• Title/Summary/Keyword: Nodules

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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

The Influence of the Characteristics of Drainage Basin on Depositional Processes of the Alluvial Fan: An Example from the Cretaceous Duwon Formation in Goheung Area (유역분지 특성에 따른 충적선상지의 퇴적작용: 고흥군 백악기 두원층의 예)

  • Lee, Kyung Jin;Park, Seung-Ik;Lee, Hyojong;Gihm, Yong Sik
    • Economic and Environmental Geology
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    • v.54 no.4
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    • pp.441-456
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    • 2021
  • The Cretaceous Duwon Formation was studied on the basis of sedimentologic analysis in order to unravel geologic conditions for the development of the streamflow-dominated alluvial fan under arid to semi-arid climatic conditions. The Duwon Formation unconformably overlies the Paleoproterozoic gneiss (basement). Based on the sedimentologic analysis, the Duwon Formation is interpreted to have been deposited in gravelly braided stream (FA-1) near the basement, laterally transitional to sandy braided stream (FA-2) and floodplain environments (FA-3) with distance (< 7 km) from the basement. Lateral changes in sedimentary facies and the well development of calcrete nodules in FA-3, together with radial paleocurrent directions measured in FA-1, are suggestive of the deposition of the Duwon Formation in streamflow-dominated alluvial fan under arid to semi-arid climatic conditions. Recent analysis of detrital zircon chronology suggests that sediments of the Duwon Formation were derived from the southwestern part of the Korean peninsula, including the western part of Yeongnam Massif and the southwestern part of Okcheon Belt. This implies the alluvial fan where the Duwon Formation accumulated had the large drainage basin. Because the large drainage basin can supply the significant amounts of water and temporarily store the sediments within the basin, watery floodwater carried sediments to the alluvial fan rather than the debris flows. Furthermore, the drainage basin largely composed of coarse-grained metamorphic and igneous rocks produced sand-grade sediments, preventing evolution of floodwater into debris flows. We suggest that combined effects of the large drainage basin and its coarse-grained metamorphic and igneous rocks provided favorable conditions for the development of streamflow-dominated alluvial fan, despite arid to semi-arid climatic conditions during sedimentation.

Detection and Control of Bacterial Diseases of Cultured Fishes in Korea (양식어류(養殖魚類)의 세균성질병(細菌性疾病)의 진단(診斷)과 대책(對策))

  • Chun, Seh-Kyu
    • Journal of fish pathology
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    • v.1 no.1
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    • pp.5-30
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    • 1988
  • This is a comprehensive study for considering the effective treatment and control program of bacterial disease occurring in common carp, israel carp, color carp, crucian carp, eel and tilapia by clarifying the causes, mechanism of infection and onset and the diagnostic criteria. As a first step, the authors investigated the external views, gross and histopathologic findings of diseased fish using 450 infected fishes obtained from various farmer of Korea. This infection was characterized by hyperemia, hemorrhage and swelling of body surface and fins, congestion of liver, spleen, kidney, inflammation of intestine, hemorrhagic inflammation of various tissues, and necrosis and ulcer of various tissues were accompanied in serious cases. Bacteriologically, Aeromonas hydrophila and Edwardsiella tarda were isoiated from these fishes. Particularly in the regular check on 222 eels, 177 strains were isolated as 29.94% of Aeromonas hydrophila, 48.58% of Edwardsiella tarda and 21.47% of Flexibacter columnaris. Hexibacter columnaris was isolated from corroded gill of eels. The identical disease was occurred by innoculating the isolated Aeromonas hydrophila and Edwardsiella tarda and the identical strains were isolated from infected experimental fishes. The eels which were diagnosed Aeromonas disease from Kwangju, Pusan accompanied hemorrhage, swelling of body surface and fins, inflammation of stomach and intestine containing mucous fluids mixed with the pathogens. Color carp and crucian carp which were innoculated with the isolated 5 strins of Aeromomas hydrorphil died within 3 or 4 days accompanying with the characteristics of Aeromonas disease. Edward disease was characterized by abscesses of body surface, pus formation with concentration on phagocytes. The size of absecsses increased with progression elf disease. There were also various abscesses at internal organ and white nodules appeared in kidney. Histologically, various progressive granuloma were examined without inflammation of intestine. Columnaris disease of eels showed no hemorrhage except slight white body color. In autopsy, most of internal organs appeared normal and there were no septic odors. The only character was corrosion of gills. In order to treat these bacterial diseases, infected fishes must bathe in 20ppm chloramphenicol or kanamycin solution for 1 hour. Besides, medication program in oral ingestion of 75mg/kg chloramphenicol per day continuing for 5 to 7 days. After injecting the formalin treated Aermonas hydrophila antigen into carp, relatively high agglutination titer showed between 3 weeks and 6 weeks. Though this titer decreased from that time, it was continued for 18 weeks. In the case of injecting the formalin treated Edwardsiella tarda antigen into tilapia, the titer also increased. But tilapia which were immersed in the suspension fluid of the formalin treated Edwardsiella tarda showed no increase of the titer.

