• Title/Summary/Keyword: incidental

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Microsurgical Treatment and Outcome of Pediatric Supratentorial Cerebral Cavernous Malformation

  • Noh, Jung-Hoon;Cho, Kyung Rae;Yeon, Je Young;Seol, Ho Jun;Shin, Hyung Jin
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.237-242
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    • 2014
  • Objective : The purpose of this study was to investigate the clinical features and outcomes of pediatric cavernous malformation (CM) in the central nervous system. Methods : Twenty-nine pediatric patients with supratentorial CM underwent microsurgical excision. In selected cases, transparent tubular retractor system (TTRS) was used to reduce retraction injury and intraoperative neuromonitoring (IONM) was held to preserve functioning cortex. Patients' demographics and symptoms were reviewed and surgical outcomes were discussed. Results : The main initial clinical manifestations included the following : seizures (n=13, 45%), headache (n=7, 24%), focal neurological deficits (n=3, 10%), and an incidental finding (n=6, 21%). Overt hemorrhage was detected in 7 patients (24%). There were 19 children (66%) with a single CM and 10 (34%) children with multiple CMs. In 7 cases with deep-seated CM, we used a TTRS to minimize retraction. In 9 cases which location of CM was at eloquent area, IONM was taken during surgery. There was no major morbidity or mortality after surgery. In the 29 operated children, the overall long-term results were satisfactory : 25 (86%) patients had no signs or symptoms associated with CMs, 3 had controllable seizures, and 1 had mild weakness. Conclusion : With the assistance of neuronavigation systems, intraoperative neuromonitoring, and TTRS, CMs could be targeted more accurately and excised more safely. Based on the satisfactory seizure outcome achieved, complete microsurgical excision in children is recommended for CMs presenting with seizures but removal of hemosiderin-stained areas seems to be unnecessary.

Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism

  • Song, Jeong Eun;Shon, Mu Hyun;Kim, Ga Young;Lee, Da Young;Lee, Jung Hun;Kim, Jong Ho;Shon, Ho Sang;Lee, Ji Hyun;Jeon, Eon Ju;Jung, Eui Dal
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.131-134
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    • 2014
  • Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

Analysis of Radioactivity Concentrations in Cigarette Smoke and Tobacco Risk Assessment (담배연기와 담뱃잎 내 함유된 방사능 농도분석 및 위해도 평가)

  • Lee, Se-Ryeong;Lee, Sang-Bok;Kim, Jeong-Yoon;Kim, Ji-Min;Bang, Yei-jin;Lee, Doo-Seok;Jo, Hyung-Joon;Kim, Sungchul
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.489-494
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    • 2021
  • In this study, radioactivity quantitative analysis was performed on radon contained in cigarette, and the effective dose was calculated using the result value to determine the amount of exposure caused by smoking. A total of 5 types of cigarettes were sampled. Cigarette smoke was collected by using activated carbon, and tobacco were measured by homogenizing for quantitative analysis. For each sample, Bi-214 and Pb-214 were subjected to gamma nuclide analysis to observe the uranium-based radioactive material contained in cigarette, and a measurement time of 30,000 seconds was set for the sample based on the results of previous studies. As a result of measuring the radioactivity of tobacco, a maximum of 0.715 Bq/kg was derived, and in the case of cigarette smoke measured using activated carbon, a maximum of 3.652 Bq/kg was derived. Using this measurement, the average effective dose to the lungs is 0.938 mSv/y, and it was found that there is a possibility of receiving exposure up to 1.099 mSv/y depending on the type of tobacco. It was found that the exposure dose due to cigarette occupies a large proportion of the annual effective dose limit for the general public. Therefore, more diverse studies on radioactive substances in cigarette are needed, and measures to monitor and reduce the incidental exposure to radon should be established.

A Case of Incidental Esophageal Diverticulum During Thyroidectomy (갑상선절제술 중 우연히 발견된 식도 게실 1예)

  • Kim, Min-Sik;Kim, Dong-Jo;Lee, Jin-Choon;Sung, Eui-Suk
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.316-320
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    • 2018
  • Esophageal diverticulum is very rare disease. Since it usually has no symptoms, it is hard to find and diagnose. Moreover, if the diverticulum is located nearly to thyroid gland, surgeons sometimes misdiagnose as a thyroid nodule. Here, we represent our case which has papillary thyroid cancer and esophageal diverticulum together. In this case, we experienced the surgical procedure and postoperative complications of the esophageal diverticulum. Even though esophageal diverticulum was in preoperative computed tomography and ultrasound, it was neglected before the surgery so that found during the operation. The purpose of this study was to know the preoperative radiological findings of the esophageal diverticulum and to find out what to be aware of during surgery and how to manage the complications after surgery.

