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A Case of Papillary Thyroid Cancer Presenting as Pleural Effusion (흉수로 발현한 유두모양 갑상샘암)

  • Jung, Ki Hwan;Seo, Ji A;Lee, Ju-Han;Jo, Won Min;Kim, Je Hyeong;Shin, Chol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.314-317
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    • 2008
  • We report the patient presented with a left-sided pleural effusion. Pleural fluid analysis revealed lymphocyte-dominant exudates with lower level of adenosine deaminase and negative cytologic malignancy. Thoracoscopic examination and histologic examination revealed metastatic nodules on pleurae, proven to be from the papillary thyroid cancer. There were no other sites of distant metastases. Though papillary thyroid cancer is characterized with slow progression and relatively good prognosis, metastatic pleural effusion as an initial manifestation of undiagnosed papillary thyroid cancer can be considered.

Surgical treatment of recurrent pseudochylothorax occurring after therapy of tuberculous pleurisy (결핵성 흉막염 치료 후 반복되는 가성유미흉의 수술적 치료)

  • Yi, Jae Ryung;Kim, Woo Sik;Jeong, Eun Jung;Jung, Yu Na;Lee, Hee Sook;Jo, Gi Ho;Lee, Ji Yeon
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.65-68
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    • 2014
  • Pseudochylothorax is an uncommon pleural effusion disease characterized by the presence of cholesterol crystals or high lipid content not resulting from a disrupted thoracic duct. Most of the cases reported so far had been found in patients with long-standing pleural effusion due to a chronic inflammatory disease such as old tuberculous pleurisy or chronic rheumatoid pleurisy. Authors encountered a case of pseudochylothorax in a 45-year-old man who had been treated for tuberculous pleurisy 6 years before his visit to authors' hospital. After that, he had visited the emergency department many times for removal of pleural effusion. The patient's chest X-ray revealed dyspnea and large left-sided pleural effusion. Although a large amount of pleural fluid was removed with a drainage catheter, massive pleural effusion was likely to recur, and the underlying lung was able to fully re-expand. Accordingly, decortication was done, and the patient's symptom was improved without postoperative complications.

A young child of anti-NMDA receptor encephalitis presenting with epilepsia partialis continua: the first pediatric case in Korea

  • Kim, Eun-Hee;Kim, Yeo Jin;Ko, Tae-Sung;Yum, Mi-Sun;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.133-138
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    • 2016
  • Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.

A Study on Costume in Mural Painting of Xu Xianxiu Tomb in Northern Qi period (북제 서현수묘 벽화 복식 연구)

  • An, Bo Yeon;Hong, Na Young
    • Journal of the Korean Society of Costume
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    • v.66 no.1
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    • pp.122-134
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    • 2016
  • The Mural Tomb of Xu Xianxiu(AD 571), a high ranking official in Northern Qi period, is located in Taiyuan, Shanxi province, China. Despite having been raided, it was still discovered to contain over 530 pieces, such as artifacts and murals, in excellent state of preservation. These murals are noteworthy for their high level of detail compared to other murals from the same era, and are important for understanding the historical context of active East-West and Han-Hu cultural exchange in the $6^{th}$ to $7^{th}$ century. The murals of Xu Xianxiu's tomb depict round-collared and narrow-sleeved garments as well as straight collared robes typical of the Xianbei tribe's attire. Notable are the ermine fur overcoat and a headwear with flares on the left and right thought to be unique to the Xianbei. The wife and female servants show female attire of the Xianbei at the time; this attire can be characterized by narrow-sleeved long gowns and asymmetrical flying-bird buns. Despite the anti-Han policy of Northern Qi, influences such as the right sided gathering of the robes and embellished hair styles remain. The procession also depicts the three-cornered headdress and long-tailed hood of the Xianbei men, which have been recorded in documents. The large rounded pearl pattern containing the palmette, the divine animal, and bodhisattva's head motifs show the influence of the Western China [Xi'yu]. Considering that Northern Qi had more active interactions with the three ancient kingdoms of Korea than with the Southern Kingdoms[Nanchao], the findings of this study call for further research on the correlation between the attire of ancient Korea and Northern Qi.

Parry-Romberg syndrome with ipsilateral hemipons involvement presenting as monoplegic ataxia

  • Lee, Yun-Jin;Chung, Kee-Yang;Kang, Hoon-Chul;Kim, Heung Dong;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.354-357
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    • 2015
  • Parry-Romberg syndrome (PRS) is a rare, acquired disorder characterized by progressive unilateral facial atrophy of the skin, soft tissue, muscles, and underlying bony structures that may be preceded by cutaneous induration. It is sometimes accompanied by ipsilateral brain lesions and neurological symptoms. Here we present the case of a 10-year-old girl with right-sided PRS and recurrent monoplegic ataxia of the left leg. At 4 years of age, she presented with localized scleroderma over the right parietal region of her scalp; her face gradually became asymmetric as her right cheek atrophied. Brain magnetic resonance imaging revealed hemiatrophy of the face and skull base, and T2-weighted images showed increased signal in the right hemipons and hemicerebellar peduncle. Magnetic resonance angiography findings were unremarkable. She was treated with oral prednisolone, and her recurrent gait ataxia diminished within 2 months of the follow-up period. To the best of our knowledge, this is only the second case of PRS presenting with an abnormal involvement of the ipsilateral hemipons.

