• Title/Summary/Keyword: 확장증

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BALLOON DILATATION OF ESOPHAGEAL STRICTURE (Balloon 확장술에 의한 식도협착증의 치료)

  • 윤성철;나인국;김형종;노영수;임현준;이길우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.33-33
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    • 1991
  • 부식성 식도염에서 속발한 식도협착의 비외과적 치료법으로 사용되었던 종래의 각종 소식자를 이용한 확장술은 그 효과가 일시적이며 소아에서 시행시 많은 문제점이 있다. 근래들어 관상동맥, 요관, 대장 등의 협착에 사용되어온 balloon Catheter를 이용한 식도 확장술은 비교적 안전하고 효과적이어서 소아나 정도가 심한 식도협착의 치료에 큰 도움을 줄 수 있다. 본 교실에서는 최근 2년간 부식성 식도염 후 속발한 식도협착 6 례를 Balloon catheter 확장법으로 치료하여 아래와 같은 결과를 얻었기에 보고하는 바이다. 1) 전체 6명 중 남자가 4명 여자가 2명으로 평균 연령은 45.7세였다. 2) 부식제의 종류는 가성소다가 5명 초산이 1명이였다. 3) 협착부위는 1례가 경부식도이며 5례가 흉부식도였고 이중 1례는 다발성 협착이 였다. 4) 확장 전 식도조영사진 상 협착부위의 평균 내경은 4.3mm였다. 5) 확장술을 시행한 횟수는 2회에서 5회( 평균 3.5회 )로 확장술이 끝난 후의 평균 내경은 13.5mm였다. 5) 확장술시 3례에서 식도파열이 발생하였으나 보존적 치료법으로 치유되었다.

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The Consideration of the Region of Interest on $^{99m}Tc$-DMSA Renal Scan in Pediatric Hydronephrosis Patients (수신증을 진단 받은 소아 환자의 DMSA 신장 검사에서 정확한 관심영역 설정에 대한 고찰)

  • NamKoong, Hyuk;Lee, Dong-Hyuk;Oh, Shin-Hyun;Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.27-33
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    • 2012
  • Purpose: Most of diagnosis in the pediatric hydronephrosis patients have been performed $^{99m}Tc$-DMSA renal scan. Then the region of interest (ROI) is set for comparative analysis of uptake ratio in left-right kidney after acquiring the image. But if the equipment set an automatic ROI, the ROI could include expanded renal pelvis due to hydronephrosis and the uptake ratio of left-right kidney will be incorrect result. Therefore this study compared both ROIs including expanded renal pelvis and excluding renal pelvis through experiment using normal kidney phantom and expanded renal pelvis phantom and suggested setting method of improved ROI. In addition, this study have been helped by readout doctor for investigate distinction radiopharmaceutical uptake between renal cortex and remained urine by expanded renal pelvis. Materials and Methods: The both of renal phantoms were filled with water and shacked with $^{99m}TcO_4$ 111 MBq. In order to describe the expanded renal pelvis, the five latex balloon were all filled with 10 mL water and each of balloon was mixed with $^{99m}TcO_4$ 18.5, 37, 55.5, 74, 92.5 MBq. And we made phantom with fixed $^{99m}TcO_4$activity of 37 MBq and mixed water 5, 10, 15, 20, 25 mL in each balloon. The left kidney was fixed its shape and the right kidney was modified like as hydronephrosis kidney by attached the latex balloons. And the acquiring counts were 2 million. After acquisition, we compared the image of ROI with Expanded renal pelvis and the image of ROI without renal pelvis for analyzing difference in the uptake ratio of left-right kidney and for reproducibility, set the ROI 5 times in the same images. Patients were injected $^{99m}Tc$-DMSA 1.5~1.9 MBq/kg and scanned 3 to 4 hours after injection. The each of 3 skillful radio technologists performed the comparing estimation by setting ROI. To determine statistical significance between two data, SPSS (ver. 17) Wilcoxon Signed Ranks Test was used. Results: As a result of renal phantom's experiment, we compared with average of counts Background (BKG) ratios in the setting of ROI including expanded renal pelvis and setting of excluding expanded renal pelvis. Therefore, they can obtain changed counts and changed ratios. Patient also can obtain same results. In addition, the radiopharmaceutical uptake in expanded renal pelvis was come out the remained urine that couldn't descend to ureter by the help of readout doctor. Conclusion: As above results, the case of setting ROI including expanded renal pelvis was more abnormally increasing uptake ratio than the case of setting ROI excluding expanded renal pelvis in analysis the uptake ratio in left-right kidney of hydronephrosis. Because of the work convenience and prompted analysis, the automatic ROI is generally used. But in case of the hydronephrosis study, we should set the manual ROI without expanded renal pelvis for an accurate observation of the uptake ratio of left-right kidney since the radiopharmaceutical uptake in expanded renal pelvis is the remained urine.

