• Tuberculosis and Respiratory Diseases
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• 제49권2호
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• pp.225-230
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• 2000

기관지내 발생하는 신경초종은 매우 드물며 임상 증상과 방사선적 영상으로 진단하기가 어려워 기관지 내시경을 이용한 생검술이 필요하다. 저자들은 임상적으로 진단하기 어렵고 드문 기관지내 신경초종을 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.145-148
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• 2014

Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

• The Korean Journal of Pain
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• 제6권1호
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• pp.83-95
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• 1993

In out-patient clinic, it seems to be common that most back pain arise from muscular origins rather than from skeletal origins. Most physicians have wished to diagnose lower back pain from the radiologic findings only. From clinical experiences and anatomical studies, I have gotten a different opinion from common sense about backaches. If I met a patient who had lower back pain around the posterior superior iliac crest(P.S.I.C.) area, I would had to search a trigger point in the erector spinae muscles at the level of thoraco-lumber junction rather than at the level of the painful site. It is why that sensory innervation over the posterior superior iliac crest area is the posterior primary branch of T12 spinal nerve running down through the erector spinae muscles. Pain on the iliac crest area is supposedly due to hyperirritability of the sensory nerve distributing to this area. Hyperirritability of the posterior primary branch of $T_{12}$ spinal nerve may be due to the spasm of the longissimus thoracis muscle in the erector spinae muscles at the level of the thoraco-lumbar junction. So finally, I would like to insist that spasmolytic treatment on the muscle at the level of the thoraco-lumbar junction would be better for pain relief around P.S.I.C. than treatment at the painful site only.

• The Korean Journal of Pain
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• 제26권1호
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• pp.94-97
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• 2013

Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the $1^{st}$ and $4^{th}$ (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient's pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.

• 대한세포병리학회지
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• 제19권1호
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• pp.57-64
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• 2008

Giant cell tumor of the tendon sheath (GCTTS) is a slowly growing, benign soft tissue tumor. The tumors occur predominantly on the hands and feet. Although the clinical and histopathologic features are well-defined, only a few reports have described the cytologic appearance of this entity. A 26-year-old woman presented with a gradually developing circumscribed soft tissue mass near the proximal phalanx of her left little finger for one year. Imprint and fine needle aspiration (FNA) smears were obtained from the excisional biopsy specimen. The imprint smears were composed of predominantly singly dispersed bland mononuclear cells and several giant cells. The mononuclear cells were polygonal to round, and they showed a histiocyte-like appearance. Osteoclast-type multinucleated giant cells of various sizes were randomly scattered throughout the smears, and these cells contained 3 to 50 nuclei. Nuclear atypia and pleomorphism were absent in both the single and giant cells. Loose aggregates of hemosiderin-laden macrophages and binuclear stromal cells were also seen. The cytologic features of the FNA smears were similar with those of the imprint, Additionally, the FNA smears contained several clumps of densely collagenous stromal tissue that were seldom noted in previously reported cytologic material. The cytologic features were well-correlated with the concurrent histologic findings and the diagnosis of GCTTS was made. When the clinical and radiologic datas are integrated, the diagnosis of GCTTS can be strongly suggested, based on the pre-operative cytologic specimen.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.535-537
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• 2007

Purpose: We experienced a patient with posttraumatic duplication of the sternoclavicular joint causing a protruding deformity, whose major complaint was aesthetic. The patients history, radiologic findings, and surgical treatment are reported. Methods: A 41-year-old bus driver complained a bony prominence at the left medial clavicle, which had developed after a fracture. The patient was annoyed by the protrusion, which was even visible, when he was wearing a pullover. A three dimensional CT scan showed that the medial head was split into two portions, of which the anterior portion was protruding. In general anesthesia the anterior portion of the medial head was excised. Results: The bony prominence was corrected successfully. Follow up three dimensional CT scans showed that the anterior cortex of the clavicle had regenerated completely at the resection line one year after the operation. Conclusion: Surgical interventions for complications after clavicular fracture are usually carried out, only if there is a limitation of function or if it is painful. We report of a patient with posttraumatic bifurcation of the medial clavicular head, most probably caused by malunion. Upon the patient's request, the deformity causing protrusion of the medial clavicular area was successfully resected for cosmetic reasons.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.586-593
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• 2019

Objective : To study risk factors of secondary lumbar discectomy (LD) for recurrent herniated lumbar disc (HLD) and identify methods to lower the rate of recurrence. Methods : Data from 160 patients who underwent primary LD were collected retrospectively. Demographic features, radiologic findings including Pfirrmann disc degeneration, and surgical information were analyzed to compare risks between revision and non-revision patients. Results : The revision rate was 15% (24 patients), and the mean follow-up was 28.3 months. HLD recurrence was not related to any demographic characteristics. Primary and secondary LD were most common at the L4-5 level, but the level of operation was not significantly associated with revision. Primary LD most commonly had a Pfirrmann disc degeneration grade of 3, followed by 4. For recurrent HLD, Pfirrmann grade 4 was most common and was statistically significant (p<0.05). A body mass index (BMI) over 30 was considered obese and was significantly related with HLD revision (p<0.05). Conclusion : Patients with high BMI or severe disc degeneration should be informed of HLD revision.

• 대한두경부종양학회지
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• 제35권1호
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• pp.41-44
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• 2019

Intraductal papilloma is an extremely rare benign tumor especially when it arises from major salivary gland. Recently, we experienced a case of an intraductal papilloma arising from the parotid gland in a 51-year-old woman. The radiologic finding showed lobulated enhancing and cystic solid mass in the left parotid superficial lobe. Superficial parotidectomy was performed. Pathological findings showed papillary proliferations with fibrovascular cores lined with bland cuboidal or columnar epithelial cells, and immunohistochemical stain results were consistent with intraductal papilloma. We report a case of intraductal papilloma in parotid gland with a review of literature.

• Clinical Pain
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• 제19권2호
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• pp.133-137
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• 2020

Bertolotti's syndrome (BS) is a disease that should be differentiated from low back pain (LBP) in young patients. BS shows an anatomical abnormality in which elongated transverse processes of the last lumbar vertebra articulate or fuse with varying degrees to the sacrum or ilium according to radiologic findings, which is associated with the clinical feature of LBP or radiating pain. In this case report, we describe various clinical features such as a waddling gait with severe foot and triceps surae muscle pain, in addition to the typical symptom of BS such as LBP. We report the various clinical symptoms and treatment progress in this case and review the literature.

• 대한영상의학회지
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• 제81권3호
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• pp.714-718
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• 2020

유방에서 발생하는 헤르페스 감염은 매우 드물며 영상 소견 또한 잘 알려져 있지 않다. 본 증례 보고는 사춘기 여성 환자에서 발생한 헤르페스 유선염의 증례로 임상 소견 및 초음파 영상 소견을 기술하였다. B-mode 초음파에서는 일측성의 유륜 피부 두께 증가 및 액와부 림프절 종대의 소견을 보였고 도플러 초음파 상에서는 분지하는 양상의 선형 혈류 증대가 관찰되었다. 유륜 피부 생검을 통하여 헤르페스 감염으로 확진되었다. 헤르페스 유선염의 영상 소견은 국소적인 유두와 유륜 피부 비후와 혈류 증가로 유방의 Paget 병과 유사할 수 있으므로 감별이 필요하다.