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Capillary Hemangioma in the Posterior Mediastinum -A case report- (후종격동에 발생한 모세혈관상 혈관종 -1예 보고-)

  • Yang, Joo-Min;Chung, Won-Sang;Kang, Jung-Ho;Kim, Young-Hak;Kim, Hyuck;Jang, Ki-Seok;Park, Moon-Hyang
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.460-463
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    • 2004
  • Hemangiomas of mediastinum are rare lesions comprising less than 0.5% of all mediastinal masses. Posterior mediastinal hemangiomas are less common than anterior mediastinal. A 21 year old female was refered to our hospital because of abnormal mediastinal shadow in simple chest X-ray. Chest CT scan and T-spine MRI revealed a posterior mediastinal dumbbell-shaped mass with extradural extension. Surgical excision was performed and pathologic diagnosis was confirmed as 3${\times}$4${\times}$2 cm sized capillary hemangioma.

Relationship between Chronic Rhinosinusitis and Blood Pressure (비부비동염과 혈압의 상관관계)

  • Seo, Youn Tae;Kim, Deok Su;Kil, Bu Kwan;Shin, SeungHeon;Ye, Mi Kyung
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.182-189
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    • 2018
  • Background and Objectives : There were few literatures about the relationship between upper airway disorders and cardiovascular risk factors such as hypertension, although an association between impaired lower respiratory function and cardiovascular alterations was often reported. Our purpose was to assess the relationships between chronic sinusitis and hypertension. Materials and Methods : Three hundred subjects with bilateral chronic sinusitis who underwent functional endoscopic sinus surgery between 2015and 2017 were evaluated. Six hundred forty subjects without any nasal diseases were enrolled as a control group. Blood pressure and body mass index (BMI) were measured using a standardized method, and subjects were asked about current use of any antihypertensive medication, history of diabetes, smoking and alcohol drinking habits.Sinusitis group was assessed by nasal endoscopic examination, paranasal sinus CT scan and allergy test. Results : Average systolic and diastolic blood pressures were statistically significantly higher in subjects with sinusitis than control group. Chronic rhinosinusitis was associated with a 1.415-fold (95% confidence interval 1.053-1.930) increased hazard of hypertension after multivariate adjustment. Conclusions : These results suggest that sinusitis is associated with high blood pressure. Therefore patients with sinusitis may need special attention for blood pressure control. Further studies need to be performed to elucidate the pathogenesis behind such associations.

Effect of Manual Therapy on a Patient With Atlantoaxial Rotatory Subluxation (환축추 회전 아탈구 환자에 대한 도수치료 효과)

  • Jeon, Jae-guk;Yang, Seong-hwa;Shin, Eui-ju
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.25 no.1
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    • pp.71-76
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    • 2019
  • Background: An 8-year-old girl had severe neck pain and stiffness after trauma. CT scan showed atlantoaxial rotatory subluxation (AARS). She had conservative treatment because she did not have neurological symptoms and spinal basilar artery dysfunction. Conservative therapy was halter traction twice for 4 weeks. However, pain and stiffness persisted. She had been recommended to have surgery from her physician, but she received manual therapy for non-surgical procedures. Methods: The joint mobilization, muscle energy technique, motor control exercise, and deep neck flexor (DNF) endurance exercise were applied as manual therapy and 10 session for 2weeks. Results: Clinical outcomes were measured at initial baseline, after 2 weeks, and after 6weeks. Active range of motion was completely restored after 6weeks and numeric pain rating scale was completely reduced after 2 weeks. The strength of neck flexor muscle recovered to normal after 2 weeks, and the DNF endurance was improved to 25 seconds after 2 weeks and to 42 seconds after 6weeks. Motor control capacity recovered to 30 ㎜Hg after 2 weeks. Conclusions: This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain following AARS. Clinical rationale and patient preference aided the decision to incorporate manual therapy as a treatment for this patient. Manual therapy has shown a successful recovery in AARS patients, more research is needed to validate the inference of this case report.

