• 대한영상의학회지
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• 제82권2호
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• pp.423-428
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• 2021

Progressive transformation of germinal centers (이하 PTGC)는 드물게 나타나는 양성 림프절 질환으로, 주로 만성적인 림프절 비대의 형태로 나타난다. 주로 한 개 또는 여러 개의 림프절의 무통성 비대로 나타나며, 가장 흔히 침범하는 부위는 경부 림프절, 다음으로 액와부와 서혜부 림프절로 알려져 있다. 일부 환자들에서는 조직병리에서 림프종이 함께 존재하기도 하지만, PTGC 자체는 전암병변으로 인식되지는 않는다. 조직학적으로 PTGC로 진단되는 경우도 적지만, 이에 대한 영상의학적 소견은 거의 보고된 바가 없다. 이에 저자들은 침윤성 유방암 환자에서 수술 후 반대편 액와부 림프절 비대로 나타나 전이성 림프절로 오인한 PTGC 증례의 영상 소견을 보고하고자 한다.

• 대한영상의학회지
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• 제84권1호
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• pp.298-303
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• 2023

전자담배 관련 폐 손상(electronic cigarette or vaping-associated lung injury)은 전자담배에 의해 발생하는 폐 손상으로, 주된 병리 소견은 기질화폐렴 혹은 미만성폐포손상이며 드물게 급성호산구폐렴을 보인다. 본 증례에서 대마 추출물이 없는 니코틴 액상 전자담배 흡연력의 34세 남자 환자가 급성 호흡기 증상, 흉부 CT에서 양측 폐하엽의 주변부의 다발성 경화와 간유리음영, 미만성의 소엽간격막 비후, 흉막삼출을 보였다. 기관지폐포세척액에서는 호산구증이 있었고 감염성 검사들은 모두 음성으로 보였기에 진단기준에 부합하는 급성호산구 폐렴으로 발현한 대마 추출물이 없는 니코틴 액상 전자담배 관련 폐 손상의 희귀한 증례를 보고한다.

• 대한영상의학회지
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• 제85권2호
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• pp.415-420
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• 2024

유방 림프종은 유방 악성 종양의 드문 형태로 유병률이 낮다. 유방 림프종의 초음파 소견은 비특이적인 것으로 알려져 있다. 일반적으로 유방 림프종은 초음파에서 저에코의 단일 종괴로 보이며, 칼라 도플러 초음파에서 고혈관성을 보인다. 이에 저자들은 초음파에서 양측 유방에 다수의 고에코의 결절들로 보이는 비전형적인 유방 림프종의 증례를 보고한다.

• 대한영상의학회지
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• 제83권5호
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• pp.1195-1200
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• 2022

과립 세포 종양은 드문 연조직 종양으로써 주로 혀의 줄무늬 근육에서 발생한다. 과립 세포 종양이 대흉근에서 발생한 예는 매우 드물게 보고되었다. 이에 저자들은 유방 아래의 대흉근에 발생한 과립 세포 종양의 증례를 다양한 영상 소견과 함께 보고하고자 한다.

• 대한영상의학회지
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• 제81권3호
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• pp.465-466
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• 2020

• 대한임상독성학회지
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• 제16권2호
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• pp.86-92
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• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.

• Laboratory Medicine Online
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• 제1권2호
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• pp.110-114
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• 2011

혈구포식 림프조직구증(hemophagocytic lymphogistiocytosis, HLH)에서 관찰되는 클론성 염색체이상은 혈액종양이 골수조직을 침범한 경우에 흔하게 발견되며, 혈액종양의 근거가 없는 환자에서 EBV 감염과 관련되어 드물게 보이는 경우가 있다. 본 저자들은 혈액종양 병력도 없고 EBV 감염도 없이 클론성 염색체이상을 동반하였으며 치명적인 임상경과를 보인 HLH 1예를 경험하여 보고하는 바이다. 본 증례는 지속적인 발열 및 상기도감염 증상을 주소로 내원한 75세 남자환자였다. 검사소견에서 범혈구감소증, 저섬유소원증, 간기능 이상과 비장종대, 골수에서 현저한 혈구탐식을 보이는 성숙한 양성 조직구의 증식이 관찰되었다. 전혈에서 실시한 EBV RT-PCR 결과는 음성이었으나 CMV RT-PCR에서는 319 copies/mL의 양성소견이 관찰되었다. 골수검체를 이용한 핵형 분석결과에서는 복잡한 클론성이상을 보이는 비정상 염색체가 존재하였다. 본 환자는 염색체이상을 동반한 HLH 진단 하에 스테로이드 충격요법과 감염에 대한 예방적 항생제치료를 시행하였으나, 내원 13일째 파종성 혈관내응고로 사망하였다.

• 대한임상독성학회지
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• 제21권2호
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• pp.69-80
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• 2023

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients' sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10-29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.91-97
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• 2018

Objective: The aim of this study was to compare the electrodiagnostic outcomes of carpal tunnel release in patients with and without diabetes with carpal tunnel syndrome (CTS), and to evaluate the effect of diabetes mellitus (DM) on electrodiagnostic outcomes. Method: We conducted a retrospective analysis of 67 patients with electro-diagnostic evidence of CTS. Patients were classified into two groups according to the presence of DM. Both groups were evaluated using nerve conduction studies preoperatively and 3 weeks and 3 months postoperatively. Results: There were no statistical differences in any of the electrodiagnostic parameters between groups 3 weeks postoperatively. However, there were statistical differences in the amplitude and the latency of compound muscle action potential, and sensory nerve conduction velocity 3 months postoperatively. Conclusion: Patients with DM did not show a significantly different outcome 3 weeks after surgery but showed a worse electrodiagnostic outcome 3 months after surgery than those without DM.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.153-158
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• 2018

Posterior interosseus (PI) nerve compression is a rare form of compressive neuropathy. It can cause pain along the radial nerve course and weakness of radial nerve innervating muscles without sensory symptoms. A 65-year-old man visited our institution complaining weakness of finger extension and thumb abduction after 2 times of injections at the right elbow in local clinic. The patient's clinical history and physical examination implied an iatrogenic radial nerve injury caused by the injection. The electrophysiologic study revealed of posterior interosseus neuropathy (PIN) with incomplete conduction block. However, the ultrasound study showed that the PI nerve was compressed by an anechoic cyst. The magnetic resonance imaging also confirmed of a ganglion cyst, not a hematoma. After repeated aspirations and a steroid injection, the electrophysiologic study showed recovery of motor weakness. Despite of the clue which implying an iatrogenic injury, clinician should consider other possibilities such as ganglion cysts and ultrasound guided aspiration and steroid injection could be an effective option for conservative management.