• Title/Summary/Keyword: 특별진단

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The Objective Measurement of the Lung Parenchyma Motion for Planning Target Volume Delineation (폐 부위 Planning Target Volume(PTV)설정시 폐 움직임의 객관적 측정)

  • Chung, Weon-Kyu;Cho, Jeong-Gill
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.387-392
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    • 1997
  • Purpose : To quantify the movement of lung Parenchyma for ICRU 50 Planning Target Volume (PTV) delineation of the lung region. Materials and Method : Fluoroscopic observations and measurements are Performed on 10 patients with chest region cancer who have normal putmonary functions We have divided the lung region into 12 parts for the right lung, 10 parts for the left lung and four to five Points of lung parenchyma were selected for anatomical analysis Points, Fluoroscopic images are sent to a computer and then movements are measured. Results : Both lowe lobes showed the longest longitudinal movements because of breathing (average 14.1mm, maximum 22.1mm), while anteroposterior displacement showed the smallest value. Lateral movements of the lung parenchyma averaged 6.6mm, and the maximum value was 9.1mm, (both hilar regions showed maximum values because of cardiac motion) Conclusion : We could quantify the lung movements by measuring parenchyma displacements. The movements of both upper lobes were less than those of the middle and upper lobes in longitudinal and transverse movements. Optimal margins can be selected for PTV delineation using these results.

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Thrombolysis for Prosthetic Mitral Valve Thrombosis - 3 cases report - (인공승모판막 혈전의 용해 치료 - 3례 보고 -)

  • Baek, Man-Jong;Kim, Hyoung-Mook;Lee, In-Sung;Sun, Kyung;Kim, Kwang-Taik;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.70-74
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    • 1999
  • Thrombosis in valve or left atrium after mechanical mitral valve replacement causes prosthetic valve dysfunction or thromboembolism. Early and adequate therapy is very important but clinically not easy. Thrombolysis can avoid reoperation-related risks and act as an optimal therapy for prosthetic valve thrombosis. This report describes three patients who were treated by using low molecular weight heparin (LMWH) and wafarin. Two patients, including one pregnant woman, had prosthetic valve thrombosis and immobility of valve leaflets, and one patient with recent cerebral infarction due to thromboembolism had thrombus in left atrium. Fraxiparine 0.3 cc (7,500 ICU AXa) was administrated subcutaneously twice or triple daily. At discharge, thrombosis in valve and left atrium were completely or near totally lysed and valve leaflets were normally mobile. During the period of thrombolysis and follow up, there were no complications in all patients.

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Gastropericardial Fistula as a Late Complication after Esophagectomy with Esophagogastrostomy, A Case report (식도 절제술 및 위-식도문합술 후 만기 합병증으로 발생한 위-심막루)

  • Kim, Tae-Gyun;Kang, Jung-Ho;Chung, Won-Sang;Kim, Young-Hak;Kim, Hyuck;Jee, Heng-Ok;Lee, Chul-Bum;Ham, Shi-Young;Jeon, Seok-Chol
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.248-250
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    • 2002
  • A 56 year-old man complaining of dry cough, dyspnea, chest pain, fever, and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy and subsequent radiotherapy because of an esophageal cancer. After the emergency echocardiography revealed a small amount of pericardial effusion and pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach and the pericardium, and an emergency operation was done under the diagnosis of gastropericardial fistula. The patient expired postoperative seven days later. Gastropericardial fistula caused by a peptic ulcer perforation after the esophagectomy and esophagogastrostomy operation is a very rare complication and brings forth a disastrous result. Early detection using the chest radiography, electrocardiogram, upper Gl study, echocardiography and a review of physical examination, and an immediate treatment are therefore mandatory.

Myocardial Uptake and Clearance of Thallium-201 in Normal Subjects: A Comparison Between Pharmacologic Stress with Intravenous Adenosine, Dipyridamole and Dobutamine, and Exercise Stress Testing (정상인 심근의 Thallium-201 섭취 및 제거 : Adenosine, Dipyridamole Dobutamine 정맥주사와 운동부하시의 비교)

