• Annals of Clinical Neurophysiology
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• 제2권2호
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• pp.89-94
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• 2000

Purpose : Carpal tunnel syndrome (CTS) is a disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and nerve conduction study (NCS). However, sometimes, NCS does not provide a reliable evidence to reach the diagnosis. Thus, authors performed this study to determine whether NCS was correlated with specific parameters measured on magnetic resonance imaging (MRI) which might become a potential complemental diagnostic tool. Methods : We performed MRI in 34 wrists of 18 patients with clinical manifestations of CTS and pathologic nerve conduction values and analyzed them at levels of the distal radioulnar joint, pisiform and hook of hamate, Results : Increase in the cross-sectional area of the median nerve at the pisiform level and flattening, increased signal intensity, and contrast enhancement of the median nerve at levels of the pisiform and hook of hamate were statistically significant. Change in cross sectional areas between the distal radioulnar joint and hamate and the signal intensities at levels of pisiform and hamate were well correlated with the median nerve conduction velocity. Conclusions : Characteristic MRI findings in CTS reported previously were well demonstrated and some of MRI parameters are well correlated with nerve conduction study. MRI, despite cost, may help in evaluating CTS.

• Journal of Korean Neurosurgical Society
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• 제46권5호
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• pp.468-471
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• 2009

Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권1호
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• pp.88-92
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• 2009

산발성 C형 간염 환자의 약 40%에서 감염경로가 확실치 않다. 이러한 환자들에서 HCV 감염이 수혈, 투석, 수술, 수직감염 및 성적 접촉 등의 잘 알려진 감염 경로 이외에도 침, 귓불 천공 등의 경피적 경로를 통해 전파 될 수 있음을 간과하지 말아야 할 것이다. 저자들은 간염의 가족력이나 수술과 수혈 과거력이 없는 10세 여아에서 피어싱과 침술로 인해 발생한 만성 C형 간염을 진단하고, pegylated interferon과 경구 ribavirin으로 치료한 증례를 경험하였기에 문헌고찰과 함께 보고 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.395-400
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• 1999

Elongation of the styloid process (styloid syndrome, Eagle's Syndrome) is named after Eagle who insisted the styloid process as a cause of pain but distinguishable from the glossopharyngeal neuralgia. Eagle's syndrome is characterized by a dull nagging pharyngeal pain, a palpable hardness in the tonsillar fossa, radiopaque elongation and enlargement of the syloid process. This is to report two cases of Eagle's Syndrome. The clinical and radiological features, development and pathogenesis of the Eagle's Syndrome and pathologic findings of the calcified styloid ligaments were described with review of literatures. The external cervical approach to resect the enlarged calcified processes can be an option due to better visualization and accessbility, less infection at risk than intra-oral approach. The findings and results were as follows ; 1. The calcified styloid ligaments accompanied with throat pain were reseded in size of $5.5{\times}48mm(#1,\;Rt)$, $3.6{\times}5mm(#1,\;Lt)$, $5.2{\times}51mm(#2,\;Rt)$ and $3.1{\times}38mm(#2,\;Lt)$. 2. The submandibular approach to resect the calcified styloid process is of help to get better visibility and accessiblilty avoiding the injury to the deep cervial vital structures. 3. The resected styloid processes were examined histopathologically as the matured cortical bones with marrow structures or cartilagenous cells without any findings of neoplasmic changes. 4. The remained process did not show any noticeable regrowth in 3 years after surgical amputation.

• Journal of Chest Surgery
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• 제18권2호
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• pp.241-249
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• 1985

