• Title/Summary/Keyword: 임상 소견

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Clinical Study of Pulmonary Paragonimiasis (폐흡충증 환자의 임상적 고찰)

  • Choi, Jin-Won;Park, Ik-Soo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.274-282
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    • 1993
  • Background: Pulmonary paragonimiasis is caused by consumption of raw or improperly cooked crabs infected by a laval stage (metacercaris) of the parasite. In our country it had been a highly prevalent endemic disease until th late 1960s, and after then it's prevalence has been markedly decreased. But because some people have continued to ingest undercooked crabs, this disease have yet occured sporadically. Methods: We reviewed the clinical and radiological findings retrospectively in seventy-four patients of pulmonary paragonimiasis including familial infestation in 7 familes (20 cases) who were confirmed by food history, clinical and radiological findings, and labaratory data. Results: The male: female ratio was 2.2:1 and most prevalent age was 40-49 years old. Twen6ty nine patients (39%) had ova-positive infection. The detection sites were sputum (48%), pleural fluid (17%), fine needle aspiration biopsy of nodular or cystic lesion (17%), pleural biopsy (7%), skin nodule biopsy (7%), and stool (3%). The patients had pulmonary symptoms in 63 cases (85%) but 9 cases did not have any symptoms. The 53 cases (72%) had abnormal radiological findings in lung parenchyme (75%) and pleura (63%). However 21 cases (28%) showed no specific findings in their chest X-ray. Serum titers (ELISA) of specific IgG for paragonimiasis in 13 cases were followed for average 9.8 months after treatment, which showed slow decreasement. In the evaluation of family member (7 family, 20 cases), all members having the common dietary history together with a proven patients were confirmed this disease by serological test, regardless of the presence or the abscence of clinical or radilogical symptoms. Conclusion: We evaluated the clinical and radiological findings in 74 cases of pulmonary paragonimiasis including 7 family members who had a history of ingestion of improperly cooked crabs together with patients. The paients of pulmonary paragonimiasis have various findings in clinical and radiological findings. Common diet exposure history and laboratory findings including specific IgG were important in earlier diagnosing and treating in family members of patients.

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Usefulness of DTI-based three dimensional corticospinal tractography in children with hemiplegic cerebral palsy (편마비를 가진 뇌성마비 환아에서 확산 텐서강조영상을 이용한 3차원 피질척수로 영상의 유용성)

  • Yeo, Ji Hyun;Son, Su Min;Lee, Eun Sil;Moon, Han Ku
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.99-104
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    • 2009
  • Purpose : Magnetic resonance diffusion tensor imaging-based three-dimensional fiber tractography (DTI-FT) is a new method which demonstrates the orientation and integrity of white matter fibers in vivo. However, clinical application on children with cerebral palsy is still under investigation. We present various abnormal patterns of DTI-FT findings and accordance rate with clinical findings in children with hemiplegic cerebral palsy, to recognize the use fulness of DTI-FT. Methods : The thirteen children with hemiplegic cerebral palsy evaluated at Yeungnam University hospital from March, 2003 to August, 2007 were enrolled in this study and underwent magnetic resonance DTI-FT of the corticospinal tracts. Two regions of interest (ROI) were applied and the termination criteria were fractional anisotropy ${\geq}0.3$, angle ${\leq}70^{\circ}$. Results : The patterns and distribution of abnormal DTI-based corticospinal tractographic findings were interruption(10 cases, 76.9%), reduction of fiber volume (8 cases, 61.5%), agenesis of corticospinal tract (3 cases, 23.1%), transcallosal fiber (2 cases, 15.4%) and, aberrant corticospinal tracts (4 cases, 30.8%). Abnormal DTI-based corticospinal tractographic findings were in accordance with the clinical findings of cerebral palsy in 84.6% of the enrolled patients. Conclusion : Our results suggest that DTI-FT would be a use ful modality in the assessment of the corticospinal tract abnormalities in children with hemiplegic cerebral palsy.

Ischemic Enterocolitis in Children (소아에서 발생한 허혈성 소장결장염)

