• Title/Summary/Keyword: multifocal

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A Case of Intrathyroidal Spread of Papillary Thyroid Carcinoma (갑상선 유두암종의 갑상선내 확산 1례)

  • Lee, Jung Kyu;Cho, Yong Min;Lee, Jin Hwan;Woo, Jeong-Soo;Cho, Jae-Gu
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.47-51
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    • 2021
  • Papillary thyroid carcinoma (PTC) typically has a good prognosis, but it frequently metastasizes to the regional lymph nodes. Although survival impact of lymph node metastasis is not clear, complementary treatment is generally added after surgery when lymphatic metastasis exists. Several previous studies have reported that the multifocal PTC is associated with poor prognosis and requires selective neck dissection to prevent regional lymph node metastasis, but they are under controversy. In this study, we present a 24-year-old female patient, diagnosed as PTC with intrathyroidal spread and regional lymph node metastases. Intrathyroidal spread of PTC can only be observed microscopically and is believed to have the similar origin of unicentric multifocal PTC. As multifocal PTC is highly associated with regional lymph node metastasis and requires an additional treatment, PTC with intrathyroidal spread may follow a similar clinical course and treatment plan. Here we report the case with a brief literature review and expect its attribution to further academic interest of treatment choice.

Evaluation of Visual Performance for Implanted Aspheric Multifocal Intraocular Lens in the Cataract Patients (백내장 환자에서 비구면 다초점 인공수정체 삽입 후 시기능 평가)

  • Kim, Jae-Yoon;Lee, Koon-Ja
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.3
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    • pp.347-356
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    • 2013
  • Purpose: To evaluate the visual acuity and visual performance after implantation of a aspheric multifocal (ReSTOR$^{(R)}$ SN6AD3) intraocular lens (IOL). Methods: Nineteen cataract patients (30 eyes) implanted with an aspheric multifocal IOL (ReSTOR$^{(R)}$ SN6AD3) either unilaterally or bilaterally were participated. Visual acuity (VA) and objective optical performance were evaluated at the time of preoperation, 1 week, 1 month, and 3 month after operation. At 3 month of post-operation, objective visual performance were measured and compared with the 38 eyes of 20 age-matched normal control. Distance VA was measured by using the ETDRS LCD chart and intermediate and near visual acuity were measured using Jaeger chart. Objective visual performance was assessed preoperatively and 1 week, 1 month and 3 month postoperatively using a double-pass system (Optical Quality Analysis System) with a 4-mm pupil diameter, the OSI (objective scatter index), MTF (modulation transfer function) cut off and strehl ratio. At 3 month of post-operation, visual acuity and visual performance compared with age matched normal control. Results: The uncorrected distance VA, OSI, MTF cut off and strehl ratio were significantly improved (p<0.05) until 1 month postoperatively. Visual performance of MTF cut off and strehl ratio after 3 month of operation were significantly improved compared to the normal control (p=0.063, p=0.103 respectively), however, OSI was higher than normal control. Patients implanted with aspheric multifocal IOL were satisfied with distance and near VA however, were unsatisfied with intermediate VA and reported glare and halos. Conclusions: The visual performance reaches to a stable condition in 1 month of implantation of aspheric multifocal IOL and improved to the level of age-mated normal patients. Also patients were satisfied with their quality of vision, however, intermediate VA, glare and halos were reported as complications.

Usefulness of Preoperative Breast MRI in Breast Cancer Diagnosed After Excisional Biopsy (유방 절제 생검 후 유방암이 진단된 환자에서 수술 전 자기공명영상의 유용성)

