• Title/Summary/Keyword: Surgical diagnosis

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Neuromyelitis Optica Mimicking Intramedullary Tumor

  • Oh, Si-Hyuck;Yoon, Kyeong-Wook;Kim, Young-Jin;Lee, Sang-Koo
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.316-319
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    • 2013
  • Neuromyelitis optica (NMO) is considered to be a rarer autoimmune disease than multiple sclerosis. It is very difficult to make a diagnosis of MNO for doctors who are not familiar with its clinical features and diagnostic criteria. We report a case of a young female patient who had been suffering motor weakness and radiating pain in both upper extremities. Cervical MRI showed tumorous lesion in spinal cord and performed surgery to remove lesion. We could not find a tumor mass in operation field and final diagnosis was NMO. NMO must be included in the differential diagnosis of lesions to rescue the patient from invasive surgical interventions. More specific diagnostic tools may be necessary for early diagnosis and proper treatment.

Ossifying fibroma in the maxilla and orbital floor: report of an uncommon case

  • Macedo, Diogo de Vasconcelos;Ferreira, Gabriely;Vieira, Eduardo Hochuli;Monnazzi, Marcelo Silva
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.3
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    • pp.204-207
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    • 2020
  • Benign fibro-osseous lesions occur when normal bone is replaced by cellular fibrous connective tissue and mineralized structures. One rare type of these lesions is the ossifying fibroma (OF). The aim of this study is to report an unusual case of OF in a 57-year-old female. Physical examination showed facial asymmetry without any tenderness, fluctuation, ocular pain, or ophthalmoplegia. Imaging exams revealed a solid mass involving the left maxilla and orbital floor. Surgical resection was performed without any complications or sequelae, and the histopathological results confirmed OF. Although recurrence is rare in this condition, the patient remains under follow-up.

Gastric Cancer with Peritoneal Tuberculosis: Challenges in Diagnosis and Treatment

  • Alshahrani, Amer Saeed;Lee, In Seob
    • Journal of Gastric Cancer
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    • v.16 no.2
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    • pp.111-114
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    • 2016
  • Herein, we report a 39-year-old female patient presenting with gastric cancer and tuberculous peritonitis. The differential diagnosis between advanced gastric cancer with peritoneal carcinomatosis and early gastric cancer with peritoneal tuberculosis (TB), and the treatment of these two diseases, were challenging in this case. Physicians should have a high index of suspicion for peritoneal TB if the patient has a history of this disease, especially in areas with a high incidence of TB, such as South Korea. An early diagnosis is critical for patient management and prognosis. A surgical approach including tissue biopsy or laparoscopic exploration is recommended to confirm the diagnosis.

Nutcracker syndrome in children: review of symptom, diagnosis, and treatment

  • Diana S. Kalantar;Se Jin Park;Jae Il Shin
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.89-96
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    • 2023
  • Renal nutcracker syndrome (NCS) is the entrapment of the left renal vein between the abdominal aorta and superior mesenteric artery. Although uncommon in pediatric patients, early diagnosis is crucial to avoid potential severe complications, such as anemia or renal vein thrombosis. NCS presents a variety of symptoms, most commonly including "Triade's symptoms"-hematuria, proteinuria, and flank pain. Diagnosis and treatment include invasive and noninvasive management, although due to a lack of pediatric clinical studies, management is widely variable. Conservative diagnosis and treatment are recommended as a first-line option for pediatric patients; however, invasive surgical treatment may be recommended based on symptom severity. This review aims to provide a comprehensive overview of NCS in children to better understand the widely variable incidence, occurrence, and management from early on to allow for early-onset management.

A Study of Ultrasonography in One Congenital Hydrocephalus Case Accompanied with Meningoencephalocele (수막뇌류(髓膜腦瘤)를 수반(隨伴)한 선천성뇌수종(先天性腦水腫) 1례(例)의 초음파소견(超音波所見)에 관한 보험의학적(保險醫學的) 연구(硏究))

  • Han, Hye-Jin;Kim, Kang-Seuck
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.245-252
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    • 1985
  • Ultrasonographic examination in the obstetrics not only makes easy of the diagnosis of Hydrocephalus, placenta previa, anencephalus and ectopic pregnancy, etc, but also guaranteed its excellence in the diagnosis of women gynecology disease. Especially in case that it doesn't affect radiation hazard on the embryo, its efficiency keeps increasing and it is spotlighted to many clinic doctors. Even though in general hospital we often observe congenital hydrocephalus in Med. Dept. which entirly undergoes the medical examination to the insured, we don't observe even the women delivered with child and it is very difficult to find a rare congenital hydrocephlus throughout other present insurance companies. We inspected a congenital hydrocephalus, which other medical equipments of present insurance companies have many difficulties in the medical examination, accompanied by meningoencephalocele by ultrasonic diagnosis. We analyzed and compared the data by ultrasonic diagnosis with that of surgical diagnosis and the results are follows; 1) We could correctly describe meningoencephalocele by ultrasonic diagnosis. 2) It was able to be diagnosed in LMP 22 weeks. 3) BPD has about 10 mm higher than normal value in LMP 22 weeks. 4) Dilatation of lateral ventricle was observed in LMP 22 weeks. 5) As paralled with ultrasonic diagnosis in pregnancy medical examination, accepting declines including the risk rate can be restrained.

