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A False Diagnosis of Hypoplastic Left Heart Syndrome in a Fetus (태아기에 좌심형성부전증후군으로 잘못 진단되었던 1례)

  • Shin, Youn Jeong;Jang, Sung Hee;Choi, Jung Yun;Han, Eun Sook
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.267-272
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    • 2002
  • Typical hypoplastic left heart syndrome(HLHS) is a distinct pathologic entity with aortic atresia, mitral atresia, very hypoplastic or absent left ventricle and thread like ascending aorta. Occasionally, the lesser degree of hypoplasia is found and is called hypoplastic left heart complex(HLHC) by some authors. This HLHC is often associated with critical aortic stenosis. Fetal echocardiography has enabled us to observe human fetal heart in-utero and to diagnose congenital heart disease prenatally over the last 20 years. The diagnosis of HLHS in fetal echocardiography is based on 2-dimensional echocardio -graphic evidence of a diminutive ascending aorta, aortic atresia, mitral atresia or severe stenosis and a hypoplastic left ventricle. Abnormal flow direction through atrial septum or through isthmus greatly aids the diagnosis. This report shows a fetal case who showed hypoplastic left side chambers and retrograde isthmic flow and was diagnosed with hypoplastic left heart syndrome. After birth, although the baby had tachy-dyspnea for the first 3 weeks, she finally recovered without any intervention and showed catch up growth of left side chambers. This case illustrates the extreme difficulty of assessing left ventricle in a fetus.

Upper Body Somatotypes of the Left-Handed and the Right-Handed - Focusing on male and female collegians in their 20s - (왼손 및 오른손 사용자(使用者)의 상반신체형(上半身體型)에 관한 비교연구(比較硏究) - 20대(代) 남녀(男女) 대학생(大學生)을 중심(中心)으로 -)

  • Shim, Boo-Ja
    • Journal of Fashion Business
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    • v.7 no.4
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    • pp.78-92
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    • 2003
  • The upper-body characteristics of the right-handed and the left-handed are examined and compared through 1-dimensional measurement and 2-dimensional measurement. The results were as follows: 1. According to 1-dimensional measurement results, the clearest differences were seen in girth items rather than height or length items. In particular, hand girth, lower arm girth, and upper arm girth were bigger on the left side in the left-handed group and the right side in the right-handed group. This is thought to be relevant to the arm muscles frequently used. 2. According to 2-dimensional measurement results, significant differences appeared in the females of the left-handed group: shoulder point among width items. In the right-handed group, some differences of significance were shown in females (shoulder point, rear armpit point, and B.P. point among width items) and males (front neck point among extreme vertical distance items). In summary, the body type characteristics of the left-handed and the right-handed reveal great differences in the items related to arm length and arm girth. In other words, the sleeve and shoulder patterns production based on the right-handed don't rightly reflect the somatotype characteristics of the left-handed. In addition, in the cases of athletes, laborers, and the disabled who frequently use particular muscles or parts of the body, this sort of research in the patterns is consistently needed in order to reflect the size differences in girth items in upper body.

Postpneumonectomy Syndrome -A Case Report- (전폐절제술후 증후군 -1례 보고-)

  • 성숙환
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1047-1051
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    • 1994
  • Airway obstruction may be caused by extreme mediastinal shift and rotation after right pneumonecotmy or after left pneumonecotomy in the presence of right aortic arch.We experienced such a complication after right pneumonectomy, so called right postpneumonectomy syndrome. The patient was 28 years old female, and 4 month ago she had undergone right pneumonecotomy via video assisted thoracoscopic surgery[VATS] for endobronchial tuberculus dissemination and secondary pulmonary infection. She was treated by mediastinal repositioning which were composed of substernal fixation of pericardium and insertion of expandable prosthesis of 1000 cc capacity. She had good postoperative course and now she feels no obstructive symptoms.