Twenty-one patients with Double Chambered Right Ventricle [DCRV] associated with Ventricular Septal Defect [VSD] were treated by open heart surgery under cardiopulmonary bypass with moderate hypothermia in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital between June 1982 and October 1984. The following results were obtained 1. The symptoms and physical signs, specific for DCRV, could not be identified. 2. The radiologic findings on simple chest X-ray, specific for DCRV, could not be identified. 3. Electrocardiographic findings, specific for DCRV, could not be identified. 4. Cardiac catheterization was found to be the most important diagnostic method, revealing pressure gradient between proximal chamber and distal chamber in the right ventricle. The average pressure gradient between two chambers showed 48.1523.29 mmHg[varying from 15mmHg to 94mmHg]. 5. Cardiac angiography was found to visualize the anomalous muscle bundles in right ventricle [in 17 cases, 81%] but the evidence of pressure gradient between two chambers within right ventricle is considered necessary for the diagnosis of DCRV. 6. Via surgical observation, anatomical and pathologic findings of the anomalous muscle bundles, associated DCRV were identified. 7. As the direct pressure was measured on the operating table before and after surgery, the average pressure gradient across the muscle bundles showed 40.5219.75mmHg [varying from 16 to 89mmHg] preoperatively and 8.909.72mmHg [varying from 0 to 32mmHg] postoperatively, indicating significant surgical correction of the obstruction present. 8. The presence of anomalous muscle bundles, dividing the right ventricle into two separated chambers, and the presence of the pressure gradient over 15mmHg are considered necessary for the diagnosis of DCRV.

• Clinical and Experimental Pediatrics
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• 제50권3호
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• pp.255-261
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• 2007

목 적 : 산소치료를 받았던 극소저출생 체중아에서 교정 주령 38에서 42주에 폐 HRCT를 시행하여 폐 실질 내의 변화를 관찰하고 기관지폐이형성증의 임상적 중증도와 비교 하고자 하였다. 방 법 : 산소 치료 받은 재태연령 32주미만, 출생체중 1,500 g미만의 극소저출생 체중아 44명을 대상으로 출생 후 교정주령 38-42주에 폐 HRCT를 시행하였다. 흔히 관찰되는 폐 HRCT 소견들을 기술하고 그들의 빈도를 구했다. 폐 HRCT 소견에서 폐 손상 정도를 정량적으로 표시한 공기폐색 점수, 무기폐 점수, 총 CT 점수와 기관지-폐동맥 직경 비를 기관지 폐이형성증 환아군과 기관지폐이형성증이 없는 환아군 사이에 비교하고, Jobe-Bancalari 진단 기준에 의한 기관지폐이형성증의 임상적 중증도와 비교하였다. 결 과 : 1) 폐 HRCT 소견은 공기 폐색(56.8%), 무기폐(70.5 %), 선상 음영 증가(77.3%), 기관지-폐혈관 다발의 변형(65.9%) 등이 흔히 관찰되었다. 이들 소견들은 기관지폐이형성증이 있는 환아 군에서 기관지폐이형성증이 없는 환아 군에 비해 통계적으로 의미 있게 혼재되어 자주 관찰되었으나(P<0.05), 기관지폐이형성증이 없는 환아 군 일부에서도 관찰되었다. 공기폐색 점수, 무기폐 점수, 총 CT 점수는 기관지폐이형성증이 있는 환아 군에서 기관지폐이형성증이 없는 환아 군에 비해 통계적으로 의미 있게 높았고(P<0.05), 기관지-폐동맥 직경 비는 통계적으로 의미 있게 낮았다(P<0.05). 총 CT 점수(r=0.799, P<0.0001)와 기관지-폐동맥 직경 비(r=0.576, P<0.0001)는 임상적 기관지폐이형성증의 중증도와 통계적으로 의미 있는 직선의 상관관계를 보였다. 결 론 : 산소치료를 받았던 극소저출생 체중아를 대상으로 신생아기에 촬영한 폐 HRCT 소견은 폐 실질 내의 변화를 잘 반영하고, 기관지폐이형성증의 임상적 중증도와 의미 있는 상관관계를 보였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권1호
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• pp.91-95
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• 2005

HCV의 가족 내 집단 감염은 드물게 발생하며 배우자에서 감염의 위험이 가장 높고 수직 감염의 빈도는 매우 낮게 보고되고 있다. 저자들은 환자와 환자의 어머니, 외할머니, 이모, 이종 사촌 언니에서 HCV 감염이 확인되어 가족 구성원의 50%가 HCV에 감염된 극히 드문 가족 내 집단 감염을 경험하였기에 문헌 고찰과 함께 보고한다.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.519-531
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• 1993

