• 한국임상수의학회지
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• 제29권5호
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• pp.404-407
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• 2012

3년령 암컷 잡종개(체중 5.3 kg)가 실신, 운동불내성, 의기소침, 기면 등의 증상으로 강원대학교 동물병원에 내원하였다. 진단검사상 적혈구증가증이 관찰되고, 흉부방사선 검사상 심한 우심종대 패턴이 관찰되었으며, 심초음파상우-좌 단락의 심방중격 결손증, 심한 폐동맥 협착증(~5 m/s of peak velocity)과 우심실 비대소견이 관찰되었다. 환자는 진단영상학적 소견을 근거로 팔로삼징(trilogy of Fallot)으로 진단되었다. 환자의 임상증상을 안정화시키기 위해 diltiazem과 enalapril을 투여하였고 일주일에 한번씩 정맥사혈을 실시하고 있다. 본 증례는 국내에서 최초로 보고되는 팔로삼징의 증례이다.

• 한국동물위생학회지
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• 제34권4호
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• pp.403-407
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• 2011

This study describes a canine lymphosarcoma with a rapid proliferation and recurrence. A 4-year-old, male, Shih Tzu dog was examined for acute swelling mass. The mass had been identified since 3 months ago and enlarged $10{\times}7$ cm and located in the right axillary region. The surgical removal was recommended when patient visited veterinarian and the operation was conducted. The removed tumor was $11{\times}8{\times}7$ cm and firm, lobulated and white cut surface. Routine screening laboratory test was assessed with blood and radiological analysis. The metastasis sign was not detected on thoracic and abdominal radiography. Blood test revealed decreased lymphocytes. After surgical removal of the mass, microscopic histopathological examination was performed to determine the final diagnosis. Histopathologically, the tumors are characterized by the same histological features, including the presence of neoplastic cellular populations, and lymphocytes infiltration in varying proportions. Also, DNA was extracted and PCR analysis was employed to analyze the origin of tumor cells. T-cell specific nucleic acid fragments were specifically amplified by PCR. On the basis of the laboratory results, the tumor was diagnosed with canine T-cell lymphosarcoma. On the basis of our knowledge, this is the first report of canine T-cell lymphosarcoma in a Shih Tzu dog.

• Tuberculosis and Respiratory Diseases
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• 제42권4호
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• pp.624-628
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• 1995

Lymphangioleiomyomatosis is a rare disease which afflicts young women of childbearing age. We experienced a 32-year-old female who was admitted because of worsening exertional dyspnea after hormonal therapy with Clomifen for five months and intermittent hemoptysis. Chest PA showed diffuse ground glass appearance with some reticular infiltrations. High resolution CT scan showed multiple small thin walled cysts distributed homogeneously throughout the entire lung. Pulmonary function test showed characteristic obstructive pattern despite the restrictive interstitial pattern of chest radiography. Thoracoscopic lung biopsy specimen showed abnormal proliferation of smooth muscle cells in the walls of lymphatic vessels, bronchioles, and pulmonary vessels typical of pulmonary lymphangioleiomyomatosis. Hormonal therapy with medroxyprogesterone was initiated.

• Journal of Chest Surgery
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• 제30권6호
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• pp.566-572
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• 1997

유전자 치료등 폐암에 대한 새로운 치료법의 개발및 그 효능의 검증에 있어 적절한 동물 모델이 없음은 큰 제 한점중의 하나이다. 특히 종양의 생물학적 특성이나 치료에의 효과등이 장기자체의 환경에 크게 영향 을 받는다는 사실은, 인체에서의 폐암의 특성을 가지며 폐에 정 위적으로 발생하는 폐암의 동물모델의 개발 을 시급하게 한다. 저자등은 Nude rat을 대상 동물로 하여, 개흉하에 종양세포 부유액을 원하는 폐말단 부위에 직접 주입함으로 폐에 정 위적으로 폐암의 발달을 유도하였으며 이를 이용하여 발생된 비소세포 폐암의 병태를 연구하였다. 종양은 실험 대상 등물에서 모두 발생하였으며 이용한 두 가지 종류의 세포주(NCI-H46O과 NCI-H1299)에서 모두 효과적으로 발생하였다. 발생된 폐종양은 시간 경과에 따라 주위 조직으로의 침윤과 종격동 전이의 양상를 보였다. 종양 숙주 동물의 평균 수명은 약 5주 정도였다. 저자등이 개발한 비소세포폐암의 동물 모델은 기관지를 통한 종양 세포 주입법에 의한 폐암 모델에 비해 국소적으로 진행된 폐암을 원하는 부위에 정확히 만들 수 있음은 물론 외과적 처치를 비롯한 국소적 치료 방법의 개발이나 ?과의 검증에 두루 이용되기에 적절하다고 사료된다.

