• 한국임상수의학회지
• /
• 제40권6호
• /
• pp.457-463
• /
• 2023

A 13-year-old neutered male Pomeranian, weighting 3 kg, presented with respiratory distress and depression. Radiographic examination revealed calcified ring-like opacities in the main pulmonary artery, mimicking thoracic foreign bodies. Additionally, right heart and main pulmonary artery enlargement and notable lung infiltrations were also observed. Echocardiography showed coil shaped structures in the main pulmonary artery with increased echogenicity compared to other nearby heartworms, which is consistent with calcified Dirofilaria immitis (heartworms). The dog was diagnosed with caval syndrome, which is the advanced and severe manifestation of heartworm infection. This report presents a rare case of calcified heartworm infection observed during a radiological examination, which resemble foreign bodies. Therefore, chronic heartworm disease should be considered as a differential diagnosis when radiopaque ring-like opacities are observed in the pulmonary artery on thoracic radiographs.

• 한국임상수의학회지
• /
• 제24권3호
• /
• pp.410-413
• /
• 2007

암컷 4살령치 미니어쳐 핀셔가 간헐적인 기침 증상으로 본 원에 내원하였다. 흉부 방사선 검사와 초음파 검사를 통해 좌측 폐의 전엽이 경화되고 흉수가 동반된 것을 확인하고 개흉술을 통해 염전된 폐엽을 절제하였다. 본 증례는 흥부 초음파 검사를 통해 폐염전을 진단하여 신속히 수술적인 치료를 적용함으로써 좋은 예후를 얻을 수 있었다. 폐염전은 대형견종에서 호발하는 것으로 알려져 있으나 근래 소형 견종에서의 발생 보고가 증가하고 있다. 본 증례는 소형 견종 중 미니어쳐 핀셔에서는 처음 보고되는 폐염전 증례로 갑작스러운 호흡 곤란을 보이고 흉부 방사선 검사와 초음파 검사상 흉수와 폐경화, 비정상적인 폐엽의 방향 등의 이상 소견을 보이는 경우, 본 증례와 같이 이전에 폐염전이 발생한 보고가 없거나 드문 소형 견종에서도 폐염전을 감별 진단 리스트에 포함시켜야 할 것으로 생각한다.

• 한국임상수의학회지
• /
• 제32권1호
• /
• pp.49-55
• /
• 2015

This study was retrospectively investigated the clinical features, diagnostic imaging, treatment, and prognosis of foreign bodies according to alimentary site and type of foreign body, in 143 dogs. Among 28 breeds, Maltese, Shih Tzu, and terriers including the Yorkshire terrier were presented with high prevalence. Bone was the most commonly identified (33%) foreign body regardless of alimentary site. Approximately 76% of foreign bodies were in the stomach and small intestine. All esophageal foreign bodies were diagnosed on survey radiography, with the most common location being the caudal thoracic esophageal segment. Further diagnostic examinations including ultrasonography or contrast studies were additionally performed to detect radiolucent foreign bodies and perforation or leakage in the stomach and intestine. However, most seeds could be identified based on the characteristic features such as hyperdense thin double lines and inner gas on survey radiography. In conclusion, complications such as peritonitis and intestinal perforation were mainly observed in cases with seeds and linear foreign bodies. Especially, fabric foreign bodies could be induce peritonitis and re-perforation with high prevalence after surgical correction.

• 한국임상수의학회지
• /
• 제18권4호
• /
• pp.452-454
• /
• 2001

A two-month-old female Yorkshire terrier was referred to the Veterinary Teaching Hospital, College of Veterinary Medicine, Kyungpook national University. The patient was presented with a history of dyspnea, cough, exercise intolerance and abdominal distension, but she was appetence. In physical examination the puppy was coughed on slight tracheal compression. Rectal temperature, pulse and respiratory rate were normal, and grade 3/6 systolic murmur heard at the left heart base. The murmur was crescendo-decrescendo. Electrocardiography showed sinus arrhythmia, right-ventricular hypertrophy pattern, and right axis deviation. Thoracic radiography revealed cardiomegaly, bulging of the main pulmonary artery, and enlarged left side heart. Abdominal radiography revealed abdkominal distention. Echocardiography showed hypertrophy of right ventricle and turbulence in the pulmonary artery in parasternal oblique view. Subvalvular pulmonic stenosis was diagnosis based upon the clinical signs, physical examination, electrocardiography, radiography and echocardiography. We treated the patient with furosemide, enalapril and $\beta$-blocker. After the clinical signs of cough, abdominal distension and dyspnea were disappeared, she was on just $\beta$-blocker for prevention of occurrence of congestive heart failure. Now she was recovered her health, and she is not on any medication.

