• 제목/요약/키워드: CT-scan

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공혈형 내측 활막추벽 증후군 - 1례 보고 - (Fenestrated Medial Plica Syndrome - A Case Report -)

  • 배대경;전명호;표나실;이정희
    • 대한관절경학회지
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    • 제3권2호
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    • pp.150-154
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    • 1999
  • 공혈형 내측 활막추벽은 내측 활막추벽의 한 형태로 흔하지 않은 것으로 알려져 있으며 그 크기는 다양하여 직경 5mm에서 3-4cm 되는 것도 있다고 보고된다. 그 증상은 비특이적이나 다양한 내측 슬관절 증상을 유발하여 다른 슬관절 내장증의 원인들과 감별 진단이 요구된다. CT scan, MR imaging 등이 진단에 도움이 되지만 결정적인 진단은 관절경술에 의해 이루어지며 보존적 치료를 시행하고 이에 반응하지 않는 경우에 관절경적 절제술을 이용하여 치료를 시행하면 지속적이고 만족스러운 임상 호전을 얻을 수 있다고 보고된다. 본 정형외과 교실에서는 그 빈도가 흔하지 않은 양측 슬관절 공혈형 내측 활막추벽 증후군이 관찰되어 관절경적 절제술을 시행하고 술후 및 외래 추시시 즉각적이며 극적인 임상 호전을 보인 1례가 있어 문헌 고찰과 함께 임상 경험을 보고하는 바이다.

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진성 성조숙증으로 전환된 선천성 부신 과형성증 1례 (A Case of True Precocious Puberty Complicating Congenital Adrenal Hyperplasia)

  • 김수진;이주석;김수영
    • Clinical and Experimental Pediatrics
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    • 제46권4호
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    • pp.400-403
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    • 2003
  • 진단이 지연되었거나 적절하게 치료되지 않은 선천성 부신 과형성증을 가진 남아에서 장기간 고농도의 남성호르몬에 노출될 경우 처음에는 가성 성조숙증이었다가 이후 진성 성조숙증으로 전환될 수 있으므로 선천성 부신 과형성증의 조기진단과 치료가 필요하다. 저자들은 가성 성조숙증에서 진성 성조숙증으로 전환된 선천성 부신 과형성증을 가진 남아에서 hydrocortisone과 GnRH 유도체를 사용하여 큰 부작용 없이 2차 성징의 퇴축을 가져온 1례를 경험하고 문헌고찰과 함께 보고하는 바이다.

뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과 (Effect of the Intra-arterial Papaverine Infusion on the Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage)

  • 신준재;이재환;신용삼;허승곤;김동익;이규창
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.325-333
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    • 2001
  • Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

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골다공증성 척추 압박골절 환자의 경피적 척추성형술에서 Polymethylmethacrylate의 경막 외 유출 (Epidural Leakage of Polymethylmethacrylate Following Percutaneous Vertebroplasty in the Patients with Osteoporotic Vertebral Compression Fractures)

  • 오윤규;류경식;박춘근;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.319-324
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    • 2001
  • Objectives : The percutaneous vertebroplasty provides a good result in the treatment of osteoporotic vertebral compression fractures. But, the epidural leakage of polymethylmetacrylate(PMMA) after vertebroplasty may decrease the therapeutic effects because of the compression of thecal sac and/or nerve roots. The authors carried out a prospective study to evaluate the causative factors of epidural leakage of PMMA and to assess the influence on the outcome. Methods : This study involved 347 vertebral levels of compression fractures in 159 patients. Among these, the epidural leakages were identified in 92 vertebral levels(26.5%) in 64 patients(40.3%) on post-operative CT scan. Results : The incidence of epidural leakage of PMMA was significantly higher in the level above T7(p=0.001). The large amount of the injected PMMA and the use of an injector also increased the incidence(p=0.03 and p=0.045, respectively). The position of the needle tip in the vertebral body and the pattern of venous drainage did not influence. The immediate post-operative visual analogue scale(VAS) scores and facial scales(FS) were higher in the patients with epidural leakage(p=0.009). But there were no significant differences between the two groups after three months of operation(p=0.541). Conclusions : The incidence of epidural leakage of PMMA after percutaneous vertebroplasty appears to have relationship with the amount of PMMA and the levels injected. The epidural leakage of PMMA reduced the immediate therapeutic effects of vertebroplasty, but did not influence the late outcome. However, the epidural leakage should be avoided because of its potential neurological complications.

