachs Lesion (전방 견관절 불안정성에서 Hill-sachs 병변의 관절경적 Remplissage)

  • Ko, Sang-Hun;Jung, Kwang-Hwan;Shin, Seung-Myeong;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.53-58
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    • 2011
  • Purpose: We evaluated the minimal 1 year follow-up results (shoulder stability and the clinical and functional results) for the Remplissage technique to fill a Hill-Sachs lesion. Materials and Methods: The subjects were 12 patients who could be followed up for more than 12 months after the "Remplissage" procedures in our hospital from December 2008 to November 2009. Their mean age was 27.9 years old and the mean follow-up was 19 months. The evaluations included the ROM, the ASES score, the KSSI score, the ROWE score and postoperative MRI. Results: On the postoperative functional evaluation after an average of 16 months, the ASES score improved from 50.8 preoperatively to 78.3 postoperatively, the KSSI score improved form 44.5 preoperatively to 81.0 postoperatively and the ROWE score improved from 40.2 preoperatively to 84.3 postoperatively. After an average 14 months for all the cases, the range of movement was nearly in the normal range, which is 178.6${\pm}$18.6 (165~180) degrees for forward flexion and 49.3${\pm}$10 (43~60) degrees for external rotation. Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique has a good outcome after more than 1 year follow-up in terms of the shoulder stability and the clinical and functional results.

Clinical Analysis of Primary Mediastinal Tumors (원발성 종격동 종양의 임상적 고찰)

  • 변정욱;조창욱
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.55-60
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    • 1997
  • We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%). and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed In 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's Iymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

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Comparison of New AJCC Staging System with OId AJCC Staging System in Nasopharyngeal Carcinoma (비인강암에서의 AJCC의 새로운 병기 분류법과 기존 병기 분류법의 비교)

  • Hong Semie;Wu Hong-Gyun;Park Charn I1
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.221-225
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    • 2000
  • Purpose : This study was designed to examine the reliability of the new version of the AJCC staging system (1997) of nasopharyngeal carcinoma in comparison with the AJCC staging system of 1992. Materials and Methods :Between 1983 and 1996, 185 patients with histologically proven nasopnaryngeal carcinoma were treated with radiation therapy at the Department of Therapeutic Radiology Seoul National University Hospital. For these patients, AJCC staging system of 1992 was compared with the 1997 version by reviewing hospital records, computed tomography (CT) and/or magnetic resonance imaging (MRI). Results :5-year overall suwival rates according to the 1992 and 1997 AJCC staging systems were 100$\%$, and 100$\%$ at stage 1: 100$\%$, and 68.8$\%$ at stage 11; 61.4$\%$, and 63.8$\%$ at stage 111; 61.1$\%$, and 63.2$\%$ at stage IV. S-year overall survival rates of each classification showed significant differences between stages (p=0.0049 for the old version, p=0.01 for the new), but no significant difference was found between the staging systems except at stage 11. Conclusion : The new AJCC staging system allows staging as reliably as the 1992 version, but the adequacy of the newly modified staging classification should be confirmed by further clinical examination.

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Secondary Dental Pain and Facial Pain Due to Pansinusitis : A Case Report (범부비동염에 의한 이차성 치통과 안면통: 증례보고)

  • Kim, Nam-Koo;Auh, Q-Schick;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.329-336
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    • 2007
  • Toothache is a common complaint in the dental office. Most toothaches have their origin in the pulpal tissues or periodontal structures1). These odontogenic pains are managed well and predictably by dental therapies. One of the most frequent encounters and most confusing phenomena with which the dental diagnostician must deal is the problem of referred pain. The most important step toward proper management of a toothache is to consider that the pain may not be of dental origin. And Patients with orofacial pain, especially those in chronic pain, present a diagnostic and management challenge for the practitioners. There are many structures in the head and neck that can produce heterotopic pains felt in the teeth and other structures. Once referred pain is suspected, the true source of the pain must be located in order to render effective therapy. With increased interest in temporomandibular disorders and orofacial pain, many studies of accurate diagnosis and differential diagnosis about orofacial pain have been established. The purpose of this paper is to present a case for pansinusitis which produced pain referral in teeth and mimicked the symptoms of migraine.

