• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.257-264
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• 2022

Background: Chronic subscapularis tendon tear (SBT) is a degenerative disease and a common pathologic cause of shoulder pain. Several potential risk factors for chronic SBT have been reported. Although metabolic abnormalities are common risk factors for degenerative disease, their potential etiological roles in chronic SBT remains unclear. The purpose of this study was to investigate potential risk factors for chronic SBT, with particular attention to metabolic factors. Methods: This study evaluated single shoulders of 939 rural residents. Each subject undertook a questionnaire, physical examinations, blood tests, and simple radiographs and magnetic resonance imaging (MRI) evaluations of bilateral shoulders. Subscapularis tendon integrity was determined by MRI findings based on the thickness of the involved tendons. The association strengths of demographic, physical, social, and radiologic factors, comorbidities, severity of rotator cuff tear (RCT), and serologic parameters for SBT were evaluated using logistic regression analyses. The significance of those analyses was set at p<0.05. Results: The prevalence of SBT was 32.2% (302/939). The prevalence of partial- and full-thickness tears was 23.5% (221/939) and 8.6% (81/939), respectively. The prevalence of isolated SBT was 20.2% (190/939), SBT combined with supraspinatus or infraspinatus tendon tear was 11.9% (112/939). In multivariable logistic regression analysis, dominant side involvement (p<0.001), manual labor (p=0.002), diabetes (p<0.001), metabolic syndrome (p<0.001), retraction degree of Patte tendon (p<0.001), posterosuperior RCT (p=0.010), and biceps tendon injury (p<0.001) were significantly associated with SBT. Conclusions: Metabolic syndrome is a potential risk factor for SBT, as are these factors: overuse activity, diabetes, posterosuperior RCT, increased retraction of posterosuperior rotator cuff tendon, and biceps tendon injury.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.193-196
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• 2019

Background and Objectives: Facial nerve stimulation (FNS) is a complication of cochlear implantation (CI). This study compared the thickness and density of the bone separating the upper basal turn of the cochlea (UBTC) and the labyrinthine segment of the facial nerve (LSFN) on preoperative computed tomography (CT) in patients with and without FNS after CI. Subjects and Methods: Adult patients who underwent CI from January 2011 to February 2017 with preoperative CT at a tertiary referral hospital were considered for this retrospective case-control study. Patients were divided into two groups: with FNS (n=4) and without FNS (n=53). The density and thickness of the bone between the LSFN and UBTC were measured on preoperative CT. Charts were reviewed for other parameters. Results: A statistically significant difference was seen in the thickness (p=0.007) but not in the density (p=0.125) of the bone between the UBTC and LSFN. Four patients had FNS at the mid-range electrode arrays, and one of them additionally had FNS at the basal arrays. Conclusions: Decreased thickness of the bone between the UBTC and LSFN can explain postoperative FNS, confirming the histologic and radiologic findings in previous studies, which indicated that the thickness of the temporal bone between the LSFN and UBTC is less in patients who experience FNS. While the density in this region was also less, it was not statistically significant.

• 대한청각학회지
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• 제23권4호
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• pp.193-196
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• 2019

Background and Objectives: Facial nerve stimulation (FNS) is a complication of cochlear implantation (CI). This study compared the thickness and density of the bone separating the upper basal turn of the cochlea (UBTC) and the labyrinthine segment of the facial nerve (LSFN) on preoperative computed tomography (CT) in patients with and without FNS after CI. Subjects and Methods: Adult patients who underwent CI from January 2011 to February 2017 with preoperative CT at a tertiary referral hospital were considered for this retrospective case-control study. Patients were divided into two groups: with FNS (n=4) and without FNS (n=53). The density and thickness of the bone between the LSFN and UBTC were measured on preoperative CT. Charts were reviewed for other parameters. Results: A statistically significant difference was seen in the thickness (p=0.007) but not in the density (p=0.125) of the bone between the UBTC and LSFN. Four patients had FNS at the mid-range electrode arrays, and one of them additionally had FNS at the basal arrays. Conclusions: Decreased thickness of the bone between the UBTC and LSFN can explain postoperative FNS, confirming the histologic and radiologic findings in previous studies, which indicated that the thickness of the temporal bone between the LSFN and UBTC is less in patients who experience FNS. While the density in this region was also less, it was not statistically significant.

