• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.236-239
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• 2011

A 10 month-old female (intact) Maltese dog was presented due to continuous heart murmur. The dog was diagnosed with patent ductus arteriosus (PDA) based on two-dimensional echocardiography, computed tomography (CT) and angiography. Transarterial coil embolization was used for transcatheter occlusion of the PDA. A single coil was placed successfully and effectively occluded the blood flow through the ductus. Continuous heart murmur disappeared immediately the coil placement and no residual flow was detected. Complications and safety following the procedure were evaluated regularly based on clinical signs, cardiac examinations and serum troponin-I concentrations. This is the first clinical application of coil embolization for transcatheter closure of PDA in a dog in Korea.

• Journal of Preventive Medicine and Public Health
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• v.33 no.1
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• pp.76-82
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• 2000

Objectives : We attempted to assess He accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. Methods : A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met ore of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. Results : The accuracy rate of the ICMIC was 83.0% (425 cases) Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. Conclusion : The accuracy rate of the ICMIC was 83.0%.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.600-604
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• 2010

A ten-year-old female mongrel dog was presented to Veterinary Medical Center, Chungbuk National University with the signs of anorexia, weakness, and hemoglobinuria. Patient had been diagnosed as dirofilariasis based on heartworm antigen test and treated with adulticide (melarsomine) at local hospital one day before admission. On laboratory examinations, there were hypochromic and microcytic regenerative anemia, thrombocytopenia, moderate neutrophilia, and increase ALT, AST, and ALP. Radiographic exam showed main pulmonary artery bulging, pulmonary infiltration and hypervascularity, reduced abdominal serosal detail and mild hepatomegaly. Abdominal ultrasonographic exam showed mild peritoneal effusion and large hyperechoic thrombi at trifurcation of the porta hepatica and the splenic vein. In addition, intraluminal low density area and intravascular filling defect were confirmed on contrast enhanced CT scanning at the same anatomic locations. Patient was treated with anticoagulant and thrombolytic therapy. On day 42 after treatment, complete resolution of thrombi was confirmed via ultrasonography and improvement of clinical signs was observed.

• Journal of the Optical Society of Korea
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• v.20 no.5
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• pp.607-613
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• 2016

The pleura is known as an end target organ of exposure to toxic environmental materials such as fine particulate matter and asbestos. Moreover, long-term exposure to hazardous materials can eventually lead to fatal lung disease such as diffuse pleural fibrosis or mesothelioma. Chest computed tomography (CT) and ultrasound are gold standard imaging modalities for detection of advanced pleural disease. However, a diagnostic tool for early detection of pleural reaction has not been developed yet due to difficulties in imaging ultra-fine structure of the pleura. Optical coherence tomography (OCT), which provides cross-sectional images of micro tissue structures at a resolution of 2-10 μm, can image the mesothelium with a thickness of ~100 μm and therefore enables investigation of the early pleural reaction. In this study, we induced the early pleural reaction according to a time sequence after pleurodesis using talc, which has been widely used in the clinical field. The pleural reaction in talc grouped according to the time sequence (1st, 2nd, 4th weeks) showed a significant thickening (average thickness: 45 ± 7.5 μm, 80 ± 10.7 μm, 90 ± 12.5 μm), while the pleural reaction in sham and normal groups showed pleural change from normal to minimal thickening (average thickness: 16 ± 5.5 μm, 17 ± 4.5 μm, 15 ± 6.5 μm, and 12 ± 7.5 μm, 13 ± 2.5 μm, 12 ± 3.5 μm). The measurement of pleural reaction by pathologic examinations was well-matched with the measurement by OCT images. This is the first study for measuring the thickness of pleural reactions using a biophotonic modality such as OCT. Our results showed that OCT can be useful for evaluating the early pleural reaction.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.649-653
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• 2001

The Chiari malformation is a deformation within the central nervous system which the lower brain stem and the cerebellum migrate into the foramen magnum causing herniation. In 1891, Arnold Chiari classified such symptoms into 3 categories. This case report is of a 8-year-old female with the complaint of a slight facial swelling and pain on the upper right molar during tooth brushing since 10 days before. Clinical examination showed gingival pocket formation on distal of the upper right first molar with pain and mobility of the tooth. Radiographic examination showed generalized low bone density in the upper molar area, and especially no bone support above the upper right and left first molars were noted. With a temporary diagnosis of Early-onset periodontitis, consultations with medical doctors for the possibility of an underlying systemic disease were made during periodontal treatment. 3D CT was taken with after a final diagnosis of Chiari malformation. Generalized thinning and defect of the cranial bone was noted and the foramen magnum was slightly enlarged. The occipital and maxillary bone was low in density, and the alveolar bone of maxillary posterior teeth was especially almost non-existing causing the upper right and left first molar to be floating. For this, the patient went under consultation with the department of neurosurgery and is still under observation. Periodontitis in childreren is very rare. When symptoms of periodontitis appear in a child, due to the possibility of an underlying systemic disease such as leukemia, histiocytosis X, and hypophosphatasia, proper examinations should be carried out so that the primary factor the symptoms can be treated.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.519-522
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• 2014

A 2-year-old, 2 kg Maltese dog was evaluated for progressive tetraparesis and neck pain. The dog had been treated with steroids for the preceding 2 weeks after unknown trauma but was deteriorating progressively and had become tetraparetic. The dog was presented with a non-ambulatory tetraparesis. Radiographic and computed tomographic examinations revealed a transverse C2 fracture with subluxation of the atlantoaxial joint and C2-C3. In addition, hydrocephalus was observed on magnetic resonance imaging. Stabilization of C1-C3 using screws, wires, and polymethyl methacrylate (PMMA) was performed. Application of ventral screws, wires, and PMMA resulted in improvement of the clinical signs after 4 weeks, and the dog could walk as before the tetraparesis 6 weeks after the operation. This stabilization method is an effective surgical treatment for management of cervical instability.

