• Title/Summary/Keyword: 확장증

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Middle Lobe Syndrome (중엽증후군)

  • 이용훈;김병철
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.621-625
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    • 1996
  • "Middle lobe syndrome" which was described y Graham and associates at first is always caused by ex- ternal bronchial compression by Iymph nodes. Although the patients may not present any symptom, the most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic procedures includ chest X-ray bronchoscopy, brochography, chest CT, and the principal finding is the contracted middle lobe which is usually airless. We experienced fifteen cases of middle lobe syndrome from April 1990 to May 1995. Eleven patients were treated surgically. The surgical candidates for middle lobe syndrome are suspicious malignancy, fixed bronchiectasis, bronchostenosis, intractable to medical treatment, recurrent infection. Operations were right middle lobectomy (8), right middle and lower bilobectomy (2), right upper and middle bilobectomy (1). Postoperative histological findings were tuberculosis in six, chronic inflammation in three, malignancy in one, and focal hemorrhage in one. There were two cases of postoperat ve complications which were postoperative atelectasis and hepatopathy.patopathy.

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Four Cases of Kartagener's Syndrome (Kartagener 증후군 4예)

  • Lee, Yong-Chul;Song, Hang-Yong;Lim, Suk-Tae;Kim, Hyung-Chung;Lee, Heung-Bum;Lee, Young-Seung;Rhee, Yang-Keun;Chung, Jae-Man
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.663-669
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    • 1994
  • Kartagener's sydrome is an autosomaly inherited recessive condition characterized by situs inversus, bronchiectasis, and chronic sinusitis. And recently it was recognized as a subclass of dyskinetic cilia syndrome which caused by a defect in mucociliary transport owing to immotile or dyskinetic beating of cilia. Electron microsopy of cilia from sperm tails, nasal and bronchial epithelium of patients reveals the partial or complete absence of dynein arms. Our four patients were diagnosed as a Kartagener's syndrome by classic triad. We carried out electron microscopy of cilia of the nasal mucosa. And many other tests were done. One patient had squamous cell carcinoma of the lung, and another one patient revealed features of adult respiratory distress syndrome at admission. All patients improved with conservative therapy such as physiotherapy, bronchodilater, antibiotics except one patient who mechanical ventilation was required. A brief review of literature was made.

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Virtual Bronchoscopy for Diagnosis of Tracheo-Bronchial Disease (기관지질환 진단을 위한 가상내시경)

  • Kim, Do-Yeon;Park, Jong-Won
    • The KIPS Transactions:PartB
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    • v.10B no.5
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    • pp.509-514
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    • 2003
  • The virtual bronchoscopy was implemented using chest CT images to visualize inside of tracheo-bronchial wall. The optical endoscopy procedures are invasive, uncomfortable for patients and sedation or anesthesia may be required. Also, they have serious side effects such as perforation, infection and hemorrhage. In order to determine the navigation path, we segmented the tracheo-bronchial wall from the chest CT image. We used the coordinates as a navigation path for virtual camera that were calculated from medial axis transformation. We used the perspective projection and marching cube algorithm to render the surface from volumetric CT image data. The tracheobronchial disease was classified into tracheobronchial stenosis causing from inflammation or lung cancer, bronchiectasis and bronchial cancer. The virtual bronchoscopy is highly recommended as a diagnosis tool with which the specific place of tracheobronchial disease can be identified and the degree of tracheobronchial disease can be measured qualitatively, Also, the virtual bronchoscopy can be used as an education and training tool for endoscopist and radiologist.