  • Lee, Byung-Ky;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.138-146
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    • 2007
  • Purpose: Ischemic enterocolitis (IEC) is the total or partial infarction of the intestine in the absence of occlusion of a major mesenteric blood vessel. The purpose of this study was to evaluate the clinical features of IEC in children. Methods: A clinical analysis of 6 patients with IEC who were admitted to the Department of Pediatrics at Pusan National University Hospital, between 1996 and 2005 was conducted retrospectively. Patients were diagnosed with IEC based on clinical characteristics, including radiologic, endoscopic, histopathologic, and intraoperative findings. Results: Four boys and 2 girls between the age of 6 weeks and 6 years were included in this study. Most of the patients were born at term and had a birth weight that was appropriate for their gestational age. The major symptoms of IEC observed included hematochezia or hematemesis (5 cases), vomiting, diarrhea, abdominal pain or irritability (4 cases), as well as abdominal distension and fever (3 cases). IEC occurred in thecolon in 5 cases (2 descending colon, 1 descending and sigmoid colon, 1 sigmoid colon, 1 whole colon) and the duodenal bulb and gastric antrum in 1 case each. The type of the lesions observed includedulcera, which were found in 3 cases, perforation, which was pbserved in 2 cases, necrotic patches, which were observed in 2 cases, stricture, which was observedin 1 cases, and massive membranous desquamation of the epithelium, which was observed in 1 case. Two of the patients received surgical treatment and the remaining four were treated conservatively. None of the patients died. Conclusion: The presentation of IEC varies, and the findings of this study will be helpful in managing patients with IEC.

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Clinical Features of Eosinophilic Colitis Developed in Early Infancy (영아 초기에 발생한 호산구성 대장염의 임상적 고찰)

  • Kwak, Jeong Won;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.122-129
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    • 2005
  • Purpose: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. Methods: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. Results: Five males and one female were included. The mean age when bloody stool was identified was $79.2{\pm}56.1$ days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count $11,763{\pm}3,498/mm^3$, eosinophils $17.0{\pm}4.3%$, absolute eosinophil count $2,044{\pm}996/mm^3$) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. Conclusion: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

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Clinicopathological Correlation of Intralobar Pulmonary Sequestration (내엽성 폐격리증의 임상적 특성과 조직병리학적 소견의 연관성)

  • Cho, Hyun-Min;Shin, Dong-Hwan;Kim, Kil-Dong;Lee, Sak;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.356-362
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    • 2003
  • Background: Intralobar and extralobar pulmonary sequestrations have been considered as congenital lesions that occur at different stages of embryonic life. However, most cases of intralobar pulmonary sequestration (IPS) seem to have an acquired origin, as they are absent in infants and associated anomalies are relatively, uncommon among them. Material and Method: The cases of 25 patients who were diagnosed as IPS after surgical resection from December, 1985 to July, 2002 were included in this study. The medical records wire retrospectively reviewed and the clinical characteristics were age at operation; gender; symptoms at presentation; presence of congenital anomalies; combined diseases; preoperative studies and diagnosis; location of the lesion; method of surgical resection; origin, size and numbers of aberrant artery; histopathological findings; and postoperative complications. Result: There were 17 (68%) female patients and 8 (32%) male patients, their ages ranged from 1 to 57 and mean value was 23 years old. Though 14 patients (56%) complained of respiratory symptoms such as pneumonia and recurrent respiratory infections, a large number of patients (44%) were asymptomatic or had chest pain only when the lesion was discovered. Only 8 patients (32%) were diagnosed as pulmonary sequestration preoperatively and 8 (32%) were suspected as mediastinal or lung tumor, 5 (20%) were congenital or acquired cystic lung disease, and 4 (16%) were lung abscess or bronchiectasis, respectively. The majority of aberrant arteries (86.4%) confirmed during the operation were originated from thoracic aorta and 2 were thoracic and abdominal aorta, 1 was abdominal aorta, respectively. The younger patients (less than 10 years old) had more other congenital anomalies (30% vs 6.7%) but the proportion of congenital IPS was not significantly different (10% vs 6.7%, p>0.05) compared with elder patients. Histopathologically, almost all lesions showed chronic inflammation, cystic changes and similar pleural adhesions regardless of age. Conclusion: The large portion of the patients with IPS (44%) was clinically asymptomatic or presented non-respiratory symptoms at diagnosis and likely to be diagnosed as mediastinal or lung tumor especially in elder patients. Though the younger patients had more other congenital anomalies, most cases of IPS proved to be acquired lesions in terms of the histopathlogical findings and the proportion of congenital evidences.

Tuberculous Subdeltoid Bursitis - A Case Report - (결핵성 삼각근하 점액낭염 - 증례 보고 -)

  • Lee, Woo-Seung;Yoon, Jung-Ro;Kang, Kyu-Bok;Yang, Jae-Hyuk;Lim, Hyung-Tae
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.45-48
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    • 2010
  • We report a case of an 85-year-old woman with tuberculous subdeltoid bursitis. Tubeculous bursitis without adjacent joint tuberculosis may occur any site but it is rare. It is common in bursae subjected to trauma like trochanteric, prepatellar, olecranon and so on. Because the clinical findings or physical examination of tuberculous subdeltoid bursitis are similar to rotator cuff disorder and the MRI or arthroscopic findings are similar to synovial diseases, careful differential diagnosis is necessary.