Clinical Studies on Abomasal Displacement of Dairy Cows (유우제사위전위증에 관한 임상적 조사연구)

  • Cheong Chang-Kook;Jo Choong-Ho;Sung Jai-ki;Choi Hee-In;Hwang Woo-Suk;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.1 no.1
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    • pp.11-23
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    • 1984
  • Epizootiolosical factors of 166 cows with abomasal displacement were studied and in 21 out of 166 cows, the functions of liver and kidney were also tested. 1. Incidence of abomasal displacement was perdominant in small sized dairy herd less than 15 cows, using area of paddock below 165㎡. 2. Out of 166 cows with abomasal displacement, 116 cows (70%) were found left sided displacement and 50 cows (30%) were right. 3. Generally, one to two weeks were taken before treatment of veterinarian following onset of sign of the diseases. Therefore many cases were found to be severe in their illness. 4, Incidence rate of abomasal displacement was predominant in summer season (June, July and Au-gust). However, occurence of the disease was continuous throughout the year. About 80 percent of abomasal displacement was distributed from first to third purturition. 5. High milk production and feeding with high concentrates and low roughage showed a tendendy to occurs the disease. 6. Approximately 75% of abomasal displacement was distributed within 1 month pre and post partum. 7. Cows with abomasal displacement consumed little concetrates and 75% of cows with abomasal displacement passed abnormal fecal material. 8. Sixty six out of 166 cows with abomsal displacement were coincident with diseases such as retained placenta, metritis, traumatic reticulo-peritonitis and mastitis. 9. In many cass of abomasal displacement, abomasum was extended with gas. 10. Activities of AST ana LDH showed the trends to reduce after surgical intervention comparing with pre-surgery. Bilirubin concentration markedly decreased after surgical treatment comparing with pre-surgery. 11. The concentration of BUN and creatinine moderatly decreased after surgery compared with pre-surgery.

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Trilogy of Fallot in a Dog (개에서 발생한 팔로삼징)

  • Choi, Ran;Ahn, Hyo-Jin;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.404-407
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    • 2012
  • A 3 years-old female mixed dog (weighing 5.3 kg) was referred to veterinary teaching hospital of Kangwon National University with primary complaints of syncope, severe exercise intolerance, depression and lethargy. Diagnostic studies revealed polycythemia, right sided cardiac enlargement on thoracic radiography and right-to left atrial septal defect, severe pulmonary stenosis (~5 m/s of peak velocity) and right ventricular hypertrophy. Based on diagnostic findings, the dog was diagnosed as trilogy of Fallot. To improve clinical condition of this dog, diltiazem and enalapril were prescribed with weekly phlebotomy. To author's best knowledge, this is the first case of trilogy of Fallot in Korea.

A Study on the Development of Jeogori's Structure and Changes of its Form -Focused on the Era of the Three Kingdoms to United Shilla Era (저고리 세부 구조의 발생과 그 형태 변화에 대한 연구)

  • Chae Keum-Seok
    • Journal of the Korean Society of Costume
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    • v.55 no.1 s.91
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    • pp.113-128
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    • 2005
  • To find our own individuality, there must be an active study on jeogori which is an unexplored field. Therefore, the purpose of this study is to consider artistic beauty and predominance of jeogori and recognize it as a precious culture, and also encourage interest about traditions. The range of this study is ancient times to Chosun dynasty, and in this study which will be the first part, the range is till the era of the Three Kingdoms. The study about jeogori is based on mural paintings of Goguryeo burial mounds, clay dolls and remains during Shilla, Beakjae, and United-shilla era. The contents of this study is 1. research the origin of jeogori's detail structures and changes of the form, 2. analyze the form and structure of the jeogori in each era, and therefore 3. find the predominance of Goguryeo costume by considering functional and design aspects. Therefore the conclusion of this study about the era of the Three Kingdoms are First, jeogori of the three kingdom era were developed from ancient times caftan style which Korea, China and Japan wore all together. Second, the structure of the jeogori during the Three Kingdom are ryeongeum, gil, somae and seon. Third, there is a special line that starts from the neckline and ends at the hem line which should be called ryeongeum in my opinion. Forth, while researching Goguryeo murals there were both left and right sided open jeogori. therefore, I would like to set up a new theory that during the ancient times to Three Kingdom era, not did China's clothing effected the Korean costume but the costume in east asia shared their forms all together.

Surgical Correction of Tetralogy of Fallot in Adults - 101 Cases Report - (성인 활로씨 4징증 수술치험 101예 보고)

  • 조범구
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.649-655
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    • 1988
  • One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.

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Development of an Arachnoid Cyst after Ventriculoperitoneal Shunt Placement - A Case Report - (뇌실복강간 단락술 후 발생한 뇌지주막 낭종 - 증 례 보 고 -)

  • Choi, Kwang Yeong;Rhee, Bong Arm;Lim, Young Jin;Kim, Tae Sung;Kim, Gook Ki;Leem, Won
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.364-367
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    • 2001
  • A 4-month-old female patient admitted because of hydrocephalus. She was premature infant with germinal matrix hemorrhage at gestational period 27 wks. A ventriculoperitoneal shunt with a low-pressure type valve was placed. Follow-up CT scan obtained 3 months after VP shunt placement, revealed a new Lt. middle cranial fossa cyst. The girl was readmitted to hospital at 7 months after VP shunt placement, complaining of lethargy and vomiting. A CT scan was demonstrated a increase in size of a cyst, She subsequently underwent a left-sided pterional craniotomy with partial excision of membrane and cyst fenestration into the basal cisterns. Follow-up CT scan after 18 months revealed reaccumulation of cyst, the girl was reoperated on. After 2 months, the size of cyst was not decreased. Finally, She underwent a cystoperitoneal shunt. Follow-up CT scan after 5 months was demonstrated disappeared cyst and reexpansion of brain parenchyma. We report the development of a symptomatic sylvian fissure arachnoid cyst developed after ventriculoperitoneal shunt.

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