First Selection Algorithm of Minimum Degree Vertex for Maximum Independent Set Problem (최대독립집합 문제의 최소차수 정점 우선 선택 알고리즘)

  • Lee, Sang-Un
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.19 no.3
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    • pp.193-199
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    • 2019
  • In this paper I propose an algorithm of linear time complexity for NP-complete Maximum Independent Set (MIS) problem. Based on the basic property of the MIS, which forbids mutually adjoining vertices, the proposed algorithm derives the solution by repeatedly selecting vertices in the ascending order of their degree, given that the degree remains constant when vertices ${\nu}$ of the minimum degree ${\delta}(G)$ are selected and incidental edges deleted in a graph of n vertices. When applied to 22 graphs, the proposed algorithm could obtain the MIS visually yet effortlessly. The proposed linear MIS algorithm of time complexity O(n) always executes ${\alpha}(G)$ times, the cardinality of the MIS, and thus could be applied as a general algorithm to the MIS problem.

Maxillary antroliths detected by cone-beam computed tomography in an adult dental population

  • Cho, Bong-Hae;Jung, Yun-Hoa;Hwang, Jae-Joon
    • Imaging Science in Dentistry
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    • v.49 no.1
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    • pp.59-63
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    • 2019
  • Purpose: This study evaluated the prevalence and characteristics of maxillary antroliths using cone-beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. Materials and Methods: CBCT scans of 13,946 patients over the age of 20 were reviewed for maxillary antroliths, and prevalence according to sex, age, and the side of the jaw was calculated. The relationships of single or multiple antroliths with sex, side, and the degree of sinus inflammation were evaluated. The shape and dimension of antroliths were also assessed. The data were analyzed using descriptive statistics, the chi-square or Fisher exact tests, and Kendall's tau-b. Results: A total of 138 (0.99%) of the 13,946 patients showed an antrolith in at least 1 sinus. Only 18 patients presented a bilateral manifestation, which brought the total number of sinuses containing an antrolith to 156 (0.56%). Multiple antroliths were observed in 36 sinuses, and the total number of antroliths was 207: 110 punctate, 65 linear, and 32 amorphous. The antrolith dimensions varied from $1mm^2$ to $91mm^2$ (average, $10.2{\pm}15.5mm^2$). No statistically significant differences were found according to sex, side, and age group (P>0.05). However, there was a statistically significant difference between the multiplicity of antrolith and the degree of sinus inflammation (P<0.05). Conclusion: Cone-beam computed tomography is an effective modality for the detection of incidental antroliths. Maxillary antroliths were found to be very rare and were usually asymptomatic. Dentists should have a comprehensive understanding of their diagnosis and treatment in light of possible associated dental problems.

More frequent detection of calcified carotid atherosclerotic plaques and mineralized laryngeal cartilages on digital than on film-based panoramic radiographs

  • de-Azevedo-Vaz, Sergio Lins;Machado, Joao Victor Pereira;Pereira, Teresa Cristina Rangel;Freitas, Deborah Queiroz
    • Imaging Science in Dentistry
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    • v.49 no.1
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    • pp.65-70
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    • 2019
  • Purpose: To determine whether calcified carotid atherosclerotic plaques(CCAPs) and mineralized laryngeal cartilages (MLCs) were more frequently detected on digital or film-based panoramic radiographs. The clinical relevance of this question is that some radiopacities seen on digital radiographs may correspond to medium-density tissues that are not necessarily mineralized. Materials and Methods: Data were collected from panoramic radiographs and the respective reports issued by 2 private oral radiology centers. A total of 388 radiographs and reports were divided into film-based (group A) and digital (group D) radiographs. The frequencies of CCAPs and MLCs were analyzed using the Fisher exact test, and odds ratios were also calculated (${\alpha}=1%$). Results: The mean age of patients whose reports and radiographs showed CCAPs and/or MLCs ranged from 50.1 to 54.1 years. There was a predominance of females. A higher frequency of CCAPs and MLCs was observed in group D than in group A at both centers(P<0.01). CCAPs and MLCs were detected 4 times more frequently in group D than in group A at one of the centers. Conclusion: CCAPs and MLCs were more frequently detected on digital than on film-based panoramic radiographs. Further studies are needed to determine whether such radiopacities do indeed correspond to mineralized, rather than medium-density, tissues.

