• Title/Summary/Keyword: Radiologic factors

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Intracranial Hemangiopericytomas : A Retrospective Study of 15 Patients with a Special Review of Recurrence

  • Noh, Sung Hyun;Lim, Jae Joon;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.211-216
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    • 2015
  • Objectives : Although surgical resection is used to treat meningeal hemangiopericytoma (MHPC), there is a high risk of subsequent recurrence. This study investigated factors associated with treatment outcomes and recurrence in patients who had undergone surgical resection of intracranial MHPC. Methods : Fifteen patients underwent surgical treatments performed by one senior neurosurgeon between 1997 and 2013. Clinical data, radiologic images, surgical outcomes, recurrence, and other relevant characteristics were reviewed and analyzed. Results : Fifteen patients were included in the analysis, 12 (80%) of whom had tumors in the supratentorial region, and 3 (20%) of whom had tumors in the infratentorial region. Complete resection was achieved in all 15 patients, and 3 (20%) patients were administered radiosurgery and conventional radiotherapy after surgery as adjuvant radiotherapy. Three patients developed recurrence, 2 of whom had not received adjuvant radiotherapy. In 1 of the patients who had not received adjuvant radiotherapy, recurrence developed at the original tumor site, 81 months after surgery. The other 2 recurrences occurred at other sites, 78 and 41 months after surgery. The 5- and 10-year overall survival rates were 88.3%, while the 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively. Additionally the mean Ki-67 index differed significantly between patients who did and did not develop recurrence (43% vs. 14%; p=0.001). Conclusion : Because of the high risk of MHPC recurrence, MHPC tumors should be completely resected, whenever feasible. However, even when complete resection is achieved, adjuvant radiotherapy might be necessary to prevent recurrence.

The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children

  • Lee, Eun;Lee, So-Yeon;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.63 no.7
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    • pp.251-258
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    • 2020
  • Exposure to environmental factors can cause interstitial lung diseases (ILDs); however, such types of ILDs are rare. From 2007 to 2011, an ILD epidemic occurred in South Korea owing to inhalational exposure to toxic chemicals in humidifier disinfectants (HDs). HD-associated ILDs (HD-ILDs) are characterized by rapidly progressing respiratory failure with pulmonary fibrosis and a high mortality rate of 43.8%-58.0%. Although 18.1%-31.1% of the general population used HDs, only a small proportion of HD users were diagnosed with HD-ILDs. This finding suggests that investigation of the pathophysiologies underlying HD-ILDs is needed in addition to the identification of susceptibility to HD-ILDs. Further, there have been several concerns regarding the diverse health effects of exposure to toxic chemicals in HDs, including those that have not been identified, and long-term prognoses in terms of pulmonary function and residual pulmonary lesions observed on follow-up chest images. In this review, we summarize the clinical features, pathologic findings, and changes in radiologic findings over time in patients with HD-ILDs and the results of previous experimental research on the mechanisms underlying the effects of toxic chemicals in HDs. Studies are currently underway to identify the pathophysiologies of HD-ILDs and possible health effects of exposure to HDs along with the development of targeted therapeutic strategies. The experience of identification of HD-ILDs has encouraged stricter control of safe chemicals in everyday life.

Leukoencephalopathy and Disseminated Necrotizing Leukoencephalopathy Following Intrathecal Methotrexate Chemotherapy and Radiation Therapy for Central Nerve System Lymphoma or Leukemia

