• 제목/요약/키워드: Ultrasound head

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혈관기원종양으로 오인된 귓바퀴의 색소 모기질종: 증례 보고 (Pigmented Pilomatricoma on the Ear Resembling Vascular Tumor before Surgery: A Case Report)

  • 임석범;고인창;김훈;권건영;임수연
    • 대한두경부종양학회지
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    • 제39권2호
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    • pp.31-34
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    • 2023
  • Pilomatricoma is characterized by a semi-transparent epidermis, especially pigmented pilomatricoma, containing melanocytes in basaloid cells, which are dark and purple, resembling vessel-derived skin masses. If the vascularity at doppler ultrasound is high before surgery, it may be misdiagnosed. A 10-year-old female patient visited our clinic because of a mass in the right ear triangular fossa. Ultrasonography was performed, and a vascular-origin tumor was suspected because of the high vascularity. The excised mass was diagnosed as pigmented pilomatricoma by a pathologist. Pilomatricoma is mistaken for other masses owing to its various phenotypes. A misdiagnosis can lead to misdirected strategies which can cause delayed treatment and can result in an increase in the size of the pilomatricoma, making the sequalae of surgery more complicated. For proper treatment, careful examination and evaluation are required before surgery.

삼킴 장애 환자에서 보튤리눔 독소의 임상적 적용 (Clinical Applications of Botulinum Toxin in Patients with Dysphagia)

  • 조정해
    • 대한후두음성언어의학회지
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    • 제30권2호
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    • pp.77-81
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    • 2019
  • Dysphagia may result from dysfunction of any of the components involved in the complex neuromuscular interaction of swallowing. Hyperfunction of any of the muscles involved in swallowing is a frequent cause of dysphagia. The cricopharyngeus muscle (CPM) is a key component of the upper esophageal sphincter. Cricopharyngeus muscle dysfunction (CPD) refers to the muscle's failure to appropriately and completely relax or expand during deglutition. A variety of disease processes may cause CPD and accurate diagnosis is paramount for appropriate treatment. In appropriately selected patients, intervention at the CPM may yield significant improvement in dysphagia. Interventions include nonsurgical, pharyngoesophageal segment dilatation, botulinum toxin (BoNT) injection, and criccopharyngeal myotomy. Injections of BoNT in patients with CPD have been reported to result in marked relief of dysphagia. Different techniques for instilling BoNT into the CPM have been described. Awake, in-office CPM BoNT injection with electromyography and/or fluoroscopic or ultrasound guidance is performed transcervically or via flexible endoscopy. Operative CPM BoNT injection involves rigid laryngoscopy and esophagoscopy with direct visualization of the CPM. BoNT should be prepared in low-volume, high-concentration dilutions to minimize the potential for undesired diffusion of the toxin. The effects of BoNT occur within weeks of injection and typically last up to 5 or 6 months.

Imaging Characteristics of Perosomus elumbis in a Puppy

  • Choi, Sooyoung;Lee, Byungho;Lee, Byungdon;Seo, Jiwon;Park, Hyunyoung;Kwon, Kyunghun;Lee, Youngwon;Choi, Hojung
    • 한국수정란이식학회지
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    • 제30권4호
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    • pp.341-344
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    • 2015
  • A 4-day-old, male Poodle dog was presented with dull, depressed and exhausted activity after the birth. On physical examination, the puppy showed arthrogryposis, muscular atrophy and no movement of hindlimbs. Palpation on dorsum revealed an absence of lumbar and sacral vertebrae. On prenatal and postnatal radiography, lumbar vertebrae, sacrum and coccygeal vertebrae were not visualized. On ultrasonography, bilateral kidney and urinary bladder were observed. On computed tomography, there were no apparent abnormalities in the forelimbs, cervical vertebrae or head, while lumbar vertebrae, sacrum and coccygeal vertebrae were not observed. At necropsy examination, the liver, stomach, intestine, kidney and urinary bladder were normal. This congenital anomaly was consistent with Perosomus elumbis. Perosomus elumbis in dogs is a rare condition of unknown etiology. In this report, Perosomus elumbis was evaluated with radiography, ultrasound and computed tomography.

근막이완술이 경추성 두통환자의 뇌혈류와 통증수준에 미치는 영향 (The Effects of Myofascial Relaxation on Blood Flow Velocity of the Cranial Artery and Pain Level in Cervicogenic Headache Patients)

  • 이준희;강다행;강정일
    • The Journal of Korean Physical Therapy
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    • 제22권5호
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    • pp.49-56
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    • 2010
  • Purpose: The aim of this study was to evaluate a possible role for cranial artery velocity in cervicogenic headache. Methods: We studied 13 patients with cervicogenic headaches (M=9, F=4, age=$24.50{\pm}3.50\;y$) these were compared to 20 normal subjects (M=10, F=10, age=$23.30{\pm}2.90\;y$). Cervicogenic headache patients were divided into two groups (a myofascial relaxation group, a placebo group). Pain levels were measured using a visual analog scale (VAS). Transcranial Doppler (TCD) ultrasound recordings were used to measure blood flow velocity in the cranial artery. Results: Cervicogenic headache patients exhibited a significantly lower blood flow velocity in the middle cerebral artery. The patients who received an intervention had a significantly higher blood flow velocity in the left middle cerebral artery, right vertebral artery and basilar artery. Compared to the placebo group, the myofascial relaxation group exhibited a significantly decreased level of pain. Conclusion: Cervicogenic headache is pain referred to the head from a source in the cervical spine. Manual therapy affect to cervical spine and soft tissue as well as the passage of these vessels and nerves to recover because it is thought to be able to help.

