• Title/Summary/Keyword: Focal Defect

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A Case of Unilateral Focal Pigmented Paravenous Retinochoroidal Atrophy (단안에 국소적으로 발현된 색소정맥옆망막맥락막 위축 1예)

  • Park, Hyo Song;Yang, Jong Yun;Park, Hyun Ju
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1190-1194
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    • 2018
  • Purpose: We report a case of unilateral, focal, pigmented paravenous retinochoroidal atrophy (PPRCA). Case summary: A 46-year-old female visited our clinic in complaint of a vague problem with her right eye identified during a general medical examination. The visual acuity (without correction) of both eyes was 1.0. Slit-lamp examination of both eyes revealed no specific signs. Fundus examination of the right eye revealed focal, bony-spicule-shaped retinochoroidal atrophy with pigmentation along the course of the superior retinal vein. A fundus autofluorescence examination revealed principally hypofluorescence with some hyperfluorescence at the margin of the atrophic retinochoroidal lesion. Optical coherence tomography revealed mixed clumping and atrophy of the retinal pigment epithelium (RPE) layer and thinning of the choriocapillaris layer. Fluorescence angiography revealed a window defect and blockage at the site of the lesion (the fluorescent material did not enter the lesion). The site of the window defect was in correlation with the atrophic RPE region. The site of the blockage at lesion also matched with the site of the regional pigment clumping. No definite leakage was observed. Conclusions: To the best of our knowledge, this is the first case of unilateral focal PPRCA reported from Korea.

[ $^{99m}Tc-RBC$ ] Hepatic Scintiscan in focal Hepatic Lesions ($^{99m}Tc-RBC$ 간신티스캔을 이용한 간내 공간점유병소의 감별진단)

  • Lee, Do-Yun;Yoo, Hyung-Sik;Lee, Jong-Tae;Kim, Ki-Whang;Park, Chang-Yun;Park, Chan-H.
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.191-197
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    • 1987
  • 39 patients with focal hepatic lesions were evaluated by $^{99m}Tc-RBC$ liver scan. The diagnosis of focal hepatic lesions were made by percutaneous needle biopsy, angiography, surgery, or clinical courses. Thses diagnoses included 24 cases of hemangioma, 7 hepatomas, 6 metastatic disease, 1 abscess, and 1 cyst. 19 hemangiomas showed focal hot activity on delayed static planar images. 3 small deep seated hemangiomas were diagnosed by SPECT that would have been missed by planar images alone. 2 large hemangiomas had no radioisotope uptake within the lesions on delayed images and at surgery cavernous hemangioma with thrombosis, calcification, and fibrosis were found. For hepatic hemangiomas in our series, the sensitivity was 91.7% and the specificity was 100%. The remaining 15 patients including hepatomas, metastatic lesions, cyst and abscess showed cold defect on delayed blood pool images. It is concluded that $^{99m}Tc-RBC$ liver scan should be the choice of primary diagnostic procecure for clinically suspected hepatic hemangioma since it's inexpensive, non-invasive, and readly available.

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RECONSTRUCTION OF LOWER EYELID DEFECT ; REPORT OF A CASE (하안검 전충결손의 재건의 치험례)

  • Oh, Choong-Won;Yeo, Hwan-Ho;Lee, Chul-Woo;Yang, In-Seok;Shin, Kang-Soo;Park, Cheung-Yeoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.3
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    • pp.201-206
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    • 1992
  • The eyelids perform many complex functions and are esthetically important, since eye is focal point of face. Tumor extirpation or trauma can lead to full-thickness eyelid defect, which Should be reconstructed as soon as possible There are a number of operation methods for lower lid reconstruction, and among them, Hughes procedure is a time-honored method. Its advantages are good cosmetic result and conjunctival repair by using eyelid structures to rebuild eyelid structures. However, this is a two-staged procedure in which the vision of the affected eye is obstructed during the interval between the operations. We experienced a case of trauma-induced full-thickness lower lid defect extending over one-third of lid length treated by Hughes method. The cosmetic and functional result was good and there was no donor site morbidity, and now we report this case with review of literatures.

