• Title/Summary/Keyword: Surgical diagnosis

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A Case of Tuberculous Pericardial Abscess Mimicking Thymic Carcinoma (악성 흉선종으로 오인된 결핵성 심낭농양 1예)

  • Park, Ji-Young;Park, Seung-Ah;An, Young-Hwan;Jang, Gil-Su;Kim, So-Yeon;An, Jeung-Sun;Hong, Eun-Young;Lim, Soo-Young;Kim, Kun-Il;Seo, Jin-Won;Park, Sung-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.347-351
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    • 2011
  • We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.

Surgical Treatment of Esophageal Perforation (식도천공의 외과적 치료)

  • Park Jae Hong;Chei Chang Seck;Kim Dae Hwan;Hwang Sang Won;Yoo Byung Ha;Kim Han Yong
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.214-219
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    • 2006
  • Background: Perforation of esophagus is relatively uncommon. but it is associated with high morbidity and mortality. Treatment and outcome are largely determined by the time of presentation. We performed a retrospective review of patients with esophageal perforation to assess the outcome of current management techniques. Material and Method: A retrospective chart review was performed on all patients treated for perforation of esophagus from March 1990 to March 2005. There were 28 patients (22 men and 6 women: mean age 51 years, range 17 to 82 years) The causes of the perforations were as follows: foreign body retention (9 patients), trauma (7 patients), spontaneous rupture (7 patients), and iatrogenic (5 pati-ients). 18 patients were presented within 24 hours and 10 patients were presented after 24 hours., Esophageal repair was performed in 21 ($75\%$) of them, 4 patients were treated with esophagectomy, 3 patients were treated with feeding gastrostomy and drainage. Result: Hospital mortality was $18\%$ and iatrogenic was increase the mortality rate (p < 0.05). Site of perforation, time from perforation, and treatment method had no influence on mortality. Postoprative leaks occurred in 4 patients after primary repair and were treated conservatively. Conclusion: Esophageal perforation remains a devastating event which is difficult to diagnose and manage. Primary repair can be performed in most patients with esophageal perforation regardless of time to presentation with a low mortality. Accurate diagnosis and early treatment are essential to the successful management of patients.

Bilateral Popliteal Artery Entrapment Syndrome (양측성 슬와동맥 포착증후군)

  • Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.136-139
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    • 2007
  • Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was peformed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type 1, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

An Unusual Cause of Acute Maxillary Sinusitis in a 9-year-old Child: Odontogenic Origin of Infected Dentigerous Cyst with Supernumerary Teeth (9세 남자 환아에서 급성 부비동염의 드문 원인 : 과잉치가 동반된 감염된 함기성 낭종)

  • Yun, Hye-Won;Kwon, Hyuck-Jin;Woo, In-Hee;Yang, Byung-eun;Lee, So-Yeon;Lee, Hae-Ran;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.201-205
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    • 2015
  • Acute maxillary sinusitis is a common disorder affecting children. Untreated acute sinusitis can develop into chronic sinusitis, and complications, such as orbital cellulitis or abscess, can occur. Maxillary sinusitis of odontogenic origin is not a well-recognized condition and is frequently missed in children. As an odontogenic source of sinusitis, the dentigerous cyst is one of the most prevalent types of odontogenic cysts, and it is associated with the crown of an unerupted or developing tooth. This report concerns a nine-year-old boy who was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. The boy visited our pediatric clinic presenting with rhinorrhea and nasal obstruction and was initially diagnosed with maxillary sinusitis only. With antibiotic treatment, his symptoms seemed to improve, but after 2 months, he came to our clinic with left facial swelling with persistent rhinorrhea and nasal obstruction. Radiographic examinations of the sinuses were performed, and he was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. After a surgical procedure involving the removal of the dentigerous cyst with supernumerary teeth, the symptoms of sinusitis gradually diminished. There are only very few cases in the pediatric medical literature that remind us that odontogenic origin can cause maxillary sinusitis in children. Our patient can act as a reminder to general pediatricians to include dentigerous cysts in the differential diagnosis of maxillary sinusitis.

