• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.132-137
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• 2015

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma has been rarely reported, whereas only a few cases of Cushing syndrome accompanied by opportunistic infections have been reported. We experienced a patient with pheochromocytoma with ectopic Cushing syndrome complicated by invasive aspergillosis. A 35-year-old woman presented with typical Cushingoid features. Her basal plasma cortisol, ACTH, and 24-hour urine free cortisol levels were significantly high, and 24-hour urine metanephrine and catecholamine levels were slightly elevated. The endogeneous cortisol secretion was not suppressed by either low- or high-dose dexamethasone. Abdominal computed tomography (CT) revealed a heterogeneous enhancing mass measuring approximately 2.5 cm in size in the left adrenal gland. No definitive mass lesion was observed on sellar magnetic resonance imaging. On fluorine-18 fluorodeoxyglucose positron emission tomography/CT, a hypermetabolic nodule was observed in the left upper lung. Thus, we performed a percutaneous needle biopsy, which revealed inflammation, not malignancy. Thereafter, we performed a laparoscopic left adrenalectomy, and its pathologic finding was a pheochromocytoma with positive immunohistostaining for ACTH. After surgery, the biochemistry was normalized, but the clinical course was fatal despite intensive care because of the invasive aspergillosis that included the lungs, retina, and central nervous system.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.781-784
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• 2007

Foreign body aspiration (FBA) is a common accident in young children. Undiagnosed and retained foreign bodies may result in severe early and late complications such as asphyxia, pneumonia, atelectasis and bronchiectasis. Moreover, because it can mimic bronchiolitis, croup or asthma, an accurate history and a high index of suspicion are of paramount importance for early diagnosis. With our experience on bronchial FBA initially misdiagnosed as acute bronchiolitis, we emphasize that a minute radiological finding should not be neglected and a repeat chest radiograph may be helpful when the initial study shows normal findings. Multidetector computed tomography is a very useful noninvasive diagnostic modality for FBA.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.107-107
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• 1993

Tuberculous cervical lymphadenitis is one of the most common causes of neck mass in Korea. But the diagnostic confirmation is difficult and it's effective treatment modalities are still in controversy. Through a retrospective study of 32 cases of tuberculous cervical lymphadenitis treated with surgical treatment during recent 4 years, we have analyzed 5 subtypes of CT finding and surgical treatment modalities and received following results 1. The locations of lymphadenitis were posterior triangle(12 cases), submandibular area(9 cases), supraclavicular area(8 cases), submental area(2 cases), and parotid area(1 case). 2. Five subtypes of CT findings were observed : Homogeneous enhancement type(3 cases), peripheral rim enhancement type(6 cases), peripheral rim enhancement with perinodal fat obliteration type(12 cases), coalescent cold abscess type(8 cases), and mixed type(3 cases). 3. Surgical treatment modalities : Excision (13 cases), incision and drainage(9 cases), selective neck dissection(8 cases), and curettage(2 cases).

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1396-1402
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• 1997

Epithelioid Hemangioendothelioma(EH) is a rare vascular tumor, originating from endothelial cells. The principal locations are lung, soft tissue, bone and liver. This tumor is of borderline malignancy, relatively benign course. In the lung, the tumor is often multifocal, bilateral and frequently lead to the mistaken diagnosis of metastatic carcinoma. Although EH of the lung is relatively slow growing tumor, extensive pulmonary involvement, systemic metastasis, mainly to the liver have been documented. A 26-year-old man with EH involving the lung and liver was reported. Chest X-ray and chest CT showed multiple nodules in both lung fields and Abdominal CT multiple round low densities in liver. Transbronchial lung biopsy was performed. The patient diagnosed as EH by light microscopic finding and immunohistochemical study for Factor VIII-related antigen.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.23-27
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• 2022