• 대한방사선기술학회지:방사선기술과학
• /
• 제36권4호
• /
• pp.273-280
• /
• 2013

흉추 측면검사에서의 T-spine breathing technique을 실제 임상에서 사용되고 있는 4가지 검출기인 computer radiography (CR), charge coupled device (CCD), indirect digital radiography (IDR)와 direct digital radiography (DDR)을 사용하여 임상 유용성을 넓히고자 하였다. 화질 평가는 흉추 측면검사의 평가요소 중 5곳 (극돌기, 추궁근, 추체, 추간공, 추간)을 Image J 프로그램을 이용하여 관심영역을 정하고 신호 평균값과 표준편차를 구하여 대조도 잡음비와 신호 대 잡음비를 측정하여 비교하였다. 실험결과 4가지 검출기에서 T-spine breathing technique에서 극돌기, 추궁근, 추체, 추간공, 추간의 5곳 구조에서 우수하게 나타났다. 기존의 T-spine exhalation technique에 비해 T-spine breathing technique으로 촬영한 영상은 우수한 화질을 제공하므로 추후 심호기가 어려운 고령환자들에게 유용한 방법이라 사료된다. 그리고 4가지 검출기에서 contrast to noise ratio (CNR)와 signal to noise ratio (SNR) 같은 정량적인 수치를 제시함으로써 T-spine breathing technique의 적용 가능성을 나타내었다.

• Journal of Trauma and Injury
• /
• 제20권2호
• /
• pp.130-137
• /
• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• 한국방사선학회논문지
• /
• 제5권2호
• /
• pp.81-92
• /
• 2011

응급상황에서 방사선 촬영 분포 분석 및 문헌을 토대로 응급상황 대처 및 서비스 효율성을 개선시키기 위하여 연구를 하였다. 2010년 12월, 광주 광역시 한 대학병원에 응급실을 내원한 1270명 응급 외래환자를 분석하여 방사선 촬영 분포 데이터를 분석하였다. 결과는 다음과 같다. 응급 방사선 촬영은 56.6% 일반 방사선 촬영, 2.5% 특수촬영, CT 34.2%, 초음파 6.7%였으며, 일반 방사선 촬영에서 남성은 51.7%, 흉부외과의 촬영률 90.0%, 입원환자 77.9% 및 응급실에서 머무르는 시간이 긴 환자에게서 촬영하였다. 특수 촬영의 비율은, 비뇨기계 28.6%, CT에서는 신경외과 49.2%, 신경과 36.7%의 높은 비율을 나타냈다. 초음파의 경우 여성이 8.8%, 내과가 15.9% 비율을 나타냈다. 방사선 촬영의 분포도를 분석하면, 일반 방사선 촬영에서 흉부촬영 55.3%, 특수 촬영에서는 1.2%의 비뇨기계, CT에서는 두부 검사가 40.0%로 높은 비율을 차지했다. 일반 촬영의 진료과의 분포도에 따르면, 두부가 64.6% 신경외과, 흉부검사는 흉부외과는 90.9%, 복부가 58.0% 일반외과, 척추는 신경외과 40.0%, 골반 및 상하지는 정형외과가 15.9%, 20.5%, 31.8%를 차지하였다. 일반 촬영의 환자 1인당 평균검수는 전체 인원을 고려하여 성별, 연령별, 전원 여부별 모두에서 유의한 차이를 나타냈다(p<0.05). 촬영만을 고려한 경우에는 성별에서 남자가 2.2건 높았으며, 연령대에서는 30대에서 2.7건이, 진단부분에서는 신경외과가 3.4건이 더 높게 차지하였다. 전체 촬영 부위 건수에서는 흉부가 998건으로 가장 많았다. 결과를 고려해보면, 응급실에서 근무하는 방사선사는 응급 촬영에서 노년층을 돌봐야 하며, 촬영동안에 가능한 2차 손상을 특수 촬영인 비뇨기계 계통이 기구와 관련이 되어 있기 때문이다. 줄이기 위한 부상응급 환자를 검사하는 모든 방사선사는 방사선 촬영하는 동안에 긴급 상황에 대처해야 한다. 방지 대처가 필요하다. 왜냐하면, 특히 야간에 CT 촬영하는 두부 손상 환자는 환자 처치가 매우 중요하다. 담당 의사는 언제나 CT실에 상주하여 환자를 지켜봐야 한다. 응급실에서 방사선 촬영은 여러 진료과에서 관여 한다. 일반 방사선 촬영의 높은 비율, 응급 방사선 촬영에 대한 특수 촬영실이 응급실 내에 설치하여만 하고, 능력이 있는 응급 환자 처치를 할 수 있는 방사선사가 필요로 하고 응급환자 증가로 적절한 인원배치가 필요하다.

