• 제목/요약/키워드: 간 초음파 영상

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Polarization-sensitive Optical Coherence Tomography Imaging of Pleural Reaction Caused by Talc in an ex vivo Rabbit Model (생체 외 토끼 모델에서의 탈크에 의해 유발되는 흉막 반응의 편광 민감 광 결맞음 단층촬영 이미징)

  • Park, Jung-Eun;Xin, Zhou;Oak, Chulho;Kim, Sungwon;Lee, Haeyoung;Park, Eun-Kee;Jung, Minjung;Kwon, Daa Young;Tang, Shuo;Ahn, Yeh-Chan
    • Korean Journal of Optics and Photonics
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    • v.31 no.1
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    • pp.1-6
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    • 2020
  • The chest wall, an organ directly affected by environmental particles through respiration, consists of ribs, a pleural layer and intercostal muscles. To diagnose early and treat disease in this body part, it is important to visualize the details of the chest wall, but the structure of the pleural layer cannot be seen by chest computed tomography or ultrasound. On the other hand, optical coherence tomography (OCT), with a high spatial resolution, is suited to observe pleural-layer response to talc, one of the fine materials. However, intensity-based OCT is weak in providing information to distinguish the detailed structure of the chest wall, and cannot distinguish the reaction of the pleural layer from the change in the muscle by the talc. Polarization-sensitive OCT (PS-OCT) takes advantage of the fact that specific tissues like muscle, which have optical birefringence, change the backscattered light's polarization state. Moreover, the birefringence of muscle associated with the arrangement of myofilaments indicates the muscle's condition, by measuring retardation change. The PS-OCT image is interpreted from three major perspectives for talc-exposure chest-wall imaging: a thickened pleural layer, a separation between pleural layer and muscle, and a phase-retardation measurement around lesions. In this paper, a rabbit chest wall after talc pleurodesis is investigated by PS-OCT. The PS-OCT images visualize the pleural layer and muscle, respectively, and this system shows different birefringence of normal and damaged lesions. Also, an analyisis based on phase-retardation slope supports results from the PS-OCT image and histology.

Small Bowel Intussusception in Children: Spontaneous Resolution vs. Surgical Intervention (소아에서 소장형 장중첩증; 자연 정복과 수술적 치료의 비교)

  • Park, Mi-Ran;Lim, Mi-Sun;Seo, Jeong-Kee;Ko, Jae-Sung;Chang, Ju-Young;Yang, Hye-Ran;Lim, Yoon-Joung;Kim, Woo-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.128-133
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    • 2010
  • Purpose: Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children. Methods: We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010. Results: The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6${\pm}$0.7 and 1.7${\pm}$1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups. Conclusion: Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

A Patterns of Care Study of the Various Radiation Therapies for Prostate Cancer among Korean Radiation Oncologists in 2006 (Patterns of Care Study를 위한 2006년 한국 방사선종양학과 전문의들의 전립선암 방사선치료원칙 조사연구)

  • Kim, Jin-Hee;Kim, Jae-Sung;Ha, Sung-Whan;Shin, Seong-Soo;Park, Won;Cho, Jae-Ho;Suh, Chang-Ok;Oh, Young-Taek;Shin, Sei-Won;Kim, Jae-Chul;Jang, Ji-Young;Nam, Taek-Keun;Choi, Young-Min;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.96-103
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    • 2008
  • Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

INHIBITORY EFFECT OF Er:YAG LASER ON THE GROWTH OF STREPTOCOCCUS MUTANS (Er:YAG 레이저 조사가 Streptococcus mutans의 증식억제에 미치는 효과)