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F-18 FDG PET Scan findings in Patients with Pulmonary Involvement in the Hypereosinophilic Syndrome (원발성 과호산구증가 증후군 환자들 중 폐침범을 보이는 환자군의 F-18 FDG PET 소견)

  • Lee, Jae-Hoon;Kim, Tae-Hoon;Yun, Mi-Jin;Hur, Jin;Kim, Tae-Sung;Kim, Sang-Jin;Kim, Hyung-Joong;Pai, Moon-Sun;Ryu, Young-Hoon;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.4
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    • pp.239-245
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    • 2005
  • Purpose: Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the iung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or injection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. Material and Methods: F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. light patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia werr included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. Results: F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Conclusions: Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement.

Pulmonary Mycoses in Immunocompromised Hosts (면역기능저하 환자에서 폐진균증에 대한 임상적 고찰)

  • Suh, Gee-Young;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Kim, Tae-Sung;Chung, Man-Pyo;Kim, Ho-Joong;Han, Jong-Ho;Choi, Dong-Chull;Song, Jae-Hoon;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1199-1213
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    • 1998
  • Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.

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Geology of Athabasca Oil Sands in Canada (캐나다 아사바스카 오일샌드 지질특성)

  • Kwon, Yi-Kwon
    • The Korean Journal of Petroleum Geology
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    • v.14 no.1
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    • pp.1-11
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    • 2008
  • As conventional oil and gas reservoirs become depleted, interests for oil sands has rapidly increased in the last decade. Oil sands are mixture of bitumen, water, and host sediments of sand and clay. Most oil sand is unconsolidated sand that is held together by bitumen. Bitumen has hydrocarbon in situ viscosity of >10,000 centipoises (cP) at reservoir condition and has API gravity between $8-14^{\circ}$. The largest oil sand deposits are in Alberta and Saskatchewan, Canada. The reverves are approximated at 1.7 trillion barrels of initial oil-in-place and 173 billion barrels of remaining established reserves. Alberta has a number of oil sands deposits which are grouped into three oil sand development areas - the Athabasca, Cold Lake, and Peace River, with the largest current bitumen production from Athabasca. Principal oil sands deposits consist of the McMurray Fm and Wabiskaw Mbr in Athabasca area, the Gething and Bluesky formations in Peace River area, and relatively thin multi-reservoir deposits of McMurray, Clearwater, and Grand Rapid formations in Cold Lake area. The reservoir sediments were deposited in the foreland basin (Western Canada Sedimentary Basin) formed by collision between the Pacific and North America plates and the subsequent thrusting movements in the Mesozoic. The deposits are underlain by basement rocks of Paleozoic carbonates with highly variable topography. The oil sands deposits were formed during the Early Cretaceous transgression which occurred along the Cretaceous Interior Seaway in North America. The oil-sands-hosting McMurray and Wabiskaw deposits in the Athabasca area consist of the lower fluvial and the upper estuarine-offshore sediments, reflecting the broad and overall transgression. The deposits are characterized by facies heterogeneity of channelized reservoir sands and non-reservoir muds. Main reservoir bodies of the McMurray Formation are fluvial and estuarine channel-point bar complexes which are interbedded with fine-grained deposits formed in floodplain, tidal flat, and estuarine bay. The Wabiskaw deposits (basal member of the Clearwater Formation) commonly comprise sheet-shaped offshore muds and sands, but occasionally show deep-incision into the McMurray deposits, forming channelized reservoir sand bodies of oil sands. In Canada, bitumen of oil sands deposits is produced by surface mining or in-situ thermal recovery processes. Bitumen sands recovered by surface mining are changed into synthetic crude oil through extraction and upgrading processes. On the other hand, bitumen produced by in-situ thermal recovery is transported to refinery only through bitumen blending process. The in-situ thermal recovery technology is represented by Steam-Assisted Gravity Drainage and Cyclic Steam Stimulation. These technologies are based on steam injection into bitumen sand reservoirs for increase in reservoir in-situ temperature and in bitumen mobility. In oil sands reservoirs, efficiency for steam propagation is controlled mainly by reservoir geology. Accordingly, understanding of geological factors and characteristics of oil sands reservoir deposits is prerequisite for well-designed development planning and effective bitumen production. As significant geological factors and characteristics in oil sands reservoir deposits, this study suggests (1) pay of bitumen sands and connectivity, (2) bitumen content and saturation, (3) geologic structure, (4) distribution of mud baffles and plugs, (5) thickness and lateral continuity of mud interbeds, (6) distribution of water-saturated sands, (7) distribution of gas-saturated sands, (8) direction of lateral accretion of point bar, (9) distribution of diagenetic layers and nodules, and (10) texture and fabric change within reservoir sand body.

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National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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