• Journal of Korean Neurosurgical Society
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• 제66권4호
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• pp.426-437
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• 2023

Objective : To investigate the efficacy and safety of the posterior endoscopic cervical foraminotomy (PECF) using ultrasonic osteotome for the treatment of cervical osseous foraminal stenosis, focusing on introduction of the advantages of ultrasonic osteotome in partial pediculectomy and ventral osteophyte resection in PECF. Methods : Nineteen patients with cervical osseous foraminal stenosis who underwent PECF using ultrasonic osteotome in our institution between April 2018 and April 2021 were enrolled in this study. All the patients were followed up more than 12 months. The patients' medical data, as well as pre- and postoperative radiologic findings were thoroughly investigated. The visual analogue score (VAS), Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (Neck disability index, NDI), and modified MacNab criteria were used to assess the surgical efficacy. Results : All the patients were successfully treated with PECF using ultrasonic osteotome. The pre- and postoperative VAS, NDI, and JOA scores were significantly improved (p<0.05). According to the modified MacNab criteria, 17 patients were assessed as "excellent", two patients were assessed as "good" at the last follow-up. There was no dura tear, nerve root damage, incision infection, neck deformity, or other complications. Conclusion : Adequate nerve root decompression can be accomplished successfully with the help of ultrasonic osteotome in PECF, which has the advantage of reducing the probability of damage to the nerve root and dura mater, in addition to the original merits of endoscopic surgery.

• 대한영상의학회지
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• 제83권3호
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• pp.744-749
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• 2022

섬유성 종격동염은 종격동 내 고밀도 섬유 조직의 증식을 특징으로 하는 드문 양성 질환이다. 섬유성 종격동염은 일반적으로 중간 종격동 또는 폐문 부위의 국소적 또는 침윤성 연조직 종괴로 나타나며, 이는 혈관이나 기도와 같은 인접한 종격동 구조를 둘러싸거나 압박할 수 있다. 본 증례 보고에서 우리는 좌하엽 기관지의 폐색을 유발하는 종격동 종괴의 양상으로 나타난 13세 소녀의 섬유성 종격동염의 드문 증례를 보고하고자 한다. 환자는 전신 코르티코스테로이드 치료 후 증상과 추적관찰 흉부 CT 소견에서 호전되었다. 섬유성 종격동염은 전신 스테로이드 요법으로 호전될 수 있으므로 영상의학과 의사는 종격동의 침윤성 연조직 병변을 감별 진단할 때 섬유성 종격동염의 영상의학적 소견을 알고 있어야 한다.

• 대한영상의학회지
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• 제82권4호
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• pp.953-958
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• 2021

고소 뇌부종은 높은 지대를 여행하는 사람들에게서 발병하는, 잠재적 치명성을 갖는 신경학적 증후군이다. 본 증례는 높은 지대를 여행한 후 수 시간의 의식불명이 있었던 49세 남자에서 나타난 고소 뇌부종의 비전형적 영상 소견에 대한 보고이다. 환자의 자기공명영상 자기화율강조영상에서 미세한 점상의 다수의 미세출혈이 양쪽 뇌량을 따라 분포하고 있었고 몇 개의 미세출혈이 전두엽과 두정엽의 피질하 백질에서 관찰되었으나 T2 강조영상에서는 이에 상응하는 부위에 신호강도의 증가가 관찰되지 않았다. 확산강조영상에서는 양쪽 기저핵에서 작은 결절형의 고신호강도가 관찰되었다. 본 증례는 T2 강조영상에서 비정상적인 신호강도 없이 양쪽 뇌량에서 다수의 미세출혈을 보였던, 비전형적인 사례로서의 고소 뇌부종의 증례에 대해 문헌 고찰과 함께 보고하고자 한다.

