• Title/Summary/Keyword: delayed CT

Search Result 168, Processing Time 0.022 seconds

느린 홱보기를 동반한 척수소뇌실조 2형 1예 (A Case of Spinocerebellar Ataxia Type 2 with Slowed Saccades)

  • 남정무;김병건;구자성;박종무;이정주;권오현
    • Annals of Clinical Neurophysiology
    • /
    • 제9권2호
    • /
    • pp.102-104
    • /
    • 2007
  • Spinocerebellar ataxia type 2 (SCA2) is characterized by progressive cerebellar ataxia and slow saccades. A 40-year-old woman presented with progressive gait disturbance and ataxia over 15 years. Neurologic examination revealed scanning speech, ataxia, and hyporeflexia. Brain CT showed diffuse atrophy of the cerebellum. Electronystagmography demonstrated slowed saccades with normal accuracy and delayed latency. The diagnosis of SCA2 was confirmed by the genetic test. Documentation of slow saccades may help differentiation among SCA subgroups.

  • PDF

외상성 기관지 파열 -1례 보고- (Tracheobronchial Rupture following Blunt Chest Trauma -1 case report-)

  • 김용한
    • Journal of Chest Surgery
    • /
    • 제23권3호
    • /
    • pp.588-593
    • /
    • 1990
  • The rupture of tracheobronchial tree caused by non penetrating blunt trauma is being increased in incidence though it is still rarely occurred on now Because this type of injury is uncommon, a high index of suspicion should be maintained in all crush injuries involving the chest. Early diagnosis and primary repair not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced a case of tracheobronchial rupture caused by non penetrating blunt chest trauma without rib fracture. The patient was a 16 year old male who was a high school student. He was compressed on anterior chest by hand ball goal post being failed down on the morning of admission day. After this accident, he was suffered from progressively developing dyspnea and subcutaneous emphysema on face, neck and anterior chest. The diagnosis, tracheal rupture, was made by chest CT and bronchoscopy. After right thoracotomy, the ruptured site was directly closed by using interrupted suture. Post-operative course was uneventful. Thus we report this case of traumatic tracheal rupture with review of literature.

  • PDF

두 가지 El Niño 형태에 따른 한강 유역의 연최대홍수량 및 저유량의 변화 분석 (Impacts of Two Types of El Niño on Hydrologic Variability in Annual Maximum Flow and Low Flow in the Han River Basin)

  • 김종석;윤선권;이주헌
    • 한국수자원학회논문집
    • /
    • 제45권10호
    • /
    • pp.969-981
    • /
    • 2012
  • 본 연구에서는 서로 다른 ENSO(El Ni$\tilde{n}$o Southern Oscillation) 형태에 따른 한강유역의 연최대홍수량과 저유량의 정량적 변화 및 발생시점의 변화를 분석하였다. 경향성 분석결과, 연최대유출의 경우 한강 전체 유역면적의 48.3%가 통계적으로 유의한 증가패턴을 보였으며, 연최대 유출의 발생시기는 한강 서부유역에서 늦어지고, 동부유역에서는 빨라지는 경향이 있음을 확인하였다. 또한 7일 저유량의 경우, 24개 중권역중 6개 유역(전체 면적의 26.0%)에서 통계적으로 유의한 감소경향을 보였으며, 저유량의 발생시기는 한강중상류 유역에서 빨라지는 경향이 있음을 확인하였다. CT(Cold tongue)/WP(Warm-pool) El Ni$\tilde{n}$o 시기에 연최대유출의 발생시점의 차이는 크지 않으나, CT El Ni$\tilde{n}$o 시기에는 전체유역의 89.0%에서 연최대유출량이 평년보다 작게 나타났다. 또한, 7일 저유량의 발생시점은 WP El Ni$\tilde{n}$o 시기에 평균적으로 약 17일 정도 빠르며, CT El Ni$\tilde{n}$o (WP El Ni$\tilde{n}$o)시기에는 전체 유역의 72.7%(20.0%)에서 통계적으로 유의한 증가(감소)패턴을 보이는 것으로 분석되었다. 본 연구는 서로 다른 형태의 CT/WP El Ni$\tilde{n}$o가 한강 유역 수자원의 양과 발생시점의 변화에 민감하게 영향을 미치고 있음을 확인하였으며, 향후 다양한 형태의 ENSO에 따른 수문변량의 변화에 대한 진단연구를 통하여 장기적인 수자원관리 및 예측을 위한 기초 자료로 활용이 가능하리라 사료된다.