Construction of Medical Image-Based Learning Data Support Platform for Machine Learning and Its Application of Sarcopenia Data AI (머신러닝을 위한 의료영상기반 학습 데이터 지원 플랫폼 구축 및 근감소증 데이터 AI 응용)

  • Kim, Ji-Eon;Lim, Dong Wook;Yu, Yeong Ju;Noh, Si-Hyeong;Lee, ChungSub;Kim, Tae-Hoon;Jeong, Chang-Won
    • Annual Conference of KIPS
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    • 2021.11a
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    • pp.434-436
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    • 2021
  • 의료산업은 진단 및 치료 위주의 기술개발이 진행되어왔다. 최근 의료 빅데이터를 기반으로 진단, 치료 및 재활뿐만 아니라 예방과 예후관리까지 지원하는 의료서비스에 대한 패러다임이 변화되고 있다. 특히, 여러 의료 중심의 플랫폼 기술 가운데 객관적인 진단지표를 가지고 있는 의료영상을 기반으로 인공지능 학습에 적용하여 진단 및 예측을 중심으로 한 플랫폼 개발이 진행되고 있다. 하지만, 인공지능 연구에는 많은 학습 데이터가 요구될 뿐만 아니라 학습에 적용하기 위해서는 데이터 특성에 따른 전처리 기술과 분류 작업에 많은 시간 소요되어 이와 같은 문제점을 해결할 수 있는 방법들이 요구되고 있다. 따라서, 본 논문은 인공지능 학습까지 적용하기 위한 의료영상 데이터에 대한 확장 모델을 개발하여 공통적인 조건에 따라 의료영상 데이터가 표준화되어 변환하며, 자동화 시스템 구조에 따라 데이터가 분류·저장되어 인공지능 학습까지 지원할 수 있는 플랫폼을 제안하고자 한다. 그리고 근감소증 학습데이터 관리 및 적용 결과를 통해 플랫폼의 수행성을 검증하였다. 향후 제안한 플랫폼을 통해 의료데이터에 대한 전처리, 분류, 관리까지 지원함으로써 CDM 확장 표준 의료데이터 플랫폼으로 활용 가능성을 보였다.

Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies (소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술)

  • Kwak, Ju Yuong;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.137-142
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    • 2005
  • Purpose: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. Methods: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. Results: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). Conclusion: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

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The Neonatal Follow up and Correlative Analysis of Fetal Hydronephrosis (산전 수신증의 생후 추적 관찰)

  • Yoon Ho-Young;Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil;Kim Myung-Joon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.60-68
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    • 1998
  • Purpose: To determine the various prenatal factors related to the prenatal hydronephrosis diagnosed on prenatal ultrasonography. We also attempted to correlate the prenatal and neonatal renal pelvic anteroposterior diameter with the outcome in infancy Methods: Between 1985 and 1997. We retrospectively reviewed 105 renal unit (75 patient) with fetal hydronphrosis persisting postnatally. Investigation consisted of renal ultrasonography, voiding cystourethrography, diurectic renogram, and DMSA scan. Results: The 75 patient assesed had the following underlying cause: UPJ(Ureteropelvic juction) obstruction(52%). multicystic dysplastic kidney(10%). UVJ (Ureterovesicai juction) obstruction (10%) and no underlying cause (25%). Of theses cases 36 cases (40 renal unit) underwent operation, while 28 cases (50 renal unit) resoled spontaneously. 12% of mild hydornephrosis deteriorated. whereas 50% of modrate hydrophrosis and 81% of severe hydronephrosis required surgical correction. Attempting to find the renal unit that were at risk for deterioration. our study showed that urinary tract infection group and calyceal blunting group had a predictive role. Conclusion: It is necessary to follow up after birth dilatation of caylx or urinary tract infection are present. Early operation is considered when prenatal pelvic AP diameter greater is than 22 mm and postnatal diameter greater than 17 mm. This may make it possible to prevent further progression of renal damage and prompt treatment of asymptomatic hydronephrosis before complications occur.

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Usefulness Comparative Experimental Study of the CT and MR Imaging in the Dog Clonorchiasis (잡견 간흡충증의 전산화단층촬영과 자기공명영상의 유용성에 관한 실험적 연구)

