• Title/Summary/Keyword: 비침습적 검사

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Limited Lateral Retinacular Release for Treatment of Painful Bipartite Patella (통증이 있는 이분슬개골의 제한적인 외측 지대 유리술 치료)

  • Yi Seung Rim;Hahn Sung Ho;Yang Bo Kyu;Chung Shun Wook;Ha Jung Hyun;Ahn Young Joon;Chung Byung June;Jeon Do Hwan;Bin Sung Woo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.60-65
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    • 2004
  • Purpose: The purpose of this study was to evaluate the results of limited vastus lateralis release for treatment of painful bipartite patella. Materials and Methods: From Jan. 1995 to Jun. 2002, we performed limited lateral retinacular release in 14 patients(16 cases) for treatment of painful bipartite patella. All patients were men and mean age was 22.3 years old. The opeative techique was that insertion of the vastus lateralis to the painful patellar fragment is detached subperiosteally. We evaluated the clinical results by degree of pain and level of activity. Also we analyzed the radiologic findings by measuring fragment tilting angle and gap between fragments. The mean follow up period was 14 months. Results: At final follow up, all of the patients showed pain relief and can be returned to more than recreational sports activity after the operation. On radiologic findings, fragment tilting angle and gap between fragments were reduced at statistically significant level. Conclusion: The limited lateral retinacular release for treatment of painful bipartite patella is one of good methods which is less invasive and shows good results in clinical and radiologic findings.

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Evaluation of Fibrosis in Liver Cirrhosis by Superparamagnetic Iron Oxide (SPIO)-Enhanced MR Imaging: Does the Radiological Non-Invasive Fibrosis Index Correlate with the Laboratory Non-Invasive Fibrosis Index? (Superparamagnetic Iron Oxide-Enhanced MRI를 이용한 간섬유화의 평가: 영상의학적 비침습적 간섬유화 지표가 AST/혈소판 비와 상관 관계가 있는가?)

  • Kim, Shin-Kee;Lee, Chang-Hee;Kim, Kyeong-Ah;Choi, Jae-Woong;Lee, Jong-Mee;Park, Cheol-Min
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.115-122
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    • 2008
  • Purpose : To evaluate the correlation between the radiological non-invasive hepatic fibrosis index (RNHFI), as determined by SPIO-enhanced MRI, and the laboratory non-invasive hepatic fibrosis index. Materials and Methods : Patients (99 total: 61 men and 38 women; mean age: 58 years) who underwent SPIO-enhanced MRI (1.5T) during 5 years included. These patients were subdivided into a liver cirrhosis group (LCG) and a non-liver cirrhosis group (non-LCG). Using PACS view, we measured the RNHFI (mean standard deviation of hepatic signal intensity (SD), noise-corrected coefficient of variation (CV)) of three ROIs in the liver parenchyma by SPIO-enhanced MRI. The laboratory non-invasive hepatic fibrosis index (AST-platelet ratio index (APRI)) of all patients was calculated from the laboratory data. We compared the RNHFI and APRI of LCG with those of non-LC group using Student's t-test. A bivariate correlation was performed to investigate the relationship between the RNHFI and APRI in the LCG. Results : For the LCG, mean values of SD and CV by SPIO-enhanced MRI were $10.3{\pm}3.7$ and $0.19{\pm}0.08$, respectively. For the non-LCG, mean values of SD and CV were $6.5{\pm}1.6$ and $0.08{\pm}0.05$, respectively. The mean APRI of the LCG and the non- LCG were $2.04{\pm}1.7$ and $0.32{\pm}0.32$, respectively. The RNHFI and APRI were significantly different between both groups (p<0.05). For the LCG, the bivariate correlation between SD and APRI revealed a statistically significant positive correlation (r=0.5, p<0.001). In both groups, there was no statistically significant correlation between CV and APRI. Conclusion: A measurement of SD can be a simple and useful method for the evaluation of hepatic fibrosis.