Monte Carlo Simulation of Irradiation Treatment of Peaches (Prunus persica L. Batsch) (몬테카를로 시뮬레이션을 이용한 복숭아의 방사선 조사)

  • Kim, Jongsoon;Kim, Dong-Hyun;Park, Jong-Min;Choi, Won-Sik;Kwon, Soon Hong
    • Journal of the Korean Society of Industry Convergence
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    • v.21 no.6
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    • pp.337-344
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    • 2018
  • Food irradiation is important not only in ensuring safety but also improving antioxidant activity of peaches. Our objective was to establish the best irradiation treatment for peaches by calculating dose distribution using Monte Carlo simulation. 3-D geometry and component densities of peaches, extracted from CT scan, were entered into MCNP to obtain simulated dose distribution. Radiation energies for electron beam were 1.35 MeV (low energy) and 10 MeV (high energy). Co (1.25 MeV) and the Husman irradiator, containing three sealed Cs source rods in an annular array, were used for gamma irradiation. At 1.35 MeV electron beam simulation, electrons penetrated well beyond the peach skin, enough for surface treatment for microorganisms and allergens. At 10 MeV electron beam simulation, for top-beam only treatment, doses at the core were the highest and for double beam treatment, the electron energy was absorbed by the entire sample. At Co source, the radiation doses were presented on the whole area. At Cs source, the dose uniformity ratios were 2.78 for one source and 1.48 for three ones at 120 degrees interval. Proper control of irradiation treatment is critical to establish confidence in the irradiation process.

Three-dimensional finite element analysis of buccally cantilevered implant-supported prostheses in a severely resorbed mandible

  • Alom, Ghaith;Kwon, Ho-Beom;Lim, Young-Jun;Kim, Myung-Joo
    • The Journal of Advanced Prosthodontics
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    • v.13 no.1
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    • pp.12-23
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    • 2021
  • Purpose. The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio. Materials and Methods. Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creating an excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges. Results. The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain. CONCLUSION. Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.

Cryptococcosis with Mediastinal Lymph Node and Lung Involvement in an Immunocompetent Adolescent: A Case Report (정상 면역체계를 가진 청소년에서 발생한 종격동 림프절과 폐 크립토코쿠스증 1예)

  • Lee, Jiyeon;Cho, Chang-Min;Cho, Hyun-Hae;Park, Heae Surng;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.124-131
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    • 2021
  • Cryptococcus neoformans is a fungus that primarily causes opportunistic infections in immunocompromised hosts. It can also cause various infections in immunocompetent patients. Pulmonary cryptococcosis involving the lymph node is relatively rare in immunocompetent patients. In this report, a previously healthy 17-year-old girl presented with high-grade fever and persistent cough. Chest X-ray and computed tomography (CT) scan revealed an anterior mediastinal conglomerate mass that expanded to the right supraclavicular area. Ultrasound-guided gun biopsy revealed histological evidence of cryptococcosis. Immunological screening tests did not identify immunodeficiency. She recovered completely with a combination therapy of amphotericin B and flucytosine for 2 weeks, followed by fluconazole for 8 months. The characteristics of cryptococcosis involving the mediastinal lymph node and the lung should be understood, and the possibility of cryptococcosis even in immunocompetent hosts should be considered.

A Case of Olfactory Disorder Treated with Mahwanggachul-tang (마황가출탕(麻黃加朮湯)으로 호전된 후각장애 1례)

  • Ji-One Im;Ji-Young Choi;Young-Eun Lee;Seon-Young Jee;Min Hwangbo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.37 no.3
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    • pp.110-116
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    • 2024
  • Objectives : The purpose of this study is to report the case of olfactory disorder treated with Mahwanggachul-tang. Methods : A 58-year-old female patient began to smell the odor of swimming pool water during daily life at the October 2023. Symptoms get worse over time, all smells in daily life felt like bad odors from around January 2024. A brain CT scan was performed to identify other causative diseases, but no abnormal findings were diagnosed. The patient visited the clinic on April 1, 2024, and the patient received Korean medical treatment, including herbal medicine(Mahwanggachul-tang) and acupuncture. The severity of olfactory disorder was evaluated by NRS before and after administration of each treatment term. Results : The patient's symptoms improved and NRS changed 10 to 0. Conclusions : This case study showed an effectiveness of Mahwanggachul-tang treated on Olfactory disorder.

Natural course of chronic subdural hematoma following surgical clipping of unruptured intracranial aneurysm by pterional approach