  • Goo, Eun-Hoe;Kweon, Dae-Cheol;Kim, Dong-Sung;Choi, Chun-Kyu
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.33-39
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    • 2003
  • Purpose : Be aware of clinical possibilities on image quality by comparison of contrast-enhanced dynamic CT and MR imaging applied of MIP technique after the experimentally induced clonorchasis infection in dogs. Materials and Method : Twenty mongrel dogs prepared in zoo-laboratory were followed up with serial CT scans and MR imaging for 13 weeks after the experimental infection in liver. Two-phase helical CT was acquired in the supine position with the following scanning parameters. After the injection of contrast material, the arterial phase was initiated using a bolus-racking method. The portal phase scan was started 15 seconds after the arterial phase scan. CT protocol was determined after single level dynamic scans. MR imaging used the CP body coil and images get a 2D image using HASTE, FLASH, TSE pulse sequence. Bile duct MR imaging were obtained in three plans. Then each image was post processed by using target MIP algorithm. Two experimentation above, as a method of evaluation, one pathologist, three radiologist and five radiological technologist were analyzed visually for evaluation of following findings, enhancement of the bile duct wall, dilatation of bile duct tip, liver parenchyma, background suppression. Results : Five dogs was died of a disease after the infection, the rest one else shows the chronic dilatation of the intrahepatic bile duct with CT and MR imaging. Contrast administration of CT shows the contrast-enhanced of the bile duct walls with live parenchyma. MR imaging calculated of CNR and CR from pulse sequence for comparative evaluation and shows the pattern of the intrahepatic bile duct, dilatation of bile duct tip using MIP technique. CNR of the clonorchiasis, HASTE was $16{\pm}0.83$, TSE $7.06{\pm}3.0$, FLASH $1.19{\pm}0.2$ and CR, HASTE was 73.3%, TSE 62.3%, FLASH 6.4%. Conclusion : CT and MR imaging is very usefulness in diagnosis of dog clonorchiasis.

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THE PRELIMINARY STUDY OF THE QUANTITATIVE MORPHOLOGIC ANALYSIS USING MRI OF THE LATERAL VENTRICLE IN EARLY-ONSET PSYCHOTIC DISORDER (조기 발병한 정신증적 장애에서 자기공명영상을 이용한 측뇌실에 대한 구조적인 예비연구)

  • Lee, Youn-Hee;Kang, Min-Hee;Kim, Chul-Eung;Bae, Jae-Nam;Hong, Kang-E;Lee, Jeong-Seop
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.256-262
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    • 2001
  • Objective:The enlargement of the lateral ventricle is well established finding in adult-onset schizophrenia, but in the patients with early-onset psychotic disorder(EOPD) is still controversal. To identify structural abnormalities of the lateral ventricle in patients with EOPD and difference of the brain developmental course in EOPD group, planimetrical assessment of the lateral ventricle was conducted by means of retrospective quantitative neuroimaging. Methods:The brain MR images of 14 patients with EOPD(mean age $14.0{\pm}2.1$ years) who met the DSM-III-R diagnostic criteria for schizophrenia and bipolar disorder and 24 control subjects with simple headache(mean age $10.0{\pm}2.1$ years) were collected. Single best view for the lateral ventricle, one axial slice was selected for analysis. MR images were redigitalized with flatbed scanner and data were analyzed with NIH IMAGE software. Results:In the patients with EOPD, there were significant correlations between aging and lateral ventricular sizes and between aging and ventricular brain ratio(VBR). The statistical significance of normal asymmetry of the lateral ventricle was not observed for the EOPD group. The EOPD group had larger lateral ventricular sizes and VBR than control group, but these results were not statistically significant. Conclusion:These findings suggest that the brain abnormalities in patients with EOPD progress from the earlier course of the disorders and the course of brain development in EOPD group is different from control group.

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The Clinical Study of Hemoptysis in Lung Disease (객혈을 주소로 입원한 환자의 임상적 고찰)

  • Lee, Hyang-Ju;Um, Hye-Suk;Kim, Jung-Tae;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.760-773
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    • 2000
  • Background : Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treament treatment of hemoptysis Methods : We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. Results : The mean age at diagnosis was 49.3 years and male to female ratio was 2.1 : 1. The main causes were active pulmonary pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronic bronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. Sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial arteη embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases(43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. Conculsion : The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

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PSEUDOHYPOPARATHYROIDISM : CASE REPORT (가성부갑상선 기능저하증 환아의 구강 증상)

  • Kim, Seong-Oh;Hong, Eun-Kyoung;Choi, Hyung-Joon;Lee, Jae-Ho;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.262-266
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    • 2004
  • The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

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