• 한국임상수의학회지
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• 제41권2호
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• pp.106-111
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• 2024

A 4-year-old neutered female domestic shorthair cat weighing 5.1 kg was referred to Jeju National University Hospital with acute onset respiratory distress, weakness, and anorexia. The patient had a history of stressful antecedent events that involved bullying by a newly introduced cat. Thoracic radiography and echocardiography revealed a stage C hypertrophic cardiomyopathy phenotype based on the American College of Veterinary Internal Medicine classification system with pulmonary edema, pleural effusion, and pericardial effusion at the same time. The patient was treated with furosemide, pimobendan, and rivaroxaban. Pericardiocentesis was performed because pericardial effusion was identified. Reevaluation after 30 days revealed a normal respiratory rate on physical examination, normal cardiac shape on thoracic radiographs, and normal cardiac measurements on echocardiography. The patient was tentatively diagnosed with transient myocardial thickening (TMT) and all medications were discontinued. Six months after the initial hospitalization, the cat continued to do well without any clinical signs or left ventricular wall thickening. This case is the first report describing feline TMT in Korea. Moreover, it involves a rare case in which pulmonary edema, pleural effusion, and pericardial effusion, which induce cardiac tamponade, occurred simultaneously due to TMT-related congestive heart failure.

• 한국방사선학회논문지
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• 제6권6호
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• pp.455-464
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• 2012

본 연구는 일반 X선 검사에서 CR 시스템을 이용한 환자의 근사적 피폭 선량을 평가할 수 있는 실험적 모델을 제시하고 저선량 영역에서 의료 피폭에 대한 방어의 최적화 조건으로 환자의 선량 권고량(diagnostic reference level. DRL)을 비교하고자 하였다. 이를 위하여 기준선량계와 광자극발광선량계(optically stimulated luminescence dosimeters. OSLDs)를 이용하여 관전압(kVp) 및 관전류 노출시간의 곱(mAs)에 따른 입사표면선량(entrance surface dose. ESD)을 교차 측정하였으며 CR 시스템에서 각 노출 조건에 대한 Hounsfield unit (HU) scale을 측정하여 ESD와 HU 스케일에 대한 특성 관계를 이용하여 근사적 피폭 선량을 구하였다. 또한 임상적으로 적용 가능한지를 알기 위하여 두부, 경부, 흉부, 복부, 골반부 노출 조건으로 물 팬텀에 모사하여 피폭 선량을 구하였다. 결과적으로 두 선량계의 평균 ESD는 각각 2.10, 2.01, 1.13, 2.97, 1.95 mGy 이었으며 CR 영상에서 측정한 HU 스케일은 각각 $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, $2,318{\pm}4.64$ 이었다. 이 때 ESD와 HU 스케일에 대한 특성 관계를 이용하여 근사적으로 구한 ESD는 각각 2.16, 2.06, 1.19, 3.05, 2.07 mGy이었으며 평균 측정값과 근사적으로 구한 ESD의 오차는 3% 미만으로 영상의학 분야의 측정 오차 5%를 감안한다면 신뢰할 수 있는 오차 범위라 할 수 있었다. 결론적으로 CR 시스템을 이용한 일반 X선 검사에서 환자의 피폭 선량을 근사적으로 평가할 수 있는 새로운 실험적 모델을 제시하였으며 CR 검사뿐 만 아니라 디지털 방사선촬영(digital radiography. DR) 시스템 및 필름-증감지 시스템에 적용 가능할 것으로 판단되었다.

• 한국방사선학회논문지
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• 제1권1호
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• pp.25-30
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• 2007

본 연구의 목적은 ROC를 이용하여 일반 촬영기기에 따른 영상의 질을 평가해보고자 함이다. 본 연구의 수행을 위하여 CR(Computed Radiography)과 DDR(Direct Digital Radiography)을 사용하였으며 피사체로 흉부 팬텀을 사용하였다. 각 기기에서 영상을 획득한 후 ROC평가를 이용하여 영상의 질 및 기기의 특성을 평가하였다. 조사 조건으로 관전압 120kVp와 관전류량 3.2 mAs를 이용하였고 SID(Source to Image Distance)는 180cm로 설정하였다. 팬텀의 심장, 폐야, 흉추부위에 병소를 표현하였으며 각 장비에서 획득한 영상의 질 및 기기의 특성을 파악하기 위하여 방사선학 전공자 29명을 대상으로 ROC평가를 실시하였다. ROC 평가 결과 DDR의 TPF(true positive fraction)는 0.552, FPF(false positive fraction)는 0.474, CR의 TPF는 0.629, FPF는 0.405로 나타났다. 본 연구 결과 CR의 영상이 DDR의 영상보다 더 나은 영상의 질을 나타내는 것을 확인하였다. 영상의 질의 확연한 차이의 원인은 DDR의 경우 enhance board의 미 삽입으로 인한 영상 후처리의 미수행이라고 사료된다. 추후 DDR의 enhance board의 삽입 후 영상의 후처리가 가미된 DDR영상의 질에 대한 연구가 필요하며 본 연구의 결과로 인하여 영상의 후처리가 임상의 판독에 있어서 매우 중요한 요소임을 확인할 수 있었다.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.155-158
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• 2015

Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

• The Korean Journal of Pain
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• 제23권4호
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• pp.247-253
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• 2010

Background: Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. Methods: In this study, the loss-of-resistance technique was used and an imaging agent was injected through the indwelling epidural anesthesia catheter to confirm the position of its tip and examine the migration rate. Study subjects were patients scheduled to undergo surgery using general anesthesia combined with epidural anesthesia. Placement of the epidural catheter was confirmed postoperatively by injection of an imaging agent and X-ray imaging. Results: The indwelling epidural catheter was placed between upper thoracic vertebrae (n = 83; incorrect placement, n = 5), lower thoracic vertebrae (n = 123; incorrect placement, n = 5), and lower thoracic vertebra-lumbar vertebra (n = 46; incorrect placement, n = 7). In this study, a relatively high frequency of incorrectly placed epidural catheters using the loss-of-resistance technique was observed, and it was found that incorrect catheter placement resulted in inadequate analgesia during surgery. Conclusions: Although the loss-of-resistance technique is easy and convenient as a method for epidural catheter placement, it frequently results in inadequate placement of epidural catheters. Care should be taken when performing this procedure.

• 한국임상수의학회지
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• 제17권1호
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• pp.266-269
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• 2000

Tracheal collapse at the thoracic inlet is described in a 4 year-old female yorkshire terrier. The initial presenting signs included coughing, dyspnea, cyanosis and collapse. Diagnosis was based upon the clinical signs, physical examination, plain radiography and fluoroscopy. The collapse was corrected by the aplication of a neumber of modified total ring prostheses (m-TRP) applied to the cervical trachea. Clinical complicatons were minimal and limited to mild, short-term coughing. The present study indicated that m-TRP were easy to apply to tracheal collapse and were able to decrese clinical signs. Therefore, m-TRP may be applied to tracheal collapse as new prostheses.

• 한국임상수의학회지
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• 제25권3호
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• pp.195-199
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• 2008

A 2-year-old female Maltese dog was referred with primary complaints of exercise intolerance and abnormal heart sound. Clinical and diagnostic investigation revealed split S2 and S4 gallop in the cardiac auscultation, tall P wave and left anterior fascicular block in the electrocardiogram, left atrial enlargement on the thoracic radiography, ostium primum atrial septal defect and cleft of the anterior leaflet of the mitral valve on the echocardiography. Based on those findings, the dog was diagnosed as the partial atrioventricular canal defect. Since the dog showed mild exercise intolerance, enalapril and furosemide were prescribed.

• 대한수의학회지
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• 제48권4호
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• pp.481-487
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• 2008

A 17-month-old intact male Cocker Spaniel was presented with primary complaints of severe ascites, exercise intolerance, and diarrhea. Diagnostic studies revealed tricuspid and pulmonic regurgitation on phonocardiogram, right ventricular enlargement on the electrocardiogram, typical right cardiac enlargement signs on the thoracic radiography and tricuspid valve malformation and marked enlargement of the right atrium and right ventricle on the echocardiography and tricuspid and pulmonary regurgitation on the color spectral echocardiography, suggesting tricuspid valve dysplasia and pulmonary hypertension. Using angiography and cardiac catheterization, pulmonary hypertension was ruled out. Further echocardiographic study revealed membranous valvular structures cranial to pulmonary annulus causing pulmonary regurgitation. Based on these findings on the diagnostic investigation, the case was diagnosed as tricuspid valve dysplasia complicated with pulmonic regurgitation. The dog was medically managed with furosemide, enalapril, nitroglycerine transdermal patch and pimobendan after the ascitic fluid removal.

• 대한수의학회지
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• 제59권4호
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• pp.223-226
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• 2019

A 7-year-old, spayed female Chihuahua with dyspnea, intermittent cyanosis, and dermal plaques was diagnosed with hyperadrenocorticism. Thoracic radiographs showed markedly hyperdense alveoli in multiple lung lobes. Computed tomography (CT) images showed lung mineralization confined to the lung parenchyma and pituitary macroadenoma. Pulmonary mineralization secondary to hyperadrenocorticism is commonly found on histopathologic examination. However, those lesions are rarely identified radiographically. We describe obvious pulmonary mineralization secondary to hyperadrenocorticism found on radiographs and present the first report regarding CT imaging of the mineralization. Pulmonary mineralization should be considered when a dog affected by hyperadrenocorticism shows diffuse lung mineralization on radiographs.

• 대한수의학회지
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• 제58권3호
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• pp.159-162
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• 2018

An 11-year-old, castrated male dog presented with a 3-month history of cough and depression. Auscultation revealed systolic murmur and thoracic radiographs showing enlargement of both the atrium and left ventricle. Echocardiography showed thickened mitral valve and moderate-to-severe left atrial enlargement. Additionally, M-mode echocardiography showed symmetric left ventricular wall thickening and systolic anterior motion of the mitral valve, while Doppler imaging revealed high velocity turbulent flow through the left ventricular outflow tract. Based on echocardiography, this case was diagnosed with hypertrophic obstructive cardiomyopathy. After 5 months, the dog was clinically static in radiography and echocardiography.