• 한국임상수의학회지
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• 제27권1호
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• pp.88-92
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• 2010

11살의 중성화 암컷 miniature Schnauzer 견이 식욕부진, 복부팽만, 빈뇨증상과 변비증상으로 내원하였다. 복부 일반 방사선 검사에서 하나의 큰 균질한 지방 밀도의 종괴가 후복강과 골반강에서 확인되었다. 그 종괴는 내림결장을 변연부와 배쪽으로, 방광을 배쪽으로 변위시켰다. 복부 초음파 검사에서 종괴는 내부의 거친 에코구조와 바깥쪽에 고에코성 막을 갖고 있으며, 컴퓨터단층촬영에서 균질하게 주위 지방과 같은 (-180 ~ -110 HU) 감쇄성을 보였다. 주위 조직으로의 침습의 증거는 없었다. 세침흡인을 통한 세포검사 결과는 많은 층과 군집의 지방세포들이었다. 환자는 수술적으로 종괴를 제거한 후 임상증상이 완전히 해소되었다. 조직병리학적 검사를 통해 그 종괴는 지방종으로 진단되었다.

• 한국임상수의학회지
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• 제31권3호
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• pp.226-232
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• 2014

8개월령의 단모종 집고양이가 감소된 식욕과 활력 저하로 내원하였다. 진단을 위한 영상 검사에서 종격동의 종괴와 종격동 림프절의 비대 소견을 확인할 수 있었다. 이어서 진행한 세침흡인술 검사로, 악성 림프구를 다수 확인할 수 있었으며, 이 고양이는 다발성 림프종 (병기 V-b)로 진단되었다. 치료는 COP 프로토콜을 사용하였으며, 완전 완화를 확인할 수 있었지만, 항암 치료를 시작한 후 314일 째 재발과 함께 중추신경계로 전이된 소견을 확인할 수 있었다. 구조화학 요법을 실시하여, 단기적으로는 임상증상의 큰 개선을 확인할 수 있었지만, 부분완화만이 관찰되었으며, 처음 내원 부터 약 383일 정도 생존하였다. 부검과 조직병리학적 검사를 통해, 다발성의 T 세포 림프종으로 확인하였으며, 뇌에서도 병변을 확인할 수 있었다.

• Annals of Clinical Neurophysiology
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• 제10권2호
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• pp.83-97
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• 2008

Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

• 대한두경부종양학회지
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• 제23권2호
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• pp.161-164
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• 2007

Thyroid hemiagenesis is a rare anomaly, which is the result of failure of embryologic development of a lobe of thyroid gland. It is more frequently found in the left lobe and in female patients. We, herein, report an extremely rare case of thyroid hemiagenesis associated with papillary thyroid carcinoma. A 69-year-old female presented with an incidentally discovered thyroid nodule in the right thyroid during a routine medical check-up. Ultrasonography(US) and computed tomography(CT) disclosed $0.7{\times}0.5cm\;and\;2.8{\times}2.2cm$ sized nodules in the right thyroid. The left thyroid, however, was not seen in the imaging studies of US and CT. Fine-needle aspiration of the small and large nodules showed papillary thyroid carcinoma and adenomatous hyperplasia, respectively. The patient underwent a right total thyroidectomy with central compartment node dissection. The operative findings and histologic examination confirmed the absence of the left thyroid associated with papillary thyroid carcinoma and ademonatous hyperplasia of the right thyroid.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.132-137
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• 2015

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma has been rarely reported, whereas only a few cases of Cushing syndrome accompanied by opportunistic infections have been reported. We experienced a patient with pheochromocytoma with ectopic Cushing syndrome complicated by invasive aspergillosis. A 35-year-old woman presented with typical Cushingoid features. Her basal plasma cortisol, ACTH, and 24-hour urine free cortisol levels were significantly high, and 24-hour urine metanephrine and catecholamine levels were slightly elevated. The endogeneous cortisol secretion was not suppressed by either low- or high-dose dexamethasone. Abdominal computed tomography (CT) revealed a heterogeneous enhancing mass measuring approximately 2.5 cm in size in the left adrenal gland. No definitive mass lesion was observed on sellar magnetic resonance imaging. On fluorine-18 fluorodeoxyglucose positron emission tomography/CT, a hypermetabolic nodule was observed in the left upper lung. Thus, we performed a percutaneous needle biopsy, which revealed inflammation, not malignancy. Thereafter, we performed a laparoscopic left adrenalectomy, and its pathologic finding was a pheochromocytoma with positive immunohistostaining for ACTH. After surgery, the biochemistry was normalized, but the clinical course was fatal despite intensive care because of the invasive aspergillosis that included the lungs, retina, and central nervous system.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4323-4328
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• 2015