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Changes of Serotype Distribution of Streptococcus pneumoniae Isolated from Children in Korea over a 15 Year-period(1991~2005) (15년간(1991~2005년) 우리나라 소아에서 분리된 폐구균의 혈청형 분포의 변화)

  • Kim, So-Hee;Song, Eun-Kyung;Lee, Jun-Ho;Kim, Nam-Hee;Lee, Jin-A;Choi, Eun-Hwa;Lee, Hoan-Jong
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.89-98
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    • 2006
  • Purpose : The prevalence of serotypes can be changed with respect to age of the patients, regions and times of the surveillance. The aim of this study is to analyze changes in serotype distribution of pneumococcal isolates from Korean pediatric patients. Methods : Four hundred and sixty five strains of S. pneumoniae were isolated from various clinical specimens at the Seoul National University Children's Hospital during a 15 year-period, from 1991 to 2005, were subjected to serotype and penicillin susceptibility. The study period was divided into three 5 year-periods, 1991~1995(period I), 1996~2000(period II), and 2001~2005(period III). Results : Common serotypes were 19F, 23F, 19A, 6B, 14, 6A and 9V in decreasing orders of frequency, and these 7 serotypes accounted for 79% of total 465 strains. In the serotype distribution of invasive infection isolates from children <60 months of age, similar serotypes accounted for 70% of 101 strains. In total strains, the proportion of serotype 19A and 6A increased, while that of serotype 19F and 14 decreased. The majority(75~92%) of vaccine types and cross-reactive types from invasive infection isolates was penicillin-resistant, whereas 34.4% of non-vaccine types was penicillin-resistant. Conclusion : Distribution of serotypes of S. pneuomoniae isolated from Korean children has changed significantly over the last 15 years. The surveillance for pneumococcal serotypes should be continued to monitor changes in serotype distribution which are essential for the establishment of pneumococcal vaccine policy.

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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

M-mode Ultrasound Assessment of Diaphragmatic Excursions in Chronic Obstructive Pulmonary Disease : Relation to Pulmonary Function Test and Mouth Pressure (만성폐쇄성 폐질환 환자에서 M-mode 초음파로 측정한 횡격막 운동)

  • Lim, Sung-Chul;Jang, Il-Gweon;Park, Hyeong-Kwan;Hwang, Jun-Hwa;Kang, Yu-Ho;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.736-745
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    • 1998
  • Background: Respiratory muscle interaction is further profoundly affected by a number of pathologic conditions. Hyperinflation may be particularly severe in chronic obstructive pulmonary disease(COPD) patients, in whom the functional residual capacity(FRC) often exceeds predicted total lung capacity(TLC). Hyperinflation reduces the diaphragmatic effectiveness as a pressure generator and reduces diaphragmatic contribution to chest wall motion. Ultrasonography has recently been shown to be a sensitive and reproducible method of assessing diaphragmatic excursion. This study was performed to evaluate how differences of diaphragmatic excursion measured by ultrasonography associate with normal subjects and COPD patients. Methods: We measured diaphragmatic excursions with ultrasonography on 28 healthy subjects(l6 medical students, 12 age-matched control) and 17 COPD patients. Ultrasonographic measurements were performed during tidal breathing and maximal respiratory efforts approximating vital capacity breathing using Aloka KEC-620 with 3.5 MHz transducer. Measurements were taken in the supine posture. The ultrasonographic probe was positioned transversely in the midclavicular line below the right subcostal margin. After detecting the right hemidiaphragm in the B-mode the ultrasound beam was then positioned so that it was approximately parallel to the movement of middle or posterior third of right diaphragm. Recordings in the M-mode at this position were made throughout the test. Measurements of diaphragmatic excursion on M-mode tracing were calculated by the average gap in 3 times-respiration cycle. Pulmonary function test(SensorMedics 2800), maximal inspiratory(PImax) and expiratory mouth pressure(PEmax, Vitalopower KH-101, Chest) were measured in the seated posture. Results: During the tidal breathing, diaphragmatic excursions were recorded $1.5{\pm}0.5cm$, $1.7{\pm}0.5cm$ and $1.5{\pm}0.6cm$ in medical students, age-matched control group and COPD patients, respectively. Diaphragm excursions during maximal respiratory efforts were significantly decreased in COPD patients ($3.7{\pm}1.3cm$) when compared with medical students, age-matched control group($6.7{\pm}1.3cm$, $5.8{\pm}1.2cm$, p< 0.05}. During maximal respiratory efforts in control subjects, diaphragm excursions were correlated with $FEV_1$, FEVl/FVC, PEF, PIF, and height. In COPD patients, diaphragm excursions during maximal respiratory efforts were correlated with PEmax(maximal expiratory pressure), age, and %FVC. In multiple regression analysis, the combination of PEmax and age was an independent marker of diaphragm excursions during maximal respiratory efforts with COPD patients. Conclusion: COPD subjects had smaller diaphragmatic excursions during maximal respiratory efforts than control subjects. During maximal respiratory efforts in COPD patients, diaphragm excursions were well correlated with PEmax. These results suggest that diaphragm excursions during maximal respiratory efforts with COPD patients may be valuable at predicting the pulmonary function.