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Histomorphometric Analysis of the Spine and Femur in Ovariectomized Rats Using Micro-Computed Tomographic Scan

  • Shin, Yong-Hwan;Cho, Dae-Chul;Yu, Song-Hee;Kim, Kyoung-Tae;Cho, Hee-Jung;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • 제52권1호
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    • pp.1-6
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    • 2012
  • Objective : The purpose of this study was to evaluate the different patterns of bone loss between the lumbar spine and the femur after ovariectomy in rats. Methods : Twenty-four female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy (the ovariectomized group). Four and eight weeks after operation, six rats from each of the two groups were euthanized. Serum biochemical markers of bone turnover including osteocalcin and alkaline phosphatase (ALP), which are sensitive biochemical markers of bone formation, and the telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption, were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae and femur were determined by micro-computed tomography. Results : Ovariectomized rats were found to have higher osteocalcin, ALP and CTX levels than sham controls. Additionally, 8 weeks after ovariectomy in the OVX group, serum levels of osteocalcin, ALP and CTX were significantly higher than those of 4 weeks after ovariectomy. Bone loss after ovariectomy was more extensive in the 4th lumbar spine compared to the femur. Bone loss in the 4th lumbar spine was mainly caused by trabecular thinning, but in the femur, it was mainly caused by trabecular elimination. Conclusion : The present study demonstrates different patterns of bone loss between the 4th lumbar spine and the femur in ovariectomized rats. Therefore, when considering animal models of osteoporosis, it is important that bone sites should be taken into account.

입체각 측정을 통한 대퇴골두에 대한 관골구 coverage 측정 (The solid angle estimation of acetabular coverage of the femoral head using 3D method)

  • 최교환;김만찬;임제탁;김선일
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 춘계학술대회
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    • pp.123-126
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    • 1997
  • We present a method for the estimation of 3D solid angle assessment of the acetabular coverage of the femoral head in 3D space. At first, femoral head and acetabulum is segmented from the original CT scan images. The slice thickness is 1.5mm and the number of slices is usually 30-40 to cover the entire acetabulum. The superior half of the femoral head is modeled as part of a sphere. Thus, the axial cross sections of the upper half of the femoral head are also modeled as circles. A set of points from each outline image of femoral head is fitted recursively into a circle by minimizing root-mean-square (RMS) error. With these fitted circles, a center point of the femoral head model is evaluated. This is a reference point for calculating the solid angle of the acetabular inner surface. Next, the tangent lines connecting from a set of points of the acetabular edge to the center of the fitted sphere are obtained. The lines pass through the unit sphere whose center is the same as that of the femoral head. With the points on the unit sphere, we calculate area and estimate the solid angle. Based on this solid angle, the deformity of the acetabulum is analyzed. In case of normal subject, the solid angle is about 4.3 (rad) and acetabular coverage is 68%.