대장직장암 및 기타 소화기암에서의 단세포군항체를 이용한 방사면역신티그라피의 진단 (Immunoscintigraphy of Colorectal and Other Gastrointestinal Cancers with Radioactive Monoclonal Antibodies to CEA and CA 19-9)

  • 장대환;최덕주;이범우;박원;한창순;김학산;김종순
    • 대한핵의학회지
    • /
    • 제22권1호
    • /
    • pp.83-92
    • /
    • 1988
  • The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

  • PDF

Sternal Healing after Coronary Artery Bypass Grafting Using Bilateral Internal Thoracic Arteries: Assessment by Computed Tomography Scan

  • Shin, Yoon Cheol;Kim, Sue Hyun;Kim, Dong Jung;Kim, Dong Jin;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
    • /
    • 제48권1호
    • /
    • pp.33-39
    • /
    • 2015
  • Background: This study aimed to investigate sternal healing over time and the incidence of poor sternal healing in patients undergoing coronary artery bypass graft (CABG) surgery using bilateral internal thoracic arteries. Methods: This study enrolled 197 patients who underwent isolated CABG using skeletonized bilateral internal thoracic arteries (sBITA) from 2006 through 2009. Postoperative computed tomography (CT) angiography was performed on all patients at monthly intervals for three to six months after surgery. In 108 patients, an additional CT study was performed 24 to 48 months after surgery. The axial CT images were used to score sternal fusion at the manubrium, the upper sternum, and the lower sternum. These scores were added to evaluate overall healing: a score of 0 to 1 reflected poor healing, a score of 2 to 4 was defined as fair healing, and a score of 5 to 6 indicated complete healing. Medical records were also retrospectively reviewed to identify perioperative variables associated with poor early sternal healing. Results: Three to six months after surgery, the average total score of sternal healing was $2.07{\pm}1.52$ and 68 patients (34.5%) showed poor healing. Poor healing was most frequently found in the manubrium, which was scored as zero in 72.6% of patients. In multivariate analysis, the factors associated with poor early healing were shorter post-surgery time, older age, diabetes mellitus, and postoperative renal dysfunction. In later CT images, the average sternal healing score improved to $5.88{\pm}0.38$ and complete healing was observed in 98.2% of patients. Conclusion: Complete sternal healing takes more than three months after a median sternotomy for CABG using sBITA. Healing is most delayed in the manubrium.

한국형 COVID-19 흉부영상 진단 시행 가이드라인 (Korean Clinical Imaging Guidelines for Justification of Diagnostic Imaging Study for COVID-19)

  • 진광남;도경현;남보다;황성호;최미영;용환석
    • 대한영상의학회지
    • /
    • 제83권2호
    • /
    • pp.265-283
    • /
    • 2022
  • 흉부영상의 적절한 활용을 위해 한국형 코로나바이러스 감염증(이하 COVID-19) 흉부영상진단 시행 가이드라인을 개발하였다. 8가지 문장형 핵심 질문을 선정하고, 근거기반 임상영상 가이드라인 수용개작 방법론에 의거하여 권고안을 작성하였다. 권고 내용은 다음과 같다. COVID-19 확진자와 접촉한 증상이 없는 사람에 대하여 COVID-19의 진단을 위하여 흉부영상검사(흉부X선검사 또는 CT)를 사용하지 않는 것이 적절하다. COVID-19가 의심되는 증상이 있으나 reverse transcription polymerase chain reaction 검사를 이용할 수 없는 경우 흉부영상검사 사용을 고려할 수 있다. COVID-19가 확인된 환자에게 병원 입원을 결정하기 위하여 임상 평가 및 검사실 검사와 함께 흉부영상검사를 고려할 수 있다. COVID-19 입원환자의 증상 경중 및 위험요인의 유무에 따라 흉부영상검사를 고려할 수 있으며, 치료 방법을 결정하거나 수정하는데 이용할 수 있다. COVID-19 환자에서 객혈 또는 폐색전증이 의심되는 경우 CT 혈관조영술을 시행할 수 있다. 증상이 호전된 COVID-19 환자의 퇴원 결정을 하는데 흉부영상검사를 사용하지 않는 것이 적절하다. COVID-19에서 회복된 환자를 추적검사할 때 폐 기능 장애가 있는 환자에서 치료 가능한 폐질환과 구별하기 위해 흉부영상검사를 고려할 수 있다.

