• 대한영상의학회지
• /
• 제84권6호
• /
• pp.1367-1372
• /
• 2023

원발성 중추신경계 혈관염은 중추 신경계에서 발생하는 드문 혈관염이다. 뇌농양과 구별하기 힘든, 괴사 패턴의 원발성 중추신경계 혈관염을 진단, 치료를 하였던 본원의 증례를 보고하고자 한다. 시야 흐림, 두통을 주소로 19세 남자 환자가 내원하였다. 조영증강영상에서 가장자리가 조영이 잘되는 괴사성 종괴들의 소견이 뇌량과 좌측 두정-측두 뇌실주위 영역에서 보였는데, 확산강조영상에서 뇌량에 있는 종괴는 중심부에 높은 신호강도를 보였고, 좌측 두정-측두 뇌실주위영역에 있는 종괴는 주변부에서 높은 신호강도를 보였다. 자화율강조영상에서 종괴들 내에 다발성 점상 출혈 소견을 보였다. 비정형적인 뇌농양과 종양성 원발성 중추신경계 혈관염의 가능성을 생각하였다. 먼저 뇌농양을 배제하기 위해 항생제 치료를 시작하였다. 하지만 2주간의 항생제 치료 이후에 시행한 뇌 자기공명영상에서 괴사성 종괴들은 호전되지 않은 소견을 보였다. 병변에 대해 수술적 생검을 시행하였고, 최종적으로 괴사 패턴의 원발성 중추신경계 혈관염으로 진단되었다. 고용량 스테로이드 치료 이후 시행한 뇌 자기공명영상에서 괴사성 종괴들은 작아졌다.

• Investigative Magnetic Resonance Imaging
• /
• 제17권1호
• /
• pp.50-54
• /
• 2013

노카디아병 (nocardiosis)은 actinomycetales 목, nocardia 과에 속하는 호기성 양성 간균에 의한 감염으로 노카디아종은 사람과 동물에서 국소적, 전신적인 화농성 질환을 일으킬 수 있다. 노카디아병은 일반적으로 기회감염으로 생기지만 감염자의 1/3은 면역기능이 정상이다. 저자들은 고령의 크론병 (Crohn's disease) 여자 환자에서 노카디아종에 의해 발생한 폐 노카디아병과 뇌농양의 증례를 보고하고자 한다. 이 병변은 영상 검사상 주위 부종을 동반하며 조영 증강을 보여 수술 전에는 종양으로 생각되었고, 전이성 뇌암처럼 공격적인 병의 진행을 보였다. 노카디아병의 조기 진단, 기저 질환이 없는 경우, 적절한 항생제 치료가 이루어 졌을 때 예후가 좋다. 저자들은 뇌에 생긴 노카디아병을 보고하여 자기공명영상과 컴퓨터 단층촬영 소견을 알리고 악성 병변과의 감별에 도움이 되고자 한다.

• Imaging Science in Dentistry
• /
• 제41권4호
• /
• pp.189-193
• /
• 2011

The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

• Journal of Chest Surgery
• /
• 제33권8호
• /
• pp.688-692
• /
• 2000

Descending Necrotizing Mediastinitis(DNM) is a complication of oropharyngeal infections that can spread to the mediastinum. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. late diagnosis is the principal reason for the high mortality in DNM. An 18-year-old female admitted with Ludwig's angina from dental caries. Despite of combined antibiotics, dental extraction and drainge of submental abscess, infection spread to the cervical area. Chest computed tomogram revealed extension of the abscess to the pretracheal and periaortic space and development of bilateral pleural empyema. We performed bilateral cervical mediastinotomy and thoracotomy for drainage and debridement. Tracheostomy to secure the airway and postoperative pleural irrigation were performed. Postoperative course was uneventful and patient was discharged on the 40th postoperative day. It is important to perform chest CT scanning for early diagnosis of DNM when oropharyngeal infection spreads to the cervical area. Improved survival of patients with DNM implies early and radical surgical drainage and debridement via a cervical mediastinomy and thoracotomy.

• 대한정형외과 초음파학회지
• /
• 제6권2호
• /
• pp.76-80
• /
• 2013

소아의 급성 혈행성 골수염에서 각종 합병증을 피하기 위해서는 조기 진단이 매우 중요하다. 저자들은 파행과 발열을 보이는 5세 환아에서 초음파를 이용하여 경골 원위부의 골막하 농양을 동반한 급성 혈행성 골수염을 조기 진단 후 치료한 경험을 보고하고자 한다.