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Development of a Conceptual Framework of Nursing from Selected Concepts of Nursing Diagnoses (간호진단 분류체계에 근거한 간호개념틀 개발)

  • 김조자
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.177-193
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    • 1996
  • For the purpose of integrating nursing diagnosis into the nursing curriculum, a descriptive survey research was done using the inductive method with questionnaires and a literature review. Research subjects included nurse educators, textbooks of adult nursing published in Korea, and the course outline for adult nursing used in one college of nursing. The Results show that there was common agreement on 39 nursing diagnosis which should be in cluded in the adult nursing curriculum, textbooks of adult nursing, and patient care on the medical-surgical units. The two existing nursing diagnosis classification systems(NANDA and Gordon's Human Response Patterns) show different basic frameworks and difficulties were discovered in integration of nursing diagnosis into the curriculum. To develop a conceptual framework for a nursing diagnosis classification system, diagnosis were classified into three categories ; health promotion, high risk problem, and actual problem on the basis of the framework used in adult nursing textbooks and Gordon's 11 Functional Health Patterns. Subconcepts for actual problems were classified as ; activity and rest, nutrition and elimination, perception and coordination, stress and coping. Progress in this study supports further development of a conceptual framework of nursing based on a nursing diagnosis classification system, from which improvement in nursing education and clinical practice can be expected.

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Surgical Treatment of Cor Triatriatum (삼방심의 외과적 치료 -수술치험 24례-)

  • Kim, Yeong-Tae;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.259-265
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    • 1994
  • Cor triatriatum is a relatively rare cardiac anomaly, whose major feature is a fenestrated membrane separating an upper common pulmonary venous chamber from a lower true left atrial cavity. Interatrial communications may be present between the right atrium and the common pulmonary venous chamber or the true left atrium. From April 1981 to April 1992, 24 patients with cor triatriatum were treated at Seoul National University Hospital. Ages ranged from 1 month to 24 years with mean of 7.4 years. Twenty patients had interatrial communications through a patent foramen ovale, primum or secundum defect of the atrial septum. Four had no interatrial communications. Fourteen patients had associated anomalies; partial anomalous pulmonary venous connection in 3, total anomalous pulmonary venous connection in 2, persistent left superior vena cava in 3, and other anomalies in 6 patients. Surgical corrections were performed through right atriotomy in 18 patients, left atriotomy in 4, and both atriotomy in 2. Three patients [12.5%] died early after operation; two of them were associated with single ventricle. Six out of 21 survivors [28.6%] experienced complications; recurrent pneumonia, pulmonary embolism, ischemic encephalopathy, diaphragmatic palsy and tachyarrhythmias. At the time of follow up, all survivors, except one, were in functional class I. Surgical correction of cor triatriatum restored normal hemodynamic status with relatively low operative mortality, especially in patients not complicated with severe anomalies. This report summarizes the clinical diagnosis, associated anomalies, interatrial communications, surgical approach and late result of 24 patients underwent surgical corrections in our hospital.

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Analysis According to Characteristics of 18 Cases of Brachial Plexus Tumors : A Review of Surgical Treatment Experience

  • Jung, In-Ho;Yoon, Kyeong-Wook;Kim, Young-Jin;Lee, Sang Koo
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.625-632
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    • 2018
  • Objective : Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Methods : The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed. Results : The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age. Conclusion : For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.

Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3595-3604
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    • 2015
  • Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

Frozen Section -Application in the Surgical Pathology- (동결절편법(Frozen Section) -외과병리 영역에서의 적용에 대하여-)

  • Chai, Won-Hee;Lee, Tae-Sook;Hong, Suk-Jae
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.179-183
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    • 1986
  • The frozen section technique is a means of intraoperative pathological diagnosis, and a procedure of great value to the surgeon. This method should be accurate, rapid and reliable. This method serves useful purposes, such as determining the presence of tumor, its type(especially whether it is benign or malignant), the adequacy of a biopsy of a suspected lesion, and the conditions of the surgical margins. But, it bears many disadvantages, the most of which is the danger of incorrect diagnosis. We studied the indications, the limitations, and the accuracy of the frozen section method and the materials studies was total of frozen section during recent 3 years. The overall accuracy of the frozen section diagnosis of 809 cases was 98.1% with 0.5% of false negative, 0% of false positive, 0.5% of incorrect histological diagnosis or grading errors, and 0.9% of deferred cases. The tissues submitted were lymph node, gastrointestinal tract, skin subcutaneous tissues in decreasing oder of frequency. The false positive case is not present, while the false negative cases were 4.

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