• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.12-23
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• 2023

Glossopharyngeal neuralgia (GPN) is a rare disease that must be differentiated from trigeminal neuralgia. The purpose of this article is to provide a comprehensive review of anatomy, pathophysiology, diagnostic criteria, and several options of treatment for GPN. Lessons learned through our experience of treating GPN are presented in detail, as well as cases of misdiagnosis and diagnostic pitfalls. Microvascular decompression (MVD) should be primarily considered for medically intractable GPN. Techniques employed in MVD for GPN are categorized and described. Especially, we underscore the advantages of the 'transposition' technique where insulating material is positioned 'off' the root entry zone (REZ), instead of 'on' it. We believe this 'off-the-REZ' technique can fundamentally prevent recurrence, if applicable. In addition, Gamma Knife radiosurgery can be an alternative option when a patient is ineligible for MVD, though it is categorized as a destructive procedure.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.63-68
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• 2007

The EEG plays an important diagnostic role in epilepsy and provides supporting evidence of a seizure disorder as well as assisting with classification of seizures and epilepsy syndromes. There are a variety of electroclinical syndromes that are really defined by the EEG such as Lennox-Gastaut syndrome, benign rolandic epilepsy, childhood absence epilepsy, juvenile myoclonic epilepsy and also for localization purposes, it is vitally important especially for temporal lobe epilepsy. The sensitivity of first routine EEG in diagnosis of epilepsy has been known about 20-50%, but this proportion rises to 80-90% if sleep EEG and repetitive recording should be added. Convincing evidences suggest that the EEG may also provide useful prognostic information regarding seizure recurrence after a single unprovoked attack and following antiepileptic drug (AED) withdrawal. Moreover, patterns in the EEG make it possible to disclose an ictal feature of nonconvulsive status epilepticus, separate epileptic from other non-epileptic episodes and clarify the clues predictive of the cause of the encephalopathy (i.e., triphasic waves in metabolic encephalopathy). Therefore, regardless of its low sensitivity and other pitfalls, EEG should be considered not only in the situation of new onset episode such as a newly developed, unprovoked seizure or a condition manifesting decreased mentality from obscure origin, but also as a barometer of the long-term outcome following AED withdrawal.

• The Korean Journal of Cytopathology
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• v.9 no.2
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• pp.169-180
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• 1998

Fine needle aspiration cytology(FNAC) has been used effectively as the initial modality in evaluating various thyroid lesions. We correlated cytologic and histopathologic features to investigate the diagnostic pitfalls of FNAC of the thyroid. A total of 1,593 FNACs of the thyroid were diagnosed at the Department of Pathology, Hanyang University Hospital, from January 1993 to December 1997 There were 963 cytologically benign cases(60.5%), 97 suspicious cases(6.1%), and 75 malignant cases(4.71%). The remaining 458 cases(28.8%) were unsatisfactory. Subsequent surgical resection was done in 192 cases. Seventy-two cases(37.5%) were cytologically diagnosed as benign, 45 cases(23.4%) suspicious, 56 cases(29.2%) malignant, and 19 cases(9.9%) unsatisfactory. Histopathologically, 101 cases were benign(11 thyroidites, 52 adenomatous hyperplasias, 34 follicular adenomas, and four Hurthle cell adenomas), and 91 cases malignant(72 papillary carcinomas, 16 follicular carcinomas, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor). After excluding 19 unsatisfactory cases, 63 were misdiagnosed. They included 17 benign(three thyroidites and 14 adenomatous hyperplasias), 27 suspicious(10 follicular adenomas, four Hurthle cell adenomas, and seven follicular carcinomas), and 19 malignant(16 papillary carcinoma, one medullary carcinoma, one anaplastic carcinoma. and one granular cell tumor) lesions. The accuracy rates in the benign, suspicious, and malignant categories were 54.9%, 49.8%, & 92.8%, respectively. The cytological pitfalls were as follows: (1) background, (2) crowded follicular cell clusters indistinguishable between follicular neoplasia and adenomatous hyperplasia, (3) papillary structure, irregular nuclear membrane and pleomorphism mimicking those of papillary carcinoma, (4) indistinct eosinophilia in follicular epithelial cells, (5) unusual cellular components not commonly seen in FNACS of the thyroid.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.60-63
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• 1999

Transcranial Doppler(TCD) is an important diagnostic tool for evaluating the patients with stroke. It has some advantages and unique role when compared with other neuroimaging modalities. Recent development of transcranial color-coded Doppler(TCD) improves the limitation and pitfalls of TCD. The current indications of TCD are as follows: 1. Screening and evaluation of the intracranial major vessels 2. early detection and follow-up of vasospasm due to SAH 3. emboli detection (high-imtensity transient signals, HITs) 4. dignosis and follow-up of subclavian steal 5. evaluation of intracranial collaterals when the extracranial ICA has severe stenosis or occlusion 6. evaluation of cerebral perfusion pressure (intracranial pressure) 7. evaluation of arteriovenous malformation 8. diagnosis and follow-up of arterial dissenction 9. diagnosis and follow-up of venous sinus thrombosis (experimental).