  • Su-Bin Kweon;Suchel Kim;Min-Yong Kwon;Chang-Hyun Kim;Sae Min Kwon;Yong San Ko;Chang-Young Lee
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.390-402
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    • 2023
  • Objective: Chronic subdural hematoma (CSDH) is a neurological complication following clipping surgery. However, the natural course and ideal approach for the treatment of clipping-related-CSDH (CR-CSDH) have not been clearly established. We aimed to investigate the course of CR-CSDH using chronological radiological findings. Methods: We performed a retrospective analysis of 28 (3.8%) patients who developed CSDH among 736 patients who underwent surgical clipping using pterional approach for unruptured aneurysms at our institution between December 2010 and December 2018. Patients underwent follow-up CT scan 6-8 weeks after clipping surgery and decision to pursue surgical intervention rests upon the patient's symptom based on the Markwalder's grading scale (MGS) and numeric rating scale (NRS). Results: Of the 28 patients, 3 patients (10.7%) underwent surgery, while 25 (89.2%) showed spontaneous resolution of CR-CSDH. Eighteen patients (64.2%) had mild headache with MGS of 0-1. The mean maximum hematoma volume was 41.9±30.9 ml (5.8-135 ml), and 26 patients (92.8%) had homogeneous hematoma. The mean time to hematoma resolution was 126.7±52.9 days (46-228 days). Comparing group of CR-CSDH volume ≥43 ml or a midline shift ≥5 mm, the difference in presence of linear low-density area (p=0.002) and age (p=0.026) between the conservative and operative groups were found to be statistically significant. Conclusions: Most CR-CSDH cases spontaneously resolved within 4 months. Therefore, we suggest that close observation should be performed if patient's symptoms are mild and special radiologic findings are present, despite its relatively large volume and midline shifting.

Distribution of Mediastinal Lymph Node Enlargement in Non-Small-Cell Lung Cancer (비소세포폐암에서의 종격동 림프절 종대의 분포)

  • Bae, Mun Seop;Lee, Shin Yup;Lee, Jae Hee;Park, Jae Hyung;Kim, Eun Jin;Jeon, Kyung Nyeo;Cha, Seung Ick;Kim, Chang Ho;Jung, Tae Hoon;Park, Jae Yong
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.646-656
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    • 2004
  • Background : The aim of this study was to elucidate the mediastinal lymphatic drainage of nonsmall- cell lung cancer (NSCLC). Methods : We retrospectively analyzed the frequency of enlarged mediastinal lymph node (LN) in 256 NSCLC patients with N2 or N3 diseases on CT scan, especially with respect to the location of primary tumor. Results : In 57 patients with right upper lobe (RUL) tumors, right lower paratracheal LN (89.5%) was the most commonly enlarged, followed by subcarinal LN (54.4%). In 61 patients with left upper lobe (LUL) tumors, left lower paratracheal (70.5%) and subaortic LNs (52.5%) were commonly enlarged. Subcarinal LN enlargement without ipsilateral superior mediastinal LN enlargement was rarely found in both upper lobe tumors; RUL 8.8%, LUL 6.6%. In patients with right or left lower lobe (RLL or LLL) tumors, the most commonly enlarged LN was subcarinal; 88.2%, 65.7%, respectively. In RLL tumors with both subcarinal and superior mediastinal LN enlargements, the frequency of ipsilateral superior mediastinal LN involvement was similar to that of bilateral superior mediastinal involvement. In LLL tumors with both subcarinal and superior mediastinal LN enlargements, bilateral superior mediastinal involvement was more frequent than ipsilateral superior mediastinal involvement. Conclusion : The results of this study suggest that both upper lobe tumors are mainly drained directly to ipsilateral superior mediastinal LNs, and that both lower lobe lesions are drained to superior mediastinal LN via subcarinal LNs.

Stereotactic Radiosurgery for Intracranial Tumors; Early Experience with Linear Accelerator (두개강내 종양에 대한 방사선 뇌수술의 역할)

  • Suh Chang Ok;Chung Sang Sup;Chu Sung Sil;Kim Young Soo;Yoon Do Heum;Kim Sun Ho;Loh John Juhn Kyu;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.7-14
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    • 1992
  • Between August 1988 and December 1991, 24 patients with intracranial tumors were treated with stereotactic radiosurgery(RS) using a 10 MV linear accelerator at Severance Hospital, Yonsei University College of Medicine. There were 5 meningiomas, 3 craniopharyngiomas, 9 glial tumors, 2 solitary metastases, 2 acoustic neurinomas, 2 pineal tumors, and 1 non-Hodgkin's lymphoma. Ten patients were treated as primary treatment after diagnosis with stereotactic biopsy or neuroimaging study. Nine patients underwent RS for post-op. residual tumors and three patients as a salvage treatment for recurrence after external irradiation. Two patients received RS as a boost followed by fractionated conventional radiotherapy. Among sixteen patients who were followed more than 6 months with neuroimage, seven patients (2 meningiomas, 4 benign glial tumors, one non-Hodgkin's lymphoma) showed complete response on neuroimage after RS and nine patients showed decreased tumor size. There was no acute treatment related side reaction. Late complications include three patients with symptomatic peritumoral brain edema and one craniopharyngioma with optic chiasmal injury. Through this early experience, we conclude that stereotactically directed single high doses of irradiation to the small intracranial tumors is effective for tumor control. However, in order to define the role of radiosurgery in the management of intracraniai tumors, we should get the long-term results available to demonstrate the benefits versus potential complications of this therapeutic modality.

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