• Title/Summary/Keyword: anomaly diagnosis

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Endoscopic Chemocauterization for Pyriform Sinus Fistula (이상와루(Pyriform Sinus Fistula)에 대한 내시경적 경화요법의 3예)

  • Park Yoon-Ah;Seo Jin-Hak;Cho Sang-Hyun;Chung Woong-Yoon;Choi Eun-Chang;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.234-237
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    • 2001
  • Pyriform sinus fistula is a rare anomaly arising from 3rd or 4th branchial apparatus and has been recognized as one cause of acute suppurative thyroiditis or acute deep neck infection. Pyriform sinus fistula must be considered when a clinician is encountered recurrent left lower neck abscess and a history of repeated incision and drainage. The confirmation of the diagnosis is made when the fistula tract is identified on a barium swallow study and when the internal orifice of the fistula is found at the apex of pyriform sinus on laryngoscopic examination. A complete excision of the fistula tract has been proposed as a treatment of choice. However, in some cases it is very difficult to resect the tract completely because of severe inflammation and repeated drainage procedure. We present three cases of pyriform sinus fistula which are successfully treated by laryngomicroscopic chemocauterization using synthetic fibrin and $AgNO_3$.

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Tubular Colonic Duplication Presenting as Rectovestibular Fistula

  • Karkera, Parag J.;Bendre, Pradnya;D'souza, Flavia;Ramchandra, Mukunda;Nage, Amol;Palse, Nitin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.197-201
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    • 2015
  • Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus.

Successful Correction of Coarctation of the Aorta, the Patent Ductus Arteriosus, and Persistent Left Superior Vena Cava (대동맥축착 동맥관개존 좌공정맥을 합병한 다발성혈관기형의 수술치험예)

  • 김근호
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.93-100
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    • 1974
  • This is a case report of successful surgical correction of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart anomaly was suspected at the sixth month after birth. Afterward there has been no embarrassing symptoms until the day of operation except slight dyspnea on exertion, The diagnosis of coarctation of the aorta and the patent ductus arteriesus detected by physical signs and X-ray studies including aortography. In the first place, coarctation of the aorta was corrected with following procedure: partial resections of the aortic wall just above and below the coarctating line of the aorta and removal of diaphragmatic structure of coarctation performed by. cross clamping aorta above and below coarctation, and then the defect of the aortic wall was closed by lateral aortorrhapic suture with atraumatic needle 3-0 silk continuously [Fig. 6]. In the second place, the patent ductus arteriosus was closed with double ligation method. The persistent left superior vena cava left as it has been, because there has been no evidence of hemodynamic abnormal shunt. After operation, excellent result was obtained; blood pressure in the upper and lower extremities was normalized and subjective complains of hypertension in the upper extremity was disappeared.

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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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A Case Report of Tracheal Bronchus Associated with Pulmonary Actinomycosis (폐방성균증을 동반한 기관기관지 환자 수술 치험 1예)

  • 양승인;이형렬;박준호;이민기;박순규;김건일;이창훈
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.878-882
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    • 2003
  • Tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and may be related to inflammatory conditions affecting the lung, including recurrent pneumonia, bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but either clinical or radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6month follow-up period.

A Design of Automated Contingency Management and Case Study for Monopropellant Propulsion System (단일추진시스템의 ACM 설계 및 사례연구)

  • Lee, Young-Jin;Lee, Kwon-Soon;Vachtsevanos, George
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.16 no.2
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    • pp.1-11
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    • 2008
  • Increasing demand for improved reliability and survivability of mission-critical systems is driving the development of health monitoring and Automated Contingency Management (ACM) systems. An ACM system is expected to adapt autonomously to fault conditions with the goal of still achieving mission objectives by allowing some degradation in system performance within permissible limits. ACM performance depends on supporting technologies like sensors and anomaly detection, diagnostic/prognostic and reasoning algorithms. This paper presents the development of a generic prototype test bench software framework for developing and validating ACM systems for advanced propulsion systems called the Propulsion ACM (PACM) Test Bench. The architecture has been implemented for a Monopropellant Propulsion System (MPS) to demonstrate the validity of the approach. A Simulink model of the MPS has been developed along with a fault injection module. It has been shown that the ACM system is capable of mitigating the failures by searching for an optimal strategy. Furthermore, the concepts of Validation and Verification (V&V) of such systems are introduced with relevant examples.