  • Kim, Ji-Yeon;Kim, Sung-Tae;Nam, Do-Hyun;Lee, Jung-Il;Park, Kwan;Kong, Doo-Sik
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.304-310
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    • 2011
  • Objective : Intrathecal methotrexate (MTX) therapy combined with whole brain radiotherapy (WBRT) is one of the major treatment modalities for leukemia and lymphoma involving the central nervous system (CNS). The purpose of this study was to retrospectively determine the incidences of leukoencephalopathy and disseminated necrotizing leukoencephalopathy (DNL) following intrathecal MTX therapy for CNS lymphoma or leukemia and to assess the potential risk factors. Methods : Between January 2000 and August 2009, 143 patients with CNS lymphoma or leukemia received intrathecal MTX therapy alone or in combination with WBRT at a single institution. Patients were followed up clinically and radiologically at regular two- or three-month intervals. Medical records were reviewed to obtain information regarding the patients' demographics, medical histories, radiologic characteristics, treatments, and clinical courses. Results : On follow-up MR images, leukoencephalopathy was found in 95 of 143 patients (66.4%). The median time to develop leukoencephalopathy was 6.6 months. Among those with leukoencephalopathy, four patients showed seven extensive white-matter changes with strongly enhancing lesions demonstrating DNL. Histological confirmation was done in six lesions of three patients and radiological diagnosis alone in one patient. Four lesions spontaneously disappeared on MR images without any treatment, with a mean duration of 14 months before disappearance of DNL. Conclusion : Leukoencephalopathy is a common phenomenon that occurs following intrathecal MTX therapy; however, DNL occurs at a very low incidence. For newly developed enhancing lesions, consideration for the occurrence of DNL should be taken to avoid unnecessary invasive procedures or therapies.

Predictors of Relapse in Patients with Organizing Pneumonia

  • Kim, Minjung;Cha, Seung-Ick;Seo, Hyewon;Shin, Kyung-Min;Lim, Jae-Kwang;Kim, Hyera;Yoo, Seung-Soo;Lee, Jaehee;Lee, Shin-Yup;Kim, Chang-Ho;Park, Jae-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.190-195
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    • 2015
  • Background: Although organizing pneumonia (OP) responds well to corticosteroid therapy, relapse is common during dose reduction or follow-up. Predictors of relapse in OP patients remain to be established. The aim of the present study was to identify factors related to relapse in OP patients. Methods: This study was retrospectively performed in a tertiary referral center. Of 66 OP patients who were improved with or without treatment, 20 (30%) experienced relapse. The clinical and radiologic parameters in the relapse patient group (n=20) were compared to that in the non-relapse group (n=46). Results: Multivariate analysis demonstrated that percent predicted forced vital capacity (FVC), $PaO_2/FiO_2$, and serum protein level were significant predictors of relapse in OP patients (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.70-0.97; p=0.018; OR, 1.02; 95% CI, 1.00-1.04; p=0.042; and OR, 0.06; 95% CI, 0.01-0.87; p=0.039, respectively). Conclusion: This study shows that FVC, $PaO_2/FiO_2$ and serum protein level at presentation can significantly predict relapse in OP patients.

THE PROPERTIES OF ANTIBIOTIC AND NSAIDS ADMINISTRATION BEFORE EXTRACT OF THE IMPACTED MANDIBULAR THIRD MOLAR. (매복된 하악 제 3대구치 발거시 항생제 및 진통제 투여의 효용성)

  • Kil, Yong-Kab;Kang, Hee-In;Kim, Kyoung-Soo;Kim, Jae-Seong;Kwak, Myung-Ho;Seo, Hyun-Soo;Hong, Soon-Min;Park, Jun-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.505-509
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    • 2009
  • Purpose: To evaluate the properties of antibiotic and NSAIDs administration before extract of the impacted mandibular third molar. Materials & Methods: No patient showed any sign of pain, inflammation, or swelling at the time of removal. A group of 50 patients was classified in Group 1(preemptive and oral medication was carried out for 3 days postoperatively, N=23) and Group 2(oral medication was carried out for 3 days postoperatively, N=27) subgroups. Clinical and radiologic factors were recorded for each case, and the rationale for assigning the patients to the groups was strictly random. The surgical technique was the same in all cases, and the follow-up period was 1 week. Parameters that were evaluated were infection, swelling, pain and differences in mouth opening. Results: We could not find any significant difference between the 2 groups regarding the evaluated parameters. Conclusion: The results of our study show that antibiotic and NSAIDs administration before the removal of lower third molars does not contribute to a decrease infection, swelling, pain or increase mouth opening. Therefore antibiotic and NSAIDs administration before the removal of lower third molars is not recommended for routine use.

