• Title/Summary/Keyword: anatomical site

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Diagnostic Performance of On-Site Automatic Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve

  • Doyeon Hwang;Sang-Hyeon Park;Chang-Wook Nam;Joon-Hyung Doh;Hyun Kuk Kim;Yongcheol Kim;Eun Ju Chun;Bon-Kwon Koo
    • Korean Circulation Journal
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    • v.54 no.7
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    • pp.382-394
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    • 2024
  • Background and Objectives: Fractional flow reserve (FFR) is an invasive standard method to identify ischemia-causing coronary artery disease (CAD). With the advancement of technology, FFR can be noninvasively computed from coronary computed tomography angiography (CCTA). Recently, a novel simpler method has been developed to calculate onsite CCTA-derived FFR (CT-FFR) with a commercially available workstation. Methods: A total of 319 CAD patients who underwent CCTA, invasive coronary angiography, and FFR measurement were included. The primary outcome was the accuracy of CT-FFR for defining myocardial ischemia evaluated with an invasive FFR as a reference. The presence of ischemia was defined as FFR ≤0.80. Anatomical obstructive stenosis was defined as diameter stenosis on CCTA ≥50%, and the diagnostic performance of CT-FFR and CCTA stenosis for ischemia was compared. Results: Among participants (mean age 64.7±9.4 years, male 77.7%), mean FFR was 0.82±0.10, and 126 (39.5%) patients had an invasive FFR value of ≤0.80. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-FFR were 80.6% (95% confidence interval [CI], 80.5-80.7%), 88.1% (95% CI, 82.4-93.7%), 75.6% (95% CI, 69.6-81.7%), 70.3% (95% CI, 63.1-77.4%), and 90.7% (95% CI, 86.2-95.2%), respectively. CT-FFR had higher diagnostic accuracy (80.6% vs. 59.1%, p<0.001) and discriminant ability (area under the curve from receiver operating characteristic curve 0.86 vs. 0.64, p<0.001), compared with anatomical obstructive stenosis on CCTA. Conclusions: This novel CT-FFR obtained from an on-site workstation demonstrated clinically acceptable diagnostic performance and provided better diagnostic accuracy and discriminant ability for identifying hemodynamically significant lesions than CCTA alone.

A Case of Eosinophilic Gastritis Mimicking Borrmann Type-4 Advanced Gastric Cancer (Borrmann 4형 진행위암과 같은 형태를 보인 호산구성 위염(Eosinophilic Gastritis) 1예)

  • Shin Hyun-Wook;Suh Byoung-Jo;Yu Hang-Jong;Lee Hye-Kyung;Kim Jin-Pok
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.47-51
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    • 2005
  • Eosinophilic gastroenteritis is a rare clinicopathologic entity of unknown etiology with a variety of digestive symptoms. The pathogenesis is poorly understood. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence of extraintestinal disease, and exclusion of various disorders that could mimic similar conditions. The disease might involve any area of the gastrointestinal tract from the esophagus to the rectum, but the stomach and the proximal small bowel are most commonly affected. The clinical features depend on which layer and site are involved. We report the case of a 59-year-old male patient with a 3-week history of post-prandial vomiting with malnutrition and weight loss. An abdominopelvic CT showed a gastric outlet obstruction with diffuse wall thickening, as with linitis plastica. Three gastrofiberscopic biopsies showed chronic gastritis. We carried out a radical total gastrectomy with D2 lymph node dissection. The pathologic report revealed a mural type eosinophilic gastritis with a marked hypertrophic scar formation at the proper muscle layer. We report this case with a brief review of the literature. (J Korean Gastric Cancer Assoc 2005;5:47-51)

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Compression Neuropathy of Superficial Radial nerve by Variation of Course of Radial Artery in Distal Forearm - A case report - (원위 전완부에서 요골 동맥의 주행 변이로 발생된 표재성 요골 신경 압박증 - 1례 보고 -)

  • Kim, Chong-Kwan;Ahn, Bung-Woo;Kwak, Wan-Sub;Jo, Jae-Il;Kim, Woo-Sik;Yoon, Jong-Ho
    • Archives of Reconstructive Microsurgery
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    • v.15 no.1
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    • pp.38-41
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    • 2006
  • A 57-year-old male suffered from tingling and paraesthesia on radial side of right hand. We carried out exploration, the process being done, a radial artery passing between the two branches of bifurcated superficial radial nerve was found by accident. Then we performed dissection of the radial artrery a little more distally. It was passing above the extensors of thumb to anstomical snuff box. We treated it with ligating the radial artery, which was done a little above the bifurcated site of superficial radial nerve after angiography of upper extremity. While we were following this procedure, we noticed that symptoms had improved a lot. To our knowlege, neuropathy, by itself of superficial radial nerve by the radial artery with anatomical variation has never been reported and therefore we report this case.