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Two Cases of Wolff-Parkinson-White Syndrome in a Family (가족 내 발생을 보인 Wolff-Parkinson-White 증후군 2례)

  • Joo, Chan Uhng;Lim, So Hee;Hwang, Pyung Han
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1150-1154
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    • 2002
  • Wolff-Parkinson-White(WPW) syndrome is characterized by electrographic evidence of ventricular preexcitation, which predisposes to supraventicular arrhythmias. Familial occurrence of WPW syndrome is uncommon. We observed two affected siblings in a family. Five members of the family underwent 12-lead electrocardiography and echocardiography. Although known genetic abnormality of the 7q34-q36(PRKAG2) for the familial WPW syndrome was evaluated, the mutation was not detected in this family. Other unknown mutations responsible for this familial WPW syndrome were suggested.

Imaging Findings of Metastatic Breast Malignant Fibrous Histiocytoma: A Case Report (전이성 유방 악성 섬유성 조직구종의 영상 소견: 증례 보고)

  • Lee, Hyun Sil;Kang, Bong Joo;Kim, Sung Hun;Lee, Ahwon
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.4
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    • pp.316-320
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    • 2013
  • Malignant fibrous histiocytoma (MFH) of the breast is extremely rare and most of the previous reports were focused on the clinicopathological features of breast MFH, so analysis of its imaging findings have been limited. We report a case of MFH involving left breast and left axilla, metastasized from known MFH of left forearm, with focusing on imaging findings based on radiologic evaluation of the breast including mammography, ultrasound and breast MRI.

The Legal Protection of Digital Medical Imaging in U-healthcare (U-헬스케어에 있어서 디지털 의료영상정보의 법률적 보호)

  • Jeong, Young-Yeub
    • Korean Journal of Digital Imaging in Medicine
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    • v.7 no.1
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    • pp.23-31
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    • 2005
  • 원격진료 홈네트워크 아파트 진료용 키오스크 모바일주치의 등으로 대표되는 U-헬스케어에 있어서 기초가 되는 것은 의료정보를 디지털화해서 전자적 자료의 형태로 저장 보관하고 이를 송 수신할 수 있는 기술이라고 할 수 있다. 우리나라의 경우, U-Korea 전략의 하나로 보건복지부가 주축이 되어 2005년 10월 현재 국가보건의료정보화계획(ISP)을 수립하기 위한 작업을 추진중에 있다. 여기서, 예컨대 임상병리검사소견이나 방사선촬영소견 등의 의료정보가 전자적 장치에 의해 디지털화 할 경우 디지털 의료정보가 되는 것이며, 이 가운데 특히 방사선촬영소견 등 방사선분야의 모든 촬영기록이 PACS시스템을 통해 기재되거나 저장 전송될 경우 이를 디지털 의료영상정보라고 할 수 있다. 그런데 오늘날 정보통신기술의 발달로 말미암아 디지털 의료영상정보를 포함한 디지털의료정보는 대량적으로 수집 저장되고 유통 내지 공동활용이 보편화되어 감에 따라 그 의료정보의 보호에 관한 문제가 중요한 이슈로 대두되고 있다. 결론적으로 말하자면, 이러한 디지털 의료영상정보가 전자의무기록(EMR) 형태로 저장 보관되는 경우 이는 전자의무기록에 관한 법률규정이 적용되어 법률적 보호를 받게 되며, 그 보호의 강도는 종래 오프라인 상의 의료정보 보호보다 한층 강화된 규정을 두고 있다. 이와 같은 흐름에 있어서 최근 정부가 국가보건의료정보화계획 수립과 함께 제정작업을 추진하고 있는 가칭 의료정보화촉진 및 개인정보보호에 관한 법률(안)은 시사점이 크다고 보기 때문에 소개하고자 한다.

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A Case of Churg-Strauss Syndrome in Infancy (영아기 Churg-Strauss Syndrome 1예)

  • Shon, Su-Min;Kim, Kyo-Il;Park, Moon-Ho;Kang, Yu-Na;Lee, Hee-Jung;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.66-70
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    • 2007
  • Churg-Strauss syndrome (CSS) is a disorder characterized by pulmonary and systemic smallvessel vasculitis, extravascular eosinophilic infiltration and hypereosinophilia; it is rarely diagnosed in the pediatric age group. We experienced a case of CSS in a male infant who had repeated symptoms of asthma with hypereosinophilia and transitory non-fixed pulmonary infiltrates on chest radiographs. He also had rectal bleeding in early infancy and multiple erosions with extravascular eosinophilic infiltrations in the sigmoid colon. We report a rare case of CSS in a 14-month-old infant and review the medical literature.

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