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MRI Findings of the Repaired Anterior Cruciate Ligament (전방 십자 인대의 일차 봉합술 후 MRI 소견)

  • Kim, Jung-Man;Koh, In-Jun;Lee, Dong-Yeob;Lee, Yoon-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.14-21
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    • 2009
  • Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.

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Nondestructive Evaluation of Defect Size by Using a Contrast Parameter of Infrared Image (적외선 열화상 이미지 컨트라스트 파라미터를 이용한 결함 크기의 비파괴 평가)

  • Choi, Jungyoung;Choi, Sooyoung;Kim, Jaeyeon;Yoo, Kitae;Park, Jaiwon;Hyun, Changyong;Byeon, Jaiwon
    • Journal of Applied Reliability
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    • v.18 no.1
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    • pp.87-94
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    • 2018
  • Purpose: In this study, the defect quantification of thin metal plate was evaluated by using lock-in infrared thermography. Methods: A STS304 standard specimens, which had the artificial-defects of different size, were used. The focal distance between the infrared camera and the specimen was set to 500mm, and the distance between the lump and the specimen was set to 200mm. One halogen lamp with a maximum capacity of 1kW was used, and phase-lock infrared thermal images with a frequency of 1Hz were captured and analyzed. Result: Objectively quantified data values were obtained by analyzing the contrast ratio and signal-to-noise ratio. Conclusion: The possibility of defect diagnosis for thin metal plate was confirmed by using the lock-in infrared thermography technique.

The Effects of the Prefabricated Periosteofascial Flap through the Vascular Pedicles Transfer on the Bone Defect and the Optimal Period of the Pedicles Implantation (혈관경 전위를 이용한 선조작 골건막피판이 골 결손부 이식물에 미치는 영향과 적절한 혈관경 이식기간)

  • Won, Chang-Hoon;Kim, Sang-Bum;Seo, Sung-Ik;Han, Seung-Kyu;Kim, Woo-Kyung;Lee, Byung-Il
    • Archives of Reconstructive Microsurgery
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    • v.13 no.2
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    • pp.93-100
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    • 2004
  • This study was designed to investigate the optimal period of pedicles implantation in the prefabricated periosteofascial flap with a vascular tissue transfer. The flap prefabrication was prepared with a transposition of left occipital pedicles on the calvarial fascia of male Sprague-Dawley rats. Thirty flaps were divided into five groups of six flaps, including control group (group I) of the conventional periosteofascial flap based on the lateral border of the rat calvarium. The prefabricated flap was elevated as an $1{\times}1cm$ sized island flap based on the implanted pedicle at 1, 2, 3, and 4 weeks after the pedicles transfer in groups II, III, IV, and V, respectively. After the completion of creating a critical-sized calvarial defect and implanting with hydroxyapatite granules, the flap was sutured back for covering the defect and kept isolated from surrounding tissues. Six weeks after flap repositioning, the osseous changes of the defect were examined with simple radiographic findings, radiodensitometric analysis, and histological studies. By simple radiographic findings, specimens of the control, groups IV and V showed homogeneous radioopacity within the defect. But in groups II and III, focal radiolucency was observed in the defect. In the radiodensitometric analysis, the control group and the group V showed significant increased radiodensites statistically. Histologically, the implanted hydroxyapatite was absorbed partly in the defect in groups II, III, and IV. In the defects of the control group and the group V, the implanted hydroxyapatite was kept in its volume and the deposition of the bone cells was observed sparsely. In conclusion, the prefabricated periosteofascial flap can be created with a vascular tissue transfer and the pedicles should be implanted at least for 4 weeks to bring out positive osseous changes in the calvarial defect.