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Glomus Tumor in Left Main Bronchus (좌측 주기관지에 위치한 사구종양)

  • 곽기오;김병훈;이양행;조광현
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.761-764
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    • 1999
  • The glomus tumor is a distinctive benign neoplasm with a small painful nodule, occurs most commonly in extremities but may be found elsewhere in the body. Its occurrence in the trachea or lung parenchyme has been recognized with extreme rarity and there has not been any report, to our knowledge, of its occurrence in the main bronchial glomus tumor. We report a case of a glomus tumor in the left main bronchus in a 67-year-old man who was presented with blood-tinged sputum and dyspnea, which was completely relieved by surgical resection.

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Usefulness and Limitations of Extreme Value Theory VAR model : The Korean Stock Market (극한치이론을 이용한 VAR 추정치의 유용성과 한계 - 우리나라 주식시장을 중심으로 -)

  • Kim, Kyu-Hyong;Lee, Joon-Haeng
    • The Korean Journal of Financial Management
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    • v.22 no.1
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    • pp.119-146
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    • 2005
  • This study applies extreme value theory to get extreme value-VAR for Korean Stock market and showed the usefulness of the approach. Block maxima model and POT model were used as extreme value models and tested which model was more appropriate through back testing. It was shown that the block maxima model was unstable as the variation of the estimate was very large depending on the confidence level and the magnitude of the estimates depended largely on the block size. This shows that block maxima model was not appropriate for Korean Stock market. On the other hand POT model was relatively stable even though extreme value VAR depended on the selection of the critical value. Back test also showed VAR showed a better result than delta VAR above 97.5% confidence level. POT model performs better the higher the confidence level, which suggests that POT model is useful as a risk management tool especially for VAR estimates with a confidence level higher than 99%. This study picks up the right tail and left tail of the return distribution and estimates the EVT-VAR for each, which reflects the asymmetry of the return distribution of the Korean Stock market.

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Morphometric Analysis of the Ureter with Respect to Lateral Lumbar Interbody Fusion Using Contrast-Enhanced Computed Tomography

  • Chunneng Huang;Zhenyu Bian;Liulong Zhu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.2
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    • pp.155-161
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    • 2023
  • Objective : To analyze the anatomical location of the ureter in relation to lateral lumbar interbody fusion and evaluate the potential risk of ureteral injury. Methods : One hundred eight patients who performed contrast-enhanced computed tomographic scans were enrolled in this study. The location of the ureter from L2-L3 to L4-L5 was evaluated. The distances between the ureter and psoas muscle, intervertebral disc, and retroperitoneal vessels were also recorded bilaterally. Results : Over 30% of the ureters were close to the working corridor of extreme lumbar interbody fusion at L2-L3. Most of the ureters were close to working corridor of oblique lumbar interbody fusion, especially at L4-L5. The distance from the ureter to the great vessels on the left side was significantly narrowing from L2-L3 to L4-L5 (28.8±9.5 mm, 22.0±8.0 mm, 15.5±8.4 mm), and it was significantly larger than that on the right side (12.3±6.1 mm, 7.4±5.7 mm, 5.4±4.4 mm). Conclusion : Our findings indicate that the location of the ureter varies widely among individuals. To avoid unexpected damage to the ureter, it is imperative to directly visualize it and verify the ureter is not in the surgical pathway during lateral lumbar interbody fusion.

A clinical study about painful manifestation on lumbar with regard to movement change of trunk (체간의 움직임 변화에 따른 요추부 근육의 통증 발현에 대한 임상적 고찰)

