• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.10-17
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• 2018

Purpose: To evaluate interpretation errors involving spine MRIs by residents in their second to fourth year of training, classified as minor, intermediate and major discrepancies, as well as the types of commonly discordant lesions with or without clinical significance. Materials and Methods: A staff radiologist evaluated both preliminary and final reports of 582 spine MRIs performed in the emergency room from March 2011 to February 2013, involving (1) the incidence of report discrepancy, classified as minor if there was sufficient description of the main MR findings without ancillary or incidental lesions not influencing the main diagnosis, treatment, or patients' clinical course; intermediate if the correct diagnosis was made with insufficient or inadequate explanation, potentially influencing treatment or clinical course; and major if the discrepancy affected the main diagnosis; and (2) the common causes of discrepancy. We analyzed the differences in the incidence of discrepancy with respect to the training years of residents, age and sex of patients. Results: Interpretation discrepancy occurred in 229 of the 582 cases (229/582, 39.3%), including 146 minor (146/582, 25.1%), 40 intermediate (40/582, 6.9%), and 43 major cases (43/582, 7.4%). The common causes of major discrepancy were: over-diagnosis of fracture (n = 10), missed cord lesion (n = 9), missed signal abnormalities associated with diffuse marrow (n = 5), and failure to provide differential diagnosis of focal abnormal marrow signal intensity (n = 5). No significant difference was found in the incidence of minor, intermediate, and major discrepancies according to the levels of residency, patients' age or sex. Conclusion: A 7.4% rate of major discrepancies was found in preliminary reporting of emergency MRIs of spine interpreted by radiology residents, probably related to a relative lack of clinical experience, indicating the need for additional training, especially involving spine trauma, spinal cord and bone marrow lesions.

• Journal of Chest Surgery
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• 제47권5호
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• pp.458-464
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• 2014

Background: The effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery. Methods: We retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup. Results: Of the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion. Conclusion: Our study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.

• Journal of Chest Surgery
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• 제56권5호
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• pp.328-335
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• 2023

Background: Thromboangiitis obliterans (TAO) poses a higher risk of amputation than atherosclerosis obliterans. It is characterized by onset at a relatively young age. There are currently no clear treatment guidelines for TAO other than smoking cessation. In this study, we aimed to identify factors that could influence a favorable prognosis of TAO. Methods: From January 2009 to December 2019, we retrospectively reviewed the initial symptoms, characteristics, treatments, and disease course of 37 patients (45 limbs) with TAO. Logistic regression analysis was performed to investigate factors affecting the course of symptoms that persisted or worsened despite treatment. Results: Patients' mean age was 37.2±11.4 years, and all patients were men. The mortality rate was 0% during the follow-up period (76.9±51.1 months). All patients were smokers at the time of diagnosis, and 19 patients (51.4%) successfully quit smoking during treatment. When comparing the Rutherford categories before and after treatment, 23 limbs (51.1%) showed improvement, the category was maintained in 11 limbs (24.4%), and 11 limbs (24.4%) worsened. Symptom persistence or exacerbation despite treatment was associated with a higher initial Rutherford category (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.04-2.42; p=0.03) and a higher score of the involved below-knee artery at the time of diagnosis (OR, 2.26; 95% CI, 1.10-4.67; p=0.03). Conclusion: The degree of disease progression at the time of diagnosis significantly affected patients' prognosis. Therefore, early diagnosis and intervention are important to improve the course of TAO.

• 제3의학
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• 제1권1호
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• pp.115-122
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• 1996

A clinical observation was done on 98 cases performed neurometer diagnosis before Guibitang administration first, and rechecked neurometer diagnosis after Guibitang administration for 10 days. Electric current post administration was compared with ant administration. The following result were obtained. 1. A peak incidence was observed in 30-39 age group. 37 cases(37.8%) were in 30-39 age group. The ratio of male to female was 1:31.7. 2. Chief complaints were fatigue, menoxenia, indigestion, anorexia, constipation, headache, palpitation, insomnia etc. 3. The common result of neurometer point checking was that patients who had the pecularity of low electric current were much than patients who had the pecularity of high electric current. 4. By neurometer diagnosis a peak incidence was observed in gallbladder. Increment was also highest in gallbladder. Gallbladder has a function of psychomotility in oriental physiology. ?5. After Guibitang administration the increment of neurometer electric current was comparatively high in kidney, stomach, small intestine meridian. According to the above menthioned results I consider that Guibitang has the curative effects along the meridian selectively. and increases in function or preserves health within physycal limit.

