Lee Jae-Hoon;Chung Woung-Yoon;Kang Hae-Youn;Park Cheong-Soo
Korean Journal of Head & Neck Oncology
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v.16
no.2
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pp.201-205
/
2000
Objectives: Despite of high prevalence of tuberculosis in Korea, thyroid tuberculosis is very rare and only a few records are available. This study was carried out to evaluate the clinicopathologic characteristics of thyroid tuberculosis and to find out optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1986 to July. 2000, of 5,493 patients who were underwent thyroidectomy, only 8(0.14%) had discovered to have thyroid tuberculosis. The medical records of them were analyzed retrospectively. Results: There were one man and seven women with a mean age of 40.3 years. Only one had tuberculosis sequalae on chest X-ray and two had past history of tuberculous lymphadenitis. However, none of them had symptomatic pulmonary tuberculosis. Most frequent symptom was palpable neck mass. The preoperative U/S, CT and FNAB failed to diagnose thyroid tuberculosis. The pathologic reports were chronic granulomatous thyroiditis with caseous necrosis in all the cases and AFB stain was positve in 5 cases. All cases were successfully treated by surgical resection and anti-Tbc. medications. Conclusions: The incidence of thyroid tuberculosis was extremely low and most of them have been presented as a palpable neck mass especially in relatively young-aged female patients. Although any diagnosis for thyroid tuberculosis prior to microscopical study of tissue removed at operation was not yielded, the preoperative diagnostic workups will be available with experience. Surgical resection and anti- Tbc medication would be the choice in the management of thyroid tuberculosis.
Acute flank pain from urolithiasis is the most common condition in people visiting emergency rooms. This study is to evaluate the usefulness of color Doppler in detecting ureteral stones in patients without hydronephrosis. We performed ultrasonography and retrospective analysis on 161 patients who were suspected of urinary stones through plain radiography of the kidney, ureter, and bladder examination or urine tests that showed positive signs of hematuria. In ultrasonography, a total of 154 (95.6%) cases from the 161 patients were diagnosed with ureteral stones. In color Doppler, ureteral stones with twinkling artifact (TA) in the absence of hydronephrosis was shown in 18 (85.7%) cases of the 21 patients(p<0.001). The use of color Doppler has a high diagnostic efficacy for the detection of indistinguishable stones, non-dilatational ureteral stones, and middle ureter stones.
Kim, Beom-Gyu;Kang, Jin-Wook;Kim, Young-Jae;Nam, Soon-Yuhl
Korean Journal of Bronchoesophagology
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v.8
no.2
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pp.36-42
/
2002
Aspirated and ingested foreign bodies continue to present challenges to otolaryngologists. The major discussions were the accurate diagnosis and speedy, safe removal of foreign body. Many diagnostic tools have been tried and removal of foreign bodies has been facilitated by technical improvements with rod lens telescope, video endoscope, flexible fiberoendoscope and safer anesthesia. In spite of these advances, more than 3000 children's death occur per year in the world because of foreign bodies and untold number of parients survive with variable sequelae. In these study, 59 consecutive cases of children and adults with tracheobronchial foreign bodies were reviewed from 1992 to 2001. We studied the history, symptoms, ausculatory radiologic, bronchoscopic finding and post operative complications. 71% (42 cases in 59 cases) of patients had foreign body aspiration history or choking crisis. In 64% (38cases) cough was observed. 81% (48cases) had abnormal finding in chest auscultation and 78% in chest X-ray. Computed tomography was done in 12 cases, all were founded foreign body shadow. Main site of foreign body was right main bronchus (41%, 24cases) and most frequent foreign body was peanut (36% , 21cases) . 4 experienced ICU(intensive care unit) care. 2 cases were failed to remove foreign. In these cases 1 cases was improved by steroid therapy and physical therapy and the other was treated with thoracotomy. We concluded the morbidity and motality were much correlated with speedy decision making and experienced skill of operator.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.5
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pp.519-526
/
2000
Osteoporosis has recently been recognized as a major health problem in the elderly population. The disorder is manifested as a loss of bone mass accompanied by structural alteration of bone and increased incidence of fracture. Mandible also may be affected. So, I evaluated panoramic views of 66 postmenopausal women for finding the possibility of useful diagnostic mandibular parmeters of osteoporosis. To know the correlationship between skeleton and mandible, the average of the bone mineral density of lumbar from 2nd to 4th by the dual energy X-ray absorptiometry(DEXA, LUNAR DPZ. USA), and age and mandibular parameters, that is, the number of residual teeth, alveolar ridge resorption ratio, panoramic mandibular index (PMI), mandibular cortical width (MCW), angular cortical thickness (ACT), ramus cortical thickness (RCT), morphology of mandibular inferior cortical (MIC) were compared. And I divided the all tested women to the osteoporotic group and non-osteoporotic group by the use of T-score -2.0, which was derived from skeletal bone mineral density (BMD). To find the correlationship of the each group with mandibular parameters, t-test and discriminant analysis were done. The results of the t-test were that all parameters were highly related with 2 groups (p<0.05). Especially ACT, MIC, age have had even higher correlationship than others (p<0.001). The results of the discriminant analysis by the use of these ACT, MIC and age were that the discriminant function was Z = -2.973+(-1.447)$\times$(ACT)+1.131$\times$(MIC score)+(0.052)$\times$(age), the cutting score was 0.257 and the classification accuracy was 84.8%. Therefore I suggest that the consideration of the angular cortical thickness (ACT), the age of patient and the morphology of mandibular inferior cortical(MIC) may help find the osteoporosis.