Background: Breast cancer is the most common cause of deaths of cancer in women. Nowadays, following completion of imaging methods, mainly fine needle aspiration biopsy (FNAB) and core biopsy methods have been used for establishing cytopathological diagnosis although discussions regarding superiority continue. Materials and Methods: Those with a complaint of "mass in breast" along with those diagnosed to have a mass as a result of routine physical examination among all patients applying to our clinic between 01.01.2009 and 31.12.2011 were retrospectively assessed. Totals of 146 and 64 patients with complete radiological observation who had undergone FNAB and core biopsies, respectively, were evaluated. Postoperative pathological results of patients of both groups receiving surgery were also taken into consideration. All results were compared in terms of false positivity/negativity, sensitivity/specifity, surgery types and distribution of postoperative results with regard to diagnoses along with those of malignant/benign masses with regard to quadrants determined. Results: Diagnostic malignancy power of mammographic BIRADS classification was 87.3%. However, the value was 75% in the core biopsy group. Sensitivity and specifity following comparison of FNAB and postoperative pathology results of those receiving surgery were 85.4% and 92.9% while they were 93.5% and 100% in the core biopsy group. Diagnostic malignancy power, calculated by determining AUC in ROC analysis, of FNAB was 89.1% while that of core biopsy was 96.7%. Conclusions: It was shown that core biopsy is superior to FNAB in terms of sensitivity, specificity and accurate histopathological classification. However; quick, cheap and basic diagnosis by means of FNAB should not be ignored. Sensitivity of FNAB is rather high in experienced hands and furthermore it would be expected to be lower than with core biopsy.

• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.607-611
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• 2010

Bickerstaff 뇌간 뇌염은(BBE) 4주 이내의 진행성이며, 비교적 대칭성으로 오는 안근 마비와 실조증, 의식 장애 또는 심부건 반사 항진 등의 임상적 특징을 가지며, 뇌간을 침범하는 타 질환을 배제하였을 때 진단할 수 있는 드문 질환이다. 혈청 또는 뇌척수액의 항 Ganglioside 항체(GM, GD and GQ) 는 때로 BBE의 진단에 도움이 되기도 하며, 뇌 자기 공명 영상, 뇌 척수액 검사, 신경 전도 검사 및 근 전도 검사 등은 진단에 크게 도움이 되지 않는다. 저자들은 안근 마비, 실조증, 언어 운동 장애, 연하 장애, 점진적 사지 마비, 의식 저하 등의 증상을 보이며 혈청과 뇌척수액에서 anti-GM1 항체의 증가를 보여 BBE로 진단하고 면역 글로불린과 스테로이드 치료 후 완치되었던 9세의 여아의 증례를 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다.

• The Korean Journal of Pain
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• 제10권2호
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• pp.214-219
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• 1997

Background: Epidural neural blockade with local anesthetics combined with steroids has been in clinical trials for patients with low back pain. But pain treatment of low back pain remains somewhat problematic. Many patients with low back pain have epidural fibrosis and adhesions proved with magnetic resonance imaging(MRI) examination. These findings might play an important role in the origin of back pain. Present study was aims to investigate the effect of epidural adhesiolysis in patients with low back pain. Methods: We investigated 76 patients suspected with epidural fibrosis and adhesion was suspected. Nerve pathology was demonstrated and epidural fibrosis suspected or proved with MRI examination. 17G needle specially designed by Racz was inserted at sacral hiatus and catheter was inserted untill its tip was located at lesion site under fluoroscopic guidance. Injection of contrast dye was achieved and prospected spread of agents. Injection of 0.25% bupivacaine, triamcinolone, and 10% hypertonic saline via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) post-epidural adhesiolysis 3 days, 1 week, and 3 months. We also looked for complication of epidural adhesiolysis. Results: Statistical analysis(Friedman nonparametric repeated measures test and Dune's multiple comparison test) demonstrated NRS was significantly less during 3 months after epidural adhesiolysis(P<0.05). Especially, there is a extremely significance in post-epidural adhesiolysis 3 days (P<0.001). Only four patients reported any complications the most common symptom among three persistent headache but disappeared after a few months without residual sequelae. Conclusion: We conclude epidural adhesiolysis is a safe and effective method of pain therapy for low back pain with proven lumbo-sacral fibrosis and adhesion. A direct visualization by epiduroscopy may be more useful to the resulting functional changes after epidural adhesiolysis.

• The Korean Journal of Pain
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• 제27권3호
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• pp.253-259
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• 2014

Background: Caudal block is a common technique in children for reducing postoperative pain, and there have been several reports on the variations of the sacral canal in children. However, previous studies have mainly focused on the needle trajectory for caudal block, and there is limited information on the structural variations of the sacrum in children. The purpose of this study was to analyze the anatomic variations of sacral canals in children. Methods: Three-dimensional computed tomographic images were analyzed. The data from the images included (1) fusion of the sacral vertebral laminae and the sacral intervertebral space (2) existence of the sacral cornua and (3) the types of sacral hiatus. The types of sacral hiatus were classified into 3 groups: group I (fusion of S3 or S4 vertebral laminae), group II (unfused vertebral arch with the distance of the S3 and S4 vertebral laminae < 50% of the distance between the cornua), and group III (unfused vertebral arch with the distance of the S3 or S4 vertebral laminae ${\geq}50%$ of the distance between the cornua). Results: A total of 143 children were included in this study. All of the sacral vertebral arches were not fused in 22 children (15.4%). Cornua were not identified bilaterally in 5 (3.5%) and unilaterally in 6 (4.2%) children. In the sacral hiatus, group II and group III were identified in 22 (15.4%) and 31 (21.7%) children, respectively. Conclusions: The sacral canal has various anatomical variations in children. Careful attention must be paid to identify the correct anatomic landmark.

• Tuberculosis and Respiratory Diseases
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• 제76권2호
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• pp.88-92
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• 2014

We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.