Biliary Atresia with Extrahepatic Biliary Cyst (간 외 담관 낭성확장이 동반된 선천성 담도폐쇄증)

  • Chung, Jae-Hee;Lee, Han-Hong;Cha, Seon-Wook;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.136-141
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    • 2004
  • Biliary atresia (BA) with extrahepatic biliary cysts (EHBC) is a rare disease. It has been generally recognized as type I (correctable with cystic dilatation), which means a good prognosis. From a total of 73 patients with BA who underwent operation from September 1988 to September 2003 at our institute, 7 (9.6 %) cases of type III BA with EHBC (uncorrectable with cystic dilatation) are reviewed. Clinical findings, laboratory data, radiologic findings, treatment methods and outcomes were reviewed. Female was more prevalent (male to female ratio; 2:5). All cases were type III with EHBC according to the intraoperative cholangiography, and underwent Kasai' s portoenterostomy. The mean age was 57 days at operation. Three patients(42.9 %) are long term survivors. Further evaluation is needed to determine the correlation between prognostic factors and outcome for.

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A Clinical Study of Surgically Treated 194 Cases of the Thyroid Cancer (외과적 절제술로 치험한 갑상선암 194예의 임상적 고찰)

  • Lee Suk-Jae;Kim Sung-Bae;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.50-55
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    • 2002
  • Objectives: Thyroid cancer is the most common endocrine malignancy with favorable histologic and prognostic characteristics. Total or near total thyroidectomy has been used as a standard surgical procedure. The aims of this study are to determine the extent of resection of thyroid gland and to find the influencing factors of lymph node metastasis. Materials and Methods: The authors reviewed the records of 194 patients of thyroid cancer surgically treated at Department of General Surgery, Inje University Busan Paik Hospital from January, 1996 to December, 2000. Pathologic classifications, surgical procedures, and lymph node metastasis were analyzed. Results: There were 163 women and 31 men. The age ranged from 12 to 79 years old (mean age 43.2 years). The histological classifications of 194 cases revealed papillary cancer in 171 cases (88.1%), follicular cancer in 17 cases (8.8%), undifferentiated cancer in 3 cases (1.6%), medullary cancer in 2 cases (1.0%) and mixed cancer in 1 case (0.5%). Among the 194 patients, lobectomy was perfomed in 31 patients, subtotal thyroidectomy in 30 patients, near total thyroidectomy in 82 patients and total thyroidectomy in 51 patients. In the subgroup of papillary carcinoma 141 cases with lymph node dissection, lymph node metastasis had no statistical significance according to sex, age and primary tumor size. Conclusions: The mainly performed surgical procedures were total thyroidectomy and near total thyroidectomy. In thyroid cancer surgery, the extent of resection was influenced by age, differentiation and primary tumor size. The lymph node dissection should be decided by lymph node metastasis identified by preoperative radiologic evaluation or intraoperative lymph node findings.

Significances of Minimal Extrathyroidal Invasion in Papillary Thyroid Carcinoma (유두상 갑상선암에서 최소 갑상선외 침범의 의의)