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듀얼센서 기반 X-선 검색영상 스테레오 가시화 연구 (A Study on Stereo Visualization of the X-ray Scanned Image Based on Dual-line Sensors)

  • 이남호;황영관;박종원;임용곤
    • 한국정보통신학회논문지
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    • 제14권9호
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    • pp.2083-2090
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    • 2010
  • 본 논문에서는 고속 이동 컨테이너 화물을 효율적으로 검색하기 위한 스테레오 방사선 영상 기반 3차원 형상화 연구에 관하여 기술하였다. 스테레오 방사선 영상은 X-선 발생장치, 선형 방사선 센서 그리고 이동 스테이지로 구성한 일련의 장치로부터 실물을 대상으로 획득하였다. 두 개의 방사선 센서는 검색 대상체의 정류된 X-선 영상을 얻도록 설계 및 제작되었다. 스테레오 X-선 영상을 이용하여 두 영상간의 대응점을 찾는 매칭 알고리즘을 구현하고, 대상체의 실제 3차원 형상을 복원과정을 연구하였다. 대상체는 컨테이너 화물을 모사하기 위해 평형 철재 상자 내부에 넣은 다음 시험하였다. 3가지 대상체에 대해 스캔시험과 3차원 복원과정을 차례로 진행하였으며, 방사선 영상의 정보부족으로 인한 한계를 극복하기 위해 에지정보를 기반으로한 영상복원을 시도하였다. 시험결과는 제안한 기술이 컨테이너 화물 검색에서 보다 효율적인 정보를 제공할 수 있음을 확인시켜 주었다.

시츄견에서 경부 림프절로 전이된 편도 편평세포암종 (Cervical Lymph Node Metastases of Tonsillar Squamous Cell Carcinoma in a Shih-tzu)

  • 정동인;이경우;박기태;왕지환;연성찬;이효종;이희천
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.154-158
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    • 2011
  • A 8-year-old female Shih-tzu dog (weighting 4.5 kg) with history of both hindlimb lameness and cervical mass was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, ataxia, kyphosis, back pain and cervical mass were identified. Marked periosteal new bone formation of the fourth lumbar vertebra and soft tissue opacity mass of cervical region were observed in survey radiographs. Transverse computed tomography (CT) scan obtained at the lumbar and cervical lesions shown a well defined multilobulated bony mass and partially destructive lytic lesions the fourth lumbar vertebral body and a enlarged retropharyngeal lymph node with heterogeneous contrast enhancement and moderately enhancing left tonsillar mass. Neoplastic squamous epithelium which have developed vessel and lymphocyte infiltration in surrounding tissue were confirmed based on histopathologic examination. Based on the diagnostic findings the dog was diagnosed as a cervical lymph node metastases of tonsillar squamous cell carcinoma.

관상동맥질환을 동반한 대동맥류 수술치험 1례 (Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease A Case Report -A Case Report-)

  • 우종수;서정욱
    • Journal of Chest Surgery
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    • 제30권7호
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    • pp.724-728
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    • 1997
  • 68세된 남자로 좌측과 후측 흉부에 통증을 주소로 내원하였다. 술전 시행한 흉복부 W scan에서 대동맥류는 좌측 쇄골하동맥에서 횡격막까지 연결되었고 긴박성 파열의 소견도 보였다. 또한 술전 관동맥조영술에서는 좌회선동맥에 95%, 좌전하행지에 50%의 협착소견을 보였다. 수술은 고동맥-고정맥 우회술을 하면서 좌측 제 4늑간을 통하여 측후방 개흉절개를 하여 수술시야를 확보하였고 대동맥을 차단한뒤 대동맥류를 절개하고 인조혈관으로 대치하였다. 그리고 심박동하에서 대복제정 맥을 이용하여 좌회선동맥의 두번째 둔각변연동맥과 좌측 쇄골하동맥 기시부에 관상동맥 우회술을 하였다. 술후 환자는 술중 저혈압성 쇼크와 저산소증으로 다발성 뇌경색의 합병증을 보였다.

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반복적인 비경구노출에 의한 유기인계 중독: 중간형증후군과 급성췌장염 1례 (A Case of Organophosphate Insecticide Intoxication by Repetitive Parenteral Exposure, Complicated with Intermediate Syndrome and Acute Pancreatitis)

  • 오세현;강희동;이부수
    • 대한임상독성학회지
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    • 제4권2호
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    • pp.161-165
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    • 2006
  • Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

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