• Title/Summary/Keyword: Precise Diagnosis

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Imaging of Sequestered Lumbar Discs (요추 분리추간판의 영상 소견)

  • Gangwon Jeong;Heecheol Park;Sun Joo Lee;Dae-Hyun Park;Sung Hwa Paeng;Eugene Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.3-23
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    • 2024
  • Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

Imaging Evaluation of Early and Long-Term Complications Associated with the Postoperative Spine (척추 수술 후 영상 평가: 초기 및 중장기 합병증)

  • Jae Hwi Park;Dong Hyun Kim;Jee Won Chai;Hyo Jin Kim;Jiwoon Seo;Jin Young Son
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.36-53
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    • 2024
  • As the number of spinal surgeries being performed expands, the number of medical imaging procedures such as radiography, CT, and MRI is also increasing, and the importance of their interpretation is becoming more significant. Herein, we present the radiological findings of a variety of complications that can occur after spinal surgery and discuss how effectively and accurately they can be diagnosed through imaging. In particular, this study details the characteristic imaging findings specific to the early and long-term postoperative periods. Early complications of spinal surgery include improper placement of surgical instruments (instrument malpositioning), seromas, hematomas, pseudomeningoceles, and infections in the region surrounding the surgical site. Conversely, long-term complications may include osteolysis around surgical instruments, failure of fusion, adjacent segment disease, and the formation of epidural fibrosis or scar tissue. A precise understanding of the imaging assessments related to complications arising after spinal surgery is crucial to ensure timely and accurate diagnosis, which is necessary to achieve effective treatment.

Application of Transposable Elements as Molecular-marker for Cancer Diagnosis (암 진단 분자 마커로서 이동성 유전인자의 응용)

  • Kim, Hyemin;Gim, Jeong-An;Woo, Hyojeong;Hong, Jeonghyeon;Kim, Jinyeop;Kim, Heui-Soo
    • Journal of Life Science
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    • v.27 no.10
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    • pp.1215-1224
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    • 2017
  • Until now, various oncogenic pathways were idenfied. The accumulation of DNA mutation induces genomic instability in the cell, and it makes cancer. The development of bioinformatics and genomics, to find the precise and reliable biomarker is available. This biomarker could be applied the early-dignosis, prediction and convalescence of cancer. Recently, Transposable elements (TEs) have been attracted as the regulator of genes, because they occupy a half of human genome, and the cause of various diseases. TEs induce DNA mutation, as well as the regulation of gene expression, that makes to cancer development. So, we confirmed the relationship between TEs and colon cancer, and provided the clue for colon cancer biomarker. First, we confirmed long interspersed nuclear element-1 (LINE-1), Alu, and long terminal repeats (LTRs) and their relationship to colon cancer. Because these elements have large composition and enormous effect to the human genome. Interestingly, colon cancer specific patterns were detected, such as the hypomethylation of LINE-1, LINE-1 insertion in the APC gene, hypo- or hypermethylation of Alu, and isoform derived from LTR insertion. Moreover, hypomethylation of LINE-1 in proto-oncogene is used as the biomarker of colon cancer metastasis, and MLH1 mutation induced by Alu is detected in familial or hereditary colon cancer. The genes, effected by TEs, were analyzed their expression patterns by in silico analysis. Then, we provided tissue- and gender-specific expression patterns. This information can provide reliable cancer biomarker, and apply to prediction and diagnosis of colon cancer.