• Journal of Chest Surgery
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• 제11권4호
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• pp.529-534
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• 1978

Recent advances in the surgical treatment of congenital disorders of the heart have necessitated an accurate preoperative diagnosis. Right heart catheterization has become widely accepted as a research tool and diagnostic test to detect the heart diseases, especially in the congenital heart anomalies. Right heart catheterizations were carried out in 50 cases of congenital heart diseases at Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, during the period of June, 1975 through September 1978. In age distribution, 27cases were below 10 years of age, 18 cases between 11 and 20, and 5 cases above 20 male to female ratio was 2.8:1. The distribution of congenital heart diseases was VSD [42%], TOF [36%], PDA [10%], ASD [8%], and PS[4%]. Of these, 44 cases [88%], were compatible with the clinical impressions that were made preliminarily before cardiac catheterization, and all the cases except 1 case of VSD was correlated well with the postoperative diagnosis. The right heart catheterization is considered to be reliable and accurate toll in the preoperative diagnosis of congenital heart diseases. These procedures caused complications such as left side hemiplegia [lcase], occlusion of the femoral artery [lcase], and transient ventricular tachycardia [1case], and so the complication rate of right heart catheterization was 6% [3 cases]. None of patients who have undergone right heart catheterization was died.

• Journal of Chest Surgery
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• 제11권4호
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• pp.523-528
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• 1978

Recent advances in the surgical treatment of congenital disorders of the heart have necessitated an accurate preoperative diagnosis. Right heart catheterization has become widely accepted as a research tool and diagnostic test to detect the heart diseases, especially in the congenital heart anomalies. Right heart catheterizations were carried out in 50 cases of congenital heart diseases at Department of Thoracic and Cardiovascular Surgery, , Kyungpook National University Hospital, during the period of June, 1975 through September 1978. In age distribution, 27cases were below 10 years of age, 18 cases between 11 and 20, and 5 cases above 20 male to female ratio was 2.8:1. The distribution of congenital heart diseases was VSD [42%], TOF [36%], PDA [10%], ASD [8%], and PS[4%]. Of these, 44 cases [88%], were compatible with the clinical impressions that were made preliminarily before cardiac catheterization, and all the cases except 1 case of VSD was correlated well with the postoperative diagnosis. The right heart catheterization is considered to be reliable and accurate toll in the preoperative diagnosis of congenital heart diseases. These procedures caused complications such as left side hemiplegia [lcase], occlusion of the femoral artery [lcase], and transient ventricular tachycardia [1case], and so the complication rate of right heart catheterization was 6% [3 cases]. None of patients who have undergone right heart catheterization was died.

• Journal of Oral Medicine and Pain
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• 제13권1호
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• pp.13-21
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• 1988

The author studied the vertical height of tooth crown and the amounts of alveolar bone resorption with age. All 84 subjects(44 male, 40female) who visited Dental hospital of Wonkwang University with no history of sever periodontal disease and no experience of periodontal surgery. 84 subject were divided into 3 groups by age, that is, group I(28-32yrs), group II(38-42yrs), and group III(48-52yrs). Informal radiogram with bite wing film(horizontal angulation : $0^{\circ}$, vertical angulation : $+5^{\circ}~+10^{\circ}$) were taken on premolar and molar area. The distances from cusp tip to cementoenamel junction (vertical height of tooth crown) and from cementoenamel junction alveolar crest(amount of alveolar bone resorption) were measured, and then recorded data from 946 teeth were statistically analysed. This study was undertaken to obtain the data for age estimation by the changes of tooth crown height and alveolar bone resorption in the point of forensic odontology. The obtained results were as follows : 1. The average crown height of mandibular right 1st. molar was 7.1mm in group I, 6.7mm in group II, and 6.6mm group III, and the average amount of alveolar bone resorption on mandibular right 1st. molar were 1.8mm in group I, 2.5mm in group II, and 3.0mm in group III. Ratio of tooth crown height to amount of alveolar bone resorption was 4.0:1 in groupI, 2.7:1 in group II, and 2.2:1 in group III, the ratio was decreased with age. 2. In comparison with upper teeth and lower teeth in ipsilateral side, the average value of tooth crown height and amount of alveolar bone resorption were slightly higher in upper arch than those in lower arch, but there was not a statistically significant difference. 3. The ratio of height of tooth crown to amount of alveolar bone resorption was decreased with age, and which depended mainly upon the change of amount of alveolar bone resorption rather than the change of tooth crown height.