  • Lee, Jae-Tae;Chung, Byung-Chun;Choi, Jung-Il;Kwak, Dong-Suk;Lee, Kyu-Bo;Chae, Shung-Chull;Chung, Chin-Hong
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.35-50
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    • 1993
  • 심근관류 스캔에서 약제부하 검사에 많이 이용되는 것으로는 adenosine, dipyridamole, dobutamine등이 있다. 이 약제들이 혈역학 및 thallium의 약동학에 미치는 효과를 검사하기 위하여 저자들은 15명의 건강인을 대상으로 이들 약제를 정맥주사한 후에와 그리고 운동부하를 시행한 후에 thallium-201 신근관류 스캔을 시행하여 thallium의 약동학에 미치는 영향에 대하여 서로 비교하였다. 부작용은 adenosine (87%), dipyridamole(80%), dobutamine (73%)을 정맥주사할 시에 흔히 나타났으나 경미하였다. 1예에서는 dobutamine을 주사할때의 부작용으로 인하여 최대용량을 투여하지는 못한바 있었다. 대상들은 dipyridamole (13%)이나 dobutamine (27%)보다 adenosine (60%)을 선호하였다 (P<0.05). Thallium의 절대 적인 심근섭취는 운동부하 검사보다 adenosine (1.3배), dipyridamole(1.2배), dobutamine(1.4배) 부하시에 더 많았고, 이들 약제 사이에는 유의한 차이는 없었다. Thallium의 심근제거율(%/hr)는 운동부하 검사보다 약제부하한 후에가 더 늦었다. 폐, 간, 비장, 및 내장지역에서 thallium의 섭취 및 제거는 운동부하 검사보다 약제부하시에 더 많았으나, 이들 약제 사이에는 유의한 차이가 없었다. Dobutamine 투여시의 thallium의 섭취 및 제거는 adenosine 또는 dipyridamole을 투여시의 결과와 상응하였다. 저자들은 adenosine, dipyridamole 및 dobutamine을 이용한 약제부하 thallium-201 심근관류 검사를 시행하는데 코든 대상들에서 어려움 없이 쉽게 시행할 수 있었다. Thallium의 심근내 섭취 및 제거는 각 약제부하에 따라서 다를 수가 있으므로 심근관류 스캔의 정량적인 분석을 시행할 때는 각각 약제에 대한 특별한 진단기준이 마련되어야 할 것으로 생각된다.

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Department of DNA Chromatographic System for On-Site Detection of Food-Contaminating Bacteria (식중독균 현장탐지를 위한 DNA 크로마토그래피 분석시스템의 개발)

  • 김석하;정우성;백세환
    • KSBB Journal
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    • v.18 no.3
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    • pp.190-196
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    • 2003
  • An analytical system detecting DNA particularly utilizing a concept of membrane strip chromatography initially applied to home-version tests for, such as, pregnancy and ovulation has been developed. We have chosen S. typhimurium as model analyte among food-contaminating microorganisms that occurred in high frequencies, and invA gene, as a detection target, specific to Salmonella species. This gene was able to be amplified by PCR under optimal conditions employing newly designed primers in our laboratory. The PCR product was specifically measured via hybridization between the analyte and a DNA probe, which was a totally different feature from the conventional gel electrophoresis detecting the products based only on the molecular size. It is notable thar the DNA probe sequence was specially designed such that no separation of excess primers present after PCR was required. This was immobilized on a nitrocellulose (NC) membrane via streptavidin-biotin linkage minimizing a steric effect when the hybridization with the amplified DNA took place. The analyrical system detected the microorganism in a concentration of minimum $10^3$ cfu/mL (i.e., 10 cells per system), estimated from the standard curve, 20 to 40 minutes after adding the sample. This sneitivity was approximately 10 times higher than that of gel electrophoresis as an analytical tool conventionally used. Furthermore, the assay was able to be run at room temperature, which would ofter an extra advantage to users.

INVASION OF ALVEOLAR BONE INTO ROOT CANAL AFTER TRAUMATIC INJURY (외상 후 근관내로의 치조골 함입)

  • Im, Ye-Jin;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.399-406
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    • 2011
  • Traumatic injury on tooth occurs frequently among trauma patients, and mainly occurs on tooth with premature roots which influences pulp tissue, periodontal ligament, alveolar bone, and Hertwig's epithelial root sheath. According to the degree of trauma, a number of kinds of healing process can be observed, such as complete re-vascularization of pulp, root canal obliteration, growth suspension of root apex, and invasion of alveolar bone into root canal, and there can be some complications such as necrotic change of inflammatory root resorption and partial pulp necrosis due to pulp necrosis toward complete necrosis. In this clinical case, 3 patients who had traumatic injury showed root growth suspension and alveolar bone invasion into root canal due to proliferation of periodontal ligament cell and osteocyte at the base of extraction socket into pulp chamber because of the injury on Hertwig's epithelial root sheath. If intrusion of alveolar bone into root canal due to injury on Hertwig's epithelial root sheath after having traumatic injury doesn't show any complication, the pulp may be considered to have normal vitality and doesn't need any further treatment, therefore differential diagnosis is very necessary. However, it may be accompanied with suspension of root growth, therefore, additional trauma during the treatment of injured tooth should not be applied.

Fat Embolism Syndrome with Pulmonary Hemorrhage of Unknown Origin (원인을 알 수 없는 폐출혈을 동반한 지방색전 증후군 1예)

  • Jeong, Hye-Cheol;Jung, Ki-Hwan;Kim, Byung-Gyu;Kim, Kyung-Kyu;Lee, Sang-Youb;Park, Sang-Myun;Lee, Sin-Hyung;Shin, Chol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kim, Han-Gyum;Yoo, Sa-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.383-387
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    • 2000
  • Fat embolism syndrome is a rare but serious complication occurring mostly in patients with long bone fractures and occasionally in patients who have had an underlying disease. For example, pancreatitis, diabetes mellitus, alcoholic liver disease and connective tissue disease can be risk factors. The 44-year old woman with a sudden dry cough, blood tinged sputum, and exertional dyspnea visited the Korea University Hospital. Petechiae on her anterior chest wall was found. Chest X-ray and CT showed patchy opacities and multifocal ground-glass opacities in both lung fields. An open lung biopsy demonstrated diffuse pulmonary hemorrhage and intravascular macrovesicular fat bubbles. After conservative management, her symptoms and radiologic findings were significantly improved. A case of fat embolism syndrome without any known risk factors is reported.

