• Title/Summary/Keyword: 척추 방사선수술

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Results of Radioiodine Treatment for Distant Metastases of Differentiated Thyroid Carcinoma (분화성 갑상선암의 원격 전이에서 방사성옥소 치료 성적)

  • Kim, Yu-Kyeong;Chung, June-Key;Kim, Seok-Ki;Yeo, Jung-Seok;Park, Do-Joon;Jeong, Jae-Min;Lee, Dong-Soo;Cho, Bo-Youn;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.107-118
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    • 2000
  • Purpose: To evaluate the effectiveness of radioiodine treatment for metastatic thyroid carcinoma, we reviewed results of radioactive iodine treatment in patients with functional lung or bone metastases. Materials and Methods: Of 760 patients who were treated for differentiated thyroid cancer between 1984 and 1998, we detected pulmonary metastases and bone metastases in 76 patients (10.0%) and 20 patients (2.6%), respectively. Among them, we could evaluate the effectiveness of I-131 therapy in 53 patients with lung metastases and 15 patients with bone metastases. Results: Of 53 patients who received I-131 therapy with a mean cumulative dose of 26.2 GBq (1.1-84.4 GBq) for pulmonary metastases, metastatic lung lesions completely resolved in 19 patients (35.8%) and improved in 22 patients (41.5%). In 13 of 19 patients with complete remission of pulmonary metastases, the total accumulated dose of I-131 was less than 18.5 GBq. We found 43 sites of metastatic bone lesions in 15 patients with bone metastases. Of 29 lesions which received I-131 therapy, metastatic lesions improved in 14 sites (48.3%), but did not change or progress in 15 sites (51.7%) despite the I-131 therapy. Three lesions were completely cured with a combination treatment of surgery(${\pm}$ external radiotherapy) and I-131 therapy, and the other 11 lesions improved. Conclusion: Radioactive iodine treatment gives favorable results for pulmonary metastases. However, for bone metastases, there might be a need to use combination therapy including I-131 and surgery or external irradiation.

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Treatment of Osteoid Osteoma (유골 골종의 치료)

  • Han, Chung-Soo;Cho, Chang-Hyun;Cho, Young-Lin;Cho, Nam-Su;Lim, Chan-Teak
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.22-29
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    • 2000
  • Purpose : The purpose of the current study was to report the results of curettage and en bloc excision as well as to introduce how to excise the nidus percutaneously with Halo-mill. Material and Methods : Twenty patients(14 men and 6 women) were evaluated, who had operative treatments after diagnosed as osteoid osteoma from March 1990 to January 1998. These patients ranged in age from 7 to 42 years(average: 20.8 years). Locations were 9 femurs, 6 tibias, 2 vertebras, 1 ulna, 1 maxilla and 1 skull. Nine femoral lesions included 5 proximal metaphysis, 2 neck and 2 diaphysis, while 5 tibial lesions included 3 diaphysis, 1 proximal metaphysis and 1 distal metaphysis. We used simple radiography, bone scan, CT and MRI for the accurate diagnosis and localization. As for surgical treatments, while excision and curettage had to need open-exposure of lesion, the percutaneous excision of nidus did not need openexposure : guided Halo-mill into K-wire inserted to nidus under image intensifier. Results : Simple radiography showed that 10 cases had typical nidus and others had only cortical sclerosis. Bone scan was performed at 14 cases and all had hot uptake except one case. We used CT in 10 cases and MRI in 4 cases as diagnostic methods, of which 1 case didn't reveal nidus at CT. Surgical treatment consisted of 6 curettages, 11 excisions, 2 percutaneous excisions with halo-mill and 1 total elbow arthroplasty. We used 7mm sized Halo-mill. During the follow-up period, all patient relieved symptoms and there were no recurrences. All had histologically typical findings except one which had hyperostosis without nidus. Conclusion : Complete removal of the nidus is the most important factor in the treatment. We could excise the nidus percutaneously in 2 cases with the minimal injury to surrounding soft tissues. If we could evaluate the precise location, size of nidus and percutaneous acccesibility, the percutaneous excision of nidus with Halo-mill could be an alternative method as a treatment of osteoid osteoma.