• Archives of Reconstructive Microsurgery
• /
• 제20권2호
• /
• pp.102-107
• /
• 2011

Purpose: As clinical manifestations of thoracic outlet syndrome are vague pain or symptoms in upper extremity, the diagnosis of the disease is delayed or misdiagnosed as cervical HNP, shoulder pathologies, or peripheral neuropathies. In that reason, many patients spend time for unnecessary or ineffective treatments. We report the results of our thoracic outlet syndrome cases, which were treated by conservative care or surgical treatment. Materials & Methods: Twenty five cases, diagnosed as thoracic outlet syndrome since 1999, were reviewed retrospectively. Physical examinations including Adson's and reverse Adson's test, hyperabduction test, costoclavicular maneuver, and Roo's test, plain radiography of shoulder and cervical spine, MRI of neck or brachial plexus, and EMG were checked. If subjective symptoms were not improved after conservative treatments over three months, surgical treatment were performed. Nine patients were performed operative treatment and the others had conservative treatment in outpatient clinic. Postoperative improvement of symptoms and the follow up period, and the results of conservative care were reviewed. Results: Among five physical examinations, mean 1.75 tests were positive, and EMG has little diagnostic value. MRI were performed in twenty cases and compression of brachial plexus were found in 6 cases (30%). Ten patients out of 16 conservative treatment group had excellent improvement of symptoms, and 5 had good results. Eight patients out of 9 operative treatment group had excellent improvement with mean 5.1 months of follow-up period. Conclusion: Diagnosis of thoracic outlet syndrome is difficult due to bizarre and vague symptoms. However if the diagnosis is suspected by careful physical examinations, radiologic studies, or nerve conduction studies, conservative care should be done as initial treatment and at least after three months, reassess the patient's condition. If the results of conservative treatment is not satisfactory and still the thoracic outlet syndrome is suspected, surgical treatment should be considered. Conservative treatment and operative technique are the valuable for the treatment of this disease.

• Journal of Chest Surgery
• /
• 제46권1호
• /
• pp.41-48
• /
• 2013

Background: We present our 12-year experience of pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Materials and Methods: Between January 1999 and March 2011, 16 patients underwent pulmonary thromboendarterectomy. Eleven patients (69%) were classified as functional class III or IV based on the New York Heart Association (NYHA) classification. Seven patients had a history of inferior vena cava filter insertion, and 5 patients showed coagulation disorders. Pulmonary thromboendarterectomy was performed during total circulatory arrest with deep hypothermia in 14 patients. Results: In-hospital mortality and late death occurred in 2 patients (12.5%) and 1 patient (6.3%), respectively. Extracorporeal membrane oxygenation support was required in 4 patients who developed severe hypoxemia after surgery. Thirteen of the 14 survivors have been followed up for 54 months (range, 2 to 141 months). The pulmonary arterial systolic pressure and cardiothoracic ratio on chest radiography was significantly decreased after surgery ($76{\pm}26$ mmHg vs. $41{\pm}17$ mmHg, p=0.001; $55%{\pm}8%$ vs. $48%{\pm}3%$, p=0.003). Tricuspid regurgitation was reduced from $2.1{\pm}1.1$ to $0.7{\pm}0.6$ (p=0.007), and the NYHA functional class was also improved to I or II in 13 patients (81%). These symptomatic and hemodynamic improvements maintained during the late follow-up period. Conclusion: Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension shows good clinical outcomes with acceptable early and long term mortality.

• 한국임상수의학회지
• /
• 제40권2호
• /
• pp.119-123
• /
• 2023

Although various imaging evaluation methods have been developed and utilized, thoracic radiography remains essential and is the top priority for diagnosing and managing cardiac diseases. Thoracic radiographic measurements associated with the vertebral heart scale (VHS) and caudal vena cava (CVC) can objectively diagnose cardiac disease in many animals. In particular, VHS measurement is primarily used to evaluate the dimensions of the heart size on thoracic radiographs and can measure cardiomegaly more objectively. Additionally, the value of the CVC compared with the aorta (Ao) and the length of vertebrae (VL) can be used as valuable parameters in right congestive heart failure. To describe the CVC/Ao and CVC/VL ratios in 10 long-tailed gorals (Naemorhedus caudatus) without subjective radiographic evidence of cardiac diseases. The VHS, CVC, Ao, and VL of gorals were measured in the right lateral (RL) view of the thoracic radiographs. In the RL view of 10 gorals, the VHS was 9.31 ± 0.55 vertebrae (v), the CVC/Ao ratio was 0.84 ± 0.13, and the CVC/VL ratio was 0.67 ± 0.09. Additionally, the thoracic morphology of gorals was determined to be intermediate (thoracic depth-to-width ratio, 1.04 ± 0.09, 0.75-1.25). This study confirmed that VHS was significantly correlated with CVC and Ao, and measuring and comparing each value would help diagnose cardiac diseases in gorals. The radiographic measurements in this study will allow veterinarians to diagnose several cardiac diseases in gorals.