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Renal Cell Carcinoma in a Pekingese Dog (페키니즈견에서 신장세포암종)

  • Lee Ki-chang;Jung Joo-hyun;Byeon Ye-eun;Oh Sun-kyung;Seo Eun-jung;Song Kyung-jin;Kweon Oh-kyeong;Yoon Jung-hee;Choi Min-cheol
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.148-152
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    • 2005
  • An intact female, 5-year-old, Pekingese, weighing 3.5kg with a history of a palpated abdominal mass was referred to Veterinary Medical Teaching Hospital, Seoul National University. In laboratory examination, there were no remarkable abnormalities. Radiographic findings included a left mid-abdominal mass with ill-defined margin, serosal detail loss of peritoneal space, non-uniform opacity of retroperitoneal space, and a radiopaque cystic calculus. On abdominal ultrasonography, a heterogeneous parenchymal mass with irregular contour in the left renal region was found. Computed tomographic findings showed a tumor embolus within the caudal vena cava and an invasion into mesentery, small bowel loops, spleen and pancreas around the large left renal mass. Unilateral nephroureterectomy was performed. Histopathologic examination of the resected mass confirmed the diagnosis of renal cell carcinoma. The dog died one day after surgery. Although ultrasonography could give diagnostic information about mass characteristics, computed tomography (CT) can provide key imaging features of mass characteristics.

A Clinical Study of Congenital Duodenal Obstruction (선천성 십이지장 폐쇄증의 임상적 고찰)

  • Huh, Young-Soo;Suh, Bo-Yang;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.39-48
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    • 1990
  • Congenital duodenal obstruction in the newborn infant may be due to a variety of causes. Duodenal obstruction often presents with bilious vomiting and upper abdominal distention. Diagnosis is usually established on plain x-ray of the abdomen by the classic finding of the double-bubble. In the period July 1986 to June 1990, 16 patients with congenital duodenal obstruction were operated and the following results were obtained. 1. Sixteen patients were comprised of 11 males and 5 females, the ratio of male and female was 2.2:1. 2. Thirteen patients(81%) had been admitted to our hospital during one month of life. 3. Congenital duodenal obstruction was in 16 cases; malrotation in eight(50%), annular pancreas in six(38%), type 1 atresia in one(6%), and wind-sock anomaly in one(6%). 4. There were two premature patients and six patients of small for gestational age. 5. Overall, bilious vomiting, occurring in three fourths, was the single most frequent presenting complaint. 6. Polyhydramnios occurred in two of the patients. 7. Diagnosis was possible with clinical symptom and simple abdomen. 8. The operative procedures performed were ; duodenoduodenostomy in five, duodenojejunostomy in two, excision of wind-sock membrane in one, and Ladd's procedure in eight. 9. A total of ten asociated congenital anomalies were found in six patients. 10. Postoperative complications occurred in five cases(31%).

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Sudden Death Caused by Clostridium perfringens Type D Enterotoxemia in Feedlot Cattle (비육 우의 Clostridium perfringens D 형 장독 혈증에 의한 폐사)

  • Jang, Seong-Jun;Do, Sun-Hee;Ki, Mi-Ran;Hong, Il-Hwa;Park, Jin-Kyu;Cho, Yu-Jeong;Ji, Ae-Ri;Park, Se-Il;Park, Sang-Joon;Kim, Tae-Hwan;Kwak, Dong-Mi;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.20 no.5
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    • pp.639-643
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    • 2010
  • Sudden deaths have occurred in feedlot cattle with marked necro-hemorrhagic enteritis of the jejunum, ileum and colon. Suckling beef calves are the most frequently affected. Over-consumption of large amounts of milk, inadequate colostrum intake, chilling and stress are conducive to the development of enterotoxemia. Enterotoxemia caused by Clostridium perfringens type D mostly occurs following a sudden change of diet, particularly to feeds made richer in order to grow the cattle to market weight in feedlots. During July 2006, sudden deaths of cattle occurred in the Youngcheon regional area of Gyeongbuk province. There were no significant clinical signs except anorexia, depression, intermittent diarrhea and mild respiratory failure. Histological findings revealed a prominent intranuclear inclusion as well as infiltration of the globular leukocytes in various organs including the heart, kidneys, liver, spleen and lymph nodes. Spleen and lymphatic tissues showed lymphatic necrosis and a starry sky appearance. In the submucosa of the small intestines, basophilic aggregation was detected with massive infiltration of the globular leukocytes and eosinophils. Gram staining for the tissue sections containing inclusions of the small intestines revealed a positive histochemical reaction. Taken together, we suggest that Clostridium perfringens type D-induced enterotoxemia is determined to be the cause of sudden death of feedlot cattle.