• Korean Journal of Radiology
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• v.22 no.9
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• pp.1547-1554
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• 2021

Objective: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). Materials and Methods: This retrospective study included 300 patients (mean age ± standard deviation, 68.5 ± 8.1 years; 131 male and 169 female) who had undergone at least one ICM-enhanced perfusion brain CT scan, had their baseline and follow-up serum creatinine levels available, and had not undergone additional contrast-enhanced examinations 72 hours before and after a time window of interest were included. The study population was divided into three groups: single-dose group and groups of patients who had received multiple contrast administrations in the time window of interest with the minimum contrast repeat interval either within 4 hours (0-4-hour group) or between 4 to 48 hours (4-48-hour group). Multivariable logistic regression analysis was conducted to evaluate the association between AKI and repeated ICM administrations. A similar supplementary analysis was performed including both ICM and GBCA. Results: When ICM was only considered ignoring GBCA, among 300 patients, 207 patients received a single dose of ICM, 58 had repeated doses within 4 hours (0-4-hour group), and 35 patients had repeated doses between 4 to 48 hours (4-48-hour group). Most patients (> 95%) had a baseline estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m². AKI occurred in 7.2%, 13.8%, and 8.6% of patients in the single-dose, 0-4-hour, and 4-48-hour groups, respectively. In the 0-4-hour and 4-48-hour groups, additional exposure to ICM was not associated with AKI after adjusting for comorbidities and nephrotoxic drugs (all p values > 0.05). Conclusion: Repeated intravascular administrations of ICM within a short interval did not increase the risk of AKI in our study patients suspected of acute stroke with a baseline eGFR of ≥ 30 mL/min/1.73 m².

• Korean Journal of Radiology
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• v.25 no.6
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• pp.575-588
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• 2024

Objective: Differentiating intracranial aneurysms from normal variants using CT angiography (CTA) or MR angiography (MRA) poses significant challenges. This study aimed to evaluate the efficacy of proton-density MRA (PD-MRA) compared to high-resolution time-of-flight MRA (HR-MRA) in diagnosing aneurysms among patients with indeterminate findings on conventional CTA or MRA. Materials and Methods: In this retrospective analysis, we included patients who underwent both PD-MRA and HR-MRA from August 2020 to July 2022 to assess lesions deemed indeterminate on prior conventional CTA or MRA examinations. Three experienced neuroradiologists independently reviewed the lesions using HR-MRA and PD-MRA with reconstructed voxel sizes of 0.25³ mm³ or 0.2³ mm³, respectively. A neurointerventionist established the gold standard with digital subtraction angiography. We compared the performance of HR-MRA, PD-MRA (0.25³-mm³ voxel), and PD-MRA (0.2³-mm³ voxel) in diagnosing aneurysms, both per lesion and per patient. The Fleiss kappa statistic was used to calculate inter-reader agreement. Results: The study involved 109 patients (average age 57.4 ± 11.0 years; male:female ratio, 11:98) with 141 indeterminate lesions. Of these, 78 lesions (55.3%) in 69 patients were confirmed as aneurysms by the reference standard. PD-MRA (0.25³-mm³ voxel) exhibited significantly higher per-lesion diagnostic performance compared to HR-MRA across all three readers: sensitivity ranged from 87.2%-91.0% versus 66.7%-70.5%; specificity from 93.7%-96.8% versus 58.7%-68.3%; and accuracy from 90.8%-92.9% versus 63.8%-69.5% (P ≤ 0.003). Furthermore, PD-MRA (0.25³-mm³ voxel) demonstrated significantly superior per-patient specificity and accuracy compared to HR-MRA across all evaluators (P ≤ 0.013). The diagnostic accuracy of PD-MRA (0.2³-mm³ voxel) surpassed that of HR-MRA and was comparable to PD-MRA (0.25³-mm³ voxel). The kappa values for inter-reader agreements were significantly higher in PD-MRA (0.820-0.938) than in HR-MRA (0.447-0.510). Conclusion: PD-MRA outperformed HR-MRA in diagnostic accuracy and demonstrated almost perfect inter-reader consistency in identifying intracranial aneurysms among patients with lesions initially indeterminate on CTA or MRA.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.295-299
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• 2009

Background: There are various etiologies causing bronchiectasis, but the cases without definite causes account for a quite high proportion. It is also uncertain that immunoglobulin G subclass deficiency (IgGSD) is associated with bronchiectasis. Therefore, we tried to measure the frequency of IgGSD in patients with bronchiectasis of unclear etiology, and to observe the clinical features of those patients with bronchiectasis and IgGSD. Methods: For the outpatients of a university hospital who were diagnosed as bronchiectasis by chest CT, we produced comprehensive history taking and physical examinations, and finally selected 31 patients with bronchiectasis of unclear etiology. Results: Two patients had total immunoglobulin G deficiency. The frequency of IgGSD was comparatively high (n=14). When we compared IgGSD group to normal immunoglobulin G subclass group, there were no significant differences in sex, age, and the frequency of sinusitis, bronchial asthma, and the abnormal lung function. Conclusion: In cases of bronchiectasis without definite causes, it can be considered to measure the level of immunoglobulin G subclass. It is also probably worthwhile to further evaluate the relationship between IgGSD and bronchiectasis.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.117-123
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• 2010

Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.