Characristics and Management Plans of Myeongwoldae and Myeongwol Village Groves Located in, Jeju (제주 팽림월대(彭林月臺)의 경관특성 및 관리방안)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Chol, Yung-Hyun;Kahng, Byung-Seon;Kim, Young-Suk
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.2
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    • pp.68-81
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    • 2014
  • This study was conducted to identify the spacialty, to illuminate the existence and values of Myeongwoldae(明月臺) and Forest Myeongwol, and to suggest the sustainable usage, preservation and management plans with the purpose of ecological and cultural landscaping characteristic and value identification. The result of the study is as follows. Castle Myeongwol and Port Myeongwol shows the status of Hallim-eup Myeongwol District which is the administrative center of western Jeju as well as is the fortress. Building Wolgyejeongsa and School Woohakdang, the head temple of education and culture, located in Myeongwol District represents the spaciality of Myeonwol-ri which was the center of education. Stand Myeongwol is one of the most representative Confucian cultural landscapes in Jeju Island and the field of communion with nature where scholars enjoy poetries, nature, changgi(Korean chess), and go in the Joseon Dynasty period. It was found that the current relics of Myeongwoldae was recovered through the maintenance project conducted by Youth Group Myeongwol composed with Hongjong-si(洪鍾時) as the center during the Japanese colonial era in 1931. It seems that the stonework of Myeongwoldae composed of three levels in the order of square, octagon, and circle based on the heaven-man unity theory of Confucianism and the octagon in the middle is the messenger of Cheonwonjibang(天圓地方), in other words, between the square-shaped earth and the circle-shaped sky. It is assumed that both Grand Bridge Myeongwol and Bridge Myeongwol were constructed as arched bridges in early days. Bridge Myeongwol is the only arched bridge remaining in Jeju Island now, which has the modern cultural heritage value. In Forest Myeongwol, 97 taxa of plants were confirmed and in accordance with 'Taxonomic Group and Class Criteria of Floristic Specific Plants', eight taxa were found; Arachniodes aristata of FD IV and Ilex cornuta, Piper kadsura, Litsea japonica, Melia azedarach, Xylosma congestum, Richosanthes kirilowii var. japonica, Dichondra repens, Viburnum odoratissimum var. awabuki of FD III. Otherwise, 14 taxa of naturalized plants including Apium leptophylihum which is imported to Jeju Island only were confirmed. In Forest Myeongwol, 77 trees including 41 Celtis sinensis, 30 Aphananthe aspera, two Wylosma congestum, a Pinus densiflora, a Camellia japonica, a Melia azedarach, and an Ilex cornuta form a colony. Based on the researched data, the preservation and plans of Myeongwoldae and Forest Myeongwol is suggested as follows. Myeongwoldae, Bridge Myeongwol, and Forest Myeongwol should be managed as one integrated division. Bridge Myeongwol, an arched bridge which is hard to be found in Jeju Island is a high-standard stonework requiring long-term preservation plans. Otherwise, Grand Bridge Myeongwol that is exposed to accident risks because of deterioration and needs safety diagnosis requires measures according to the result of precise safety diagnosis. It is desirable to restore it to a two-sluice arched bridge as its initial shape and to preserve and use it as a representative local landmark with Stand Myeongwol. In addition, considering the topophsis based on the analysis result, the current name of Jeju Special Self-Governing Province Monument No. 19 'Myoengwol Hackberry Colony' should change to 'Myeongwol Hackberry-Muku Tree Colony'. In addition, the serial number system which is composed without distinction of hackberry and muku tree should be improved and the regular monitoring of big and old trees, specific plants, and naturalized species is required.

A Study on the Postoperative Stability of Hard Tissue in Orthognathic Surgery Patients Depending on the Difference of Occlusal Plane (악교정 수술시 교합평면의 차이에 따른 술후 경조직의 안정성에 관한 연구)

  • Hwang, Chung-Ju;Lim, Seon-A;Moon, Jeong-Lyon
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.239-249
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    • 1999
  • In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse positions are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups, A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between $T_2$ and $T_3$ for both A and B are HRP-Me at vortical measurements, articular angle(p<0.01), gonial angle(p<0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B. 3. There is no significance in skeletal stability aster the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. Plane angle, and gonial angle after the surgery.