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Efficacy of Transcervical Fallopian Tube Catheterization in Infertility Patients with Fallopian Tube Occlusion (난관 폐쇄에 기인한 불임 환자에서 난관 개통술의 효용성)

  • Park, Chan-Woo;Cha, Sun-Hwa;Yang, Kwang-Moon;Han, Ae-Ra;Yoo, Ji-Hee;Song, In-Ok;Kim, Hye-OK;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.321-327
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    • 2010
  • Objective: To evaluate the significance and efficacy of trans-cervical fallopian tube catheterization (TFTC) in diagnosis and optimal treatment modality for tubal blockage. Methods: The retrospective study was performed in those underwent TFTC from January 2005 to December 2009. A total of 342 fallopian tubes in 215 patients which showed tubal blockage in hysterosalpingography (HSG), were subjected to TFTC. Recanalization rate (RR) was compared according to portion of tubal blockage; proximal, isthmic and distal portion and blockage type; tapering, concave, and convex type. Results: In total, RR was 72.5% (248/342 tube). According to the portion of tubal blockage, RR was 83.8% in proximal, 45.6% in isthmic and 100% in distal portion. RR was 92.3% in tapering, 80.2% in concave and 25.5% in convex type, respectively. There were 98 pregnancies in 156 patients after successful recanalization, which shows 62.7% pregnancy rate. Conclusio: TFTC were capable of recanalizing tubal blockage in 248 of 342 tubes in 156 of 215 patients (72.5%). The RR was increased with proximal portion and tapering type tubal blockage.

The Effect of a Proton-pump Inhibitor in Unexplained Chronic Cough Patients (진단이 내려지지 않은 만성기침 환자에서 양자펌프억제제의 치료효과)

  • Yang, Joo Youn;Lee, Ho Youn;Kim, Nam Hee;Kim, Youn Seup
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.137-142
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    • 2006
  • Background: Recent studies have suggested an association between chronic cough and gastroesophageal reflux. Our study aimed to assess the utility of a proton-pump inhibitor in unexplained chronic cough patients. Methods: Patients with chronic cough of unknown etiology were evaluated using a chest x-ray, methacholine challenge test, and an empirical trial of postnasal drip therapy. After excluding other potential causes of the cough, forty patients were included in the study and treated for 8 weeks with a proton-pump inhibitor. Results: Eleven and three patients in the first and second 4 weeks were lost to follow-up, leaving twenty-six patients finally included in the study. Of these patients, two were unimproved, eight partially responded to the proton-pump inhibitor and sixteen responded completely after the 8 week treatment. Conclusion: We suggest that empirical treatment with a proton pump inhibitor in all patients with persistent cough, which is not secondary to asthma or postnasal drip syndrome, represents a practical and simple approach to this ailment.

