• 한국임상수의학회지
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• 제25권1호
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• pp.58-63
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• 2008

Peritoneopericardial diaphragmatic hernia(PPDH) is uncommon and congenital disease in dogs and cats. In PPDH, the peritoneal organs such as liver, small intestine, stomach and omentum are displaced into the congenital defect between pericardial sac and diaphragm and cause the abnormal round and enlarged cardiac silhouette. Abnormal cardiac silhouette contacts with the cranial diaphragmatic border consistently and soft tissue- and/or gas- density structures are summated over the cardiac density in radiography. The contrast medium flows from peritoneal cavity into the pericardial sac and demonstrates the herniated abdominal organs and the abnormal defect in positive peritoneography. In this study, 4 dogs was diagnosed as PPDH using radiography, peritoneography and thoracic ultrasonography and showed various clinical signs according to the kind, amount and clinical state of herniated abdominal organs.

• 한국임상수의학회지
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• 제26권3호
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• pp.298-302
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• 2009

A poodle with clinical signs of colorectal disease was diagnosed as pneumatosis coli. In this dog, hypoadrenocorticism and immune-mediated hemolytic anemia concurred. Pneumatosis coli is one of the emphysematous gastrointestinal diseases. The etiology is unknown but mechanical, pulmonary and bacterial theories have been proposed. In pneumatosis coli, gas accumulates within submucosal or subserosal layer of colon or rectum, so intramural radiolucent gas is observed on abdominal radiographs. In this dog, intramural gas accumulation occurred in cecum. Definitive diagnosis was based on radiographic findings and an underlying cause was not elicited. Pneumatosis coli should be included into differential diagnosis for nonspecific colorectal signs.

• 한국임상수의학회지
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• 제24권3호
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• pp.467-472
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• 2007

Alimentary lymphoma accounts for approximately 5% of neoplasm and diffuse lesion is more common than solitary nodular form in dogs. An eleven year-old male Yorkshire terrier was examined because of nonspecific gastrointestinal symptoms such as anorexia and vomiting for 10 days. An abdominal mass was palpated, which was originated from small intestinal wall in abdominal ultrasonography. Small intestine was obstructed by hypoechoic mass and lost normal layering and measured 24.5m. After fine-needle aspiration, septic peritonitis due to intestinal rupture occurred and emergency surgery was performed. Solitary mass was found in small intestine and diagnosed as alimentary lymphoma through histopathologic examination. Conclusively, abdominal ultrasonouaphy could verify the thickened bowel, loss of wall layering and decrease of motility and percutaneous ultrasound-guided fine-needle aspiration is considered as useful diagnostic technique, especially in nodular form of alimentary lymphoma.

• 한국임상수의학회지
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• 제28권1호
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• pp.163-172
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• 2011

Subcutaneous foreign body causes recurrent problems such as chronic soft tissue swelling and discharge. Wooden foreign body is one of the most common foreign bodies found in subcutaneous region including face, interdigit, and thoracic or abdominal area. This report demonstrated three dogs with wooden foreign body located in subcutaneous region of thoracic wall, abdominal wall and upper eyelid, respectively. Three dogs showed prominent soft tissue swelling adjacent the foreign body. A sinus or drainage tract was developed in two of these dogs. Ultrasonography revealed that hyperechoic linear structure accompanied acoustic shadow in all dogs, and which was diagnosed as a subcutaneous foreign body. Anechoic or hyperechoic fluid and hypoechoic tissue circumscribed the foreign body. A subcutaneous foreign body in case 3 was removed by clamp under ultrasound-guide with sedation. Sinography was performed in case 1 and clarified that the wooden foreign body did not perforate the thoracic wall and there was no direct communication into thoracic cavity. Ultrasonography and sinography can be used to identify the subcutaneous foreign body and evaluate the inflammatory reaction and relationship between foreign body and adjacent structures.

• 한국임상수의학회지
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• 제24권1호
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• pp.51-55
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• 2007

A 13-year-old male Yorkshire terrier was Presented with Persistent weight loss anorexia and dark brown urine of 3-month duration. On physical examination, a firm oval mass was palpated at left renal region. In hematology and blood chemistry, neutrophilia, anemia, thrombocytopenia and elevation of ALKP were found. Abdominal radiography, ultrasonography and ultrasound-guided percutaneous pyelogram revealed masses originated from left kidney, mildly dilated renal Pelvis and intact ureter. Urinalysis showed hematuria and proteinuria. Because the state of dog became deteriorated during transfusion and the frail renal tumor was suspected to be the cause of inflammation and anemia, nephrectomy was performed. Renal masses, approximately $2{\times}3cm\;and\;5{\times}4cm$ respectively in size, was surrounded by swollen and congested mesentery and ascites. Metastatic lesion was not found in other organs. During recovery, the dog showed cardiopulmonary arrest and did not respond to critical care. Histologically the kidney was affected by necrotic and hemorrhagic change. This hemangiosarcoma most likely arose from the renal parenchyma resulting In diffuse lesions in the kidneys thought to be the cause of chronic anorexia and weight loss.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1539-1541
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• 2012