A Case of Intracranial Tuberculoma and Optic Disc Tuberculoma Suspected by Miliary Tuberculosis (속립성 결핵에서 발생된 것으로 사료된 두개내 및 시신경 유두부의 결핵성 육이종 1예)

  • Lim, Byung-Hun;Jeon, Kyeong-Hong;Cho, Yong-Kyun;Hang, Ki-Eun;Kim, Ki-Tack;Lim, Si-Young;Kim, Byeung-Ik;Lee, Sang-Jong;Lee, Byeung-Ro
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.236-242
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    • 1996
  • Intracranial tuberculoma results from hematogenous spread of pulmonary, intestinal or urogenital tuberculosis. However, it might be caused by pulmonary tuberculosis, mainly. Clinically, symptoms of intracranial tuberculoma are headache and seizure, its symptoms are simillar to intracranial tumor. A 25-year-old-unmarried shopgirl was visited to this hospital because of headache, dizziness and visual disturbance for couple weeks in Sep. 1995. She had been treated with anti-tuberculosis agents of miliary tuberculosis during past nine months period. Brain MRI revealed intracranial tuberculoma and brain edema but not involved optic nerve. Ophthalmic examination revealed severe papilledema and splinter hemorrhage with bitemporal hemianopsis and central scotoma. This finding was strongly suggested of optic disc tuberculoma. Her symptoms became much better following repeated retrobulbar steroid injection with continuous anti-tuberculosis agents. We report a interesting case with intracranial tuberculoma and optic disc tuberculoma associated by miliary tuberculosis during anti-tuberculous treatment.

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A Case of Rapid Cycling Secondary Bipolar Disorder Following Rt. Hemisphere Cerebral Infarction in a Patient with Preceeded Left Hemisphere Poststroke Depression (좌반구 뇌졸중후 우울증 환자에서 우반구 뇌경색이 수반된 급속 순환형 이차성 양극성장애 1례)

  • Chang, Ho-Kyun;Yi, Ho-Taek;Paik, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.79-84
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    • 1998
  • Authors report a case of poststroke bipolar disorder that occurs much less frequently than poststroke depression(PSD). A MRI study performed to identify the etiology of a secondary manic episode in a patient with preceded PSD after left basal ganglia infarction revealed newly developed right basal ganglia infarction associated with poststroke bipolar disorder. It is interesting to note that (1) the temporal relationship was found between the occurrence of PSD after left hemisphere stroke and the occurrence of poststroke bipolar disorder following right hemisphere stroke, and that (2) the occurrence of PSD and the occurrence of poststroke bipolar disorder are associated with lesion location respectively. It has been reported that bipolar disorders were associated with subcortical lesions of the right hemisphere, whereas right-cortical lesions led to unipolar mania and that risk factors for mania included a family history of psychiatric disorders and mild subcortical atrophy. In this case, MR image shows subcortical lesions of the right hemisphere and mild subcortical atrophy. The investigation of the relationships among stroke lesion locations and potstroke mood disorders and risk factors for poststroke bipolar disorder may contribute to understanding the neurobiology of primary mood disorder. A clinical implication is that the risk of secondary bipolar disorder after cerebral infarction should be highlighted.

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Association between Cognitive Function, Behavioral and Psychological Symptoms of Dementia and White Matter Hyperintensities in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병 및 경도인지장애 환자에서 인지기능 및 행동심리증상과 백질고강도신호와의 연관성)

  • Kwon, Ji Woong;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.119-126
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    • 2018
  • Objectives : The aim of this study is to investigate correlation between degree of white matter hyperintensities (WMH) and neurocognitive function along with behavioral and psychological symptoms of dementia (BPSD) in Korean patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 115 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this retrospective study. WMH in brain MRI were rated with standardized visual rating scales (Fazekas scales) and the subjects were divided into two groups according to Fazekas scale. Cognitive function was evaluated with Korean version of the consortium to establish a registry for Alzheimer's Disease (CERAD-K), and BPSD was evaluated with Korean neuropsychiatric inventory (K-NPI). Independent t-test was performed to analyze the relationship between the degree of WMH and neurocognitive functions & BPSD. Results : Especially, the group with high severity of WMH showed significantly lower language fluency (p<0.05). In addition, the group with high severity of WMH showed significantly higher score in K-NPI. Conclusions : There was a significant association between WMH and neurocognitive test related with executive function. Moreover, WMH seems to affect BPSD severity. Evaluation of WMH would provide useful information in clinical settings.

Case of Treatment Using Adaptive Servo-Ventilation in a Patient with Central Sleep Apnea after a Lateral Medullary Infarction (외측 연수 경색에 의해 발생한 중추성 수면 무호흡 환자의 자동-적응형 양압기를 사용하여 치료한 경험)

  • Kim, Dae Jin;Cho, Jae Wook;Kim, Hyun Woo;Choi, Jeong Su;Mun, Sue Jean
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.278-283
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    • 2020
  • Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.