연구배경 : 폐 림프관평활근종증은 주로 가임연령의 여성에 발생하는 매우 드문 질환으로 치료에도 불구하고 점차 진행하여 호흡부전에 이르는 무서운 질형이다. 그러나 이 질환의 임상경과는 아직 정확하게 알려져 있지 않고 20여년전부터 항에스트로젠제재가 치료에 사용되고 있으나 그 효과에 대해서도 논란이 있는 실정이다. 저자들이 경험한 4례의 폐 림프관평활근종증 증례를 보고하고 극내 폐 림프관평활근종증의 임상적 고찰을 하여 폐 림프관평활근종증에 대한 이해를 돕고자 본 연구를 시행하였다. 방법 : 국내 림프관평활근종증 12례중 199년 2월 일본 교또에서 열린 림프관평활근조증 심포지움에서 국내 증례의 임상적, 방사선학적, 병리학적 소견에 대해 토의한 결과 최종진단에 이의가 제기된 2례를 제외한 10예의 임상소견, 방사선소견과 병리소견을 검토하였다. 결과 : 모든 환자는 여성이었으며 평균연령은 $33{\pm}7$세 였다. 가장 흔한 증상은 노작성 호흡곤란이었고 대부분에서 재발성 기흉의 병력이 관찰되었다. 폐기능검사상 전례에서 폐확산능의 감소가 있었다. 전예에서 고해상도 전산화단층촬영상 특정적인 낭이 전폐야에서 관찰되었다. 대부분 호르몬요법으로 증상의 호전을 보이지 않았다. 결론 : 재발성 기흉의 병력과 노작성 호흡곤란을 호소하는 가임기 여성에서는 폐 림프관평활근종증의 가능성을 반드시 염두에 두어야하고 의심되면 우선 고해상도 전산화단층촬영으로 특징적인 낭 유무를 확인하고 필요하면 개흉폐생검으로 확진해야 할 것으로 판단된다.

• Childhood Kidney Diseases
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• 제7권1호
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• pp.67-72
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• 2003

알포트 증후군은 유전성 신염 중 발생빈도가 높은 대표적 질환이며 급성 연쇄상 구균 감염 후 사구체 신염은 연쇄상 구균에 감염되고 1-2주 후에 발병하며 증상이 없는 경한 현미경적 혈뇨에서부터 급성 신부전에 이르기까지 다양한 임상양상을 특징으로 하는 질환이다. 급성 연쇄상 구균 감염 후 사구체 신염이 알포트 증후군에 미칠 수 있는 영향에 대해서는 알려진 바 없으나 저자들은 육안적 혈뇨를 주소로 내원한 형제에서 신생검을 시행하여 급성 연쇄상구균 감염 후 사구체 신염과 동반된 알포트 증후군으로 진단된 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제22권5호
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• pp.788-793
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• 1989

We have observed 501 cases of spontaneous pneumothorax from January 1981 to June 1989 at the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 57 patients have undergone thoracotomy to treat the pneumothorax after closed thoracostomy. These 57 patients were based on this retrospective clinical analysis, and the results were as follows: The ratio of male to female was 4.2:1 in male predominance and the old aged patients, over 50 years old, occupied 47.3% of all patients. Primary spontaneous pneumothorax was 19 cases and secondary spontaneous pneumothorax was 38 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis emphysema and chronic obstructive pulmonary disease in 35 cases. The indications of thoracotomy were persistent air leakage in 23 cases recurrent pneumothorax in 21 cases, inadequate expansion in 13 cases. Rupture of bullae or blebs were most frequent operative and pathologic findings in persistent air leakage group and recurrent pneumothorax group. In inadequate expansion group, predominant finding was destructive lung lesion. Bullectomy and/or bullae ligation was most effective procedures in 36 cases [63%] for operative management of spontaneous pneumothorax. Duration of preoperative and postoperative chest tube indwelling day was 13.35 days and 8.05 days in persistent pneumothorax group, 8.92 days and 7.77 days in recurrent pneumothorax group, 13.23 days and 10.21 days in inadequate expansion group.