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Evaluation of Effect of Decrease in Metallic Artifacts using the Synthetic MR Technique (Synthetic MR 기법을 이용한 금속 인공물 감소 효과 평가)

  • Soon-Yong, Kwon;Nam-Yong, Ahn;Jeong-Eun, Oh;Seong-Ho, Kim
    • Journal of the Korean Society of Radiology
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    • v.16 no.7
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    • pp.835-842
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    • 2022
  • This study is aimed to evaluate the effects of a synthetic MR technique in reducing metal artifacts. In the experiment, the in-plane and through-plane images were acquired by applying a synthetic MR technique and a high-speed spin echo technique to a phantom manufactured with screw for spinal surgery. The area of the metal artifact was compared. The metal artifacts were measured by dividing the signal-loss and the signal pile-up areas, and the area of the final artifact was calculated through the sum of the two. As a result, the metal artifacts were relatively reduced when the synthetic MR techniques were applied to both in-plane and through-plane. Comparing by sequence, the in-plane T1 images decreased by 23.45%, T2 images by 20.85%, PD images by 19.67%, and FLAIR images by 22.12%. Also, in the case of the through-plane, the T1 image decreased by 62.95%, the T2 image decreased by 73.93%, the PD image decreased by 74.68%, and the FLAIR image decreased by 66.43%. The cause of this result is that when the synthetic MR technique is applied, the distortion is due to the signal pile-up and does not occur and the size of the entire metal artifact is reduced. Therefore, synthetic MR technique can very effectively reduce metal artifacts, which can help to increase the diagnostic value of images.

Surgical Treatment of Occluded Aberrant Left Subclavian Artery with Right-sided Aortic Arch -A case report- (우측 대동맥궁을 가진 환자에서 이상 기시된 좌쇄골하 동맥 폐색의 수술적 치료 - 1예 보고)

  • Cho Yang Hyun;Ryu Se Min;Kim Hyun Koo;Cho Jong Ho;Sohn Young-sang;Choi Young Ho;Kim Hark Jei
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.241-244
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    • 2005
  • A 57-year-old man with numbness and paresthesia of left arm is presented. There was no pulse in the left arm was absent and his chest radiograph suggested right-sided aortic arch. The aortogram showed right-sided aortic arch with Kommerell's diverticulum. The proximal portion of left subclavian artery was totally occluded and blood was being supplied through vertebral arteries to distal subclavian artery. He underwent bypass grafting between both subclavian arteries by an expanded polytetrafluoroethylene graft. Because the size of Kommerell's diverticulum was small, it need to be observed closely.

A Case of Gunshot Injury to the Spinal Cord in a Cat:Clinical, Surgical, and Computed Tomographic Features (고양이 척수 총상 증례: 임상소견, 수술소견, 컴퓨터단층영상소견)

  • Ahn, Seoung-Yob;Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.187-190
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    • 2015
  • An 18-month-old female spayed domestic short-haired cat, weighing 4.1 kg, was presented as an emergency case after it suffered a gunshot injury. Physical examination of the cat revealed paraplegia, with loss of deep nociception. A bullet (diameter, 3 mm) lodged in the left epaxial muscle at the level of the first lumbar (L1) was observed on radiographic examination, and a hyperattenuating spot in the spinal canal was confirmed using computed tomography. Exploratory laminectomy was performed, and an incomplete fracture of the right caudal articular process of L1 and a necrotizing spinal cord lesion were found. The animal was euthanized and necropsy was performed, which revealed a crack on the left pedicle of L1. This case report presents the first detailed clinical description of a gunshot injury to the spinal cord in a cat.

Diagnosis of Spinal Arachnoid Cyst using Magnetic Resonance Imaging in a Dog (개에서 자기공명영상을 이용한 척추부 지주막 낭종의 진단)

  • Shin, Chang-ho;Kim, Young-ki;Hwang, Tae-sung;Yoon, Young-min;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.464-468
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    • 2015
  • A 6-year-old, intact male maltese was presented with hindlimb ataxia of 4 day duration. Physical and neurological examinations revealed a bright, alert, and responsive dog, with no evidence of cranial nerve deficits, conscious proprioceptive deficits. Spinal reflexes of the hind and forelimbs were normal. Patellar, cranial tibial, and withdrawal reflexes were normal. Pain could not be elicited on manipulation of the neck or palpation of the spinal column. Survey radiographs of the vertebral column were unremarkable. Computed tomography (CT) scans in the transverse plane were performed. The results of CT imaging were unremarkable. Magnetic resonance imaging (MRI) in both sagittal and transverse planes was performed. The extent of the lesion was 25 mm in length by 4 mm in thickness. The spinal cord was deviated ventrally and appreared thinner. On T1-weighted and FLAIR images, a discrete hypointense lesion dorsal to the spinal cord was observed at L1-2 which was contiguous with the subarachnoid space. On T2-weighted images, this region was hyperintense, consistent with a fluid-filled structure. The signal intensity of the cysts was equivalent to cerebrospinal fluid (CSF). Surgical treatment involving dorsal laminectomy had successful outcomes.