각종 뇌 종양의 Thallium-201 뇌 SPECT에서 Thallium-201의 동태 (Thallium-201 Uptake and Washout in T1-201 Brain SPECT of Various Brain Tumors)

  • 임상무;홍성운;이창훈;이승훈;김종현
    • 대한핵의학회지
    • /
    • 제26권2호
    • /
    • pp.360-364
    • /
    • 1992
  • Treatment for the brain tumors consist of surgery, chemotherapy, and a variety of methods of irradiation. Therapy is aimed to destroy the tumor, but necrosis and edema occur concurrently. Conventional structural imaging techniques such as CT or MRI are unable to reliably distinguish persistent and recurrent tumor from necrosis or edema. T1-201 has been shown to be useful in the evaluation of the myocardial viability by comparing the early uptake and redistribution image. The aim of this study is to evaluate the clinical usefulness of the early uptake and delayed washout images of the T1-201 brain SPECT in the brain tumors. In the pathologically diagnosed various brain tumor patients, brain SPECT was done with rotating gamma camera 15 minutes and 3 hours after T1-201 injection, and the T1-201 uptake in the tumor was compared with the skull and scalp activity. In the glioblastoma multiforme, meningioma and metastatic tumor, the T1-201 uptake was higher than low grade glioma in both 15 minute and 3 hour images (p<0.02). In the low grade glioma,3 hour T1-201 uptake was significantly lower than 15 minute uptake (p<0.05) but in the glioblastoma, meningioma and metastatic tumor there was no significant difference. There was no significant difference in the T1-201 uptake among the glioblastoma, meningioma and metastatic tumors. In one matastatic tumor, T1-201 uptake was decreased after radiation therapy. T1-201 brain SPECT could distinguish the benign and malignancy, and seems to be useful in the follow-up after treatment. But one of the early or delayed SPECT seems not to be necessary for these purposes.

  • PDF

하이브리드 슈퍼코팅(HSC)과 유리섬유를 통한 조적조 내진보강 연구 (Experimental Study of Hybrid Super Coating (HSC) and Cast Reinforcement for Masonry Wall)

  • 이가윤;문아해;이승준;김재현;이기학
    • 한국지진공학회논문집
    • /
    • 제25권5호
    • /
    • pp.213-221
    • /
    • 2021
  • Many Korean domestic masonry structures constructed since 1970 have been found to be vulnerable to earthquakes because they lack efficient lateral force resistance. Many studies have shown that the brick and mortar suddenly experience brittle fracture and out-of-plane collapse when they reach the inelastic range. This study evaluated the seismic retrofitting of non-reinforced masonry with Hybrid Super Coating (HSC) and Cast, manufactured using glass fiber. Four types of specimen original specimen (BR-OR), one layered HSC (BR-HS-O), two-layered HSC (BR-HS-B), one layered HSC, and Cast (BR-CT-HS-O) were constructed and analyzed using compression, flexural tensile, diagonal compression, and triplet tests. The specimen responses were presented and discussed in load-displacement curves, maximum strength, and crack propagation. The compressive strength of the retrofit specimens slightly increased, while the flexural tensile strength of the retrofit specimens increased significantly. In addition, the HSC and Cast also produced a considerable increase in the ductile response of specimens before failure. Diagonal compression test results showed that HSC delayed brittle cracks between the mortar and bricks and resulted in larger displacement before failure than the original brick. The triplet test results confirmed that the bonding strength of the retrofit specimens also increased. The application of HSC and Cast was found to restrain the occurrence of brittle failure effectively and delayed the collapse of masonry wall structures.

A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy

  • Lee, Suhyeon;Yu, Yeonsil;An, Jinyoung;Lee, Jeongmin;Son, Jin-Sung;Lee, Young Kyung;Song, Sookhee;Kim, Hyeok;Kim, Suhyun
    • Tuberculosis and Respiratory Diseases
    • /
    • 제77권4호
    • /
    • pp.178-183
    • /
    • 2014
  • Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.

인두후부의 농양과 유사하게 표현된 비전형적인 가와사끼병 (Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess)

  • 김유진;임영수;윤지은;한헌석
    • Clinical and Experimental Pediatrics
    • /
    • 제52권2호
    • /
    • pp.251-255
    • /
    • 2009
  • 가와사끼병은 급성 전신적 염증성 질환으로, 그 원인은 아직 밝혀지지 않았고, 임상양상은 비특이적으로 많은 소아의 감염성 질환이나 면역학적 질환에서도 볼 수 있다. 저자들은 발열과 경부 임파선병증을 보인 두 증례에서 경부 전산화단층촬영상 인두후부의 농양과 유사한 소견을 보였으나 항생제 치료에 반응하지 않으며 인두 후부의 흡인술에서도 농양이 없던 경우로, 시간이 지나면서 전형적인 가와사끼 증상의 출현과 함께 심초음파에서 방실 판막의 역류를 보여 늦게 진단할 수 있었다. 본 증례에서처럼 발열과 경부임파선병증으로 나타나는 경우에도 가와사끼병을 의심해야 하며, 이 경우 전산화단층촬영에서 인두후부의 농양 유사 병변은 위양성 소견으로 볼 수 있다. 경부임파선병증이 적절한 항생제치료에도 불구하고 발열 등의 증상이 지속되는 경우에는, 심초음파를 포함한 검사를 조기에 시행하여 불필요한 내과적, 외과적 치료를 줄여야 할 필요가 있겠다.