Prevalence and Related Factors of Knee Osteoarthritis in Rural Woman (농촌지역 여성들의 무릎 골관절염 유병률 및 관련요인)

  • Kang, Pock-Soo;Kim, Seok-Beom;Lee, Kyeong-Soo;Yun, Sung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.331-336
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    • 2001
  • Objectives : To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. Methods : Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). Results : The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.03) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). Conclusions : Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.

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The Predictable Factors of the Postoperative Kyphotic Change of Sagittal Alignment of the Cervical Spine after the Laminoplasty

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Kim, Dong Ha;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.577-583
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    • 2017
  • Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

Analysis of the Characteristics and Treatment of Breast Cancer Patients in a Korean Medicine Hospital (일개 한방병원에 내원한 유방암 환자의 특성 및 치료 분석)

  • Kim, Gyu-Tae;Hwang, Young-Sik;Lee, Jin-Wook;Park, Seung-Hyeok;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.4
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    • pp.132-143
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    • 2019
  • Objectives: The purpose of this study is to provide basic information on Korean medical research and treatment through analysis of breast cancer patients, who visited ${\bigcirc}{\bigcirc}$ university Korean medicine hospital. Methods: To analyze characteristics of breast cancer patients who visited korean medicine hospital, we searched medical records from January 1, 2016 to May 13, 2019, and 86 breast cancer patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $47.65{\pm}9.62years$ and 40's was the most (46.51%). The average height was $159.78{\pm}4.91cm$ and the average weight was $57.29{\pm}9.34kg$. The average body mass index (BMI) of the patients was $22.40{\pm}3.50kg/m^2$. 2. The stage distribution record indicated stage0 (9.72%), stageI (31.94%), stageII (34.72%), stageIII (20.83%) and stageIV (2.78%). 14 patients with unknown stage were excluded. 3. Before coming to the korean medicine hospital, of the 86 patients, 72 (83.72%) patients received surgical therapy, 55 (63.95%) patients received chemotherapy and 44 (51.16%) patients received radiotherapy. 11 (12.79%) patients chose oriental medicine as their primary treatment option. 4. The mean duration from diagnosis to hospital visit was $13.87{\pm}15.53months$. Among the total 86 patients, 46 (53.49%) patients visited for symptom relief during the follow-up period. 5. The most common symptom was general weakness in 29 (33.72%) patients, followed by hot flash, myalgia, insomnia, digestion disorder, numbness, edema, arthralgia, operation site pain, cold sensation and mastalgia. 6. Among 86 patients, 55 (63.95%) patients received acupuncture and moxibustion together. The most prescribed herbal medicine to subjects was Sibjeondaebo-tang-gamibang and Cheonhye-dan (25%). Conclusions: These results could be helpful to provide basic data on the Korean medical approach of breast cancer patients.

A Case of Granular Cell Tumor of the Breast in a Male Patient (남성유방에서 과립세포종양의 증례 보고)

  • Lee, Gyoung-Eun;Kim, Ji-Young;Kim, Jae Hyung;Jeong, Myeong Ja;Kim, Soung Hee;Kim, Soo Hyun;Kang, Mi-Jin;Lee, Ji Hae;Bae, Kyung-Eun;Kim, Tae Gyu
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.259-263
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    • 2018
  • A 52-year-old male complained of a painless, firm, and slow-growing mass in his right breast outer portion. The chest CT revealed a 3.3 cm-sized oval shaped, microlobulated, mild enhancing mass. Ultrasound showed a microlobulated marginated heterogeneous hypoechoic mass with internal vascularity and calcifications in the mass. On the ultrasound-guided core needle biopsy, the mass was confirmed as a benign granular cell tumor (GCT). The patient transferred to another hospital and underwent surgical removal of the lesion. GCT of the breast is uncommon and mostly benign neoplasm to originate from Schwann cell. Clinical and radiologic features of GCTs, including CT and ultrasound images, mimic malignancy and make diagnosis of GCT more difficult. The CT images of GCTs are much rarely reported. Physicians and radiologists must be aware of radiologic characteristics of this rare benign tumor for male breast, to avoid misdiagnosis this tumor for breast malignancy and overtreat.