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A Case of an EXIT procedure for Airway management of fetus with Agnathia (하악결손증 태아에서 기도확보를 위해 시행한 EXIT 시술 1례)

  • Bong Jeong Pyo;Kim Yoo Jung;Yang Jong Won;Kim Jin Hyung;Kim Tae Hwan;Choi Seong Jin
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.32-36
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    • 2005
  • This study aimed to report a case of infant who presented with a prenatal ultrasound diagnosis of agnathia, polyhydramnios followed by a review of previous studies. As widely acknowledge, agnathia is a complex lethal malformation characterized by absent mandible, microstomia, microglossia and ear anomaly which are secondary results to a defect of the first branchial auh. Newborn infants with agnathia often suffer from airway obstruction, causing fatal respiratory failure. The most difficult part of treating those newborns is to keep the airway patent. Therefore, as early airway management planning as possible is the most important part. Airway management was achieved with tracheotomy through an ex utero intrapartum treatment procedure(EXIT). The case of this infant, reporting here, was underwent tracheotomy with preservation of uteroplacental blood flow and gas exchange.

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Recognition and management of palatogingival groove for tooth survival: a literature review

  • Kim, Hee-Jin;Choi, Yoorina;Yu, Mi-Kyung;Lee, Kwang-Won;Min, Kyung-San
    • Restorative Dentistry and Endodontics
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    • v.42 no.2
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    • pp.77-86
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    • 2017
  • Palatogingival groove (PGG) is an anomaly in the maxillary anterior teeth, often accompanied by the area of bony destruction adjacent to the teeth with no carious or traumatic history. The hidden trap in the tooth can harbor plaque and bacteria, resulting in periodontal destruction with or without pulpal pathologic change. Related diseases can involve periodontal destruction, combined endodontic-periodontal lesions, or separate endodontic and periodontal lesions. Disease severity and prognosis related to PGG depend on several factors, including location, range, depth, and type of the groove. Several materials have been used and recommended for cases of extensive periodontal destruction from PGG to remove and block the inflammatory source and recover the health of surrounding periodontal tissues. Even in cases of severe periodontal destruction, several studies have reported favorable treatment outcomes with proper management. With new options in diagnosis and treatment, clinicians need a detailed understanding of the characteristics, treatment, and prognosis of PGG to successfully manage the condition.

Anomalies of the clivus of interest in dental practice: A systematic review

  • McCartney, Troy E.;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.51 no.4
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    • pp.351-361
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    • 2021
  • Purpose: The clivus is a region in the anterior section of the occipital bone that is commonly imaged on large-volume cone-beam computed tomography (CBCT). There have been several reports of incidental clivus variations and certain pathological entities that have been attributed to the variations. This study aimed to evaluate the effects of these variations within the scope of dentistry. Materials and Methods: Medical databases (PubMed, Scopus, and Web of Science) were searched using a controlled vocabulary (clival anomalies, cone-beam CT, canalis basilaris medianus, fossa navicularis magna, clival variation). The search was limited to English language, humans, and studies published in the last 25 years. The articles were exported into RefWorks® and duplicates were removed. The remaining articles were screened and reviewed for supporting information on variations of the clivus on CBCT imaging. Results: Canalis basilaris medianus and fossa navicularis magna were the most common anomalies noted. Many of these variations were asymptomatic, with most patients unaware of the anomaly. In certain cases, associated pathologies ranged from developmental (Tornwaldt cyst), to acquired (recurrent meningitis). While no distinct pathognomonic aspects were noted, there were unique patterns of radiographic diagnosis and treatment modalities. Most patients had a normal course of follow-up. Conclusion: Interpretation of CBCT volumes is a skill every dentist must possess. When reviewing large-volume CBCT scans, the clinician should be able to distinguish pathology from normal anatomic variations within the skull base. The majority of clivus variations are asymptomatic and will remain undetected unless incidentally noted on radiographic examinations.

A Case of Severe Hyperammonemic Encephalopathy Caused by Urinary Tract Infection in Obstructive Uropathy

  • Mun, Bo Gyung;Lee, Joo Hoon;Park, Young Seo;Jung, Jiwon
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.112-116
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    • 2021
  • Hyperammonemia is mainly caused by diseases related to liver failure. However, there are also non-hepatic causes of hyperammonemia, such as urinary tract infection (UTI) due to urease-producing organisms. Urease production by these bacteria induces a hydrolysis of urinary urea into ammonia that can cross the urothelial cell membrane and diffuse into blood vessels, leading to hyperammonemia. Delayed diagnosis and treatment of hyperammonemia can lead to lethal encephalopathy that can cause brain damage and life-threatening conditions. In the presence of obstructive uropathy, UTI by urease-producing bacteria can lead to more severe hyperammonemia due to enhanced resorption of ammonia into the systemic circulation. In this report, we present a case of acute severe hyperammonemic encephalopathy leading to brain death due to accumulation of ammonia in blood caused by Morganella morganii UTI in a 10-year-old girl with cloacal anomaly, causing obstructive uropathy even after multiple corrections.