• 대한영상의학회지
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• 제82권4호
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• pp.971-976
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• 2021

유방 엽상종양은 전체 유방 종양의 1% 미만을 차지하는 드문 섬유상피종양이다. 엽상종양은 유관주위 버팀질 세포에서 기원하여 상피 성분과 버팀질 성분을 모두 포함하는 특징을 가지며, 조직학적으로 양성, 경계성, 악성으로 구분된다. 엽상종양의 상피 성분에서 암이 발생하는 것은 매우 드물기 때문에 이에 대한 영상의학적 소견은 명확히 정립된 바가 없다. 이에 저자들은 21세 젊은 여성에서 경계성 엽상종양 내에서 생긴 침윤성 유관암을 경험하였기에 자기공명영상을 포함한 영상의학적 소견과 조직병리학적 소견을 보고하고자 한다.

• 대한영상의학회지
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• 제81권5호
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• pp.1121-1133
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• 2020

염증성 가성 종양은 주로 폐와 안와에서 드물게 발생하는 종괴 형성 병변이다. 복부 및 골반에서의 염증성 가성 종양의 발생은 매우 드물지만, 이는 조영증강되는 연부조직 병변으로 나타날 수 있으며 악성 종양 혹은 섬유경화질환과 혼동될 수 있다. 대개 이는 여러 장기에서 다양한 불특정 영상 소견을 보인다. 적절한 임상 정보와 함께 술전 염증성 가성 종양의 진단이 이루어지는 것은 알맞은 환자 처치를 도울 수 있다. 현 임상화보에서는 간, 비장, 신장, 위장관, 장간막, 골반, 후복강에서 발생한 복부골반강의 염증성 가성 종양의 영상의학적 소견을 정리한다.

• Korean Journal of Radiology
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• 제25권5호
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• pp.473-480
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• 2024

We systematically reviewed radiological abnormalities in patients with prolonged SARS-CoV-2 infection, defined as persistently positive polymerase chain reaction (PCR) results for SARS-CoV-2 for > 21 days, with either persistent or relapsed symptoms. We extracted data from 24 patients (median age, 54.5 [interquartile range, 44-64 years]) reported in the literature and analyzed their representative CT images based on the timing of the CT scan relative to the initial PCR positivity. Our analysis focused on the patterns and distribution of CT findings, severity scores of lung involvement on a scale of 0-4, and the presence of migration. All patients were immunocompromised, including 62.5% (15/24) with underlying lymphoma and 83.3% (20/24) who had received anti-CD20 therapy within one year. Median duration of infection was 90 days. Most patients exhibited typical CT appearance of coronavirus disease 19 (COVID-19), including ground-glass opacities with or without consolidation, throughout the follow-up period. Notably, CT severity scores were significantly lower during ≤ 21 days than during > 21 days (P < 0.001). Migration was observed on CT in 22.7% (5/22) of patients at ≤ 21 days and in 68.2% (15/22) to 87.5% (14/16) of patients at > 21 days, with rare instances of parenchymal bands in previously affected areas. Prolonged SARS-CoV-2 infection usually presents as migrating typical COVID-19 pneumonia in immunocompromised patients, especially those with impaired B-cell immunity.

• 대한영상의학회지
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• 제84권6호
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• pp.1384-1390
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• 2023

심장과 대혈관 기원의 원발성 종괴는 매우 드물다. 그중에서도 악성 말초신경초종은 더 드물게 보고되었다. 76세 남성에서 발견된 흉수의 원인 평가를 위해 시행한 조영증강 컴퓨터단층촬영에서 우폐정맥과 좌심방을 침범하는 저음영의 종괴가 발견되었고 초음파상 우폐정맥에서 기인한 종괴로 의심되었다. 종괴는 수술적 절제를 통해 폐정맥 기원의 악성 말초신경초종으로 최종 진단되었다. 저자들은 국내에서 보고된 바가 없는 드문 증례인 폐정맥 기원의 원발성 악성 말초신경초종을 보고하고, 종괴가 폐정맥 기원임을 시사하는 영상의학적 소견에 대해 고찰하고자 한다.