• 대한물리치료과학회지
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• 제10권2호
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• pp.42-52
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• 2003

An assessment of the subtalar joint in cerebral palsies can contribute to predict the function of ambulation in CP children. Ambulation is one of the most important function to guarantee the CP children independent life. This paper is to investigate some relationships between the function of standing and walling and the assessment of the subtalar joint in children with Cerebral palsy. And also to present the correlation between the ambulation and the Gross Motor Function Measures in children with cerebral palsy. Sixty-eight children with cerebral palsy were participated in this study. Evaluations of the subtalar pint parameters were performed by the goniometer and the angle finder, and the GMFM scores were measured by their teacher and researcher trained technically. A regression analysis was applied to figure out the relationship between the subtalar pint parameters(ROM and RCSP) and the function of standing and walking. A correlation analysis was employed to see how much the subtalar pint parameters could be predicted from GMFM scores in walling and standing. The results were as follows: 1) The significant differences were not observed between the total ROM, RCSP and the function of standing(F=8.065, p<.001) and walking(F=6.511, p<.001) in CP children. 2) The subtalar pint parameters(total ROM, RCSP) have the lower relevance to the function of standing and walling in CP children.(p>.05) 3) The total ROM and RCSP in both feet have the significant differences between the CP children and the normal children.(p<.001) 4) The GMFM scores were significantly correlated with the function of walling and standing in CP children.(r=247, p<.05) In this research, it is found that the significant relevance between the quantitative analysis of subtalar pint in children with cerebral palsy and the gross motor function of ambulation in standing and walling. However, it is difficult to predict the direct relationship of subtalar pint parameters and the function of ambulation, because subtalar pint scores and GMFM are only measured as quantities not qualities. Therefore, it is more reasonable to investigate the influence of subtalar pint parameters on ambulation in children with cerebral palsies, adding to the multifocal assessment of the children, rather than vice versa.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.161-167
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• 2022

Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

• Journal of Yeungnam Medical Science
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• 제27권1호
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• pp.57-62
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• 2010

Pulmonary alveolar proteinosis (PAP) is a rare disorder that's characterized by accumulation of surfactant components in the alveolar space. Idiopathic PAP is recognized as an autoimmune disease that's due to impaired alveolar macrophage function and this caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). We report here a case of pulmonary alveolar proteinosis that was deemed interstitial lung disease at the initial diagnosis. A 61-year-old man presented with intermittent blood tinged sputum and dyspnea on exertion. The man was a painter for 30 years and he had a 10 pack-years smoking history. Chest computerized tomography (CT) revealed multifocal ground-glass opacity with interstitial thickening at both lungs. His pulmonary function tests and methacholine test revealed non specific results. He was diagnosed with interstitial lung disease on the basis of the chest CT finding and occupational history. However, seven months later, his symptoms progressed. Follow-up chest CT was performed. Wedge resection via video-assisted thoracoscopic surgery (the anterior basal segment of the left lower lobe) was done. Microscopic examination showed large groups of alveoli with excessive amounts of surfactant and a complex mixture of protein and lipid (fat) molecules. Finally, he was diagnosed as having pulmonary alveolar proteinosis.

• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• The Korean Journal of Medicine
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• 제99권2호
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• pp.116-121
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• 2024

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis predominantly involving medium- or small-sized arteries, typically of the kidneys and other internal organs. Given the rarity of PAN and the variable clinical presentation, diagnosis is challenging and, to date, no definitive diagnostic marker has been identified. A patient diagnosed with immunoglobulin A nephropathy was observed to exhibit deterioration in renal function. To determine whether new structural abnormalities had developed, computed tomography scans of the kidneys, ureters, and bladder were obtained. Both kidneys exhibited multiple cortical defects, and a renal angiogram was performed to determine the cause. Angiography revealed partial obliteration of the left distal renal artery branches and multifocal extensive infarctions in both kidneys, and the patient was diagnosed with renal-limited PAN. Following steroid monotherapy, an improvement in renal function was observed. We believe that this case report may be helpful to physicians who assess and treat patients with suspected renal-limited PAN.

