• Title/Summary/Keyword: 폐쇄성 내만

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Delayed Parenchymal Transit During Tc-99m MAG3 Renography is a Valuable Sign in Diagnosing Urinary Obstruction in Patients with Early Hydronephrosis (초기의 수신증 환자의 요로폐쇄 진단에 있어 Tc-99m MAG3 신장 스캔시 실질통과지연 소견의 유용성)

  • Lee, Won-Woo;Moon, Dae-Hyuk;Kim, Jae-Seung;Ryu, Jin-Sook;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.306-313
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    • 2002
  • Purpose: Diuretic renography (DR) can be false negative in patients with upper urinary tract obstruction due to low compliance of the renal pelvis. Delayed parenchymal transit (DPT) may be a valuable sign in case of false negative DR. We compared the diagnostic values of DR and DPT during Tc-99m MAG3 diuretic scan in adults with suspected unilateral obstructive uropathy. Materials and Methods: Fifty-four patients(male:female=30:24, age: $40.7{\pm}15.5$ yrs) who underwent Tc-99m MAG3 diuretic scan due to suspicious unilateral obstructive uropathy were analyzed. DR with a $T_{1/2}\;of\;>\;15min$ was considered as positive for obstruction. DPT was considered to be present when there was delayed appearance of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal parenchyma. The renal area ratio was defined as the ratio of pixel number of hydronephrotic kidney over that of normal contralateral at $1{\sim}2min$ images. Definition of obstruction was improved hydronephrosis after intervention, or aggravated hydronephrosis without intervention. Non-obstruction was defined as unchanged hydronephrosis over 6 months. Results: Twenty-six renal units had obstruction and 28 no obstruction. The sensitivities of DR and DPT were 69% (18/26) and 50% (13/26) respectively. Two renal units with DPT but negative DR showed the renal area ratio of <1.1. Among the 20 obstructive renal units with DPT or positive DR, 13 with DPT had lower renal area ratio than 7 renal units without DPT ($0.97{\pm}0.20\;vs\;1.30{\pm}0.41,\;p<0.05$). Differential renal function was not significantly different between these groups. DPT correctly diagnosed all renal units with non-obstruction (specificity 100%), while the specificity of DR was 89% (25/28). Conclusion: DPT during Tc-99m MAG3 diuretic scan may be a valuable sign in diagnosing urinary obstruction especially in patients with false negative DR and early HN.

Treatment of Occult Bronchial Foreign Body with 30-Year Retention - A case report - (30년간 잠복한 기관지 내 이물의 치험 - 1예 보고 -)

  • Choi, Jae-Sung;Kim, Eung-Joong
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.667-670
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    • 2008
  • Occult bronchial foreign bodies are rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. Treatment guidelines, according to the severity of the bronchial or lung parenchymal damage and the duration of foreign body retention, have not been established. A 40-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobe collapse and obstructive pneumonitis as evidenced by imaging studies. He had aspirated the cap of a felt-tipped pen 30 years before presentation, which was unrevealed until his medical history was carefully reviewed during this episode. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. This case added important information to our body of knowledge concerning the various clinical features of occult bronchial foreign bodies.

Prevalence of Combined Bronchial Asthma with COPD in Patients with Moderate to Severe Air flow Limitation (중등증 및 중증의 만성 기류 장애 환자에서 만성폐쇄성폐질환과 기관지 천식의 합병률)

  • Rhee, Yang Keun;In, Byeong Hyun;Lee, Yang Deok;Lee, Yong Chul;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.386-394
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    • 2003
  • Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

Intestinal pseudo-obstruction as the initial presentation of systemic lupus erythematosus in a 13-year-old girl (장 가성 폐쇄로 진단된 전신 홍반 루푸스 1예)

  • Cho, Ky Young;Khil, Tae Young;Ahn, Hye Mi;Lee, Sun Wha;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.655-659
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    • 2008
  • Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.

Spontaneous Hemothorax in a Patient with Posterior Mediastinal Neurilemmoma -A case report- (자발성 혈흉을 동반한 후종격동 신경섬유초종)

  • 김혁;양주민;정기천;김영학;강정호;정원상
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1019-1021
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    • 2004
  • Neurogenic tumors are common in posterior mediastinal tumors. In most cases, tumors were accidentally showed on simple chest X-ray. In some cases, they were presented by symptoms which were induced by nerve compression or airway compression. But as in our case, neurogenic tumor with spontaneous hemothorax is very rare. A 45-year-old man admitted to emergency room of other hospital because of acute right chest pain and dyspnea. A chest X-ray showed a right pleural effusion. Hemothorax was diagnosed after closed thoracostomy. Following chest CT showed posterior mediastinal mass. The patient was transferred to our hospital. T spine MRI showed dumbbell shaped mass. Diagostic impression was neurogenic tumor. The pathologic result was neurilemmoma after surgical resection.

Analysis of the Relationship between Fatty Pancreas and Cardiovascular Disease in Abdominal Ultrasonography (복부초음파검사에서 지방췌장증과 심혈관계질환과의 연관성 분석)

  • Cho, Jin-young;Ye, Soo-young
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.729-737
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    • 2019
  • Fatty pancreas is an abnormal process of lipid deposition in cells, resulting in increased fat tissue and obesity. The result is a risk factor for cardiovascular and metabolic diseases. The aim of this study was to evaluate the usefulness of pancreatic fat as a predictor of cardiovascular disease and metabolic syndrome in pancreatic ultrasonography. In 407 patients who underwent a comprehensive screening at the W Health Care Center in Busan from September 2. 2018 to December 31, 2018, the degree of fat deposition in the pancreas was evaluated as the degree of mild, moderate. Data on non-obstructive atherosclerosis, BMI, hyperlipidemia, hypertension, and diabetes were collected to assess the association of pancreatic fat deposition with cardiovascular disease and metabolic syndrome. In addition, we tried to analyze the correlation between liver dysfunction and thyroid dysfunction as the degree of fat pancreas increased. We examined the relationship between six parameters including atherosclerosis, BMI, hyperlipidemia, hypertension, diabetes, liver dysfunction, and thyroid dysfunction among patients with fatty pancreas. We concluded that the carotid intima-media thickness of atherosclerosis, which is a risk factor of cardiovascular disease, is most closely related to fatty pancreas.