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Treatment of Osteoid Osteoma (유골 골종의 치료)

  • Han, Chung-Soo;Cho, Chang-Hyun;Cho, Young-Lin;Cho, Nam-Su;Lim, Chan-Teak
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.22-29
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    • 2000
  • Purpose : The purpose of the current study was to report the results of curettage and en bloc excision as well as to introduce how to excise the nidus percutaneously with Halo-mill. Material and Methods : Twenty patients(14 men and 6 women) were evaluated, who had operative treatments after diagnosed as osteoid osteoma from March 1990 to January 1998. These patients ranged in age from 7 to 42 years(average: 20.8 years). Locations were 9 femurs, 6 tibias, 2 vertebras, 1 ulna, 1 maxilla and 1 skull. Nine femoral lesions included 5 proximal metaphysis, 2 neck and 2 diaphysis, while 5 tibial lesions included 3 diaphysis, 1 proximal metaphysis and 1 distal metaphysis. We used simple radiography, bone scan, CT and MRI for the accurate diagnosis and localization. As for surgical treatments, while excision and curettage had to need open-exposure of lesion, the percutaneous excision of nidus did not need openexposure : guided Halo-mill into K-wire inserted to nidus under image intensifier. Results : Simple radiography showed that 10 cases had typical nidus and others had only cortical sclerosis. Bone scan was performed at 14 cases and all had hot uptake except one case. We used CT in 10 cases and MRI in 4 cases as diagnostic methods, of which 1 case didn't reveal nidus at CT. Surgical treatment consisted of 6 curettages, 11 excisions, 2 percutaneous excisions with halo-mill and 1 total elbow arthroplasty. We used 7mm sized Halo-mill. During the follow-up period, all patient relieved symptoms and there were no recurrences. All had histologically typical findings except one which had hyperostosis without nidus. Conclusion : Complete removal of the nidus is the most important factor in the treatment. We could excise the nidus percutaneously in 2 cases with the minimal injury to surrounding soft tissues. If we could evaluate the precise location, size of nidus and percutaneous acccesibility, the percutaneous excision of nidus with Halo-mill could be an alternative method as a treatment of osteoid osteoma.

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Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Clinical Aspects in Patients with Thyrotoxic Periodic Hypokalemic Paralysis (갑상선 중독성 주기성마비 환자의 임상적 고찰)

  • Narn, Sang-Yob;Kirn, Jae-Hong;Oh, Jung-Hyn;Park, Jin-Chul;Yoon, Hyun-Dae;Won, Kyu-Chang;Cho, Ihn-Ho;Sung, Cha-Kyung;Lee, Hyoung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.228-236
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    • 1999
  • Background: Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However, the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clinical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center(YUMC) during the past decade. Methods: The medical records of 997 YUMC patients, seen between 1986 and 1996, with diagnosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyroidism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, comparisons were made on age, sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. Results: The prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfunctional state of the thyroid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their thyroid hormone levels were significantly more increased than those of the patients without hypokalemia. Interestingly, our study shows the recurrence of paralysis after treatment. Conclusion: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyroidism. The interactive roles of thyroid hormone, Na-K pump, and genetically inherited defect in the cellular membrane potential of the skeletal muscle can be speculated. Further investigation will be needed to firmly establish the mechanism of thyrotoxic periodic paralysis.

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Survey of antibody on Orientia Tsutsugamushi among wild rodents in Gyeongnam area and detection by nested polymerase chain reaction (경남지역 야생들쥐에서 Orientia tsutsugamushi에 대한 항체 조사 및 PCR에 의한 검색)