• 한국임상수의학회지
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• 제31권4호
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• pp.316-318
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• 2014

3년령 한국 집고양이가 갑작스럽게 발병한 간헐적 경련 증상을 주 증상으로 내원하였다. 신체검사상 구리 빛 홍채가 관찰되었고, 양안에서 위협반사 소실이 관찰되었다. 혈액학 검사와 혈청 화학 검사에서 경증의 적혈구 증가증과 심한 소적혈구증, 증가된 ALT 활성도가 확인되었으며, 추가로 실시한 간기능 평가에서는 담즙산염 농도와 암모니아 농도가 증가하였다. 방사선 검사에서 간 내 다수의 결절이 관찰되었고, 간외성 션트 혈관을 발견하였으며, 추가로 실시한 컴퓨터 단층 촬영을 통해 복합 간외션트를 확인하였다. 고양이는 션트 혈관에 대한 외과적 처치술을 받기 위해 증상 완화를 위한 디아제팜과 락툴로즈를 투여하였으나 경련이 심화되었고, 심장 정지가 와서 폐사하였다.

• Tuberculosis and Respiratory Diseases
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• 제46권5호
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• pp.723-728
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• 1999

Pulmonary embolism from metallic mercury is rare. It may occur after a deliberate intravenous injection of mercury as a suicide gesture, in the presence of drug abuse or severe psychiatric disturbance, with the hope of increasing athletic and sexual performance, and accidentally during right heart catheterization while sampling blood with mercury containing syringes. We have experienced the first case of pulmonary embolism associated with intravenous mercury injection in Korea. The blood mercury level remain elevated within the toxic range to date. This may be due to the continued absorption of embolized mercury. Multifocal areas of patchy perfusion defects are in both upper lung fields on perfusion scan of lung. Few of the abnormalities of respiratory or renal function reported previously were demonstrated. We report the case of a young male patient presenting with a clinical picture of pulmonary embolism, in whom widespread deposit of metallic mercury were demonstrated throughout both lungs and elsewhere in the body.

• Tuberculosis and Respiratory Diseases
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• 제67권1호
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• pp.37-41
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• 2009

LIP는 매우 드문 간질성 폐질환의 일종으로 비특이적인 방사선학적 소견으로 보이므로 타 간질성 폐질환과의 감별을 위해서는 반드시 개흉 폐생검을 하여야 한다. 또한 LIP 진단 후 다른 자가 면역 질환 및 감염의 확인이 치료방향의 결정에 있어 필요하며 폐섬유화 및 폐성심으로의 진행을 막기 위해서 조기에 적극적인 폐생검을 시행하여 적극적인 치료를 시작하여야 한다. 또한 일부 악성 림프종으로의 진행도 보고 되고 있어 정기적인 추적 검사가 필요하다. 저자들은 1개월 간의 기침과 운동 시 호흡곤란으로 내원하여 개흉 폐생검 결과 LIP로 진단 후 스테로이드 치료로 호전된 1예를 경험하였기에 관련 문헌고찰과 함께 보고한다.

• Clinical and Experimental Pediatrics
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• 제53권2호
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• pp.262-266
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• 2010

$TNF-{\alpha}$ 는 소아기 류마티스모양 관절염의 병태생리학에 관여하는 주요 cytokine 이다. Etanercept 는 $TNF-{\alpha}$ 억제제 중 하나로 소아기 류마티스모양 관절염에 효과적인 약물로 각광받고 있다. Etanercept의 주요 부작용은 면역력 저하에 의한 감염으로, 대게 중등도의 상기도 감염이 대부분으로 알려져 있으나, 최근 중증의 감염도 보고되고 있다. 저자들은 소아기 류마티스모양 관절염 환자가 etanercept를 14개월간 투약 후 발생한 뇌염 1예를 경험하였기에 보고하는 바이다.

• 대한두경부종양학회지
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• 제14권2호
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• pp.228-235
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• 1998

Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.