Systemic lupus erythematosus(SLE) is a multisystemic disorder of autoimmune etiology. SLE can occur commonly in young women, and the early symptoms include fever, myalgia, arthralgia, weight loss, lymphadenopathy and these nonspecific symptoms develop into skin rash, splenomegaly, serositis and encephalopathy. Diagnosis of SLE requires clinical and serologic criteria, and treatment choices are hydroxyquinolone and NSAIDs for mild disease, corticosteroids and immunosuppressant for severe disease. In lupus patient, the prevalence of lymphadenopathy is 12~59%. Although lymphadenopathy is common finding in SLE, it is hard to distinguish in early phase of SLE. A 38-year-old woman visited our hospital for cervical lymphadenopathy with polyarthritis and malaise. Multiple cervical lymph nodes enlargement was found on Neck CT, and serologic laboratory test including ANA, antiphospholipid antibody, and anti-dsDNA was positive. For excluding lymphoma, PET-CT and excisional biopsy were performed. The patient finally diagnosed with SLE, and got regular follow-up without complication.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.33-42
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• 2014

Purpose: I-131 scan using High Energy (HE) collimator is generally used. While, Medium Energy (ME) collimator is not suggested to use in result of an excessive septal penetration effects, it is used to improve the sensitivities of count rate on lower dose of I-131. This research aims to evaluate I-131 SPECT/CT image quality using by HE and ME collimator and also find out the possibility of ME collimator clinical application. Materials and Methods: ME and HE collimator are substituted as Siemens symbia T16 SPECT/CT, using I-131 point source and NEMA NU-2 IQ phantom. Single Energy Window (SEW) and Triple Energy Windows (TEW) are applied for image acquisition and images with CTAC and Scatter correction application or not, applied different number of iteration and sub set are reconstructed by IR method, flash 3D. By analysis of acquired image, the comparison on sensitivities, contrast, noise and aspect ratio of two collimators are able to be evaluated. Results: ME Collimator is ahead of HE collimator in terms of sensitivity (ME collimator: 188.18 cps/MBq, HE collimator: 46.31 cps/MBq). For contrast, reconstruction image used by HE collimator with TEW, 16 subset 8 iteration applied CTAC is shown the highest contrast (TCQI=190.64). In same condition, ME collimator has lower contrast than HE collimator (TCQI=66.05). The lowest aspect ratio for ME collimator and HE collimator are 1.065 with SEW, CTAC (+) and 1.024 with TEW, CTAC (+) respectively. Conclusion: Selecting a proper collimator is important factor for image quality. This research finding tells that HE collimator, which is generally used for I-131 scan emitted high energy ${\gamma}$-ray is the most recommendable collimator for image quality. However, ME collimator is also applicable in condition of lower dose, lower sensitive if utilizing energy window, matrix size, IR parameter, CTAC and scatter correction appropriately.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.204-211
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• 2018

Background and Objectives : Unilateral maxillary sinus lesions are relatively common but may occur in variety of causes. Therefore, accurate diagnosis and appropriate treatment are needed. The aim of this study is to review patients with unilateral maxillary sinus lesion who underwent surgical treatment and to analyze causes and characteristics of unilateral maxillary sinus lesions with literature review. Materials and Methods : A retrospective chart analysis was completed on 318 patients with unilateral maxillary sinus lesions who underwent surgical treatment from January, 2008 through May, 2018. Clinical history and data such as age, sex, symptoms of initial, radiologic and dental finding, operation type were collected from medical record. Results : Patients mean age was 50.7 years with slight male gender dominance. Most common type was sinusitis (42.7%), followed by odontogenic sinusitis (22.3%) and fungal ball (19.5%). In particular, the most common cause of odontogenic sinusitis was post dental surgery such as implant. Middle meatal antrostomy (90.9%) was accounted for a great part of surgery underwent to patients. Patients complained of post nasal discharge (62.9%), nasal obstruction (40.9%) and odor smell(35.2%) most commonly. Periapical lucency (35.8%) was the most common in CT finding followed by implant perforation (17.3%) and oroantral fistula (12.3%) in odontogenic sinusitis. Conclusions : Unilateral maxillary sinus lesions are relatively common, but they are increasing recently with dental procedures such as implant surgery, and serious adverse effects due to malignant tumors or improper treatment may occur, so accurate diagnosis and treatment are needed.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.59-67
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• 1992