• Journal of Oral Medicine and Pain
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• 제16권1호
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• pp.121-136
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• 1991

This study was undertaken to obtain the data for age determination following the calcification degree of the second molar, third molar in the point of forensic odontology. The intraoral panoramic radiograph of 1600 male and 1600 female (100 persons each age) ranging from 7 to 2 years of age were studied. The developmental state of the second molar and third molar were divided into 12 stages following the calcification degree and correlations of second molar developmental stage and statistically analyzed. The results were as follows : 1. There was remarkable correlation between the development of the second molar, the third molar and age. 2. There was no significant developmental differences between the right and left second molar, third molar.(p>0.05) 3. The developmental stages of the lower second molar was more advanced than those of upper second molar. (p<0.05) 4. The developmental stages of upper third molar was more advanced than those of lower third molar. (p<0.05) 5. Both the developmental stages of second, third molars were earlier in the female than in the male. (p<0.001) 6. For the purpose of age estimation according to developmental stages of the second, third molar, linear equations are as follows. (p<0.001) second molar : male upper : Y=1.3927X + 0.2213 (r=0.72) lower : Y=1.4132X + 0.0012 (r=0.78) female upper : Y=1.4914X + 0.2151 (r=0.73) lower : Y=1.5429X - 0.0911 (r=0.78)

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.54-59
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• 2001

Objectives : With the advancement of a social life, the pediatric head injuries(PHI) occur greater than ever. Since the PHI differs from adult head injury with regards to mechanism of trauma, prognosis, and mortality, it is important to identify the characteristics of the PHI for its proper treatments and prognosis. Methods : For this study, a series of 365 PHI patients under 15 years of age who were admitted to our hospital, were evaluated from January 1991 to December 1996. The clinical variable studied were age, sex, Glasgow coma score(GCS), causes of trauma, diagnosis, symptoms, associated injuries and Glasgow outcome score (GOS). The characteristics of PHI were evaluated according to presentations of skull fractures, intracranial hemorrhages, associated injuries, GCS at admission and GOS. Results : Mean age of the studied patients was 6.51 years of age. The majority of PHI patients were under the 7 years of age(66.7%). The ratio of male to female was 2.2:1. Seasonally, PHI occurred more frequently during March to August(61.6%). The main causes of the injuries were accidental falls and traffic accidents(47.1% and 46.3%). One hundred ninety seven(54%) patients suffered from skull fractures and 110(30.1%) patients were developed intracranial hemorrhages and acute epidural hematomas(17.8%) which were the most common intracranial hemorrhages. There was statistical significance between skull fractures and intracranial hemorrhage (p=0.032) and between GCS and GOS(p=0.001). However, there was no statistical significance between skull fractures and intracranial hemorrhage(epidural hematomas, subdural hematomas, and intracerebral, intraventricular and subarachnoid hemorrhage)(p=0.061, 0.251 and 0.880). Also there were no significance of prognosis between under the seven and over the 8 years of age(p=0.349). Conclusions : The core management for PHI is prevention from its occurrences. However, when unexpected accident occurs, early diagnosis and treatment for PHI by through examination for associated injuries and other damages even if there is no skull fracture are essential in managing patient's outcome.

• Advances in pediatric surgery
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• 제15권1호
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• pp.27-37
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• 2009

Neuroblastoma is the most common extracranial solid tumor in children. We retrospectively analyzed the results of neuroblastoma treatment of 191 patients (116 males and 75 females) treated between January 1986 and December 2005 at the Department of Pediatric Surgery and the Department of Pediatrics, Seoul National University Children's Hospital. The mean age at diagnosis was 3.1 years (0.1 yrs - 13.5 yrs). Forty-seven patients were under 1 year of age. The mean follow-up period was 57.3 months (24 days - 19.1 yrs). Patients were classified into two groups according to the completeness of resection of the primary tumor; (1) gross total resection (GTR) and (2) incomplete resection (IR). The number of patients in stages I, II, III, IV, IV-S were 17 (8.9 %), 12 (6.3 %), 43 (22.5 %), 114 (59.7 %), 4 (2.1 %), respectively. GTR was achieved in 120 patients and IR in 71 (22 stage III, 47 stage IV, 1 stage IV-S, 1 brain). Overall survival (OS) was 65.2 % and event-free survival (EFS) was 48.6 %. EFS were 100 %, 75 %, 66.8 %, 31.3 %, 75 % at stage I, II, III, IV, IV-S, respectively. There was no significant difference in EFS according to the completeness of resection. EFS was improved in GTR group (p=ns) of stage III, but by contrast, stage IV patients showed worse EFS in GTR group. EFS was improved significantly after the introduction of autologous stem cell transplantation (ASCT) (58.1% vs. 40.6%, p=.029). The EFS improved significantly after the introduction of ASCT in IR group (p=.009) rather than GTR group (p=ns). The EFS of the patients under 1 year of age (N=47) was better than the patients over 1 year of age (N=144) significantly (75.5 % vs. 39.4 %, p=.0034). The prognosis of neuroblastoma was related to the INSS stage and age at diagnosis. The survival of IR group significantly improved after ASCT.