  • Wui, Jung-Hyun;Kang, Bong-Joo;Cha, Eun-Suk;Kim, Sung-Hun;Jung, Na-Young;Choi, Jae-Jeong
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.161-169
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    • 2008
  • Purpose : The aim of this study was to evaluate the usefulness of MRI performed after excisional biopsy to diagnose residual cancer and additional lesions. Materials and Methods : A total of 16 patients who had breast cancer diagnosed by excisional biopsy underwent preoperative breast MRI between March 2005 and August 2007 were included. MRI findings were considered positive for residual cancer if focal, thick, or irregular rim enhancement or adjacent enhancing lesion was identified around the postoperative biopsy cavity. And additional lesions separated from biopsy cavity including multifocal, multicentric, or contralateral lesion were evaluated. We evaluated the diagnostic accuracy of MRI, comparing MRI with histopathologic finding, and the impact of MRI on surgical planning. Results : The sensitivity and specificity of MRI for detecting residual disease considering rim enhancement were 85.7%(6/7) and 55.6%(5/9). Additional lesions including multifocal, multicentric, or contralateral lesion were found in 6 patients. In 7 patients, results of MRI findings changed surgical treatment planning. Conclusion : The pattern of rim enhancement on MRI after excisional biopsy is not differential point to evaluate remnant lesion. But MRI has an important role to help the detection of multifocal or multicentric, or contralateral breast malignancies, resulting in beneficial change in surgical treatment planning.

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Chronic Recurrent Multifocal Osteomyelitis Associated With Inflammatory Bowel Disease Successfully Treated With Infliximab

  • Kwak, Shinhyeung;Kim, Dongsub;Choi, Joon-sik;Yoon, Yoonsun;Kim, Eun Sil;Kim, Mi Jin;Yoo, So-Young;Shim, Jong Sup;Choe, Yon Ho;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.96-104
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    • 2022
  • Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

Clinical Neuropathological Analysis of 10 Cases of Cerebral Amyloid Angiopathy-Related Cerebral Lobar Hemorrhage

  • Li, Xiao-Qiu;Su, Dong-Feng;Chen, Hui-Sheng;Fang, Qu
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.30-35
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    • 2015
  • Objective : The clinical and pathological characteristics of 10 cases of cerebral amyloid angiopathy (CAA)-related cerebral lobar hemorrhage (CLH) that was diagnosed at autopsy were investigated to facilitate the diagnosis of this condition. Methods : The clinical characteristics of 10 cases of CAA-related CLH were retrospectively reviewed, and a neuropathological examination was performed on autopsy samples. Results : The 10 cases included two with a single lobar hemorrhage and eight with multifocal lobar hemorrhages. In all of the cases, the hemorrhage bled into the subarachnoid space. Pathological examinations of the 10 cases revealed microaneurysms in two, double barrel-like changes in four, multifocal arteriolar clusters in five, obliterative onion skin-like intimal changes in four, fibrinoid necrosis of the vessels in seven, neurofibrillary tangles in eight, and senile plaques in five cases. Conclusion : CAA-related CLHs were located primarily in the parietal, temporal, and occipital lobes. These hemorrhages normally consisted of multiple repeated CLHs that frequently bled into the subarachnoid space. CAA-associated microvascular lesions may be the pathological factor underlying CLH.

Multifocal Calcifications of the Falx Cerebri and Dura Presenting as Hot Spots in the Skull on Bone Scintigraphy (골 신티그래피상 두개골에 열소로 나타난 대뇌겸과 경수뇌막에 다발성석회화)

  • Sohn, Myung-Hee;Jeong, Hwan-Jeong;Lim, Seok-Tae;Yim, Chang-Yeol
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.64-65
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    • 2007
  • A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.

A Case Report about Treatment by a Combination of Traditional Korean Medicine and Western Medicine in a Patient with Progressive Multifocal Leukoencephalopathy and HIV/AIDS (진행성 다발성 백질뇌병증을 합병한 HIV/AIDS 환자의 한양방 협진 치료 치험 1례)

  • Lim, Myong-ah;Lee, Hee-jung;Seo, Ho-seok;Kim, Pan-kyoo;Kim, Jin-won
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.1076-1084
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    • 2017
  • Objectives: This report describes the case of a patient with progressive multifocal leukoencephalopathy (PML) with hemiplegia, who was treated with a combination of traditional Korean medicine and western medicine. Methods: The patient received traditional Korean medical treatments, including acupuncture, during robust antiretroviral therapy with rehabilitative exercise. Results: During 24 months of treatment, the patient showed improvement in hemiplegia on a manual muscle test. Conclusions: The combination of traditional Korean medicine and western medicine was effective in the treatment of PML in a patient with hemiplegia.