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The Anatomical Variations of DIEA (Deep Inferior Epigastric Artery) in Microsurgical Breast Reconstruction: Clinical Report (미세유방재건술시 깊은 아래 배벽 동맥의 해부학적 변형에 대한 임상 보고)

  • Jang, Seo-Yoon;Kim, Deok-Woo;Dhong, Eun-Sang;Yoon, Eul-Sik;Ryu, Woo-Sang;Son, Gil-Soo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.14-17
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    • 2011
  • Autologous breast reconstruction after mastectomy in breast cancer patient is now increasing. The deep inferior epigastric artery (DIEA) free flap is well known as an ideal donor site for the microsurgical breast reconstruction. The branching pattern of the DIEA was well described in the literature. In that study, DIEA has three branching patterns near the arcuate line. We describe a case in which branching variation of the DIEA before entering the posterior surface of the rectus abdominis muscle. In three cases, DIEA originated from the external iliac artery ascended as a double trunk at 1cm, 2cm, and 4cm above the originating point, respectively. In one case, DIEA ascended as a single trunk along the linea alba toward to the umbilicus until it supply overlying subcutaneous tissue. Preoperative 3D computed tomographic angiography to identify the anomaly is recommended and meticulous dissection to the originating point of DIEA is needed.

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Species Identification of Wood Coffins in Chosun Dynasty Period Excavated in Andong Area

  • Eorn, Young-Geun
    • Journal of the Korean Wood Science and Technology
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    • v.27 no.4
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    • pp.15-19
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    • 1999
  • Three wood coffins of Chosun Dynasty period buried about 450 years ago were excavated in the sound condition in Andong area in the early 1998. The proprietors of wood coffins were grandparents, Mr. Myoung Jong Lee and Mrs. Mun, and their grandson, Mr. Eung Tae Lee, and the social standing of their family was known to belong to the nobility in those days by the clan genealogy. All the wood coffins investigated through light microscopy had same anatomical characteristics as follows: abrupt to somewhat abrupt tracheid transition from earlywood to latewood; normal longitudinal and horizontal resin canals with thin-walled epithelium; tylosoids in resin canals; bordered pits frequently in 1 row on radial walls of tracheids; 1 or 2 window-like pits per cross-field; uniseriate and fusiform rays; heterogeneous rays composed of body ray parenchyma cells and marginal ray tracheids or homgeneous rays composed of only ray tracheids; dentate ray tracheids; occasional trabeculae traversing tracheids in radial direction. Based on theses microscopic characteristics, all the wood coffins were identified to be Korean red pine (Pinus densiflora) or Korean black pine (Pinus thunbergii). Korean black pine growing naturally in coastal area might not be probable because the site of excavation, Andong area, was mountainous and inland area of Korea Thus, Korean red pine was thought to be the possible species for the wood coffins because of its natural distribution through the Korean Peninsula and the easy availability.

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Anatomical study to determine a new approach to treat benign masses located in the anterior condyle region: a case report

  • Sin Guen Kim;Sung Chul Bok;Suk In Choi;Jun Woo Park;Dong Ju Choi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.110-115
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    • 2024
  • A 22-year-old male patient presented to the clinic with severe pain in the preauricular area with an inability to completely occlude the jaw. Facial computed tomography and magnetic resonance imaging revealed a well-defined lesion that was tentatively diagnosed as a benign tumor or cystic mass. Surgical approach of a lesion in the condyle is delicate and problematic as many vulnerable anatomical structures are present. There are several methods for surgery in this area. Typically, an extraoral approach is dangerous because of potential injuries to nerves and arteries. The intraoral approach also presents difficulties due to the lack of visibility and accessibility. On occasion, coronoidectomy may be performed. The goal here was to determine an easier and safer new surgical approach to the condyle. We reached the anterior part of the pterygoid plate in the same method as in Le Fort I surgery. From this point, through the external pterygoid muscle, approaching the anterior aspect of the condyle is relatively easy and safe, with minimal damage to the surrounding tissues. Pus was drained at the site, and the lesion was diagnosed as an abscess. Pain and inability to close the mouth resolved without recurrence.

Psychosocial Factors and Musculoskeletal Pain Among Rural Hand-woven Carpet Weavers in Iran

  • Chaman, Reza;Aliyari, Roqayeh;Sadeghian, Farideh;Shoaa, Javad Vatani;Masoudi, Mahmood;Zahedi, Shiva;Bakhshi, Mohammad A.
    • Safety and Health at Work
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    • v.6 no.2
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    • pp.120-127
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    • 2015
  • Background: Musculoskeletal pain (MSP) is a common and disabling problem among carpet weavers and is linked to physical and psychosocial factors of work. This study aimed to determine the prevalence of MSP, its psychosocial risk factors, and association of pain in each pair of anatomical sites among carpet weavers. Methods: A cross-sectional study was performed among 546 hand-woven carpet weavers in rural small-scale workshops of Iran. Data were collected by using parts of a standardized CUPID (Cultural and Psychosocial Influences on Disability) questionnaire focused on MSP in 10 body sites, including the low-back, neck, both right and left shoulders, elbows, wrists/hands, individual, physical and psychosocial risk factors. Statistical analysis was performed applying logistic regression models. Results: Prevalence of MSP in at least one body sitewas 51.7% over the past month. The most common sites were low back and right shoulder pain 27.4% and 20.1%, respectively. A significant difference was found between the mean number of painful anatomical sites and the level of education, age, physical loading at work, time pressure, lack of support, and job dissatisfaction. In pairwise comparisons, strongest association was found between pain in each bilateral anatomical site (odds ratio = 11.6-35.3; p < 0.001). Conclusion: In home-based workshops of carpet weaving, psychosocial factors and physical loading were associated with MSP. This finding is consistent with studies conducted among other jobs. Considering the preventive programs, the same amount of attention should be paid to psychosocial risk factors and physical loading. Also, further longitudinal studies are needed to investigate the relationship of psychological factors.