Cholangitis is relatively uncommon but associated mortality is high due to the predisposition in people with underlying disease. For this recognition of contributing risk factors is necessary. Therefore, the present descriptive-analytical cross-sectional survey was designed to determine contributing risk factors for post-ERCP cholangitis in patients with pancreatic cancer. From 2005 to 2010, 110 consecutive cases of pancreatic cancer attending to a tertiary referral centre (Taleghani Hospital), Tehran, Iran were recruited. The patients all underwent stenting via endoscopic retrograde cholangiopancreatography (ERCP). On univariate analysis, a metallic stent type (95% confidence interval (CI) 1.025-11.34, P=0.037), having no jaundice (1.44-2.22, P=0.009), having no pain (1.32-1.91, P=0.026), a history of prior ERCP (1.16-10.37, P=0.020), and having a proximal biliary stone (1.002-5.93, P=0.046) were related to cholangitis. However on multivariate analysis, none of these factors were found to be contributing risk factors. Cholangitis is avoidable with adequate biliary drainage. Because success rates are higher and complication rates lower for endoscopists performing large volumes of ERCP, performance of the procedure should be concentrated as much as possible in institutions with endoscopists having adequate experience. Patients with a high risk for complications may be best served by referral to an advanced center.

• 한국임상수의학회지
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• 제31권3호
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• pp.237-240
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• 2014

12살령의 암컷 알라스칸 말라뮤트가 후지 파행과 통증으로 내원하였다. 방사선 검사에서 요추 5번 추체 내 방사선 투과성 병변이 확인되었다. MR 영상에서 요추 5번 추체에서 T1 저신호, T2 고신호, GE 저신호 및 조영 후 T1 영상에서 이질적인 조영 증가 병변이 확인되었고, 병변은 척수까지 침입하여 척수 실질을 심하게 압박하고 있었다. 요추 6번 추체 내에서도 국소적인 방사선 투과성 병변이 확인되었으며, MR 영상에서 T1, T2 및 GE 고신호 및 조영 후 국소적인 조영 증가 병변이 관찰되었다. 심한 통증으로 안락사 후, 생검을 통해 형질세포종이 진단되었다. 척수 질환 환자에서 종양은 반드시 고려되어야 하며 영상 검사가 병변의 위치와 범위를 평가하는데 도움이 된다. 이 증례는 개 척추에서 발생한 고립성 형질세포종의 영상에 대한 유용한 정보를 제공할 것이라 생각한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.185-192
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• 2020

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

• Korean Journal of Radiology
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• 제24권9호
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• pp.890-902
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• 2023

Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

• 한국의료질향상학회지
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• 제9권2호
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• pp.198-208
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• 2002

본 연구에서는 종합전문요양기관과 협력관계를 맺은 병의원과 협력관계를 맺지 않은 병의원을 대상으로 진료의뢰와 관련된 중요고려요인, 그리고 기대요인 및 만족도를 비교하였다. 본 연구 결과 종합전문요양기관과의 협력관계 체결여부에 따라 협력병원 집단군이 협력관계가 없는 병원집단군보다 진료의뢰 중요요인의 평균이 높았으며, 그 중 '환자 의뢰절차의 간편성(p<0.01)' '병원간의 협력병원 체재 구축(p<0.05)'에 대해서는 통계적으로 유의한 차이를 보였다. 협력병원 여부에 따른 진료의뢰후 기대요인에 있어서는 '의료시설 및 장비의 이용' '종합전문요양기관 의료진과의 자유로운 인간관계 형성' '협력기관이라는 간판의 설치' 항목 등이 통계적으로 유의한 차이가 있었다. 그러나 협력병원 관계 여부에 따른 만족도에 있어 두 집단간 통계적으로 유의한 차이가 없었다. 개원의가 진료의뢰 시 중요하게 고려하는 요인과 진료의뢰후의 만족도간의 관계는 협력병원에 있어 '환자의뢰 절차의 간편성' '첨단 의료장비의 보유' '진료의뢰센터 직원의 친절도' 항목이 만족도보다 고려요인에서 높게 고려되고 있다고 조사되었으며 통계적으로 유의한 차이를 보이고 있었다.