Primary Pulmonary Hypertension in a Maltese Dog (말티즈 견에서 발생한 원발성 폐동맥 고혈압증)

  • Moon, Hyeong-Sun;Lee, Seung-Gon;Choi, Ran;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.613-617
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    • 2007
  • A 1-year-old castrated male Maltese dog(weighing 2.4 kg) was presented with primary complaints of occasional coughing, dyspnea and exercise intolerance. Based on diagnostic findings including paradoxical split S2, diastolic regurgitant murmur, marked dilation of pulmonary artery, right ventricular eccentric hypertrophy with thickening of ventricular septum, severe tricuspid and pulmonic regurgitation(5.4 m/sec and 3.4 m/sec, respectively) and the absence of any congenital intracardiac shunting, obstructive pulmonary diseases and systemic diseases associated with right ventricular pressure overload or pulmonary hyperperfusion, the case was tentatively diagnosed as primary pulmonary hypertension. The dog was treated with furosemide, aspirin and oxygen supplementation. This case report described a rare case of primary pulmonary hypertension in a Maltese dog.

On the relationship between the phonetic realizations of the allophones of the Korean liquid /l/ and their prosodic status (한국에 유음 /l/의 변이음들의 음성적 실현과 운율적 위상과의 상관관계에 관하여)

  • 이숙향
    • The Journal of the Acoustical Society of Korea
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    • v.18 no.7
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    • pp.85-91
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    • 1999
  • The purpose of this study is to investigate phonetic realization of flap [r], one of the allophones of Korean /l/. Phonetic realization of a segment is affected by not only its neighboring segments but also its prosodic position in an utterance. This study examined how various prosodic positions affect the phonetic realization of [r]. Effects of the four prosodic positions on the phonetic realization of [r] were examined: utterance initial, Intonation Phrase initial, Accentual Phrase initial, and Accentual Medial positions. Word positional effect was also examined: word initial, medial, and final positions. Acoustic and statistical analyses showed that flap [r] was realized in a variety of phonetic forms: from sonorant(the most reduced form) to short stop(the least reduced form). It was shown that generally. word-initial position is stronger than word-medial position. It was also shown that in many cases, utterance-initial position and intonation-phrase-initial position are stronger than accentual-phrase-initial and accentual-phrase-medial positions. Sonorants were observed more often in the prosodically weaker portions. VOT duration was also shorter in accentual-phrase-initial and accentual-phrase-medial positions.

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Patent Ductus Arteriosus Occlusion with an $Amplatz^{(R)}$ Canine Duct Occluder in a Dog (개에서 $Amplatz^{(R)}$ Canine Duct Occluder를 이용한 동맥관개존증의 폐쇄 증례)

  • Kang, Min-Hee;Kim, Seung-Gon;Hahn, Tae-Yeon;Park, Hyun-Ah;Min, Sa-Hee;Park, Ji-Hwan;Kim, Tae-Woo;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.498-501
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    • 2012
  • A 10-month-old intact male Maltese dog (body weight, 1.6 kg) presented with intermittent cough and abnormal heart sounds. The dog was diagnosed with a left-to-right patent ductus arteriosus (PDA) on the basis of the results of transthoracic echocardiography, color flow Doppler examination, and angiography. Transcatheter occlusion of the PDA was performed using the $Amplatz^{(R)}$ Canine Duct Occluder (ACDO) via the femoral artery. The device was placed under fluoroscopic guidance and successfully occluded the PDA. The continuous heart murmur disappeared immediately after the correction and no residual flow was detected. The dog was discharged the following day and regularly examined for complications and safety. This is the first report demonstrating the clinical application of ACDO for the transcatheter closure of PDA via the femoral artery in a small-breed dog in Korea.

Clinical Analysis of Arterial Bypass on the Atherosclerotic Occlusive Disease in Lower Extremities (폐쇄성 하지동맥 경화증에서 동맥 우회술의 임상적 고찰)

  • Park, Sung-Hyuk; Youm, Wook
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.195-199
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    • 1997
  • From Dec. 1992 to Dec. 1995, 20 patients with atherosclerotic occlusive disease in the lower extremities underwent arter al bypass surgery. The age of the patients ranged between 46 and 77 years(mean .60.8 years) and the most prevalent incidence was in the 7th decades. The mean follow up period was 18.8 months ranging from 4 to 36 months. Associated diseases were diabetus mellitus(25%), hypertension (35%), cerebrovascular accident(25%), and acute myocardial infarction(5%). Disabling intermittent claudifcation(35%), resting pain(20%) or ischemic gangrene(or ulceration)(45%) were operative indications. Aorto-bifemoral bypass in 4 cases, aorto-single femoral bypass in 2 cases, Aorto-bifemoral bypass and femoropopliteal bypass in 3 cases, aorto-single femoral bypass and femoropopliteal bypass in 1 case, femoropopliteal bypass in 4 cases, femorotibial bypass in 1 case, popliteotibial bypass 4 cases and femorofemoral bypass in 1 case were the surgical approches. Early thrombosis(2 cases) and wound infection(2 case) were main complication. Postoperative complication rate was 20% . Postoperative patency rates re 92.6% at 6 months, 84.2% at 1 year, 75.4% at 2 years and 69.4% at 3 years.

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