Acrodysostosis Associated with Symptomatic Cervical Spine Stenosis

  • Ko, Jung-Min;Kwack, Kyu-Sung;Kim, Sang-Hyun;Kim, Hyon-Ju
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.145-150
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    • 2010
  • Acrodysostosis is an extremely rare disorder characterized by short fingers and toes with peripheral dysostosis, nasal hypoplasia, and mental retardation. We report a 16-year-old Korean boy with acrodysostosis who had characteristic clinical features and cervical spine stenosis manifested by neurologic symptoms. On presentation, he complained of difficulty in raising his arms, and suffered from intermittent pain and weakness in both upper extremities. He had short stature and dysmorphic facial features, including a broad, depressed nasal bridge, small, upturned nose, bilateral epicanthal folds, and mild hypertelorism. Moderate mental retardation and sensorineural hearing loss in both ears were also present. Radiological findings included broad, short metacarpals and phalanges with cone-shaped epiphyses, bilateral Madelung deformities, hypertrophied first metatarsals, and thickening of the calvarium. Magnetic resonance imaging findings included stenosis of the cervical spine, platybasia with compression into the cervicomedullary junction, and downward displacement of the cerebellar tonsils. Here, we report a case of acrodysostosis with symptoms and signs of cervical spinal stenosis first in Korea. If it is diagnosed in the early stages, possible life-threatening complications, including spinal canal stenosis, can be managed properly and permanent neurologic sequelae might be avoided. Therefore, it is important to consider acrodysostosis in the differential diagnosis of peripheral dysostosis.

Ultrasound-Guided Injections in the Lumbar and Sacral Spine (요추 및 천추부에 대한 초음파 유도하 중재 시술)

  • Ko, Kwang Pyo;Song, Jae Hwang;Kim, Whoan Jeang;Kim, Sang Bum;Min, Young Ki
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.185-195
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    • 2018
  • Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

A Case of Cerebral Metastasis from Malignant Fibrous Histiocytoma (뇌로 전이한 악성 섬유성 조직구종 1례)

  • Kang, Kwan-Soo;Lee, Jung-Il;Suh, Yeon Lim
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1340-1344
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    • 2001
  • This is a rare case of cerebral metastasis from malignant fibrous histiocytoma(MFH) of the soft tissue. A 62-year-old man underwent craniotomy for resection of multiple intracerebral masses under the impression of metastatic brain tumor with unknown primary site. Preoperative investigation failed to detect any extracranial lesion. At six months after the operation and whole brain radiotherapy, right shoulder mass was detected to grow and excised. Specimen from the brain and shoulder lesions revealed identical pathological findings of malignant fibrous histiocytoma except existence of glial fibrillary acidic protein(GFAP)-positive cells only in brain lesions. Palliative radiotherapy was performed for subsequently developing metastatic lesions in skeletal system. At twelve months after initial diagnosis recurrent lesion at right shoulder was detected and chemotherapy is given. This case is unique because metastatic brain lesion from MFH is rare and also cerebral metastasis as an initial manifestaion of MFH has not been reported before. Another important finding is that there was expression of GFAP only in brain lesions but not in extracranial primary site lesion. Although the presence of GFAP-positive cells is thought as one of characteristic histological findings of primary intracrainal MFH, our observation supports the hypothesis that GFAP-positive cells in primary intracranial MFH may be nonneoplastic astrocytes secondarily involved by MFH.

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Isotopic Determination of Food Sources of Benthic Invertebrates in Two Different Macroalgal Habitats in the Korean Coasts (동위원소 분석에 의한 동해와 남해 연안의 상이한 해조류 군락에 서식하는 저서무척추동물 먹이원 평가)

  • Kang, Chang-Keun;Choy, Eun-Jung;Song, Haeng-Seop;Park, Hyun-Je;Soe, In-Soo;Jo, Q-Tae;Lee, Kun-Seop
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.4
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    • pp.380-389
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    • 2007
  • Stable carbon and nitrogen isotopes were analyzed in suspended particulate organic matter, macroalgae and macrobenthic invertebrates in order to determine the importance of primary organic matter sources in supporting food webs of rocky subtidal and intertidal macroalgal beds in the Korean coasts. Investigations were conducted at the inter tidal sites within Gwangyang bay, a semi-enclosed and eutrophicated bay, and the subtidal sites of the east coast, a relatively oligotrophic and open environment, in May and June 2005. Water-column suspension feeders showed more negative $\delta^{13}C$ values than those of the other feeding guilds, indicating trophic linkage with phytoplankton and thereby association with pelagic food chains. In contrast, animals of the other feeding guilds, including interface suspension feeders, herbivores, deposit feeders, omnivores and predators, displayed relatively less negative $\delta^{13}C$ values than those of the water-column suspension feeders and similar with that of macroalgae, indicating exclusive use of macroalgae-derived organic matter and association with benthic food chains. Most the macrobenthic species were considered to form strong trophic links with benthic food chains. In addition, the distribution of higher $\delta^{15}N$ values in macrobenthic consumers and macroalgae at the intertidal sites of Gwangyang Bay than those at the subtidal sites of the east coast suggests that anthropogenic nutrients may enhance the macroalgal production at the intertidal sites and in turn be incorporated into the particular littoral food web in Gwangyag Bay. These results confirm the dominant role of macroalgae in supporting rocky subtidal and intertidal food webs in the Korean coasts.