Reevaluation of Midline Malignant Reticulosis with Systemic Manifestation after Irradiation (방사선치료 후 전신적증세의 발현을 나타낸 Midline Malignant Reticulosis 환자군에 대한 재고)

  • Kim G. E.;Suh C. O.;Kim B. S.;Hong W. P.
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.71-79
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    • 1984
  • During a 10 year periods, 42 patients with well-documented Midline Malignant Reticulosis were treated with local irradiation and followed for extended periods of time. 13 cases with systemic manifestation after irradiation illustrate the protean features of this disease. Although it commonly Presents in upper airway tracts such as nasal cavity and/or septum, soft palate and palatine tonsil, the lesion may be localized as well as diffuse. 2 cases among them showed systemic relapse on lung, pancreas and scrotum probably from either a multifocal or metastatic deposits. Another 3 eases were associated with systemic diseases such as stomach carcinoma, typhoid enteritis and CNI of fat tissue. Remained cases were diagnosed by clinical or radiological examination. Possibility of close relation to lymphoma with Midline Malignant Reticulosis are also suggested in 1 case. In Midline Malignant Reticulosis, the best results of treatment are obtained in localized lesion of the upper airway treated early with irradiation: A poorer outcome is associated with multifocal systemic involvement, which necessitates a systemic therapy.

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Segmental Sensory Nerve Conduction Study in Vibration Exposed Subjects

  • Kim Mi-Jung;Yoon Cheol-In;Choi Hyun-Ju
    • Biomedical Science Letters
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    • v.11 no.2
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    • pp.193-199
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    • 2005
  • The present study was performed to assess peripheral neural involvement by exposure to hand-arm vibration. Segmental sensory nerve conduction in the median and ulnar nerves were measured in shipyard workers exposed to vibration. The subjects were 47 male adults exposed to hand-arm vibration and 7 healthy male controls. The subjects underwent an extensive bilateral neurophysiological examination. Sensory compound nerve action potential (SNAP) of the median and ulnar nerves in palm-finger and wrist-palm segments were measured by antidromic method. And SNAP of the median and ulnar nerves in wrist-proximal finger and wrist-distal finger segments were measured by orthodromic method. Result of sensory nerve conduction study was abnormal in 31 patients $(66\%)$ and normal in 16 patients $(34\%)$ of subjects. The pathological pattern in the hand-arm vibration exposed group was 13 patients $(28\%)$ of carpal tunnel syndrome, 18 patients $(38\%)$ of distal sensory neuropathy, 7 patients $(15\%)$ of multifocal and 1 patient $(2\%)$ of Guyon syndrome. The present study indicates that vibration-induced nerve impairments exist both in the finger-palm and palm-wrist segment of median and ulnar sensory nerves. The results suggest that segmental sensory nerve conduction study would be useful as objective indication of peripheral nerve impairment induced by the hand-arm vibration.

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Bovine abortion associated with neospora in Korea (Neospora에 의한 소 유산 발생)

  • Kim, Dae-yong;Hwang, Woo-suk;Kim, Jae-hoon;Hur, Kwon;Hwang, Ui-Gyeong;Lee, Byeong-chun;Jean, Young-hwa;Rhee, Jae-chin;Choi, Sang-ho
    • Korean Journal of Veterinary Research
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    • v.37 no.3
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    • pp.607-612
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    • 1997
  • A case of neosporosis is described in a 6-month-old aborted bovine fetus. Grossly, numerous, well-demarcated, 2-3mm, yellowish white foci were scattered in the heart and skeletal muscle. Histopathologic changes were confined to the brain, heart, and skeletal muscle. Multifocal areas of necrotizing encephalitis were observed in the cerebrum as well as cerebellum. Severe multifocal to coalescing nonsuppurative inflammation was observed in the myocardium and skeletal muscle. The tachyzoites of Neospora caninum were demonstrated in the brain, myocardium and skeletal muscle with immunohistochemical method using Neospora caninum-specific antibody. Based on the histopathology and immunohistochemistry, this case was diagnosed as neosporosis in aborted Korean cattle. This is believed to be the first reported case of bovine neosporosis in Korea.

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