• Journal of Chest Surgery
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• 제43권2호
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• pp.194-198
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• 2010

대동맥 벽내 혈종은 대동맥 내벽의 열상 등 손상이 없으면서 대동맥의 혈관벽내의 출혈로 정의되며 고전적인 대동맥 박리로 진행할 수 있는 질환으로 대동맥 박리의 변형된 형태로 여겨지기도 한다. 대동맥 벽내 혈종은 높은 이환율과 사망률을 보이나 궁극적 치료는 아직 확실하지 않다. 하지만 상행 대동맥에 발생한 대동맥 벽내 혈종은 대동맥 파열과 심낭 압전의 위험성으로 인해 보통 수술적인 치료가 고려되고 있다. 저자들은 실신을 주소로 내원한 71세 남환에서 대동맥 벽내 혈종 1예를 수술 치험 하였다. 잘못된 진단으로 인해 응급실 내원 5시간 뒤 시행된 대동맥 단층 컴퓨터 촬영 검사 결과 상행대동맥 벽내 혈종과 심낭 압전 소견이 동반되어 있었으며 이로 인해 급성 신부전, 허혈성 장기손상의 합병증이 발생하였다. 응급 수술로 상행대동맥 및 대동맥궁 치환술을 진행하였고 환자는 수술 14일 뒤 합병증 없이 퇴원하였다.

• Journal of Chest Surgery
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• 제43권5호
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• pp.546-549
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• 2010

70세 남자 환자가 심한 복부 및 배부 통증으로 흉부 대동맥류 파열 의심 하에 전원되었다. 환자는 6개월 전 타 병원에서 하행대동맥류 의심 하에 대동맥 스텐트를 삽입하였던 병력이 있었으나 전산화 단층촬영 소견은 후종격동 악성 종양을 시사하였다. 개흉 후 이와 같은 진단이 확인되었으며 종격동의 육종은 거기에 둘러싸인 대동맥과 함께 성공적으로 절제되었다. 본 증례는 최근 주목을 받고 있는 대동맥 스텐트 그라프트 삽입에 대한 맹목적인 선호에 대하여 주의를 환기시키는 교훈적인 경우라고 판단된다.

• 성인간호학회지
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• 제14권3호
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• pp.459-469
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• 2002

Purpose: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. Method: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test Result: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. Conclusion: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.122-126
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• 2015

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1785-1787
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• 2016

Granular cell tumor (GCT) of the oral cavity is a benign lesion. Half of oral GCTs demonstrate pseudocarcinomatous hyperplasia (PCH) of the mucosa which can mimic invasive islands of oral squamous cell carcinoma (SCC). Such similarity can be confusing when diagnosing or evaluating the two conditions, potentially leading to misdiagnosis or misclassification. Indeed, several misdiagnosed cases of oral GCT have been reported in the literature as OSCC or malignant oral GCT that resulted in unnecessary aggressive treatment for the affected patients. The aim of this study was to investigate if the cytokeratin pattern of the PCH can help in differentiating GCT from oral SCC. To distinguish between these two entities, we examined 12 patient specimens of oral GCT-PCH and oral SCC histologically and via immunohistochemistry (IHC) for CK13, CK17 and P75. The results suggest that the cytokeratin profile of PCH is similar to that of oral SCC. Therefore, consideration of IHC findings for epithelial markers alone may lead to erroneous diagnosis; thus, the presence of the granular tumor underneath the PCH and its immunopositivity for P75 or other neural definition markers can be essential to identify the underlying tumor and exclude oral SCC. Finally we recommend more studies on the molecular biology of PCH to understand how it can mimic oral SCC histologically without harboring its malignant phenotype clinically, which could have significant translational potential for understanding invasive oral SCC.

• Asian-Australasian Journal of Animal Sciences
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• 제31권11호
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• pp.1700-1713
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• 2018

Objective: The aim of this study was to verify the usefulness of artificial neural networks (ANN), multivariate adaptive regression splines (MARS), naïve Bayes classifier (NBC), general discriminant analysis (GDA), and logistic regression (LR) for dystocia detection in Polish Holstein-Friesian Black-and-White heifers and cows and to indicate the most influential predictors of calving difficulty. Methods: A total of 1,342 and 1,699 calving records including six categorical and four continuous predictors were used. Calving category (difficult vs easy or difficult, moderate and easy) was the dependent variable. Results: The maximum sensitivity, specificity and accuracy achieved for heifers on the independent test set were 0.855 (for ANN), 0.969 (for NBC), and 0.813 (for GDA), respectively, whereas the values for cows were 0.600 (for ANN), 1.000 and 0.965 (for NBC, GDA, and LR), respectively. With the three categories of calving difficulty, the maximum overall accuracy for heifers and cows was 0.589 (for MARS) and 0.649 (for ANN), respectively. The most influential predictors for heifers were an average calving difficulty score for the dam's sire, calving age and the mean yield of the farm, where the heifer was kept, whereas for cows, these additionally included: calf sex, the difficulty of the preceding calving, and the mean daily milk yield for the preceding lactation. Conclusion: The potential application of the investigated models in dairy cattle farming requires, however, their further improvement in order to reduce the rate of dystocia misdiagnosis and to increase detection reliability.

• Journal of Chest Surgery
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• 제19권4호
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• pp.618-626
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• 1986

Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

• 대한물리의학회지
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• 제2권2호
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• pp.205-212
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• 2007

Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

• 대한임상검사과학회지
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• 제36권1호
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• pp.38-42
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• 2004

Because of the lack of resources on the importance of cell block, the diagnosis of cytologic specimen has been overlooked. Out of 1,243 cases of non-gynecologic cytology specimen, about 87.1% has been proven to be diagnostically useful. About 0.9% of those were rendered diagnostic by cell block alone. If cell block was not made it could have resulted in misdiagnosis. The effect on making cell block might not be directly linked to the patient but to the pathologist, it can be a helpful secondary tool in lowering the chance of giving false negative results hence. Giving the patient the opportunity of an adequate treatment. This study has proven that cell block has diagnostic value in non-gynecologic cytology. We are doing our best to increase the production rate of cell block and to improve the quality of cytology smears and cell block, so that we can increase the accuracy of diagnosis.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.67-74
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• 2009

Purpose: The etiology and treatment strategy of the anterior interosseous nerve (AIN) syndrome are still controversial. Seven patients with the AIN syndrome who were treated by surgical exploration and neurolysis were reviewed at a mean of 35.9 months follow up period. Materials & Methods: There were six men and one woman. The mean age was 37.3 years, ranging from 26 to 59. No patient was related to trauma and associated neurological lesion. Surgical exploration was performed at 7.7 months after onset of paralysis. Results: All except one patients experienced pain around the elbow region before the onset of the palsy. On 7 patients, only the flexor pollicis longus was paralysed in 1, only the index flexor digitorum profundus in 2, and none had paralysis of the middle. The most common compression structures were fibrous bands within flexor digitorum sublimis arcade. However there was no demonstrable abnormality in three. Recovery was complete in all cases within 12 months after surgery. Conclusion: We recommended surgical exploration and neurolysis in patients who have shown no improvement after 6 months of conservative treatment. And careful preoperative examination is essential to avoid misdiagnosis and inappropriate surgery, especially in incomplete AIN syndrome.