From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.735-740
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• 2007

Purpose: Blowout fracture is an outward fracture of the orbital wall. That usually occurs at inferior or medial wall of the orbit. The main pathophysiology is high intraocular pressure derived from impact of trauma. Among the four orbital wall, the medial wall is thinnest and most vulnerable to trauma. Many kinds of methods were introduced for correction of medial orbital wall fracture. Recently, transnasal endoscopic reconstruction methods were widely used. Endoscopic methods had many advantages. However, we experienced some cases of postoperative maxillary sinusitis. This study was planned to find out the effectiveness of middle meatal antrostomy after endoscopic reconstruction of medial orbital wall fracture. Methods: This study was retrospective analysis of 28 patients who underwent transnasal endoscopic repair of medial orbital wall fracture. The 18 male and 10 female patients were ranged from 17 to 57 years of age(mean, 30.9 years). Among 28 patients, randomly selected 17 patients underwent middle meatal antrostomy as additional procedure by the same surgeon. After at least 12 months of follow-up period, we examined the nasal symptom, endoscopic and CT findings. Results: One patient complained of nasal obstruction in middle meatal antrostomy group and four patients complained nasal symptoms in non middle meatal antrostomy group. On the endoscopic findings, three patients of non middle meatal antrostomy group had continuous nasal discharge. But middle meatal antrostomy group had no abnormal endoscopic findings. The abnormal CT finding(abnormal mucosal hypertrophy) were detected in four patient of non middle meatal antrostomy group. There were no abnormal CT findings in middle meatal antrostomy group. The data were statistically significant at comparative study. Conclusion: Authors think that the middle meatal antrostomy has some advantages as a additional procedure of endoscopic reconstruction of medial orbital wall fracture. Especially, it is good at preventing postoperative maxillary sinusitis. But, more larger group and strict application of disease entity are need for correct evaluation of middle meatal antrostomy effect.

• Journal of Biomedical Engineering Research
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• v.30 no.2
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• pp.135-141
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• 2009

Purpose: The aim of present study is to evaluate a possibility of clinical application for the effect of low intensity ultrasound stimulation (LIUS) in mechanical characteristics of bone on osteoporotic fractures prevention. Materials and Methods: Eight virgin ICR mice (14 weeks old, approximate weight 25g) were ovariectomized (OVX) to induce osteoporosis. The right hind limbs were then stimulated with LIDS (US Group), whereas left hind limbs were not stimulated (CON Group). Both hind limbs of all mice were scanned by in-vivo micro-CT to acquire two-dimensional (2D) images at 0 week before stimulation and 3 weeks and 6 weeks after stimulation. Three-dimensional (3D) finite element (FE) models generated by scanned 2D images were used to determine quantitatively the effect of LIUS on strength related to bone structure. Additionally, distributions of Hounsfield units and elastic moduli, which are related to the bone quality, for the bones in the US and CON groups were determined to analyze quantitatively a degree of improvement of bone qualities achieved by LIUS. Results: The result of FE analysis showed that the structural strength in US Group was significantly increased over time (p<0.05), while that in CON Group was statistically constant over time (p>0.05). High values of Hounsfield units obtained from voxels on micro-CT images and high values of elastic moduli converted from the Hounsfield units were dominantly appeared in US Group compared with those in CON Group. Conclusion: These finding indicated that LIUS would improve the mechanical characteristics of osteoporotic bone via the effects of bone structure (bone strength) and quality (Hounsfield unit and elastic modulus). Therefore, the LIUS may decrease effectively the risk of osteoporotic fracture in clinics.