A 27 years old male developed right-sided massive, recurrent, pleural transudate. EKG and echocardiogram showed right ventricular hypertropy. Chest X-ray and concurrent perfusion lung scan, performed after enough expansion of the right lung by drainage of the effusion through small cathter, showed that perfusion defect mismatched with the roentgenographic defect, which was likely to be a high probability of pulmonary thromboembolism. By cardiac catherization and pulmonary angiography the occlusion of pulmonary veins drained from the upper and middle lobe of the right lung could be revealed. More precise cause of occlusion couldn't be clear up because thoracotomy had to have been dangerous due to severe pulmonary hypertension. So the massive reurrent effusion was treated by repeated tetracycline instilations through chest tube and he was discharged. After following up 14 months at out-patient clinic, he expired because of sudden massive hemoptysis.
Purpose : To investigate the diagnostic significance of cortical changes in the bone of diseased jaws utilizing computed tomography (CT). Materials and Methods: Computed tomographic images of 91 patients, consisting of 7 osteomyelitis, 46 cysts, 18 benign tumors, and 20 malignant tumors, were analyzed. The pattern of cortical expansion was classified into three types: no expansion (N), buccal or lingual expansion (B/L), and buccolingual expansion (B & L). The pattern of cortical destruction was classified into four types: no destruction (N), point destruction (PO), gross destruction (GR), and permeative destruction (PE). The pattern of periosteal reaction was classified into four types: parallel, irregular, spicule, and Codmans triangle. The relationship between the pattern of cortical bone changes and diseases of the jaws was assessed. Results: When the pattern of cortical expansion was compared to diseases of the jaw, N-type was most prevalent in cases of osteomyelitis and malignant tumors, B/L-type with cysts, and B&L-types with benign tumors. Comparison between the pattern of cortical bone destruction with diseases of the jaw showed strong correlations between PO and PE-types to osteomyelitis, N-type with cysts, N and GR-types with benign tumors, and GR-type with malignant tumors. Finally, the relationship between the pattern of periosteal reaction to diseases of the jaw showed a strong correlation between parallel-type to osteomyelitis and spicule-type to malignant tumors. Conclusion : The pattern of cortical expansion and cortical destruction is useful in differentiating diseases of the jaws.
Alveolar bone changes after immediate loading on implants up to one year were observed by means of standard intraoral X-ray measurement which were taken at 3 month intervals. At the same time, bone density changes were observed according to digital subtraction method which is a becoming a more and more promising diagnostic tool for implants. Following results were obtained ; 1. There was no significant difference in the amount of alveolar bone loss implant type, sex and implant diameter, but there was difference according to case selection. In fully bone anchored prostheses cases, bone loss was $1.16{\pm}0.15m$ whereas, in partial edentulous cases, it was $1.84{\pm}0.08mm$. 2. Alveolar bone loss after immediate loading showed a higher degree of bone loss than after submerged loading in the initial three months. But there were no significant difference at the 12th month. 3. According to the one year bone density change observation at the alveolar bone surrounding the implant, significant change was observed vertically, whereas no significant change could observed horizontally. According to the above mentioned results, we can conclude that immediate loading of implants results in a higher degree of alveolar bone loss in one year than submerged loading. But since alveolar bone loss rate decreases to a reasonable rate after the initial 3 months of rapid bone loss, immediate loading of implants seems to be an acceptable treatment modality for patients with good bone conditions. Fully bone anchored cases showed an favorable outcome, but partial edentulous cases showed more bony resorption. So this cases considered in case selections. Bone density changes observation in the study was performed for only one year therefore a more longitudinal observation may be studied.