표피 종양처럼 보이는 투명 세포 열선 종의 초음파 및 변형 탄성 소견: 증례 보고 (Sonographic and Strain Elastographic Findings of a Clear Cell Hidradenoma that Looked Like an Epidermoid Tumor: A Case Report)

  • 김진희;박희진;김지나
    • 대한영상의학회지
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    • 제83권1호
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    • pp.194-198
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    • 2022
  • 투명 세포 열선 종(clear cell hidradenoma; 이하 CCH)은 외분비 또는 아포크린 분화 땀샘의 드문 종양이다. 신체의 어느 곳에서나 발생할 수 있지만 일반적으로 머리, 얼굴, 몸통과 사지에서 발생한다. 여러 보고에서 CCH의 초음파 소견에 대해 언급하였지만 변형 탄성 초음파(strain elastography; 이하 SE) 소견에 대한 연구는 겨드랑이의 병변에 대해 보고한 한 경우밖에 없다. 우리는 표피 종양(epidermoid tumor)처럼 보였던 종아리에서 발생한 CCH의 사례를 초음파 소견과 SE 소견을 함께 보고하는 바이다.

액와부에서 발생한 경화성 섬유종: 영상 소견을 포함한 증례 보고 (Sclerotic Fibroma Presenting as an Axillary Mass: A Case Report with Imaging Features)

  • 김태은;이지영
    • 대한영상의학회지
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    • 제82권4호
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    • pp.977-981
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    • 2021
  • 경화성 섬유종 또는 나선형 교원종은 주로 머리, 목 또는 사지의 피부층에서 발생하는 드문 양성 종양이다. 드물게 이 종양은 피하층과 같이 진피층이 아닌 곳에서 발생하기도 한다. 이 종양이 액와부에서 발생한 증례는 보고되지 않았을 뿐만 아니라, 영상 소견을 서술한 논문 역시 보고되지 않았다. 저자들은 초음파와 전산화단층촬영의 소견과 함께 경화성 섬유종이 액와부의 깊은 피하층에서 발생한 증례를 보고하고자 한다.

강아지에서 컨벡스스캐너를 이용한 정상적인 심장구조물의 초음파상 (Ultrasound Imaging of Normal Cardiac Structures with Convex Scanner in Puppies)

  • 정순욱;박희명;한숙희;윤정희;한홍율
    • 한국임상수의학회지
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    • 제11권2호
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    • pp.529-537
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    • 1994
  • Sector scanner which has a conical end is used to image through the intercostal space because heart is protected by the ribs. Cardiac data published all around the world were also obtained by sector scanner. Although scanners being used in every small animal practice and animal hospital at college in Korea include convex ape and linear type, linear type is not appropriate f3r cardiac scan because of a wide contact surface. The purpose of this study is to establish ultrasonographic images of normal cardiac structures by measuring shape, size of reflectable cardiac structure according to restraint position in scanning normal heart of the puppies with 6.5 MHz convex scanner(SonoAce 4500, Medison, Korea) used in our veterinary teaching hospital, Seoul national university. Seventeen male and female puppies considered having healthy hear by X-ray and clinical examination are used feom April to July 1994. Scanning point selection of probe head and the distinction of imaged cardiac structures were accomplished by necropsy and cardiac scanning performed through thoracotomy under general anesthesia. At 10 o'clock position of transducer(at an angle of 30$^{\circ}$ between imaginary line from elbow joint to 3rd sternum and probe head, 60$^{\circ}$ from body surface, 4th intercostal space of right thorax) with the marker of scanner toward the head of dogs right atrium, left atrium and left ventricle were observed in 2, 3, 4, 5 intercostal space(2cm from the sternum) of experimental dog positioned ventrodorsally under general anesthesia. Under these conditions, the numerical values of imaged diastolic hear are as follows : the distance from skin to apex(mean$\pm$S.D) 47.53$\pm$6.94mm, thickness of left ventricular wall 6.00$\pm$1.60mm, length of left ventricle 16.27$\pm$5.31mm, width of left ventricle 15,33$\pm$4.25mm, length of left atrium 12.33$\pm$3.82mm, width of left atrium 11. 33$\pm$3.94mm, length of right atrium 1.00$\pm$2.41mm, width of right atrium 11.21$\pm$2.76mm and the area of left ventricle 270.92$\pm$109.81mm$^2$, area of left atrium 98.00$\pm$41.08mm$^2$, area of right atrium 62.75$\pm$21.04mm$^2$.