  • Song, Gwang-Chul;Lee, Chang-Seop;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.15-24
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    • 2003
  • The purpose of this study is to investigate the sterilization effect of Er:YAG laser against the intraoral acid producing bacterium, S. mutans, by irradiating the culture solution containing S. mutans KCTC 3065 with Er:YAG laser having a $650{\mu}m$ diameter beam through the non-contact method. We obtained the following results after examining the temperature changes of the culture solution, numbers of bacterial colonies, and acid-producing ability and attaching ability on teeth by measuring the amount of extracellular polysaccharide produced by S. mutans. The number of bacterial colony was decreased in $10{\mu}l$ culture solution irradiated with laser in overall compared to the control solution. The number decreased as the irradiation intensity and pulse repetition rate were larger and as the exposure time was increased. However, it did not change significantly in $100{\mu}l$ culture solution compared to the control solution. Although the acid-producing ability of S. mutans was inhibited for a certain duration after laser irradiation in 10r1 bacterial culture solution, it did not change in $100{\mu}m$ solution compared with the control solution. The amount of extracellular polysaccharide synthesized by S. mutans was partially decreased through laser irradiation in $10{\mu}m$ culture solution but did not change in $100{\mu}m$ culture solution. Based on these findings, we concluded that Er:YAG laser has an sterilization effect on S. mutans in which we presume that the mechanism is through the heat effect rather than the mechanical effect from development of ultrasound.

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The difference between the two methods for myocardial performance index in children (소아에서 심근 수행 지수 측정 방법간의 차이)

  • Joung, Jae-Il;Lee, Chang-Hyun;Kim, Jae-Kwang;Park, Kie-Young;Kim, Bong-Sung;Lee, Jung-Ju;Han, Myung-Ki
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1324-1328
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    • 2006
  • Purpose : The object of this study was to determine the difference between two methods for myocardial performance index(MPI) in children, using the conventional and pulsed Doppler echocardiography. Methods : A total of 27 children with anatomically normal hearts were enrolled for the study. all were examined by conventional and pulsed Doppler echocardiography at Gangneung Asan Hospital between December, 2005 and February, 2006. First, we measured the time interval(a1) between the mitral inflows from apical 4-chamber view, and the ejection time(ET1) from apical 5-chamber view. And then, we calculated MPI1, isovolumic contraction time(ICT1) and isovolumic relaxation time (IRT1). Secondly, we measured ICT2, ET2 and IRT2 from apical 5-chamber view with a Dopper signal placed at just below junction between mitral and aortic valve at the same cardiac cycle. And then, we calculated MPI2. We compared MPI1 to MPI2. All MPIs were calculated by using the formula, MPI=(ICT+IRT)/ET. Results : The mean age was $5.7{\pm}2.2years$ old(M:F=15:12). The MPI2 was higher than MPI1: $0.277{\pm}0.083$ vs. $0.428{\pm}0.081$(MPI1 vs MPI2, P=0.000). Also, the ICT2 was higher than ICT1: $56{\pm}15msec$ vs $97{\pm}18msec$(ICT1 vs ICT2, P=0.000) and the IRT2 was higher than IRT1: $42{\pm}8msec$ vs $53{\pm}9msec$(IRT1 vs IRT2, P=0.000). But, the ET2 was lower than ET1: $260{\pm}16msec$ vs $254{\pm}14msec$ (ET1 vs ET2, P=0.01). There was, as well, positive linear correlation between MPI1 and MPI2. Conclusion : This study showed that there is a difference between MPI1 and MPI2 in connection with estimating methods. However, the two MPIs had a positive linear correlation. Judging from our results, the MPI of the new method might be a useful index of venticular global function in children.

Effects of Single Fetal Death on Mother and Live Co-twin in Twin Pregnancy (쌍태 임신에서 일측 태아의 자궁내 사망이 산모와 생존아에 미치는 영향)

  • Kim, So Youn;Chung, Hae Yul;Back, Hee Jo;Choi, Ic Sun;Cho, Chang Yee;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1512-1518
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    • 2002
  • Purpose : Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors. Methods : A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital. Results : Gestational age was $33.7{\pm}3.2weeks$, birth weight was $1,992{\pm}592g$. Interval between one fetal death being detected and the delivery of a live co-twin was $32.4{\pm}29.5days$. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin. Conclusion : We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.