Kim, Shin-Chae;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
Tuberculosis and Respiratory Diseases
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v.49
no.1
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pp.117-121
/
2000
The mucormycosis is a group of serious opportunistic infections caused by fungi of the class Zygomycetes and order Mucorales. Pulmonary mucormycosis is a relatively rare disease but typically manifested by a rapidly progressive, often fatal pneumonia in patients with diabetes mellitus, hematologic malignant neoplasms, or organ transplants. The radiologic manifestations of pulmonary mucormycosis are nonspecific and include progressive lobar or multilobar consolidations, pulmonary masses and pulmonary nodules. Recently, we experienced a pulmonary mucormycosis in 32-year-old man with uncontrolled diabetes. He complained of cough, left pleuritic chest pain and generalized weakness. Initial chest X-ray finding was the consolidation on the lower lobe of the left lung. On the sixth hospital day, bronchoscopic examination with lung biopsy revealed broad, non-septate hyphae with right-angle branching, diagnostic of mucormycosis, and consequently amphotericin B therapy was started. We performed a lobectomy of the left lower lobe of the lung on 29th hospital day.
Park, Soo Jin;Park, Ji Ye;Jung, Joonho;Park, Seong Yong
Journal of Chest Surgery
/
v.49
no.4
/
pp.287-291
/
2016
Background: Spontaneous pneumomediastinum (SPM) is an uncommon disorder with only a few reported clinical studies. The goals of this study were to investigate the clinical manifestations and the natural course of S PM, as w ell as examine the current available treatment options for SPM. Methods: We retrospectively reviewed 91 patients diagnosed with SPM between January 2008 and June 2015. Results: The mean age of the patients was $22.7{\pm}13.2years$, and 67 (73.6%) were male. Chest pain (58, 37.2%) was the predominant symptom. The most frequent precipitating factor before developing SPM was a cough (15.4%), but the majority of patients (51, 56.0%) had no precipitating factors. Chest X-ray was diagnostic in 44 patients (48.4%), and chest computed tomography (CT) showed mediastinal air in all cases. Esophagography (10, 11.0%), esophagoduodenoscopy (1, 1.1%), and bronchoscopy (5, 5.5%) were performed selectively due to clinical suspicion, but no abnormal findings that implicated organ injury were documented. Twelve patients (13.2%) were discharged after a visit to the emergency room, and the others were admitted and received conservative treatment. The mean length of hospital stay was $3.0{\pm}1.6days$. There were no complications related to SPM except for recurrence in 2 patients (2.2%). Conclusion: SPM responds well to conservative treatment and follows a benign natural course. Hospitalization and aggressive treatment can be performed in selective cases.
Acute transient synovitis of the hip presents clinically pain and limping. But in the majority of the cases, definite positive findings are not manifest in roentgenogram in its early phase. However radionuclide bone imaging combines with the assessment of vascularization and bone tracer uptake is of great value in solving this diagnostic problem. The materials for this study consisted of 29 children with acute transient synovitis of the hip, characterized by symptoms and physical signs of an arthritis, negative X-ray findings and disappearance of all symptoms and signs within a short period of time. They were twenty males and 9 females and age ranged from 1 to 12 years. We took pelvic reontgenogram in AP and frog-leg views. After intravenous bolus injection of 10 to 15 mCi of $^{99m}Tc-methylene$ diphosphonate, 24 sequential image of the pelvis was taken at 2-second interval for blood flow study. The scintigrams were made using a gamma camera with high resolution parallel hole collimator. Blood pool imaging was obtained at 2 minutes after tracer administration. After 3 hours, static images were taken and then closeup image of the hip using pin-hole collimator was followed. The results were as follows: 1) Bone scintigram was much more sensitive than conventional roentgenogram in diagnosis of acute transient synovitis of the hip. 2) Three-phase imagings showed increased vascular activities in blood pool scintigrams in 96%. 3) Pin-hole imaging showed increased tracer uptake in the regional bones of the hip, par ticularly in the medial aspect of femoral head and acetabulum. 4) We confirmed that three-phase imaging reinforced with pin-hole technique were very useful in diagnose of acute transient synovitis of the hip.
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