  • Lee, Byoung-Kil;Lee, Min-Joo;Youn, Hyun-Jo;Jung, Sung-Hoo
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.8-11
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    • 2009
  • Background and Objectives : In the TNM 6th classification system, extrathyroidal invasion of differentiated thyroid carcinoma has been classified into T3(minimal invasion), T4a(extended invasion), and T4b(more extensive unresectable invasion) according to the degree and it has been recognized as an important prognostic factor. In this study, we investigated the prognostic significances of minimal extrathyroidal invasion in papillary thyroid carcinoma(PTC). Material and Methods : We retrospectively studied 221 patients who are underwent thyroidectomy due to PTC from September 2003 to December 2006. Fifty-four(24.4%) patients had a PTC with minimal extrathyroidal invasion(Group A) and 167(75.6%) patients had a PTC without extrathyroidal invasion(Group B). The existence of minimal extrathyroidal invasion was based on operative and pathological findings. Results : Minimal extrathyroidal invasion in PTC was related to tumor size, lymph node metastasis, and operative method(p<0.001). But, there is no significant difference in age, gender, and multifocality between Group A and B. Hashimoto's thyroiditis was observed more frequently in Group B(p=0.019). Conclusion : These findings suggest that minimal extrathyroidal invasion is related to poor prognostic factors in PTC. Therefore, aggressive surgical approach is required when there is evidence of minimal extrathyroidal invasion in preoperative radiologic examination or operative finding.

Fabrication of $CaSO_4:Eu$ TLD and Its Physical Characteristics ($CaSO_4:Eu$ TLD의 제작과 물리적 특성)

  • Kim, Do-Sung;Park, Myeong-Hwan
    • Journal of Sensor Science and Technology
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    • v.8 no.5
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    • pp.388-393
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    • 1999
  • In this study, the $CaSO_4:Eu$ TLDs are fabricated and their trap parameters are determined. The optimum concentration of Eu for fabrication of the $CaSO_4:Eu$ TLD is 0.5 mol% and optimum temperature is $600^{\circ}C$ for 2 hours sintering in air. The glow curve of $CaSO_4:Eu$ consists of two glow peaks and these peaks are isolated by thermal bleaching method. Trap parameters of two glow peaks are measured using the initial rise, the peak shape, the heating rate and the least square curve fitting methods. The activation energies of the glow peak I and II are 1.00 eV and 1.09 eV, and the frequency factors are $7.04{\times}10^{11}\;s^{-1}$ and $5.12{\times}10^{11}\;s^{-1}$ and the kinetic orders are 1.11 and 1.33, respectively.

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High-Pressure Finger Injection Injury Caused by Paint Thinner: Case Report (페인트 신나에 의한 수지 고압 손상의 경험)

  • Song, Jin Woo;Choi, Hwan Jun;Kim, Mi Sun
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.269-273
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    • 2007
  • Purpose: High-pressure injection(HPI) injury is an injury caused by accidental injection of substances by industrial equipment. HPI injury of the hand is a serious injury that can be potentially devastating. There have been a number of publications on the results of its treatment and its functional outcome of these hands. Unfortunately, the clinical outcomes were unsatisfactory following an initial treatment approach of digital expression of the injection material, elevation, soaks, dressing changes, and antibiotics. Methods: A 43-year-old right handed man sustained a high pressure injection injury to the tip of the left index finger. The injected material was industrial paint thinner. Tissue necrosis was noted at the pulp of the finger. Several debridements and irrigation were required. A pedicled chest flap transfer was performed on the eighteenth day after injury as the dorsal nail complex remained viable. This is a retrospective review of our experience with high-pressure finger injection injury caused by paint. A literature review, retrospective chart and radiologic review were presented. Results: Follow-up length was about 1 year. The injuried hand was left nondominant hand, the index. Patient complaints were cold intolerance, paresthesia, contact pain, and impairment of activities of daily living. Conclusion: The outcome of high-pressure injection injuries of the hand is affected by many factors. The time between injury and operative treatment has been regarded as a key determinant by a number of authors. The nature of the injected material is probably more important. It has been noted by many authors that injuries with paints have a worse outcome than those with oil or grease. This study confirms the fact that high-pressure injection injury caused by paint thinner to the hand is a significant problem. Virtually a patient suffers sequelae of this injury. The injury has significant repercussions for future function and reintegration into the work force.