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Reconstruction of extensive jaw defects induced by keratocystic odontogenic tumor via patient-customized devices

  • Park, Seok-Yong;Shin, Young-Jo;Kim, Chul-Hoon;Kim, Bok-Joo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.37.1-37.4
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    • 2015
  • Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. According to their size, location, and relations with surrounding structures, they are treated by cyst enucleation or enucleation after either marsupialization or decompression. Enucleation is performed when cysts are not large and when only minor damage to adjacent anatomical structures is expected. Although marsupialization and decompression follow the same basic bone-regeneration principle, which is to say, by reducing the pressure within the cyst, the former leaves a large defect after healing due to the large fistula necessary to induce the conversion of the cyst-lining epithelia to oral epithelia; the latter leaves only a relatively small defect, because of the continuous washing carried out by means of a tube inserted into a small hole in the cyst. In the latter case too, a decompressor appropriate for the focal position is required, owing to the importance of maintaining the device and controlling for oral hygiene. We report herein decompression treatment with a patient-customized device for an extensive cyst in the anterior region of the mandible.

Comparison of Diagnostic Value between the Absolute and Relative Uptake Rate on $^{99m}Tc-DMSA$ Renal Scan of Children with Febrile Urinary Tract Infection (발열성 요로감염 환아의 $^{99m}Tc-DMSA$ 신주사에서 절대적 신섭취율과 상대적 신섭취율의 진단적 가치에 대한 비교연구)

  • Kim Hee-Yeon;Bae Sang-Young;Whang Su-Ja;Park Eun-Ae;Kim Ho-Sung;Seo Jung-Wan;Lee Sung-Joo
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.24-30
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    • 1997
  • Purpose: To evaluate the diagnositc value of the absolute and relative renal uptake rates on $^{99m}Tc-DMSA$ renal scan of children with febrile UTI. Method: The absolute and relative renal uptake rates of $^{99m}Tc-DMSA$ were checked in 68 children with febrile urinary tract infection (35 with unilateral focal defect; 13 with bilateral focal defect; and 20 with diffuse bilateral defect) and 49 children with afebrile UTI and normal $^{99m}Tc-DMSA$ renal scan as control. Results: The renal absolute uptake rate in the control group were $21.8{\pm}3.9%(right),\;22.2{\pm}3.9%(left),\;and\;44.2{\pm}7.8%(total)$. The absolute uptake rate gradually increased until the age 12 months and then was stationary. In febrile UTI with unilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, both relative and absolute uptake rates were similarly diagnostic ($41.2{\pm}9.7%,\;16.5{\pm}5.4%$ vs $50.0{\pm}2.6%,\;22.0{\pm}3.9%$, p<0.01). In acute pyelonephritis with bilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly more diagnostic than the relative uptake rate[$17.3{\pm}5.3%$ (right), $17.4{\pm}5.3%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$, (left)% p<0.01]. In febrile UTI with bilateral diffuse defects on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly diagnostic than the relative uptake rate [$18.1{\pm}3.9%\;(right),\;18.4{\pm}3.8%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$(left), p<0.01]. Conclusion: In the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was more useful than the relative uptake rate to evaluate bilateral acute pyelonephritis.

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Use of the Sundt Clip Graft in a Previously Coiled Internal Carotid Artery Blister-Like Aneurysm

  • Cho, Jae Ik;Cho, Jae Hoon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.496-499
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    • 2014
  • Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).

Reperfusion Injury after Autologous Cranioplasty in a Patient with Sinking Skin Flap Syndrome

  • Kwon, Sae-Min;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.117-119
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    • 2012
  • The sinking skin flap syndrome is a rare complication after a large craniectomy. It consists of a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. In patient with sinking skin flap syndrome, cerebral blood flow and cerebral metabolism are decreased by sinking skin flap syndrome, and it may cause the deterioration of autoregulation of brain. We report a case of a patient with sinking skin flap syndrome who suffered from reperfusion injury after cranioplasty with review of pertinent literature.