Three-Dimensional Printed Model of Partial Anomalous Pulmonary Venous Return with Biatrial Connection (양측 심방 연결을 형성하는 부분 폐정맥 환류 이상의 3D 프린팅 모델)

  • Myoung Kyoung Kim;Sung Mok Kim;Eun Kyoung Kim;Sung-A Chang;Tae-Gook Jun;Yeon Hyeon Choe
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1523-1528
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    • 2020
  • Partial anomalous pulmonary venous return (PAPVR) is a rare congenital cardiac anomaly that can be difficult to detect and often remains undiagnosed. PAPVR is diagnosed using non-invasive imaging techniques such as echocardiography, CT, and MRI. Image data are reviewed on a 2-dimensional (D) monitor, which may not facilitate a good understanding of the complex 3D heart structure. In recent years, 3D printing technology, which allows the creation of physical cardiac models using source image datasets obtained from cardiac CT or MRI, has been increasingly used in the medical field. We report a case involving a 3D-printed model of PAPVR with a biatrial connection. This model demonstrated separate drainages of the right upper and middle pulmonary veins into the lower superior vena cava (SVC) and the junction between the SVC and the right atrium, respectively, with biatrial communication through the right middle pulmonary vein.

Interrelationships and Differences of Brachial-Ankle Pulse Wave Velocity (baPWV), Body Composition and Cardiovascular Variables between Genders Who Have Been Exercised or Not in Elderly (운동참여 여부와 성별에 따른 노인의 맥박파전파속도, 신체구성과 심혈관계 변인의 상관성 및 재변인의 차이)

  • Lee, Jong-Woo;Kim, Dae-Sik;Cho, Eun-Kyung
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.378-387
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    • 2016
  • This study sought to investigate interrelationships and differences of brachial-ankle pulse wave velocity (baPWV), body composition and cardiovascular variables between genders who have been exercised or not in elderly. One hundred fifty participants were classified four groups. Especially out of variables, in male elderly group who had participated in exercise program the PWV range were significantly correlated with muscle mass (r=0.357, p=0.026), SBP (r=0.468, p=0.003), right baPWV (r=0.406, p=0.010), and left baPWV (r=0.333, p=0.038). In male elderly group who had not participated in exercise program, the PWV range were significantly correlated with heart rate (r=0.395, p=0.014), right baPWV (r=0.598, p=0.000), and left baPWV (r=0.602, p=0.000). In female elderly group who had participated in exercise program, the PWV range were significantly correlated with name of diagnosis (r=0.321, p=0.044), SBP (r=0.399, p=0.011), DBP (r=0.545, p=0.000), right baPWV (r=0.648, p=0.000), and left baPWV (r=0.676, p=0.000). In female elderly group who had not participated in exercise program, the PWV range were significantly correlated with age (r=0.471, p=0.003), right baPWV (r=0.836, p=0.000), and left baPWV (r=0.801, p=0.000). The PWV among four groups were not significant different after experiment. However, there were significant differences in the waist/hip ratio (F=9.197, p=0.000), muscle mass (F=74.295, p=0.000), and %fat (F=35.045, p=0.000) from body composition. And there were significant differences in the SBP (F=3.525, p=0.017) after experiment. In conclusion, these data show that regular exercise is associated with arterial compliance (PWV range, right or left PWV) and differed from genders. In other words, this paper may support the concept that regular exercise program may exert a protective effect on arterial compliance, body composition and cardiovascular systems.

Endovenous Laser Treatment (EVLT) with High Ligation of an Incompetent Small Saphenous Vein (소복재정맥 역류에서 고위결찰술을 동반한 정맥내 레이저 치료)

  • Jeong, Jae-Han;Kim, Kun-Il;Lee, Won-Yong;Kim, Hyoung-Soo;Cho, Sung-Woo;Lee, Hee-Sung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.150-155
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    • 2010
  • Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.