• 대한핵의학회지
• /
• 제2권1호
• /
• pp.59-66
• /
• 1968

Technetium 99m pertechnetate brain scanning were performed in 3 cases of head injury (2 chronic subdural hematomas and 1 acute epidural hematoma), 2 cases of brain abscess and I case of intracerebral hematoma associated with arteriovenous anomaly. In all the cases brain scintigrams showed "hot areas." Literatures on radioisotope scanning of intracranial lesions were briefly reviewed. With the improvement of radioisotope scanner and development of new radiopharmaceuticals brain scanning became a safe and useful screening test for diagnosis of intracranial lesions. Brain scanning can be easily performed even to a moribund patient without any discomfort and risk to the patient which are associated with cerebral angiography or pneumoencephalography. Brain scanning has been useful in diagnosis of brain tumor, brain abscess, subdural hematoma, and cerebral vascular diseases. In 80 to 90% of brain tumors positive scintigrams can be expected. Early studies were done with $^{203}Hg$-Neohydrin or $^{131}I$-serum albumin. With these agents, however, patients receive rather much radiation to the whole body and kidneys. In 1965 Harper introduced $^{99m}Tc$ to reduce radiation dose to the patient and improve statistical variation in isotope scanning.

• 치과방사선
• /
• 제21권1호
• /
• pp.109-118
• /
• 1991

The author studied the age distribution, etiology, affected site and several radiographic features of periapical granulomas, cysts, and abscesses. The material consisted of 928 films obtained from the patients who were diagnosed and treated under the diagnosis of periapical granulomas, cysts, and abscesses during the past 8 years (1979-1986) at the Infirmary of Dental School, Chosun University. The obtained results were as follows: 1. The order of incidence was as follows: periapical abscess (67.2%), granuloma, and cyst. 2. The age distribution revealed the highest incidence around the age of 30 and relatively higher incidence over the age of 60 in the case of periapical abscess and granuloma. 3. In the frequency of location: Periapical abscesses occured most frequently in the mandibular molars. Granulomas showed relatively higher incidence in maxilla than in mandible. Cysts were most common in the maxillary anterior teeth. 4. The mean diameter of dental granuloma was 5.9㎜, however, all dental granulomas were less than 9.3㎜ in diameter. The mean diameter of periapical cyst was l3.8㎜. 5. Periapical cyst revealed well circumscribed radiolucent lesions and 77.8% of the lesion showed white line. 86.0% of dental granuloma showed well circumscribed border, 54.5% sclerosis on surrounding bone and 38.5% partial white line. Periapical abscess revealed diffuse radiolucent lesion, 89.6% of the lesions had sclerosis on surrounding bone, and 38.0% sinus tract.

• Journal of Yeungnam Medical Science
• /
• 제34권1호
• /
• pp.96-100
• /
• 2017

Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infection. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.

• 한국임상수의학회지
• /
• 제36권4호
• /
• pp.238-243
• /
• 2019

A 6-year-old, spayed female Maltese was presented with the condition of a chronic recurrent abscess formation in the left flank region. Despite the antibiotics and drainage therapy given to the dog, the lesion formed a continued serosanguineous to the point that a purulent discharge was evident. In the meantime, an abdominal ultrasound revealed the presence of a well-defined mass with a hypoechoic outer margin, and a hyperechoic inner rim in the cranial of the kidney. A fistula was noted as being present with a connection between the subcutaneous lesion of the left flank and the abdominal mass. It is emphasized that CT scans revealed the existence of a soft tissue dense mass with low attenuation area, as seen in some internal areas and also a peripheral contrast enhancement was noted within a nonenhancing central region. There was additional nonenhancing fluid found dorsal to the inflammatory tract passing under the epaxial muscles and at the peritoneum. Likewise, the tract exited the skin surface in the left flank. A tentative diagnosis of an abdominal abscess with spontaneous cutaneous fistula was made based on the ultrasonographic and CT appearances. A foreign body such as surgical gauze should always be considered a potential cause of draining tract in small animals, as was considered to be the problem in this case.

• 대한두개안면성형외과학회지
• /
• 제20권4호
• /
• pp.274-278
• /
• 2019

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule ($1.5{\times}1.2cm$) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.