Diagnostic Usefulness of Fine Needle Aspiration Cytology on Lymphadenopathy (림프절종대의 세침흡인 세포검사의 진단적 유용성 - 림프절의 세침흡인 세포검사 1,216예의 분석 -)

  • Kim, Dong-Won;Jin, So-Young;Lee, Dong-Hwa;Lee, Chan-Soo
    • The Korean Journal of Cytopathology
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    • v.8 no.1
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    • pp.11-19
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    • 1997
  • Clinical lymphadenopathies are subjected to fine needle aspiration cytology(FNAC) for diagnosing not only benign lesions but also malignant ones, as the first diagnostic procedure. While the diagnostic reliability in metastatic carcinoma is high, it is difficult to differentiate malignant lymphoma from reactive conditions. We evaluated the diagnostic reliability of FNAC in lymphadenopathy, and discuss the diagnostic limitation and its place in clinical practice in this study, Over 8 years from January 1988, FNAC of 1,216 lymphadenopathies were analyzed and among them 170 cases were compared with histopathology. The results are as follows. 1. Of ail the cases, 890 cases(73.2%) were diagnosed cytologically as benign, 312 cases(25.7%) as malignant, and 14 cases(1.1%) as unsatisfactory material. Reactive hyperplasia was diagnosed in 585 cases(65.7%) of the benign lesions, and among the malignant diseases, metastatic carcinoma was diagnosed in 248 cases(79.5%), and malignant lymphoma in 62 cases(19.9%). 2. The overall diagnostic accuracy was 89.2%, and no false positive case and 9 false negative results were observed among 170 cases which were proven by histopathology. Six cases of sampling error of false negative diagnoses included 3 of metastatic carcinomas and 3 of malignant lymphomas. The causes were difference between aspiration and biopsy site, poor fixation, or scanty cellularity with bloody smear. All 3 cases of misinterpretation error were malignant lympliomas, one of mixed type on biopsy which was diagnosed as reactive hyperplasia cytologically. In summary, FNAC technique is thought to be useful in the initial diagnosis of lymphadenopathies as well as in the follow-up of patients with known malignancy. Although the results of malignant lymphoma was less accurate than other malignant lesions, the application of strict cytologic criteria or lymphoid marker studies of aspiration material will reduce the false negative rate.

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Anatomical Variants of "Short Head of Biceps Femoris Muscle" Associated with Common Peroneal Neuropathy in Korean Populations : An MRI Based Study

  • Yang, Jinseo;Cho, Yongjun;Cho, Jaeho;Choi, Hyukjai;Jeon, Jinpyeong;Kang, Sukhyung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.509-515
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    • 2018
  • Objective : In Asians, kneeling and squatting are the postures that are most often induce common peroneal neuropathy. However, we could not identify a compatible compression site of the common peroneal nerve (CPN) during hyper-flexion of knees. To evaluate the course of the CPN at the popliteal area related with compressive neuropathy using magnetic resonance imaging (MRI) scans of healthy Koreans. Methods : 1.5-Tesla knee MRI scans were obtained from enrolled patients and were retrospectively reviewed. The normal populations were divided into two groups according to the anatomical course of the CPN. Type I included subjects with the CPN situated superficial to the lateral gastocnemius muscle (LGCM). Type II included subjects with the CPN between the short head of biceps femoris muscle (SHBFM) and the LGCM. We calculated the thickness of the SHBFM and posterior elongation of this muscle, and the LGCM at the level of femoral condyles. In type II, the length of popliteal tunnel where the CPN passes was measured. Results : The 93 normal subjects were included in this study. The CPN passed through the "popliteal tunnel" formed between the SHBFM and the LGCM in 36 subjects (38.7% type II). The thicknesses of SHBFM and posterior portions of this muscle were statistically significantly increased in type II subjects. The LGCM thickness was comparable in both groups. In 78.8% of the "popliteal tunnel", a length of 21 mm to <40 mm was measured. Conclusion : In Korean population, the course of the CPN through the "popliteal tunnel" was about 40%, which is higher than the Western results. This anatomical characteristic may be helpful for understanding the mechanism of the CPNe by posture.

Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.5
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    • pp.423-429
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    • 2020
  • Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.