• 한국임상수의학회지
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• 제24권2호
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• pp.233-237
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• 2007

10 개월령 수컷 래브라도 리트리버종 개가 특히 과도한 운동 이후에 나타나는 운동 불내성으로 내원하였다. 신체검사에서 좌측 심첨부와 심저부에서 제1심음의 분열음과 grade III/IV의 이완기 역류성 잡음이 청진되었다. 심전도 검사에서 휴식기에는 정상 동박동을 나타낸 반면, 운동 후에는 각 차단과 함께 심실상성 빈맥이 나타났다. 흉부 방사선에서는 정상 심장크기(VHS 10.2)이나, 확장된 상행 대동맥이 관찰되었다. 심장초음파에서는 대동맥 판막상단부위에서 기시된 비정상적인 판막성 구조물에 의해 대동맥 역류증이 관찰되었고 그 결과 좌심실 박출율(LVEF)이 감소되는 소견을 보였다. 상기의 결과를 토대로 본 증례를 비정상의 판막 구조물에 의한 선천성 대동맥 역류증으로 진단하였다. 환자에게 diltiazem을 처방하였으며, 운동제한을 시켰다. 본 증례는 매우 드물게 보고되는 대동맥 판막 기형이다.

• 한국임상수의학회지
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• 제32권4호
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• pp.313-318
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• 2015

The lung opacity on radiography is influenced by various factors. The physical density of the lung and the attenuation ensured on computed tomography (CT) scans is determined by three components : lung tissue, blood, and air. Temporary right lateral recumbency may responsible for the increase of opacity on ventrodorsal projection view. Thus, our aim is to demonstrate that the effect of right lateral recumbency posture on right lung opacity using radiograph and CT scan. In this study, 62 dogs without clinical or radiologic signs of cardiopulmonary disease are selected. Thorax radiographs per 30 seconds for 2 minutes (30s, 60s, 90s, 120s) were performed for 62 dogs. After discussion of the radiographic findings of lung field by two radiologists and a student at Chungbuk national university veterinary medical center a consensus opinion was recorded. Computed tomography per a minute (1 min, 2 min) for 2 minutes were performed for 2 dogs. Mean x-ray attenuation of lung was measured quantitatively using software at two levels (aortic arch and basal level). Among 62 dogs with radiograph comparison, 9.3% of dogs showed influence by postural effect. However, all 2 dogs with computed tomography comparison, showed influence by postural effect. In conclusion, position dependent changes of lung density in CT exam are not consistent with thoracic radiograph.

• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.377-381
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• 2007

Objective : The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion [ALIF]. Methods : Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging [MRI] before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale [VAS] scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery. Results : The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased [p<0.001], and the mean foraminal width was decreased [p=0.014] significantly after surgery. The mean epidural foraminal height [p<0.001], epidural foraminal width [p<0.001], and epidural foraminal area [p<0.001] showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery [p<0.001]. VAS scores for leg pain [p=0.001] and Oswestry disability index [p=0.001] was decreased significantly at one year after surgery. Conclusion : Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.

• Journal of Korean Neurosurgical Society
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• 제60권4호
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• pp.433-440
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• 2017

Objective : Although minimally invasive posterior cervical foraminotomy (MI-PCF) is an established approach for motion preservation, the outcomes are variable among patients. The objective of this study was to identify significant factors that influence motion preservation after MI-PCF. Methods : Forty-eight patients who had undergone MI-PCF between 2004 and 2012 on a total of 70 levels were studied. Cervical parameters measured using plain radiography included C2-7 plumb line, C2-7 Cobb angle, T1 slope, thoracic outlet angle, neck tilt, and disc height before and 24 months after surgery. The ratios of the remaining facet joints after MI-PCF were calculated postoperatively using computed tomography. Changes in the distance between interspinous processes (DISP) and the segmental angle (SA) before and after surgery were also measured. We determined successful motion preservation with changes in DISP of ${\leq}3mm$ and in SA of ${\leq}2^{\circ}$. Results : The differences in preoperative and postoperative DISP and SA after MI-PCF were $0.03{\pm}3.95mm$ and $0.34{\pm}4.46^{\circ}$, respectively, fulfilling the criteria for successful motion preservation. However, the appropriate level of motion preservation is achieved in cases in which changes in preoperative and postoperative DISP and SA motions are 55.7 and 57.1%, respectively. Based on preoperative and postoperative DISP, patients were divided into three groups, and the characteristics of each group were compared. Among these, the only statistically significant factor in motion preservation was preoperative disc height (Pearson's correlation coefficient=0.658, p<0.001). The optimal disc height for motion preservation in regard to DISP ranges from 4.18 to 7.08 mm. Conclusion : MI-PCF is a widely accepted approach for motion preservation, although desirable radiographic outcomes were only achieved in approximately half of the patients who had undergone the procedure. Since disc height appears to be a significant factor in motion preservation, surgeons should consider disc height before performing MI-PCF.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.151-158
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• 2018

Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

• Pediatric Infection and Vaccine
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• 제26권1호
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• pp.71-79
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• 2019

8세 남아가 호흡곤란과 기면증을 보이며 응급실에 내원하였다. 극도의 호흡부전을 보이고 있었고 고유량의 산소 공급을 함에도 불구하고 88-90%로 밖에 유지되지 않았고 단순 흉부 방사선 검사에서 전 폐야에 불투과도가 증가하였고 중등도의 흉수를 보였다. 마이코플라스마 폐렴 진단 하에 정맥 macrolide 를 포함한 항생제 치료를 시작하였으나 2병일 째 간, 신장에 다기관 부전 및 급성 호흡부전 증상을 보였다. 정맥-정맥 체외순환막성산소화기를 삽입하였고 지속적 신대체요법도 병행하였다. 18병일 째 성공적으로 체외순환막성산소화기에서 이탈하였고 저산소성 뇌 손상 없이 성공적으로 치료되었기에 본 사례를 보고한다.