Diagnosis of the growth status and actual condition of the remaining old trees in the village - Focused on Hyeongok-myeon in Gyeongju-si - (마을 내 잔존 노거수의 생육현황 및 실태진단 - 경주시 현곡면을 중심으로 -)

  • Kim, Young-Hun;Deng, Bei-Jia;Chen, Geng;You, Ju-Han
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.23 no.6
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    • pp.109-123
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    • 2020
  • The purpose of this study is to provide basic data for the establishment of future countermeasures by diagnosing the growth status and actual condition of undesignated old trees distributed in Hyeongok-myeon, Gyeongju, Gyeongsangbuk-do. The number of old trees surveyed was 2 weeks in Gajeong-ri, 2 weeks in Haguri, 3 weeks in Nae-Tae-ri, 1 week in Nawon-ri, 6 weeks in Oryu-ri, 3 weeks in Sangguri, and 2 weeks in Sohyeon-ri, The trees species composition was 6 trees Celtis sinensis Pers., 1 Diospyros lotus L. trees, 4 trees Salix chaenomeloides Kimura trees, 2 Styphnolobium japonicum L. trees, and 7 Zelkova serrata (Thunb.) Makino trees. Growth status is 7.1~22.0m in height, 14.6~25.1m in long axis, 10.2~19.2m in short axis, root diameter is 76.0~236.4cm, diamter at breast height is 67.0~220.0cm, soil acidity is pH4.9~7.0, soil The hardness was measured to be 4.0-27.0mm. The result grade of the scoring data of health information is represented by monitoring generally, monitoring critically, and absolute monitoring, and it was confirmed that out of the 20 trees population in Hyeongok-myeon, the general monitoring grade was 7 weeks, the major monitoring grade was 13 weeks, and there was no absolute monitoring grade. Accordingly, the number of old trees of the general surveillance level was maintained at the current level, and ecological surgical operations were introduced for the major surveillance level, but the case of village forests should be different, and sequential treatments were the old tree urgently needed. The level and bark of the target tree, the state of the crown, the root exposure, the presence of pests and pests, the vitality and the ground condition, the degree of pollution are normal, poor, or very poor, operation and protection management, soil improvement, removal of cover, and disinfection were urgently needed for the old trees with the surveyed data. In order to compensate for these matters, continuous monitoring and management measures for the old number should be sought.

Full mouth rehabilitation in osteoporosis patient with loss of teeth and excessive wear (치아 상실과 심한 마모를 보이는 골다공증 환자에서의 완전구강 회복 증례)

  • Kim, Hyun-Tack;Kim, Myung-Joo;Lim, Young-Jun;Kwon, Ho-Beom
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.63-70
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    • 2022
  • Teeth wear with loss of posterior support often leads to symptoms such as irregular occlusal plane and excessive wear of anterior teeth. In such environment, establishing proper posterior support and harmonious anterior guidance and occlusal plane is recommended. In this case, the patient had excessively worn dentition with loss of posterior support, while denying surgical treatment due to her(his) history of osteoporosis, ibandronate injection, and risk of medication-related osteonecrosis of the jaw (MRONJ). To recover the vertical space needed for prosthetic restoration, full mouth rehabilitation with vertical dimension increase of remaining teeth was decided. Missing teeth in the posterior area were restored with mandibular removable partial denture. The treatment plan was determined through careful diagnosis, and every step of procedures including tooth preparation, provisional phase with the increased vertical dimension, and definitive prosthetic phase were carried out accordingly. Once the treatment was completed, the patient was satisfied functionally and esthetically. Periodic examination of oral hygiene, occlusal stability was conducted.