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Ultrasonographic Findings in Children with Vesicoureteral Reflux (방광요관역류를 가진 소아에서의 신초음파 소견)

  • Choi, Min-Jung;Park, Se-Jin;Shin, Jae-Il;Kim, Kee-Hyuck
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.32-37
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    • 2012
  • Purpose: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). Methods: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultrasonography at Ilsan hospital between January 2000 and December 2010. Results: Among 166 renal units, 108 (65.0%) were found to have vesicoureteral reflux (VUR). Fifty-one (73.9%) had VUR in renal units with abnormal ultrasonography (USG), whereas 57 (58.7%) had VUR in renal units with normal USG. Abnormal USG findings were independent risk factors for VUR (Odds ratio, 1.98; 95% CI, 1.01-3.89; $P$=0.045). In renal units with VUR, the number of normal USG finding was 52.8%, and the abnormal findings were as follows; increased cortical echogenicity 16.7%, hydronephrosis 17.6%, megaureter or ureter dilatation 8.3%, hydronephrosis and ureter dilatation 1.9%, duplication of ureter 1.9%, and atrophic kidney 0.9%. The prevalence of VUR was relatively higher in renal units with hydronephrosis (23/19, 82.6%), ureter dilatation (9/9, 100%), duplication of ureter (2/3, 66.6%), and atrophic kidney (1/1, 100%). Conclusion: Our study indicates that VUR was associated with abnormal USG findings. When there are abnormal USG findings such as hydronephrosis, ureter dilatation, duplication of ureter, and atrophic kidney in children with UTI, VCUG is recommended to detect VUR after controlling UTI.

A Case of Bronchiectasis with High Serum CA19-9 (혈중 CA19-9이 지속적으로 상승되었던 기관지 확장증 환자 1예)

  • Huh, Jung Hun;Lee, Su Mi;Koo, Tae Hyoung;Shin, Bong Chul;Um, Soo Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Rho, Mee Sook;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.383-386
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    • 2008
  • An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients' clinical condition.

Atrial Flutter with Poor Ventricular Response in a Bull Terrier Dog (불테리어종 개에서 발생한 미약한 심실반응이 있는 심방조동)

  • Lee, Joon-Seok;Han, Suk-Hee;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.435-439
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    • 2010
  • A six-year-old intact female Bull Terrier dog (weighing 17 kg) was referred to the Veterinary Teaching Hospital with exercise intolerance and occasional syncope as the primary complaint. Diagnostic studies revealed a rare case of atrial flutter with complete heart block and aberrant ventricular activation from the ectopic focus, possibly due to idiopathic dilated cardiomyopathy. Although the dog was responded with cardiac medication for right-sided heart failure and anti-arrhythmic agent (dofetilide), the dog died suddenly of cardiac arrest after 11 months of treatment.

Segmental Dilatation of the Ileum Combined with Colonic Duplication: - a Case Report - (대장 중복증과 동반된 회장 분절 확장증 1례)

  • Han, Seok-Joo;Kim, Seung-Min;Son, Soeg-U;Kim, Ho-Geun;Kim, Jai-Eok;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.166-171
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    • 1998
  • Segmental dilatation of the small intestine is a rare form of the congenital intestinal anomaly. Many other combined anomalies have been reported in, but the association with colonic duplication has not been reported in the literature. We report a case of segmental dilatation of the distal ileum associated with colonic duplication. The main clinical and pathogenic aspects are discussed, and the literatures are reviewed.

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Persistent Right Aortic Arch in a Dog (우대동맥궁 잔존)

  • 최지혜;박성민;조태현;김현욱;최민철;윤정희
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.450-453
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    • 2000
  • 식후 만성적인 구토 증상을 보이는 3개월령 암컷 Schunauzer가 본 (주)해마루 소동물 임상 의학 연구소에 내원하였다. 신체 검사시 비정상직인 소견은 보이지 않았으나, 유동식을 공급하는 중에도 식 후 1시간 이내에 포말성 역류 증상을 보였고, 기립 자세에서 식이를 공급 해도 증상은 호전되지 않았다 일반 방사선 검사에서 전반적인 식도 확장이 관찰되었고. 식도 조영술을 실시하여 심기저부 앞부분의 협착과 협착부 전후의 식도 확장을 확인하고 우대동백궁 잔존증으로 진단하였다. 수술을 통해 식도를 압박하고 있는 인대를 제기하고 유동식을 공급하였다. 술 후 임상 증상은 다소 호전이 되었으나 여전히 고형식은 섭취하지 못하고 방사선 검사상 소견도 술전과 큰 차이를 보이지 않았다

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