  • Kim, Sung-Ryul;Lee, Suk-Min;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.16 no.3
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    • pp.86-96
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    • 2004
  • A clinical study about painful manifestation on lumbar with regard to movement change of trunk The purpose of this study is to present the basis of low back pain therapy which is close examined of back muscle that is the main reason for that case of back pain when trunk rotation, flexion and extension. Therefore this study, which is based on literature review and clinical experience, has tried to figure out that back pain which is considered to be significant for the most increasing time, posture, motion, painful area, involved muscle have any influence on trunk rotation, flexion and extension This study has done with the patients in oriental rehabilitation clinic, K-oriental hospital, from Jan, 2003 to Dec, 2003. Total cases were 145(male:$39\%$-52 patients, female:$64.1\%$-93 patients) those who complained lumbosacral pain with radiating that makes patient unable to bending or extending the trunk. And they were surveyed retrospect way, checking the medical record and that of therapist. Results are as followings. 1. For sprain patient, $34.5\%$ complained pain on extension, and among them, the most remarkably, patients who did right rotation extension pattern were $20\%$. Herniated disc patient shows greater limit on flexion when trunk moves bending route, but right rotation with extension pattern shows the most limitation on flexion-extension according to the rotation of trunk 2. Cases of morning back pain($60.5\%$) showed high value on right rotation extension pattern($18.6\%$), right rotation flexion pattern($16.3\%$) but did not show big difference on left flexion and extension pattern 3. Patients those who complain pain on sitting position showed highest value each left, right $14.6\%$ of left and right rotation extension pattern 4. Among extension painful patient, there showed highest value of each $32.5\%$ on right rotation extension pattern, and $20.0\%$ on right rotation flexion pattern. 5. Tenderness distribution of quadratus lumborum showed $34.5\%$ on right rotation extension pattern, $20.7\%$ on left rotation extension pattern, and that of iliopsoas muscle at right rotation flexion pattern showed right muscle $20.0\%$, left $50.0\%$ Derived from the results of survey above, for sprain and HIVD patient showed greatest pain on right rotation pattern, for pain plus patient on right rotation extension among those who has extreme pain on sitting in the morning described tenderness on right quadratus lumborum, and those who complain pain on left rotation extension described tenderness on left lumborum the most Decisively, it is possible to figure out the problem muscle that involved when I found the time, position, motion that aggravating and painful area. Therefore this study would be expected to be able to be a useful clinical materials on diagnosis and therapy of low back pain.

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Postpneumonectomy-Like Syndrome in the Destroyed Lung (파괴폐에서 발생한 전폐절제술후양 증후군의 치험 1예)

  • 이승훈;최용수;김관민;심영목;김진국
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.703-706
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    • 2003
  • Postpneumonectomy syndrome is a rare condition characterized by dyspnea due to an extreme mediastinal shift and bronchial compression of the residual lung after a right pneumonectomy or a left pneumonectomy with the right aortic arch, Severe fibrosis of the lung such as tuberculsosis (TB) - destroyed lung can cause similar clinical features in the absence of pneumonectomy. We report a unique case of postpneumonectomy syndrome without pneumonectomy, which was successfully treated with pneumonectomy and mediastinal repositioning with tissue expanders.

Meningioma in a 20-Month-Old Boy

  • Jung, Yeon-Seong;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.219-221
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    • 2012
  • A 20-month-old boy presented with a intraparenchymal mass in the right frontoparietal area manifesting as complex partial seizure, secondary generalization and left hemiparesis. Magnetic resonance images (MRI) of the brain showed inhomogeneously enhancing mass in the right frontoparietal area which has irregular margin and perilesional edema. Based on the radiological findings, a preoperative diagnosis was an intraaxial tumor, such as pilocytic astrocytoma or dysembryoplastic neuroepithelial tumor. The patient underwent a surgery including frontal craniotomy. The tumor had a partially extreme adherence to the surrounding brain tissue but it showed no dural attachment. Gross-total resection of the tumor was achieved. Postoperative follow-up computed tomography scans showed no residual tumor. The pathological findings confirmed the tumor as a WHO grade I meningioma, transitional type. Nine months after the surgery, follow-up brain MRI showed no recurrence of the tumor, porencephaly in site where the tumor was resected; the patient's symptoms had fully recovered. We report the case of a meningioma in a 20-month-old boy.

A Case of Epidermoid Cyst Initially Misdiagnosed as Temporomandibular Joint Disorder

  • Choi, Yun-Jeong;An, Seo-young;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.43 no.2
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    • pp.56-60
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    • 2018
  • Epidermoid cyst in bony wall of external auditory canal (EAC) is a very rare pathologic condition. In addition to its extreme rarity, its positional proximity to temporomandibular joint (TMJ) might lead to clinical misdiagnosis as TMJ disorders, especially when it is accompanied by temporomandibular disorders-like symptoms. In this article, we report a patient with epidermoid cyst in anterior bony wall of EAC, which was misdiagnosed as TMJ disorder because the left TMJ pain aggravated during mastication.