The Fusion Effect of Deep Transverse Stroking, Manual Stretching Exercise and Active Muscle Release Technique on Psoas Major Muslce Thickness and Muscle Tone and Pelvic Angle of Non-specific Low Back Pain Patient (비특이성 허리통증환자 큰허리근의 근두께와 근긴장도, 골반각도에 심부횡적강찰법과 수동신장운동, 능동적근육이완기법이 융합적으로 미치는 영향)

  • Lee, Ho-Jae;Shim, Jae-Hun;Kim, Ji-Won;Kim, Ki-Song
    • Journal of the Korea Convergence Society
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    • v.9 no.3
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    • pp.137-144
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    • 2018
  • The purpose of this study was to investigate the fusion effects and difference them of the deep transverse stroking, manual stretching exercise and active muscle release technique on psoas major muscle thickness and muscle tone, and pelvic angle in non-specific low back pain patients. Psoas major muscle thickness was significantly decreased after the application of the deep transverse stroking $0.19{\pm}0.16cm$ (p <0.05), manual stretching exercise $0.18{\pm}0.14cm$ (p <0.05), and active muscle release technique $0.43{\pm}0.35cm$ (p <0.05). The pelvic angle was significantly decreased after the application of the deep transverse stroking $4.48{\pm}1.63^{\circ}$ (p <0.05), manual stretching exercise $5.36{\pm}2.04^{\circ}$ (p <0.05), and active muscle release technique $7.24{\pm}2.23^{\circ}$ (p <0.05). The Psoas major muscle tone was significantly decreased after application of the deep transverse stroking $0.96{\pm}0.93Hz$ (p <0.05), but manual stretching exercise $0.87{\pm}1.20Hz$ (p> 0.05) and active muscle release technique $0.82{\pm}0.98Hz$ (p> 0.05) there was no significant difference after application. There were no significant differences between the three intervention methods in the pelvic angle and psoas major muscle thickness and tone changes. In order to change psoas major muscle thickness and pelvic angle, three intervention methods should be applied appropriately according to the condition and environment of the patient, and deep transverse stroking is more effective for changing psoas major muscle tone.

A Newborn Case of Maple Syrup Urine Disease Type 1B Presenting with Lethargy and Central Apnea (기면과 중추성 무호흡으로 나타난 단풍시럽뇨병 Type 1B 신생아 1례)

  • Kang, Youngtae;Choi, Sung Hwan;Ko, Jung Min;Shin, Seung Han;Kim, Ee-Kyung;Kim, Han-Suk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.2
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    • pp.43-49
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    • 2018
  • Maple syrup urine disease (MSUD, OMIM#248600) is a rare and autosomal recessively-inherited metabolic disorder that is caused by mutations in the branched-chain ${\alpha}$-ketoacid dehydrogenase (BCKDH) genes. It prevents the normal breakdown of branched-chain amino acids (BCAAs), such as leucine, isoleucine, and valine, and leads to poor feeding, lethargy, abnormal movements, seizure, and death if untreated. Here, we report the case of a Korean newborn of biochemically- and genetically-confirmed MSUD manifesting lethargy and central apnea, the acute state of which was successfully treated. The molecular genetic investigation revealed two novel heterozygous mutations (p.Ala32Phefs*48 and p.Val 130Phe) in BCKDHB, and both parents were confirmed as carriers. We emphasize the importance of early diagnosis and prompt introduction of specific treatment for MSUD in life saving and prognosis.

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Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft (봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과)

  • Ko, Sang-Hun;Park, Ki-Bong;Park, Gil-Young;Kwon, Sun-Hwan;Kim, Myung-Seo;Park, Sun-Jae
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.135-142
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    • 2020
  • Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

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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