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봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과 (Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft)

  • 고상훈;박기봉;박길영;권순환;김명서;박선재
    • 대한정형외과학회지
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    • 제55권2호
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    • pp.135-142
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    • 2020
  • 목적: 본 연구에서는 봉합 불가능한 광범위 회전근 개 파열에 있어서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 임상적 유용성 및 장기 추시 결과를 발표하고자 한다. 대상 및 방법: 봉합 불가능한 광범위 회전근 개 파열 환자 중 상완 이두근 건 장두에 50% 미만의 파열이 있는 41명의 환자를 대상으로 상완 이두근 건 장두를 이용하여 관절경하 부분 봉합술을 시행받은 1군과 파열되지 않은 상완 이두근 건 장두가 있으나 자가 이식건을 이용하지 않고 관절경하 부분 봉합술만을 시행한 2군으로 나누었다. 임상 점수는 시각통증점수(visual analogue pain scale, VAS), 운동범위(range of motion, ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES) 및 Korean Shoulder Scoring System (KSS) 점수로 측정하였으며 최종 추시에 측정된 점수가 사용되었다. 수술 전과 최종 추시에 촬영한 단순 방사선 사진을 이용하여 견봉상완거리(acromiohumeral interval, AHI)를 측정하였고 최종 추시에 시행한 초음파 또는 자기공명영상 검사를 이용하여 재파열 여부를 평가하였다. 결과: 환자의 평균 연령은 62.1±12.7세였으며, 평균 추시 기간은 90.3±16.8개월이었다. 1군과 2군 간에 VAS와 ROM (전방 거상, 외회전, 내회전)의 유의한 차이는 없었다(p=0.179, p=0.129, p=0.098, p=0.155). UCLA, ASES 및 KSS 점수는 2군과 비교해 1군에서 기능적 개선을 보였다(p=0.041, p=0.023, p=0.019). 최종 추시 시 AHI는 1군 9.46±0.41 mm, 2군 6.86±0.64 mm로 측정되었다(p=0.032). 재파열은 1군 21예 중 6예(28.6%), 2군 20예 중 9예(45.0%)에서 발견되었다. 1군의 경우 2군에 비하여 유의하게 낮은 재파열률을 보였다(p=0.011). 결론: 본 연구에서는 봉합이 불가능한 광범위 회전근 개 파열이 있는 환자들에게 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술을 시행하여 장기 추시한 결과, 상완 이두근 건 장두를 사용하지 않은 군에 비하여 기능적 향상 및 낮은 재파열률을 보인다. 따라서 이는 봉합 불가능한 광범위 회전근 개 파열이 있는 환자에서 좋은 수술적 방법으로 생각된다.

견갑골 내측 상부의 발통점에 체외충격파와 초음파 적용시 통증과 피부두께, 근력변화에 미치는 영향 (The Effects of ESWT and US on Muscle Power, Pain and Muscle Tension at Trigger Point of the Scapular Inter Angle)

  • 이승협;피어라;정하늬;이호석;주다솔;이승희;최민희;최현지;홍영인;김지은;한상완
    • 대한임상전기생리학회지
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    • 제7권1호
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    • pp.29-34
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    • 2009
  • Purpose : This study aims to investigate into the change in muscle power, pain and muscle tension upon application of extracorporeal shock wave therapy (ESWT) and ultrasound (US) at trigger point (TrP) of the Scapular inter angle. Methods : In total of 24 human subjects that experience pain upon stimulation at the scapular inter angle were recruited. They were divided into three groups: control, ESWT and US group. Each group was subjected to appropriate stimulation three times per week for four weeks except the control group which had no restrictions in lifestyle. The ESWT group was subjected to Extracorporeal Shock Wave Therapy with a 2 $cm^2$ head, 20 times at speed of application of 60 pulses/min and depth of intrusion of 25 mm Whereas the US group was subject to Ultra sound therapy with 1$cm^2$ head, 1 MHz in frequency, 1.5 W/$cm^2$ of strength with five minutes of continuous application. Measurements were performed immediately prior to and at the end of the experiment. Results : There was no statistical significance in the change in muscle tension and muscle power as well as the difference between both groups before and after the experiment. VAS and VRS, all of which indicates changes in pain level, had statistically significant differences between them in pretest posttest comparisons. However, ESWT was superior to US in terms of decreasing muscle tension and pain while increasing muscle power. Conclusion : This study has made it evident that ESWT is far more reasonable to apply to TrP.

갑상선 우연암종의 임상병리적 특성 (Clinicopathologic Characteristics of Incidentally Discovered Thyroid Carcinomas)

  • 정웅윤;정재호;장항석;박정수
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.64-68
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    • 2000
  • Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.

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