Growth Pattern and Prognostic Factors of Untreated Nonfunctioning Pituitary Adenomas

  • Hwang, Kihwan;Kwon, Taehun;Park, Jay;Joo, Jin-Deok;Han, Jung Ho;Oh, Chang Wan;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.256-262
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    • 2019
  • Objective : Pituitary adenomas (PAs) are often detected as incidental findings. However, the natural history remains unclear. The objective of this study was to evaluate the natural history and growth pattern of untreated PAs. Methods : Between 2003 and 2014, 59 PAs were managed with clinico-radiological follow up for longer than 12 months without any kind of therapeutic intervention. Tumor volumes were calculated at initial and last follow-up visit, and tumor growth during the observation period was determined. Data were analyzed according to clinical and imaging characteristics. Results : The mean initial and last tumor volume and diameter were $1.83{\pm}2.97mL$ and $13.77{\pm}6.45mm$, $2.85{\pm}4.47mL$ and $15.75{\pm}8.08mm$, respectively. The mean annual tumor growth rate was $0.33{\pm}0.68mL/year$ during a mean observation period of $46.8{\pm}32.1months$. Sixteen (27%) PAs showed tumor growth. The initial tumor size (HR, 1.140; 95% confidence interval, 1.003-1.295; p=0.045) was the independent predictive factor that determined the tumor growth. Six patients (11%) of 56 conservatively managed non-symptomatic PAs underwent resection for aggravating visual symptoms with mean interval of 34.5 months from diagnosis. By Cox regression analysis, PAs of last longest diameter over 21.75 mm were a significant prognostic factor for eventual treatment. Conclusion : The initial tumor size of PAs was independently associated with the tumor growth. Six patients (11%) of conservatively managed PAs were likely to be treated eventually. PAs of last follow-up longest diameter over 21.75 mm were a significant prognostic factor for treatment. Further studies with a large series are required to determine treatment strategy.

Current Status and Directions of Professional Identity Formation in Medical Education (전문직 정체성 형성 및 촉진을 위한 의학교육 현황과 고려점)

  • Han, Heeyoung;Suh, Boyung
    • Korean Medical Education Review
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    • v.23 no.2
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    • pp.80-89
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    • 2021
  • Professional identity formation (PIF) is an essential concept in professional education. Many scholars have explored conceptual frameworks of PIF and conducted empirical studies to advance an understanding of the construct in medical education. Despite its importance, it is unclear what educational approaches and assessment practices are actually implemented in medical education settings. Therefore, we conducted a literature review of empirical studies reporting educational practices for medical learners' PIF. We searched the Web of Science database using keywords and chose 37 papers for analysis based on inclusion and exclusion criteria. Thematic analysis was conducted. Most empirical papers (92%) were from North America and Western Europe and used qualitative research methods, including mixed methods (99%). The papers reported the use of reflection activities and elective courses for specific purposes, such as art as an educational activity. Patient and healthcare experiences were also found to be a central theme in medical learners' PIF. Through an iterative analysis of the key themes that emerged from the PIF studies, we derived the following key concepts and implications: (1) the importance of creating informal and incidental learning environments, (2) ordinary yet authentic patient experiences, (3) a climate of psychosocial safety in a learning environment embracing individual learners' background and emotional development, and (4) the reconceptualization of PIF education and assessment. In conclusion, research on PIF should be diversified to include various cultural and social contexts. Theoretical frameworks should also be diversified and developed beyond Kegan's developmental framework to accommodate the nonlinear and dynamic nature of PIF.

A Delphi Survey for the Revision of the Diagnostic Criteria for Sanhupung (Puerperal Wind Disorder, U32.7) (산후풍 진단 기준 개정 위한 델파이조사 결과)

  • Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.2
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    • pp.42-53
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    • 2022
  • Objectives: The definition of Sanhupung (Puerperal wind disorder) has been varied and there has been a prior study to establish the definition, but no clear conclusion has been reached on diagnostic criteria. Therefore, the aim of this study was to clearly redefine the definition of Sanhupung using the Delphi method. Methods: This study used the Delphi technique. A panel consisting of 13 experts of Korean medicine, particularly in Obstetrics & Gynecology, participated in the Delphi survey that included answering the 3rd round survey. The Delphi survey was conducted by evaluating and correcting the questionnaire using e-mail. Results: Through the Delphi survey, we have reached an agreement regarding the diagnostic criteria of Sanhupung. They are as follows: 1) Sanhupung can be diagnosed based on basic symptoms. If one or more symptoms are expressed in the basic symptom group, it can be diagnosed as Sanhupung. It is diagnosed in detail as a pain type or a sensory impairment type according to the category of basic symptoms. 2) Incidental symptoms are not essential for diagnosis, and are referred to for checking general weakness and autonomic nervous system conditions. 3) In order to meet the diagnostic criteria, the symptoms should occur within 6 months after childbirth or miscarriage, and the cause of the symptoms should not be classified as other diseases. Conclusions: The diagnostic criteria of Sanhupung were suggested based on the Delphi survey among experts in the field. Further research is necessary to improve the reliability and validity of the criteria.