• The Korean Journal of Cytopathology
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• v.16 no.1
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• pp.31-35
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• 2005

Eccrine acrospiroma is a rare adnexal tumor of the skin. When the clinical presentation is that of a breast lump, diagnosis can be difficult. Also, most of the cytopathologists are not familial with the cytologic features of this tumor and this is responsible for diagnostic pitfalls. We experienced a case of eccrine acrospiroma of the right breast in a 41-year-old female, misdiagnosed by fine needle aspiration cytology (FNAC). FNAC was characterized by tight clusters or sheets of small round cells, polygonal cells, and spindle cells and tubule like structures within clusters. Myoepithelial cells were not noted in the clusters. The diagnosis of eccrine acrospiroma was confirmed by histology.

• The Korean Journal of Cytopathology
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• v.16 no.2
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• pp.98-101
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• 2005

Eccrine spiradenoma is a rare adnexal tumor of the skin and its cytomorphology has seldom been described in literature. To evaluate the cytologic features and diagnostic pitfalls of eccrine spiradenoma, we report a case of 33-year-old male whose clinical presentation was a painful subcutaneous mass at the right preauricular area. Fine needle aspirates revealed tight clusters of multilayered, uniform, cuboidal cells arranged around hyalinized perivascular spaces. Some epithelial cells showed tubules or rosette formations. The background showed scattered, naked nuclei. The histologic findings confirmed the eccrine spiradenoma. The recognition of peculiar cytologic features and clinical correlation could be helpful in the diagnosis of skin adnexal tumors.

• Educational Technology International
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• v.10 no.1
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• pp.107-135
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• 2009

The purpose of this paper is to review a variety of challenges facing the Human Performance Technology (HPT) in supporting knowledge workers' performance, and to explore possible HPT models for knowledge workers. The first section of this paper investigates the core attributes and major models of HPT as a foundation. While HPT has a lot of strengths in terms of systemic, systematic, methodologically eclectic, evidence based, and results oriented approaches, some pitfalls - which could be detected if these principles were mindlessly applied to problem areas - are explored. The second section presents some considerations such as analysis, intervention design, and leadership that HP technologists need to take in order to make HPT a better field of practice for knowledge workers. The author also suggests a tentative diagnostic model and a process model for knowledge workers, core principles of which are based on systems thinking, in particular Senge's the fifth discipline and Checkland's soft systems methodology. The importance of formative evaluations to improve these models is noted as a conclusion.

• Korean Journal of Radiology
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• v.25 no.1
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• pp.33-42
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• 2024

Focal enhancement typically suggests local tumor progression (LTP) after renal cell carcinoma is percutaneously ablated. However, evaluating findings that are false positive or negative of LTP is less familiar to radiologists who have little experience with renal ablation. Various imaging features are encountered during and after thermal ablation. Ablation procedures and previous follow-up imaging should be reviewed before determining if there is LTP. Previous studies have focused on detecting the presence or absence of focal enhancement within the ablation zone. Therefore, various diagnostic pitfalls can be experienced using computed tomography or magnetic resonance imaging examinations. This review aimed to assess how to read images during or after ablation procedures, recognize imaging features of LTP and determine factors that influence LTP.

• Journal of Gastric Cancer
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• v.20 no.1
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• pp.106-114
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• 2020

Breast metastases of extramammary malignant neoplasms are rare, with an incidence of 0.3%-2.7% among all malignant mammary tumors. Breast metastases from gastric carcinoma are very rare (<0.1%), and this event is even rarer during pregnancy. Herein, we describe a 39-year-old Caucasian woman with a history of an Epstein-Barr virus-associated gastric carcinoma (EBVaGC) that was characterized by prominent tumor infiltrating lymphocytes. Three years after undergoing radical surgery, the patient developed bilateral breast nodules during her pregnancy. A breast biopsy was performed, and histology confirmed a diagnosis of EBVaGC; tumor cells showed positivity for cytokeratin 8/18 and E-cadherin, and negativity for cytokeratin 7, cytokeratin 20, cytokeratin 5/6, caudal type homebox 2, androgen receptor, mammaglobin, gross cystic disease fluid protein-15, and estrogen and progesterone receptors. We also discuss the main diagnostic pitfalls. To our knowledge, this is the first report of an EBVaGC with lymphoid stroma that developed breast metastases during pregnancy.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.97-97
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• 2003

Contrast-enhanced MR angiography (CE-MRA) gradually occupies its position as a primary evaluation tool forsteno-occlusive disease of supra-aortic cervical arteries. It has several advantages over time-of-flight (TOF) technique such as shorter imaging time, less saturation effect, and less flow- and motion-related artifacts. Diverse methods of k-space sampling, imaging sequences, and strategies for image acquisitiontiming have been introduced since its early clinical application. Especially, methods of k-space sampling and image acquisition timing are very important to achieve maximal arterial enhancement and suppress venous signal while maintaining large scan coverage and high spatial resolution. In addition, regardless of several advantages over TOF technique, it still has a tendency to overestimate the degree of stenosis in patients with carotid or vertebralartery disease. In this exhibit, we will overview the current techniques of CE-MRA with special attention to methods of k-space sampling and image acquisition timing. We will also discuss diagnostic accuracy of CE-MRA in patients with supra-aortic cervical artery stenosis and artifacts frequently misinterpreted as steno-occlusive lesion on CE-MRA.