• Journal of Trauma and Injury
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• 제29권3호
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• pp.61-67
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• 2016

Purpose: Abdominal and pelvic computed tomography (APCT) is frequently used as a diagnostic tool in trauma patients. However, trauma unrelated, incidental findings are frequently encountered. The aim of this study was to determine the prevalences of incidental findings on APCT scans in trauma patients. Methods: The archived records of 801 trauma patients treated from January 2013 to December 2015 were reviewed retrospectively. Six hundred and forty of these patients underwent contrast enhanced APCT in an emergency department and were included in this study, and 205 (32.1%) of these patients had incidental findings. These findings were divided into two categories: category I, meaning a radiological benign finding not requiring further evaluation or follow-up, and category II, requiring further evaluation and follow-up. Results: One hundred and sixty (24.8%) patients were allocated to category I and 45 (7.2%) to category II. The most frequent incidental findings were discovered in kidneys (34.6%), followed by liver (28.8%), and gallbladder (15.6%). The most frequent finding in category I was a benign cyst (60.1%), followed by a simple stone (15.6%), and hemangioma (11.9%). Adenomyomatosis of the gallbladder (17.8%) was the most common lesion in category II, followed by atypical mass (15.6%), complicated stone (15.6%) and cystic neoplasm (15.6%). Conclusion: The prevalence of an incidental finding on APCT scans was 32.1%. Although category II lesions were not common in trauma patients, these findings should be communicated to patients, and when necessary referred to a primary care physician. Systems are required for producing appropriate discharge summaries and informing patients about the implications of incidental findings.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.603-606
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• 2008

Purpose: Sclerosing lipogranuloma is an unusal benign condition of the genitalia following injections into the genitalia with exogenous paraffin or mineral oil. A few cases have been reported in which sclerosing lipogranuloma of the lid was caused by paraffin-containing ointment plugs after the endonasal sinus surgery. A 52-year-old man presented with a painless hard mass of the right lower lid after the MRI scan at the Ophthalmology department. Nine months before, he had undergone right maxilla sinus surgery through the oral incision. And he was also gotten nasal packing with Vaseline gauze after the surgery. Methods: The round shaped two masses in the Right lower lid were approximately $1.0{\times}1.0cm$ in size. There were no size or color change, bleeding and ulceration. The MRI scan showed a suspicious part of an abscess of benign tumor. Also, He was planned cyst remove through the endonasal surgery due to the mucoid cyst in the right maxillary sinus in the ENT dept. Under the general anesthesia, the patient underwent surgical excision through a subcilliary incision with endonasal sinus surgery. The masses were in deep subcutaneous orbital fat with no connection with right maxillary sinus. Results: The masses were excised $2.1{\times}0.7cm$ in size including surrounding necrotic fatty tissue. Histopathological diagnosis was 'sclerosing lipogranuloma' due to paraffin or similar substance with fat necrosis and cystic change. This tissue was positive in PAS, S-100, CD68 reaction. Conclusion: It is extremely rare to find a granulomatous orbital lesion arising to a endonasal surgery. In conclusion, if sclerosing lipogranuloma is suspected excisional biopsy should be undertaken. Surgery should be reserved for recurrent or refractory cases when steroids have failed as first-line treatment at the 6-month follow-up examination, There was no complication or recurrence.

• Journal of Chest Surgery
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• 제39권8호
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• pp.655-658
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• 2006

중피낭종은 드문 종격동질환으로서 주로 우측 심장횡격막 각에서 잘 발생한다. 그러나 드물게는 비전형적인 위치에서 발생하며 특히 후 종격동에서의 발생은 매우 드물다. 교통사고로 내원한 30세 여자환자에서 우연히 심낭과 척추체 사이의 후 종격동에 위치하는 큰 낭종이 발견되었다. 낭종은 장축이 18 cm에 이르는 매우 큰 크기였으며 주로 좌측 흉강 쪽으로 커져 있었으나 환자는 증상을 호소하지 않았다. 반대측 흉강으로의 박리에 어려움이 있어서 작은 수술창을 동반한 비디오흉강경 수술로 완전 절제를 시행하였다. 장기 관찰에서 재발 없이 경과는 양호하였다.

• Journal of Chest Surgery
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• 제39권8호
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• pp.652-654
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• 2006

림프관종은 대부분 목이나 액와부에 발생되며, 드물게 종격동, 후복강, 서혜부와 골반강 내에서 발생이 보고된다. 흉벽에 국한된 림프관종은 드물게 발견되는 양성종양이며, 종괴의 크기가 큰 경우에는 외과적인 절제술이 치료방법으로 추천된다. 3세 여아의 흉벽에 발생된 큰 종괴를 절제하였다. 조직학적인 검사에서 림프관종으로 진단되었다.

• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.73-78
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• 2010

Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as $40^{\circ}C$. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

• 대한한방부인과학회지
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• 제27권2호
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• pp.71-82
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• 2014

Objectives: The purpose of this systematic review was to overview and evaluate the efficacy of acupuncture treatment for women with polycystic ovary syndrome (PCOS). Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in MEDLINE, EMBASE, and CENTRAL, up to Dec 2013, and by additional hand searches. Data were extracted regarding anovulation, hyperandrogenism, obesity indices. Meta-analyses were separatedly conducted for the symptoms of PCOS. The risk of bias was assessed. Results: Three studies which were included for analysis, but they showed severly heterogeneity therefore meta-analysis could not be performed. Outcomes for evaluating the efficacy of acupuncture treatment for PCOS were anovulation index (menstrual frequency), hyperandrogenism index (free testosterone) and obesity index (body-mass index). For menstrual frequency, acupuncture treatment consistently suggested an interventional benefit. Although other outcomes did not suggest any enough relevant evidence to interventional benefit for acupuncture treatment. Conclusions: Acupuncture treatment appeared to improve menstrual frequency in PCOS patients. Since a limited number of RCTs were available in the current literature and those studies were also clinically heterogeneous, further research is needed to gather evidence to support acupuncture therapy in PCOS.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권3호
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• pp.140-146
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• 2014

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion.

• Tuberculosis and Respiratory Diseases
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• 제53권4호
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• pp.439-444
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• 2002

종격동 결핵은 발생빈도는 낮으나 최근에는 그 발생빈도가 높아지고 있다. 특히 결핵은 유방, intra sella, intramedullary, 종격동등 어떤 위치에서도 종괴나 낭종형태로 나타날 수 있으므로, 결핵이 호발하는 지역이나 고령자 혹은 HIV 감염환자에서는 종격동 낭종의 감별진단에 있어서 반드시 종격동 결핵도 염두에 두어야 할 것이다. 저자들은 국내에는 아직까지 보고된 바 없는, 종격동 결핵이 거대 낭성 변화를 보이며 이와 함계 심낭과 교통을 보인 1례를 겸험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제54권5호
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• pp.219-223
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• 2011

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.251-256
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• 2011

Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.