  • Hah, Dae-Sik;Kim, Young-Hoon;Park, Jung-Ung;Park, Jae-Kap;Kim, Chung-Hui;Ryu, Jae-Doo;Jong, Myung-Ho;Heo, Jung-Ho;Shu, Jong-Lip;Cho, Myung-Heui;Lee, Kuk-Cheon;Kim, Gon-Sup;Kim, Eui-Kyung;Kim, Jong-Shu
    • Korean Journal of Veterinary Research
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    • v.44 no.2
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    • pp.241-249
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    • 2004
  • As a part of epidemiologic investigation of tsutsugamushi disease, the wild rodents which were captured in Gyeongnam area were diagnosed with indirect immunofluorescent antibody assay (IFA) and Polymerase Chain Reaction (PCR) to find if they have an antibody against Orientia tsutsugamushi. The conclusion was drawn as followings. (1) The captured 58 wild rodents showed that the subspecies distribution of Apodemus agrarius was 86.2%, Microtus fortis was 8.6% and Crocidura lasiura was 5.2%. (2) The antibody positive rate of O. tsutsugamushi Gilliam, Karp, Karto and Boryong by IFA method was 32.0% in Apodemus agrarius among 50 wild rodents and 40.0% in Microtus fortis among 5 wild rodents, respectively. It was negative in the case of all the 3 Crocidura lasiura. (3) The antibody titers on Apodemus agrarius, Microtus fortis and Crocidura lasiura against Gilliam, Karp, Karto and Boryong were measured between 1:20 and 1:640. The antibody titer against each antigen was in the order Boryong>Gilliam>Karp. (4) O. tsutsugamushi was detected from the blood, spleen and kidney from the artificially infected mice by IFA and PCR. IFA showed the positive response between 3 and 18 days after inoculation. On the other hand, positive response was found from all the samples by PCR. (5) From PCR of the genomic DNA extracted from the blood, spleen and kidney samples of the captured wild rodents, Boryong-specific amplification product with size of 210 bp, which is particular in Boryong, was detected from spleen and kidney samples, but not detected in the blood. (6) Boryong-specific amplification product was detected from spleen and kidney samples which were obtained at 3, 6, 12, 18 and 24 days after the infection with Boryong. But, it wasn't detected from the uninfected samples. (7) From PCR of spleen and kidney samples of the captured wild rodents, it was found that positive rate of O. tsutsugamushi in Apodemus agrarius and Microtus fortis were 25.0% (4/16) and 20.0% (1/5), respectively. From the above results, it can be concluded that Apodemus agrarius resided in Gyeongnam area carried O. tsutsugamushi and PCR method might be a simple, precise, rapid and useful diagnostic tool than IFA for the diagnosis of O. tsutsugamushi.

The Flow-rate Measurements in a Multi-phase Flow Pipeline by Using a Clamp-on Sealed Radioisotope Cross Correlation Flowmeter (투과 감마선 계측신호의 Cross correlation 기법 적용에 의한 다중상 유체의 유량측정)

  • Kim, Jin-Seop;Kim, Jong-Bum;Kim, Jae-Ho;Lee, Na-Young;Jung, Sung-Hee
    • Journal of Radiation Protection and Research
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    • v.33 no.1
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    • pp.13-20
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    • 2008
  • The flow rate measurements in a multi-phase flow pipeline were evaluated quantitatively by means of a clamp-on sealed radioisotope based on a cross correlation signal processing technique. The flow rates were calculated by a determination of the transit time between two sealed gamma sources by using a cross correlation function following FFT filtering, then corrected with vapor fraction in the pipeline which was measured by the ${\gamma}$-ray attenuation method. The pipeline model was manufactured by acrylic resin(ID. 8 cm, L=3.5 m, t=10 mm), and the multi-phase flow patterns were realized by an injection of compressed $N_2$ gas. Two sealed gamma sources of $^{137}Cs$ (E=0.662 MeV, ${\Gamma}$ $factor=0.326\;R{\cdot}h^{-1}{\cdot}m^2{\cdot}Ci^{-1}$) of 20 mCi and 17 mCi, and radiation detectors of $2"{\times}2"$ NaI(Tl) scintillation counter (Eberline, SP-3) were used for this study. Under the given conditions(the distance between two sources: 4D(D; inner diameter), N/S ratio: $0.12{\sim}0.15$, sampling time ${\Delta}t$: 4msec), the measured flow rates showed the maximum. relative error of 1.7 % when compared to the real ones through the vapor content corrections($6.1\;%{\sim}9.2\;%$). From a subsequent experiment, it was proven that the closer the distance between the two sealed sources is, the more precise the measured flow rates are. Provided additional studies related to the selection of radioisotopes their activity, and an optimization of the experimental geometry are carried out, it is anticipated that a radioisotope application for flow rate measurements can be used as an important tool for monitoring multi-phase facilities belonging to petrochemical and refinery industries and contributes economically in the light of maintenance and control of them.